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At least 19 recordsLinked to original sources

[History of medicine and military health service in doctorate's and habilitation theses written in Military Medicine Academy in Lodz-retrospective bibliography against the background of medicine and military medicine bibliographies].

The work introduces the subject of medicine history, military health service history and medicine bibliographies with particular attention to Polish accents. It remembers the beginnings of medicine history education in Poland in the 19th century, in the II Polish Republic and after 1945. It discusses widely the achievements of Military Medicine Academy in the range of medicine history military health service together with bibliography. It points out the necessity of dealing with this subject in didactic and scientific activity of the Academy.

Academic Dissertations as Topic↗

Medical student interest in internal medicine. Initial report of the Society of General Internal Medicine Interest Group Survey on Factors Influencing Career Choice in Internal Medicine.

OBJECTIVE: To determine the factors that attract students toward and push students away from a career in internal medicine. DESIGN: National survey of senior U.S. medical students using a stratified random cluster sampling of medical schools. PARTICIPANTS: The survey included 1650 U.S. senior students from 16 medical schools, of whom 1244 (76%) responded. MEASUREMENTS AND MAIN RESULTS: A survey instrument was developed and pilot tested at 17 medical schools. Twenty-four percent of the respondents to the final survey chose a career in general internal medicine (9%) or subspecialty internal medicine (15%). A career in internal medicine had been "seriously considered" by 608 respondents (50%) who finally chose a career other than internal medicine (the "switchers"). Compared with other specialties, internal medicine was perceived as being more stressful to residents, more demanding of time and workload as a career and a residency, and as an easier residency to enter. Internal medicine was also seen as providing less satisfaction for residents, having lower income potential, and allowing less leisure time. For the 608 switchers, the most important influences leading to their decision to switch were the type of patient seen in internal medicine (for example, chronically ill, alcohol and drug abusing patients) as well as dissatisfaction and stress among internal medicine residents. Factor analysis showed that three factors, "intellectual challenge of internal medicine," "primary care interests," and "the medicine clerkship" attracted students toward internal medicine, whereas three others, "taking care of chronically ill patients," "level of satisfaction among internists and medical residents," and "workload and stress" pushed students away from internal medicine. Factors pushing students away from internal medicine were significantly more negative with regard to a career in general as opposed to subspecialty internal medicine (P less than 0.001). CONCLUSION: Medical students have serious reservations about internal medicine as a career choice. Perceptions about the medical residency, the patients they expect to see, and the dissatisfaction among residents and internists are foremost in their thinking. Changes to improve the attractiveness of internal medicine should address these adverse perceptions while building on the positive influences identified by the respondents.

Career Choice↗

[Interrelationship between folk plant medicine of Arhorchin Mongolian and Mongolian medicine as well as Chinese herbal medicine].

Based on the results of investigation of Arhorchin Mongolian folk medicinal plants and related knowledge system, the present paper discussed the interrelationship between folk plant medicine and Mongolian medicine as well as Chinese herbal medicine by the items of plant species, medicinal parts, treating disease and administering methods. The results show that there are some consistency between folk medicine and Mongolian medicine as well as Chinese herbal medicine, and there are also some other inconsistency. Consistency between folk medicine and Mongolian medicine may be illustrated the fact that the Arhorchin Mongolian folk medicinal knowledge and Mongolian medicine are belongs to same system. Consistency between folk medicine and Chinese herbal medicine are illustrated the fact that knowledge exchange and cultural infiltration between Arhorchin Mongolians and Han nationality. Inconsistency may be illustrated richness and exploration value of folk medicinal knowledge.

China↗

The impact of an ambulatory rotation on medical student interest in internal medicine. The Society of General Internal Medicine Task Force on Career Choice in Internal Medicine.

