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PubMedDate not supplied

Physician personality types in physical medicine and rehabilitation as measured by the Myers-Briggs Type Indicator.

Personality is one variable that correlates with specialty selection and practice type. To test our hypothesis that there has been a change in the personality type of those entering Physical Medicine and Rehabilitation (PM&R) and to identify the academic potential of those in rehabilitation, we invited all residents and graduates of our training program to participate in a study of personality types within PM&R by completing a Myers-Briggs Type Indicator (MBTI). Thirty residents and 48 graduates completed the questionnaire. A wide range of personality types were represented in our sample. The most common types are shared by a number of other people-oriented, primary care specialties. There was a statistically significant difference between residents and graduates on two of the four MBTI indexes, with graduates more introverted (P < 0.05) and judging (P < 0.001) than the present residents. Intuition, previously correlated with research and academic practice, was the dominant process for the majority of graduates and residents. This would confirm, according to type theory, the academic potential of both graduates and residents in our training program.

Emotions↗
PubMed1987

Performance of residents who had academic difficulties in medical school.

An assessment of how well graduates of one medical school performed in residency training was undertaken to assess the school's monitoring of students' performances. The minutes of the school's student progress committee for four years were reviewed to identify all students who had had academic difficulty. Seven students had been recommended for dismissal but ultimately graduated, 22 students were on academic probation for longer than one year, and 22 students were on academic probation for less than one year. The residency performance of 43 of these 51 students were compared with the performances of a randomly selected group of students who had had no academic difficulties and had graduated during the same period. Of 12 performance and knowledge items assessed by the residency directors for the studied graduates, the one dealing with quality of interaction with patients showed significant differences among the residents. The residents who had had academic difficulty had lower ratings on this item than the residents who had not had academic trouble. On all other items, those residents who had had academic difficulties received generally lower scores than the other residents, but the differences were not statistically significant. Of the seven students considered for dismissal, one had been dismissed and one had withdrawn from the residencies; the other five generally received positive ratings from their residency directors. The findings suggest that the medical school's overall monitoring of students' performance was working and confirmed the authors' opinion that each decision concerning a student with academic difficulties should be based on the student's individual situation.

Educational Measurement↗
PubMedDate not supplied

Does academic intervention impact ABS qualifying examination results?

OBJECTIVES: To assess the impact of a focused academic support program on American Board of Surgery In-Training Examination (ABSITE) scores and Qualifying Examination (QE) outcomes. METHODS: A mandatory intervention program was begun in April 2001 for residents with ABSITE Total Test (TT) percentiles <31. Program elements included: 1) individual faculty mentoring and personal learning plan 2) QE videotape review sessions 3) Surgical Education and Self-Assessment Program (SESAP) 4) monthly rotation evaluations, and 5) quarterly status feedback. A free medical evaluation was offered. Mock orals participation, educational psychologist consultation, and voluntary followup mentoring were added later. Study data were reviewed for 2003-2005 Chief Residents including ABSITE scores, QE results, conference attendance, rotation Overall Performance ratings, and resident surgeon case volumes. Results were compared for the academic intervention (AI) and no intervention (NI) groups. RESULTS: Fifteen residents graduated during the study period. Eight residents completed nine interventions; seven returned to TT percentiles >30 (7/8, 88%). First post-intervention ABSITE gains were large compared to NI and national peer groups. Standard Score (SS) TT gains were maintained until residency completion by four AI residents. Median AI PGY-5 TT percentile was 32 and three scores were <or=25. Six AI residents (6/8, 75%) and all NI residents (7/7, 100%) passed the QE on their first attempts. AI and NI groups were similar for conference attendance, rotation evaluations, and operative log totals. CONCLUSIONS: A focused academic support intervention for residents with marginal ABSITE TT percentiles can produce immediate substantial gains. Gains are variably maintained through remaining residency years. PGY-5 TT percentiles <or=25, seen with three AI residents (3/8, 38%), are associated with a 40% first QE failure rate. Therefore, our 75% QE first-time pass rate for AI residents argues for intervention success.

Curriculum↗
PubMed2006

Skin cancer examination teaching in US medical education.

