Failure on the American Board of Surgery Examinations of General Surgery Residency Graduates Correlates Positively with States' Malpractice Risk.

PubMed

Dent, Daniel L; Al Fayyadh, Mohammed J; Rawlings, Jeremy A; Hassan, Ramy A; Kempenich, Jason W; Willis, Ross E; Stewart, Ronald M

2018-03-01

It has been suggested that in environments where there is greater fear of litigation, resident autonomy and education is compromised. Our aim was to examine failure rates on American Board of Surgery (ABS) examinations in comparison with medical malpractice payments in 47 US states/territories that have general surgery residency programs. We hypothesized higher ABS examination failure rates for general surgery residents who graduate from residencies in states with higher malpractice risk. We conducted a retrospective review of five-year (2010-2014) pass rates of first-time examinees of the ABS examinations. States' malpractice data were adjusted based on population. ABS examinations failure rates for programs in states with above and below median malpractice payments per capita were 31 and 24 per cent (P < 0.01) respectively. This difference was seen in university and independent programs regardless of size. Pearson correlation confirmed a significant positive correlation between board failure rates and malpractice payments per capita for Qualifying Examination (P < 0.02), Certifying Examination (P < 0.02), and Qualifying and Certifying combined index (P < 0.01). Malpractice risk correlates positively with graduates' failure rates on ABS examinations regardless of program size or type. We encourage further examination of training environments and their relationship to surgical residency graduate performance.

A national survey on the current status of informatics residency education in pharmacy.

PubMed

Blash, Anthony; Saltsman, Connie L; Steil, Condit

2017-11-01

Upon completion of their post-graduate training, pharmacy informatics residents need to be prepared to interact with clinical and technology experts in the new healthcare environment. This study describes pharmacy informatics residency programs within the United States. Preliminary information for all pharmacy informatics residency programs was accessed from program webpages. An email was sent out to programs asking them to respond to a six-item questionnaire. This questionnaire was designed to elicit information on attributes of the program, behaviors of the preceptors and residents, and attitudes of the residency directors. Of 22 pharmacy informatics residencies identified, nineteen (86%) participated. Twenty (91%) were second post-graduate year (PGY2) residencies. Ten (45%) were accredited by the American Society of Health-System Pharmacists (ASHP), while eight (36%) were candidates for accreditation. Hospital (17/22, 77%) and administrative offices (3/22, 14%) were the predominant training sites for pharmacy informatics residents. Large institutions were the predominant training environment for the pharmacy informatics resident, with 19 of 22 (86%) institutions reporting a licensed bed count of 500 or more. The median (range) number of informatics preceptors at a site was six to eight. Regarding barriers to pharmacy informatics residency education, residency directors reported that residents did not feel prepared based on the limited availability of curricular offerings. In the United States, relatively few residencies are explicitly focused on pharmacy informatics. Most of these are accredited and hospital affiliated, especially with large institutions (>500 beds). Copyright © 2017 Elsevier Inc. All rights reserved.

42 CFR 403.811 - Enrollment and disenrollment and associated endorsed sponsor requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... card programs, offered in the individual's State of residence. (11) In order to access negotiated... residence outside the service area of the current program; (ii) A change in residence to or from a long-term... individual's current endorsed discount card program is terminated or terminates; or (v) Other exceptional...

Assessing the New Competencies for Resident Education: A Model from an Emergency Medicine Program.

ERIC Educational Resources Information Center

Reisdorff, Earl J.; Hayes, Oliver W.; Carlson, Dale J.; Walker, Gregory L.

2001-01-01

Based on the experience of Michigan State University's emergency medicine residency program, proposes a practical method for modifying an existing student evaluation format. The model provides a template other programs could use in assessing residents' acquisition of the knowledge, skills, and attitudes reflected in the six general competencies…

Lessons from pediatrics residency program directors' experiences with work hour limitations in New York State.

PubMed

Samuels, Ronald C; Chi, Grace W; Rauch, Daniel A; Palfrey, Judith S; Shelov, Steven P

2005-05-01

To evaluate the impact of residency work hour limitations on pediatrics residency programs in New York State, and to learn lessons that can be used nationally with the implementation of the Accreditation Council of Graduate Medical Education's similar rules. A three-page questionnaire was mailed to all pediatrics residency program directors in New York. The questionnaire assessed methods used to accommodate the work hour limitations and perceptions of the limitations' effects. Twenty-one program directors responded (68%). Only large programs used night floats and night teams to meet work hour requirements. Programs of all sizes and in all settings used cross coverage and sent residents home immediately post call. About half of the programs hired additional nonresident staff, usually nurse practitioners, physician assistants, and/or attendings. The most frequently reported effects were decreases in the amount of time residents spent in inpatient settings, patient continuity in inpatient settings, flexibility of residents' scheduling, and increased logistical work needed to maintain continuity clinic. A summary of advice to other program directors was "be creative" and "be flexible." New York's pediatrics residency programs used a variety of mechanisms to meet work hour restrictions. Smaller programs had fewer methods available to them to meet such restrictions. Although the logistical work needed to maintain continuity clinic increased greatly, continuity and outpatient settings themselves were not greatly affected by work hour limitations. Inpatient settings were more affected and experienced much more in the way of change.

Pediatric dermatology training survey of United States dermatology residency programs.

PubMed

Nijhawan, Rajiv I; Mazza, Joni M; Silverberg, Nanette B

2014-01-01

Variability exists in pediatric dermatology education for dermatology residents. We sought to formally assess the pediatric dermatology curriculum and experience in a dermatology residency program. Three unique surveys were developed for dermatology residents, residency program directors, and pediatric dermatology fellowship program directors. The surveys consisted of questions pertaining to residency program characteristics. Sixty-three graduating third-year residents, 51 residency program directors, and 18 pediatric dermatology fellowship program directors responded. Residents in programs with one or more full-time pediatric dermatologist were more likely to feel very competent treating children and were more likely to be somewhat or extremely satisfied with their pediatric curriculums than residents in programs with no full-time pediatric dermatologist (50.0% vs 5.9%, p = 0.002, and 85.3% vs 52.9%, p < 0.001, respectively). Residents in programs with no full-time pediatric dermatologist were the only residents who were somewhat or extremely dissatisfied with their pediatric training. Residency program directors were more satisfied with their curriculums when there was one or more pediatric dermatologist on staff (p < 0.01). Residents in programs with pediatric dermatology fellowships were much more likely to report being extremely satisfied than residents in programs without a pediatric dermatology fellowship (83.3% vs 21.2%; p < 0.001). The results of this survey support the need for dermatology residency programs to continue to strengthen their pediatric dermatology curriculums, especially through the recruitment of full-time pediatric dermatologists. © 2013 Wiley Periodicals, Inc.

Neurology Didactic Curricula for Psychiatry Residents: A Review of the Literature and a Survey of Program Directors

ERIC Educational Resources Information Center

Reardon, Claudia L.; Walaszek, Art

2012-01-01

Objective: Minimal literature exists on neurology didactic instruction offered to psychiatry residents, and there is no model neurology didactic curriculum offered for psychiatry residency programs. The authors sought to describe the current state of neurology didactic training in psychiatry residencies. Methods: The authors electronically…

Training in Psychiatric Genomics during Residency: A New Challenge

ERIC Educational Resources Information Center

Winner, Joel G.; Goebert, Deborah; Matsu, Courtenay; Mrazek, David A.

2010-01-01

Objective: The authors ascertained the amount of training in psychiatric genomics that is provided in North American psychiatric residency programs. Methods: A sample of 217 chief residents in psychiatric residency programs in the United States and Canada were identified by e-mail and surveyed to assess their training in psychiatric genetics and…

Ethics education in family medicine training in the United States: a national survey.

PubMed

Manson, Helen M; Satin, David; Nelson, Valerie; Vadiveloo, Thenmalar

2014-01-01

Although professional organizations endorse ethics education in family medicine training, there is little published evidence that ethics teaching occurs. This survey collated data on the aims, content, pedagogical methods, assessment, and barriers relating to formal ethics education in family medicine residency programs in the United States. A questionnaire surveyed all 445 family medicine residency programs in the United States. Forty percent of programs responded (178/445). Of these, 95% formally teach at least one ethics topic, 68.2% teach six or more topics, and 7.1% teach all 13 core topics specified in the questionnaire. Programs show variation, providing between zero to 100 hours' ethics education over the 3 years of residency training. Of the responding programs, 3.5% specify well-defined aims for ethics teaching, 25.9% designate overall responsibility for the ethics curriculum to one individual, and 33.5% formally assess ethics competencies. The most frequent barriers to ethics education are finding time in residents' schedules (59.4%) and educator expertise (21.8%). Considerable variation in ethics education is apparent in both curricular content and delivery among family medicine residency programs in the United States. Additional findings included a lack of specification of explicit curricular aims for ethics teaching allied to ACGME or AAFP competencies, a tendency not to designate one faculty member with lead responsibility for ethics teaching in the residency program, and a lack of formal assessment of ethics competencies. This has occurred in the context of an absence of robust assessment of ethics competencies at board certification level.

Neurology didactic curricula for psychiatry residents: a review of the literature and a survey of program directors.

PubMed

Reardon, Claudia L; Walaszek, Art

2012-03-01

Minimal literature exists on neurology didactic instruction offered to psychiatry residents, and there is no model neurology didactic curriculum offered for psychiatry residency programs. The authors sought to describe the current state of neurology didactic training in psychiatry residencies. The authors electronically surveyed 172 directors of U.S. psychiatric residency training programs to examine the types and extent of neurology didactic instruction offered to their residents. Fifty-seven program directors (33%) responded. The majority of these psychiatry residency programs offer neurology didactic instruction to their residents, as provided by both neurology and psychiatry faculty, in a number of different settings and covering many topics. However, room for improvement likely remains. The authors hope this report will guide psychiatry residencies in optimizing their neurology didactic curricula. Further research should explore tools for assessing resident knowledge in neurology and measure the effectiveness of neurology curricula in increasing knowledge and improving clinical outcomes.

Arthroscopic training resources in orthopedic resident education.

PubMed

Koehler, Ryan; John, Tamara; Lawler, Jeffrey; Moorman, Claude; Nicandri, Gregg

2015-02-01

The purpose of this study was to determine the frequency of use, perceived effectiveness, and preference for arthroscopic surgical skill training resources. An electronic survey was sent to orthopedics residents, residency program directors, and orthopedic sports medicine attending physicians in the United States. The frequency and perceived effectiveness of 10 types of adjunctive arthroscopic skills training was assessed. Residents and faculty members were asked to rate their confidence in resident ability to perform common arthroscopic procedures. Surveys were completed by 40 of 152 (26.3%) orthopedic residency program directors, 70 of 426 (16.4%) sports medicine faculty, and 235 of 3,170 (7.4%) orthopedic residents. The use of adjunctive methods of training varied from only 9.8% of programs with virtual reality training to 80.5% of programs that used reading of published materials to develop arthroscopic skill. Practice on cadaveric specimens was viewed as the most effective and preferred adjunctive method of training. Residents trained on cadaveric specimens reported increased confidence in their ability to perform arthroscopic procedures. The resources for developing arthroscopic surgical skill vary considerably across orthopedic residency programs in the United States. Adjunctive training methods were perceived to be effective at supplementing traditional training in the operating room. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Plastic Surgery Training Worldwide: Part 1. The United States and Europe

PubMed Central

Kamali, Parisa; van Paridon, Maaike W.; Ibrahim, Ahmed M. S.; Paul, Marek A.; Winters, Henri A.; Martinot-Duquennoy, Veronique; Noah, Ernst Magnus; Pallua, Norbert

2016-01-01

Background: Major differences exist in residency training, and the structure and quality of residency programs differ between different countries and teaching centers. It is of vital importance that a better understanding of the similarities and differences in plastic surgery training be ascertained as a means of initiating constructive discussion and commentary among training programs worldwide. In this study, the authors provide an overview of plastic surgery training in the United States and Europe. Methods: A survey was sent to select surgeons in 10 European countries that were deemed to be regular contributors to the plastic surgery literature. The questions focused on pathway to plastic surgery residency, length of training, required pretraining experience, training scheme, research opportunities, and examinations during and after plastic surgery residency. Results: Plastic surgery residency training programs in the United States differ from the various (selected) countries in Europe and are described in detail. Conclusions: Plastic surgery education is vastly different between the United States and Europe, and even within Europe, training programs remain heterogeneous. Standardization of curricula across the different countries would improve the interaction of different centers and facilitate the exchange of vital information for quality control and future improvements. The unique characteristics of the various training programs potentially provide a basis from which to learn and to gain from one another. PMID:27257571

Interest in and perceived barriers to flexible-track residencies in general surgery: a national survey of residents and program directors.

PubMed

Abbett, Sarah K; Hevelone, Nathanael D; Breen, Elizabeth M; Lipsitz, Stuart R; Peyre, Sarah E; Ashley, Stanley W; Smink, Douglas S

2011-01-01

The American Board of Surgery now permits general surgery residents to complete their clinical training over a 6-year period. Despite this new policy, the level of interest in flexible scheduling remains undefined. We sought to determine why residents and program directors (PDs) are interested in flexible tracks and to understand implementation barriers. National survey. All United States general surgery residency programs that participate in the Association of Program Directors in Surgery listserv. PDs and categorical general surgery residents in the United States. Attitudes about flexible tracks in surgery training. A flexible track was defined as a schedule that allows residents to pursue nonclinical time during residency with resulting delay in residency completion. Of the 748 residents and 81 PDs who responded, 505 residents and 45 PDs were supportive of flexible tracks (68% vs 56%, p = 0.03). Residents and PDs both were interested in flexible tracks to pursue research (86% vs 82%, p = 0.47) and child bearing (69% vs 58%, p = 0.13), but residents were more interested in pursuing international work (74% vs 53%, p = 0.004) and child rearing (63% vs 44%, p = 0.02). Although 71% of residents believe that flexible-track residents would not be respected as the equal of other residents, only 17% of PDs indicated they would not respect flexible-track residents (p < 0.001). Most residents and PDs support flexible tracks, although they differ in their motivation and perceived barriers. This finding lends support to the new policy of the American Board of Surgery. Copyright © 2011 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Survey of robotic surgery training in obstetrics and gynecology residency.

PubMed

Gobern, Joseph M; Novak, Christopher M; Lockrow, Ernest G

2011-01-01

To examine the status of resident training in robotic surgery in obstetrics and gynecology programs in the United States, an online survey was emailed to residency program directors of 247 accredited programs identified through the Accreditation Council for Graduate Medical Education website. Eighty-three of 247 program directors responded, representing a 34% response rate. Robotic surgical systems for gynecologic procedures were used at 65 (78%) institutions. Robotic surgery training was part of residency curriculum at 48 (58%) residency programs. Half of respondents were undecided on training effectiveness. Most program directors believed the role of robotic surgery would increase and play a more integral role in gynecologic surgery. Robotic surgery was widely reported in residency training hospitals with limited availability of effective resident training. Robotic surgery training in obstetrics and gynecology residency needs further assessment and may benefit from a structured curriculum. Published by Elsevier Inc.

Resident research in internal medicine training programs.

PubMed

Alguire, P C; Anderson, W A; Albrecht, R R; Poland, G A

1996-02-01

To determine how well medical residency programs are prepared to meet the new Accreditation Council of Graduate Medical Education (ACGME) accreditation guidelines for resident scholarly activity. Cross-sectional study using a mailed survey. Program directors of all ACGME-accredited internal medicine residency programs. Program directors were asked to list the scholarly activities and products of their residents and their programs' minimal expectations for resident research; available academic, faculty, technical, and personnel support for resident research; perceived barriers to resident research; and the desired educational and skill outcomes of resident research. The responses of university-based training programs were compared with those of non-university-based programs. 271 program directors returned the survey, yielding a response rate of 65%. Ninety-seven percent of all programs have established scholarly guidelines consistent with accreditation requirements. Although only 37% of programs reported having an organized, comprehensive research curriculum, 70% taught skills important to research. Technical support and resources were generally available for resident research; the most frequently cited barrier to resident research was lack of resident time. University-based and non-university-based training programs differed in important ways. Generally, non-university-based programs had more research activity and structure, and they exceeded university-based programs in the number of oral and poster presentations given at local, state, and national professional meetings. Most programs have in place the basic elements conducive to resident research. Program directors have identified and teach educational outcomes and skills that are likely to have lifelong benefits for most of their graduates.

Communication Skills Training in Ophthalmology: Results of a Needs Assessment and Pilot Training Program.

PubMed

Mishra, Anuradha; Browning, David; Haviland, Miriam J; Jackson, Mary Lou; Luff, Donna; Meyer, Elaine C; Talcott, Katherine; Kloek, Carolyn E

To conduct a needs assessment to identify gaps in communication skills training in ophthalmology residency programs and to use these results to pilot a communication workshop that prepares residents for difficult conversations. A mixed-methods design was used to perform the needs assessment. A pre-and postsurvey was administered to workshop participants. Mass Eye and Ear Infirmary, Harvard Medical School (HMS), Department of Ophthalmology. HMS ophthalmology residents from postgraduate years 2-4 participated in the needs assessment and the workshop. Ophthalmology residency program directors in the United States participated in national needs assessment. Ophthalmology program directors across the United States were queried on their perception of resident communication skills training through an online survey. A targeted needs assessment in the form of a narrative exercise captured resident perspectives on communication in ophthalmology from HMS residents. A group of HMS residents participated in the pilot workshop and a pre- and postsurvey was administered to participants to assess its effectiveness. The survey of program directors yielded a response rate of 40%. Ninety percent of respondents agreed that the communication skills training in their programs could be improved. Fifteen of 24 residents (62%) completed the needs assessment. Qualitative analysis of the narrative material revealed four themes; (1) differing expectations, (2) work role and environment, (3) challenges specific to ophthalmology, and (4) successful strategies adopted. Nine residents participated in the workshop. There was a significant improvement post-workshop in resident reported scores on their ability to manage their emotions during difficult conversations (p = 0.03). There is an opportunity to improve communication skills training in ophthalmology residency through formalized curriculum. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Disaster Education: A Survey Study to Analyze Disaster Medicine Training in Emergency Medicine Residency Programs in the United States.

PubMed

Sarin, Ritu R; Cattamanchi, Srihari; Alqahtani, Abdulrahman; Aljohani, Majed; Keim, Mark; Ciottone, Gregory R

2017-08-01

The increase in natural and man-made disasters occurring worldwide places Emergency Medicine (EM) physicians at the forefront of responding to these crises. Despite the growing interest in Disaster Medicine, it is unclear if resident training has been able to include these educational goals. Hypothesis This study surveys EM residencies in the United States to assess the level of education in Disaster Medicine, to identify competencies least and most addressed, and to highlight effective educational models already in place. The authors distributed an online survey of multiple-choice and free-response questions to EM residency Program Directors in the United States between February 7 and September 24, 2014. Questions assessed residency background and details on specific Disaster Medicine competencies addressed during training. Out of 183 programs, 75 (41%) responded to the survey and completed all required questions. Almost all programs reported having some level of Disaster Medicine training in their residency. The most common Disaster Medicine educational competencies taught were patient triage and decontamination. The least commonly taught competencies were volunteer management, working with response teams, and special needs populations. The most commonly identified methods to teach Disaster Medicine were drills and lectures/seminars. There are a variety of educational tools used to teach Disaster Medicine in EM residencies today, with a larger focus on the use of lectures and hospital drills. There is no indication of a uniform educational approach across all residencies. The results of this survey demonstrate an opportunity for the creation of a standardized model for resident education in Disaster Medicine. Sarin RR , Cattamanchi S , Alqahtani A , Aljohani M , Keim M , Ciottone GR . Disaster education: a survey study to analyze disaster medicine training in emergency medicine residency programs in the United States. Prehosp Disaster Med. 2017;32(4):368-373.

Results of the 2005-2008 Association of Residents in Radiation Oncology Survey of Chief Residents in the United States: Clinical Training and Resident Working Conditions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gondi, Vinai, E-mail: gondi@humonc.wisc.edu; Bernard, Johnny Ray; Jabbari, Siavash

2011-11-15

Purpose: To document clinical training and resident working conditions reported by chief residents during their residency. Methods and Materials: During the academic years 2005 to 2006, 2006 to 2007, and 2007 to 2008, the Association of Residents in Radiation Oncology conducted a nationwide survey of all radiation oncology chief residents in the United States. Chi-square statistics were used to assess changes in clinical training and resident working conditions over time. Results: Surveys were completed by representatives from 55 programs (response rate, 71.4%) in 2005 to 2006, 60 programs (75.9%) in 2006 to 2007, and 74 programs (93.7%) in 2007 tomore » 2008. Nearly all chief residents reported receiving adequate clinical experience in commonly treated disease sites, such as breast and genitourinary malignancies; and commonly performed procedures, such as three-dimensional conformal radiotherapy and intensity-modulated radiotherapy. Clinical experience in extracranial stereotactic radiotherapy increased over time (p < 0.001), whereas clinical experience in endovascular brachytherapy (p <0.001) decreased over time. The distribution of gynecologic and prostate brachytherapy cases remained stable, while clinical case load in breast brachytherapy increased (p = 0.006). A small but significant percentage of residents reported receiving inadequate clinical experience in pediatrics, seeing 10 or fewer pediatric cases during the course of residency. Procedures involving higher capital costs, such as particle beam therapy and intraoperative radiotherapy, and infrequent clinical use, such as head and neck brachytherapy, were limited to a minority of institutions. Most residency programs associated with at least one satellite facility have incorporated resident rotations into their clinical training, and the majority of residents at these programs find them valuable experiences. The majority of residents reported working 60 or fewer hours per week on required clinical duties. Conclusions: Trends in clinical training and resident working conditions over 3 years are documented to allow residents and program directors to assess their residency training.« less

Allergy education in otolaryngology residency: a survey of program directors and residents.

PubMed

Bailey, Sarah E; Franzese, Christine; Lin, Sandra Y

2014-02-01

The purpose of this study was to survey program directors of the accredited otolaryngology residency programs and resident attendees of the 2013 American Academy of Otolaryngic Allergy (AAOA) Basic/MOC Course regarding resident education and participation as well as assessment of competency in otolaryngic allergy and immunotherapy. A multiple-choice questionnaire was sent to all accredited otolaryngology residency training programs in the United States as part of resident attendance at the 2013 AAOA CORE Basic/MOC Course. Following this, a similar multiple-choice survey was sent to all resident attendees from the programs that responded positively. Program directors reported that 73% of their academic institutions offer allergy testing and immunotherapy. More PDs than residents indicated that residents participate in allergy practice and perform/interpret skin testing and in vitro testing, and more residents (85%) than program directors (63%) reported inadequate or no allergy training. Program directors and residents equally indicated that residents do not calculate immunotherapy vial formulations or administer immunotherapy injections. The majority of program directors indicated that resident competency in allergy was assessed through direct observation, whereas residents more commonly perceived that no assessment of competency was being performed for any portion of allergy practice. This survey demonstrates a discrepancy between program directors and residents regarding resident involvement and adequacy of training in the allergy practice. Although the majority of otolaryngology residencies report offering otolaryngic allergy services and education, the vast majority of residents report inadequate allergy training and less participation in an allergy practice compared to the majority of program directors. © 2013 ARS-AAOA, LLC.

Personal digital assistant use in Florida obstetrics and gynecology residency programs.

PubMed

Joy, Saju; Benrubi, Guy

2004-05-01

Improvements in electronic technologies have resulted in affordable, smaller computers that operate at faster speeds. The personal digital assistant (PDA) is a tool that has the potential to enhance residency education by allowing residents immediate access to an abundance of information. This article assesses the current use of this tool at obstetrics and gynecology residency programs in the state of Florida. The authors conducted a statewide survey addressing the general question: is the PDA useful in an obstetrics and gynecology residency training program? Specifically, the authors asked residents how much time was perceived to be saved weekly with the use of this tool, and in what aspect of their training use of this tool was most helpful. At the survey's close, five of seven programs had returned the survey for evaluation. These five institutions included both university- and community-based residency programs. Forty percent of obstetrics and gynecology residents at these programs responded to this questionnaire. Resident responses to the survey revealed that most of the perceived benefit was in maintaining procedural statistics logs, pharmacology reference manuals, and personal clinical protocols. Most responses revealed that only minimal time savings (<2 h/wk) were gained with using this tool. However, many residents felt they were not using this tool to its maximum potential. Nearly 90% of those who responded felt that the PDA should be available at residency programs and anticipated using it after completing residency. This study posed the question of PDA usefulness at obstetric and gynecology residency programs in the state of Florida. Although not all programs provided their residents with a PDA, 95% of the respondents revealed that they owned one of these tools. Experience at the authors' institution revealed high expectations for the potential uses of a PDA. Although many residents were not using this tool to its full potential, a PDA tutorial session could educate residents on the many applications available for PDAs, including applications to maintain on-call schedules and sign-out lists, statistics and procedure logs for credentialing and board certification, electronic billing, and electronic prescriptions.

Attrition in graduate surgical education: an analysis of the 1993 entering cohort of surgical residents.

PubMed

Kwakwa, F; Jonasson, O

1999-12-01

Pyramidal surgical residency programs, in which more residents are enrolled than can complete the program, have gradually declined in number in recent years. In 1996, the Residency Review Committee for Surgery established a policy that the number of residents appointed to a program must be consistent with the number who will complete the program. Even so, there is still attrition in the ranks of surgical residents, some of whom hold undesignated preliminary positions and have no guarantee of a position that will lead to completion of the program. This study examined the 1993 entering cohort of surgical residents to determine the rate of attrition as of 1998. Data were collected from the AMA's Medical Education Research Information Database, the American College of Surgeons Resident Masterfile, and the Association of American Medical Colleges GME Tracking Census database. The data were examined by specialty, gender, ethnic background, and type of medical school attended. The overall attrition rate from surgical GME was 12%; the rate for international medical graduates was 33%; and the rate for osteopathic residents was 28%. African-American United States and Canadian graduates had attrition rates of 16% for men and 8% for women, and Hispanic United States and Canadian graduates had attrition rates of 14% for men and 15% for women. General surgery residents had an attrition rate of 26%, which included residents in undesignated preliminary positions. Gender was not a risk factor except for the significantly higher attrition rate of African-American men. Most (81%) of the residents who dropped out of surgical GME enrolled in GME in other specialties. The attrition rate from surgical GME is low, and most residents who drop out reenter GME in another specialty. Of concern is the high rate of attrition of African-American men who are United States or Canadian graduates. The highest rate of attrition, by far, is in the group of international medical graduates, many of whom are likely to have held undesignated preliminary positions.

Do otolaryngology residency applicants relocate for training?

PubMed

Gebhard, Grant M; Hauser, Leah J; Dally, Miranda J; Weitzenkamp, David A; Cabrera-Muffly, Cristina

2016-04-01

To determine whether there is an association between the geographic location of an applicant's undergraduate school, medical school, and residency program among matched otolaryngology residency applicants. Observational. Otolaryngology residency program applications to our institution from 2009 to 2013 were analyzed. The geographic location of each applicant's undergraduate education and medical education were collected. Online public records were queried to determine the residency program location of matched applicants. Applicants who did not match or who attended medical school outside the United States were excluded. Metro area, state, and region were determined according to US Census Bureau definitions. From 2009 to 2013, 1,089 (78%) of 1,405 applicants who matched into otolaryngology residency applied to our institution. The number of subjects who attended medical school and residency in the same geographic region was 241 (22%) for metropolitan area, 305 (28%) for state, and 436 (40%) for region. There was no difference in geographic location retention by gender or couples match status of the subject. United States Medical Licensing Exam step 1 scores correlated with an increased likelihood of subjects staying within the same geographic region (P = .03). Most otolaryngology applicants leave their previous geographic area to attend residency. Based on these data, the authors recommend against giving weight to geography as a factor when inviting applicants to interview. NA. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

The state of the service: a survey of psychiatry resident education in psychosomatic medicine.

PubMed

Heinrich, Thomas W; Schwartz, Ann C; Zimbrean, Paula C; Wright, Mark T

2013-01-01

Although required by the Accreditation Council for Graduate Medical Education, training of general psychiatry residents in Psychosomatic Medicine (PM) varies significantly between programs. In 1996, the Academy of Psychosomatic Medicine (APM) developed guidelines for residency training in PM. Since then, there has been no assessment of the status of PM training during psychiatry residency. Assessment of the current state of PM training in U.S. psychiatry residency programs. A 46-item questionnaire was sent via e-mail to 206 residency directors. Four major areas were assessed: the timing and duration of the PM rotation, level of faculty supervision, didactic curriculum, and role (or potential role) of the APM in residency education. Ninety-two surveys were returned (response rate 45%). Forty-four (54%) of the general psychiatry residencies reported the total duration of the C-L rotation as being between 3 and 6 months (including both full- and part-time rotation). Only 38 (46%) programs' residents complete their PM experience in 1 year of residency. The average Full-Time Equivalent of teaching faculty per service was 1.74 (standard deviation 0.92). Sixty-four (77%) programs have a formal didactic curriculum in C-L. Eighty-one (98%) respondents were aware of the APM. Fifty-eight (70%) had APM members among faculty. The most popular responses on how the APM could best serve training programs were the creation of a subspecialty curriculum (73%) as well as the development of a competency-based evaluation tool (66%). There is significant variation in how residents are taught PM during their training. The APM is a well-recognized organization that may define what constitutes adequate residency training in PM and may help programs fulfill the educational needs of residents. © 2013 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

[Oral and maxillofacial surgery residency training in the United States: what can we learn].