OBJECTIVE: To determine whether students who take ambulatory rotations in internal medicine are more likely to choose internal medicine careers. DESIGN: National survey. SETTING AND PARTICIPANTS: The intended sample was 1,650 senior U.S. medical students from 16 medical schools, of whom 1,244 (76%) responded. Representative schools nationwide were selected using a stratified, random-sampling method. MEASUREMENTS: The questionnaire asked about characteristics of the ambulatory rotation, perceptions of internal medicine, and factors influencing students toward or away from an internal medicine career. RESULTS: Ambulatory rotations were taken by 543 students (43%). Of these rotations, 73% were required, 74% were during the fourth year, 77% were in general internal medicine, 73% provided continuity of care, and 19% were during the medicine clerkship. Overall, 24% of the students chose careers in general (9%) or subspecialty internal medicine (15%). Thirty percent of the students who did ambulatory rotations planned internal medicine careers, compared with 19% of the students who had no rotation [odds ratio (OR) = 1.8, 95% confidence interval (CI) 1.3 to 2.4, p = 0.0001]. This association was of similar magnitudes for students completing required rotations (OR = 1.6, 95% CI 1.2 to 2.2, p = 0.002) and for students completing rotations before or in proximity to when they chose careers (OR = 1.7, 95% CI 1.1 to 2.4, p = 0.01). Ninety percent of the 543 students who had ambulatory rotations were satisfied with the experience. Thirty-eight percent of the highly satisfied students chose internal medicine careers, compared with 21% of the students who had low or moderate satisfaction (p = 0.0001). CONCLUSIONS: An ambulatory rotation is strongly associated with positive perceptions of, attraction to, and choice of a career in internal medicine. Research is needed to determine specific components of an effective rotation. Further development of ambulatory rotations could help attract more students to internal medicine.

Adult↗

[Investigation of radiation safety management of nuclear medicine facilities in Japan; contamination of radioactivity in the draining-water system. A Working Group of Japanese Society of Nuclear Medicine for the Guidelines of Nuclear Medicine Therapy].

Radiation safety management condition in Japanese nuclear medicine facilities were investigated by the questionnaire method. The first questionnaire was asked in all Japanese 1,401 Nuclear Medicine facilities. Answers from 624 institutes (44.5%) were received and analyzed. The radiation-safety management in nuclear medicine institutes was considered to be very well performed everyday. Opinion for the present legal control of nuclear medicine institutes was that the regulation in Japan was too strict for the clinical use of radionuclides. The current regulation is based on the assumption that 1% of all radioactivity used in nuclear medicine institutes contaminates into the draining-water system. The second questionnaire detailing the contamination of radioactivity in the draining-water system was sent to 128 institutes, and 64 answers were received. Of them, 42 institutes were considered to be enough to evaluate the contamination of radioactivity in the draining-water system. There was no difference between 624 institutes answered to the first questionnaire and 42 institutes, where the radioactivity in the draining-water system was measured, in the distribution of the institute size, draining-water system equipment and the radioactivity measuring method, and these 42 institutes seemed to be representative of Japanese nuclear medicine institutes. Contamination rate of radioactivity into the draining system was calculated by the value of radioactivity in the collecting tank divided by the amount of radionuclides used daily in each institute. The institutes were divided into two categories on the basis of nuclear medicine practice pattern; type A: in-vivo use only and type B: both in-vivo and in-vitro use. The contamination rate in 27 type A institutes did not exceed 0.01%, whereas in 15 type B institutes the contamination rate distributed widely from undetectable to above 1%. These results indicated that the present regulation for the draining-water system, which assumed that 1% of all radioactivity used in nuclear medicine institutes contaminated into draining-water system, should be reconsidered in nuclear medicine facilities where radionuclides are used only in in-vivo studies.

Health Facilities↗

The attractiveness of internal medicine: a qualitative analysis of the experiences of female and male medical students. Society of General Internal Medicine Task Force on Career Choice in Internal Medicine.

OBJECTIVE: To understand better the decline in medical student interest in internal medicine. DESIGN: Qualitative analysis of 500 essays from respondents who participated in a national survey of graduating medical students from the class of 1990 in 16 medical schools. Medical students were asked the open-ended question, "What suggestions do you have for improving the attractiveness of internal medicine?" A model of career choice was developed for the analysis that included the following factors: ambulatory care exposure and primary care (including relationships with patients); attending physician-student interactions and learning climate; stress and workload; income and prestige; and intellectual stimulation. PARTICIPANTS: The original survey included 1650 fourth-year medical students; 500 essay respondents were stratified by sex and then randomly chosen for the analysis. RESULTS: Students most frequently suggested that ambulatory care experiences be increased and that better relationships with patients be established during medical training (65% of women and 50% of men, P < 0.01). The second most frequent suggestion was to improve internal medicine attending physicians' interactions with students (51% and 48% of women and men, respectively). Students who had seriously considered a career in medicine but switched to other primary care careers (general pediatrics, family medicine) had few concerns about income and prestige, whereas those who chose internal medicine had reservations about expected workload and income. Women were more likely than men to reject internal medicine for other primary care fields (26% of women compared with 16% of men, P = 0.05). CONCLUSIONS: Students, particularly female students, expressed a strong interest in establishing better relationships with patients. Lack of respect by medical attendings and negative teaching methods were important sources of dissatisfaction among both men and women. Attention to these relationship issues, in addition to housestaff stress and expected future income, may improve the attractiveness of internal medicine.

