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Graduate medical education

Patrick T Delaplain, Victor C Joe
The current system of burn care delivery attempts to meet the needs of the nearly 500 000 patients in the United States who require medical treatment annually. However, specialization of care and lack of fundamental burn and wound care knowledge among graduating medical trainees has unintended consequences, leaving the system inefficient, with inherent inequities in care delivery and with the potential to be overwhelmed in a mass casualty event. While increasing accessibility to specialty burn centers through technology could mitigate some of these problems, increased education is more practical...
June 1, 2018: AMA Journal of Ethics
Vendhan Gajalakshmi, Ben Lacey, Vendhan Kanimozhi, Paul Sherliker, Richard Peto, Sarah Lewington
BACKGROUND: The association between cause-specific mortality and body-mass index (BMI) has been studied mainly in high-income countries. We investigated the relations between BMI, systolic blood pressure, and mortality in India. METHODS: Men and women aged 35 years or older were recruited into a prospective study from the general population in Chennai, India between Jan 1, 1998, and Dec 31, 2001. Participants were interviewed (data collected included age, sex, education, socioeconomic status, medical history, tobacco smoking, and alcohol intake) and measured (height, weight, and blood pressure)...
July 2018: Lancet Global Health
Barbara F Brandt, Simon Kitto, Ronald M Cervero
The National Collaborative for Improving the Clinical Learning Environment (NCICLE) is a growing group of over 40 organizations representing a variety of health professions. NCICLE is beginning a discussion of issues related to culture in health care, specifically how the current culture inhibits optimal outcomes, and the discordance between current early interprofessional education (IPE) curricula in health professions schools and traditional practice models in health care. In October 2017, the Accreditation Council for Graduate Medical Education and the Josiah Macy Jr...
June 12, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Roger Strasser, Hoi Cheu
OBJECTIVE: To explore the Northern Ontario School of Medicine (NOSM) student and graduate experience of generalism in rural practice, in the context of a growing discourse on generalism. DESIGN: Qualitative analysis. SETTING: Northern Ontario School of Medicine in multiple sites across northern Ontario, which is the NOSM campus. PARTICIPANTS: A total of 37 graduating medical students and 9 practising NOSM graduates. METHODS: The Centre for Rural and Northern Health Research and NOSM tracking studies use mixed methods drawing on data from various sources...
June 2018: Canadian Family Physician Médecin de Famille Canadien
Elizabeth Armitage-Chan, Stephen A May
Professional studies teaching in medical and veterinary education is undergoing a period of change. Traditional approaches, aiming to teach students professional values and behaviors, are being enhanced by curricula designed to support students' professional identity formation. This development offers the potential for improving student engagement and graduates' mental well-being. The veterinary professional identity associated with emotional resilience and success in practice incorporates complexity in professional decision making and the importance of context on behaviors and actions...
June 13, 2018: Journal of Veterinary Medical Education
Abigail S Cohen, Saef Izzy, Monisha A Kumar, Cara J Joyce, Stephen A Figueroa, Matthew B Maas, Christiana E Hall, David L McDonagh, David P Lerner, Paul M Vespa, Lori A Shutter, Eric S Rosenthal
OBJECTIVE: To define expectations for neurocritical care (NCC) core competencies vs competencies considered within the domain of other subspecialists. METHODS: An electronic survey was disseminated nationally to NCC nurses, physicians, fellows, and neurology residents through Accreditation Council for Graduate Medical Education neurology residency program directors, United Council for Neurologic Subspecialties neurocritical care fellowship program directors, and members of the Neurocritical Care Society...
June 12, 2018: Neurology
Xiaoxi Feng, Jennifer Colvin, Judith French, Jane Wey
OBJECTIVE: There is no standardized method of communication regarding the arrival of outside hospital (OSH) transfers at our institution. We utilized quality improvement methodologies to enhance sign-out, benefiting both resident workflow and patient care. DESIGN: A dynamic census log of pending OSH transfers was created. Total number of OSH transfers (with or without prior notification), time to admission orders, and resident self-reported preparedness in receiving/triaging OSH admissions were measured before and after implementation of the census log tool...
