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At least 1,279 records · Page 71Linked to original sources
PubMed1994

The National Study of Internal Medicine Manpower: XX. The changing demographics of internal medicine residency training programs.

Three annual physician workforce surveys of internal medicine residency programs from 1990-1991, 1991-1992, and 1992-1993 show that changes in the demographic characteristics of internal medicine residents detected in the period 1986-1989 have been sustained; specifically, more women and international medical graduates are entering internal medicine. Women and international medical graduates now compose 32% and 36% of internal medicine trainees, respectively. The percentage of U.S. medical graduates was lower in traditional 3-year (categorical) tracks (64%) and highest in preliminary tracks (1 year of internal medicine leading to another specialty) (87%). Approximately 1500 more first-year residents than positions offered through the National Residency Matching Program were reported in 1992-1993. This suggests that many programs concentrate their recruiting efforts outside the Matching Program. The data also show a continuing high subspecialization rate for residents who complete 3 years of training in internal medicine (approximately 60%), although about one third do not go directly into subspecialty training. We discuss the implications of these findings for the national goal of increasing the number of primary care physicians.

Career Choice↗
PubMed1985

An in-hospital training program in gynecologic laser therapy.

Because of the success of a previous pilot program developed to introduce laparoscopy as a diagnostic and therapeutic tool to residents and attending physicians not previously familiar with the instrument and procedures, a similar program was initiated in laser surgery in gynecology. With a similar format of didactic lectures, journal clubs reviewing the literature on laser surgery and supervision of the attendings learning the procedures, it was thought, the attending could then be certified to perform laser surgery independently and could be used as a teaching resource with other attendings and residents. To date, 15 attendings and 5 senior residents have been so certified. This program is an excellent alternative to laser courses and perhaps a superior method of introducing the instrument and procedure to practicing gynecologists and those in training. Since certification by the Joint Commission of Hospital Accreditation must be obtained, this program allows teaching and certification sessions simultaneously.

Certification↗
PubMed1985

Facial plastic surgery in an otolaryngology training program.

The medical complications and unsatisfactory results of facial plastic surgery performed by residents under close supervision are compared with those of the staff who train them and the literature. In 502 rhinoplasty, rhytidectomy, browlift, blepharoplasty, otoplasty, dermabrasion, and chemical peel procedures, there were no significant differences between the resident and staff operations except that residents required more time to perform the procedure. Operations which might be combined at one sitting should be staged during a resident's early experience with cosmetic surgery.

Face↗
PubMed1989

[A group-based training program. A model for general practice?].

General practice is fully recognized speciality in Norway, and the education is based on a five year programme of training. Part of the training takes place in groups with case meetings and tutorials. Practical skills are not a mandatory part of the programme, but a check list is introduced in order to give each trainee an opportunity to identify his/her level of experience. The article discusses several problems concerning teaching and learning practical procedures in general practice. Two models are presented whereby the trainees can learn procedures from each other.

Education, Medical, Continuing↗
PubMedDate not supplied

A survey of exposure to regional anesthesia techniques in American anesthesia residency training programs.

BACKGROUND AND OBJECTIVES: The American Board of Anesthesiologists and the Residency Review Committee for Anesthesiology do not keep records regarding the individual resident's cumulative exposure to specific peripheral nerve block techniques. Further, little is known about individual trainee confidence in performing regional anesthetic blocks. To improve training and anesthesia practice, such information is necessary. In this nationwide survey, we assessed residents' perceived cumulative regional anesthesia experience and their confidence level. METHODS: A survey was distributed to 42 U.S. residency programs in 22 states. Information collected included the resident's clinical anesthesia (CA) training level, estimated number of regional anesthetics performed, and the resident's confidence level in performing these techniques. Confidence was graded on a 3-point scale, as being very confident (1.0), somewhat confident (2.0), or not confident (3.0). We analyzed the estimated cumulative number and type of blocks performed in relation to training level and confidence level; differences were considered significant when P< .001. RESULTS: The response rate was 67.2% (736/1,096); 32% (n = 232) of responders were CA-3 residents. At all training levels, the number of blocks performed varied widely according to type of block, with spinal and epidural blocks being performed most often at all training levels and sciatic, retrobulbar, and femoral blocks being performed least (median = 0 each for CA-1, CA-2, and CA-3 residents). Confidence was high with frequently performed blocks (spinal and lumbar epidural) and low for those performed less than 10 times per resident. The CA-3 residents reported a cumulative experience with a median (interquartile range) of 100 (50-100) spinal anesthetics and 150 (100-200) lumbar epidural blocks with all residents being very confident. The CA-3 residents completed a median of 20 (10-30) axillary blocks but a median of less than 10 for each of these techniques: intravenous regional anesthesia, ankle, interscalene, femoral, sciatic, and retrobulbar. For interscalene block, 51% of CA-3 residents were not confident; for femoral, 62%; for sciatic, 75%; and for retrobulbar block, 91%, were not confident. CONCLUSIONS: Most CA-3 residents are confident in performing lumbar epidural and spinal anesthesia. However, many are not confident in performing the blocks with which they have the least exposure. Changes need to be made in the training processes so that residents can graduate with enough confidence to continue selecting less familiar blocks in postgraduate practice.

Anesthesia, Conduction↗
PubMedDate not supplied

[Evaluation of a training program for nurses specializing in anesthesia and resuscitation in Cambodia].

Following the signing of a treaty drafted between the Cambodian Ministry of Health, Médecins Sans Frontières, and the universities of Paris Nord and Bordeaux-II, the first class of sixteen nurses completed the training in anesthesia and resuscitation, between September 1991 and June 1993. The training course took into account the special context in which the course was planned and organized. By bringing together the specific skills of non-government organizations and universities, the students obtained high quality professional skills which have become extremely rare in Cambodia, where almost all competent health-care professionals have disappeared. The results of the program were evaluated several months after the graduation. Using quantitative and qualitative methods, evaluators tried to assess if the nurses were able to apply what they had learned, if the course material was relevant, and how well the nurses adapted in terms of actual work, and professional recognition and development. Eight months after graduation, the nurse anesthetists' activities represented approximately 24% of the total activity of the departments in which they worked. Thirteen of the sixteen nurses received significant professional recognition for their responsibilities in the departments, and for their independence in administering anesthesia. The working conditions were satisfactory, and the nurses were able to correctly apply what they had learned and solve many problems. However, because the anesthesia and resuscitation departments were being set up at the time of their arrival, the nurses were not able to fully care for the patients during the pre- and post-operation periods. Objectives for improving the training courses were defined, following a detailed analysis of the results of the study. However, proper supervision of the newly trained nurses remains an essential element in maintaining their competencies and motivation. By 1997, fifty-four people (fourty-five nurses and nine doctors) should be trained in anesthesia and resuscitation. The continuation of the school depends on the possibility of the Cambodians to take charge of the program. For this purpose, two of the graduate nurses began training as teachers in November 1993.

Cambodia↗