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PubMed1997

Comparison of performance on the American Osteopathic Board of Internal Medicine certifying examination 1986 to 1996 by type of residency.

The purpose of this study was to determine if internal medicine residency type or location was associated with differences in performance of candidates as measured by the internal medicine certifying examination. Included in the study were all first-time taker candidates for the 1986 to 1996 American Osteopathic Board of Internal Medicine certifying examinations in internal medicine. Group analysis was performed based on the type of residency track leading to board eligibility: (1) traditional internship plus 3 years of internal medicine residency; (2) traditional internship plus 2 years of internal medicine residency and 1 year of subspecialty training; (3) specialty track internship plus 2 years of internal medicine residency; and (4) traditional internship plus 3 years of allopathic internal medicine residency. Subgroup analysis of the subspecialty track group was performed to determine if any particular subspecialty-trained subgroup performed better than the others. Results indicate that all groups had similar scores and pass rates except for the allopathic-trained residents, whose scores and pass rates were lower. Subgroup analysis of the subspecialty-trained candidates revealed that procedure-oriented subspecialty candidates performed similar to non-procedure-oriented candidates. No gender differences were noted in scores or pass rates. It is concluded that the overall performance of candidates is equivalent for each of the residency training tracks developed by the American College of Osteopathic Internists. Future performance on the recertification examination will need to be tracked to determine if these trends continue for practicing internists.

Certification↗
PubMed1992

Satisfaction of recent University of British Columbia dietetics graduates with undergraduate education and current job.

This study was designed to investigate the career status of recent University of British Columbia (UBC) dietetics graduates and their satisfaction with undergraduate education and current job. All graduates from the UBC Dietetics Program between 1978-1987, inclusive (n = 238), were mailed questionnaires. Information was sought regarding success in obtaining a dietetic internship, current employment status, job satisfaction, and satisfaction with undergraduate education. Questionnaires were returned by 67% (n = 130) of those who received them. Approximately 83% were eventually successful in obtaining an internship. Most respondents (68.5%) were employed as dietitian/nutritionists, and 69% of those who were employed worked full-time. Those who interned had significantly higher salaries than those who did not. A measure of overall job satisfaction revealed that 89.6% were satisfied to very satisfied with their present job, and scores on the Brayfield-Rothe Index of Job Satisfaction revealed no differences between those who did and did not intern. With regard to undergraduate education, respondents were most satisfied with library resources, class size and quality of teaching, and least satisfied with internship opportunities. Those who had interned were significantly more satisfied with their undergraduate education than were those who had not. We conclude that success in obtaining a dietetic internship affects salary and satisfaction with undergraduate education, but does not affect job satisfaction.

Attitude of Health Personnel↗
PubMed1992

[Medical undergraduate education is outdated. From the interns' point of view].

This survey is based on a questionnaire sent to all 517 interns in Norway in December 1990, of whom 93% replied. Ten interns were interviewed personally. The majority felt they received a good theoretical basis during their medical studies, but less than a third stated that the education had adequate vocational orientation. Students from the University of Tromsø, were the exception in this respect. They were more positive towards the vocational aspects of their studies. Most interns had high expectations with regard to learning during internship, and half of them to have to face various traumatic experiences during this period. One out of two stated that, so far, their internship training had been inspiring for their career as medical practitioner. About a third replied that they doubted whether they would choose the same profession if they were to make this decision again. The results of this study emphasize the importance of the current changes in the curriculum at all four medical faculties in Norway. The results also suggest a need for better coordination of university studies and internship, and more structured teaching during the internship.

Curriculum↗
PubMed1990

A retrospective study of graduates of a coordinated internship/master's degree program.

The coordinated dietetic internship/master's degree program (CDI/MDP) was formed in 1965 as a consortium of three hospitals and a university combining a hospital internship and graduate degree program. As of 1984, there were 317 graduates. The purpose of this study was to determine the employment, professional activity, and further education profiles of graduates in a 20-year period. The critical path method (CPM) was used as the blueprint for the 6-month project in which 267 questionnaires were sent and 152 were returned. Findings on areas of practice of graduates of the CDI/MDP indicated that their employment generally follows the same rankings as those found in previous studies of internship, CUP, and Plan IV programs, except for greater frequency of employment in education. Activities in professional associations were notable, with many graduates serving as officers or committee members. Twenty-one percent of respondents have earned or are in the process of pursuing study beyond the master of science earned with the internship. This may indicate that students interested in completing an internship/master's program have a strong achievement orientation or that they have an unusually high regard for education. Our findings provide valuable data for understanding the career impact of advanced education combined with the internship.

Dietetics↗
PubMed1987

Training in geriatrics for future dietitians.

