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PubMed1997

Why the university-based medical school should survive: a historical perspective.

Universities and medical education have been allied since the Middle Ages. In the United States, proprietary medical schools began to unite with universities at the turn of the century. At the end of the century, this traditional alliance is being questioned, even threatened, by marketplace demands, and medical schools and their universities continue to deal with internal struggles regarding teaching and research goals, and funding. In this paper, the author defines and discusses the origins of university-medical school tensions, provides a brief review of the history of university-based medical education in the United States, and describes some of the advantages and disadvantages of the alliance. Finally, he makes a case for why medical education must continue to be grounded in universities.

History, 18th Century↗
PubMed2006

Universal health care and reform of the health care system: views of medical students in the United States.

PURPOSE: Nearly 46 million Americans did not have health insurance in 2004. Recent studies have documented physicians' support for various remedies, including universal health care. The authors undertook this study to assess medical students' views on these topics. METHOD: In 2002, the authors surveyed a national random sample of first-year and fourth-year medical students (from the American Medical Association Masterfile) to determine their views about health care reform options, including universal health care. Response data were weighted and compared using chi-squared tests; statistical significance was set at p < or = .05. RESULTS: Of 1,363 medical students, 770 completed the questionnaire (response rate = 56.5%). In rating the importance of several health care issues, more than 80% of both first-year and fourth-year students rated the expansion of health care coverage as important. Nearly all first-year (90%) and fourth-year (88%) students agreed with the statement, "Everyone is entitled to adequate medical care regardless of ability to pay." Most students favored health care reform that would achieve universal health care, with first-year students (70%) somewhat more likely than fourth-year students (61%) to support universal health care (p = .012). Students were less likely to believe that physicians support universal health care, and more likely to believe that the public does. CONCLUSIONS: Both groups of students generally support the expansion of health coverage to the uninsured and some form of universal health care. This may be relevant both to policymakers in their considerations of health care reform and to medical educators concerned with teaching students about health policy issues.

Attitude of Health Personnel↗
PubMed2002

Neurosurgery at the Catholic University in Rome.

Neurosurgery at the Catholic University in Rome was initiated by Gian Franco Rossi in 1969 and has gradually expanded since then. From the beginning, research has been regarded as an essential part of training and daily activities in the university's neurosurgery programs. The professional and research education of all faculty members includes at least 1 year abroad in a reputable neurosurgical center. Subspecialization is encouraged. Today, the faculty is composed of 3 full professors, 4 associate professors, and 16 assistant professors. The university's neurosurgery programs include the Institute of Neurosurgery, the residency program, and the following clinical units: a Division of General Neurosurgery; three subspecialty sections comprising Neurotraumatology, Pediatric Neurosurgery, and Functional and Spine Surgery; a day hospital; and dedicated laboratories. More than 1700 surgical patients are treated annually. Epilepsy, pain management, parkinsonism, spinal cord and vertebral pathologies, clinical and basic neuro-oncology, cerebrospinal fluid and intracranial pressure dynamics, cerebrovascular disease, neurotrauma, developmental malformations, and peripheral and central nervous system neuroregeneration are the main fields of clinical and research activities. The results of the research performed thus far at the Catholic University in Rome have been reported in more than 900 publications, most of which have appeared in prominent journals and books. Members of the faculty are involved in relevant editorial activities and serve as officers of national and international scientific and professional societies. In 1999, Giulio Maira succeeded Dr. Rossi in directing the Institute of Neurosurgery and the Division of General Neurosurgery. In addition to the history of neurosurgery at the Catholic University in Rome, this article describes present challenges and plans for the future in neurosurgery at the university.

Christianity↗
PubMed2005

Use of the preparticipation physical examination form to screen for the female athlete triad in Canadian interuniversity sport universities.