OBJECTIVE: To determine physician preparation for performing the skin cancer examination (SCE). DESIGN: We evaluated medical students' observation, training, and practice of the SCE; hours spent in a dermatology clinic; and self-reported skill level for the SCE by a self-administered survey. PARTICIPANTS: Graduating students at 7 US medical schools during the 2002-2003 academic year. MAIN OUTCOME MEASURES: Percentages of students reporting SCE skill observation, training, and practice. RESULTS: Of 934 students, 659 (70.6%) completed surveys. Twenty-three percent of students had never observed an SCE, 26.7% had never been trained to perform an SCE, and 43.4% had never examined a patient for skin cancer. Only 28.2% rated themselves as somewhat or very skilled in the SCE. This rate dropped to 19.7% among 553 students who had not completed a dermatology elective. Compared with students without training, students who had been trained at least once in the SCE were 7 times more likely to rate themselves as being somewhat or very skilled in the SCE. Sixty-nine percent of students agreed that insufficient emphasis in their medical training was placed on learning about the SCE. CONCLUSIONS: This survey documents the need for more consistent training of medical students in SCE. Even brief curricular additions would augment students' perceived skill levels and improve practice patterns and competencies of future physicians. More frequent and improved SCEs might result in earlier detection of melanoma and nonmelanoma skin cancers by nondermatologists, with significant public health benefits.

Adult↗
PubMed1994

The Health Security Act and academic medicine.

The mission of academic medicine is the production and dissemination of new and useful medical knowledge, and the education and training of practitioners. The authors' position is that the Clinton reform proposal is likely to interfere with the mission of academic medicine in ways that may lead to higher cost and lower quality of health care. It is the authors' opinion that the pressing moral problem of the uninsured and the undertreated can be solved without sacrificing the diversity, creativity, and excellence of American medicine. The most significant improvements in quality of care and reductions in costs of health care delivery arise from scientific discoveries and innovations in practice, and not from direct government control of prices or attempted regulation of quality.

Academic Medical Centers↗
PubMed2006

Integrating the core competencies: proceedings from the 2005 Academic Assembly consortium.

The Accreditation Council for Graduate Medical Education mandated the integration of the core competencies into residency training in 2001. To this end, educators in emergency medicine (EM) have been proactive in their approach, using collaborative efforts to develop methods that teach and assess the competencies. The first steps toward a collaborative approach occurred during the proceedings of the Council of Emergency Medicine Residency Directors (CORD-EM) academic assembly in 2002. Three years later, the competencies were revisited by working groups of EM program directors and educators at the 2005 Academic Assembly. This report provides a summary discussion of the status of integration of the competencies into EM training programs in 2005.

Clinical Competence↗
PubMedDate not supplied

Pediatric hospitalists in Canada and the United States: a survey of pediatric academic department chairs.

OBJECTIVES: To document the prevalence and practice patterns of pediatric hospitalists in academic centers in Canada and the United States; to characterize academic pediatric department chairs' definition of the term hospitalist; and to characterize pediatric department chairs' views of the training requirements for pediatric hospitalists. METHODS: A 14-item questionnaire was sent to all 145 pediatric department chairs from Canada and the United States during the fall of 1998. We defined hospitalists as physicians spending at least 25% of their time in inpatient care. RESULTS: Of the 145 eligible pediatric chairs, 128 (89%) responded (United States, 111/126; Canada, 14/16; Puerto Rico, 3/3). Ninety-nine (77%) of 128 pediatric chairs either have (64/128) or are planning to have (35/128) hospitalists in their institutions. Within academic programs with hospitalists, 82% of hospitalists currently work on general pediatric wards. Two thirds of hospitalists teach, 50% provide outpatient care, 50% have administrative duties, and 44% conduct research. One hundred eight (84%) of 128 believe that hospitalists should spend at least 50% of their time in inpatient care. Less than one third (30%) of pediatric chairs believe that hospitalists require training not currently provided in residency. CONCLUSIONS: A large proportion of academic pediatric centers either employed or planned to employ hospitalists in 1998. Pediatric academic department chairs do not see a need for training beyond residency for hospitalists. Further studies should address how pediatric hospitalists affect quality of care, cost, and patient satisfaction.

Academic Medical Centers↗
PubMed2000

Program directors' perspectives on federally funded fellowship training in primary care research.

