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J Bickel

Publications and source records attributed to J Bickel.

At least 19 recordsLinked to original sources
PubMed1996

Medical school policies for part-time faculty committed to full professional effort.

The need for information about medical schools' efforts to allow faculty who wish to remain fully academic but work less than full time has been growing steadily. Building on the AAMC's 1993-94 survey of faculty appointment and tenure policies, in 1994 the authors surveyed 102 U.S. and Canadian medical schools that had answered yes to the question, "Does the medical school provide for faculty who choose to work less than full-time but whose full professional effort is directed towards the institution?" Seventy-one U.S. and Canadian medical schools reported provisions for "full professional effort" (FPE) faculty, and 32 of these had developed specific procedures for such faculty. Other nomenclatures in use for FPE faculty include "limited full-time," "full status/partial load," and "reduced period of responsibility." Almost half of the 71 survey respondents reported that FPE faculty could be appointed to, or remain on, a tenure track; more than half of these schools said that they lengthened the probationary period on a prorated basis. Women, much more frequently than men, had chosen the FPE option, especially women clinical faculty. While FPE faculty face more challenges than full-time faculty in accomplishing the tasks necessary for promotion in academic medicine, well-structured FPE options can benefit not only individual faculty members and their families but also the institution, which retains the commitment of valued faculty members seeking flexibility.

Faculty, Medical↗
PubMed1996

Context in medical education: the informal ethics curriculum.

As some formal bioethics instruction has become the norm in American medical schools, a trend has emerged toward increased attention to context in both bioethics education and bioethical decision-making. A focus on classical dilemmas and a textbook knowledge of principles is yielding its previous dominance to permit a more detailed examination of ethical behaviour in actual practice in medicine. After documenting and analysing this emerging trend in bioethics education and its parallel in bioethics theory and research, we turn to the context of medical education itself to look beyond formal bioethics instruction to the 'informal curriculum' that is so central to the moral development of medical students and residents. A qualitative research strategy is being used to study the informal curriculum through analysing tape-recorded informal conversations students and residents have with their friends and colleagues at work about issues bearing on their professional development. Data presented are documenting 'the unwritten code' for medical students on a surgical clerkship and the senior residents' informal ways of producing a 'practical ethics of conduct' that shapes understanding of what is good, skilful, and right on that surgical service. How conceptions of appropriate conduct are conveyed, rewarded and sanctioned also reveals how professional demeanour is taught, permitting discussion about what should be retained and what changed. The context in which ethical issues arise enhances understanding of ethical practice in medicine.

Bioethics↗
PubMed1995

Gender-associated differences in matriculating and graduating medical students.

Data from the 1993 Matriculating Student Questionnaire (MSQ) and the 1994 Medical School Graduation Questionnaire (GQ) of the Association of American Medical Colleges were investigated for differences in responses between men and women. Notable differences were discovered, particularly with regard to career plans and experiences during medical school. Findings from the GQ include that a higher proportion of women rated curricular coverage of numerous subjects inadequate and that women students more frequently reported mistreatment during medical school. Women were also more likely than men to work in clinics serving the indigent and to complete a primary care clerkship. Over 30% of the 1994 women seniors, compared with 18% of the men, planned to pursue generalist careers. The authors discuss the gender-associated differences, with reference to previous studies, and conclude that medical educators should ensure that women have access to the same skill-development opportunities that men do and to a humane learning environment. Moreover, educators should examine what adaptations can encourage students of both genders to develop an ethic of "social responsibility."

Career Choice↗
PubMed1995

Maternity and parental leave policies at COTH hospitals: an update. Council of Teaching Hospitals.

Because residents' demands for parental leave are increasing, updated information about maternity and paternity leave policies was solicited from hospitals that are members of the Council of Teaching Hospitals (COTH) of the AAMC. A 20-item questionnaire, combining forced-choice categories and open-ended questions, was faxed to 405 COTH hospitals in October 1994; 45% responded. A total of 77% of the respondents reported having written policies for maternity and/or parental leave; in 1989, only 52% of COTH hospitals had reported having such policies. Forty-one percent of the 1994 responding hospitals offered dedicated paid maternity leave, with a mean of 42 days allowed. Twenty-five percent of the respondents offered paternity leave, and 15% offered adoption leave. It is encouraging that the majority of the teaching hospitals that responded to the survey had adopted written policies, but the 23% without written policies remain a source of concern. Well-defined policies for maternity, paternity, and adoption leave can reduce stress and foster equity both for trainees requiring leave and for their colleagues.

Female↗
PubMed1993

Part-time faculty in academic medicine: present status and future challenges.

OBJECTIVE: To determine the number, personal and professional characteristics, and attitudes of part-time medicine faculty. PARTICIPANTS: Part-time faculty in departments of medicine were identified by the chairs of medicine and faculty roster representatives of the Association of American Medical Colleges for each U.S. medical school and by a survey of faculty. MEASUREMENTS: A 79-item questionnaire including questions about working conditions, attitudes toward professional and personal issues, and institutional policies. RESULTS: A total of 245 eligible questionnaires were returned (69% of the estimated number of eligible part-time faculty). Sixty-three percent were men and 27% were women. Women faculty worked an average of 35 h/wk, combining their careers with childbearing, whereas men worked 51 h/wk, divided between their faculty position and private practice. Respondents' work time was devoted to teaching and patient care, with no time dedicated for research. Most faculty (86%) were in nontenured track positions; approximately one half (47%) developed the position themselves. Only 8% reported that existing institutional policies allowed part-time faculty more time to reach promotion and tenure standards. A high degree of career satisfaction existed (mean score, 8.6 on a 10-point scale) even though faculty believe that part-time status makes promotion more difficult and negatively influences colleagues' perceptions of them. CONCLUSION: We estimate that more than 400 faculty work part time in departments of medicine in U.S. medical schools. The majority are men who combine academic careers with private practice. Most part-time faculty work as clinician/teachers in nontenure track positions and are satisfied with their careers.

