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PubMed1975

Attitudes of psychiatric residents toward the necessity of internship.

The authors note that the elimination of the internship requirement for board certification has engendered much discussion and has called attention to the need for further study of training in psychiatry. To help clarify the issue, they investigated demographic and career choice factors, individual internship decisions, and perceptions and feelings about these decisions in 57 psychiatric residents. The results indicate that the career plans of students have a strong influence on their training choices--those who are oriented toward inpatient psychiatry and psychosomatic medicine view the internship as more relevant than those who plan to concentrate in other areas. The authors suggest further research on the relation between career choice and training preferences.

Adult↗
PubMed1992

Voices From the Future: what students, interns, and residents want from osteopathic graduate medical training.

The need to attract students to--and keep them in--osteopathic internship and residency programs is great. Recognizing this fact, the osteopathic hospitals, through the American Osteopathic Hospital Association, have placed a renewed focus on liaisons with osteopathic medical education. Voices From the Future represents one such effort. This report reveals how osteopathic medical students, interns, and residents perceive the current state of osteopathic graduate medical education programs as well as the changes that they would like to see incorporated.

Education, Medical, Graduate↗
PubMed1997

Family practice house officer perceptions of faculty teaching behaviors.

In 1985, Wolverton and Bosworth published an often referenced study of family practice teaching behaviors. Their research identified 20 "most helpful" and 10 "least helpful" behaviors. In 1994 all United States Army family practice house officers were asked by survey to rate each of the original 38 Wolverton and Bosworth teaching behaviors as "not at all helpful," "somewhat helpful," "moderately helpful," "very helpful," or "most helpful" in aiding their learning. Mean values were calculated for each teaching behavior. Twenty most helpful and 10 least helpful faculty teaching behaviors were identified for U.S. Army family practice house officers; several differences were identified in comparison with Wolverton and Bosworth's original study. Additionally, three most helpful and four least helpful teaching behaviors were clearly illuminated. Incorporating the results of this new study into residency programs could improve the learning opportunities afforded family practice house officers during their internships and residencies.

Attitude of Health Personnel↗
PubMed1995

Recruiting the occupational and environmental medicine physicians of the future: results of a survey of current residents.

In July 1994, current occupational and environmental medicine (OEM) residents (n = 180) were surveyed about their motivation for decisions to enter OEM residencies, near-term and long-term career goals, and their opinions on various strategies for recruitment to the field. A total of 151 persons responded (84%), representing all 40 accredited OEM residencies in the United States and Canada. A total of 16% first learned about OEM in medical school, and 11% were first exposed during residency training. Most respondents (62%) decided to enter OEM residency training after beginning their professional working careers. Only 11% of respondents decided to enter OEM residency training before (2%) or during (9%) medical school, whereas 24% made their decision during internship or residency. Respondents were attracted to several aspects of OEM, but the prevention focus of the field (64%), lifestyle (56%), and worker and labor issues (53%) were most commonly cited. Although only 25% of respondents stated that a role model had a significant impact on their decision to pursue training in OEM, persons influenced by a role model were more likely to have made the decision to pursue a career in OEM during medical school or clinical residency training (odds ratio = 2.4; 95% CI, 1.0-5.4; Fisher's exact two-tailed P value = 0.04). In the short term, residents were most often interested in working for industry (32%), whereas over the long term, careers in consulting were most often preferred (39%). The data have important implications for strategies to increase recruitment to residency training programs in OEM and to increase staffing in the field.

Canada↗
PubMed2006

Comparison of basic elements of human performance scores between urologists with various extents of experience.

BACKGROUND AND PURPOSE: An objective evaluation of innate ability and its ability to predict potential success as a surgical trainee is an appealing concept for the selection process of residency applications. The objective of this study was to evaluate whether basic elements of performance (BEP) could discriminate among resident applicants and urologists with various extents of surgical experience. SUBJECTS AND METHODS: One hundred forty-five participants were divided into four study groups: group A, 57 urology residency applicants to the 2002 and 2003 interview process; group B, 8 post-internship urology residents; group C, 19 urologists tested with BEP within 10 years of graduation from their residency training program; and group D, 61 urologists who had graduated from their residency training program more than 10 years prior to testing. The BEP measures consisted of 13 basic performance resources (BPR) including visual-information processing speed, visual-spatial immediate-recall capacity, and neuromotor channel capacity. RESULTS: The four study groups differed significantly in their mean age: group A=27.6 years, group B=29.1 years, group C=37.1 years, and group D=48.9 years (P<0.0005). There was essentially no significant difference between the groups with regard to immediate-recall memory, reaction time simple, or reaction time complicated. The younger participants (groups A and B) were faster than the older surgeons (groups C and D) (P<0.02). However, the older surgeons (groups C and D) were significantly more accurate than the younger groups (A and B) (P<0.0005). The only sex differences noted were in hand-grip strength and shoulder-strength scores, which were all higher in the men. CONCLUSIONS: There generally appears to be a lack of direct correlation between innate abilities and surgical experience. Urology resident applicants with no surgical experience and urology residents with limited surgical experience are faster but less accurate in innate skills testing than experienced practicing urologists.

Adult↗
PubMed2004

Resident burnout.