OBJECTIVE: The purpose of this study was to survey universities affiliated with Canadian Interuniversity Sport on existing screening protocols for the female athlete triad, and to identify any potential areas for improvement of this system. DESIGN: Surveys were faxed or e-mailed to Canadian Interuniversity Sport-affiliated universities in Canada, and preparticipation physical examination (PPE)/medical history forms from each institution were analyzed. SETTING: The Fowler Kennedy Sports Medicine Clinic at the University of Western Ontario. PARTICIPANTS: In 2000, of the 48 universities, 35 responded (73.0% response rate). In 2002, 39 of 49 universities responded (79.6%). MAIN OUTCOME MEASUREMENTS: Although the majority of institutions surveyed implement a PPE form (80.0% in 2000, 87.2% in 2002), only 70.6% to 75.0% of these institutions actually conduct a follow-up when deemed necessary. However, the number of forms including a specific female section increased from 46.4% in 2000 to 61.8% in 2002. Also encouraging is the percentage of universities attempting to increase awareness of the triad disorders (33.3% in 2002 vs. 14.3% in 2000). It is interesting to note that in over half of the institutions surveyed both years, the athletic therapist or trainer is responsible for analyzing the completed PPE forms. CONCLUSIONS: This study has shown substantial improvement from 2000 to 2002 in the development of the PPE across Canada, even in a relatively short period of 2 years. However, this study also demonstrates the lack of uniformity within Canada of the PPE forms. There remains a need to improve the PPE form to target a section of the form specifically to female athletes, or else cases may be missed. The triad is also not found solely in sports where leanness is associated with better performance. Better efforts need to made to increase awareness of the triad and its risks among female athletes, as well as provide educational opportunities for athletic therapists, who are the first line of intervention in many cases. CLINICAL RELEVANCE: The key to successful prevention and intervention is education. This study demonstrates the need for education for all people directly involved with the athlete, and the need to work together to promote a healthy and realistic body image and increase awareness of the female athlete triad among athletes.

Amenorrhea↗
PubMedDate not supplied

Understanding of and attitudes to organ donation and transplantation: a survey among Italian university students.

BACKGROUND: Students have a positive attitude to organ donation and transplantation, usually associated with their personal willingness to donate their organs after death. The aim of this study was to evaluate the opinions of university students on transplantation and organ donation, at a single Italian university. METHODS: University undergraduates attending the first year on five different courses in 2001 were surveyed at Padua University by using an anonymous 13-item questionnaire. RESULTS: 97.2% of the students completed the questionnaire (77.4% females, mean age 20.4 yr); they were attending Medicine (33.8%), Agriculture (5.9%), Veterinary Medicine (11.4%), Psychology (18.5%) and Educational Sciences (30.4%). The majority was aware of the problem of the paucity of organ donations and deaths on the waiting list in Italy. Most students would accept transplantation in the case of a human donor (97%), an artificial organ (95%) or an animal donor (76%); and 87% of them were prepared to donate their own organs after death. No differences were seen when students attending science courses were compared with those attending art courses. Italian university students have a very positive attitude and willingness to donate their own organs after death, with no differences emerging as regards type of university education.

Adult↗
PubMed1978

University students, mental health and development.

University students of the late 1960s and 1970s have been included in a study of factors affecting their mental health and academic functioning in many countries and cultures. Social change and intergenerational conflict were seen to be almost inseparable as social, economic and political concerns involve both students and their countries. Results of studies at Dalhousie University, six British universities, and the University of Singapore are examined in light of the socioeconomic problems existing at the time. High unemployment of university graduates, a growing factor in developing and developed nations, is pointed to as a major stress during a university education in the late 1970s.

Adolescent↗
PubMed1979

Statistics in Japanese universities.

The teaching of statistics in the U.S. and Japanese universities is briefly reviewed. It is found that H. Hotelling's articles and subsequent relevant publications on the teaching of statistics have contributed to a considerable extent to the establishment of excellent departments of statistics in U.S. universities and colleges. Today the U.S. may be proud of many well-staffed and well-organized departments of theoretical and applied statistics with excellent undergraduate and graduate programs. On the contrary, no Japanese universities have an independent department of statistics at present, and the teaching of statistics has been spread among a heterogeneous group of departments of application. This was mainly due to the Japanese government regulation concerning the establishment of a university. However, it has recently been revised so that an independent department of statistics may be started in a Japanese university with undergraduate and graduate programs. It is hoped that discussions will be started among those concerned on the question of organization of the teaching of statistics in Japanese universities as soon as possible.

History, 20th Century↗
PubMedDate not supplied

Successful turnaround of a university-owned, community-based, multidisciplinary practice network.