June 7, 2018: Journal of Surgical Education
Dominique Waterval, Janneke M Frambach, Stephen M Scott, Erik W Driessen, Albert J J A Scherpbier
BACKGROUND: The past decade has witnessed an upsurge in medical curriculum partnerships established across national boundaries to offer students at the foreign institution (host) a learning experience comparable to that of students at the exporting institution (home). However, since the learning environments and national healthcare contexts differ greatly between institutions, concerns have been raised in the literature about potential low quality of curriculum delivery, inadequate preparation of students to practice in the host country healthcare setting, and a culture shock for host students having to study a home curriculum...
June 7, 2018: BMC Medical Education
Fiona Patterson, Paul A Tiffin, Safiatu Lopes, Lara Zibarras
CONTEXT: Differential performance in postgraduate examinations between home medical graduates and those who qualified outside their country of practice is well recognised. This difference is especially marked in the practical component of the UK Membership of the Royal College of General Practitioners (MRCGP) examination. The potential causes of such disparities are not well understood. METHODS: Data were available for 1874 international medical graduates who applied for general practice (GP) specialty training in the UK in 2008-2012...
July 2018: Medical Education
Monica Bhutiani, Patrick M Jablonski, Jesse M Ehrenfeld, Matthew D McEvoy, Leslie C Fowler, Jonathan P Wanderer
BACKGROUND: The Accreditation Council of Graduate Medical Education requires monitoring of resident clinical and educational hours but does not require tracking daily work patterns or duty hour equity. Lack of such monitoring may allow for inequity that affects resident morale. No defined system for resident relief of weekday operating room (OR) clinical duties existed at our institution, leaving on-call residents to independently decide daily relief order. We developed an automated decision support tool (DST) to improve equitable decision making for clinical relief and assessed its impact on real and perceived relief equity...
June 5, 2018: Anesthesia and Analgesia
Pilar Ortega
Patient-physician language discordance within the growing Spanish-speaking patient population in the United States presents a significant challenge for health systems. The Civil Rights Act, an Executive Order, and federal standards establish legal requirements regarding patients' legal right to access medical care in their language of origin and to culturally and linguistically appropriate services, and national competency standards for undergraduate and graduate medical education and licensing examinations support the importance of patient-physician communication...
June 5, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
A J Mighell, C Freeman, P A Atkin, J H Bennett, J A G Buchanan, M Carrozzo, A J Crighton, M P Escudier, J Gibson, C M Healy, A M Hegarty, J S Kerr, C E McCreary, M N Pemberton, B Rajlawat, A Richards, K Staines, E D Theaker, A Willis
INTRODUCTION: Oral Medicine focuses on care for patients with chronic, recurrent and medically related disorders of the orofacial region that are distinct from diseases of the periodontal and tooth tissues, with an emphasis on non-surgical management. At present, there are no shared outcomes for Oral Medicine to define the standards to be achieved before new graduates become registered dentists engaged with ongoing professional development. CURRICULUM: We present a consensus undergraduate curriculum in Oral Medicine agreed by representatives from 18 Dental Schools in the United Kingdom and Republic of Ireland...
June 6, 2018: European Journal of Dental Education: Official Journal of the Association for Dental Education in Europe
Jie Ming Nigel Fong, Yeong Tze Wilnard Tan, Andrew Arjun Sayampanathan, Niraj Mohan, Yun Qing Koh, Jin Hao Justin Jang, Jin Rong Ivan Low, Anupama Vasudevan, Chew Lip Ng, Paul Ananth Tambyah
INTRODUCTION: Medical school fees are rising globally. Student debt and financial background may affect residency choices, but few studies have been conducted in Asia. This study aimed to explore the relationship between financial background, student debt and postgraduate residency choices among medical students in Singapore. METHODS: An anonymised survey of all medical students in Singapore was conducted, with a response rate of 67.9%. RESULTS: 40...
June 7, 2018: Singapore Medical Journal
Dimitrios Papanagnou, Danica Stone, Shruti Chandra, Phillip Watts, Anna Marie Chang, Judd E Hollander
Introduction Given the rapid expansion of telehealth (TH), there is an emerging need for trained professionals who can effectively deliver TH services. As there is no formal TH training program for residents, the Department of Emergency Medicine (DEM) at Thomas Jefferson University (TJU) developed a pilot training program for senior post-graduate-year three (PGY-3) residents that exposed them to TH practices. The objective of the study was to determine the feasibility of developing a resident-led, post-Emergency-Department (ED) visit TH follow-up program as an educational opportunity to 1) address patient satisfaction; and 2) expose senior residents to TH delivery...