Inclusion of geriatric training for future dietitians was assessed through a questionnaire mailed to directors of all internship programs and coordinated undergraduate programs (CUPs) accredited by The American Dietetic Association. All respondents, internship programs (70%) and CUPs (77%), included some exposure to geriatrics. Ninety-six percent of the CUPs included geriatric-related topics in undergraduate courses. Of the 95% internship programs providing class sessions on geriatrics, most included 6 hours or less. Major topics related to nutrition assessment; physical, social, and psychological needs; diet-related diseases; and nutrition programs benefiting the elderly. Fifty-one percent of the CUPs and 23% of the internship programs trained students 3 weeks or more in a geriatric setting, while 45% and 72%, respectively, trained 2 weeks or less. Nursing homes were the primary site of training. The most frequently required activities included identifying specific needs of the elderly in relation to other adults, completing diet histories, and presenting nutrition education to a geriatric population. The question remains as to whether the quantity and type of geriatric experiences currently included are sufficient to keep pace with the increasingly aging population.

Dietetics↗
PubMed2000

A survey of smoking cessation knowledge, training, and practice among U.S. Army general medical officers.

BACKGROUND: Historically, cigarette-smoking rates have been higher among military personnel than among civilians, although recently these rates have decreased. METHODS: In March 1997, a questionnaire assessing (1) training received on smoking cessation, (2) objective knowledge of smoking-cessation techniques, (3) frequency of practice habits, and (4) personal tobacco use among physicians, was successfully mailed to 232 of the total population of 279 Army general medical officers (GMOs). RESULTS: One-hundred-fifty (65%) GMOs returned questionnaires. Of these, 3.3% reported personal cigarette smoking, and 7.3% regularly used smokeless tobacco. During internship, few (13%) GMOs received smoking-cessation training. Primary care programs provided training more frequently than did surgery internship programs. The mean score on the objective knowledge portion was 72%. GMOs had a variable practice pattern in their use of smoking-cessation techniques (percent answering "usually" or "always"): helping patients set quit dates (35%), offering to prescribe the nicotine patch (59%), referring patients to a behavior-modification program (86%). Physicians who received training during internship were significantly more likely (p < 0.01) to help their patients set a quit date. Training did not result in a statistically increased frequency of other practice habits. CONCLUSIONS: GMOs received minimal training on smoking cessation during internship. GMOs refer patients to smoking-cessation classes, reflecting the strategy of the Army Health Promotion program. Strategies to increase the frequency that GMOs prescribe nicotine replacement and assist patients in setting a quit date are needed. Military smoking-cessation efforts may provide valuable lessons for the civilian community.

Adult↗
PubMed2000

The impact of job stress and working conditions on mental health problems among junior house officers. A nationwide Norwegian prospective cohort study.

CONTEXT: Previous studies have shown that physicians have an increased risk of mental health problems such as depression, suicide and substance abuse. OBJECTIVES: To study the prevalence of mental health problems during the first postgraduate year, and to investigate whether work-related factors in hospital are linked to these, when we control for gender, previous mental health problems, personality traits, stress in medical school and other possible predictors. DESIGN: Nationwide and prospective postal questionnaire survey. SETTING: University of Oslo. SUBJECTS: Medical students who answered questionnaires in their graduating semester, and 1 year later when they were junior house officers (n=371). RESULTS: Mental health problems (needing treatment) during internship were reported by 11%, with no gender difference. Adjusted predictors of mental health problems were: previous mental health problems, (odds ratio (OR)=5.1, 95% confidence interval (CI) 1.7 to 15.8); being married/cohabitant (OR=0.2, CI 0.1 to 0.7); the personality trait 'vulnerability' (OR=1.5, CI 1.1 to 2.0); negative life events during internship (OR=2.1, CI 1.2 to 3.5), and job stress as house officer (OR=1.05, CI 1.01 to 1.10). The job stress factor of emotional pressure/demands from patients was most important. Perceived study stress and lack of skills at the end of medical school were univariately related to mental health problems in internship, but not when other variables were adjusted. Gender, weekly working hours and lack of sleep were not linked to having problems. CONCLUSION: Job stress is related to mental health problems among young doctors, even when the variables of previous mental health problems and personality traits are controlled for. More support during internship is needed.

Adult↗
PubMed2003

What do students want? The types of learning activities preferred by final year medical students.