PubMed

Ren, Y F

2017-04-09

China is currently in the process of establishing formal residency training programs in oral and maxillofacial surgery and other medical and dental specialties. Regulatory agencies, and educational and academic institutions in China are exploring mechanisms, goals and standards of residency training that meet the needs of the Chinese healthcare system. This article provides an introduction of residency training in oral and maxillofacial surgery in the United States, with emphasis on the accreditation standard by the Commission on Dental Accreditation. As there are fundamental differences in the medical and dental education systems between China and United States, the training standards in the United States may not be entirely applicable in China. A competency-based training model that focus on overall competencies in medical knowledge, clinical skills and values at the time of graduation should be taken into consideration in a Chinese residency training program in oral and maxillofacial surgery.

Handheld Computer Use in U.S. Family Practice Residency Programs

PubMed Central

Criswell, Dan F.; Parchman, Michael L.

2002-01-01

Objective: The purpose of the study was to evaluate the uses of handheld computers (also called personal digital assistants, or PDAs) in family practice residency programs in the United States. Study Design: In November 2000, the authors mailed a questionnaire to the program directors of all American Academy of Family Physicians (AAFP) and American College of Osteopathic Family Practice (ACOFP) residency programs in the United States. Measurements: Data and patterns of the use and non-use of handheld computers were identified. Results: Approximately 50 percent (306 of 610) of the programs responded to the survey. Two thirds of the programs reported that handheld computers were used in their residencies, and an additional 14 percent had plans for implementation within 24 months. Both the Palm and the Windows CE operating systems were used, with the Palm operating system the most common. Military programs had the highest rate of use (8 of 10 programs, 80 percent), and osteopathic programs had the lowest (23 of 55 programs, 42 percent). Of programs that reported handheld computer use, 45 percent had required handheld computer applications that are used uniformly by all users. Funding for handheld computers and related applications was non-budgeted in 76percent of the programs in which handheld computers were used. In programs providing a budget for handheld computers, the average annual budget per user was $461.58. Interested faculty or residents, rather than computer information services personnel, performed upkeep and maintenance of handheld computers in 72 percent of the programs in which the computers are used. In addition to the installed calendar, memo pad, and address book, the most common clinical uses of handheld computers in the programs were as medication reference tools, electronic textbooks, and clinical computational or calculator-type programs. Conclusions: Handheld computers are widely used in family practice residency programs in the United States. Although handheld computers were designed as electronic organizers, in family practice residencies they are used as medication reference tools, electronic textbooks, and clinical computational programs and to track activities that were previously associated with desktop database applications. PMID:11751806

Handheld computer use in U.S. family practice residency programs.

PubMed

Criswell, Dan F; Parchman, Michael L

2002-01-01

The purpose of the study was to evaluate the uses of handheld computers (also called personal digital assistants, or PDAs) in family practice residency programs in the United States. In November 2000, the authors mailed a questionnaire to the program directors of all American Academy of Family Physicians (AAFP) and American College of Osteopathic Family Practice (ACOFP) residency programs in the United States. Data and patterns of the use and non-use of handheld computers were identified. Approximately 50 percent (306 of 610) of the programs responded to the survey. Two thirds of the programs reported that handheld computers were used in their residencies, and an additional 14 percent had plans for implementation within 24 months. Both the Palm and the Windows CE operating systems were used, with the Palm operating system the most common. Military programs had the highest rate of use (8 of 10 programs, 80 percent), and osteopathic programs had the lowest (23 of 55 programs, 42 percent). Of programs that reported handheld computer use, 45 percent had required handheld computer applications that are used uniformly by all users. Funding for handheld computers and related applications was non-budgeted in 76percent of the programs in which handheld computers were used. In programs providing a budget for handheld computers, the average annual budget per user was 461.58 dollars. Interested faculty or residents, rather than computer information services personnel, performed upkeep and maintenance of handheld computers in 72 percent of the programs in which the computers are used. In addition to the installed calendar, memo pad, and address book, the most common clinical uses of handheld computers in the programs were as medication reference tools, electronic textbooks, and clinical computational or calculator-type programs. Handheld computers are widely used in family practice residency programs in the United States. Although handheld computers were designed as electronic organizers, in family practice residencies they are used as medication reference tools, electronic textbooks, and clinical computational programs and to track activities that were previously associated with desktop database applications.

Annual State of Connecticut Obstetrics and Gynecology Resident Research Day.

PubMed

Seagle, Brandon-Luke L; Ballard, Jennifer; Kakar, Freshta; Panarelli, Erin; Samuelson, Robert; Shahabi, Shohreh

2015-01-01

To increase opportunities for Obstetrics and Gynecology(Ob/Gyn) residents to present their research, an Annual State of Connecticut Ob/Gyn Resident Research Day (RRD) was created. At the first annual RRD, 33 residents, representing five of six Connecticut Ob/Gyn residency programs, presented 39 poster and eight oral presentations. RRD evaluators rated the overall symposium and the quality of resident oral and poster presentations as either "excellent" or "above average." Residency program directors reported that the symposium was "very helpful" for evidencing resident scholarship as required by the Accreditation Council for Graduate Medical Education (ACGME). Surveyed residents reported that the symposium promoted their research and was a valuable investment of their time. An annual specialty-specific, statewide RRD was created, experienced good participation, and was well evaluated. The annual, statewide Ob/Gyn RRD may serve as a model for development of other specialty-specific, statewide RRD events.

Palliative care and palliative radiation therapy education in radiation oncology: A survey of US radiation oncology program directors.

PubMed

Wei, Randy L; Colbert, Lauren E; Jones, Joshua; Racsa, Margarita; Kane, Gabrielle; Lutz, Steve; Vapiwala, Neha; Dharmarajan, Kavita V

The purpose of this study was to assess the state of palliative and supportive care (PSC) and palliative radiation therapy (RT) educational curricula in radiation oncology residency programs in the United States. We surveyed 87 program directors of radiation oncology residency programs in the United States between September 2015 and November 2015. An electronic survey on PSC and palliative RT education during residency was sent to all program directors. The survey consisted of questions on (1) perceived relevance of PSC and palliative RT to radiation oncology training, (2) formal didactic sessions on domains of PSC and palliative RT, (3) effective teaching formats for PSC and palliative RT education, and (4) perceived barriers for integrating PSC and palliative RT into the residency curriculum. A total of 57 responses (63%) was received. Most program directors agreed or strongly agreed that PSC (93%) and palliative radiation therapy (99%) are important competencies for radiation oncology residents and fellows; however, only 67% of residency programs had formal educational activities in principles and practice of PSC. Most programs had 1 or more hours of formal didactics on management of pain (67%), management of neuropathic pain (65%), and management of nausea and vomiting (63%); however, only 35%, 33%, and 30% had dedicated lectures on initial management of fatigue, assessing role of spirituality, and discussing advance care directives, respectively. Last, 85% of programs reported having a formal curriculum on palliative RT. Programs were most likely to have education on palliative radiation to brain, bone, and spine, but less likely on visceral, or skin, metastasis. Residency program directors believe that PSC and palliative RT are important competencies for their trainees and support increasing education in these 2 educational domains. Many residency programs have structured curricula on PSC and palliative radiation education, but room for improvement exists in management of fatigue, assessing role of spirituality, and discussion regarding advance care planning. Copyright © 2016 American Society of Radiation Oncology. Published by Elsevier Inc. All rights reserved.

Opportunities to Create New General Surgery Residency Programs to Alleviate the Shortage of General Surgeons.

PubMed

Meagher, Ashley D; Beadles, Christopher A; Sheldon, George F; Charles, Anthony G

2016-06-01

To estimate the capacity for supporting new general surgery residency programs among U.S. hospitals that currently do not have such programs. The authors compiled 2011 American Hospital Association data regarding the characteristics of hospitals with and without a general surgery residency program and 2012 Accreditation Council for Graduate Medical Education data regarding existing general surgery residencies. They performed an ordinary least squares regression to model the number of residents who could be trained at existing programs on the basis of residency program-level variables. They identified candidate hospitals on the basis of a priori defined criteria for new general surgery residency programs and an out-of-sample prediction of resident capacity among the candidate hospitals. The authors found that 153 hospitals in 39 states could support a general surgery residency program. The characteristics of these hospitals closely resembled the characteristics of hospitals with existing programs. They identified 435 new residency positions: 40 hospitals could support 2 residents per year, 99 hospitals could support 3 residents, 12 hospitals could support 4 residents, and 2 hospitals could support 5 residents. Accounting for progressive specialization, new residency programs could add 287 additional general surgeons to the workforce annually (after an initial five- to seven-year lead time). By creating new general surgery residency programs, hospitals could increase the number of general surgeons entering the workforce each year by 25%. A challenge to achieving this growth remains finding new funding mechanisms within and outside Medicare. Such changes are needed to mitigate projected workforce shortages.

Neurology education: current and emerging concepts in residency and fellowship training.

PubMed

Stern, Barney J; Józefowicz, Ralph F; Kissela, Brett; Lewis, Steven L

2010-05-01

This article discusses the current and future state of neurology training. A priority is to attract sufficient numbers of qualified candidates for the existing residency programs. A majority of neurology residents elects additional training in a neurologic subspecialty, and programs will have to be accredited accordingly. Attempts are being made to standardize and strengthen the existing general residency and subspecialty programs through cooperative efforts. Ultimately, residency programs must comply with the increasing requirements and try to adapt these requirements to the unique demands and realities of neurology training. An effort is underway to establish consistent competency-testing methods. Copyright 2010 Elsevier Inc. All rights reserved.

Research training among pediatric residency programs: a national assessment.

PubMed

Abramson, Erika L; Naifeh, Monique M; Stevenson, Michelle D; Todd, Christopher; Henry, Emilie D; Chiu, Ya-Lin; Gerber, Linda M; Li, Su-Ting T

2014-12-01

The Accreditation Council for Graduate Medical Education (ACGME) states that "residents should participate in scholarly activity." However, there is little guidance for effectively integrating scholarly activity into residency. This study was conducted to understand how pediatric residency programs meet ACGME requirements and to identify characteristics of successful programs. The authors conducted an online cross-sectional survey of all pediatric residency program directors in October 2012, assessing program characteristics, resident participation in scholarly activity, program infrastructure, barriers, and outcomes. Multivariate logistic regression was used to identify characteristics of programs in the top quartile for resident scholarly activity participation. The response rate was 52.8% (105/199 programs). Seventy-seven (78.6%) programs required scholarly activity, although definitions were variable. When including only original research, systematic reviews or meta-analyses, and case reports or series with references, resident participation averaged 56% (range 0%-100%). Characteristics associated with high-participation programs included a scholarly activity requirement (odds ratio [OR] = 5.5, 95% confidence interval [CI] = 1.03-30.0); program director belief that all residents should present work regionally or nationally (OR = 4.7, 95% CI = 1.5-15.1); and mentorship by >25% of faculty (OR = 3.6, CI = 1.2-11.4). Only 47.1% (41) of program directors were satisfied with resident participation, and only 30.7% (27) were satisfied with the quality of research training provided. The findings suggest that resident scholarly activity experience is highly variable and suboptimal. Identifying characteristics of successful programs can improve the resident research training experience.

Characteristics of research tracks in dermatology residency programs: a national survey.

PubMed

Narala, Saisindhu; Loh, Tiffany; Shinkai, Kanade; Paravar, Taraneh

2017-12-15

Pursuing research is encouraged in dermatology residency programs. Some programs offer specific research or investigative tracks. Currently, there is little data on the structure or scope of research tracks in dermatology residency programs. An anonymous online survey was distributed to the Association of Professors of Dermatology listserve in 2016. Program directors of dermatology residency programs in the United States were asked to participate and 38 of the 95 program directors responded. The survey results confirmed that a 2+2 research track, which is two years of clinical training followed by two years of research, was the most common investigator trackmodel and may promote an academic career at the resident's home institution. Further studies will help determine the most effective research track models to promote long-term outcomes.

An Overview of Cultural Competency Curricula in ACGME-accredited General Surgery Residency Programs.

PubMed

Shah, Sagar S; Sapigao, Francisco B; Chun, Maria B J

Cultural competency(CC) in surgical residency curricula is not the novel idea it was fourteen years ago when the ACGME challenged program directors to teach and assess six core competencies. CC is recognized as a component of "patient care", "professionalism", and "interpersonal and communication skills." The results of five programs (2004-2012) with CC curricula were identified in a 2013 paper by Ly and Chun. The primary objective of this paper is to provide the current status of CC curricula in general surgery residency programs. Three sources were used for this study. First, a four question survey on the current status of CC education was sent to program directors of ACGME-accredited surgery residency programs. Second, the lead authors from five programs previously reported in the 2013 paper were interviewed. Third, the survey mentioned above was resent to 52 residency programs who implemented New York University's (NYU) SPICE program, which has a CC component. Participants for the survey consisted of program directors of ACGME-accredited surgery residency programs. The interviews were conducted with the corresponding authors from the previous study by Ly and Chun. Of the 256 surveyed, nine responded; seven stated that CC is not taught formally at their institution while four stated that they do not feel any part of CC curricula is missing from their program. Due to the low response rate, we identified and conducted interviews with general surgery residency programs with CC curricula. Of the five programs contacted, only three remain active and utilize Objective Structured Clinical Examinations (OSCEs) to teach cultural competency. One of the three, the SPICE program at NYU, has expanded to 52 other residency programs in the US. Although the importance of CC has been identified in general surgery, formal curricula and documentation of implementation remains elusive. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Factors associated with successful matching to dermatology residency programs by reapplicants and other applicants who previously graduated from medical school.

PubMed

Stratman, Erik J; Ness, Rachel M

2011-02-01

To identify factors associated with and not associated with successful matching and matriculation (hereinafter "matching") to dermatology residency programs for applicants who previously graduated from medical school and to distinguish which factors are within applicants' control. Observational cohort study. Six accredited academic dermatology residency training programs in the United States. A total of 221 residency applicants who previously graduated from medical school and who applied through standardized electronic application to 1 or more of the participating residency training programs. Matriculation to a dermatology residency program by August 2008 following the 2006 residency application period. Forty-six of 221 former medical school graduates included in this study matched to a dermatology residency program. Factors strongly associated with matching included United States Medical Licensing Examination Step 3 score; submission of letters written by dermatologists from institutions that train dermatology residents; completion of preliminary medicine internships rather than transitional or other internship types; listing of research experience; publishing of medical manuscripts; and completion of non-Accreditation Council for Graduate Medical Examination dermatology fellowships. Factors not associated with increased matching included volunteer work; PhD status; sex; number of posters or presentations at dermatology conferences; quality of journal publications; and first authorship. Most successful applicants limited personal statements to 1 page and did not mention previously failing to match. The study sample represented at least 86% of such nontraditional applicants who matched in 2006. For candidates seeking to match into dermatology residency programs after graduating from medical school, there are factors within their control that are associated with higher rates of match success. This study provides evidence to assist mentors who counsel such candidates. ©2011 American Medical Association. All rights reserved.

Maternity leave: existing policies in obstetrics and gynecology residency programs.

PubMed

Davis, J L; Baillie, S; Hodgson, C S; Vontver, L; Platt, L D

2001-12-01

To survey program directors in obstetrics and gynecology regarding maternity leave and to determine how programs are dealing with maternity leave coverage. Questionnaires regarding impact and policy on maternity leave were mailed to accredited obstetrics and gynecology residency programs. A total of 188 of 274 (69%) questionnaires were returned completed. Respectively, 80% and 69% of respondents indicated that they have a formal maternity (maximum mean 8.7 weeks) and paternity (mean 5.27 days) leave policy. Approximately 75% of programs require residents to make up time if their leave exceeds 8 weeks during the first 3 years. Eighty-five percent of programs require residents to make up time if their leave exceeds 6 weeks during the fourth year. Ninety-three percent of programs require residents to make up time if their leave exceeds 20 weeks over the 4 years. Seventy-seven percent of respondents have other residents in their program cover for the absent resident. Thirty-seven percent of programs have schedules flexible enough to allow rearrangement so that some rotations go uncovered. Eighty-three percent of programs surveyed stated that maternity leave has a somewhat to very significant impact on the residents' schedules. Most residency programs have written maternity/paternity leave policies. A more flexible curriculum may help to accommodate the residents on leave without overburdening the residents who are left to cover.

Accommodating to Restrictions on Residents' Working Hours.

ERIC Educational Resources Information Center

Foster, Henry W., Jr.; Seltzer, Vicki L.

1991-01-01

In response to New York State legislation limiting house staff working hours, a survey of obstetrics and gynecology resident programs (n=26) was conducted. Results were used to construct a prototype call schedule and a hypothetical monthly schedule indicating how a single resident would function without violating any state regulations. (MSE)

Finding a Third Space in Teacher Education: Creating an Urban Teacher Residency

ERIC Educational Resources Information Center

Klein, Emily J.; Taylor, Monica; Onore, Cynthia; Strom, Kathryn; Abrams, Linda

2013-01-01

This paper describes an urban teacher residency program, the Newark Montclair Urban Teacher Residency, a collaborative endeavor between the Newark, New Jersey Public Schools and Montclair State University, built on a decades-long partnership. The authors see the conceptual work of developing this program as creating a "third space" in…

Abortion training in Canadian obstetrics and gynecology residency programs.

PubMed

Liauw, J; Dineley, B; Gerster, K; Hill, N; Costescu, D

2016-11-01

To evaluate the current state of abortion training in Canadian Obstetrics and Gynecology residency programs. Surveys were distributed to all Canadian Obstetrics and Gynecology residents and program directors. Data were collected on inclusion of abortion training in the curriculum, structure of the training and expected competency of residents in various abortion procedures. We distributed and collected surveys between November 2014 and May 2015. In total, 301 residents and 15 program directors responded, giving response rates of 55% and 94%, respectively. Based on responses by program directors, half of the programs had "opt-in" abortion training, and half of the programs had "opt-out" abortion training. Upon completion of residency, 66% of residents expected to be competent in providing first-trimester surgical abortion in an ambulatory setting, and 35% expected to be competent in second-trimester surgical abortion. Overall, 15% of residents reported that they were not aware of or did not have access to abortion training within their program, and 69% desired more abortion training during residency. Abortion training in Canadian Obstetrics and Gynecology residency programs is inconsistent, and residents desire more training in abortion. This suggests an ongoing unmet need for training in this area. Policies mandating standardized abortion training in obstetrics and gynecology residency programs are necessary to improve delivery of family planning services to Canadian women. Abortion training in Canadian Obstetrics and Gynecology residency programs is inconsistent, does not meet resident demand and is unlikely to fulfill the Royal College of Physicians and Surgeons of Canada objectives of training in the specialty. Copyright © 2016 Elsevier Inc. All rights reserved.

Transforming the Primary Care Training Clinic: New York State's Hospital Medical Home Demonstration Pilot.

PubMed

Angelotti, Marietta; Bliss, Kathryn; Schiffman, Dana; Weaver, Erin; Graham, Laura; Lemme, Thomas; Pryor, Veronica; Gesten, Foster C

2015-06-01

Training in patient-centered medical home (PCMH) settings may prepare new physicians to measure quality of care, manage the health of populations, work in teams, and include cost information in decision making. Transforming resident clinics to PCMHs requires funding for additional staff, electronic health records, training, and other resources not typically available to residency programs. Describe how a 1115 Medicaid waiver was used to transform the majority of primary care training sites in New York State to the PCMH model and improve the quality of care provided. The 2013-2014 Hospital Medical Home Program provided awards to 60 hospitals and 118 affiliated residency programs (training more than 5000 residents) to transform outpatient sites into PCMHs and provide high-quality, coordinated care. Site visits, coaching calls, resident surveys, data reporting, and feedback were used to promote and monitor change in resident continuity and quality of care. Descriptive analyses measured improvements in these areas. A total of 156 participating outpatient sites (100%) received PCMH recognition. All sites enhanced resident education using PCMH principles through patient empanelment, development of quality dashboards, and transforming resident scheduling and training. Clinical quality outcomes showed improvement across the demonstration, including better performance on colorectal and breast cancer screening rates (rate increases of 13%, P≤.001, and 11%, P=.011, respectively). A 1115 Medicaid waiver is a viable mechanism for states to transform residency clinics to reflect new primary care models. The PCMH transformation of 156 sites led to improvements in resident continuity and clinical outcomes.

Effect of the framing of questionnaire items regarding satisfaction with training on residents' responses.

PubMed

Guyatt, G H; Cook, D J; King, D; Norman, G R; Kane, S L; van Ineveld, C

1999-02-01

To determine whether framing questions positively or negatively influences residents' apparent satisfaction with their training. In 1993-94, 276 residents at five Canadian internal medicine residency programs responded to 53 Likert-scale items designed to determine sources of the residents' satisfaction and stress. Two versions of the questionnaire were randomly distributed: one in which half the items were stated positively and the other half negatively, the other version in which the items were stated in the opposite way. The residents scored 43 of the 53 items higher when stated positively and scored ten higher when stated negatively (p < .0001). When analyzed using an analysis-of-variance model, the effect of positive versus negative framing was highly significant (F = 129.81, p < .0001). While the interaction between item and framing was also significant, the effect was much less strong (F = 5.56, p < .0001). On a scale where 1 represented the lowest possible level of satisfaction and 7 the highest, the mean score of the positively stated items was 4.1 and that of the negatively stated items, 3.8, an effect of 0.3. These results suggest a significant "response acquiescence bias." To minimize this bias, questionnaires assessing attitudes toward educational programs should include a mix of positively and negatively stated items.

Residency Applicants Misinterpret Their United States Medical Licensing Exam Scores

ERIC Educational Resources Information Center

Jones, Roger C.; Desbiens, Norman A.

2009-01-01

Proper interpretation of the results of the United States Medical Licensing Exam (USMLE) is important for program directors, residents, and faculty who advise applicants about applying for residency positions. We suspected that applicants often misinterpreted their performance in relationship to others who took the same examination. In 2005, 54…

The association of departmental leadership gender with that of faculty and residents in radiology.

PubMed

Shah, Anand; Braga, Larissa; Braga-Baiak, Andresa; Jacobs, Danny O; Pietrobon, Ricardo

2007-08-01

Although the number of women graduating from medical school continues to increase, their representation in radiology residency programs has not increased over the past 10 years. We examined whether the gender of radiology faculty and residents differed according to the gender of the departmental leadership. We issued an anonymous Web-based survey via e-mail to all 188 radiology residency program directors listed in the Fellowship and Residency Electronic Interactive Database (FREIDA Online). Data regarding the gender of the department chairperson, residency program director, faculty, and residents were collected. The institutional review board granted a waiver for this study, and all subjects provided informed consent. Of the 84 program directors who responded, 9 (10.7%) were chaired by females and 75 (89.3%) by males; residency program director positions were held by 36 (42.9%) females and 48 (57.1%) males. More programs were located in the northeastern United States (n = 31, 36.9%) than in any other region, and more were self-described as academic (n = 36, 42.9%) than any other practice type. Programs that were led by a male chairperson had a similar proportion of female faculty (25.2% versus 27.3%; P = .322) and residents (26.2% versus 27.4%; P = .065) compared with those led by a female. Similarly, radiology departments with a male residency program director had a similar proportion of female residents (24.8% versus 28.7%; P = .055) compared with programs with a female residency program director. The gender composition of radiology faculty and residents does not differ significantly according to the gender of the departmental chairperson or residency program director. Nevertheless, there continues to be a disparity in the representation of women among radiology faculty and residents.

A Descriptive Survey of Anesthesiology Residency Simulation Programs: How Are Programs Preparing Residents for the New American Board of Anesthesiology APPLIED Certification Examination?

PubMed

Isaak, Robert S; Chen, Fei; Arora, Harendra; Martinelli, Susan M; Zvara, David A; Stiegler, Marjorie P

2017-09-01

Anesthesiology residency programs may need new simulation-based programs to prepare residents for the new Objective Structured Clinical Examination (OSCE) component of the American Board of Anesthesiology (ABA) Primary Certification process. The design of such programs may require significant resources, including faculty time, expertise, and funding, as are currently needed for structured oral examination (SOE) preparation. This survey analyzed the current state of US-based anesthesiology residency programs regarding simulation-based educational programming for SOE and OSCE preparation. An online survey was distributed to every anesthesiology residency program director in the United States. The survey included 15 to 46 questions, depending on each respondent's answers. The survey queried current practices and future plans regarding resident preparation specifically for the ABA APPLIED examination, with emphasis on the OSCE. Descriptive statistics were summarized. χ and Fisher exact tests were used to test the differences in proportions across groups. Spearman rank correlation was used to examine the association between ordinal variables. The responding 66 programs (49%) were a representative sample of all anesthesiology residencies (N = 136) in terms of geographical location (χ P = .58). There was a low response rate from small programs that have 12 or fewer clinical anesthesia residents. Ninety-one percent (95% confidence interval [CI], 84%-95%) of responders agreed that it is the responsibility of the program to specifically prepare residents for primary certification, and most agreed that it is important to practice SOEs (94%; 95% CI, 88%-97%) and OSCEs (89%; 95% CI, 83%-94%). While 100% of respondents reported providing mock SOEs, only 31% (95% CI, 24%-40%) of respondents provided mock OSCE experiences. Of those without an OSCE program, 75% (95% CI, 64%-83%) reported plans to start one. The most common reasons for not having an OSCE program already in place, and the perceived challenges for implementing an OSCE program, were the same: lack of time (faculty and residents), expertise in OSCE development and assessment, and funding. The results provide data from residency programs for benchmarking their simulation curriculum and ABA APPLIED Examination preparation offerings. Despite agreement that residency programs should prepare residents for the ABA APPLIED Examination, many programs have yet to implement an OSCE preparation program, in part due to lack of financial resources, faculty expertise, and time. Additionally, in contrast to the SOE, the OSCE is a new format for ABA primary certification. As a result, the lack of consensus concerning preparation needs could be related to the amount information that is available regarding the examination content and assessment process.

Combating the stress of residency: one school's approach.

PubMed

Dabrow, Sharon; Russell, Stephen; Ackley, Karen; Anderson, Eric; Fabri, Peter Jeff

2006-05-01

Residency is a time of stress and turmoil for many residents. The stresses are varied and great, often involving both personal and professional issues. One institutional mechanism that has been shown to help residents cope with stress is the use of residents' wellness, or assistance, programs. The University of South Florida (USF) College of Medicine developed the USF Residency Assistance Program (RAP) in 1997, modeled after business employee assistance programs but tailored to enhance the well-being of residents. The program was developed in an organized, thoughtful manner starting with a Request for Proposals to all local employee assistance programs and the selection of one of these to run the program. The RAP is broad-based, readily available, easily accessible, totally voluntary and confidential, and not reportable to the state board of medicine. It is well integrated into all residency programs and has had excellent acceptance from the administration; information about access to the RAP is available to all residents through multiple venues. The cost is minimal, at only seven cents a day per resident. The authors present data from the eight years the RAP has been operating, including information on program use, referral rates, acceptance, and types of problems encountered. One suicide occurred during this time period, and the RAP provided a significant role in grief counseling. Assistance programs are critical to the well-being of residents. The USF program presents a model that can be used by other programs around the country.

Generating Cultural Capital? Impacts of Artists-in-Residence on Teacher Professional Learning

ERIC Educational Resources Information Center

Hunter, Mary Ann; Baker, William; Nailon, Di

2014-01-01

In 2008, the Australian Government established the Artist-in-Residence (AiR) program as a four-year $5.2m initiative to improve young people's access to quality arts education. Managed by State and Territory Government Education and Arts Departments, the program funded professional artists-in-residence in schools, early childhood centres and…

The Burden of the Fellowship Interview Process on General Surgery Residents and Programs.

PubMed

Watson, Shawna L; Hollis, Robert H; Oladeji, Lasun; Xu, Shin; Porterfield, John R; Ponce, Brent A

This study evaluated the effect of the fellowship interview process in a cohort of general surgery residents. We hypothesized that the interview process would be associated with significant clinical time lost, monetary expenses, and increased need for shift coverage. An online anonymous survey link was sent via e-mail to general surgery program directors in June 2014. Program directors distributed an additional survey link to current residents in their program who had completed the fellowship interview process. United States allopathic general surgery programs. Overall, 50 general surgery program directors; 72 general surgery residents. Program directors reported a fellowship application rate of 74.4%. Residents most frequently attended 8 to 12 interviews (35.2%). Most (57.7%) of residents reported missing 7 or more days of clinical training to attend interviews; these shifts were largely covered by other residents. Most residents (62.3%) spent over $4000 on the interview process. Program directors rated fellowship burden as an average of 6.7 on a 1 to 10 scale of disruption, with 10 being a significant disruption. Most of the residents (57.3%) were in favor of change in the interview process. We identified potential areas for improvement including options for coordinated interviews and improved content on program websites. The surgical fellowship match is relatively burdensome to residents and programs alike, and merits critical assessment for potential improvement. Published by Elsevier Inc.

