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PubMed1984

The Maryland plan for recruiting psychiatrists into public service.

A joint initiative by the University of Maryland and the Maryland Mental Hygiene Administration succeeded in recruiting 116 university-trained psychiatrists into state employment in a period of 7 years. The program emphasizes the creation of an academic environment in state treatment facilities, integration of university and state residency training programs, part-time faculty status for state psychiatrists, and rapid promotion of talented young psychiatrists to positions of authority. The program has been successfully implemented at no cost to either the university or the state.

Foreign Medical Graduates↗
PubMedDate not supplied

The training and careers of regional anesthesia fellows--1983-2002.

BACKGROUND AND OBJECTIVES: The education and subsequent careers of regional anesthesia fellows have not been examined but may provide insight into improving future fellowship training and/or the future of the subspecialty. METHODS: Regional anesthesia fellows educated during a 20-year period (1983-2002) were asked to complete a comprehensive survey that detailed their training, current professional setting, and use of regional anesthesia, and how they foresee the future of regional anesthesia. A separate survey of academic anesthesiology chairs assessed the role of and need for regional anesthesiologists in teaching departments. RESULTS: Twelve regional anesthesia fellowship programs in the United States and Canada provided contact information on 176 former fellows. The survey response rate from those practicing in North America was 49% (77/156). Two of the 12 responding institutions have trained 68% of regional anesthesia fellows. Of respondents, 61% are or have been in academic practice. Regional anesthesia remains an integral part of most respondents' current practice, as evidenced by significant use of regional techniques, active involvement in subspecialty societies, and participation in continuing medical education programs. Academic chairs indicate that fellowship-trained regional anesthesiologists play important roles in resident education and are in demand by academic departments. CONCLUSIONS: This report details how regional anesthesia fellows from 1983 to 2002 were trained and how they currently practice and examines their insights regarding the strengths and weaknesses of past and future regional anesthesia education.

Adult↗
PubMed1996

Neurosurgery workforce in Canada, 1996 to 2011. Canadian Neurosurgical Society.

OBJECTIVE: To determine the number of neurosurgeons in clinical practice in Canada on Jan. 1, 1996, and their practice profile and to determine requirements for 2001 and 2011. DESIGN: Telephone survey and national mail survey. SETTING: Canada. PARTICIPANTS: All 174 neurosurgeons in Canada engaged in active clinical practice on Jan. 1, 1996, and all residents enrolled in neurosurgery training programs in Canada during the 1995-96 academic year. OUTCOME MEASURES: Demographic characteristics, full-time equivalents, workload, attrition, reasons for exit, vacancies, supply and shortfall. RESULTS: All 174 neurosurgeons responded to the survey. There is a chronic shortage of 25 neurosurgeons in Canada. Sixty-two established neurosurgeons will have stopped practice by 2001 and 181 by 2011. They will need to be replaced, for a total requirement of 87 and 206 neurosurgeons by 2001 and 2011 respectively. Canadian neurosurgery training programs can currently generate only up to 69 and 177 graduates by 2001 and 2011 respectively. During the period 1985-95, 50% of neurosurgery graduates emigrated from Canada within 2 years of obtaining certification, creating potential deficits of up to 52 and 117 neurosurgeons by 2001 and 2011 respectively. CONCLUSIONS: Strategies need to be developed quickly to address not only the chronic shortfall but also the attrition of established neurosurgeons. Strategies to increase and retain the number of Canadian neurosurgery graduates are also needed.

Adult↗
PubMed1998

Emergency nurse practitioner services in major accident and emergency departments: a United Kingdom postal survey.

OBJECTIVE: To establish the current and predicted distribution of formal emergency nurse practitioner services in major accident and emergency departments in the United Kingdom; to determine organisational variations in service provision, with specific reference to funding, role configuration, training, and scope of clinical activity. METHODS: Postal survey of senior nurses of all major accident and emergency departments in the United Kingdom (n = 293) in May/June 1996. RESULTS: There were 274 replies (94% response rate): 98 departments (36%) provided a formal service; a further 91 departments (33%) reported definite plans to introduce a service by the end of 1996; smaller departments, under 40000 new patient attendances annually, were less likely to provide a service than busier units (p < 0.001, chi2 for trend). Three different methods of making the role operational were identified: dedicated, integrated, and rotational. Only 16 (18%) were able to provide a 24 hour service; 91 departments (93%) employed emergency nurse practitioners who had received specific training, but wide variations in length, content, and academic level were noted; 82 departments (84%) authorised nurse practitioners to order x rays independently, but only 35 (36%) allowed them to interpret radiographs; 67 (68%) permitted "over the counter" drug supplying under local protocol, and 52 (54%), "prescription only" drug supplying from an agreed list. CONCLUSIONS: Formal emergency nurse practitioner services are provided in all parts of the United Kingdom, with predicted figures suggesting a rapidly accelerating upward trend. Wide variations in service organisation, training, and scope of activity are evident.

Chi-Square Distribution↗
PubMed1993

Patient mix in the primary ambulatory care clinics of an academic medical center.