PURPOSE: The University of Utah purchased a 100-clinician, 9-practice multi-specialty primary care network in 1998. The university projected the network to earn a profit the first year of its ownership in a market with growing capitation; however, capitation declined and the network incurred up to a 21 million dollars operating loss per year. This case study describes the financial turnaround of the network. METHODS: In 2001, the university reconfigured the practices for a fee-for-service environment while preserving the group's multidisciplinary clinical and ancillary services. Changes included reorganization under the existing University of Utah Hospitals and Clinics system, new governance and leadership, closure of practices, creation of a billing office, new financial reporting, implementation of electronic health records, revision of physician compensation, capture of referrals, leadership and staff training, and practice reengineering. RESULTS: The network as a whole became profitable in 2004-2005. Its primary care component is projected to become profitable in 2 to 3 years. The network is opening new sites strategically important to the health system. CONCLUSIONS: This turnaround required commitment from senior university leaders, management with knowledge of primary care practice, retention of ancillary revenues, and management and business services specific to the network with support from other units within the university. Culture change within the group was essential. Our experience suggests that an academic health center can successfully operate a primary care network by attending to the unique needs of this challenging business. Doing so can strengthen the institution's overall financial and clinical performance and provide an important setting for teaching and research.

Community Health Centers↗
PubMed2006

[University residence halls: socialization processes and drug consumption].

OBJECTIVE: To investigate and analyze the discourse of students living in university residence halls regarding socialization processes and drug consumption. METHODS: This was qualitative research among 20 undergraduate students living in university residence halls in the city of São Paulo, Brazil, in 2003. Residence halls were taken to be socialization spaces for young people that enable the presence of low-income students at university. The interviews covered students' knowledge of the history of the residence hall, their experience of living in student residences and their perceptions regarding drug consumption. The methodological procedure that served as the basis for collection, organization and analysis of the interview data was examination of the collective discourse of the subjects. RESULTS: It was shown that the students had little knowledge of the history of the residence hall; solutions for problems they faced in the residence hall were sought individually; and the two main concepts observed among the people living there for preventing drug consumption were war on drugs and damage limitation. It was seen that there was a negative view regarding student residence halls that related to the constant publication of disturbing events and lack of knowledge of the importance of residence halls for enabling poor students to remain at university. CONCLUSIONS: In the opinion of the people living in student residence halls, such accommodation enables access to university, despite the difficulties in living together and in administration by the university. With regard to the use of drugs in the residence hall, some of the people living there emphasized the need for less tolerance towards drug consumption, while others stressed the importance of educational work, particularly among those who are just starting to live there.

Adult↗
PubMed2004

"German methods," "unconditional gifts," and the full-time system: The case study of the University of Toronto, 1919-23.

At the end of 1919, The University of Toronto got word that the Rockefeller Foundation was looking to give the university a gift of one million dollars (US) to "aid medical education.". This was in addition to a gift of $500,000 (Canadian) from merchant millionaires Sir John Craig and Lady Eaton. The implementation of the full-time system of clinical instruction made possible by these large gifts touched off a fiery debate among the medical profession and prompted a provincial government inquiry that would have thwarted long-awaited innovations in medical teaching and threatened the autonomy of the entire university. Much has been written about the full-time system of clinical medical education, most of it dealing with the United States. Some have documented cases where donor dollars were scorned in aiding the shift to full-time clinical teaching. Less well known is the tale of the University of Toronto. "The Provincial University" is an unique case study of a public university that tried to satisfy donor conditions even as it served its constituency- the people of Ontario. The challenge of implementing a new medical pedagogy between 1919 and 1923 was that Toronto lay at the centre of three poles: private versus public funding; "research" or laboratory medicine versus "experience" or "practical" medicine; and those who wanted to try the full-time system versus the established "old guard."

Canada↗
PubMed2006

[Collaboration between university hospitals and local medical communities in Japan evaluated by a questionnaire among doctors].

AIM AND METHODS: To provide quality medical service in a society with many elderly, university hospitals should clearly define their roles and contribute to the establishment of an integrated, comprehensive medical system. In this study, we conducted a questionnaire survey of doctors working at Kyoto University Hospital and at private practices in Kyoto about their attitude toward collaboration between the university hospital and private practices and asked their opinions on the role of university hospitals in the local medical community. RESULTS: The survey showed that doctors both at the university hospital and in private practice regarded close collaboration as important, but also highlighted obstacles and problems that block collaboration. CONCLUSION: Overcoming these problems and constructing collaboration models will be a key for university hospitals to fully contribute to the establishment of a quality medical system.