Support for and aspects of use of educational games in family medicine and internal medicine residency programs in the US: a survey.

PubMed

Akl, Elie A; Gunukula, Sameer; Mustafa, Reem; Wilson, Mark C; Symons, Andrew; Moheet, Amir; Schünemann, Holger J

2010-03-25

The evidence supporting the effectiveness of educational games in graduate medical education is limited. Anecdotal reports suggest their popularity in that setting. The objective of this study was to explore the support for and the different aspects of use of educational games in family medicine and internal medicine residency programs in the United States. We conducted a survey of family medicine and internal medicine residency program directors in the United States. The questionnaire asked the program directors whether they supported the use of educational games, their actual use of games, and the type of games being used and the purpose of that use. Of 434 responding program directors (52% response rate), 92% were in support of the use of games as an educational strategy, and 80% reported already using them in their programs. Jeopardy like games were the most frequently used games (78%). The use of games was equally popular in family medicine and internal medicine residency programs and popularity was inversely associated with more than 75% of residents in the program being International Medical Graduates. The percentage of program directors who reported using educational games as teaching tools, review tools, and evaluation tools were 62%, 47%, and 4% respectively. Given a widespread use of educational games in the training of medical residents, in spite of limited evidence for efficacy, further evaluation of the best approaches to education games should be explored.

Training and use of lasers in postgraduate orthodontic programs in the United States and Canada.

PubMed

Dansie, Chase O; Park, Jae Hyun; Makin, Inder Raj S

2013-06-01

This study was designed to determine if orthodontic residents are being trained to use lasers in the postgraduate orthodontic residency programs of the United States and Canada. An anonymous electronic survey was sent to the program director/chair of each of the seventy orthodontic residency programs, and thirty-seven (53 percent) of the programs responded. Of these thirty-seven programs, twenty-eight (76 percent) reported providing patient treatment with lasers in the orthodontic graduate program, eight (22 percent) said they do not provide treatment in the orthodontic graduate program, and one program (3 percent) reported providing laser training but not using lasers on patients. Gingivectomy and canine exposure were reported as the most common procedures that residents perform with a laser, while debonding of orthodontic brackets was the least common procedure performed with a laser. A diode laser was the most common type of laser used. Of the eight programs (22 percent) not offering laser training, four indicated having no plans to begin using lasers or training on their use. The other four indicated that they have plans to incorporate laser use in the future.

The State of Communication Education in Family Medicine Residencies.

PubMed

Jansen, Kate L; Rosenbaum, Marcy E

2016-06-01

Communication skills are essential to medical training and have lasting effects on patient satisfaction and adherence rates. However, relatively little is reported in the literature identifying how communication is taught in the context of residency education. Our goal was to determine current practices in communication curricula across family medicine residency programs. Behavioral scientists and program directors in US family medicine residencies were surveyed via email and professional organization listservs. Questions included whether programs use a standardized communication model, methods used for teaching communication, hours devoted to teaching communication, as well as strengths and areas for improvement in their program. Analysis identified response frequencies and ranges complemented by analysis of narrative comments. A total of 204 programs out of 458 family medicine residency training sites responded (45%), with 48 out of 50 US states represented. The majority of respondents were behavioral scientists. Seventy-five percent of programs identified using a standard communication model; Mauksch's patient-centered observation model (34%) was most often used. Training programs generally dedicated more time to experiential teaching methods (video review, work with simulated patients, role plays, small groups, and direct observation of patient encounters) than to lectures (62% of time and 24% of time, respectively). The amount of time dedicated to communication education varied across programs (average of 25 hours per year). Respondent comments suggest that time dedicated to communication education and having a formal curriculum in place are most valued by educators. This study provides a picture of how communication skills teaching is conducted in US family medicine residency programs. These findings can provide a comparative reference and rationale for residency programs seeking to evaluate their current approaches to communication skills teaching and develop new or enhanced curricula.

Meeting the Needs of Underserved Patients in Western Kenya by Creating the Next Generation of Global Health Pharmacists.

PubMed

Miller, Monica L; Karwa, Rakhi; Schellhase, Ellen M; Pastakia, Sonak D; Crowe, Susie; Manji, Imran; Jakait, Beatrice; Maina, Mercy

2016-03-25

Objective. To describe a novel training model used to create a sustainable public health-focused pharmacy residency based in Kenya and to describe the outcomes of this training program on underserved populations. Design. The postgraduate year 2 residency was designed to expose trainees to the unique public health facets of inpatient, outpatient, and community-based care delivery in low and middle-income countries. Public health areas of focus included supply chain management, reproductive health, pediatrics, HIV, chronic disease management, and teaching. Assessment. The outcomes of the residency were assessed based on the number of new clinical programs developed by residents, articles and abstracts written by residents, and resident participation in grant writing. To date, six residents from the United States and eight Kenyan residents have completed the residency. Eleven sustainable patient care services have been implemented as a result of the residency program. Conclusion. This pharmacy residency training model developed accomplished pharmacists in public health pharmacy, with each residency class expanding funding and clinical programming, contributing to curriculum development, and creating jobs.

Cost of Incremental Expansion of an Existing Family Medicine Residency Program.

PubMed

Ashkin, Evan A; Newton, Warren P; Toomey, Brian; Lingley, Ronald; Page, Cristen P

2017-07-01

Expanding residency training programs to address shortages in the primary care workforce is challenged by the present graduate medical education (GME) environment. The Medicare funding cap on new GME positions and reductions in the Health Resources and Services Administration (HRSA) Teaching Health Center (THC) GME program require innovative solutions to support primary care residency expansion. Sparse literature exists to assist in predicting the actual cost of incremental expansion of a family medicine residency program without federal or state GME support. In 2011 a collaboration to develop a community health center (CHC) academic medical partnership (CHAMP), was formed and created a THC as a training site for expansion of an existing family medicine residency program. The cost of expansion was a critical factor as no Federal GME funding or HRSA THC GME program support was available. Initial start-up costs were supported by a federal grant and local foundations. Careful financial analysis of the expansion has provided actual costs per resident of the incremental expansion of the residencyRESULTS: The CHAMP created a new THC and expanded the residency from eight to ten residents per year. The cost of expansion was approximately $72,000 per resident per year. The cost of incremental expansion of our residency program in the CHAMP model was more than 50% less than that of the recently reported cost of training in the HRSA THC GME program.

Factors Influencing Resident Choice of Prosthodontic Residency Program.

PubMed

Wojnarwsky, Pandora Keala Lee; Wang, Yan; Shah, Kumar; Koka, Sreenivas

2017-06-01

The decision by prosthodontic residency program directors to employ the Match process highlights the need to understand applicant priorities that influence their choice of which programs to rank highly. The purpose of this study is to determine the factors that were most important to residents when choosing from among nonmilitary based prosthodontics dental residency programs in the United States. Following completion of a pilot study, all currently enrolled prosthodontic residents at nonmilitary residency programs were invited to participate via the internet. The study consisted of a survey instrument asking residents to rank 26 possible factors that might impact an applicant's choice of residency program. In addition, the instrument collected other possible influencing variables including gender and debt load. Mean rank scores were compared to determine the most and least important factors. Kruskal-Wallis test was used to compare specific factors between the possible influencing variables. Two hundred and thirty residents completed the survey instrument, representing a 54.1% response rate of possible participants. With regard to factors influencing program choice, reputation of the residency program was the factor ranked the highest by participants, followed in descending order by the program director's personality, curriculum content, access to use of the latest digital technology, and opportunities for dental implant placement. Quality of schools for children, community outreach opportunities, and the ability to moonlight were ranked as the least important factors. Male and female residents ranked factors such as tuition/stipend, curriculum content, and community outreach opportunities significantly differently. Depending on debt load, residents ranked the factors tuition/stipend, ability to moonlight, curriculum content, and safety of the area where the program is differently. Current prosthodontic residents valued the reputation of the program as the most important factor when applying to residency. Participant gender and debt load influence the factors chosen by residents as more or less important. These data will assist prosthodontic educators position their programs in the best possible light to attract applicants to their programs. © 2017 by the American College of Prosthodontists.

Implementation of a pharmacy residency in a Veterans Affairs community-based outpatient clinic.

PubMed

Phillips, Beth Bryles; Williams, Kim C

2012-05-15

The implementation of an innovative ambulatory care pharmacy residency program at a Veterans Affairs (VA) outpatient clinic is described. Community-based outpatient clinics (CBOCs) are a largely underutilized resource for pharmacy residency training. Through a collaboration of the University of Georgia College of Pharmacy in Athens and Charlie Norwood VA Medical Center in Augusta, a postgraduate year 2 (PGY2) pharmacy residency program was established at the CBOC in Athens. The program graduated its first resident in 2009; components of training included (1) disease state management at an anticoagulation clinic and a newly created disease state-focused pharmacotherapy clinic, (2) participation in the planning and implementation of a new lipid management service, (3) a variety of didactic, laboratory, and experiential teaching activities at the college of pharmacy, and (4) management experiences such as completing requests for nonformulary medications, management of drug shortages, adverse drug reaction reporting, and participation in meetings of local and regional VA pharmacy and therapeutics committees. The demonstrated value of the ongoing program led to position upgrades for two CBOC clinical pharmacists and the addition of a clinical faculty member, enabling the program to offer additional learning experiences and preceptorship opportunities. A PGY2 ambulatory care residency program established in a CBOC provided a novel practice setting for the resident, helped improve patient care and pharmacy student education, and assisted in the professional development of preceptors and providers at the training site.

Specialty education in periodontics in Japan and the United States: comparison of programs at Nippon Dental University Hospital and the University of Texas Health Science Center at San Antonio.

PubMed

Osawa, Ginko; Nakaya, Hiroshi; Mealey, Brian L; Kalkwarf, Kenneth; Cochran, David L

2014-03-01

Japan has institutions that train qualified postdoctoral students in the field of periodontics; however, Japan does not have comprehensive advanced periodontal programs and national standards for these specialty programs. To help Japanese programs move toward global standards in this area, this study was designed to describe overall differences in periodontics specialty education in Japan and the United States and to compare periodontics faculty members and residents' characteristics and attitudes in two specific programs, one in each country. Periodontal faculty members and residents at Nippon Dental University (NDU) and the University of Texas Health Science Center at San Antonio (UTHSCSA) Dental School participated in the survey study: four faculty members and nine residents at NDU; seven faculty members and thirteen residents at UTHSCSA. Demographic data were collected as well as respondents' attitudes toward and assessment of their programs. The results showed many differences in curriculum structure and clinical performance. In contrast to the UTHSCSA respondents, for example, the residents and faculty members at NDU reported that they did not have enough subject matter and time to learn clinical science. Although the residents at NDU reported seeing more total patients in one month than those at UTHSCSA, they were taught fewer varieties of periodontal treatments. To provide high-quality and consistent education for periodontal residents, Japan needs to establish a set of standards that will have positive consequences for those in Japan who need periodontal treatment.

National trends in pediatric resident recruitment.

PubMed

Piatt, J P; Bergeson, P S

1992-08-01

Primary care residency programs throughout the nation are having increasing difficulty recruiting sufficient residents. Only 65% of pediatric residency positions are filled with medical graduates from the United States. We sent a questionnaire to pediatric residency program directors throughout the country to assess what changes pediatric programs had implemented in response to matching concerns. Forty-one percent had recruited non-house officer professionals to perform resident-type work. Such professionals included osteopathic and/or foreign-trained physicians (55%) and moonlighters (49%). House staff work hours had been reduced in 35% of programs and on-call frequency in 33%. Sixty-one percent had made significant changes in their recruiting practices in the past 5 years that are described herein. Annual recruiting budgets varied from nothing to over $75,000. This survey reveals widespread reduction in resident work load and increased intensity in the recruiting process throughout the country.

The Impact of the 2008 Council of Emergency Residency Directors (CORD) Panel on Emergency Medicine Resident Diversity.

PubMed

Boatright, Dowin; Tunson, Java; Caruso, Emily; Angerhofer, Christy; Baker, Brooke; King, Renee; Bakes, Katherine; Oberfoell, Stephanie; Lowenstein, Steven; Druck, Jeffrey

2016-11-01

In 2008, the Council of Emergency Medicine Residency Directors (CORD) developed a set of recruitment strategies designed to increase the number of under-represented minorities (URMs) in Emergency Medicine (EM) residency. We conducted a survey of United States (US) EM residency program directors to: describe the racial and ethnic composition of residents; ascertain whether each program had instituted CORD recruitment strategies; and identify program characteristics associated with recruitment of a high proportion of URM residents. The survey was distributed to accredited, nonmilitary US EM residency programs during 2013. Programs were dichotomized into high URM and low URM by the percentage of URM residents. High- and low-URM programs were compared with respect to size, geography, percentage of URM faculty, importance assigned to common applicant selection criteria, and CORD recruitment strategies utilized. Odds ratios and 95% confidence limits were calculated. Of 154 residency programs, 72% responded. The median percentage of URM residents per program was 9%. Only 46% of EM programs engaged in at least two recruitment strategies. Factors associated with higher resident diversity (high-URM) included: diversity of EM faculty (high-URM) (odds ratio [OR] 5.3; 95% confidence interval [CI] 2.1-13.0); applicant's URM status considered important (OR 4.9; 95% CI 2.1-11.9); engaging in pipeline activities (OR 4.8; 95% CI 1.4-15.7); and extracurricular activities considered important (OR 2.6; 95% CI 1.2-6.0). Less than half of EM programs have instituted two or more recruitment strategies from the 2008 CORD diversity panel. EM faculty diversity, active pipeline programs, and attention paid to applicants' URM status and extracurricular activities were associated with higher resident diversity. Copyright © 2016 Elsevier Inc. All rights reserved.

Survey of United States neurosurgical residency program directors.

PubMed

Lunsford, L Dade; Kassam, Amin; Chang, Yue-Fang

2004-02-01

The field of neurosurgery in the United States faces many challenges. Neurosurgical program directors in the United States represent a logical source for inquiries about manpower issues, the training process, and Residency Review Committee (RRC) oversight. Ninety-one active residency program directors were sent an anonymous 31-question survey. The respondents were given the option of adding additional comments. The questions were designed to address issues related to manpower, the training process, and RRC governance. Sixty-one responses were returned before an email reminder and 11 after the reminder (a total response rate of 79%). The data were entered into a database, and a descriptive analysis, with frequency distribution, was performed. The purpose of this review was to gain a preliminary understanding of the perceptions of program directors regarding the neurosurgical training process, the RRC, the oversight process, and projected manpower needs. A 79% response rate is high for a mail survey and likely reflects heightened concern and interest in such issues. The survey responses indicate general satisfaction with the role and governance of the RRC, significantly divergent perceptions of resident output and available positions, and serious concerns regarding the current training process. This survey suggests that a broader discussion of resident training issues would be valuable, perhaps using validated survey instruments.

Wellness Works: A Collaborative Program for Youth and Adults in Rural Utah

ERIC Educational Resources Information Center

Shirley, Lindsey; Roark, Mark F.; Lewis, Lisa

2012-01-01

Utah State University Cooperative Extension programming, provided through the historic land-grant system, is one method used to meet the needs of residents located in rural communities. Residents in a Central Utah county need Cooperative Extension programs to address the health and wellness of their rural community. According to the Utah…

Breastfeeding education and support services offered to pediatric residents in the US.

PubMed

Osband, Yardaena B; Altman, Robin L; Patrick, Patricia A; Edwards, Karen S

2011-01-01

The American Academy of Pediatrics (AAP) encourages pediatricians to support the practice of breastfeeding and residency educators to develop formal curricula in breastfeeding education. Few studies, however, describe breastfeeding education or support services currently provided to pediatric residents in the United States. The goals of this study were to investigate breastfeeding training offered during 3-year pediatric residency programs and to describe residency programs' policies and services for residents who breastfeed. We conducted a cross-sectional study using a Web-based survey of pediatric program directors regarding breastfeeding education and support services for residents. Seventy percent of program directors (132 of 189) completed the survey, with 77.3% of respondents (n = 102) estimating the amount of breastfeeding education offered to their pediatric residents. Residents are provided with a median total of 9.0 hours of breastfeeding training over 3 years, primarily in continuity clinic and in lectures and rounds with attendings. At the programs' primary teaching hospitals, breastfeeding residents are provided breastfeeding rooms (67.0%), breast pumps (75.3%), and breast milk storage facilities (87.6%). Only 10 programs reported having an official policy to accommodate breastfeeding residents. Pediatric residents receive approximately 3 hours of breastfeeding training per year. In addition, there is less than universal implementation by residency programs of AAP recommendations for supporting breastfeeding in the workplace. Pediatric residency programs should find ways to improve and assess the quality of breastfeeding education and workplace support to better role model this advocacy standard. Copyright © 2011 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Outcomes assessment of a residency program in laboratory medicine.

PubMed

Morse, E E; Pisciotto, P T; Hopfer, S M; Makowski, G; Ryan, R W; Aslanzadeh, J

1997-01-01

During a down-sizing of residency programs at a State University Medical School, hospital based residents' positions were eliminated. It was determined to find out the characteristics of the residents who graduated from the Laboratory Medicine Program, to compare women graduates with men graduates, and to compare IMGs with United States Graduates. An assessment of a 25 year program in laboratory medicine which had graduated 100 residents showed that there was no statistically significant difference by chi 2 analysis in positions (laboratory directors or staff), in certification (American Board of Pathology [and subspecialties], American Board of Medical Microbiology, American Board of Clinical Chemistry) nor in academic appointments (assistant professor to full professor) when the male graduates were compared with the female graduates or when graduates of American medical schools were compared with graduates of foreign medical schools. There were statistically significant associations by chi 2 analysis between directorship positions and board certification and between academic appointments and board certification. Of 100 graduates, there were 57 directors, 52 certified, and 41 with academic appointments. Twenty-two graduates (11 women and 11 men) attained all three.

First Author Research Productivity of United States Radiation Oncology Residents: 2002-2007

DOE Office of Scientific and Technical Information (OSTI.GOV)

Morgan, Peter B.; Sopka, Dennis M.; Kathpal, Madeera

2009-08-01

Purpose: Participation in investigative research is a required element of radiation oncology residency in the United States. Our purpose was to quantify the first author research productivity of recent U.S. radiation oncology residents during their residency training. Methods and Materials: We performed a computer-based search of PubMed and a manual review of the proceedings of the annual meetings of the American Society for Therapeutic Radiology and Oncology to identify all publications and presented abstracts with a radiation oncology resident as the first author between 2002 and 2007. Results: Of 1,098 residents trained at 81 programs, 50% published {>=}1 article (range,more » 0-9), and 53% presented {>=}1 abstract (range, 0-3) at an American Society for Therapeutic Radiology and Oncology annual meeting. The national average was 1.01 articles published and 1.09 abstracts presented per resident during 4 years of training. Of 678 articles published, 82% represented original research and 18% were review articles. Residents contributed 15% of all abstracts at American Society for Therapeutic Radiology and Oncology annual meetings, and the resident contribution to orally presented abstracts increased from 12% to 21% during the study period. Individuals training at programs with >6 residents produced roughly twice as many articles and abstracts. Holman Research Pathway residents produced double the national average of articles and abstracts. Conclusion: Although variability exists among individuals and among training programs, U.S. radiation oncology residents routinely participate in investigative research suitable for publication or presentation at a scientific meeting. These data provide national research benchmarks that can assist current and future radiation oncology residents and training programs in their self-assessment and research planning.« less

A dedicated research program increases the quantity and quality of orthopaedic resident publications.

PubMed

Torres, Daniel; Gugala, Zbigniew; Lindsey, Ronald W

2015-04-01

Programs seek to expose trainees to research during residency. However, little is known in any formal sense regarding how to do this effectively, or whether these efforts result in more or better-quality research output. The objective of our study was to evaluate a dedicated resident research program in terms of the quantity and quality of resident research peer-reviewed publications. Specifically we asked: (1) Did residents mentored through a dedicated resident research program have more peer-reviewed publications in higher-impact journals with higher citation rates compared with residents who pursued research projects under a less structured approach? (2) Did this effect continue after graduation? In 2006, our department of orthopaedic surgery established a dedicated resident research program, which consisted of a new research policy and a research committee to monitor quality and compliance with this policy. Peer-reviewed publications (determined from PubMed) of residents who graduated 6 years before establishing the dedicated resident research program were compared with publications from an equal period of the research-program-directed residents. The data were assessed using descriptive statistics and regression analysis. Twenty-four residents graduated from 2001 to 2006 (before implementation of the dedicated resident research program); 27 graduated from 2007 to 2012 (after implementation of the dedicated resident research program). There were 74 eligible publications as defined by the study inclusion and exclusion criteria. Residents who trained after implementation of the dedicated resident research program published more papers during residency than did residents who trained before the program was implemented (1.15 versus 0.79 publications per resident; 95% CI [0.05,0.93]; p = 0.047) and the journal impact factor was greater in the group that had the research program (1.25 versus 0.55 per resident; 95% CI [0.2,1.18]; p = 0.005). There were no differences between postresidency publications by trainees who graduated with versus without the research program in the number of publications, citations, and average journal impact factor per resident. A regression analysis showed no difference in citation rates of the residents' published papers before and since implementation of the research program. Currently in the United States, there are no standard policies or requirements that dictate how research should be incorporated in orthopaedic surgery residency training programs. The results of our study suggest that implementation of a dedicated resident research program improves the quantity and to some extent quality of orthopaedic resident research publications, but this effect did not persist after graduation.

Attitudes and Beliefs of Pathology Residents Regarding the Subspecialty of Clinical Chemistry: Results of a Survey.

PubMed

Haidari, Mehran; Yared, Marwan; Olano, Juan P; Alexander, C Bruce; Powell, Suzanne Z

2017-02-01

-Previous studies suggest that training in pathology residency programs does not adequately prepare pathology residents to become competent in clinical chemistry. -To define the beliefs of pathology residents in the United States regarding their preparation for practicing clinical chemistry in their career, their attitude toward the discipline, and the attractiveness of clinical chemistry as a career. -The residents of all pathology residency programs in the United States were given the opportunity to participate in an online survey. -Three hundred thirty-six pathology residents responded to the survey. Analysis of the survey results indicates that pathology residents are more likely to believe that their income may be lower if they select a career that has a clinical chemistry focus and that their faculty do not value clinical chemistry as much as the anatomic pathology part of the residency. Residents also report that clinical chemistry is not as enjoyable as anatomic pathology rotations during residency or preferable as a sole career path. A large proportion of residents also believe that they will be slightly prepared or not prepared to practice clinical chemistry by the end of their residency and that they do not have enough background and/or time to learn clinical chemistry during their residency programs to be able to practice this specialty effectively post graduation. -Our survey results suggest that many pathology residents do not have a positive attitude toward clinical chemistry and do not experience a supportive learning environment with an expectation that they will become competent in clinical chemistry with a residency alone.

Happy Healers

ERIC Educational Resources Information Center

Winter, Robin O.

2011-01-01

Family Medicine residency programs in the United States are required to promote resident well-being. This article describes how one residency does this by teaching the concepts of Positive Psychology and Authentic Happiness developed by Dr. Martin Seligman utilizing a multi-media curriculum. As part of this curriculum, residents listen to the song…

Global health education in United States anesthesiology residency programs: a survey of resident opportunities and program director attitudes.

PubMed

Kaur, Gunisha; Tabaie, Sheida; Brar, Jasmit; Tangel, Virginia; Pryor, Kane O

2017-11-16

Interest in global health during postgraduate residency training is increasing across medical specialties, and multiple disciplines have categorized global health training opportunities in their arena. No such cataloging exists for anesthesiology residency programs. The aim of this study was to assess and characterize global health opportunities and the attitudes of program directors (PDs) in U.S. anesthesiology residency programs towards this training. A cross-sectional 20-question survey on global health opportunities was distributed to 128 ACGME accredited anesthesiology residency program directors via email between October 2015 and January 2016. Descriptive statistics and exploratory inferential analyses were applied. Maximal nonresponse selection bias was estimated. The overall response rate was 44%. Of those who responded, 61% reported that their residency program had a global health elective, with a maximal bias estimate of 6.5%. 45% of program directors with no global health elective reported wanting to offer one. 77% of electives have articulated educational goals, but there is substantial heterogeneity in curricula offered. Program director attitudes regarding the value of global health programs differed significantly between those with and without existing programs. The proportion of U.S. anesthesiology residency programs offering global health electives is similar to that in other medical specialties. There is inconsistency in program structure, goals, curriculum, and funding. Attitudes of program directors differ between programs with and without electives, which may reflect bidirectional influence to be investigated further. Further studies are needed to codify curricula, assess effectiveness, and validate methodologies.

Driver and Traffic Safety Education: A Lesson Plan for the Residents of Gracewood State School and Hospital.

ERIC Educational Resources Information Center

Latimer, Jonathan L.

Outlined is a course of driver education and traffic safety taught to retarded residents of a state institution. Stressed is the importance of driver education for residents able to leave the institution. The philosophy of the program is given to emphasize individualizing instruction, instructing students who possess the potential for driving,…

Psychiatry chief resident opinions toward basic and clinical neuroscience training and practice.

PubMed

Bennett, Jeffrey I; Handa, Kamna; Mahajan, Aman; Deotale, Pravesh

2014-04-01

The authors queried attendees to a chief resident conference on whether program education and training in neuroscience or in translating neuroscience research into practice is sufficient and what changes are needed. The authors developed and administered a 26-item voluntary questionnaire to each attendee at the Chief Residents' Leadership Conference at the American Psychiatric Association 2013 annual meeting in San Francisco, CA. Out of 94 attendees, 55 completed and returned questionnaires (58.5%). A majority of respondents stated that their program provided adequate training in neuroscience (61.8%); opportunities for neuroscience research existed for them (78.2%), but that their program did not prepare them for translating future neuroscience research findings into clinical practice (78.9%) or educate them on the NIMH Research Domain Criteria (83.3%). A majority of respondents stated that the ACGME should require a specific neuroscience curriculum (79.6%). Chief residents believe that curricular and cultural change is needed in psychiatry residency neuroscience education.

Increased Academic Productivity of Orthopaedic Surgery Residents Following 2011 Duty Hour Reform.

PubMed

Johnson, Joey P; Savage, Kevin; Gil, Joseph A; Eberson, Craig P; Mulcahey, Mary K

2017-12-19

In 2003 and again in 2011, the Accreditation Council for Graduate Medical Education (ACGME) mandated increasingly stringent resident duty hour restrictions. With less time required at the hospital, residents theoretically have more time for other academic activities, such as research. Our study seeks to examine whether the number of research publications by orthopaedic residents increased following implementation of the 2011 ACGME duty hour restrictions. Pubmed was queried using publicly available alumni lists from programs across the United States. The years 2008 to 2011 were included to assess pre-2011 productivity. The years 2012 to 2015 were included in the post 2011 group. Paired t tests were used to assess differences between groups. Statistical significance was set to p < 0.05 a priori. A total of 10 orthopedic surgery residency programs across the United States. The study group was composed of 5 of the 2015 top 20 National Institutes of Health (NIH) funded programs and 5 programs without NIH funding. When corrected for number of residents per year, there were 0.290 publications per resident/year from 2008 to 2011 increasing to 0.528 publications per resident/year from 2012 to 2015 following implementation of the 2011 work hour restrictions (p = 0.033). When corrected for number of residents per year, there remained no difference in publications per resident from 2008 to 2011 (p = 0.81) or from 2012 to 2015 (p = 0.10) between NIH and non-NIH funded programs. There has been little data to support the theory that resident work hour restrictions have improved education or patient care in any meaningful way. In our study, there was a statistically significant increase in publications after 2011; however, the number of publications between NIH funded and non-NIH funded programs did not differ. Our study is the first to demonstrate that with increasing duty hour restrictions, orthopaedic surgery residents may be using more of their free time to conduct research. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

A survey of residency program directors in anesthesiology regarding mentorship of residents.

PubMed

Gonzalez, Laura Shank; Donnelly, Melanie J

2016-09-01

Mentorship of residents has been extensively studied within many academic specialties, but not anesthesia. The purpose of this study is to determine the prevalence of formal mentorship programs among anesthesia residency programs accredited by the Accreditation Council for Graduate Medical Education in the United States by surveying residency directors. The secondary goals of the study are to describe the programs that exist and identify areas that residency directors think should be the focus of mentoring. Our survey was designed based on previous surveys administered to residency program directors from other specialties. After determination of exempt status by our institutional review board, the survey was administered via e-mail to program directors of Accreditation Council for Graduate Medical Education-accredited anesthesiology residencies. Response rate was 34% (45/131). The sample consisted of mainly university-based programs (93%). Most (88%) had a mentorship program in place. There was little consistency between methods of forming faculty-resident mentor pairs. Most mentors (84%) and mentees (79%) did not evaluate their programs. Nearly all program directors agree that mentorship is an important tool for resident development (90.6%) and that it is important to have a mentor during training (90.6%). Program directors identified the areas of career planning, professionalism, and achieving a balance between personal, career, and family demands to be the most valuable subjects to address in a mentoring relationship. Anesthesiology is currently underrepresented in the trainee mentoring literature. There is significant support for mentorship during resident training; however, the low rates of training for faculty and minimal evaluation by residents and faculty raise the question as to the efficacy of the existing programs. There is a need for more investigation of anesthesia residents' goals and perceptions of mentorship, and a more detailed evaluation of existing mentorship programs to determine the ideal structure of a mentoring program. Copyright © 2016 Elsevier Inc. All rights reserved.