Adult↗

European Society of Intensive Care Medicine statement: intensive care medicine in Europe--structure, organisation and training guidelines of the Multidisciplinary Joint Committee of Intensive Care Medicine (MJCICM) of the European Union of Medical Specialists (UEMS).

This article describes the structures and institutions in the European Union by which professional training and qualification in medical specialities will be harmonised. All main medical specialities are represented in the European Union of Medical Specialists (UEMS) by speciality sections. For intensive care medicine, as a multidisciplinary speciality, a new structure of a Multidisciplinary Joint Committee of Intensive Care Medicine (MJCICM) within the UEMS was established in 1999. In this MJCICM the European Society of Intensive Care Medicine and the European Society of Paediatric and Neonatal Intensive Care are represented by delegates without voting capacity in a Standing Advisory Board. Statements and recommendations which the MJCICM has worked out until now are presented: Definitions of intensive care medicine, structural conditions for education and training, continuing medical education, criteria for accreditation of intensive care medicine training centres, common core curriculum for optional specialist training in intensive care medicine, as well as an intensive care units accreditation visiting programme and standards for medical treatment and nursing care.

Accreditation↗

AAEM, CORD, and SAEM reach a landmark position: consensus recommendations to the Federation of State Medical Boards (FSMB) for revisions to the FSMB May 1998 policy statement on physician licensure. American Academy of Emergency Medicine. Council of Emergency Medicine Residency Directors. Society for Academic Medicine.

As a result of months of meetings and deliberations coordinated with the Medical Board of California and chaperoned by the California Chapter of the American Academy of Emergency Medicine (CAL/AAEM), the Society for Academic Medicine (SAEM), the Council of Emergency Medicine Residency Directors (CORD), and the American Academy of Emergency Medicine (AAEM) recently reached a landmark agreement on recommendations to the Federation of State Medical Boards (FSMB) pertaining to controversial May 1998 FSMB recommendations regarding physician licensure. Endorsed unanimously by the boards of all three emergency medicine (EM) organizations, the recommendations of this consensus have been forwarded to the FSMB and await its official response. The recommendations will also be forwarded to remaining EM organizations and to the medical community for comment and to enlist their support.

California↗

The future of general internal medicine. Council on Long Range Planning and Development in Cooperation with the American College of Physicians, the American Society of Internal Medicine, and the Society of General Internal Medicine.

The American Medical Association Council on Long Range Planning and Development has been publishing a series of reports that assess trends in the environment of medicine and their impact on physicians and health care provision. The Council believes that each specialty in medicine has unique characteristics and will respond differently to changes in the health care arena. This report, developed in cooperation with the American College of Physicians, the American Society of Internal Medicine, and the Society of General Internal Medicine, provides an overview and environmental analysis of the specialty of general internal medicine. The Council first reviews socioeconomic data pertinent to general internal medicine. This is followed by a review of key issues pertinent to internists that relate to such topics as graduate medical education, reimbursement, scope of practice, manpower, and competition. In the conclusions, the Council suggests activities for the medical profession to pursue in response to the identified environmental trends.

Adult↗

Clinical practice in academic medical center departments of family medicine. The Association of Departments of Family Medicine Task Force on Clinical Practice in US family medicine departments in academic medical centers.

BACKGROUND AND OBJECTIVES: Conducted by a task force of the Association of Departments of Family Medicine, this study defines current issues in the clinical practice of academic departments of family medicine in US medical schools. METHODS: A survey instrument on departmental demographics, funding, teaching, and governance in regard to clinical practice was sent to 130 family medicine department chairs or other key contacts in US medical schools. A total of 106 usable responses were obtained, for an 81.5% response rate. RESULTS: Results indicate that, in response to a need to increase clinical practice income, academic medical centers (AMCs) and departments are increasingly hiring physician faculty for positions that mainly involve patient care, although at salaries less than the community level. In spite of increasing departmental responsibilities in predoctoral and resident education and clinical practice, much teaching is done by community physicians. There is significant purchasing of community practices and growing involvement of the AMCs in the practice activities of departments. Two thirds of clinical chairs reported "pretty good" to "great" satisfaction on a five-point scale. CONCLUSIONS: Departments of family medicine are increasing their practice activities, perhaps to the detriment of teaching and research. The clinical practice autonomy of departments of family medicine is being diluted by increased institutional control and by mergers with the practices of other primary care disciplines. These changes give rise to a reasonable concern that academic departments of family medicine and their faculty may give up control of their clinical practice and lose their identity through conversion to "generic" primary care departments and providers.

