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Biomedical subjects

J A Benson

Publications and source records attributed to J A Benson.

At least 19 recordsLinked to original sources
PubMed1992

Integrating emerging disciplines.

The dynamics of medicine force us to continually update the content of residency curricula. Before selecting the material to be added or withdrawn from the curricula, goals for the desired product must be established. Further, the potential effects of emerging disciplines on the structure and composition of departments and residencies must be carefully considered. The Residency Review Committee for Internal Medicine (RRC-IM) is the principal instrument for forcing the integration of emerging disciplines into clinical education. Several questions must be considered when deciding how best to integrate these new disciplines. Should selected internists be designated to teach them? What are the most appropriate training sites? Which disciplines should be linked for pedagogic efficiency and relevance? How do we separate the educational pathways for generalists and subspecialists? The strategy of requiring additional training for a second certificate from the American Board of Internal Medicine (ABIM) has served internal medicine well for 50 years. Innovations in science and technology, however, are occurring at an accelerated pace. One solution may be to separate standardized residency training into multiple 4-year tracks that produce variously skilled graduates.

Accreditation↗
PubMed1992

Inhibition of dipteran larval neuromuscular synaptic transmission by analogues of philanthotoxin-4.3.3: a structure-activity study.

1. The blocking action of delta-philanthotoxin (PhTX-4.3.3), a wasp toxin composed of a polyamine chain, an aromatic amino acid (tyrosyl) nucleus and an aliphatic (butanoic) acid was studied, together with 33 structural analogues, at the glutamatergic neuromuscular synapse in larvae of the house fly, Musca domestica. 2. Shortening of the polyamine or the aliphatic acid chain, or removing the aromatic nucleus caused a decrease in potency. 3. An increase in potency was obtained by elongating the molecule in any of several directions: elongation of the polyamine chain with amine containing groups, by iodination of the aromatic moiety and by aliphatic or aromatic elongation of the butanoic acid.

Animals↗
PubMed1991

Certification and recertification: one approach to professional accountability.

Professional accountability requires a self-regulating profession to set and maintain credible, useful standards for its members. Voluntary certification and recertification--evaluation by peers--serves the responsibility of the profession to establish and enforce its own standards. The goal of certification by the American Board of Internal Medicine is to improve the quality of medical care by ensuring that the certified internist and subspecialist possess the knowledge, skills, and attitudes essential to the provision of excellent care. Without a true constituency and with a valid certification process, the Board provides a credential sought by nearly every graduate resident and acceptable both to the profession and patients. Recertification now presents the opportunity to foster continuing scholarship and self-improvement throughout the career of an internist.

Certification↗
PubMed1991

Changes in the medical knowledge of candidates for certification.

PURPOSE: To determine whether the medical knowledge of candidates from different types of medical schools changed between 1983 and 1988. SUBJECTS: Candidates for certification who took the 1983 to 1988 examinations in internal medicine were divided into five groups according to the type and location of the medical school they had attended and, in some instances, their citizenship: graduates of U.S. medical schools, of Canadian medical schools, and of osteopathic medical schools as well as U.S. citizens who graduated from foreign medical schools and non-U.S. citizens who graduated from foreign medical schools. DESIGN: Performance on items that were common to four pairs of the 1983 to 1988 certifying examinations (1983 and 1985, 1984 and 1986, 1985 and 1987, and 1986 and 1988) was analyzed. RESULTS: The scores of graduates of U.S. medical schools decreased, and the scores of non-U.S. citizens who graduated from foreign medical schools increased. Trends in the performance of graduates of Canadian and osteopathic medical schools and of U.S. citizens who graduated from foreign medical schools were not discernible. CONCLUSIONS: The cumulative decline in the performance of graduates from U.S. medical schools and the progressive improvement in the performance of non-U.S. citizens who graduated from foreign medical schools may ultimately manifest itself in patient care.

Canada↗
PubMed1990

Ethics in cardiovascular medicine. Task Force IV: Scientific responsibility and integrity in medical research.

Ethical standards are a set of affirmative responsibilities to which the investigator must subscribe; behavior that is incompatible with these responsibilities should be presumed unethical, whether or not it is explicitly proscribed. This Task Force sought to present these standards as principles or guidelines. In undertaking research an investigator must accept that publicly funded or supported research is intended to yield public benefit; personal gain should be only incidental to and not at the expense of the public benefit. The responsibilities of the investigator are summarized as follows: Design of Research To develop a research design that effectively and efficiently addresses the scientific question while minimizing the likelihood of incorrect or misleading results. To protect the rights and welfare of human subjects, assure the humane use of laboratory animals and protect the safety of laboratory workers and the environment. Conduct of Research To ensure that accepted laboratory and research practices are followed and that all data are accurately collected and properly recorded; the investigator must participate in the review of original data. To carry out research in accordance with that approved by the institutional review board and ensure that fully informed consent is obtained, that the welfare of human subjects is protected and that animal welfare and laboratory safety procedures are carried out. To provide effective ongoing supervision of research trainees and technicians. In multidisciplinary collaborative research, to have at least an overview familiarity with the work outside his or her areas of expertise. In fixed protocol, multicenter collaborative research the investigator must be satisfied with the adequacy of the collaborative activities.(ABSTRACT TRUNCATED AT 250 WORDS)

Biomedical Research↗
PubMed1990

Performances of U.S. osteopathic and Canadian medical school graduates on the American Board of Internal Medicine Certifying Examinations, 1984-1988.