CONTEXT: A well-aligned curriculum has consistent focus on curricular goals, teaching/learning activities and assessment. Poor alignment affects the way students budget learning time and may interfere with achievement of curricular goals. We noticed students' poor attendance in clinical clerkships prior to final examinations and hypothesised that they were responding to curricular misalignment. OBJECTIVES: To quantify the extent to which students and tutors perceived a mismatch between activities pertaining to their current clerkship and those they thought necessary to prepare for final examinations and internship. SUBJECTS: Medical students in final (sixth) year clerkships in medicine, surgery and critical care and clinical tutors. METHOD: A self-report questionnaire on time spent in clerkship activities was administered 3 months before the final examinations. RESULTS: The amounts of time spent on current activities were fairly evenly spread over teaching, study and self-directed patient contacts, and observing patient care (ward rounds, operating theatre, accident and emergency, outpatient department and clinical meetings). Less time was available for recreation. Students and tutors concurred, independently, that good examination and internship preparation required a shifting of the balance. Examination preparation redistributed time from observing patient care and recreation to study and self-directed patient contacts. Internship preparation redistributed time from teaching and recreation to observing patient care. CONCLUSION: Students and tutors perceived that current activities were not well aligned with assessment requirements but were better aligned with the requirements of internship. If we want students to direct their attention towards curricular goals, we need to bring goals, teaching/learning activities and assessment into alignment.

Australia↗
PubMed1975

[Experimental course in medicine at the University of São Paulo].

The structure, general objectives, characteristics, and administrative organization of the experimental course in medicine at the University of São Paulo, Brazil, are examined. The individual course subjects are then described, as are the six cycles, together with the class hours allotted to each, into which the course is divided: (1) basic instruction; (2) studies vertically integrated into the system; (3) the preclinical course; (4) the clinical course (corresponding to the fourth year); (5) the rotating internship; and (6) the elective internship. Including the internship system adopted in the last four years, the course comprises a total of 10,000 hours. Emphasized are: teacher training of instructors; position in the course of social sciences and medical psychology; factors adversely affecting the teaching of community medicine; effects on the student of the characteristics of the system adopted for practice during internship and in the teaching hospital. Establishment of a continuing process for stimulating attainment of the objectives, improving teaching methods, and securing the desired results is recommended as part of the experimental course.

Brazil↗
PubMed1966

The superiority of the rotating program.

In view of the recent trend towards straight internships in many teaching hospitals, the Intern Committee of the Henry Ford Hospital has surveyed the rotating internship in this institution. It is our belief that many factors affecting both the intern and the hospital staff make the rotating program still superior to any other type of internship offered.

Internship and Residency↗
PubMed2002

The value of experiential education in dietetics.

A survey was sent to 2000 Registered Dietitians (RD) who passed the national registration exam between 1996 and 1999. RDs were asked to self-report their perceived value of professional preparation attained from four areas of dietetic education: didactic program, supervised practice, work experience, and continuing education. Five questions in the survey asked RDs to estimate the contribution of these four areas, in percentage, to their ability, confidence, knowledge, skills and competence as an RD. Analysis of the data included descriptive statistics and two-way correlation. The return rate for the survey was 45.0%. The dietetic internship consistently received the highest mean response for all five aspects of professional development. Knowledge (31.3%) was the highest contribution from the didactic program. The internship contributed the most to skill development (44.8%). Confidence (32.5%) was the greatest contribution from work experience, and knowledge (8.6%) from continuing education. When asked to indicate their first area of practice, 63.5% of the participants reported working in a clinical position, 19.2% reported community/public health, 13.8% reported other, 12.6% reported food service/management and 3.5% reported entrepreneurial/business. Participants' responses indicate that the internship is a critical aspect of dietetics education in order to develop ability, confidence, knowledge, skills, and competence to practice as an RD. However, each component of dietetic education contributed a unique aspect of professional development that is necessary in the preparation of an entry-level dietitian.

Adult↗
PubMed2002

Minority interns' experiences during their dietetics education and their recommendations for increasing diversity in dietetics: findings from structured interviews.

Diversity among racial minorities and males has remained limited in the dietetics field. Structured interviews with eleven minority interns were conducted to assess their experiences throughout their dietetics education and to examine their perceptions of the dietetics profession. General themes were reported. Dietetics was not the first career choice for six interns. Work and volunteer experience were perceived as the most influential factors in their selection for a dietetic internship. Some perceived being the only minority in an internship program and the lack of minorities on internship selection committees as problems. Increasing minority dietitians' visibility at career days and early recruitment of students were suggested as ways to increase diversity within the profession. Resources such as the Building Our Future Mentor Program Tool Kit should be utilized to establish mentoring programs for students and to enhance diversity efforts in dietetics.

Career Choice↗
PubMed1995

Criteria for acceptance to preprofessional dietetics programs vs desired qualities of professionals: an analysis.