Attitude of Health Personnel↗
PubMed1992

Barnes Hospital and the Washington University Medical Center.

The author documents the development of the Medical School at Washington University since 1891, when the St. Louis Medical College was first included as part of the University. In 1909, Robert Brookings, President of the Corporation of Washington University, acquired a large endowment and moved the clinical and hospital facilities to a new location, enabled by the estate of Robert Barnes. Harvey Cushing was offered the chair of surgery but eventually decided in favor of Harvard University in 1910. Dr. Ernest Sachs was recruited to Washington University by Dr. Fred Murphy, and in 1919 became the first ever Professor of Neurological Surgery. The history of neurosurgery and those who served it at the Washington University Medical Center and Barnes Hospital is recounted.

History, 19th Century↗
PubMed2004

[Structural equation model for the health behaviors of university students in Korea].

PURPOSE: A structural equation model was analysed to explore the determinants of health behaviors of university students in Korea. METHOD: Nine hundred sixty nine university students were selected by random cluster sampling from five universities located in the central area of Korea. DATA COLLECTION: The data was collected by questionnaires about demographic characteristics, stressful life events, perceived social support, perceived health status and health behaviors. RESULTS: 1. Gender showed indirect effect on health behaviors. 2. Living together with(out) family had a direct effect on health behaviors: students living with family showed more positive health behaviors. 3. Stressful life events had an indirect effect on health behaviors via perceived health status; a higher score of stressful life events was the predictor for negative health behaviors. 4. A higher score of perceived health status predicted positive health behaviors. RECOMMENDATION: Each university should be encouraged to develop a health behavior control program and health promotion program for their own university students. It would be more effective to develop health programs separately according to the demographic or social characteristics of the students. It is also necessary for the Ministry of Education to reform the School Health Act and school health policy to strengthen a health promotion program for university students. In conclusion, following studies should identify and promote the validity and reliability of perceived health status and health behaviors measurements.

Adult↗
PubMed2005

[75th anniversary of the Pontifical Catholic University of Chile School of Medicine].

The Pontifical Catholic University of Chile founded its School of Medicine in 1930, preceded by the Schools of Medicine of the University of Chile (founded in 1833) and the University of Concepción (founded in 1924). The founders of the new School were prominent members of the Catholic Church, advised by distinguished Chilean physicians and scientists, most of them already full Professors at the University of Chile. During the first decades, only a small number of full-time faculties could be recruited and the academic team included mostly part-time teachers, generally shared with the already established Medical Schools, as well as practising physicians with little or no previous teaching experience. Along 75 years of fruitful existence, this Medical School has evolved to become one of the leading organizations in graduate and post-graduate medical education in Latin America, with high standards in teaching methodology and a superb productivity in clinical and biomedical research. The history of this Medical School stands as an example to the currently nascent Medical Schools founded by private universities in Chile. The standards of high quality medical education should be maintained for the well-being of our population so that these new Medical Schools can become respected and accepted as peers by the entire community of Chilean Universities.

Chile↗
PubMed1998

[Autonomy accreditation of private Chilean universities (1994-1998)].

BACKGROUND: In 1995, a score to measure the quality of private universities in Chile, using excellency indicators as predictors of autonomy certification, was devised by the author. AIM: To compare this score with autonomy certification results of ensuing years, to assess the usefulness of excellency indicators. MATERIAL AND METHODS: During 1995, the records of 21 private universities in Santiago were studied. These universities were qualified using eight indicators of academic excellency. These results were compared with the Superior Education Council qualification results, obtained between 1996 and 1998. RESULTS: The scores obtained by universities ranged from 19 and 137 points. Universities with the better scores obtained autonomy and those with the worst scores were eliminated. There was a good concordance between the score obtained in 1995 and the fate of autonomy certification. CONCLUSION: The best predictors and indicators of academic excellency to certificate autonomy of private universities were the magnitude of indirect budget contributed by the state, the size of academic list of staff and the percentage of admitted students with scores over 573 in the national academic aptitude tests.