Intense work demands, limited control, and a high degree of work-home interference abound in residency training programs and should strongly predispose resident physicians to burnout as they do other health care professionals. This article reviews studies in the medical literature that address the level of burnout and associated personal and work factors, health and performance issues, and resources and interventions in residents. MEDLINE and PubMed databases were searched for peer-reviewed, English-language studies reporting primary data on burnout or dimensions of burnout among residents, published between 1983 and 2004, using combinations of the Medical Subject Heading terms burnout, professional, emotional exhaustion, cynicism, depersonalization and internship and residency, housestaff, intern, resident, or physicians in training and by examining reference lists of retrieved articles for relevant studies. A total of 15 heterogeneous articles on resident burnout were thus identified. The studies suggest that burnout levels are high among residents and may be associated with depression and problematic patient care. However, currently available data are insufficient to identify causal relationships and do not support using demographic or personality characteristics to identify at-risk residents. Moreover, given the heterogeneous nature and limitations of the available studies, as well as the importance of having rigorous data to understand and prevent resident burnout, large, prospective studies are needed.

Burnout, Professional↗
PubMed1984

A brief history of the internship.

The internship is the focal point of the transition of medical student to physician. From its origins in hospital apprenticeships, this experience of professionalization and initiation into direct patient responsibility has followed an erratic path. Modern US internships began in the late 19th century, and evolution of many of their characteristics has been determined more by socioeconomic-political issues than by consideration of educational objectives. The recent move to incorporate internships into residency programs is currently being reconsidered because there is a new appreciation of the role that the internship experience can play in the professional maturation of the physician.

Accreditation↗
PubMed1991

A prospective study of internal medicine residents' emotions and attitudes throughout their training.

To evaluate whether the negative emotions and attitudes that residents develop during internship continue throughout the remaining years of their residency, the authors undertook a four-year prospective study of two classes of internal medicine residents who completed their training in 1985 and 1986 in a residency program based at the Oregon Health Sciences University. Every two to three months over all three years of training, the residents indicated on Likert-type scales their levels of agreement with questions about their career satisfaction and emotional states, and the satisfying and dissatisfying aspects of their residency experiences. Between the internship and the end of their residencies, the physicians indicated significant improvements in their emotions and attitudes. Those experiences identified as satisfying continued to be so, whereas those considered dissatisfying became less so. Although more research of other classes of residents is needed, the findings suggest that while internal medicine internships may be dysphoric, the residents' emotional states and attitudes tend to normalize during the remainder of the residency.

Adult↗
PubMed1990

Investigating the fairness of the National Resident Matching Program.

The National Resident Matching Program (NRMP) was established in the early 1950s to bring order and fairness to a previously chaotic application process for internship and residency positions. Over the years many reservations were raised about the fairness of the process, specifically, that hospital programs are doing better than students are (i.e., programs obtain preferred residents more often than students receive preferred programs). This paper presents an analysis of the results of the 1986 Match. The findings do not support the claim that the results of the Match are biased in a way that favors programs. Overall, the students' success was greater (i.e., receiving on average higher-ranked choices) than was the hospital programs' success. In fact, in 20 of 22 specialty programs, the students' degree of success was greater than or equal to the success of the programs. This finding raises the question of fairness toward programs rather than students. The authors analyze factors that affected both the hospitals' and the students' degrees of success in the 1986 Match and suggest strategies for improving the Match results.

Academic Medical Centers↗
PubMed2004

A literature review of "resident-as-teacher" curricula: do teaching courses make a difference?

OBJECTIVES: To examine the evaluation methods of resident teaching courses and to estimate the effectiveness of these teaching courses. DESIGN: We searched the literature from 1975 to May 2003 using the PubMed MESH terms internship and residency and teaching; 1,436 articles were identified and 77 contained information regarding teaching courses. Fourteen articles contained information regarding outcomes of resident teaching courses and were selected for intensive review. MAIN RESULTS: Five uncontrolled pre-post studies used resident self-reported teaching skills/behaviors as outcome measures; all reported some improvement in self-reported skills. Three uncontrolled pre-post studies examined live or videotaped resident teaching encounters and all revealed improvement in some teaching skills. One uncontrolled trial and three nonrandomized controlled trials used learner evaluations of resident teaching behaviors as outcomes and all revealed an improvement in ratings of residents after course participation. Four randomized controlled trials of resident teaching curricula are included in this review. One study did not show any quantitative benefit of a resident teaching course on performance on an objective structured teaching evaluation. Two studies assessing resident teaching evaluations before and after course participation showed conflicting results. One study noted improvements in resident teaching skills assessed through videotape analysis. CONCLUSIONS: Resident teaching courses improve resident self-assessed teaching behaviors and teaching confidence. Teaching courses are linked to improved student evaluations. Further studies must be completed to elucidate the best format, length, timing, and content of resident teaching courses and to determine whether they have an effect on learner performance.

Curriculum↗
PubMed1994

[Risk of pregnancy complications associated with residency].

OBJECTIVE: To determine, through a review of published articles, whether a higher prevalence of pregnancy complications is associated with residency in medicine. DATA SOURCES: Articles published between January 1980 and December 1992 found through a MEDLINE search using the MeSH terms "pregnancy complications" and "internship and residency" and through a review of the bibliographies of articles found. STUDY SELECTION: Of the 17 articles found, 6 contained data on the prevalence of pregnancy complications in residents. DATA EXTRACTION: The methodologic quality of the studies was evaluated systematically with the use of a grid. Data on the prevalence of the six most common pregnancy complications were retained. DATA SYNTHESIS: Four of the six articles had methodologic weaknesses (missing or inappropriate control groups, poorly controlled historical bias). The best study showed a higher prevalence of premature labour, pre-eclampsia and voluntary abortion in the residents than in the control subjects. CONCLUSIONS: It is difficult to draw definitive conclusions from a single study that met the criteria for methodologic quality. More and better-controlled studies involving larger numbers of subjects are needed.

Confounding Factors, Epidemiologic↗