The Utah rural residency study: a blueprint for evaluating potential sites for development of a 4-4-4 family practice residency program in a rural community.

PubMed

Catinella, A Peter; Magill, Michael K; Thiese, Steven M; Turner, Deborah; Elison, Gar T; Baden, Daniel J

2003-01-01

Most graduates of rural residencies enter rural practice. Rural residencies therefore have emerged over the past 2 decades to increase the supply of rural physicians. However, researchers have published few descriptions of strategies to evaluate and select communities in which to locate rural residencies. This report describes the development and application of such a strategy to assess 7 rural communities in Utah as potential sites for family practice residency training. Criteria were developed on the basis of an examination of the literature, residency accreditation requirements, and characteristics of existing rural residency programs. Ten rural or frontier communities with hospitals were selected as study candidates, and 7 agreed to participate. Data were collected through hospital surveys, state hospital discharge records, and community site visits. Specific evaluation criteria that were developed included the presence of a medical practice of the appropriate specialty and size, a sufficient number of medical subspecialty physicians, an adequate number and mix of hospitalized patients, an adequate number of ambulatory patients, adequate outpatient facility space to accommodate learners, and a commitment by the practicing physician and hospital to lead the program and teach residents. Two communities were found to be potentially capable of supporting a residency if physicians and hospital leaders in the communities were to become motivated to lead program development. These criteria may be useful in other states, but they have not been tested for validity or reliability and are subject to limitations such as exclusion of alternate rural residency models. Future research should address data needs and the relationship of the evaluation criteria to the quality of resident learning.

Taking it Global: Structuring Global Health Education in Residency Training.

PubMed

Arora, Gitanjli; Ripp, Jonathan; Evert, Jessica; Rabin, Tracy; Tupesis, Janis P; Hudspeth, James

2017-05-01

To meet the demand by residents and to provide knowledge and skills important to the developing physician, global health (GH) training opportunities are increasingly being developed by United States (U.S.) residency training programs. However, many residency programs face common challenges of developing GH curricula, offering safe and mentored international rotations, and creating GH experiences that are of service to resource-limiting settings. Academic GH partnerships allow for the opportunity to collaborate on education and research and improve health care and health systems, but must ensure mutual benefit to U.S. and international partners. This article provides guidance for incorporating GH education into U.S. residency programs in an ethically sound and sustainable manner, and gives examples and solutions for common challenges encountered when developing GH education programs.

A national survey of residents in combined Internal Medicine and Dermatology residency programs: educational experience and future plans.

PubMed

Mostaghimi, Arash; Wanat, Karolyn; Crotty, Bradley H; Rosenbach, Misha

2015-10-16

In response to a perceived erosion of medical dermatology, combined internal medicine and dermatology programs (med/derm) programs have been developed that aim to train dermatologists who take care of medically complex patients. Despite the investment in these programs, there is currently no data with regards to the potential impact of these trainees on the dermatology workforce. To determine the experiences, motivations, and future plans of residents in combined med/derm residency programs. We surveyed residents at all United States institutions with both categorical and combined training programs in spring of 2012. Respondents used visual analog scales to rate clinical interests, self-assessed competency, career plans, and challenges. The primary study outcomes were comfort in taking care of patients with complex disease, future practice plans, and experience during residency. Twenty-eight of 31 med/derm residents (87.5%) and 28 of 91 (31%) categorical residents responded (overall response rate 46%). No significant differences were seen in self-assessed dermatology competency, or comfort in performing inpatient consultations, cosmetic procedures, or prescribing systemic agents. A trend toward less comfort in general dermatology was seen among med/derm residents. Med/derm residents were more likely to indicate career preferences for performing inpatient consultation and taking care of medically complex patients. Categorical residents rated their programs and experiences more highly. Med/derm residents have stronger interests in serving medically complex patients. Categorical residents are more likely to have a positive experience during residency. Future work will be needed to ascertain career choices among graduates once data are available.

The research rotation: competency-based structured and novel approach to research training of internal medicine residents.

PubMed

Kanna, Balavenkatesh; Deng, Changchun; Erickson, Savil N; Valerio, Jose A; Dimitrov, Vihren; Soni, Anita

2006-10-17

In the United States, the Accreditation Council of graduate medical education (ACGME) requires all accredited Internal medicine residency training programs to facilitate resident scholarly activities. However, clinical experience and medical education still remain the main focus of graduate medical education in many Internal Medicine (IM) residency-training programs. Left to design the structure, process and outcome evaluation of the ACGME research requirement, residency-training programs are faced with numerous barriers. Many residency programs report having been cited by the ACGME residency review committee in IM for lack of scholarly activity by residents. We would like to share our experience at Lincoln Hospital, an affiliate of Weill Medical College Cornell University New York, in designing and implementing a successful structured research curriculum based on ACGME competencies taught during a dedicated "research rotation". Since the inception of the research rotation in 2004, participation of our residents among scholarly activities has substantially increased. Our residents increasingly believe and appreciate that research is an integral component of residency training and essential for practice of medicine. Internal medicine residents' outlook in research can be significantly improved using a research curriculum offered through a structured and dedicated research rotation. This is exemplified by the improvement noted in resident satisfaction, their participation in scholarly activities and resident research outcomes since the inception of the research rotation in our internal medicine training program.

The research rotation: competency-based structured and novel approach to research training of internal medicine residents

PubMed Central

Kanna, Balavenkatesh; Deng, Changchun; Erickson, Savil N; Valerio, Jose A; Dimitrov, Vihren; Soni, Anita

2006-01-01

Background In the United States, the Accreditation Council of graduate medical education (ACGME) requires all accredited Internal medicine residency training programs to facilitate resident scholarly activities. However, clinical experience and medical education still remain the main focus of graduate medical education in many Internal Medicine (IM) residency-training programs. Left to design the structure, process and outcome evaluation of the ACGME research requirement, residency-training programs are faced with numerous barriers. Many residency programs report having been cited by the ACGME residency review committee in IM for lack of scholarly activity by residents. Methods We would like to share our experience at Lincoln Hospital, an affiliate of Weill Medical College Cornell University New York, in designing and implementing a successful structured research curriculum based on ACGME competencies taught during a dedicated "research rotation". Results Since the inception of the research rotation in 2004, participation of our residents among scholarly activities has substantially increased. Our residents increasingly believe and appreciate that research is an integral component of residency training and essential for practice of medicine. Conclusion Internal medicine residents' outlook in research can be significantly improved using a research curriculum offered through a structured and dedicated research rotation. This is exemplified by the improvement noted in resident satisfaction, their participation in scholarly activities and resident research outcomes since the inception of the research rotation in our internal medicine training program. PMID:17044924

A 5-Year Update on the Uneven Distribution of Women in Orthopaedic Surgery Residency Training Programs in the United States.

PubMed

Van Heest, Ann E; Fishman, Felicity; Agel, Julie

2016-08-03

This study was undertaken to update our report from academic years 2004-2005 through 2008-2009, to include 5 additional years of the Association of American Medical Colleges GME Track data. This study will test the hypothesis that, when compared with the data from 2004-2005 through 2008-2009, there were no substantial changes from 2009-2010 through 2013-2014 in the distribution of orthopaedic surgery residency programs that train female residents and have been accredited by the Accreditation Council for Graduate Medical Education (ACGME). Data for all ACGME-accredited orthopaedic surgery residency training programs in the United States were analyzed for 2009-2010 through 2013-2014, in the same manner as our previous report analyzed data for 2004-2005 through 2008-2009. Programs were classified as having 0, 1, 2, or >2 women in training (i.e., for postgraduate year [PGY]-1 through PGY-5) for each of the 5 academic years. Programs were also analyzed for the percentage of female residents in training and were classified as being above the national average (>20%), similar to the national average (between 10% and 20%), or below the national average (<10%) for each of the 5 academic years. During the time period of 2004 to 2009, the mean percentage of female trainees in U.S. orthopaedic surgery residency programs was 11.6%, and during the time period of 2009 to 2014, this mean percentage increased to 12.6%. Residency programs in the United States do not train women at an equal rate. In the 5 years examined (2009 to 2014), 30 programs had no female trainees and 49 programs had >20% women enrolled in at least 1 of the 5 years, 8 programs had no female trainees enrolled in any of the 5 years, and 9 programs had >20% women enrolled in each of the 5 years. Female medical students continue to pursue orthopaedic surgery as a career at rates lagging behind all other surgical specialties. Not all residency programs train women at equal rates. The period of 2009-2010 through 2013-2014 showed a greater percentage of programs (68%) training ≥2 women than the period of 2004-2005 through 2008-2009 (61%). Obstacles to attracting women to orthopaedic surgery should continue to be identified and to be addressed. Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated.

Governmental efforts to improve quality of care for nursing home residents and to protect them from mistreatment: a survey of federal and state laws.

PubMed

Gittler, Josephine

2008-10-01

There are many federal and state laws addressing, directly and indirectly, the quality of care provided to nursing home residents and the protection of residents from mistreatment. They include: (a) state laws that govern the licensing of nursing homes, (b) federal laws that govern the certification of nursing homes for participation in the Medicare and Medicaid programs, (c) elder abuse laws prohibiting mistreatment of older adults in nursing homes and other settings, (d) health care fraud abuse laws that are increasingly being used to combat the provision of substandard care to Medicare and Medicaid beneficiaries in nursing homes, and (e) laws that have established long-term care ombudsman programs to promote the health, safety, well-being, and rights of nursing home residents. While these laws are generally viewed as having improved the care and treatment of nursing home residents, much remains to be done, particularly with respect to the implementation of these laws.

Radiology Resident Supply and Demand: A Regional Perspective.

PubMed

Pfeifer, Cory M

2017-09-01

Radiology was subject to crippling deficits in the number of jobs available to graduates of training programs from 2012 through 2015. As the specialty transitions to the assimilation of osteopathic training programs and the welcoming of direct competition from new integrated interventional radiology programs, the assessment of growth in radiology training positions over the 10 years preceding this pivotal time will serve to characterize the genesis of the crisis while inspiring stakeholders to avoid similar negative fluctuations in the future. The number of per capita radiology trainees in each region was derived from data published by the National Resident Matching Program, as were annual match statistics over the years 2012 through 2016. Data regarding new interventional radiology and diagnostic radiology enrollees were also obtained from the National Resident Matching Program. The seven states with the most per capita radiology residents were in the Mid-Atlantic and Northeastern United States in both 2006 and 2016, and three of these seven also showed the greatest per capita growth over the course of the 10 years studied. New radiology programs were accredited during the peak of the job shortage. Integrated interventional radiology training created 24 de novo radiology residents in the 2017 match. Fill rates are weakly positively correlated with program size. Unregulated radiology program growth persisted during the decade leading up to 2016. The region with the fewest jobs available since 2012 is also home to the greatest number of per capita radiology residents. Numerous published opinions during the crisis did not result in enforced policy change. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Do Merit-Aid Programs Help States Build Skilled Workforces?

ERIC Educational Resources Information Center

Groen, Jeffrey A.

2011-01-01

One of the major developments in financing undergraduate education in the United States in the past 20 years has been the introduction of broad-based merit-aid programs by state governments. The typical program waives tuition and fees at public colleges and universities for state residents who have attained a respectable grade-point average…

A collaborative approach to residency preparation programming for pharmacy students.

PubMed

Rider, Shyla K; Oeder, Jessica L; Nguyen, Trang T; Rodis, Jennifer L

2014-06-01

An innovative program to help pharmacy students navigate the residency application and interview process is described, including results of a survey evaluating the program's impact. The Ohio State University (OSU) chapter of the Student Society of Health-System Pharmacy (SSHP) collaborated with OSU College of Pharmacy faculty members, pharmacists from OSU Wexner Medical Center and surrounding areas, and current pharmacy residents to provide programming to equip pharmacy students with skills to succeed as residency candidates. The programming has four components: Curriculum Vitae (CV) Critique, Mock Residency Interviews, Residency 101, and Midyear to Match (M-M), a six-part series that provides guidance on the Residency Showcase at the American Society of Health-System Pharmacists (ASHP) Midyear Clinical Meeting, Match day (the annual matching process coordinated by ASHP), and the post-Match "scramble," in which unmatched applicants compete for unfilled residency slots. In an online survey conducted by the SSHP chapter after the 2012-13 residency year, 26 of 57 survey respondents indicated they had pursued a residency. Twenty respondents reported success in the Match (a rate 15% higher than the national average), with 9 reporting acceptance by their first-choice residency site. The mock interview program was rated as the most useful (a mean score of 4.8 on a 5-point scale), followed by the M-M series (mean score, 4.6). Collaborative programming coordinated by the OSU chapter of SSHP was offered to pharmacy students to improve preparation for the residency application and interview process. The program was well received by participants. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

E-learning in graduate medical education: survey of residency program directors.

PubMed

Wittich, Christopher M; Agrawal, Anoop; Cook, David A; Halvorsen, Andrew J; Mandrekar, Jayawant N; Chaudhry, Saima; Dupras, Denise M; Oxentenko, Amy S; Beckman, Thomas J

2017-07-11

E-learning-the use of Internet technologies to enhance knowledge and performance-has become a widely accepted instructional approach. Little is known about the current use of e-learning in postgraduate medical education. To determine utilization of e-learning by United States internal medicine residency programs, program director (PD) perceptions of e-learning, and associations between e-learning use and residency program characteristics. We conducted a national survey in collaboration with the Association of Program Directors in Internal Medicine of all United States internal medicine residency programs. Of the 368 PDs, 214 (58.2%) completed the e-learning survey. Use of synchronous e-learning at least sometimes, somewhat often, or very often was reported by 85 (39.7%); 153 programs (71.5%) use asynchronous e-learning at least sometimes, somewhat often, or very often. Most programs (168; 79%) do not have a budget to integrate e-learning. Mean (SD) scores for the PD perceptions of e-learning ranged from 3.01 (0.94) to 3.86 (0.72) on a 5-point scale. The odds of synchronous e-learning use were higher in programs with a budget for its implementation (odds ratio, 3.0 [95% CI, 1.04-8.7]; P = .04). Residency programs could be better resourced to integrate e-learning technologies. Asynchronous e-learning was used more than synchronous, which may be to accommodate busy resident schedules and duty-hour restrictions. PD perceptions of e-learning are relatively moderate and future research should determine whether PD reluctance to adopt e-learning is based on unawareness of the evidence, perceptions that e-learning is expensive, or judgments about value versus effectiveness.

Status of anesthesiology resident research education in the United States: structured education programs increase resident research productivity.

PubMed

Ahmad, Shireen; De Oliveira, Gildasio S; McCarthy, Robert J

2013-01-01

The enhancement of resident research education has been proposed to increase the number of academic anesthesiologists with the skills and knowledge to conduct meaningful research. Program directors (PDs) of the U.S. anesthesiology residency programs were surveyed to evaluate the status of research education during residency training and to test the hypothesis that structured programs result in greater resident research productivity based on resident publications. Survey responses were solicited from 131 anesthesiology residency PDs. Seventy-four percent of PDs responded to the survey. Questions evaluated department demographic information, the extent of faculty research activity, research resources and research funding in the department, the characteristics of resident research education and resident research productivity, departmental support for resident research, and perceived barriers to resident research education. Thirty-two percent of programs had a structured resident research education program. Structured programs were more likely to be curriculum based, require resident participation in a research project, and provide specific training in presentation and writing skills. Productivity expectations were similar between structured and nonstructured programs. Forty percent of structured programs had > 20% of trainees with a publication in the last 2 years compared with 14% of departments with unstructured programs (difference, 26%; 99% confidence interval [CI], 8%-51%; P = 0.01). The percentage of programs that had research rotations for ≥2 months was not different between the structured and the nonstructured programs. A research rotation of >2 months did not increase the percentage of residents who had published an article within the last 2 months compared with a research rotation of <2 months (difference, 13%; 99% CI, 10%-37%; P = 0.14). There was no difference in the percentage of faculty involved in research in structured compared with unstructured research education. In programs with <20% of faculty involved in research, 15% reported >20% of residents with a publication in the last 2 years compared with 36% in programs with >20% of faculty involvement (difference, 21%; 99% CI, -4% to 46%; P = 0.03). Our findings suggest that structured residency research programs are associated with higher resident research productivity. The program duration and the fraction of faculty in resident research education did not significantly increase research productivity. Research training is an integral component of resident education, but the mandatory enhancement of resident research education will require a significant change in the culture of academic anesthesiology leadership and faculty.

A preliminary report on resident emergency psychiatry training from a survey of psychiatry chief residents.

PubMed

Bennett, Jeffrey I; Dzara, Kristina; Mazhar, Mir Nadeem; Behere, Aniruddh

2011-03-01

The Accreditation Council for Graduate Medical Education (ACGME) requirements stipulate that psychiatry residents need to be educated in the area of emergency psychiatry. Existing research investigating the current state of this training is limited, and no research to date has assessed whether the ACGME Residency Review Committee requirements for psychiatry residency training are followed by psychiatry residency training programs. We administered, to chief resident attendees of a national leadership conference, a 24-item paper survey on the types and amount of emergency psychiatry training provided by their psychiatric residency training programs. Descriptive statistics were used in the analysis. Of 154 surveys distributed, 111 were returned (72% response rate). Nearly one-third of chief resident respondents indicated that more than 50% of their program's emergency psychiatry training was provided during on-call periods. A minority indicated that they were aware of the ACGME program requirements for emergency psychiatry training. While training in emergency psychiatry occurred in many programs through rotations-different from the on-call period-direct supervision was available during on-call training only about one-third of the time. The findings suggest that about one-third of psychiatry residency training programs do not adhere to the ACGME standards for emergency psychiatry training. Enhanced knowledge of the ACGME requirements may enhance psychiatry residents' understanding on how their programs are fulfilling the need for more emergency psychiatry training. Alternative settings to the on-call period for emergency psychiatry training are more likely to provide for direct supervision.

A survey of marketing practices by family practice residency programs.

PubMed

Buckley, R L; Presley, R; Barrigar, R

1995-06-01

The purpose of the study reported in this article was to identify marketing practices that are being utilized by family practice residencies in the United States and to differentiate which strategies were felt to be most useful. A survey questionnaire on marketing strategies was mailed to 361 civilian family practice residencies listed in the 1992 Director of Family Practice Residency Programs. A total of 151 questionnaires were returned for a total response rate of 42.1 percent. The results were summarized using descriptive statistics and Chi-square analysis. Family practice residency programs use a number of different strategies to attract patients. The effectiveness of a given program is dependent on local factors, program strengths and the target population desired. The three most useful marketing strategies reported in the survey were HMO listings, emergency department referrals, and patient referrals. The three least effective strategies were health fairs, sports physicals, and school presentations.

42 CFR 436.403 - State residence.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false State residence. 436.403 Section 436.403 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS ELIGIBILITY IN GUAM, PUERTO RICO, AND THE VIRGIN ISLANDS General Eligibility...

A National Cross-Sectional Study of Surgery Residents Who Underreport Duty Hours.

PubMed

Bennett, Christopher L; McDonald, David A; Chang, Yuchiao; Finch, Alex; Vuong, Kimmy; Rennie, Stuart; Nadel, Eric S

Previous work demonstrates that many surgery residents underreport duty hours. The purpose of this study was to identify characteristics of these residents and better understand why they exceed duty hours. During the winter of 2015 we conducted an anonymous cross-sectional survey of Accreditation Council for Graduate Medical Education accredited general surgery programs. A total of 101 general surgery residency programs across the United States. A total of 1003 general surgery residents across the United States. Respondents' mean age was 29.9 ± 3.0 years; 53% were male. Study response rate was 31.9%. Residents age <30 were more likely to exceed duty hours to complete charting/documentation (68% vs. 54%, p < 0.001). Females more often cited guilt about leaving the hospital (32% vs. 24%, p = 0.014) as to why they exceed duty hours. Programs with >40 residents had the highest rates of underreporting (82% vs. 67% in other groups p < 0.001) and residents who worked >90 hours on an average week more frequently cited external pressure (p = 0.0001), guilt (p = 0.006), and feeling it was expected of them (p < 0.0001) as reasons why they underreport compared to those who worked fewer hours. Underreporting and duty-hour violations are a complex issue influenced by many variables including age, sex, and internal and external pressures. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Plastic surgery chief resident clinics: the current state of affairs.

PubMed

Neaman, Keith C; Hill, Brian C; Ebner, Ben; Ford, Ronald D

2010-08-01

One of the goals of plastic surgery residency programs is to provide effective training in aesthetic surgery. Recently, programs have adopted the idea of chief clinics to provide senior residents with the opportunity to perform cosmetic surgery with an increased level of autonomy. The goal of this article is to characterize chief clinics currently in place and their usefulness in providing effective training in plastic surgery under the precepts set forth by the Accreditation Council for Graduate Medical Education. A survey was created focusing on six broad categories: respondent identifier, clinic structure, clinic monetary earnings, patient demographics, procedures, and educational utility. Surveys were distributed to all plastic surgery residency programs targeting current and recently graduated chief residents, and program directors. A total of 123 surveys were returned. Eighty of the 88 plastic surgery residency programs (91 percent) were represented. Of the programs responding, 71.3 percent (57 programs) had a chief resident clinic. Thirty-two of the respondents (43.8 percent) reported that 100 percent of the procedures performed were cosmetic in nature. Programs differed widely on their frequency of occurrence and support staff available. A majority of respondents felt these clinics enhanced resident understanding of the six Accreditation Council for Graduate Medical Education core competencies. A majority of plastic surgery training programs use the chief clinic model to enhance resident education. These clinics vary in makeup and case distribution but serve as an effective way of teaching autonomy, surgical maturity, and the six Accreditation Council for Graduate Medical Education core competencies.

Family practice residents' maternity leave experiences and benefits.

PubMed

Gjerdingen, D K; Chaloner, K M; Vanderscoff, J A

1995-09-01

A growing number of residents are having babies during residency training. While many businesses are working to improve maternity conditions and benefits for their employees, residency programs are often not prepared to accommodate pregnant residents. This study was conducted to examine the maternity leave experiences of women who delivered infants during their family practice residency training. Program directors from each of the 394 family practice residency programs listed in the 1993 Directory of Family Practice Residency Programs were asked to distribute surveys to female residents who gave birth during their residency training and had returned to work by the time of the study. Of 199 known eligible residents, 171 (86%) completed surveys; these women represented 127 programs located in 36 states and Puerto Rico. Only 56.8% of women were aware of their program having a written maternity leave policy. The average length of maternity leave was 8 weeks; 76% had leaves of 10 weeks or less. For many, the maternity leave was derived from more than one source, including vacation, sick time, or a mother-child elective. Nearly all (88.3%) the women breast-fed, and the mean duration of breast-feeding was more than 19 weeks. In general, participants believed that having a baby during residency was somewhat difficult. Problems frequently encountered by women after their return to work included sleep deprivation and tiredness, difficulty arranging for child care, guilt about child care, and breast-feeding. Factors that detracted most from the childbirth experience were too little sleep, problems arranging for child care, and lack of support from the partner, residency faculty, and other residents. Having a baby during residency is somewhat difficult for the average female resident. Factors that may ease this difficulty include getting adequate sleep and receiving support from one's partner, faculty, and other residents.

Cosmetic Surgery Training in Plastic Surgery Residency Programs.

PubMed

McNichols, Colton H L; Diaconu, Silviu; Alfadil, Sara; Woodall, Jhade; Grant, Michael; Lifchez, Scott; Nam, Arthur; Rasko, Yvonne

2017-09-01

Over the past decade, plastic surgery programs have continued to evolve with the addition of 1 year of training, increase in the minimum number of required aesthetic cases, and the gradual replacement of independent positions with integrated ones. To evaluate the impact of these changes on aesthetic training, a survey was sent to residents and program directors. A 37 question survey was sent to plastic surgery residents at all Accreditation Council for Graduate Medical Education-approved plastic surgery training programs in the United States. A 13 question survey was sent to the program directors at the same institutions. Both surveys were analyzed to determine the duration of training and comfort level with cosmetic procedures. Eighty-three residents (10%) and 11 program directors (11%) completed the survey. Ninety-four percentage of residents had a dedicated cosmetic surgery rotation (an increase from 68% in 2015) in addition to a resident cosmetic clinic. Twenty percentage of senior residents felt they would need an aesthetic surgery fellowship to practice cosmetic surgery compared with 31% in 2015. Integrated chief residents were more comfortable performing cosmetic surgery cases compared with independent chief residents. Senior residents continue to have poor confidence with facial aesthetic and body contouring procedures. There is an increase in dedicated cosmetic surgery rotations and fewer residents believe they need a fellowship to practice cosmetic surgery. However, the comfort level of performing facial aesthetic and body contouring procedures remains low particularly among independent residents.

Cosmetic Surgery Training in Plastic Surgery Residency Programs

PubMed Central

McNichols, Colton H. L.; Diaconu, Silviu; Alfadil, Sara; Woodall, Jhade; Grant, Michael; Lifchez, Scott; Nam, Arthur

2017-01-01

Background: Over the past decade, plastic surgery programs have continued to evolve with the addition of 1 year of training, increase in the minimum number of required aesthetic cases, and the gradual replacement of independent positions with integrated ones. To evaluate the impact of these changes on aesthetic training, a survey was sent to residents and program directors. Methods: A 37 question survey was sent to plastic surgery residents at all Accreditation Council for Graduate Medical Education–approved plastic surgery training programs in the United States. A 13 question survey was sent to the program directors at the same institutions. Both surveys were analyzed to determine the duration of training and comfort level with cosmetic procedures. Results: Eighty-three residents (10%) and 11 program directors (11%) completed the survey. Ninety-four percentage of residents had a dedicated cosmetic surgery rotation (an increase from 68% in 2015) in addition to a resident cosmetic clinic. Twenty percentage of senior residents felt they would need an aesthetic surgery fellowship to practice cosmetic surgery compared with 31% in 2015. Integrated chief residents were more comfortable performing cosmetic surgery cases compared with independent chief residents. Senior residents continue to have poor confidence with facial aesthetic and body contouring procedures. Conclusions: There is an increase in dedicated cosmetic surgery rotations and fewer residents believe they need a fellowship to practice cosmetic surgery. However, the comfort level of performing facial aesthetic and body contouring procedures remains low particularly among independent residents. PMID:29062658

International electives in neurology training: a survey of US and Canadian program directors.

PubMed

Lyons, Jennifer L; Coleman, Mary E; Engstrom, John W; Mateen, Farrah J

2014-01-14

To ascertain the current status of global health training and humanitarian relief opportunities in US and Canadian postgraduate neurology programs. There is a growing interest among North American trainees to pursue medical electives in low- and middle-income countries. Such training opportunities provide many educational and humanitarian benefits but also pose several challenges related to organization, human resources, funding, and trainee and patient safety. The current support and engagement of neurology postgraduate training programs for trainees to pursue international rotations is unknown. A survey was distributed to all program directors in the United States and Canada (December 2012-February 2013) through the American Academy of Neurology to assess the training opportunities, institutional partnerships, and support available for international neurology electives. Approximately half of responding programs (53%) allow residents to pursue global health-related electives, and 11% reported that at least 1 trainee participated in humanitarian relief during training (survey response rate 61%, 143/234 program directors). Canadian programs were more likely to allow residents to pursue international electives than US programs (10/11, 91% vs 65/129, 50%, p = 0.023). The number of trainees participating in international electives was low: 0%-9% of residents (55% of programs) and 10%-19% of residents (21% of programs). Lack of funding was the most commonly cited reason for residents not participating in global health electives. If funding was available, 93% of program directors stated there would be time for residents to participate. Most program directors (75%) were interested in further information on global health electives. In spite of high perceived interest, only half of US neurology training programs include international electives, mostly due to a reported lack of funding. By contrast, the majority of Canadian programs that responded allow international electives, likely due to clearer guidelines from the Royal College of Physicians and Surgeons of Canada compared to the Accreditation Council of Graduate Medical Education. However, the number of both Canadian and US neurology trainees venturing abroad remains a minority. Most program directors are interested in learning more information related to global health electives for neurology residents.

Reducing Energy Burden with Solar: Colorado's Strategy and Roadmap for

Science.gov Websites

-income residents suffer from a high energy burden, which can force these residents to choose between . The report concludes with a roadmap other states might consider when developing their own low-income states might learn from the state's experience when they design their own programs. The report concludes

Financial and Time Burdens for Medical Students Interviewing for Residency.