Adult↗
PubMed1991

Parental leave policies for faculty in U.S. medical schools.

OBJECTIVE: To assess medical school policies for maternity and other parental leaves as well as related opportunities for part-time employment, flexibility in tenure systems, and the availability of child care centers. DESIGN: Cross-sectional survey of all 127 U.S. medical schools based on telephone interviews and review of faculty handbooks. MEASUREMENTS AND MAIN RESULTS: Ninety-three percent of medical schools responded. Twenty-two percent of medical schools have no written guidelines for maternity leave, 45% categorize maternity leave as a form of sick or disability leave, and only 34% have developed specific policies. Most schools (61%) require that maternity leave be taken from allotted sick days or from vacation days (or from both) for women to obtain salary support. The time available from sick and vacation leave averages 6.8 weeks. Although 72% of schools make allowances in the tenure probationary period for extended leaves of absence, few have developed specific provisions for childbearing or childrearing. Finally, 18% of medical schools have child care facilities. CONCLUSIONS: Considerable work is needed to develop adequate support for faculty members who are parents. Recommendations include developing specific parental leave policies and flexible tenure systems and providing adequate child care facilities.

Absenteeism↗
PubMed1991

The changing faces of promotion and tenure at U.S. medical schools.

Faced with many potentially divisive questions related to tenure and promotion, leaders at medical schools have lacked an overview of examples of how other medical schools are adapting their faculty policies to reflect changing realities. This article reports results of a survey of U.S. medical school deans and of interviews with faculty affairs administrators regarding areas of change in faculty appointment, promotion, and tenure policies. Examples of adaptations are reported under the following headings: use of tenure; financial guarantees of tenure; criteria for award of tenure; probationary period; post-tenure review; advising faculty; clinician-educator tracks; and recruting women and minority faculty. Of these, the adaptation entailing the most activity and about which the most information was obtained concerns establishing a clinician-educator track. Numerous examples are provided of schools' evolutions of policies with regard to modifying titles of clinical-educators, defining promotion criteria, monitoring transfer between tracks, and defining contract periods, benefits, and privileges. The primary challenge for medical school administrators is to build sufficient flexibility into their promotion policies to show that the institution values the many different types of faculty needed, and at the same time to provide adequate security to essential faculty.

Career Mobility↗
PubMed1991

Medical students' professional ethics: defining the problems and developing resources.

An AAMC working group concluded that medical educators have paid insufficient attention to students' development of professional standards and to the immediate ethical dilemmas that students face as students. Its discussion of the primary determinants of medical students' ethical development focused on improving: (1) the evaluation of candidates for admission; (2) the medical school learning climate, including recognition of the challenges inherent in the increasing cultural diversity among students and patients; and (3) communication to students of expectations of professional behaviors and standards. An AAMC initiative is outlined that includes preparation of a resource book featuring cases illustrating common ethical dilemmas that medical students face, descriptions of effective honor systems, suggestions for faculty development, and an annotated bibliography.

Adolescent↗
PubMed1990

Ifosfamide/etoposide and mesna uroprotection in advanced breast cancer.

The object of the study was to evaluate the effectiveness of ifosfamide/etoposide and mesna therapy in advanced breast cancer. A total of 44 patients with breast cancer were included in the trial. Eligibility criteria included measurable, refractory disease; prior anthracycline therapy (or its contraindication); a life expectancy of at least 3 months; and adequate hepatic, renal, CNS and bone marrow function. All patients were less than or equal to 70 years of age and had a Karnofsky performance status of greater than or equal to 50%. There were 36 evaluable cases. Sites of metastatic disease included bone (19), skin (18), liver (9), lung (14), lymph node (19), and miscellaneous (7). Treatment consisted of 1,500 mg/m2 ifosfamide given i.v. on days 1-5, 120 mg/m2 etoposide given i.v. on days 1-3, and 400 mg i.v. mesna given with and at 4 and 8 h after ifosfamide. Cycles were repeated every 28 days. Initial doses were reduced by 25% or 50% in patients who had previously undergone both chemotherapy and radiotherapy. A median of 4 cycles (range, 2-8) were given. The myelotoxicity was marked: WHO grades 3/4 leukopenia (n = 37), grades 3/4 thrombocytopenia (n = 12), and grades 2/3 anemia (n = 13). Due to myelotoxicity, dose reduction or prolongation of treatment-free intervals was necessary in 28 cases. Alopecia was seen in 35 patients and CNS toxicity, in 8. Partial remission (PR) was obtained in five cases and complete remission (CR), in three. Sites of response included the lung (5), skin (4), lymph node (5), and peritoneum (1). The duration of response was 4 (n = 2) and 8 (n = 1) months for CR and 2 (n = 2), 6 (n = 2), and 10 (n = 1) months for PR. We conclude that the ifosfamide/etoposide and mesna regimen is effective, but its myelotoxicity is treatment-limiting.

Adult↗
PubMed1990

Specialty choice.

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Career Choice↗