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Senior medical student "Boot Camp": can result in increased self-confidence before starting surgery internships.

OBJECTIVE: Surgical residents often begin the internship without prerequisite skills necessary for appropriate patient care. The purpose of this study was to develop a surgical internship readiness elective or senior medical student (SMS) "Boot Camp" for fourth-year medical students to prepare them for the rigors of surgery internship. DESIGN: Sixteen fourth-year medical students completed a series of clinical and didactic sessions over a 4-week elective. Students evaluated the effectiveness of the elective with a pre- and post-survey that focused on confidence levels in 4 areas: anatomic dissection, administrative skills, technical skills, and patient management. Students also participated in a focus group session that identified strengths and weaknesses of the elective. Students were also assessed on performance by anesthesiology faculty in the mock patient code and by nursing faculty in mock nursing page sessions. RESULTS: Upon completion of the elective, students rated themselves as more confident in all 57 categories on the survey. During the focus group session, students identified several strengths of the elective and offered recommendations for improvements in the elective. CONCLUSION: The SMS "Boot Camp" gave fourth-year medical students confidence and an opportunity to develop necessary prerequisite skills to begin the surgery internship.

Adult↗

Interns.

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Humans↗

The implementation of postgraduate training programs through state and local resources.

A profile of implementation strategies for funding postgraduate training programs using local or state resources is described. The need for those implementation strategies as well as basic principles for successful implementation is documented. Two programs are briefly described--a University Affiliated Program (UAP) in western New York and a UAP in Missouri--as the basis for generating implementation strategies. Finally a discussion is provided reviewing the strengths and weaknesses of these strategies.

Developmental Disabilities↗

Managing health services organizations with an educational mission: the case of Canada.

Teaching hospitals represent a major segment of the Canadian health system, accounting for a disproportionate number of beds, patient days, and separations. Thus, although only six percent of hospitals are classified as teaching hospitals, they are responsible for about 36 percent of total hospital operating expenses. While affiliation with a medical school presents unique opportunities for the teaching hospital and increases its prestige, there are clear costs associated with affiliation. Administrators have less control over resource allocation decisions, including the types of teaching programs offered. Teaching hospitals cannot unilaterally design their own teaching programs around specialties and subspecialties of their own choosing; decisions related to teaching programs have a direct impact on the services provided by the hospital and may negatively affect the hospital's ability to fulfill its patient care mission. As education budgets are constrained, teaching hospitals are expected to assume outstanding teaching-related expenses. Teaching hospitals are also expected to shift some of their teaching to alternative settings, such as the community. Thus, teaching hospital administrators will require a strong background in finance as well as negotiation and political skills.

Budgets↗

INTERN year.

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Humans↗