PubMed

Callaway, Paul; Melhado, Trisha; Walling, Anne; Groskurth, Jordan

2017-02-01

Interviewing for residency positions is increasingly stressful for students and challenging for programs. Little information is available about the costs and time invested by students in interviewing or about the key factors in decisions to accept interview offers. Our objective was to assess the time and financial costs of residency interviewing for an entire class at a regional campus and explore factors influencing student decisions to accept interviews. We used a 14-item survey administered electronically immediately following National Resident Matching Program results. The response rate was 75% (49 of 65 students). About half interviewed in primary care specialties. Thirty students (63%) applied to 20 or more programs, and 91% were offered multiple interviews out of state. Seventy percent limited interviews by time and cost. Other important factors included personal "fit," program reputation, and the quality of residents. About 50% of the students spent more than 20 days and $1,000-$5,000 interviewing; 29% reported spending over $5,000. Students used multiple funding sources, predominantly loans and savings. Primary care applicants applied to fewer out-of-state programs, reported fewer interview days and lower expenses, but received more financial support from programs. Students invested considerable time and resources in interviewing, and these factors significantly influenced their decisions about accepting interviews. The other major factors in interview decisions concerned personal comfort with the program, especially the residents. The costs and time reported in this study could be greater than other schools due to the regional campus location or lower due to the high proportion of students interviewing in primary care.

The role of librarians in teaching evidence-based medicine to pediatric residents: a survey of pediatric residency program directors.

PubMed

Boykan, Rachel; Jacobson, Robert M

2017-10-01

The research sought to identify the general use of medical librarians in pediatric residency training, to define the role of medical librarians in teaching evidence-based medicine (EBM) to pediatric residents, and to describe strategies and curricula for teaching EBM used in pediatric residency training programs. We sent a 13-question web-based survey through the Association of Pediatric Program Directors to 200 pediatric residency program directors between August and December 2015. A total of 91 (46%) pediatric residency program directors responded. Most (76%) programs had formal EBM curricula, and more than 75% of curricula addressed question formation, searching, assessment of validity, generalizability, quantitative importance, statistical significance, and applicability. The venues for teaching EBM that program directors perceived to be most effective included journal clubs (84%), conferences (44%), and morning report (36%). While 80% of programs utilized medical librarians, most of these librarians assisted with scholarly or research projects (74%), addressed clinical questions (62%), and taught on any topic not necessarily EBM (58%). Only 17% of program directors stated that librarians were involved in teaching EBM on a regular basis. The use of a librarian was not associated with having an EBM curriculum but was significantly associated with the size of the program. Smaller programs were more likely to utilize librarians (100%) than were medium (71%) or large programs (75%). While most pediatric residency programs have an EBM curriculum and engage medical librarians in various ways, librarians' expertise in teaching EBM is underutilized. Programs should work to better integrate librarians' expertise, both in the didactic and clinical teaching of EBM.

Survey and analysis of the current state of residency training in medical-school-affiliated hospitals in China

PubMed Central

2014-01-01

Background Since the global standards for postgraduate medical education (PGME) were published in January 2003, they have gained worldwide attention. The current state of residency training programs in medical-school-affiliated hospitals throughout China was assessed in this study. Methods Based on the internationally recognized global standards for PGME, residents undergoing residency training at that time and the relevant residency training instructors and management personnel from 15 medical-school-affiliated hospitals throughout China were recruited and surveyed regarding the current state of residency training programs. A total of 938 questionnaire surveys were distributed between June 30, 2006 and July 30, 2006; of 892 surveys collected, 841 were valid. Results For six items, the total proportions of “basically meets standards” and “completely meets standards” were <70% for the basic standards. These items were identified in the fields of “training settings and educational resources”, “evaluation of training process”, and “trainees”. In all fields other than “continuous updates”, the average scores of the western regions were significantly lower than those of the eastern regions for both the basic and target standards. Specifically, the average scores for the basic standards on as many as 25 of the 38 items in the nine fields were significantly lower in the western regions. There were significant differences in the basic standards scores on 13 of the 38 items among trainees, instructors, and managers. Conclusions The residency training programs have achieved satisfactory outcomes in the hospitals affiliated with various medical schools in China. However, overall, the programs remain inadequate in certain areas. For the governments, organizations, and institutions responsible for PGME, such global standards for PGME are a very useful self-assessment tool and can help identify problems, promote reform, and ultimately standardize PGME. PMID:24885865

National survey of mentorship in Canadian general surgery residency programs: Where are we and what do we need?

PubMed Central

Delisle, Megan; Rivard, Justin; Hebbard, Pamela; McCarthy, Brendan; Wirtzfeld, Debrah

2017-01-01

Background The benefits of mentorship on residents are well established. The current state of mentorship in General Surgery (GS) residency programs in Canada is unknown. The objectives of this study were to obtain GS residents’ and program directors’ (PD) perspectives on resident mentorship. Study Design An electronic survey was developed and distributed to all 601 GS residents in Canada. All 17 PDs were invited for telephone interviews. Results A total of 179 of the 601 residents responded. Ninety-seven percent (n=173) felt mentorship was important. Only 67% (n=116) identified a mentor and only 53% (n=62) reported a mentorship program. Most who identified a mentor (n=87/110, 79%) were satisfied with the mentorship received. Significant variations in mentorship existed between demographic subgroups and mentorship program types. Overall, residents (n=121, 74%) favoured having a required mentorship program. A total of 11 out of 17 PDs participated in the telephone interviews. The majority of PDs (n=9, 82%) were satisfied with current resident mentorship but most acknowledged that barriers exist (n=8, 73%). Conclusion GS programs in Canada should ensure they are providing equal opportunities for mentorship across demographic subgroups. Programs are encouraged to examine both their program’s and their residents’ needs as well as local barriers to improve mentorship. PMID:29354196

Residency Program Directors' Interview Methods and Satisfaction With Resident Selection Across Multiple Specialties.

PubMed

VanOrder, Tonya; Robbins, Wayne; Zemper, Eric

2017-04-01

Competition for postdoctoral training positions is at an all-time high, and residency program directors continue to have little direction when it comes to structuring an effective interview process. To examine whether a relationship existed between interview methods used and program director satisfaction with resident selection decisions and whether programs that used methods designed to assess candidate personal characteristics were more satisfied with their decisions. Residency directors from the Statewide Campus System at the Michigan State University College of Osteopathic Medicine were invited to complete a 20-item survey regarding their recent interview methods and proportion of resident selections later regretted. Data analyses examined relationships between interview methods used, frequency of personal characteristics evaluated, and subsequent satisfaction with selected residents. Of the 186 program director surveys distributed, 83 (44.6%) were returned, representing 11 clinical specialty areas. In total, 69 responses (83.1%) were from programs accredited by the American Osteopathic Association only, and 14 (16.9%) were from programs accredited dually by the American Osteopathic Association and Accreditation Council for Graduate Medical Education. The most frequent interview method reported was faculty or peer resident interview. No statistically significant correlational relationships were found between type of interview methods used and subsequent satisfaction with selected residents, either within or across clinical specialties. Although program directors rated ethical behavior/honesty as the most highly prioritized characteristic in residents, 27 (32.5%) reported using a specific interview method to assess this trait. Program directors reported later regrets concerning nearly 1 of every 12 resident selection decisions. The perceived success of an osteopathic residency program's interview process does not appear to be related to methods used and is not distinctively different from that of programs dually accredited. The findings suggest that it may not be realistic to aim for standardization of a common set of best interview methods or ideal personal characteristics for all programs. Each residency program's optimal interview process is likely unique, more dependent on analyzing why some resident selections are regretted and developing an interview process designed to assess for specific desirable and unwanted characteristics.

Electronic Residency Application Service Application Characteristics Associated with Successful Residency Matching in Neurosurgery in 2009-2016.

PubMed

Leschke, John M; Hunt, Matthew A

2018-05-01

Resident applicants in neurosurgery often wonder what factors impact their chances of successfully matching. Using data published by the National Residency Match Program for 2009-2016, we examined which components of the Electronic Residency Application Service application correlated with successful residency matching. Data were collected from the National Residency Match Program publication Charting Outcomes in the Match from all years it was available for neurosurgery (2009, 2011, 2014, 2016). Individual factors reported (number of contiguous ranks, research projects, publications and presentations, work experiences, volunteer experiences, United States Medical Licensing Examination Step 1 and 2 score deciles, categorical data about Alpha Omega Alpha status, Ph.D. degree, other degree, and strength of medical school National Institutes of Health funding) were aggregated for all 3 years. Categorical data were available only for U.S. seniors. Spearman correlation and χ 2 were used for ranked data and categorical data, respectively. Separate analyses were run for U.S. seniors and independent applicants. For U.S. seniors applying to neurosurgery, number of contiguous ranks, United States Medical Licensing Examination Step 1 and 2 scores, research projects, Alpha Omega Alpha status, and medical school top 40 National Institutes of Health funding were significantly associated with successful matching of applicants. Number of volunteer experiences was nearly statistically significant. For independent applicants, only United States Medical Licensing Examination Step 1 and 2 scores and number of research projects were statistically significant. This is the first study to analyze National Residency Match Program data for predictors of success in neurosurgical matching. Students applying to neurosurgery residency and their mentors should be aware of which baseline objective factors are associated with match success. Copyright © 2018 Elsevier Inc. All rights reserved.

International electives in neurology training

PubMed Central

Lyons, Jennifer L.; Coleman, Mary E.; Engstrom, John W.

2014-01-01

Objective: To ascertain the current status of global health training and humanitarian relief opportunities in US and Canadian postgraduate neurology programs. Background: There is a growing interest among North American trainees to pursue medical electives in low- and middle-income countries. Such training opportunities provide many educational and humanitarian benefits but also pose several challenges related to organization, human resources, funding, and trainee and patient safety. The current support and engagement of neurology postgraduate training programs for trainees to pursue international rotations is unknown. Methods: A survey was distributed to all program directors in the United States and Canada (December 2012–February 2013) through the American Academy of Neurology to assess the training opportunities, institutional partnerships, and support available for international neurology electives. Results: Approximately half of responding programs (53%) allow residents to pursue global health–related electives, and 11% reported that at least 1 trainee participated in humanitarian relief during training (survey response rate 61%, 143/234 program directors). Canadian programs were more likely to allow residents to pursue international electives than US programs (10/11, 91% vs 65/129, 50%, p = 0.023). The number of trainees participating in international electives was low: 0%–9% of residents (55% of programs) and 10%–19% of residents (21% of programs). Lack of funding was the most commonly cited reason for residents not participating in global health electives. If funding was available, 93% of program directors stated there would be time for residents to participate. Most program directors (75%) were interested in further information on global health electives. Conclusions: In spite of high perceived interest, only half of US neurology training programs include international electives, mostly due to a reported lack of funding. By contrast, the majority of Canadian programs that responded allow international electives, likely due to clearer guidelines from the Royal College of Physicians and Surgeons of Canada compared to the Accreditation Council of Graduate Medical Education. However, the number of both Canadian and US neurology trainees venturing abroad remains a minority. Most program directors are interested in learning more information related to global health electives for neurology residents. PMID:24319037

The Fundamentals of Resident Dismissal.

PubMed

Schenarts, Paul J; Langenfeld, Sean

2017-02-01

Residents have the rights and responsibilities of both students and employees. Dismissal of a resident from a training program is traumatic and has lasting repercussions for the program director, the faculty, the dismissed resident, and the residency. A review of English language literature was performed using PUBMED and OVID databases, using the search terms, resident dismissal, resident termination, student dismissal, student and resident evaluation, legal aspects of education, and remediation. The references of each publication were also reviewed to identify additional appropriate citations. If the Just Cause threshold has been met, educators have the absolute discretion to evaluate academic and clinical performance. Legal opinion has stated that it is not necessary to wait until a patient is harmed to dismiss a resident. Evaluations should be standard and robust. Negative evaluations are not defamatory as the resident gave consent to be evaluated. Provided departmental and institutional polices have been followed, a resident can be dismissed without a formal hearing. Residencies are entitled to modify academic requirements and dismissal is not considered a breach of contract. Although there is anxiety regarding resident dismissal, the courts have uniformly supported faculty having this role. When indicated, failure to dismiss a resident also places the program director and the faculty at risk for educational malpractice.

Medical Physics Residency Consortium: collaborative endeavors to meet the ABR 2014 certification requirements.

PubMed

Parker, Brent C; Duhon, John; Yang, Claus C; Wu, H Terry; Hogstrom, Kenneth R; Gibbons, John P

2014-03-06

In 2009, Mary Bird Perkins Cancer Center (MBPCC) established a Radiation Oncology Physics Residency Program to provide opportunities for medical physics residency training to MS and PhD graduates of the CAMPEP-accredited Louisiana State University (LSU)-MBPCC Medical Physics Graduate Program. The LSU-MBPCC Program graduates approximately six students yearly, which equates to a need for up to twelve residency positions in a two-year program. To address this need for residency positions, MBPCC has expanded its Program by developing a Consortium consisting of partnerships with medical physics groups located at other nearby clinical institutions. The consortium model offers the residents exposure to a broader range of procedures, technology, and faculty than available at the individual institutions. The Consortium institutions have shown a great deal of support from their medical physics groups and administrations in developing these partnerships. Details of these partnerships are specified within affiliation agreements between MBPCC and each participating institution. All partner sites began resident training in 2011. The Consortium is a network of for-profit, nonprofit, academic, community, and private entities. We feel that these types of collaborative endeavors will be required nationally to reach the number of residency positions needed to meet the 2014 ABR certification requirements and to maintain graduate medical physics training programs.

Pregnancy and the Plastic Surgery Resident.

PubMed

Garza, Rebecca M; Weston, Jane S; Furnas, Heather J

2017-01-01

Combining pregnancy with plastic surgery residency has historically been difficult. Two decades ago, 36 percent of plastic surgery program directors surveyed actively discouraged pregnancy among residents, and 33 percent of women plastic surgeons suffered from infertility. Most alarmingly, 26 percent of plastic surgery trainees had had an elective abortion during residency. With increasing numbers of women training in plastic surgery, this historical lack of support for pregnancy deserves further attention. To explore the current accommodations made for the pregnant plastic surgery resident, an electronic survey was sent to 88 plastic surgery program directors in the United States. Fifty-four responded, for a response rate of 61.36 percent. On average, a director trained a total of 7.91 women among 17.28 residents trained over 8.19 years. Of the women residents, 1.43 were pregnant during a director's tenure, with 1.35 of those residents taking maternity leave. An average 1.75 male residents took paternity leave. Approximately one-third of programs had a formal maternity/paternity leave policy (36.54 percent) which, in most cases, was limited to defining allowed weeks of leave, time required to fulfill program requirements, and remuneration during leave. This survey of plastic surgery directors is a first step in defining the challenges training programs face in supporting the pregnant resident. Directors provided comments describing their challenges accommodating an absent resident in a small program and complying with the American Board of Plastic Surgery's required weeks of training per year. A discussion of these challenges is followed by suggested solutions.

State of Maine Student Financial Aid Guide to Post-Secondary Education. 1979-1980.

ERIC Educational Resources Information Center

Maine State Post-Secondary Education Commission, Augusta.

Financial aid information for residents of the State of Maine is presented in this booklet. Instructions for completing the College Scholarship Service Financial Aid Form are presented. The Basic Educational Opportunity Grants Program, the Supplemental Educational Opportunity Grant Program, Maine State Incentive Scholarship Program, and the New…

The state of general surgery training: a different perspective.

PubMed

Foley, P J; Roses, R E; Kelz, R R; Resnick, A S; Williams, N N; Mullen, J L; Kaiser, L R; Morris, Jon B

2008-01-01

Much has been written about the influences of Accreditation Council for Graduate Medical Education (ACGME) work restrictions, the litigious climate in American medicine, and the proliferation of subspecialty fellowships on general surgery training. Few previous studies have addressed general surgical residents' perceptions of surgical training on a national level. A 38-question Institutional Review Board-approved survey was sent via e-mail to the program directors at all ACGME-approved general surgical training programs for distribution to categorical general surgery residents. Voluntary responses to statements focusing on job satisfaction, quality of life, and the influences of operative experience, work hours, fellows, physician extenders, as well as faculty and administration on resident training were solicited. Overall, 997 responses were received from residents of all clinical levels from 40 states. Most respondents were from university-based programs (79%) with a broad representation of program sizes (mean of 6 graduates per year; range 2 to 11). Residents believe that they will be prepared to enter clinical practice at the conclusion of their training (86%), that the duration of surgical training is adequate (85%), and that they are exposed to sufficient case volume and complexity (85% and 84%, respectively). Only 360 respondents (36%) believe that they are financially compensated appropriately. Although most respondents support the ACGME work-hour restrictions (70%), far fewer feel that they improve their training or patient care (46.6% and 46.8%, respectively). Most respondents are proud to be surgical residents (88%), view surgery as a rewarding profession (87%), and would choose surgery as a profession again (77%). Surgical residents are positive regarding the quality of their training and life, although they feel poorly compensated for their work. Most residents intend to pursue fellowship training. Survey responses were consistent irrespective of gender, ethnicity, and program type.

Analysis of dermoscopy teaching modalities in United States dermatology residency programs

PubMed Central

Chen, Yun An; Rill, Joanne; Seiverling, Elizabeth V.

2017-01-01

The use of dermoscopy in dermatology residency programs is on the rise (over 94% of chief residents reported using a dermatoscope in 2013) [1]. Despite increased use (100% of our surveyed residents reported using a dermatoscope), dermoscopy training is one of the aspects of United States dermatology residency training with the lowest resident satisfaction [2]. Diagnostic accuracy with dermoscopy is highly correlated with the amount of dermoscopy training the user has undertaken [3]. We sought to analyze dermoscopy use in US Dermatology residencies to better understand resident dermoscopy utilization and teaching modalities. We found residents learn dermoscopy via multiple teaching modalities. The most commonly reported dermoscopy teaching modality was didactic lectures, followed by time in clinic with a dermoscopy expert. Of the different teaching modalities, time in the clinic with a dermoscopy expert was reported to be the most effective. We also found that the majority of dermatology residents receive didactic dermoscopy lectures and clinical dermoscopy training on the differentiation of benign nevi from melanoma using dermoscopy, the detection of basal cell carcinoma, and the identification of seborrheic keratosis. However, few residents receive dedicated training on the use of dermoscopy in the evaluation of inflammatory dermatoses and skin infections despite dermoscopy’s demonstrated value in both areas [4–7]. PMID:29085718

Firewise forever? Voluntary community participation and retention in Firewise programs

Treesearch

Michele Steinberg

2011-01-01

Firewise Communities/USA® is a national program designed to encourage residents of wildfire-prone areas to take action to reduce wildfire risks to their homes and neighborhoods. Residents of homeowner associations and small communities who are interested in improving their wildfire safety work with state forestry and fire professionals and follow a simple,...

Bleeding disorder education in obstetrics and gynecology residency training: a national survey.

PubMed

Dietrich, Jennifer E; Tran, Xuan G; Giardino, Angelo P

2011-04-01

The purpose of this study was to assess the educational approach to the bleeding disorder evaluation in Obstetrics and Gynecology residency training programs in the continental United States. Information was sought from chief residents regarding training experiences and fund of knowledge regarding the evaluation of menorrhagia and diagnosis of bleeding disorders during their residency. A 24-item questionnaire was sent to the chief residents at 241 non-military Obstetrics and Gynecology residency programs. The study was conducted at Texas Children's Health Plan in Houston, Texas. Chief residents at 241 non-military Obstetrics and Gynecology residency programs. Responses to questionnaires. The overall response rate was 30%. Residents reported training in the medical evaluation of menorrhagia during residency with a mean of 9.1 hours per year in the first year of residency and 11.1 hours/year in the 2(nd), 3(rd) and 4(th) years; 67.7% reported they viewed their training in the medical evaluation of menorrhagia and bleeding disorders as sufficient preparation for clinical practice; and over two thirds reported specific training in common bleeding disorders, such as von Willebrand disease. The current state of training in the evaluation of menorrhagia and bleeding disorders appeared to be mixed regarding the evaluation of dysfunctional uterine bleeding. An area for improvement was identified to better approach best clinical practice in the evaluation of women with menorrhagia and underlying bleeding disorders, which can be guided by the thoughtful approach taken in the recent NHLBI von Willebrand disease guidelines. Copyright © 2011 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Pregnancy and Parenthood among Surgery Residents: Results of the First Nationwide Survey of General Surgery Residency Program Directors.

PubMed

Sandler, Britt J; Tackett, John J; Longo, Walter E; Yoo, Peter S

2016-06-01

Although family and lifestyle are known to be important factors for medical students choosing a specialty, there is a lack of research about general surgery residency program policies regarding pregnancy and parenthood. Similarly, little is known about program director attitudes about these issues. We performed a cross-sectional survey of United States (US) general surgery residency program directors. Sixty-six respondents completed the survey: 70% male, 59% from university-based programs, and 76% between 40 and 59 years of age. Two-thirds (67%) reported having a maternity leave policy. Less than half (48%) reported having a leave policy for the non-childbearing parent (paternity leave). Leave duration was most frequently reported as 6 weeks for maternity leave (58%) and 1 week for paternity leave (45%). Thirty-eight percent of general surgery residency program directors (PDs) reported availability of on-site childcare, 58% reported availability of lactation facilities. Forty-six percent of university PDs said that the research years are the best time to have a child during residency; 52% of independent PDs said that no particular time during residency is best. Sixty-one percent of PDs reported that becoming a parent negatively affects female trainees' work, including placing an increased burden on fellow residents (33%). Respondents perceived children as decreasing female trainees' well-being more often than male trainees' (32% vs 9%, p < 0.001). Program director reports indicated a lack of national uniformity in surgical residency policies regarding parental leave, length of leave, as well as inconsistency in access to childcare and availability of spaces to express and store breast milk. Program directors perceived parenthood to affect the training and well-being of female residents more adversely than that of male residents. Copyright © 2016 American College of Surgeons. All rights reserved.

A national cross-sectional survey of social networking practices of U.S. anesthesiology residency program directors.

PubMed

Barker, Andrew L; Wehbe-Janek, Hania; Bhandari, Naumit S; Bittenbinder, Timothy M; Jo, ChanHee; McAllister, Russell K

2012-12-01

To determine the social networking practices of directors of anesthesiology residency programs. Cross-sectional survey. Online and paper survey tool. 132 anesthesiology residency program directors in the United States. A 13-item survey including dichotomous and multiple choice responses was administered using an online survey tool and a paper survey. Data analysis was conducted by descriptive and analytical statistics (chi-square test). A P-value < 0.05 indicated statistical significance. 50% of anesthesiology program directors responded to the survey (66/132). Policies governing social networking practices were in place for 30.3% (n=20) of the programs' hospitals. The majority of program directors (81.8%, 54) reported never having had an incident involving reprimand of a resident or fellow for inappropriate social networking practices. The majority (66.7%, n=44) of responding programs reported that departments did not provide lectures or educational activities related to appropriate social networking practices. Monitoring of social networking habits of residents/fellows by program directors mainly occurs if they are alerted to a problem (54.5%, n=36). Frequent use of the Internet for conducting searches on a resident applicant was reported by 12.1% (n=8) of program directors, 30.3% (n=20) reported use a few times, and 57.6% (n=38) reported never using the Internet in this capacity. Residency programs should have a written policy related to social media use. Residency program directors should be encouraged to become familiar with the professionalism issues related to social media use in order to serve as adequate resident mentors within this new and problematic aspect of medical ethics and professionalism. Copyright © 2012 Elsevier Inc. All rights reserved.

Pathology Informatics Essentials for Residents: A Flexible Informatics Curriculum Linked to Accreditation Council for Graduate Medical Education Milestones.

PubMed

Henricks, Walter H; Karcher, Donald S; Harrison, James H; Sinard, John H; Riben, Michael W; Boyer, Philip J; Plath, Sue; Thompson, Arlene; Pantanowitz, Liron

2017-01-01

-Recognition of the importance of informatics to the practice of pathology has surged. Training residents in pathology informatics has been a daunting task for most residency programs in the United States because faculty often lacks experience and training resources. Nevertheless, developing resident competence in informatics is essential for the future of pathology as a specialty. -To develop and deliver a pathology informatics curriculum and instructional framework that guides pathology residency programs in training residents in critical pathology informatics knowledge and skills, and meets Accreditation Council for Graduate Medical Education Informatics Milestones. -The College of American Pathologists, Association of Pathology Chairs, and Association for Pathology Informatics formed a partnership and expert work group to identify critical pathology informatics training outcomes and to create a highly adaptable curriculum and instructional approach, supported by a multiyear change management strategy. -Pathology Informatics Essentials for Residents (PIER) is a rigorous approach for educating all pathology residents in important pathology informatics knowledge and skills. PIER includes an instructional resource guide and toolkit for incorporating informatics training into residency programs that vary in needs, size, settings, and resources. PIER is available at http://www.apcprods.org/PIER (accessed April 6, 2016). -PIER is an important contribution to informatics training in pathology residency programs. PIER introduces pathology trainees to broadly useful informatics concepts and tools that are relevant to practice. PIER provides residency program directors with a means to implement a standardized informatics training curriculum, to adapt the approach to local program needs, and to evaluate resident performance and progress over time.

Finding the Perfect Match: Factors That Influence Family Medicine Residency Selection.

PubMed

Wright, Katherine M; Ryan, Elizabeth R; Gatta, John L; Anderson, Lauren; Clements, Deborah S

2016-04-01

Residency program selection is a significant experience for emerging physicians, yet there is limited information about how applicants narrow their list of potential programs. This study examines factors that influence residency program selection among medical students interested in family medicine at the time of application. Medical students with an expressed interest in family medicine were invited to participate in a 37-item, online survey. Students were asked to rate factors that may impact residency selection on a 6-point Likert scale in addition to three open-ended qualitative questions. Mean values were calculated for each survey item and were used to determine a rank order for selection criteria. Logistic regression analysis was performed to identify factors that predict a strong interest in urban, suburban, and rural residency programs. Logistic regression was also used to identify factors that predict a strong interest in academic health center-based residencies, community-based residencies, and community-based residencies with an academic affiliation. A total of 705 medical students from 32 states across the country completed the survey. Location, work/life balance, and program structure (curriculum, schedule) were rated the most important factors for residency selection. Logistic regression analysis was used to refine our understanding of how each factor relates to specific types of residencies. These findings have implications for how to best advise students in selecting a residency, as well as marketing residencies to the right candidates. Refining the recruitment process will ensure a better fit between applicants and potential programs. Limited recruitment resources may be better utilized by focusing on targeted dissemination strategies.

The role of librarians in teaching evidence-based medicine to pediatric residents: a survey of pediatric residency program directors

PubMed Central

Boykan, Rachel; Jacobson, Robert M.

2017-01-01

Objective: The research sought to identify the general use of medical librarians in pediatric residency training, to define the role of medical librarians in teaching evidence-based medicine (EBM) to pediatric residents, and to describe strategies and curricula for teaching EBM used in pediatric residency training programs. Methods: We sent a 13-question web-based survey through the Association of Pediatric Program Directors to 200 pediatric residency program directors between August and December 2015. Results: A total of 91 (46%) pediatric residency program directors responded. Most (76%) programs had formal EBM curricula, and more than 75% of curricula addressed question formation, searching, assessment of validity, generalizability, quantitative importance, statistical significance, and applicability. The venues for teaching EBM that program directors perceived to be most effective included journal clubs (84%), conferences (44%), and morning report (36%). While 80% of programs utilized medical librarians, most of these librarians assisted with scholarly or research projects (74%), addressed clinical questions (62%), and taught on any topic not necessarily EBM (58%). Only 17% of program directors stated that librarians were involved in teaching EBM on a regular basis. The use of a librarian was not associated with having an EBM curriculum but was significantly associated with the size of the program. Smaller programs were more likely to utilize librarians (100%) than were medium (71%) or large programs (75%). Conclusions: While most pediatric residency programs have an EBM curriculum and engage medical librarians in various ways, librarians’ expertise in teaching EBM is underutilized. Programs should work to better integrate librarians’ expertise, both in the didactic and clinical teaching of EBM. PMID:28983199

American Society for Radiation Oncology (ASTRO) Survey of Radiation Biology Educators in U.S. and Canadian Radiation Oncology Residency Programs

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rosenstein, Barry S., E-mail: barry.rosenstein@mssm.ed; Department of Radiation Oncology, New York University School of Medicine, New York, NY; Held, Kathryn D.

2009-11-01

Purpose: To obtain, in a survey-based study, detailed information on the faculty currently responsible for teaching radiation biology courses to radiation oncology residents in the United States and Canada. Methods and Materials: In March-December 2007 a survey questionnaire was sent to faculty having primary responsibility for teaching radiation biology to residents in 93 radiation oncology residency programs in the United States and Canada. Results: The responses to this survey document the aging of the faculty who have primary responsibility for teaching radiation biology to radiation oncology residents. The survey found a dramatic decline with time in the percentage of educatorsmore » whose graduate training was in radiation biology. A significant number of the educators responsible for teaching radiation biology were not fully acquainted with the radiation sciences, either through training or practical application. In addition, many were unfamiliar with some of the organizations setting policies and requirements for resident education. Freely available tools, such as the American Society for Radiation Oncology (ASTRO) Radiation and Cancer Biology Practice Examination and Study Guides, were widely used by residents and educators. Consolidation of resident courses or use of a national radiation biology review course was viewed as unlikely by most programs. Conclusions: A high priority should be given to the development of comprehensive teaching tools to assist those individuals who have responsibility for teaching radiation biology courses but who do not have an extensive background in critical areas of radiobiology related to radiation oncology. These findings also suggest a need for new graduate programs in radiobiology.« less

How Useful are Orthopedic Surgery Residency Web Pages?