PURPOSE: To describe the organization, models of training, and institutional impact of National Research Service Award fellowship programs in primary care research. METHOD: Survey of 25 directors of currently-funded and former training sites. RESULTS: Twenty-four program directors (96%) completed the survey. Programs allocated 39% of fellows' time to course work leading to an advanced degree or other didactic instruction, and 40% of time to the conduct of research. Collaborations with other training programs within the institution occurred at 83% of sites. Programs commonly (54%) or exclusively (42%) relied on a research model of "early research independence" in which the fellow defined an area of research interest, rather than an "apprenticeship" model in which the fellow worked in a senior investigator's research area. These programs enriched the local academic environment, but required extensive financial subsidies. The high costs of training often had adverse impacts on recruitment and other components of the training process. CONCLUSION: Research training programs in primary care often substitute acquisition of advanced degrees for early immersion in research. The "early independence" model of research differs from fellowships in the medical specialties, and requires further study to assess its effectiveness. The need to subsidize training costs poses substantial problems for the institutions that host these fellowship programs.

Attitude of Health Personnel↗
PubMedDate not supplied

A survey of residency management training: general preventive medicine graduates.

General preventive medicine residents at the University of Arizona are introduced to management skills and issues during graduate medical training to prepare them for future administrative positions. Our objectives were to learn whether administration training was effective and if acquired skills are useful in present job duties of graduates. We mailed a questionnaire to former general preventive medicine residents who had graduated between 1983 and 1992. Twenty-one (81.8%) of the 26 graduates returned a completed questionnaire rating the extent to which certain training activities improved administration skills and assessing the extent to which residency training overall prepare them for administrative work. Ratings reflected adequate preparation and usefulness of skills on the job. The survey indicates that administrative training should begin during residency years and that a variety of short-term and long-term activities, organized throughout both academic and practicum years can produce reasonable success in graduates. Medical Subject Headings (MeSH): preventive medicine, training.

Arizona↗
PubMedDate not supplied

Current status of International Emergency Medicine fellowships in the United States.

OBJECTIVE: A consensus panel of Emergency Physicians with experience in international health has published a recommended curriculum for a formal fellowship in International Emergency Medicine. This article reviews the current International Emergency. Medicine (IEM) fellowships available to residency-trained Emergency Physicians in the United States. METHODS: Every allopathic Emergency Medicine (EM) residency program in the United States was contacted via e-mail or telephone. Programs that reported having an IEM fellowship were asked detailed information about their program, including: (1) the number of years the program has been offered; (2) the duration of the program; (3) the number of fellows taken each year; (4) the number of fellowship graduates from each program and their current practice patterns; (5) how the fellowship is funded; and (6) whether a Masters Degree in Public Health (MPH) is offered. RESULTS: All 127 allopathic EM residency programs responded. Eight (6.8%) of these programs offered IEM fellowships. Of a total of 29 graduates identified, 23 (79.3%) were employed in academic medicine. All of the fellowships offered formal public health training and were funded by a combination of clinical billing and project-specific grants and scholarships. All IEM fellowships described a curriculum that reflected the previously published recommendations. CONCLUSION: Opportunities in formal training in international health are increasing for graduates of EM residencies in the United States. The proposed curriculum for IEM fellowships seems to have been implemented and graduates of IEM fellowships seem to be applying their training in international projects.

Curriculum↗
PubMed1999

Academic medical centers: a prescription for success in an era of managed care and capitation.

Academic medical centers (AMCs) have traditionally symbolized technological advancements and specialization in patient care. AMCs are defined as institutions that include at a minimum a hospital and associated clinics and a medical education role. Today, these institutions face a transition to managed care and radical changes in the financing of health care. These issues are not unique to the private sector health care industry. Military AMCs also must respond to many of the same changes. Their survival may rest on the ability to recognize that they can no longer ignore trends favoring lower costs, less specialization, and more primary care. This paper describes actions being taken at AMCs throughout the country to pursue innovative ways of providing accessible, high-quality, and affordable health care while maintaining quality training programs. Besides examining changes currently taking place within the academic medical industry, recommendations are offered for new initiatives.

Academic Medical Centers↗
PubMed2002

Bioinformatics training in the USA.