BACKGROUND: The authors wished to learn whether the primary ambulatory care clinics of a university hospital had a sufficiently diverse patient mix for training in common medical problems. METHOD: Claims data for all the ambulatory care clinics at the University of Illinois Hospital from June 1989 through June 1990 were examined for principal diagnoses. The diagnoses were grouped into common ambulatory care diagnosis clusters. The frequencies of the clusters were compared with the national frequencies from the National Ambulatory Medical Care Survey of 1989. RESULTS: Only eight of 25 leading clusters nationally were seen with frequencies greater than 1% in the hospital's primary care clinics (i.e., family practice, general internal medicine, general pediatrics). This number increased to 22 when the clinics of other specialties were included. CONCLUSION: To create an appropriate patient mix for training medical students and residents in ambulatory care, the university hospital examined in this study could supplement the use of its primary care clinics with the use of clinics in other specialties. This may be a less expensive and administratively less complex alternative to using off-campus private practices for such training.

Academic Medical Centers↗
PubMed1993

Radiologists' perception of professional journals.

RATIONALE AND OBJECTIVES: We assessed radiologists' perceptions of radiologic and general medical journals. METHODS: Five thousand randomly chosen radiologists (4,200 American College of Radiology (ACR) members and 800 members in training) were surveyed by mail concerning their opinion of selected radiology and major medical journals. The mail survey was followed up by a phone survey of 45 previously unsurveyed radiologists from a smaller list of a similar ACR population. RESULTS AND CONCLUSIONS: Of the 5,000 surveys mailed out, 987 (20%) were completed and returned. There were no systematic differences in the questionnaire results between those surveyed by phone and those surveyed by mail. In general, academic radiologists, private practice radiologists, and radiologists in training did not differ in their assessment of professional journals. The respondents picked Radiology as their first choice if they were allowed to read only one journal. The respondents believed that Radiology published the best clinical research and Investigative Radiology the best basic science research. American Journal of Roentgenology (AJR), Radiology, and Journal of Computer Assisted Tomography ranked highest for sureness and rapidity of manuscript acceptance and publication, while Radiology, New England Journal of Medicine, and the Journal of the American Medical Association ranked highest in terms of exposure and prestige.

Attitude of Health Personnel↗
PubMed1997

Academic medicine under managed care.

Academic gastroenterology is at a crossroads. If academic gastroenterologists are to survive and thrive in this era of managed care, they must develop innovative means of funding teaching and research. This funding can be accomplished while adapting to and embracing managed care. Academic gastroenterologists need to work closely with managed care in developing novel means of training fellows and focusing research on outcomes (both clinical and economic). At the same time, academic gastroenterologists have to compete in the marketplace for patient care revenue as a funding source. This competition requires a concerted effort to improve efficiency in academic practice and is likely to result in less time devoted exclusively to research and teaching. Increased clinical practice can also result in enhanced clinical research opportunities, however, as well as an ability to expand teaching in an ambulatory setting. It is clear that managed care will not adapt to academic gastroenterologists. If academic gastroenterologists are to maintain their preeminence in medical education and research, they must adapt to a managed care world.

Academic Medical Centers↗
PubMed2003

Nonsurgical sports medicine training in the United States: a survey of sports medicine fellowship graduates.

OBJECTIVE: To survey graduates of nonsurgical sports medicine fellowship training programs about the quality and content of their educational curriculum. DESIGN: Survey. PARTICIPANTS: Participants were year 2000 active members of the American Medical Society for Sports Medicine (AMSSM) and American Osteopathic Academy of Sports Medicine (AOASM) and all other attendees at the 2000 AOASM and AMSSM annual meetings. The survey also was sent to candidates sitting for the 1999 CAQ examination from the American Board of Family Practice, American Board of Internal Medicine, American College of Emergency Physicians, and American Academy of Pediatrics. RESULTS: A total of 1608 surveys were distributed; 612 were returned for a return rate of 43%. Of respondents, 294 were fellowship trained, and 318 considered themselves to be sports medicine physicians but were not fellowship trained. Sections of the survey completed only by fellowship-trained physicians and focusing on training curriculum are reported in this article. Categories of survey questions included clinical experience, curriculum, academic activities, research, teaching experiences, primary care skills, procedures, types of athletes seen during training, supervision, and benefits. General attitudes about fellowship training also were surveyed: 99% of graduates were satisfied with their training and would do a fellowship again, and 98% felt they their training prepared them for a career in sports medicine. Orthopaedic experiences and physical examination skills were rated the highest. Research experience, work with disabled athletes, and selected areas of nonorthopaedic medical training, such as sports ophthalmology and sports psychology, were rated the lowest. CONCLUSIONS: Overall, fellowship training in sports medicine seems to be satisfactory to fellowship graduates. Strengths and weaknesses in training programs were identified.

Attitude of Health Personnel↗
PubMed2001

Promoting education, mentorship, and support for pediatric research.

Pediatricians have an important role to play in the advancement of child health research and should be encouraged and supported to pursue research activities. Education and training in child health research should be part of every level of pediatric training. Continuing education and access to research advisors should be available to practitioners and academic faculty. Recommendations to promote additional research education and support at all levels of pediatric training, from premedical to continuing medical education, as well as suggestions for means to increase support and mentorship for research activities, are outlined in this statement.

Career Choice↗