PubMed

Oladeji, Lasun O; Yu, Jonathan C; Oladeji, Afolayan K; Ponce, Brent A

2015-01-01

Medical students interested in orthopedic surgery residency positions frequently use the Internet as a modality to gather information about individual residency programs. Students often invest a painstaking amount of time and effort in determining programs that they are interested in, and the Internet is central to this process. Numerous studies have concluded that program websites are a valuable resource for residency and fellowship applicants. The purpose of the present study was to provide an update on the web pages of academic orthopedic surgery departments in the United States and to rate their utility in providing information on quality of education, faculty and resident information, environment, and applicant information. We reviewed existing websites for the 156 departments or divisions of orthopedic surgery that are currently accredited for resident education by the Accreditation Council for Graduate Medical Education. Each website was assessed for quality of information regarding quality of education, faculty and resident information, environment, and applicant information. We noted that 152 of the 156 departments (97%) had functioning websites that could be accessed. There was high variability regarding the comprehensiveness of orthopedic residency websites. Most of the orthopedic websites provided information on conference, didactics, and resident rotations. Less than 50% of programs provided information on resident call schedules, resident or faculty research and publications, resident hometowns, or resident salary. There is a lack of consistency regarding the content presented on orthopedic residency websites. As the competition for orthopedic websites continues to increase, applicants flock to the Internet to learn more about orthopedic websites in greater number. A well-constructed website has the potential to increase the caliber of students applying to a said program. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Evaluation of American Board of Orthodontics certification protocols in postgraduate orthodontic programs in the United States and Canada.

PubMed

Park, Jae Hyun; Putrus, Raphael R; Pruzansky, Dawn P; Grubb, John

2017-03-01

The objective of this study was to identify the board certification protocols that hospital and university-based postgraduate orthodontic programs have in place to prepare residents for the American Board of Orthodontics (ABO) certification examination. An electronic survey was sent to the program directors of each of the 72 postgraduate orthodontic programs in the United States and Canada. The survey consisted of 49 questions about demographics, resident case assignment protocols, and ABO examination preparation methods. The response rate was 81%. Most programs were 30 to 36 months in length (72.7%). Many residents had a case load of 51 to 75 during their first year (50.9%), with an average maximum case load of 70 to 109. There was a positive correlation with both the number of cases that first-year residents start and the length of the program (Spearman correlation coefficient = 0.379; P <0.01) when compared with maximum case load. Approximately 72% of the programs do not offer a written mock board examination; however, 72% reported offering a clinical mock board examination. ABO cases are identified within the first 6 months of most programs. About 88% of respondents believe that residents take advantage of the banking system, and that over the past 5 years ABO Initial Certification Examination applications have increased. Most program directors (89.1%) believe that their program length is sufficient for board preparation. Subjects tested in the written examination are integrated into the didactic curriculum and strengthened with ongoing literature reviews, with a passing rate over 90%. Clinical examination preparation varies, with most programs requiring a mock board examination for graduation. Total participation in both the Initial Certification Examination and banking has increased since 2010; better follow-up protocols are needed to track residents after graduation. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

The State of Evaluation in Internal Medicine Residency

PubMed Central

Holmboe, Eric; Beasley, Brent W.

2008-01-01

Background There are no nationwide data on the methods residency programs are using to assess trainee competence. The Accreditation Council for Graduate Medical Education (ACGME) has recommended tools that programs can use to evaluate their trainees. It is unknown if programs are adhering to these recommendations. Objective To describe evaluation methods used by our nation’s internal medicine residency programs and assess adherence to ACGME methodological recommendations for evaluation. Design Nationwide survey. Participants All internal medicine programs registered with the Association of Program Directors of Internal Medicine (APDIM). Measurements Descriptive statistics of programs and tools used to evaluate competence; compliance with ACGME recommended evaluative methods. Results The response rate was 70%. Programs were using an average of 4.2–6.0 tools to evaluate their trainees with heavy reliance on rating forms. Direct observation and practice and data-based tools were used much less frequently. Most programs were using at least 1 of the Accreditation Council for Graduate Medical Education (ACGME)’s “most desirable” methods of evaluation for all 6 measures of trainee competence. These programs had higher support staff to resident ratios than programs using less desirable evaluative methods. Conclusions Residency programs are using a large number and variety of tools for evaluating the competence of their trainees. Most are complying with ACGME recommended methods of evaluation especially if the support staff to resident ratio is high. PMID:18612734

Frequency of and reasons for pharmacy residents breaching the National Matching Services applicant agreement.

PubMed

Cohen, Victor; Jellinek, Samantha P; Blecker, Michael; Cocchio, Craig; Likourezos, Antonios; Shah, Bupendra

2010-11-01

The frequency of and reasons for pharmacy residents breaching the National Matching Services (NMS) applicant agreement were evaluated. An electronic survey was sent via e-mail to residency program directors of ASHP-accredited postgraduate year 1 pharmacy residencies in the United States. The survey instrument was developed based on an initial pilot survey used to test the clarity and reliability of the questions. The primary objective of the survey was to determine the frequency with which pharmacy residents breach the NMS applicant agreement and fail to report to their assigned site. Characteristics of ASHP- accredited residency programs with residents who breached the NMS agreement and any punitive action taken on these individuals were also analyzed. Of the 636 surveys sent to residency program directors, 302 complete surveys were returned, yielding a response rate of 47.5%. Twenty-six respondents (8.6%) indicated that within the past five years, they had matched candidates who failed to report to their assigned site. Of these respondents, 13 (50%) reported the candidate to ASHP; 11 (44%) took no action. Respondents indicated that they would be comfortable reporting all candidates who breach the NMS agreement to ASHP and placing the candidates' information on a list accessible electronically only to residency program directors. Less than 10% of residency program directors reported having residency candidates who breached the NMS applicant agreement. The majority of these respondents indicated that these residents were not their first choices. The most common reason for candidate withdrawal was family obligation.

An Analysis of Future Publications, Career Choices, and Practice Characteristics of Research Presenters at an American College of Surgeons State Conference: A 15-Year Review.

PubMed

Ahmad, Humera F; Jarman, Benjamin T; Kallies, Kara J; Shapiro, Stephen B

The Accreditation Council for Graduate Medical Education requires scholarly activity within general surgery residency programs. The association between in-training research presentations and postgraduation publications is unknown. We hypothesized that surgical trainee presentations at an American College of Surgeons (ACS) state chapter meeting resulted in peer-reviewed publications and future scholarly activity. The ACS Wisconsin state chapter meeting agendas from 2000 to 2014 were reviewed to identify all trainees who delivered podium presentations. A literature search was completed for subsequent publications. Program coordinators were queried and an electronic search was performed to determine practice location and type for each residency graduate. Wisconsin state chapter ACS meeting. General surgery residents, fellows, and medical students in Wisconsin. There were 288 podium presentations by trainees (76% residents, 20% medical students, and 4% fellows). Presentations were clinical (79.5%) and basic science (20.5%). There were 204 unique presenters; 25% presented at subsequent meetings. Of these unique presenters, 46% published their research and 31% published additional research after residency. Among presenters who completed residency or fellowship (N = 119), 34% practiced in a university setting, and 61% practiced in a community setting; 31% practiced in Wisconsin. When comparing clinical vs basic science presenters, there was no difference in fellowship completion (37% vs 44%; p = 0.190) or practice type (38% vs 46% in a university setting; p = 0.397). Repeat presenters were more likely to pursue a fellowship vs those presenting once (76% vs 37%; p = 0.001). Research presentations by surgical trainees at an ACS state chapter meeting frequently led to peer-reviewed publications. Presenters were likely to pursue research opportunities after residency. Repeat presenters were more likely to pursue a fellowship. ACS Wisconsin chapter meetings provide an excellent opportunity for scholarly activity. These outcomes should encourage ACS chapters and ACS members to support trainee research. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Measuring impact of JAMA Dermatology Practice Gaps section on training in US dermatology residency programs.

PubMed

Britton, Kristina M; Stratman, Erik J

2013-07-01

JAMA Dermatology Practice Gaps commentaries are intended to aid in the interpretation of the literature to make it more practical and applicable to daily patient care. Practice Gaps commentaries have had an impact on physician clinical practice and dermatology residency curricula. To assess the impact of JAMA Dermatology Practice Gaps commentaries on dermatology residency training programs in the United States, including journal club discussions and local quality improvement activities. A web-based questionnaire of 17 questions was sent via e-mail to US dermatology residency program directors (PDs) in February 2012. Program director report of incorporating Practice Gaps themes and discussions into resident journal club activities, clinical practice, quality improvement activities, or research projects in the residency programs, as a result of a Practice Gaps commentary. Of the 114 surveys distributed to US dermatology residency PDs, 48 were completed (42% response rate). Sixty percent of PDs reported familiarity with the Practice Gaps section of JAMA Dermatology, and 56% discuss these commentaries during resident journal club activities. Quality improvement and research projects have been initiated as a result of Practice Gaps commentaries. Practice Gaps commentaries are discussed during most dermatology residency journal club activities. Practice Gaps have had an impact on physician practice and dermatology residency curricula and can serve as a tool for enhanced continuing medical education and quality improvement initiatives.

Psychosocial support services for family medicine resident physicians.

PubMed

Addison, Richard B; Riesenberg, Lee Ann; Rosenbaum, Paula

2004-02-01

The stress of residency is well documented. Some residency programs recognize the importance of addressing resident stress and provide psychosocial support services. This study assesses the current state of support services offered to family medicine residents and documents historical trends of support. All US family medicine residency programs were surveyed about program characteristics and the presence or absence of 21 psychosocial support services. The prevalence of current services was compared to that of 10 and 20 years ago. The percentage of family medicine programs offering 17 of 19 support services increased over the previous decades. However, percentages of some key services, especially those that address family life, are still quite low. Increases in services may be due to programs' desire to offer more positive and supportive educational experiences. Offering supportive and reflective opportunities may lessen stress, increase flexibility and balance, create enthusiasm for learning, encourage compassion for patients, and promote future well-being. In times of decreasing interest in family medicine, the presence of effective psychosocial support services may be important for attracting and training the best possible family physicians.

Program Review: Recreation, Parks, and Leisure Studies: The State University System of Florida.

ERIC Educational Resources Information Center

Mobley, Tony A.

This is the report of a 1990 review of Recreation, Parks, and Leisure Studies programs at the University of Florida (UF), Florida State University (FSU), and Florida International University (FIU). Among the conclusions are that these programs are essential to the lifestyle of Florida residents and the continued economic growth of the state.…

Continuity of care in dermatology residency programs in the United States.

PubMed

Loh, Tiffany; Vazirnia, Aria; Afshar, Maryam; Dorschner, Robert; Paravar, Taraneh

2017-05-15

As established by the AccreditationCouncil for Graduate Medical Education (ACGME),dermatology residents in the United States must participate in continuity clinic. This requirement may be achieved through multiple means, allowing for program variation. To better assess continuity clinic's role in resident learning, more data on this component of graduate medical education is needed. An anonymous online survey was distributed via the American Board of Dermatology list serv to all U.S. dermatology residents. Continuity clinic organization, setting, frequency, and patient and preceptor characteristics were assessed; resident satisfaction and learning were compared. Of 231 responses, 7.8% reported continuity clinic daily, 77.1% weekly, 9.1% every other week, 3.0%monthly, 0.4% once every several months, and 2.2%only during certain blocks. Of the clinics reported,80.1% were "resident-run with attending" and 11.3%were attending-run. The rest were "resident-run with no attending" (0.9%), both resident and attending run(3.0%), or "other" (4.8%). Trainees in resident-run clinics (with attendings) reported greater continuity of care than those in attending-run clinics (p<0.001).Residents reported better teaching with attending presence during patient encounters than when attendings were present only if concerns were raised(p<0.01).

Dermatology Residency Selection Criteria with an Emphasis on Program Characteristics: A National Program Director Survey

PubMed Central

Gorouhi, Farzam; Alikhan, Ali; Rezaei, Arash; Fazel, Nasim

2014-01-01

Background. Dermatology residency programs are relatively diverse in their resident selection process. The authors investigated the importance of 25 dermatology residency selection criteria focusing on differences in program directors' (PDs') perception based on specific program demographics. Methods. This cross-sectional nationwide observational survey utilized a 41-item questionnaire that was developed by literature search, brainstorming sessions, and online expert reviews. The data were analyzed utilizing the reliability test, two-step clustering, and K-means methods as well as other methods. The main purpose of this study was to investigate the differences in PDs' perception regarding the importance of the selection criteria based on program demographics. Results. Ninety-five out of 114 PDs (83.3%) responded to the survey. The top five criteria for dermatology residency selection were interview, letters of recommendation, United States Medical Licensing Examination Step I scores, medical school transcripts, and clinical rotations. The following criteria were preferentially ranked based on different program characteristics: “advanced degrees,” “interest in academics,” “reputation of undergraduate and medical school,” “prior unsuccessful attempts to match,” and “number of publications.” Conclusions. Our survey provides up-to-date factual data on dermatology PDs' perception in this regard. Dermatology residency programs may find the reported data useful in further optimizing their residency selection process. PMID:24772165

Study of Teaching Residents How to Teach.

ERIC Educational Resources Information Center

Edwards, Janine C.; And Others

1988-01-01

The effectiveness of a teaching skills program for residents at Louisiana State University Medical Center was evaluated among 22 residents in obstetrics and gynecology, medicine, and family medicine who were randomly assigned to control and experimental groups. There was greater increase in the scores of the experimental than the control groups.…

Survey of Threats and Assaults by Patients on Psychiatry Residents

ERIC Educational Resources Information Center

Dvir, Yael; Moniwa, Emiko; Crisp-Han, Holly; Levy, Dana; Coverdale, John H.

2012-01-01

Objective: The authors sought to determine the prevalence of threats and assaults by patients on psychiatry residents, their consequences, and the perceived adequacy of supports and institutional responses. Method: Authors conducted an anonymous survey of 519 psychiatry residents in 13 psychiatry programs across the United States. The survey…

Capricorn-A Web-Based Automatic Case Log and Volume Analytics for Diagnostic Radiology Residents.

PubMed

Chen, Po-Hao; Chen, Yin Jie; Cook, Tessa S

2015-10-01

On-service clinical learning is a mainstay of radiology education. However, an accurate and timely case log is difficult to keep, especially in the absence of software tools tailored to resident education. Furthermore, volume-related feedback from the residency program sometimes occurs months after a rotation ends, limiting the opportunity for meaningful intervention. We surveyed the residents of a single academic institution to evaluate the current state of and the existing need for tracking interpretation volume. Using the results of the survey, we created an open-source automated case log software. Finally, we evaluated the effect of the software tool on the residency in a 1-month, postimplementation survey. Before implementation of the system, 89% of respondents stated that volume is an important component of training, but 71% stated that volume data was inconvenient to obtain. Although the residency program provides semiannual reviews, 90% preferred reviewing interpretation volumes at least once monthly. After implementation, 95% of the respondents stated that the software is convenient to access, 75% found it useful, and 88% stated they would use the software at least once a month. The included analytics module, which benchmarks the user using historical aggregate average volumes, is the most often used feature of the software. Server log demonstrates that, on average, residents use the system approximately twice a week. An automated case log software system may fulfill a previously unmet need in diagnostic radiology training, making accurate and timely review of volume-related performance analytics a convenient process. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

Experience of health-system pharmacy administration residents in a longitudinal human resource management program.

PubMed

Amerine, Lindsey B Poppe; Granko, Robert P; Savage, Scott W; Daniels, Rowell; Eckel, Stephen F

2014-12-15

The experience of health-system pharmacy administration (HSPA) residents in a longitudinal human resource (HR) management program is described. The subsequent benefits to the residents, department, and profession are also discussed. Postgraduate year 2 HSPA residents at an academic medical center desired more responsibility for managing an operational area. To this end, a program was created in which these residents directly manage a small group of pharmacy technicians and report to a clinical manager or assistant director with oversight responsibility. These "resident managers" are responsible, under the direction of the area's clinical manager, for the personnel, schedule, time and attendance, and HR activities of the area. Resident managers have led and sustained operational improvement projects in their areas. In addition to providing learning experiences to residents, the HSPA residency program has also improved the operations of the areas in which these residents work. Benefits to the residents include conducting annual performance evaluations for employees with whom they have a relationship as it is a task every administrator completes. Resident managers at UNC have consistently stated that this longitudinal HR experience is one of the most rewarding and most challenging experiences offered in the two-year HSPA residency. The involvement of HSPA residents in longitudinal management responsibilities furthers residents' leadership success by providing trained managers who are ready to immerse themselves into practice postresidency, having employee engagement and HR skills as well as experiences with leading operational improvements. A longitudinal HR management experience was successfully incorporated into an HSPA residency combined Master of Science degree program. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Ophthalmology resident surgical competency: a national survey.

PubMed

Binenbaum, Gil; Volpe, Nicholas J

2006-07-01

To describe the prevalence, management, and career outcomes of ophthalmology residents who struggle with surgical competency and to explore related educational issues. Fourteen-question written survey. Fifty-eight program directors at Accreditation Council on Graduate Medical Education-accredited, United States ophthalmology residency programs, representing a total of 2179 resident graduates, between 1991 and 2000. Study participants completed a mailed, anonymous survey whose format combined multiple choice and free comment questions. Number of surgically challenged residents, types of problems identified, types of remediation, final departmental decision at the end of residency, known career outcomes, and residency program use of microsurgical skills laboratories and applicant screening tests. One hundred ninety-nine residents (9% overall; 10% mean per program) were labeled as having trouble mastering surgical skills. All of the programs except 2 had encountered such residents. The most frequently cited problems were poor hand-eye coordination (24%) and poor intraoperative judgment (22%). Most programs were supportive and used educational rather than punitive measures, the most common being extra practice-laboratory time (32%), scheduling cases with the best teaching surgeon (23%), and counseling (21%). Nearly one third (31%) of residents were believed to have overcome their difficulties before graduation. Other residents were encouraged to pursue medical ophthalmology (22%) or to obtain further surgical training through a fellowship (21%) or a supervised practice setting (12%); these residents were granted a departmental statement of satisfactory completion of residency for Board eligibility. Twelve percent were asked to leave residency. Of reported career outcomes, 92% of residents were practicing ophthalmology, 65% as surgical and 27% as medical ophthalmologists. Ninety-eight percent of residency programs had microsurgical practice facilities, 64% had a formal teaching course, and 36% had mandatory practice time. Most programs (76%) did not perform applicant vision or dexterity screening tests; questions existed about the legality and validity of such tests. The issue of ophthalmology residents who struggle to develop surgical competency appears common. Although many problems appear to be remediable with time, practice, and dedicated, patient teachers, more specific guidelines for a statement of surgical competency are likely necessary to standardize the Board certification process.

A report on the current status of grand rounds in radiology residency programs in the United States.

PubMed

Yablon, Corrie M; Wu, Jim S; Slanetz, Priscilla J; Eisenberg, Ronald L

2011-12-01

A national needs assessment of radiology program directors was performed to characterize grand rounds (GR) programs, assess the perceived educational value of GR programs, and determine the impact of the recent economic downturn on GR. A 28-question survey was developed querying the organizational logistics of GR programs, types of speakers, content of talks, honoraria, types of speakers invited, response to the economic downturn, types of speaker interaction with residents, and perceived educational value of GR. Questions were in multiple-choice, yes-or-no, and five-point Likert-type formats. The survey was distributed to the program directors of all radiology residencies within the United States. Fifty-seven of 163 programs responded, resulting in a response rate of 36%. Thirty-eight programs (67%) were university residencies and 10 (18%) were university affiliated. Eighty-two percent of university and 60% of university-affiliated residencies had their own GR programs, while only 14% of community and no military residencies held GR. GR were held weekly in 18% of programs, biweekly in 8%, monthly in 42%, bimonthly in 16%, and less frequently than every 2 months in 16%. All 38 programs hosting GR reported a broad spectrum of presentations, including talks on medical education (66%), clinical and evidence-based medicine (55%), professionalism (45%), ethics (45%), quality assurance (34%), global health (26%), and resident presentations (26%). All programs invited speakers from outside the institution, but there was variability with regard to the frequency of visits and whether invited speakers were from out of town. As a result of recent economic events, one radiology residency (3%) completely canceled its GR program. Others decreased the number of speakers from outside their cities (40%) or decreased the number of speakers from within their own cities (16%). Honoraria were paid to speakers by 95% of responding programs. Most program directors (79%) who had their own GR programs either strongly agreed or agreed that GR are an essential component of any academic radiology department, and this opinion was shared by a majority of all respondents (68%). Almost all respondents (97%) either strongly agreed or agreed that general radiologic education of imaging subspecialists is valuable in an academic radiology department. A majority (65%) either strongly agreed or agreed that attendance at GR should be expected of all attending radiologists. GR programs among radiology residencies tend to have similar formats involving invited speakers, although the frequency, types of talks, and honoraria may vary slightly. Most programs value GR, and all programs integrate GR within resident education to some degree. The recent economic downturn has led to a decrease in the number of invited visiting speakers but not to a decrease in the amounts of honoraria. Copyright © 2011 AUR. Published by Elsevier Inc. All rights reserved.

Physical Therapy Residency and Fellowship Education: Reflections on the Past, Present, and Future.

PubMed

Furze, Jennifer A; Tichenor, Carol Jo; Fisher, Beth E; Jensen, Gail M; Rapport, Mary Jane

2016-07-01

The physical therapy profession continues to respond to the complex and changing landscape of health care to meet the needs of patients and the demands of patient care. Consistent with this evolution is the rapid development and expansion of residency and fellowship postprofessional programs. With the interested number of applicants exceeding the number of residency and fellowship slots available, a "critical period" in the educational process is emerging. The purposes of this perspective article are: (1) to analyze the state of residency and fellowship education within the profession, (2) to identify best practice elements from other health professions that are applicable to physical therapy residency and fellowship education, and (3) to propose a working framework grounded in common domains of competence to be used as a platform for dialogue, consistency, and quality across all residency and fellowship programs. Seven domains of competence are proposed to theoretically ground residency and fellowship programs and facilitate a more consistent approach to curricular development and assessment. Although the recent proliferation of residency and fellowship programs attempts to meet the demand of physical therapists seeking advanced educational opportunities, it is imperative that these programs are consistently delivering high-quality education with a common focus on delivering health care in the context of societal needs. © 2016 American Physical Therapy Association.

A Cross-sectional Analysis of Minimum USMLE Step 1 and 2 Criteria Used by Orthopaedic Surgery Residency Programs in Screening Residency Applications.

PubMed

Schrock, John B; Kraeutler, Matthew J; Dayton, Michael R; McCarty, Eric C

2017-06-01

The purpose of this study was to analyze how program directors (PDs) of orthopaedic surgery residency programs use United States Medical Licensing Examination (USMLE) Step 1 and 2 scores in screening residency applicants. A survey was sent to each allopathic orthopaedic surgery residency PD. PDs were asked if they currently use minimum Step 1 and/or 2 scores in screening residency applicants and if these criteria have changed in recent years. Responses were received from 113 of 151 PDs (75%). One program did not have the requested information and five declined participation, leaving 107 responses analyzed. Eighty-nine programs used a minimum USMLE Step 1 score (83%). Eighty-three programs (78%) required a Step 1 score ≥210, 80 (75%) required a score ≥220, 57 (53%) required a score ≥230, and 22 (21%) required a score ≥240. Multiple PDs mentioned the high volume of applications as a reason for using a minimum score and for increasing the minimum score in recent years. A large proportion of orthopaedic surgery residency PDs use a USMLE Step 1 minimum score when screening applications in an effort to reduce the number of applications to be reviewed.

Effect of January vacations and prior night call status on resident ABSITE performance.

PubMed

Sugar, Jane G; Chu, Quyen D; Cole, Philip A; Li, Benjamin D L; Kim, Roger H

2013-01-01

To determine if vacations in January or on-call status have an effect on American Board of Surgery In-Training Examination (ABSITE) scores. Retrospective review of the performance of general surgery residents on ABSITE. Data collected included ABSITE scores, United States Medical Licensing Examination Step 2 scores, January vacation schedules, and call schedules. ABSITE performance was examined for correlation with vacation or call schedules. Student t test was used for statistical analysis, with a p value of less than 0.05 considered significant. General surgery residency program at the Louisiana State University Health Sciences Center-Shreveport, a university hospital-based program with 5 categorical residents per year. Postgraduate year (PGY) 1 through 5 general surgery categorical residents from 2006 to 2012. A total of 170 ABSITE scores from 55 residents were reviewed. The mean score when vacation was taken was 48.6 as compared with 36.3 when no vacation was taken (p = 0.02). Residents who took a January vacation at least once in their residency had a mean score of 42.8 as compared with 37.7 of those who did not (p = 0.43). The mean United States Medical Licensing Examination Step 2 score of residents who took a January vacation at least once in their residency was 218 as compared with 217 for their peers (p = 0.78). Among residents who took January vacations, the mean score in the years they took vacation was 49.4 as compared with 35.4 in the years they did not (p = 0.02). Prior night call status had no effect on the examination scores (44.2 vs 38.6, p = 0.30). Mean ABSITE scores were higher for residents who took a January vacation before the examination, despite no apparent difference in baseline test-taking ability. Among residents who took January vacations, mean scores were higher in the years they took vacation than in other years. On-call status did not have an effect on ABSITE performance. Vacation schedules in January can have a significant effect on ABSITE scores. Copyright © 2013 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Factors influencing anesthesia residency selection: impact of global health opportunities.

PubMed

Evans, Faye M; Mallepally, Niharika R; Dubowitz, Gerald; Vasilopoulos, Terrie; McClain, Craig D; Enneking, Kayser

2016-06-01

There is growing evidence to suggest that the current generation of medical students and young physicians is interested in global health. However, there are few data on the interest in global health by students pursuing a career in anesthesiology. The objective of this survey was to evaluate the importance of global health opportunities in regard to applicants' choice of anesthesiology residency programs. Anesthesiology residency program directors in the United States were invited to distribute an online survey to recently matched residents. To reduce study bias, the survey included a wide selection of reasons for program choices in addition to global health. Participants were asked to rate independently, on a scale of 1 to 10 (1 = least important, 10 = most important), the importance that each factor had on their selection of an anesthesiology residency program. Of the 117 U.S. anesthesiology programs contacted, 87 (74%) distributed the survey. Completed surveys were obtained from 582 of 1,092 (53%) polled participants. All factors assessed were rated between 5 and 9 and the global health median [interquartile range] rating was 6 [3-7]. Nearly half of the survey respondents were interested in incorporating global health into future careers. More than three-quarters reported being interested in participating in, or reading about, global health activities during their residency. Responders with previous global health experience, or who were interested in an "in-country" experience, were more likely to choose programs that had global health opportunities available during residency. Anesthesia residency program applicants are interested in global health. Having a global health opportunity was an important reason for choosing a residency program, comparable to some more traditional factors. Regardless of previous global health experience, the majority of future anesthesia residents are either planning or considering participation in global health activities during or after training.

The uneven distribution of women in orthopaedic surgery resident training programs in the United States.

PubMed

Van Heest, Ann E; Agel, Julie

2012-01-18

Although women represented 58% of undergraduate students and 48% of medical students in the U.S. in the 2008-2009 academic year, only 13% of orthopaedic residents and only 4% of American Academy of Orthopaedic Surgeons (AAOS) Fellows in 2009 were women. Are all orthopaedic surgery programs in the U.S. equal in their ability to attract female medical students and train female orthopaedic surgeons? This study was undertaken to test the hypothesis that all Accreditation Council for Graduate Medical Education (ACGME)-accredited orthopaedic surgery residency programs in the U.S. train a similar number of female residents. Data for all ACGME-accredited orthopaedic surgery residency training programs in the U.S. for five academic years (2004-2005 through 2008-2009) were collected with use of the Graduate Medical Education (GME) Track database. Orthopaedic residency programs in the U.S. do not train women at an equal frequency. In the academic years from 2004-2005 through 2008-2009, forty-five programs had no female residents during at least one of the five academic years reviewed, and nine programs had no female residents during any of the years. More than fifty orthopaedic residency programs in the U.S. had an average of <10% female trainees over the five-year period, and more than ten programs had an average of >20%. There was no significant change in the distribution among these categories over the five years examined (p = 0.234). Significant differences in the representation of women exist among orthopaedic residency training programs in the U.S. Further examination of the characteristics of orthopaedic residency programs that are successful in attracting female residents, particularly the composition of their faculty as role models, will be important in furthering our understanding of how orthopaedic surgery can continue to attract the best and the brightest individuals. Changes in the cultural experiences in programs that have not trained female orthopaedic surgeons, such as an increased number of female faculty, and policies that emphasize diversity may provide a greater opportunity for our orthopaedic profession to attract female medical students.

Graduating Students' and Surgery Program Directors' Views of the Association of American Medical Colleges Core Entrustable Professional Activities for Entering Residency: Where are the Gaps?