This paper provides an overview of the history and funding of bioinformatics training in the USA, and summarises some of the challenges and key features associated with bioinformatics training programmes at PhD level. The paper includes compilations of current PhD bioinformatics training programmes and sources of funding.

Academic Dissertations as Topic↗
PubMed1985

An appraisal of goals for residency training in internal medicine.

The goals for residency training in internal medicine were assessed by faculty and house staff members at one university-based program using a 38-item questionnaire based largely upon American Board of Internal Medicine criteria. The respondents rated each item according to its ideal importance, its actual emphasis in training, and the respondents' degree of satisfaction with their own level of accomplishment for that item. Faculty and house staff members shared similar perceptions of ideal goals and actual emphases of training, with both groups rating clinical judgment, gathering data, and formulating problems as the most important. Both groups also tended to rate highly as ideal goals those items that they considered to be their own professional strengths and that reflected their current respective roles in medical training. This trend was the most apparent for faculty members in ratings of academic skills and for house staff members in ratings of technical proficiency and patient management skills. The tendency to idealize one's own professional role and strengths may inhibit needed changes in residency training.

Clinical Competence↗
PubMed1993

Factors influencing the interests, career paths, and research activities of recent graduates from an academic, pediatric residency program.

OBJECTIVE: This study was undertaken to characterize the professional activity of a cohort of young pediatricians who completed an academically oriented residency program, to analyze factors which influenced their interests, career choices, and research activity, and to understand what steps might be effective in attracting more young physicians into academic and research career paths. METHOD: We studied by questionnaire a cohort of 150 pediatric residents from the Children's Hospital in Boston who completed residency training between 1976 and 1981. RESULTS: Questionnaires were returned by 117 (78%) of 150 individuals. Of these, 73% were in academic medicine and 37% were in clinical practice. Individuals were engaged in various activities with a mean of 47% effort in clinical care, 25% effort in administration and teaching, and 28% effort in basic or clinical research. The majority of respondents (71 [61%] of 117) reported at least 10% effort in all three activities. Only 9 (8%) of 117 reported no clinical activity, 8 (7%) of 117 reported no teaching or administrative activity, and 35 (30%) of 117 reported no research activity. Few individuals dedicated more than 50% of their time to research, and none reported a 100% commitment to research. Clinical sources provided 71% of all salary support, research grants 17%, government salaries 7%, and other sources 5%. For most respondents, interest in clinical practice predated medical school, whereas interest in research increased during preclinical training, particularly among those who engaged in research activities. Respondents identified previous research experience as the principle factor enhancing their decision and ability to do research. Factors that adversely influenced their decision or ability to do research included salary expectancy, funding, the perceived competitiveness of academic life, administrative duties, and family responsibilities. CONCLUSIONS: Efforts to encourage more young physicians to enter academic careers should focus on providing research experience during preclinical training and providing long-term support for research which enables physician scientists to maintain their interest and involvement in clinical medicine.

Adult↗
PubMed2005

A compulsory experiential and inter-professional rural health subject for undergraduate students.

CONTEXT: The Australian University Departments of Rural Health (UDRH) program aims to improve the rural workforce through improving rural experiences of undergraduates, graduates and health professionals. The 10 UDRHs vary in the way they implement the UDRH Program. This article describes the development of a compulsory, experiential and inter-professional rural health subject in a medical curriculum by the UDRH at the University of Melbourne, Victoria, Australia. The key concepts, underpinning theory, processes, logistics and resources required to develop and implement the subject among a network of small towns and Indigenous communities are examined. METHODS: METHODS used included formative evaluation using a participatory research approach, including the examination of internal discussion papers, minutes of meetings and planning workshops, financial records and feedback from students, staff and preceptors. ISSUES: Students, staff and preceptors generally accept the value of the rural health module in professional training. However, they stress the need for explicit learning objectives, relevant content and engaging delivery. Students expressed some concern about the compulsory nature of the subject. Significant issues are capacity, quality, sustainability and managing expectations of government and communities. Capacity includes the availability of appropriate placements and preceptors who have the capacity and capability to teach or to be supported to teach. The availability of appropriate and affordable accommodation is important, as are the cost and safety of travel to and from placements. Sustainability of 'placements' and 'placement fatigue' must be managed with a combination of resources and preceptor training and support. Quality of placements is important and highlights a paradox in that, while academically rigorous teaching, research and clinical programs for students and preceptors are important for quality, they are mostly perceived as additional burdens by health service providers. Finally, the expectations and commitment of stakeholders, in particular governments and communities, for student placements must be realistic and backed with resources. LESSONS LEARNED: A compulsory experiential inter-professional subject for undergraduate students is possible but requires significant resources and commitment over the long term. The resources must include funding for: preceptor time, training and support; recruitment and retention of appropriately qualified academic clinicians; intersectoral strategies like improved public transport and safe roads; community and other stakeholder engagement to develop and maintain educational facilities. Last but not least, funding is essential to support the long-term evaluation and monitoring of the outcomes in terms of the quality and quantity of the rural workforce over time.