Chile↗
PubMed1999

Training of surgeons in Kenya at the University of Nairobi teaching hospital.

OBJECTIVE: To determine the number of surgeons trained by the Department of Surgery, Faculty of Medicine, College of Health Sciences, University of Nairobi, since its inception in 1967. DESIGN: This was a retrospective (1975-1987) and prospective study (1988-1999). SETTING: Kenyatta National Hospital, a National Referral Hospital and University of Nairobi Teaching Hospital. SUBJECTS: All surgeons trained by the Department of Surgery of the University of Nairobi for postgraduate MMed in general surgery, anaesthesia, ENT surgery and ophthalmology from 1975 to March 1999. RESULTS: Two hundred and eighty-five surgeons with Master of Medicine degree were trained by the Department of Surgery of the University of Nairobi between 1975 and March 1999. They included 181 (63.51%) general surgeons; 46 (16.14%) anaesthetists; 35 (12.28%) ophthalmologists and 23 (8.07% ear, nose and throat (ENT) surgeons. One hundred and seventy-six, (61.75%) were from retrospective studies; 94 (32.98%) were from prospective studies while 15 (5.26%) were from both retrospective and prospective studies. Two hundred and thirty-two (81.40%) surgeons were Kenyans while 53 (18.60%) were foreigners. The majority, 42 (79.24%) of the foreigners were from other African countries. Thirty one (58.50%) were from neighbouring Uganda, Sudan, Tanzania, Ethiopia and Zambia. There was also one PhD in anaesthesia and one MD in urology during the same period. CONCLUSION: The University of Nairobi, Department of Surgery based at Kenyatta National Hospital has played a very significant and leading role in the training of surgeons for Kenya and even other African and foreign countries since its inception. Of the forty surgeons who constitute the academic staff in the Departments of General Surgery, Orthopaedic Surgery and Ophthalmology of the University of Nairobi, thirty-five surgeons (87.50%) have been trained by the Faculty of Medicine at KNH.

Education, Medical, Graduate↗
PubMed2000

[The characteristics of patients with hepatitis C virus antibodies followed in specialized university hospital units are different from those of patients in the general population. The Research Group of the REBOHC].

OBJECTIVES: To compare the characteristics of patients with anti-hepatitis C virus antibodies followed in a University Hospital Department of Hepatogastroenterology with those in patients who received medical care elsewhere. METHODS: Since 1994, a specialized viral hepatitis register has recorded since 1994 all new cases of anti-hepatitis C virus antibodies diagnosed in inhabitants of the French department of Côte-d'Or (493931). The factors correlated with the type of medical care in patients followed in the University Department were studied by logistical regression. RESULTS: One hundred of the 498 new patients with anti-hepatitis C virus antibodies diagnosed in the Côte-d'Or between 1994 and 1996 were followed in a University Hospital Department. Multivariate analysis showed that age (<60), contamination due to transfusion, elevated ALT levels and no excessive alcohol consumption were factors significantly correlated with follow-up at the University Department. Liver biopsy was more often performed (66%) and a treatment was more often prescribed (34%) in patients followed in a University Department of Hepatogastroenterology patients than in other patients (20.4%; P <0.0001 et 7.5%; P <0.0001 respectively). CONCLUSIONS: This study shows that patients with anti-hepatitis C virus antibodies who are followed by a specialised University Department are a selected group; these patients are more likely to be treated than others. This study emphasizes that the greatest care must be taken when extending the extension of results of hospital series to a non-selected population.

Biopsy↗
PubMed2001

Founding a new dental school at Nova Southeastern University.

The dental school arose from the premise that a dental school would round out the university and add prestige to the burgeoning Health Professions Division with its five schools and eight health programs. The school was founded in light of the following circumstances. Patient Pool Evaluation of community facilities and services revealed that there was an increasing patient pool, without disturbing the present mix. There was evidence of a need for dental care for large numbers of unserved or underserved people. Financial Considerations Proforma and cash flow budget projections showed financial stability of this project. The university was recognized to have the ability to absorb initial capital costs. HPD had a history of the success in functioning with tuition-dependent budgets. University Factors The university has had success in establishing and operating five health professions schools. A complete and experienced infrastructure has existed for sixteen years in the University and in the Health Professions Division. The university would provide unconditional administrative support.

Curriculum↗