PubMed

Lindeman, Brenessa M; Sacks, Bethany C; Lipsett, Pamela A

2015-01-01

Residency program directors have increasingly expressed concern about the preparedness of some medical school graduates for residency training. The Association of American Medical Colleges recently defined 13 core entrustable professional activities (EPAs) for entering residency that residents should be able to perform without direct supervision on the first day of training. It is not known how students' perception of their competency with these activities compares with that of surgery program directors'. Cross-sectional survey. All surgery training programs in the United States. All program directors (PDs) in the Association of Program Directors in Surgery (APDS) database (n = 222) were invited to participate in an electronic survey, and 119 complete responses were received (53.6%). Among the respondents, 83% were men and 35.2% represented community hospital programs. PDs' responses were compared with questions asking students to rate their confidence in performance of each EPA from the Association of American Medical Colleges Graduation Questionnaire (95% response). PDs rated their confidence in residents' performance without direct supervision for every EPA significantly lower when compared with the rating by graduating students. Although PDs' ratings continued to be lower than students' ratings, PDs from academic programs (those associated with a medical school) gave higher ratings than those from community programs. PDs generally ranked all 13 EPAs as important to being a trustworthy physician. PDs from programs without preliminary residents gave higher ratings for confidence with EPA performance as compared with PDs with preliminary residents. Among PDs with preliminary residents, there were equal numbers of those who agreed and those who disagreed that there are no identifiable differences between categorical and preliminary residents (42.7% and 41.8%, respectively). A large gap exists between confidence in performance of the 13 core EPAs for entering residency without direct supervision for graduating medical students and surgery program directors. Both the groups identified several key areas for improvement that may be addressed by medical school curricular interventions or expanding surgical boot camps in hopes to improve resident performance and patient safety. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Medical Physics Residency Consortium: collaborative endeavors to meet the ABR 2014 certification requirements

PubMed Central

Parker, Brent C.; Duhon, John; Yang, Claus C.; Wu, H. Terry; Hogstrom, Kenneth R.

2014-01-01

In 2009, Mary Bird Perkins Cancer Center (MBPCC) established a Radiation Oncology Physics Residency Program to provide opportunities for medical physics residency training to MS and PhD graduates of the CAMPEP‐accredited Louisiana State University (LSU)‐MBPCC Medical Physics Graduate Program. The LSU‐MBPCC Program graduates approximately six students yearly, which equates to a need for up to twelve residency positions in a two‐year program. To address this need for residency positions, MBPCC has expanded its Program by developing a Consortium consisting of partnerships with medical physics groups located at other nearby clinical institutions. The consortium model offers the residents exposure to a broader range of procedures, technology, and faculty than available at the individual institutions. The Consortium institutions have shown a great deal of support from their medical physics groups and administrations in developing these partnerships. Details of these partnerships are specified within affiliation agreements between MBPCC and each participating institution. All partner sites began resident training in 2011. The Consortium is a network of for‐profit, nonprofit, academic, community, and private entities. We feel that these types of collaborative endeavors will be required nationally to reach the number of residency positions needed to meet the 2014 ABR certification requirements and to maintain graduate medical physics training programs. PACS numbers: 01.40.Fk, 01.40.gb PMID:24710434

Whose Problem Is It? The Priority of Physician Wellness in Residency Training.

PubMed

Winkel, Abigail Ford; Nguyen, Anh T; Morgan, Helen K; Valantsevich, Darya; Woodland, Mark B

Physician wellness is associated with improved outcomes for patients and physicians. Wellness is a priority of the Accreditation Council on Graduate Medical Education, and many residencies have programs in place to improve wellness. This study sought to understand how stakeholders in graduate medical education perceive wellness among other educational priorities and whether these programs are improving the experience and training of residents. The Council on Resident Education in Obstetrics and Gynecology (OBGYN)/Association of Professors in Gynecology Wellness Task Force created a survey and distributed it electronically to all OBGYN residents and program directors (PDs) in 2015. The survey included demographics, questions about the priority of wellness in the educational programs, experience with wellness programming, and problems with resident wellness (burnout, depression, binge drinking, suicide/suicide attempts, drug use, or eating disorders). Data rated on a Likert scale were analyzed using Kruskal-Wallis and Mann-Whitney U tests. Among 248 OBGYN PDs, 149 (60%) completed the survey. Of a total 5274 OBGYN residents nationally, 838 (16%) completed the survey. Most of the residents, 737 (89.4%) reported that they or a colleague experienced some problem with wellness. Many PDs also reported problems with wellness, but 46 (33.9%) reported not being aware of problems in the previous 5 years. When asked to rate the priority of wellness in resident education, <1% (1) PD stated that this was not a priority; however, 85 residents (10%) responded that wellness should not be a priority for residency programs. Resident reports of problems were higher as year in training increased (depression χ 2 = 23.6, p ≤ 0.001; burnout χ 2 = 14.0, p = 0.003; suicide attempt χ 2 = 15.5, p = 0.001; drug use χ 2 = 9.09, p = 0.028; and binge drinking χ 2 = 10.7, p = 0.013). Compared with community programs, university programs reported slightly fewer problems with wellness (χ 2 = 5.4, p = 0.02) and suicide/suicide attempts (χ 2 = 13.3, p = 0.001). Most PDs reported having some programming in place, although residents reported lower rates of feeling that these programs addressed wellness. There is a discrepancy between the perspective that residents and PDs have on resident wellness, and its priority within the residency program. PDs may not be aware of the scope of the problem of resident wellness. These problems increase with year of training, and may be more common in community programs. Current wellness programming may not be effective, and a significant minority of residents feels that wellness is beyond the scope of the training program. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Sleep education in pediatric residency programs: a cross-cultural look.

PubMed

Mindell, Jodi A; Bartle, Alex; Ahn, Youngmin; Ramamurthy, Mahesh Babu; Huong, Huynh Thi Duy; Kohyama, Jun; Li, Albert M; Ruangdaraganon, Nichara; Sekartini, Rini; Teng, Arthur; Goh, Daniel Y T

2013-04-03

The objective of this study was to assess the prevalence of education about sleep and sleep disorders in pediatric residency programs and to identify barriers to providing such education. Surveys were completed by directors of 152 pediatric residency programs across 10 countries (Hong Kong, India, Indonesia, Japan, Singapore, South Korea, Thailand, United States-Canada, and Vietnam). Overall, the average amount of time spent on sleep education is 4.4 hours (median = 2.0 hours), with 23% responding that their pediatric residency program provides no sleep education. Almost all programs (94.8%) offer less than 10 hours of instruction. The predominant topics covered include sleep-related development, as well as normal sleep, sleep-related breathing disorders, parasomnias, and behavioral insomnia of childhood. These results indicate that there is still a need for more efforts to include sleep-related education in all pediatric residency programs, as well as coverage of the breadth of sleep-related topics. Such education would be consistent with the increased recognition of the importance of sleep and under-diagnosis of sleep disorders in children and adolescents.

Sleep education in pediatric residency programs: a cross-cultural look

PubMed Central

2013-01-01

Background The objective of this study was to assess the prevalence of education about sleep and sleep disorders in pediatric residency programs and to identify barriers to providing such education. Methods Surveys were completed by directors of 152 pediatric residency programs across 10 countries (Hong Kong, India, Indonesia, Japan, Singapore, South Korea, Thailand, United States-Canada, and Vietnam). Results Overall, the average amount of time spent on sleep education is 4.4 hours (median = 2.0 hours), with 23% responding that their pediatric residency program provides no sleep education. Almost all programs (94.8%) offer less than 10 hours of instruction. The predominant topics covered include sleep-related development, as well as normal sleep, sleep-related breathing disorders, parasomnias, and behavioral insomnia of childhood. Conclusions These results indicate that there is still a need for more efforts to include sleep-related education in all pediatric residency programs, as well as coverage of the breadth of sleep-related topics. Such education would be consistent with the increased recognition of the importance of sleep and under-diagnosis of sleep disorders in children and adolescents. PMID:23552445

Pathology Informatics Essentials for Residents: A flexible informatics curriculum linked to Accreditation Council for Graduate Medical Education milestones

PubMed Central

Henricks, Walter H; Karcher, Donald S; Harrison, James H; Sinard, John H; Riben, Michael W; Boyer, Philip J; Plath, Sue; Thompson, Arlene; Pantanowitz, Liron

2016-01-01

Context: Recognition of the importance of informatics to the practice of pathology has surged. Training residents in pathology informatics have been a daunting task for most residency programs in the United States because faculty often lacks experience and training resources. Nevertheless, developing resident competence in informatics is essential for the future of pathology as a specialty. Objective: The objective of the study is to develop and deliver a pathology informatics curriculum and instructional framework that guides pathology residency programs in training residents in critical pathology informatics knowledge and skills and meets Accreditation Council for Graduate Medical Education Informatics Milestones. Design: The College of American Pathologists, Association of Pathology Chairs, and Association for Pathology Informatics formed a partnership and expert work group to identify critical pathology informatics training outcomes and to create a highly adaptable curriculum and instructional approach, supported by a multiyear change management strategy. Results: Pathology Informatics Essentials for Residents (PIER) is a rigorous approach for educating all pathology residents in important pathology informatics knowledge and skills. PIER includes an instructional resource guide and toolkit for incorporating informatics training into residency programs that vary in needs, size, settings, and resources. PIER is available at http://www.apcprods.org/PIER (accessed April 6, 2016). Conclusions: PIER is an important contribution to informatics training in pathology residency programs. PIER introduces pathology trainees to broadly useful informatics concepts and tools that are relevant to practice. PIER provides residency program directors with a means to implement a standardized informatics training curriculum, to adapt the approach to local program needs, and to evaluate resident performance and progress over time. PMID:27563486

The increase in international medical graduates in family practice residency programs.

PubMed

Koehn, Nerissa N; Fryer, George E; Phillips, Robert L; Miller, John B; Green, Larry A

2002-06-01

The number of filled positions in family practice residency programs decreased by 18.6% from 1997-2001. This study sought to determine the degree of reliance on international medical graduates (IMGs) to fill family practice residency positions and the relative proportion of US citizen IMGs. We analyzed the 1992-2001 National Resident Matching Program results, the 2000 American Medical Association Masterfile, and the 1992-2001 American Academy of Family Physicians Annual Survey of Family Practice Residency Programs. The percentage of IMGs matching in family practice remained stable between the years of 1992-1996 (10.0%-11.8%) but since 1997 has increased to a high of 21.4% in 2001. This rise in IMGs corresponds with a drop in the total percentage of family practice residency positions filled in the Match from 90.5% in 1996 to 76.3% in 2001. Despite the drop in Match numbers, the percentage of first-year family practice positions filled in July has remained in the range of 95.5%-97.8% since 1996. IMGs account for an increasing percentage of post-Match fills from 16.7% in 1996 to 47.9% in 2001. In 1999, a majority of family practice programs (279 [55.6%]), had at least one IMG. Of these, 48 programs (9.6%) had at least 50% of residents who were IMGs, and eight programs (1.6%) were entirely composed of IMGs. In five states (Connecticut, Illinois, Michigan, New Jersey, and New York), more than 25% of family practice residents were IMGs. Family practice is becoming increasingly reliant on IMGs to fill residency positions.

Increasing First-Semester Student Engagement: A Residential Community Retention Study

ERIC Educational Resources Information Center

Briggs, Ronald

2012-01-01

The purpose of this study was to increase first year residential student engagement and participation in residence hall programs during the 2011 fall semester at the Downtown Phoenix Campus of Arizona State University. Six upperclassmen (Taylor Place Leaders) residing in a residence hall (Taylor Place) were matched by academic major with 17 first…

42 CFR 51.42 - Access to facilities and residents.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Access to facilities and residents. 51.42 Section... Records, Facilities and Individuals § 51.42 Access to facilities and residents. (a) Access to facilities... reasonable unaccompanied access to public and private facilities and programs in the State which render care...

Accreditation Council for Graduate Medical Education Core Competencies at a Community Teaching Hospital: Is There a Gap in Awareness?

PubMed

Al-Temimi, Mohammed; Kidon, Michael; Johna, Samir

2016-01-01

Reports evaluating faculty knowledge of the Accreditation Council for Graduate Medical Education (ACGME) core competencies in community hospitals without a dedicated residency program are uncommon. Faculty evaluation regarding knowledge of ACGME core competencies before a residency program is started. Physicians at the Kaiser Permanente Fontana Medical Center (N = 480) were surveyed for their knowledge of ACGME core competencies before starting new residency programs. Knowledge of ACGME core competencies. Fifty percent of physicians responded to the survey, and 172 (71%) of respondents were involved in teaching residents. Of physicians who taught residents and had complete responses (N = 164), 65 (39.7%) were unsure of their knowledge of the core competencies. However, most stated that they provided direct teaching to residents related to the knowledge, skills, and attitudes stated in each of the 6 competencies as follows: medical knowledge (96.3%), patient care (95.7%), professionalism (90.7%), interpersonal and communication skills (86.3%), practice-based learning (85.9%), and system-based practice (79.6%). Physician specialty, years in practice (1-10 vs > 10), and number of rotations taught per year (1-6 vs 7-12) were not associated with knowledge of the competencies (p > 0.05); however, full-time faculty (teaching 10-12 rotations per year) were more likely to provide competency-based teaching. Objective assessment of faculty awareness of ACGME core competencies is essential when starting a residency program. Discrepancy between knowledge of the competencies and acclaimed provision of competency-based teaching emphasizes the need for standardized teaching methods that incorporate the values of these competencies.

A survey of cosmetic surgery training in plastic surgery programs in the United States.

PubMed

Morrison, Colin M; Rotemberg, S Cristina; Moreira-Gonzalez, Andrea; Zins, James E

2008-11-01

Aesthetic surgery is evolving rapidly, both technologically and conceptually. It is critical for the specialty that aesthetic surgery training keep pace with this rapid evolution. To shed more light on this issue, a survey was sent to all program directors and senior plastic surgery residents to record their impressions of the quality of cosmetic surgery resident training. The authors report the results of this national cosmetic surgery training survey canvassing all 89 plastic surgery programs. A three-page survey delineating resident preparedness in aesthetic surgery was sent to senior plastic surgery residents and program directors in April of 2006 and collected through October of 2006. Of 814 surveys, 292 responses were obtained from 64 percent of program directors and 33 percent of senior residents. Breast augmentation, breast reduction, and abdominoplasty were most frequently performed with the highest resident comfort levels. Rhinoplasty remained a particular area of trainee concern, but confidence levels were also low in face lifts, endoscopic procedures, and body contouring techniques. Experience with skin resurfacing, fillers, and botulinum toxin type A was another area of concern. Although 51 percent of residents felt prepared to integrate cosmetic surgery into their practices on graduation, 36 percent felt that further cosmetic training was desirable. The information collected revealed significant differences in opinions between program directors and senior residents. Senior residents felt deficient in facial cosmetic, minimally invasive, and recently developed body contouring techniques. On the basis of these results and the authors' experience in resident education, changes in cosmetic surgery training are suggested.

An examination of professional and ethical issues in the fellowship application process in pathology.

PubMed

Domen, Ronald E; Wehler, Amanda Brehm

2008-04-01

Approximately 34 medical specialty and subspecialty fellowship programs in the United States have formalized the application process through the National Resident Matching Program. This approach sets standards for the application process, offers a formalized match similar to that for residency programs, functions within a specific timeline, and establishes binding rules of behavior for both applicants and programs. For fellowship programs that operate outside the National Resident Matching Program, such as those in pathology, no published guidelines exist to help programs and applicants address the many questions and problems that can arise. As a result, programs are free to set their own timelines for interviews, application requirements, contract negotiations and finalizations, and other details. Consequently, applicants often feel pressured to apply earlier and earlier in their residency for competitive fellowship programs, are often required to fill out multiple unique applications, may feel no "loyalty" toward honoring an acceptance without a contract, and often feel disenfranchised by the whole process. This article addresses professional and ethical aspects of the current application process and offers possible solutions for improving it.

Evaluation of ethics education in obstetrics and gynecology residency programs.

PubMed

Byrne, John; Straub, Heather; DiGiovanni, Laura; Chor, Julie

2015-03-01

The objective of the study was to assess the current status of ethics education in obstetrics-gynecology residency programs. A cross-sectional, web-based survey was designed in conjunction with a professional survey laboratory at the University of Chicago. The survey was piloted with a convenience sample of clinical medical ethics fellows to assess question content and clarity. The survey was deployed by e-mail to all obstetrics-gynecology residency program directors. Descriptive statistics were used to analyze participant responses. The University of Chicago's Institutional Review Board deemed this study exempt from institutional review board formal review. Of 242 eligible obstetrics-gynecology residency program directors, 118 (49%) completed the survey. Most respondents were from university-based programs (n = 78, 66%) that were not religiously affiliated (n = 98, 83%) and trained 4-6 residents per postgraduate year (n = 64, 70%). Although 50% of program directors (n = 60) reported having ethics as part of their core curriculum, most programs teach ethics in an unstructured manner. Fifty-seven percent of respondents (n = 66) stated their program dedicated 5 or fewer hours per year to ethics. The majority of program directors (n = 80, 73%) responded they would like more to a lot more ethics education and believed that ethics education should be required (n = 93, 85%) for residents to complete their training. Respondents identified that crowding in the curriculum was a significant barrier to increased ethics training (n = 50, 45%) and two-thirds (n = 74, 67%) reported a lack of faculty expertise as a moderate barrier to providing ethics education in the residency curriculum. This study found that a lack of structured curricula, inadequate faculty expertise, and limited time were important barriers for ethics education in obstetrics-gynecology programs across the nation. Despite these existing challenges, program directors have a strong interest in increasing ethics education in residency training. Therefore, additional resources are needed to assist program directors in enhancing resident ethics education. Copyright © 2015 Elsevier Inc. All rights reserved.

Personality Factors Associated With Resident Performance: Results From 12 Accreditation Council for Graduate Medical Education Accredited Orthopaedic Surgery Programs.

PubMed

Phillips, Donna; Egol, Kenneth A; Maculatis, Martine C; Roloff, Kathryn S; Friedman, Alan M; Levine, Brett; Garfin, Steven; Schwartz, Alexandra; Sterling, Robert; Kuivila, Thomas; Paragioudakis, Steve J; Zuckerman, Joseph D

To understand the personality factors associated with orthopedic surgery resident performance. A prospective, cross-sectional survey of orthopedic surgery faculty that assessed their perceptions of the personality traits most highly associated with resident performance. Residents also completed a survey to determine their specific personality characteristics. A subset of faculty members rated the performance of those residents within their respective program on 5 dimensions. Multiple regression models tested the relationship between the set of resident personality measures and each aspect of performance; relative weights analyses were then performed to quantify the contribution of the individual personality measures to the total variance explained in each performance domain. Independent samples t-tests were conducted to examine differences between the personality characteristics of residents and those faculty identified as relevant to successful resident performance. Data were collected from 12 orthopedic surgery residency programs 1 throughout the United States. The level of clinical care provided by participating institutions varied. Data from 175 faculty members and 266 residents across 12 programs were analyzed. The personality features of residents were related to faculty evaluations of resident performance (for all, p < 0.01); the full set of personality measures accounted for 4%-11% of the variance in ratings of resident performance. Particularly, the characteristics of agreeableness, neuroticism, and learning approach were found to be most important for explaining resident performance. Additionally, there were significant differences between the personality features that faculty members identified as important for resident performance and the personality features that residents possessed. Personality assessments can predict orthopedic surgery resident performance. However, results suggest the traits that faculty members value or reward among residents could be different from the traits associated with improved resident performance. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Thoracic surgery training in Canada according to the residents: the thoracic surgery resident survey, of the Canadian thoracic manpower and education study (T-Med).

PubMed

Schieman, Colin; Kelly, Elizabeth; Gelfand, Gary; Graham, Andrew; McFadden, Sean P; Edwards, Janet; Grondin, Sean C

2010-01-01

The resident component of the Canadian Thoracic Manpower and Education Study (T-MED) was conducted to understand the basic demographic of Canadian thoracic surgery residents, the factors influencing their selection of training programs, current work conditions, training and competencies, and opinions in regard to the manpower needs for the specialty. A modified Delphi process was used to develop a survey applicable to thoracic surgery residents. In May and June 2009, residents completed the voluntary anonymous Internet-based survey. All Canadian residents participated in the survey, providing a 100% response rate. Most respondents were male (11/12), and the average age was 34 years old with an anticipated debt greater than $50,000 on graduation. All residents worked more than 70 hours per week, with most doing 1 : 3 or 1 : 4 on-call. Two-thirds of respondents reported being satisfied or very satisfied with their training program. Rates of anticipated competence in performing various thoracic surgeries on graduation differed between residents and program directors. Two-thirds (8/12) of residents planned to practice thoracic surgery exclusively, and hoped to practice in an academic setting. Most residents (10/12) agreed or strongly agreed that not enough jobs are available in Canada for graduating trainees and that the number of residency positions should reflect the predicted availability of jobs. This study has provided detailed information on thoracic surgery resident demographics and training programs. Most thoracic surgery residents are satisfied with their current training program but have concerns about their job prospects on graduation, and they believe that the number of training positions should reflect potential job opportunities. This survey represents the first attempt to characterize the current state of thoracic surgery training in Canada from the resident's perspective and may help in directing educational and manpower planning. Copyright © 2010 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Familiarity with Long-acting Reversible Contraceptives among Obstetrics and Gynecology, Family Medicine, and Pediatrics Residents: Results of a 2015 National Survey and Implications for Contraceptive Provision for Adolescents.

PubMed

Davis, Susan A; Braykov, Nikolay P; Lathrop, Eva; Haddad, Lisa B

2018-02-01

To assess familiarity with long-acting reversible contraceptives (LARC) among current obstetrics and gynecology (OB/GYN), family medicine (FM), and pediatrics senior residents in the United States. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: We selected 156 OB/GYN, FM, and pediatrics residency programs using the American Medical Association Freida database. Senior residents completed a survey addressing any training they had received on LARC, and rated their comfort level counseling about and inserting LARC. Residents rated their likelihood of recommending LARC to an adolescent, nulliparous patient, and indicated whether they would like additional training on LARC. Descriptive and analytic statistics were generated using R statistical software (The R Project for Statistical Computing; https://www.r-project.org). The survey was completed by 326 of 1,583 residents (20.6% response rate); at least 1 resident completed the survey at 105 (67.3%) of the residency programs contacted. Most programs (84.8%) provided some training on LARC. Residents in OB/GYN programs were comfortable counseling about and inserting contraceptive implants (97%, 83%), copper intrauterine devices (IUDs; 100%, 86%), and levonorgestrel (LNG) IUDs (100%, 86%). In FM programs, fewer residents were comfortable counseling about and inserting contraceptive implants (71%, 47%), copper IUDs (68%, 21%), and LNG IUDs (79%, 18%). Residents in pediatrics programs had low comfort levels counseling about contraceptive implants (14%), copper IUDs (14%), and LNG IUDs (25%); no pediatrics residents were comfortable inserting LARC. OB/GYN residents were significantly more likely to recommend a LARC to an adolescent, nulliparous patient (P = .019). Most pediatric and FM residents desired additional training on LARC (82.7% and 60.7%, respectively). This study shows that knowledge gaps exist regarding LARC among FM and pediatrics residents. Copyright © 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Financial Aid and Students' College Decisions: Evidence from the District of Columbia Tuition Assistance Grant Program

ERIC Educational Resources Information Center

Abraham, Katharine G.; Clark, Melissa A.

2006-01-01

The District of Columbia Tuition Assistance Grant Program (DCTAG), instituted in 1999, allows D.C. residents to attend public colleges and universities throughout the country at considerably lower in-state tuition rates. We use the sharp decline in the price of public colleges and universities faced by D.C. residents to estimate the effects of…

Service vs education: situational and perceptional differences in surgery residency.

PubMed

Hendershot, Kimberly M; Woods, Randy; Parikh, Priti P; Whitmill, Melissa; Runkle, Mary

2014-01-01

This study determined whether situational or perceptional differences exist when trying to define what constitutes "service" and "education" in surgery residency in relation to the Accreditation Council of Graduate Medical Education (ACGME) survey. An institutional review board-approved, single institute, cross-sectional study was conducted through a survey. Participants were asked to rate common resident tasks. Participants were also asked general questions regarding "service" and "education." Wright State University surgery program, Dayton, OH. The study included 69 participants, which included medical students (19), residents (26), nurses/advanced practitioners (14), and attending surgeons (10). A significantly high number of attending surgeons reported that writing a history and physical examination is educational compared with residents and students. Similar results were found regarding talking with patients/families. Drawing blood and starting peripheral intravenous access were universally rated as service tasks. For laparoscopic cholecystectomy, when the resident had done one previously, it was universally thought educational. When the resident had done more, most attending surgeons thought the task educational, but residents and students thought it much less educational. When analyzing only residents, in talking with families, most interns rated this as service, whereas postgraduate years 2 and 3 reported it as more educational and postgraduate years 4 and 5 ranked it equally as service and educational. Similar results were seen in answering nursing phone calls and writing admission orders. Residents (88%) and attending surgeons (90%) agreed that service is part of residency training. Only 40% of residents, however, stated they know what the term "service" means in regard to the ACGME survey. Overall, 80% of attending surgeons and 44% of residents agree that "service" has not been well defined by the ACGME. Situational and perceptional differences do exist regarding "service" and "education" in our program, and most participants are unclear about the terms. As the definitions are situational and change with the person queried, then should this be the ACGME standard to assess programs and issue citations? Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Consumer Satisfaction in Long-Term Care: State Initiatives in Nursing Homes and Assisted Living Facilities

ERIC Educational Resources Information Center

Lowe, Timothy J.; Lucas, Judith A.; Castle, Nicholas G.; Robinson, Joanne P.; Crystal, Stephen

2003-01-01

Purpose: We report the results of a survey of state initiatives that measure resident satisfaction in nursing homes and assisted living facilities, and we describe several model programs for legislators and public administrators contemplating the initiation of their own state programs. Design and Methods: Data on state initiatives and programs…

Does medical student membership in the gold humanism honor society influence selection for residency?

PubMed

Rosenthal, Susan; Howard, Brian; Schlussel, Yvette R; Lazarus, Cathy J; Wong, Jeffrey G; Moutier, Christine; Savoia, Maria; Trooskin, Stanley; Wagoner, Norma

2009-01-01

With the creation of the Gold Humanism Honor Society (GHHS) in 2002, the Arnold P. Gold Foundation established a mechanism for recognizing medical students who demonstrate exemplary humanism/professionalism/communication skills. Currently, 80 medical schools have GHHS chapters. Selection is based on peer nomination using a validated tool. The objective of this survey was to assess the percentage of residency program directors (PDs) who are aware of and are using GHHS membership as a residency selection tool. Surgery (SURG) and internal medicine (IM) PDs in 4 United States regions were surveyed for familiarity with GHHS and perceived rank of GHHS membership relative to Alpha Omega Alpha (AOA) membership, class rank, medical student performance evaluation (MSPE), clerkship grade, and United States Medical Licensing Examination (USMLE) score, in evaluating an applicant's humanism/professionalism, service orientation, and fit with their program. Program demographics and familiarity with GHHS were also surveyed. The response rate was 56% (149 respondents). IM PDs rated GHHS membership higher than did SURG PDs when evaluating professionalism/humanism and service orientation. PDs familiar with GHHS ranked membership higher when considering professionalism/humanism (4.1 vs 3.2; p < 0.05) and service orientation (4.1 vs 2.9; p < 0.01). Familiarity with GHHS correlated with being an IM PD, residency based at teaching hospital, large residency program, knowledge of residents who were GHHS members, and having a GHHS chapter at their school (p < 0.01). Familiarity with GHHS was related to rankings of GHHS (professionalism/humanism F = 3.36; p < 0.05; service orientation F = 3.86; p < 0.05) more than the PDs' specialty was. In all, 157 GHHS students (from all 4 United States regions) were also surveyed about the 1197 interviews they had with residency PDs. They reported that although a few PDs were aware of GHHS, PDs of core medical specialties were more aware of GHHS than SURG PDs. IM PDs were more aware of GHHS (70%) than SURG PDs (30%). Awareness was related to the favorable ranking of GHHS as a selection criterion for humanism/professionalism/service orientation. PDs familiar with GHHS were from larger programs, were likely to know residents who were members, and were likely to think that GHHS membership predicted humanistic care. Membership in GHHS may set candidates apart from their peers and allow PDs to distinguish objectively the candidates who demonstrate compassionate medical care. Increased knowledge about the GHHS may therefore serve to be a useful adjunct for PDs when selecting medical students for their residency programs.

The Development of a Postgraduate Orthopaedic Manual Therapy Residency Program in Nairobi, Kenya.