The performances of Canadian medical school graduates and U.S. osteopathic medical school graduates who first took the American Board of Internal Medicine Certifying Examination between 1984 and 1988 were compared with the performances, during the same period, of U.S. and foreign medical school graduates. Approximately 100 Canadian graduates took the examination each year; by 1988 the number of osteopathic graduates taking it was 102, double the number participating in 1984. Nearly all the Canadian graduates attended university or university-affiliated residencies, whereas half of the osteopathic graduates attended non-university-affiliated programs. For their overall clinical competence and for the eight components of clinical competence, the Canadian graduates were rated highest, followed by the U.S., osteopathic, and foreign graduates. The Canadians' average examination scores were also highest. The authors discuss the relatively low level of performance of the osteopathic graduates, but conclude that these graduates appear to be an untapped source of talented physicians for internal medicine residencies. The limitations of studying self-selected groups of candidates are also discussed.

Canada↗
PubMed1989

Trends in medical knowledge as assessed by the certifying examination in internal medicine.

The past decade has seen less competition for medical school positions accompanied by the declining interest of medical students in internal medicine. At the same time, the number of first postgraduate-year positions in internal medicine residencies has increased, as has the number of first-year residents who take those positions. The purpose of this study was to examine trends in the medical knowledge of internal medicine residents during the past 6 years. Comparison of performance on the items common to pairs of the certifying examinations of the American Board of Internal Medicine from 1983 to 1988 revealed that the scores of candidates in the reference group have declined, but not dramatically. This trend has occurred among candidates from the top residency programs as well as all other residency programs, and it is present in candidates of all levels of overall clinical competence. Continuing declines in this area could ultimately affect patient care.

Canada↗
PubMed1988

Bicuculline blocks the response to acetylcholine and nicotine but not to muscarine or GABA in isolated insect neuronal somata.

The isolated somata of neurons from the thoracic ganglia of the locust, Locusta migratoria, respond to pressure microapplication of gamma-aminobutyric acid (GABA) and acetylcholine. The acetylcholine receptors fall into two groups. ACh1 (activated by nicotine) and ACh2 (activated by muscarine). The GABA receptor and the ACh1 receptor differ in pharmacology from the known vertebrate receptors. The GABA receptor is insensitive to bicuculline and its salts up to a concentration of 10(-4) M. In contrast, bicuculline is a moderately potent, at least partially competitive antagonist of the ACh1 receptor-mediated response in the thoracic neuronal somata. These observations suggest that classical diagnostic compounds such as bicuculline may show greater cross-reactivity than hitherto suspected among the members of the superfamily of ligand-activated channels.

Acetylcholine↗
PubMed1988

Evaluation of clinical competence in rheumatology training programs.

To ensure that members of the public and the medical profession can identify physicians who have demonstrated excellence in the field of rheumatology, the American Board of Internal Medicine has called upon directors of rheumatology training programs to establish systems to evaluate, document, and substantiate those components of overall clinical competence that are considered essential for certification. Many of these abilities can be assessed only by repeated, direct observations.

Certification↗
PubMed1988

Evaluation of clinical competence in cardiovascular disease.

The American Board of Internal Medicine has called on directors of cardiology training programs to establish systems to evaluate, document and substantiate those components of overall clinical competence considered essential for certification in the subspecialty. Many of these can be assessed only by repeated direct observations. In particular, proficiency is now required in advanced cardiac life support including cardioversion, electrocardiography (including ambulatory electrocardiographic monitoring) and exercise testing, echocardiography, insertion of arterial lines and right heart catheterization (including insertion of temporary pacemakers). The goal of this expanded evaluation program is to ensure that the public and the profession can identify, through certification, physicians with demonstrated excellence in cardiovascular disease.

Cardiology↗
PubMed1988

Evaluation of clinical competence in pulmonary disease.

The American Board of Internal Medicine has called upon directors of pulmonary disease training programs to establish systems to evaluate, document, and substantiate those components of overall clinical competence considered essential for certification in the subspecialty. Many of these can be assessed only by repeated direct observations. In particular, proficiency is now required in endotracheal intubation, fiberoptic bronchoscopy, mechanical ventilatory support, thoracentesis and percutaneous pleural biopsy, percutaneous arterial puncture, vascular monitoring, calibration and operation of hemodynamic recording systems, and supervision of the technical aspects of pulmonary function testing. The goal of this expanded evaluation program is to ensure that the public and the profession can identify through certification, physicians with demonstrated excellence in the practice of pulmonology.

Certification↗