April 5, 2018: Curēus
Daniel Niederer, Tobias Engeroff, Kevin Lange, Lutz Vogt, Winfried Banzer
Validated strategies and guidelines for a safe and individualized diagnosis and return-to-play (RTP) after concussion in rugby are needed. Little is known about the state of knowledge, frequency of use and application barriers of state-of-the-art guidelines among decision-makers in professional or semi-professional rugby teams. Participants (n = 195) from the coaching team (head coach, assistance coach, athletic coach), the medical team (physiotherapist, physician, rehabilitation therapist, neuropsychologist), or from the officials of a professional or semi-professional rugby team (top three major leagues in Germany), filled in a questionnaire on their knowledge, frequency of use and application barriers of evidence-based guidelines (Graduated RTP protocol and The 5R)...
June 5, 2018: Brain Injury: [BI]
Jacob M Shivley, Wilson C Brookshire, Philip A Bushby, Kimberly A Woodruff
Referral-level medicine is important in the veterinary curriculum, however veterinary students also need a solid base knowledge of clinically relevant, routine surgical and diagnostic skills to be clinically prepared after graduation. Exposure to a referral-only, or primarily referral caseload, does not always provide veterinary students with the routine hands-on experiences and competencies expected by the American Veterinary Medical Association Council on Education, the Royal College of Veterinary Surgeons, the Australian Veterinary Boards Council, or prospective employers...
2018: Frontiers in Veterinary Science
Hoai-An Truong, Michelle J Gorman, Meghan East, Dennis W Klima, Katherine A Hinderer, G Lawrence Hogue, Voncelia Brown, Robert L Joyner
Health care professionals working collaboratively on interprofessional teams are essential to optimize patient-centered care. Collaboration and teamwork can be best achieved if interprofessional education (IPE) starts early for health professions students. This commentary describes the formation, implementation, impact, and lessons learned from students' curricular and co-curricular activities and faculty collaboration over a five-year trajectory of the Eastern Shore Collaborative for Interprofessional Education (ESCIPE)...
May 2018: American Journal of Pharmaceutical Education
Timothy J Grigsby, Myriam Forster, Jennifer Tsai, Louise A Rohrbach, Steve Sussman
BACKGROUND: Alternative (or continuation) high schools are institutions designed for students at risk for not graduating due to behavioral, educational, or medical problems. The present study explored the relationship between negative substance use consequences (eg, having trouble at school or work) and noncondom use in this at-risk population and whether these associations varied by sex. METHODS: Participants (N = 1101; 62.9% Hispanic; Mage = 16.85) were sampled from 24 alternative high schools in California, and data were analyzed using cross-sectional multivariate logistic regression models...
July 2018: Journal of School Health
Min Jeong Kim, Young-Mee Lee, Jae Jin Han, Seok Jin Choi, Tae-Yoon Hwang, Min Jeong Kwon, Hyouk-Soo Kwon, Man-Sup Lim, Won Min Hwang, Min Cheol Joo, Jong-Tae Lee, Eunbae B Yang
The Korean Association of Medical Colleges (KAMC) developed graduate outcomes based on "The role of Korean doctor, 2014" to serve as guidelines regarding outcome-based education in Korea. The working group in this study analyzed 65 competencies proposed in "The role of Korean doctor, 2014" according to the developmental principle that certain outcomes should be demonstrated at the point of entry into the graduate medical education. We established 34 competencies as "preliminary graduate outcomes" (PGOs)...
June 2018: Korean Journal of Medical Education
Tobias Wasser, Amanda Sun, Saksham Chandra, Katherine Michaelsen
OBJECTIVE: The growth of forensic psychiatry has spurred efforts to improve forensic psychiatry training in general psychiatry residency. The Accreditation Council for Graduate Medical Education requires that residencies provide an experience that "exposes" residents to forensic issues, but leaves the specifics to individual programs. However, there is growing need for psychiatrists to understand the unique circumstances of individuals with mental illness involved in the criminal justice system...
June 1, 2018: Academic Psychiatry
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