Academic Medical Centers↗

[The patient and medicine in contemporary Kazakhstan, attitudes towards bio-medicine and complementary medicine].

The article discusses society's attitudes towards bio-medicine and complementary medicine in Kazakhstan around the end of the 20th century. It presents the transformation of the health-care system in independent Kazakhstan and its influence on the health situation of the population as well as public opinion on bio-medicine. Presented is a broad spectrum of various fields of complementary medicine which achieved great popularity especially during the 1990s. Among the reasons for that growing popularity appears to be public disenchantment with the collapsing state health-care system which is costly and ineffective. At the same time, an important factor is the durability of traditional beliefs of a magical type which is behind the wide use of nonconventional magic-religious practices -- spells and prayers. Overall public socio-economic malaise and a fear of the future are conducive to a general increase of interest in mystical beliefs and occult practices as well as a paranormal phenomena, and the flourishing of complementary medicine naturally fits into that scheme.

Biological Science Disciplines↗

Need and Demand for Oral Medicine Services in 1996. A report prepared by the Subcommittee on Need and Demand for Oral Medicine Services, a subcommittee of the Specialty Recognition Committee, American Academy of Oral Medicine.

The need and demand for oral medicine services in the United States and Canada was determined by a prospective survey of American Academy of Oral Medicine practitioners who attended the Academy's 1996 annual meeting. Of the 50 surveys returned from 149 eligible registrants, it was determined that, on the average, oral medicine practitioner respondents practiced 2.3 days per week and treated 8.7 patients per day; this amounts to more than 40,000 patient-care visits per year. Almost 90% of patients were treated because of medically compromising conditions, oral mucocutaneous disease, or chronic orofacial pain. Most of the care (52%) was provided in non-university settings. Most treatment involved the comprehensive evaluation of complex oral problems (36.7%), the prescription of medications (24.2%), or comprehensive dental treatment (21.8%) for patients with severe and life-threatening medical conditions. These results suggest that oral medicine services are needed and that demand for these services is high.

Adolescent↗

Academic emergency medicine's future. The SAEM Task Force on Emergency Medicine's Future. Society for Academic Emergency Medicine.

Emergency medicine (EM) will change over the next 20 years more than any other specialty. Its proximity to and interrelationships with the community, nearly all other clinicians (physicians and nonphysicians), and scientific/technologic developments guarantee this. While emergency physicians (EPs) will continue to treat both emergent and nonemergent patients, over the next decades our interventions, methods, and place in the medical care system will probably become unrecognizable from the EM we now practice and deliver. This paper, developed by the Society for Academic Emergency Medicine (SAEM) Task Force on Academic Emergency Medicine's Future, was designed to promote discussions about and actions to optimize our specialty's future. After briefly discussing the importance of futures planning, it suggests "best-case," "worst-case," and most probable future courses for academic EM over the next decades. The authors predict that EPs will practice a much more technologic and accurate form of medicine, with diagnostic, patient, reference, and consultant information rapidly available to them. They will be at the center of an extensive consultation network stemming from major medical centers and the purveyors of a sophisticated home health system, very similar to or even more advanced than what is now delivered on hospital wards. The key to planning for our specialty is for EM organizations, academic centers, and individuals to act now to optimize our possible future.

Academic Medical Centers↗

National curricular guidelines for third-year family medicine clerkships. The Society of Teachers of Family Medicine (STFM) Working Committee to Develop Curricular Guidelines for a Third-Year Family Medicine Clerkship.

In most U.S. medical schools, required clerkships in internal medicine, pediatrics, surgery, obstetrics and gynecology, and psychiatry are considered the core components of a student's clinical education. Because the specialty of family practice is not as well established in the medical school curriculum, the federal government is interested in promoting the specialty as part of its continuing efforts to increase the number of primary care physicians. Therefore, in August 1989 the Division of Medicine, Bureau of Health Professions, United States Department of Health and Human Services, awarded a purchase order to the Society of Teachers of Family Medicine to develop curricular guidelines for third-year family medicine clerkships. The authors represent the working committee that developed these guidelines. This paper describes the process used to develop the core curricular guidelines, presents the product of the curriculum development activities, and discusses dissemination, implementation, and further development activities.

Clinical Clerkship↗