Australia↗
PubMed2002

Securing the future of nutritional sciences through integrative graduate education.

The new millennium has ushered in unprecedented opportunities for research and discovery in the nutritional sciences. These have arisen from major advancements in the social and biological sciences, notably genetics, genomic technologies, computational statistics, and behavioral sciences. The most exciting academic challenges and employment opportunities for nutritional sciences graduates interface with other disciplines, and doctoral training programs in the nutritional sciences must respond to the wealth of these emerging opportunities. The American Society for Nutritional Sciences (ASNS) Graduate Nutrition Education Committee suggests that three major challenges face the nutritional sciences: (a) to train doctoral students to be full and active participants in interdisciplinary research and discovery, and (b) to achieve this goal while maintaining nutrition's unique academic identity and (c) fostering a cohesive academic community. The committee proposes that these objectives are best engaged at the level of graduate education and that the future of ASNS will be secured by strengthening graduate nutrition programs. This manuscript reviews educational strategies that address these challenges and advocates that ASNS actively engage graduate doctoral programs in nutritional sciences.

Education, Graduate↗
PubMed2002

Results of the 2001 survey of the American Association of Academic Chief Residents in Radiology.

RATIONALE AND OBJECTIVES: The American Association of Academic Chief Residents in Radiology (A3CR2) conducts an annual survey of residency training programs. The survey data allow comparative analyses to be performed among training programs regarding resident education, benefits, clinical demands, and other resident-related issues. MATERIALS AND METHODS: Questionnaires were mailed to all accredited programs registered in the A3CR2 database (150 total programs). The yearly questions address demographic information concerning the individual programs including academic affiliation, number of radiologic examinations performed per resident, changes in the number of residents per program, and financial compensation. The rotating questions, which are revisited every 4 years, focused on preparation for the American Board of Radiology examinations, educational issues, and employment outlook. RESULTS: Completed surveys were received from 55 programs (37.3%). Among the responses, three issues prevailed: (a) increased number of examinations performed per resident, with resultant decrease in educational time, (b) decreased quality of education in all sections of radiology and decreased number of educational conferences, and (c) improved employment outlook, but continued trend of fewer residents choosing a career in academics. CONCLUSION: The current boom in the radiology job market and the increased number of radiologic examinations performed annually appear to adversely affect radiologic education through a decreased number of conferences and an increased number of radiologic examinations performed per resident.

American Medical Association↗
PubMed2000

[Health research in Chile].

An analysis of health research in Chile is made, considering factors like exaggerated professional training during undergraduate studies and clinical residencies, and displacement of professionals from academic activities to more remunerative positions. Additionally, the limited role of the Ministry of Health in research promotion, evidenced by the almost absent participation of public hospitals in clinical research is discussed. Research investment, among a 0.6 to 0.8% of the GNP, is far from developed countries and Chile has not defined relevant health problems where a search effort would have an impact in public health. The marked centralism of the country attempts against regional application to financed projects. The following suggestions are made: to increase the financing for investigation, to reassign resources allowing the access of regional institutions, to financing, to discuss in the Chilean Association of Medical Faculties (ASOFAMECH) the creation of an academic degree by means of a thesis during the professional studies and to give facilities to develop research during clinical residencies. Also, the Ministry of Health should be involved, creating a national agenda or research priorities and increasing its association with Universities. Also training programs for professionals with a special interest in investigation should be devised.

Chile↗