The objectives of this analysis were to examine the literature and compare and contrast (a) qualities preferred in preprofessional dietetics students by directors of internships and approved preprofessional practice programs (AP4s), (b) characteristics needed to succeed in a scientific field, (c) traits emphasized by dietetics training programs compared with those most valued by employers, (d) skills needed by high-level managerial dietitians and those in business and communications, and (e) qualities dietitians have aspired to develop for increased competitiveness in the marketplace. Even though the revised Standards of Education have been in place since 1988, recent evaluation of criteria for internship and AP4 admission has shown traditional emphasis on academic performance and the importance of work experience. Success in scientific pursuits has been linked with more than innate intelligence; a drive for success and enthusiasm for learning are also involved. Internships foster mostly technical learning, so development of skills in human and conceptual areas are somewhat lacking. These skills, which have been identified as valuable to employers, need greater development or more consistent identification in the selection and training process. Perhaps serious consideration should be given to applicants for preprofessional programs who have shown leadership qualities through extracurricular activities or who have given themselves the opportunity to develop and improve these skills. Such students might hasten the metamorphosis of dietetics practitioners toward improved levels of compensation and professional fulfillment.

Dietetics↗
PubMed1994

Performance of the vascular physical examination by residents and medical students.

PURPOSE: This study uses an objective structured clinical examination to evaluate the performance and interpretation of the vascular physical examination by interns and medical students. METHODS: A patient with lower extremity arterial occlusive disease findings was examined by 20 third-year students (M3), 23 physicians entering surgical internship (PGY1), and 7 individuals completing internship (PGY2). The test consisted of two sections: part A evaluated the individuals' ability to perform a pulse examination (data gathering); part B evaluated the interpretation of the physical examination findings (data interpretation). National Board of Medical Examiners Part II examination results were obtained for 84% of participants. RESULTS: All groups performed poorly, with overall correct percent scores being 43% (M3), 39% (PGY1), and 62% (PGY2). PGY2s performed significantly better than M3s or PGY1s (p = 0.0002). No statistical difference was noted between M3 and PGY1 scores. Overall, data gathering skills were significantly better than data interpretation skills (51% vs 37%, p = 0.0001). National Board of Medical Examiners Part II scores did not vary substantially among groups. CONCLUSIONS: Interns and medical students demonstrated considerable inaccuracy in both data gathering and data interpretation. A modest improvement was observed in individuals tested at the end of the internship year. This study suggests that increased attention should be directed toward instructing surgical residents and students how to perform an accurate peripheral vascular physical examination and how to interpret its significance.

Arterial Occlusive Diseases↗
PubMed1984

The music therapy clinical intern: performance skills, academic knowledge, personal qualities, and interpersonal skills necessary for a student seeking clinical training.

The music therapy curriculum consists of two distinct parts: the academic phase and the internship. The music therapy student must apply for a clinical internship during the last year of the academic phase, and the student is expected to evolve from student to professional music therapist during the internship phase. The present study sought to determine the skills, knowledge, and qualities clinical training directors considered most important for a prospective intern to possess. The sample population of the survey consisted of 25 clinical training directors from the Great Lakes Region. Results of the survey indicated that piano skills, knowledge of psychology, emotional maturity, and the ability to express needs and feelings were considered most important for the prospective intern to possess.

Great Lakes Region↗
PubMed1975

Minority student success and failure with the National Intern and Resident Matching Program.

Doubts have been raised concerning the success of minority students in obtaining the more desirable teaching hospital internships in the United States. Earlier reports by others indicated that minority graduates may be anywhere from 41 percent to 70 percent successful in obtaining their first, second, or third choice of internship through the National Intern and Resident Matching Program. Ninety percent of those in the sample reported here were successful. At least one minority applicant was a successful intern candidate in 79 out of the 103 institutions where internships had been most sought after by this group. Possible reasons for these different findings are not adequately explained because of a lack of comparable data on minority and nonminority pools; further sample studies are required to establish the actual facts.

Hospitals, Teaching↗
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↗
PubMed1985

Career preferences under conditions of medical unemployment. The case of interns in Mexico.

This article presents a multivariate analysis of the career preferences of 923 Mexican interns. Such preferences were operationalized along two dimensions: type of activity (general/family practice, primary specialties, or subspecialties) and type of institution (public assistance, social security, or private). There were six independent variables: father's occupation, father's education, type of medical school, place of internship, assimilation to the internship hospital, and perception of the medical labor market. The appearance in recent years of unemployment and underemployment among Mexican physicians made labor market issues particularly salient. Thus the study offered an appropriate occasion to test the relative strengths of alternative explanations of career choice that are based on social mobility, professional socialization, or responses to labor market signals. Results obtained through multiple regression revealed that the most important variable in the determination of activity preference was medical school, although the two social origin variables retained the important role of directing students into different schools. With regard to institution preference, the most important factor was shown to be place of internship, as it interacted with the level of assimilation to the hospital. Although perception of the medical labor market was a significant predictor of both dimensions of career preference, the greater importance of the other variables indicated that, even under extreme conditions of medical unemployment, explanations of career choice must go beyond simple models of rational decisionmaking to include the experiences that socialize future physicians into dominant paradigms about medical practice.

Career Choice↗