PubMed

Cunningham, Shala; Jackson, Richard; Muli, Daniel Kangutu; McFelea, Joni

2017-01-01

There are very few opportunities for long-term, comprehensive postgraduate education in developing countries because of fiscal and human resource constraints. Therefore, physiotherapists have little opportunity following graduation to advance their skills through the improvement of clinical reasoning and treatment planning and application. To address the need for sustainable advanced instruction in physiotherapy within the country, a postgraduate Residency program was initiated in Nairobi, Kenya in 2012. The mission of the program is to graduate advanced orthopedic practitioners who can lead their communities and local profession in the advancement of clinical care and education. Since its inception, six cohorts have been initiated for a total of 90 resident participants. In addition, six program graduates are being trained to continue the Residency program and are serving as teaching assistants for the on campus modules. This training will result in a self-sustaining program by 2020. The manual therapy Residency education model allowed for advancement of the participating physiotherapists professional development utilizing evidence-based practice. This was done without altering the current education system within the country, or accessing expensive equipment. The Residency program was developed and established with the cooperation of a local education institution and a non-profit corporation in the United States. This collaboration has facilitated the advancement of orthopedic clinical standards in the country and will, hopefully, one day serve an as a template for future programs.

Effect of changes in graduate medical education funding on emergency medicine residency programs.

PubMed

Stead, L; Schafermeyer, R W; Counselman, F L; Blackburn, P; Perina, D

2001-06-01

To determine whether changes in graduate medical education (GME) funding have had an impact on emergency medicine (EM) residency training programs. A 34-question survey was mailed to the program directors (PDs) of all 115 Accreditation Council for Graduate Medical Education (ACGME)-accredited EM residency programs in the United States in the fall of 1998, requesting information concerning the impact of changes in GME funding on various aspects of the EM training. The results were then compared with a similar unpublished survey conducted in the fall of 1996. One hundred one completed surveys were returned (88% response rate). Seventy-one (70%) of the responding EM residency programs were PGY-I through PGY-III, compared with 55 (61%) of the responding programs in 1996. The number of PGY-II through PGY-IV programs decreased from 25 (28%) of responding programs in 1996 to 17 (16%). The number of PGY-I through PGY-IV programs increased slightly (13 vs 10); the number of EM residency positions remained relatively stable. Fifteen programs projected an increase in their number of training positions in the next two years, while only three predicted a decrease. Of the respondents, 56 programs reported reductions in non-EM residency positions and 35 programs reported elimination of fellowship positions at their institutions. Only four of these were EM fellowships. Forty-six respondents reported a reduction in the number of non-EM residents rotating through their EDs, and of these, 11 programs reported this had a moderate to significant effect on their ability to adequately staff the ED with resident physicians. Sixteen programs limited resident recruitment to only those eligible for the full three years of GME funding. Eighty-seven EM programs reported no change in faculty size due to funding issues. Sixty-two programs reported no change in the total number of hours of faculty coverage in the ED, while 34 programs reported an increase. Three EM programs reported recommendations being made to close their residency programs in the near future. Changes in GME funding have not caused a decrease in the number of existing EM residency and fellowship training positions, but may have had an impact in other areas, including: an increase in the number of EM programs structured in a PGY-I through PGY-III format (with a corresponding decrease in the number of PGY-II through PGY-IV programs); a decrease in the number of non-EM residents rotating through the ED; restriction of resident applicants who are ineligible for full GME funding from consideration by some EM training programs; and an increase in the total number of faculty clinical hours without an increase in faculty size.

Resident Preferences for Program Director Role in Wellness Management.

PubMed

Kolarik, Russ C; O'Neal, Richard L; Ewing, Joseph A

2018-05-01

Burnout and depression are prevalent among resident physicians, though the supportive role of the program director (PD) is not well defined. To understand the residents' view of the residency program director's role in assessing and promoting resident wellness. A single institution survey of all house staff was conducted in 2017. Rates of burnout and depression were identified via the 2-item Maslach Burnout Inventory (MBI) and the Patient Health Questionaire-2 (PHQ-2), respectively. Residents then qualified their preferences for various assistance services and for the role of their program directors in assisting them. One-hundred sixty-one of 202 (79.7%) residents completed the survey. The rate of depression was 28%. Rates of emotional exhaustion and depersonalization (2-item MBI) were 44 and 62%, respectively. Only 4% of respondents had used the Employee Assistance Program (EAP) in the prior 12 months. Eighty-two percent of residents were in favor of PDs inquiring about wellness regardless of their job performance and only 1% of residents stated the PD should not inquire about wellness at all. Thirty-three percent of residents reported that they would be likely to contact EAP on their own if they felt unwell. Significantly more residents (62%) reported being more likely to contact EAP if recommended by their PD (33 vs 62%, p < 0.001%). Important perceived barriers to seeking assistance were lack of time (65%), lack of knowledge of how to contact EAP (41%), and concerns about appearing weak (35%). Despite a high prevalence of burnout and depression, residents are unlikely to seek help on their own. Program directors have an important role in assessing and promoting the wellness of their residents. The majority of residents wants their PD to inquire about wellness and may be more likely to seek and receive help if recommended and facilitated by their PD.

Assessment of surgical competence in North American graduate periodontics programs: a survey of current practices.

PubMed

Ghiabi, Edmond; Taylor, K Lynn

2010-08-01

This cross-sectional study was designed to document the methods utilized by North American graduate periodontics programs in assessing their residents' surgical skills. A survey of clinical skills assessment was mailed to directors of all fifty-eight graduate periodontics programs in Canada and the United States. Thirty-four programs (59 percent) responded. The data collected were analyzed using SPSS version 15.0. The results demonstrate that the most common practice for providing feedback and documenting residents' surgical skills in the programs surveyed was daily one-on-one verbal feedback given by an instructor. The next two most commonly reported methods were a standard checklist developed at program level and a combination of a checklist and verbal comments. The majority of the programs reported that the instructors met collectively once per term to evaluate the residents' progress. The results suggest that graduate periodontics programs provide their residents frequent opportunities for daily practice with verbal feedback from instructors. However, assessment strategies identified in other health professions as beneficial in fostering the integration of clinical skills practices are not employed.

Correlation of United States Medical Licensing Examination and Internal Medicine In-Training Examination Performance

ERIC Educational Resources Information Center

Perez, Jose A., Jr.; Greer, Sharon

2009-01-01

The Internal Medicine In-Training Examination (ITE) is administered during residency training in the United States as a self-assessment and program assessment tool. Performance on this exam correlates with outcome on the American Board of Internal Medicine Certifying examination. Internal Medicine Program Directors use the United States Medical…

76 FR 5755 - Medicare and Medicaid Programs; Patient Notification of Right To Access State Survey Agencies and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-02

... skilled nursing care and related services to residents that require medical or nursing care or... primarily engaged in providing to residents: Skilled nursing care and related services for residents who... provided home health services to 3.2 million patients nationwide in FY 2006. The effective delivery of...

Physician supply and medical education in California. A comparison with national trends.

PubMed Central

Grumbach, K; Coffman, J M; Young, J Q; Vranizan, K; Blick, N

1998-01-01

Concerns have been voiced about an impending oversupply of physicians in the United States. Do these concerns also apply to California, a state with many unique demographic characteristics? We examined trends in physician supply and medical education in California and the United States between 1980 and 1995 to better inform the formulation of workforce policies appropriate to the state's requirements for physicians. We found that similar to the United States, California has more than an ample supply of physicians in the aggregate, but too many specialists, too few underrepresented racial/ethnic minority physicians, and poor distribution of physicians across the state. However, recent growth in the supply of practicing physicians and resident physicians per capita in California has been much less dramatic than in the country overall. The state's unusually high rate of population growth has enabled California, unlike the United States as a whole, to absorb large increases in the number of practicing physicians and residents during 1980 to 1995 without substantially increasing the physician-to-population ratio. Due to a projected slowing of the state's rate of population growth, the supply of physicians per capita in the state will begin to rise steeply in coming years unless the state implements prompt reductions in the production of specialists. An immediate 25% reduction in specialist residency positions would be necessary to bring the state's supply of practicing specialists in line with projected physician requirements for the state by 2020. We conclude that major changes will be required if the state's residency programs and medical schools are to produce the number and mix of physicians the state requires. California's medical schools and residency programs will need to act in concert with federal and state government to develop effective policies to address the imbalance between physician supply and state requirements. Images Figure 2. Figure 3. Figure 4. PMID:9614798

Bridging the Gap: Supporting Translational Research Careers Through an Integrated Research Track Within Residency Training

PubMed Central

Arbuckle, Melissa R.; Gordon, Joshua A.; Pincus, Harold A.; Oquendo, Maria A.

2013-01-01

In the setting of traditional residency training programs, physician–scientists are often limited in their ability to pursue research training goals while meeting clinical training requirements. This creates a gap in research training at a critical developmental stage. In response, Columbia University Medical Center’s Department of Psychiatry, in partnership with the New York State Psychiatric Institute, has created a formal Research Track Program (RTP) for psychiatry residents so that interested individuals can maintain their attention on research training during formative residency years. Clinical and research training are integrated through core clinical rotations on research units. With protected research time and clear developmental milestones for each year of training, the RTP allows research track residents to meet both clinical and research training goals while maintaining a healthy work–life balance. In coordination with existing postdoctoral research fellowship programs, research track residents can effectively jump-start fellowship training with advanced course work and consistent, continuous mentorship bridging residency and fellowship years. A key element of the program is its provision of core training in research literacy and extensive research opportunities for all residents, stimulating research interest across the whole residency program. Supported by the National Institutes of Health and a private foundation, this RTP capitalizes on a unique academic–private partnership to address many of the challenges facing physician–scientists. By integrating clinical and research exposures and offering protected research time, careful mentoring, and financial resources, the program aims to further the development of those most poised to establish careers in translational research. PMID:23619070

The refinement of a cultural standardized patient examination for a general surgery residency program.

PubMed

Chun, Maria B J; Deptula, Peter; Morihara, Sarah; Jackson, David S

2014-01-01

Recent articles have documented the importance of cultural competency in surgery. Surgical residency programs have used the Objective Structured Clinical Examinations or cultural standardized patient examinations as a training tool. Past studies evaluating cultural competency have noted the importance of including an observational (control) arm, which would allow for a more objective assessment of a resident's competency in this area. The purpose of our article is to present the results of a follow-up study to a pilot cultural standardized patient examination for surgery residents. All first-year surgery residents were required to participate in the videotaped cultural SP examination as part of the general surgery residency curriculum. Two measures were used to assess resident performance. On the day of the examination, the Cross-Cultural Care Survey was administered. The examination was assessed by the residents themselves, faculty observers, and standardized patients, using a written checklist that was developed to evaluate residents on all 6 Accreditation Council for Graduate Medical Education competencies. The current study includes 20 first-year surgery residents from academic years 2011 to 2012 and 2012 to 2013. The examination of pretest differences in groups found that students born outside of the United States had significantly higher scores on attitude (t = -2.68, df = 18, p = 0.02), but no statistically significant differences were found in skillfulness or knowledge or in the overall rating scale. For the overall rating scale, change from pretest to posttest was statistically significant (t = -2.25, df = 18, p = 0.04). Further analysis revealed that students who were born in the United States demonstrated a significant increase in ratings (t = -3.08, df = 10, p = 0.01) whereas students who were not born in the United States showed little change (t = -0.35, df = 7, p = 0.74). These results show that the means in attitude scales changed little for all groups, but both white and US-born students showed greater improvement on skillfulness and knowledge. Training and measurement of cross-cultural health care skills remains challenging. However, studies like these provide a good starting point from which to build. © 2013 Published by Association of Program Directors in Surgery on behalf of Association of Program Directors in Surgery.

Reproductive Psychiatry Residency Training: A Survey of Psychiatric Residency Program Directors.

PubMed

Osborne, Lauren M; MacLean, Joanna V; Barzilay, Erin Murphy; Meltzer-Brody, Samantha; Miller, Laura; Yang, Sarah Nagle

2018-04-01

The reproductive life cycle has unique influences on the phenotypic expression of mental illness in women. Didactic and clinical training focused on these sex-specific influences should be a vital component of the education of future psychiatrists. The authors sought to determine the current state of and attitudes toward reproductive psychiatry in resident education. The authors administered a web-based survey to psychiatry residency training directors. They assessed the availability of both mandated and optional didactic and clinical training experiences in reproductive psychiatry. Fifty residency program directors answered the survey, for a response rate of 28%. More than half of residency program directors (59%) reported requiring some training in reproductive psychiatry. Both the breadth and depth of topics covered varied greatly among programs. Lack of time (48%) and lack of qualified faculty (26%) were the most frequently cited barriers to more training. Only 40% of residency directors surveyed agreed that all residents should be competent in reproductive psychiatry. These findings suggest that specific training in reproductive psychiatry is inconsistent in US residency programs, and that training that does exist varies considerably in clinical time and content. Given that women comprise more than 50% of all psychiatric patients and most women will menstruate, give birth, and undergo menopause, future psychiatrists would benefit from more systematic instruction in this area. The authors propose the development of a national, standardized reproductive psychiatry curriculum to address this gap and aid in producing psychiatrists competent to treat women at all stages of life.

The Residence Education Center System of Chapman College, 1958-1982: An Essay with Bibliography and Appendices.

ERIC Educational Resources Information Center

Morris, Marilyn L.; Dye, Charles M.

The history of the Chapman College Residence Education Center (REC) System is traced from 1958 to 1982. After experimenting near its home campus in Orange, California, the program has grown to 41 centers in California and eight other states, including the Navy's shipboard PACE program. In 1958 the college met the request of students at nearby El…

Administrative organization in diagnostic radiology residency program leadership.

PubMed

Webber, Grant R; Mullins, Mark E; Chen, Zhengjia; Meltzer, Carolyn C

2012-04-01

The aim of this study was to document the current state of administrative structure in US diagnostic radiology (DR) residency program leadership. A secondary objective was to assess for correlation(s), if any, with DR residency programs that equipped positions such as assistant, associate, and emeritus program director (PD) with respect to residency size and region of the country. The Fellowship and Residency Electronic Interactive Database, as well as direct communication and programmatic Web site searches, were used to gather data regarding current US DR residency leadership. Data collected included the presence of additional leadership titles, including assistant PD, associate PD, and PD emeritus, and how many faculty members currently held each position. Programs were excluded if results could not be identified. Analysis of variance and t tests were used to estimate the correlations of the size of a residency with having additional or shared PD positions and the types of positions, respectively. Chi-square tests were used to assess for any regional differences. As of the time of this project, the Fellowship and Residency Electronic Interactive Database defined 186 US DR residency programs. A total of 173 programs (93%) were included in the analysis; the remainder were excluded because of unavailability of relevant data. Seventy-two percent (124 of 173) of programs had additional DR leadership positions. Of these, 30 programs (17%) had more than one such position. There were no significant differences in the sizes of the programs that used these additional positions (mean, 25 ± 12; range, 6-72) compared with those that did not (mean, 24 ± 12; range, 7-51). There were no significant differences between programs that had additional positions with respect to region of the country. The majority of US DR residency programs used some form of additional DR leadership position. In the majority of cases, this was in the form of an assistant or associate PD. Nearly one-fifth of programs studied had more than one such position. This is a positive model for the depth and breadth of management of US residency programs, serving both as a template for matrixed leadership and as a source of leadership succession planning. Copyright © 2012 American College of Radiology. Published by Elsevier Inc. All rights reserved.

45 CFR 400.106 - Additional services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Medical Assistance Scope of Medical Services § 400.106 Additional services. If a State or local jurisdiction provides additional medical services beyond the scope of the State's Medicaid program to destitute residents of the...

A Hospice Rotation for Military Medical Residents: A Mixed Methods, Multi-Perspective Program Evaluation

PubMed Central

Boyden, Jackelyn Y.; Kalish, Virginia B.; Muir, J. Cameron; Richardson, Suzanne; Connor, Stephen R.

2016-01-01

Abstract Background: An estimated 6,000 to 18,000 additional hospice and palliative medicine (HPM) physicians are needed in the United States. A source could be the military graduate medical education system where 15% of U.S. medical residents are trained. A community-based hospice and palliative care organization created a one-week rotation for military residents including participation in interdisciplinary group visits at patients' homes, facilities, and an inpatient hospice unit. Objective: Our goal was to evaluate the effectiveness of a one-week community HPM rotation for military medical residents. Methods: A mixed-methods, multi-stakeholder perspective program evaluation model was used for program years 2011 to 2013. Data were managed and analyzed using Microsoft Excel and Atlas.ti. Participants in the rotation were residents training at two local military hospitals. Program evaluation data were collected from residents, military program liaisons, and hospice clinical preceptors. Quantitative data included pre- and post-tests based on Accreditation Council for Graduate Medical Education competencies completed by residents. Qualitative data included resident essays and semi-structured interviews with hospice preceptors and military program liaisons. Results: Quantitative and qualitative data suggested that the rotation increased military residents' knowledge, attitudes, and comfort level with HPM. Quantitative analysis of test scores indicated improvements from pre- to post-tests in each of five areas of learning. Qualitative data indicated the rotation created a greater appreciation for the overall importance of HPM and increased understanding of eligibility and methods for pain and symptom management. Conclusions: A one-week community hospice rotation for medical military residents impacts participant's knowledge of and attitudes toward HPM. PMID:27139524

A framework for improving resident research participation and scholarly output.

PubMed

Manring, M M; Panzo, Julia A; Mayerson, Joel L

2014-01-01

The Accreditation Council for Graduate Medical Education requires that "faculty should encourage and support residents in scholarly activities." There are no guidelines, however, to illustrate how this should be done, and only a small number of published reports offer examples of successful efforts to spur resident research. We sought to improve our residents' participation in scholarly activities. We describe a multifaceted program to quickly build resident scholarship at an orthopaedic department. Large academic medical center in the Midwestern United States. An experienced medical editor was recruited to assist faculty and mentor residents in coordinating research projects and to direct publishing activity. Additional publishing requirements were added to the resident curriculum beyond those already required by the Accreditation Council for Graduate Medical Education. Residents were required to select a faculty research mentor to guide all research projects toward a manuscript suitable for submission to a peer-reviewed journal. Activities were monitored by the editor and the resident coordinator. Over 4 years, total department peer-reviewed publications increased from 33 to 163 annually. Despite a decrease in resident complement, the number of peer-reviewed publications with a resident author increased from 6 in 2009 to 53 in 2012. The addition of an experienced medical editor, changes in program requirements, and an increased commitment to promotion of resident research across the faculty led to a dramatic increase in resident publications. Our changes may be a model for other programs that have the financial resources and faculty commitment necessary to achieve a rapid turnaround. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

How Do US Pediatric Residency Programs Teach and Evaluate Community Pediatrics and Advocacy Training?

PubMed

Lichtenstein, Cara; Hoffman, Benjamin D; Moon, Rachel Y

2017-07-01

In 2013, the Accreditation Council for Graduate Medical Education updated requirements for training in community pediatrics and advocacy in pediatric residency programs. In light of this update, the aim of this study was to better understand how community pediatrics is being taught and evaluated in pediatric residency programs in the United States. Cross-sectional exploratory study using a Web-based survey of pediatric residency program directors in September 2014. Questions focused on teaching and evaluation of 10 community pediatrics competencies. Of 85 programs (43% response rate), 30% offered a separate training track and/or 6-block individualized curriculum in community pediatrics or advocacy. More than 75% required all residents to learn 7 of 10 competencies queried. Respondents in urban settings were more likely to teach care of special populations (P = .02) and public speaking (P < .01). Larger programs were more likely to teach (P = .04) and evaluate (P = .02) community-based research. Experiential learning and classroom-based didactics were the most frequent teaching methodologies. Many programs used multiple teaching methodologies for all competencies. Observation was the most frequent evaluation technique used; portfolio review and written reflection were also commonly reported. Our findings show a strong emphasis on community pediatrics and advocacy teaching among responding US pediatric residency programs. Although respondents reported a variety of teaching and evaluation methods, there were few statistically significant differences between programs. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Reflective practice and competencies in global health training: lesson for serving diverse patient populations.

PubMed

Castillo, Jonathan; Goldenhar, Linda M; Baker, Raymond C; Kahn, Robert S; Dewitt, Thomas G

2010-09-01

Resident interest in global health care training is growing and has been shown to have a positive effect on participants' clinical skills and cultural competency. In addition, it is associated with career choices in primary care, public health, and in the service of underserved populations. The purpose of this study was to explore, through reflective practice, how participation in a formal global health training program influences pediatric residents' perspectives when caring for diverse patient populations. Thirteen pediatric and combined-program residents enrolled in a year-long Global Health Scholars Program at Cincinnati Children's Hospital Medical Center during the 2007-2008 academic year. Educational interventions included a written curriculum, a lecture series, one-on-one mentoring sessions, an experience abroad, and reflective journaling assignments. The American Society for Tropical Medicine and Hygiene global health competencies were used as an a priori coding framework to qualitatively analyze the reflective journal entries of the residents. Four themes emerged from the coded journal passages from all 13 residents: (1) the burden of global disease, as a heightened awareness of the diseases that affect humans worldwide; (2) immigrant/underserved health, reflected in a desire to apply lessons learned abroad at home to provide more culturally effective care to immigrant patients in the United States; (3) parenting, or observed parental, longing to assure that their children receive health care; and (4) humanitarianism, expressed as the desire to volunteer in future humanitarian health efforts in the United States and abroad. Our findings suggest that participating in a global health training program helped residents begin to acquire competence in the American Society for Tropical Medicine and Hygiene competency domains. Such training also may strengthen residents' acquisition of professional skills, including the Accreditation Council for Graduate Medical Education competencies.

Accreditation Council for Graduate Medical Education Core Competencies at a Community Teaching Hospital: Is There a Gap in Awareness?

PubMed Central

Al-Temimi, Mohammed; Kidon, Michael; Johna, Samir

2016-01-01

Context Reports evaluating faculty knowledge of the Accreditation Council for Graduate Medical Education (ACGME) core competencies in community hospitals without a dedicated residency program are uncommon. Objective Faculty evaluation regarding knowledge of ACGME core competencies before a residency program is started. Design Physicians at the Kaiser Permanente Fontana Medical Center (N = 480) were surveyed for their knowledge of ACGME core competencies before starting new residency programs. Main Outcome Measures Knowledge of ACGME core competencies. Results Fifty percent of physicians responded to the survey, and 172 (71%) of respondents were involved in teaching residents. Of physicians who taught residents and had complete responses (N = 164), 65 (39.7%) were unsure of their knowledge of the core competencies. However, most stated that they provided direct teaching to residents related to the knowledge, skills, and attitudes stated in each of the 6 competencies as follows: medical knowledge (96.3%), patient care (95.7%), professionalism (90.7%), interpersonal and communication skills (86.3%), practice-based learning (85.9%), and system-based practice (79.6%). Physician specialty, years in practice (1–10 vs > 10), and number of rotations taught per year (1–6 vs 7–12) were not associated with knowledge of the competencies (p > 0.05); however, full-time faculty (teaching 10–12 rotations per year) were more likely to provide competency-based teaching. Conclusion Objective assessment of faculty awareness of ACGME core competencies is essential when starting a residency program. Discrepancy between knowledge of the competencies and acclaimed provision of competency-based teaching emphasizes the need for standardized teaching methods that incorporate the values of these competencies. PMID:27768565

A multicenter analysis of the ophthalmic knowledge assessment program and American Board of Ophthalmology written qualifying examination performance.

PubMed

Lee, Andrew G; Oetting, Thomas A; Blomquist, Preston H; Bradford, Geoffrey; Culican, Susan M; Kloek, Carolyn; Krishnan, Chandrasekharan; Lauer, Andreas K; Levi, Leah; Naseri, Ayman; Rubin, Steven E; Scott, Ingrid U; Tao, Jeremiah; Tuli, Sonal; Wright, Martha M; Wudunn, Darrell; Zimmerman, M Bridget

2012-10-01

To compare the performance on the American Board of Ophthalmology Written Qualifying Examination (WQE) with the performance on step 1 of the United States Medical Licensing Examination (USMLE) and the Ophthalmic Knowledge Assessment Program (OKAP) examination for residents in multiple residency programs. Comparative case series. Fifteen residency programs with 339 total residents participated in this study. The data were extracted from the 5-year American Board of Ophthalmology report to each participating program in 2009 and included residency graduating classes from 2003 through 2007. Residents were included if data were available for the USMLE, OKAP examination in ophthalmology years 1 through 3, and the WQE score. Residents were excluded if one or more of the test scores were not available. Two-sample t tests, logistic regression analysis, and receiver operating characteristic (ROC) curves were used to examine the association of the various tests (USMLE, OKAP examination year 1, OKAP examination year 2, OKAP examination year 3, and maximum OKAP examination score) as a predictor for a passing or failing grade on the WQE. The primary outcome measure of this study was first time pass rate for the WQE. Using ROC analysis, the OKAP examination taken at the third year of ophthalmology residency best predicted performance on the WQE. For the OKAP examination taken during the third year of residency, the probability of passing the WQE was at least 80% for a score of 35 or higher and at least 95% for a score of 72 or higher. The OKAP examination, especially in the third year of residency, can be useful to residents to predict the likelihood of success on the high-stakes WQE examination. Copyright © 2012 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Visiting medical student elective and clerkship programs: a survey of US and Puerto Rico allopathic medical schools

PubMed Central

2010-01-01

Background No published reports of studies have provided aggregate data on visiting medical student (VMS) programs at allopathic medical schools. Methods During 2006, a paper survey was mailed to all 129 allopathic medical schools in the United States and Puerto Rico using a list obtained from the Association of American Medical Colleges. Contents of the survey items were based on existing literature and expert opinion and addressed various topics related to VMS programs, including organizational aspects, program objectives, and practical issues. Responses to the survey items were yes-or-no, multiple-choice, fill-in-the-blank, and free-text responses. Data related to the survey responses were summarized using descriptive statistics. Results Representatives of 76 schools (59%) responded to the survey. Of these, 73 (96%) reported their schools had VMS programs. The most common reason for having a VMS program was "recruitment for residency programs" (90%). "Desire to do a residency at our institution" was ranked as the leading reason visiting medical students choose to do electives or clerkships. In descending order, the most popular rotations were in internal medicine, orthopedic surgery, emergency medicine, and pediatrics. All VMS programs allowed fourth-year medical students, and approximately half (58%) allowed international medical students. The most common eligibility requirements were documentation of immunizations (92%), previous clinical experience (85%), and successful completion of United States Medical Licensing Examination Step 1 (51%). Of the programs that required clinical experience, 82% required 33 weeks or more. Most institutions (96%) gave priority for electives and clerkships to their own students over visiting students, and a majority (78%) reported that visiting students were evaluated no differently than their own students. During academic year 2006-2007, the number of new resident physicians who were former visiting medical students ranged widely among the responding institutions (range, 0-76). Conclusions Medical schools' leading reason for having VMS programs is recruitment into residency programs and the most commonly cited reason students participate in these programs is to secure residency positions. However, further research is needed regarding factors that determine the effectiveness of VMS programs in residency program recruitment and the development of more universal standards for VMS eligibility requirements and assessment. PMID:20529301

Impact of the Primary Care Exception on Family Medicine Resident Coding.

PubMed

Cawse-Lucas, Jeanne; Evans, David V; Ruiz, David R; Allcut, Elizabeth A; Andrilla, C Holly A; Thompson, Matthew; Norris, Thomas E

2016-03-01

The Medicare Primary Care Exception (PCE) allows residents to see and bill for less-complex patients independently in the primary care setting, requiring attending physicians only to see patients for higher-level visits and complete physical exams in order to bill for them as such. Primary care residencies apply the PCE in various ways. We investigated the impact of the PCE on resident coding practices. Family medicine residency directors in a five-state region completed a survey regarding interpretation and application of the PCE, including the number of established patient evaluation and management codes entered by residents and attending faculty at their institution. The percentage of high-level codes was compared between residencies using chi-square tests. We analyzed coding data for 125,016 visits from 337 residents and 172 faculty physicians in 15 of 18 eligible family medicine residencies. Among programs applying the PCE criteria to all patients, residents billed 86.7% low-mid complexity and 13.3% high-complexity visits. In programs that only applied the PCE to Medicare patients, residents billed 74.9% low-mid complexity visits and 25.2% high-complexity visits. Attending physicians coded more high-complexity visits at both types of programs. The estimated revenue loss over the 1,650 RRC-required outpatient visits was $2,558.66 per resident and $57,569.85 per year for the average residency in our sample. Residents at family medicine programs that apply the PCE to all patients bill significantly fewer high-complexity visits. This finding leads to compliance and regulatory concerns and suggests significant revenue loss. Further study is required to determine whether this discrepancy also reflects inaccuracy in coding.

Current State of Colorectal Surgery Training: A Survey of Program Directors, Current and Recently Matched Colorectal Residents, and Recent Colorectal Graduates.

PubMed

Bailey, Matthew B; Miller, Peter E; Pawlak, Stephanie E; Thomas, Michael S; Beck, David E; Vargas, H David; Whitlow, Charles B; Margolin, David A

2016-02-01

Colorectal residency has become one of the more competitive postgraduate training opportunities; however, little information is available to guide potential applicants in gauging their competitiveness. The aim of this study was to identify the current trends colorectal residency training and to identify what factors are considered most important in ranking a candidate highly. We hypothesized that there was a difference in what program directors, current and recently matched colorectal residents, and recent graduates consider most important in making a candidate competitive for a colorectal residency position. Three 10-question anonymous surveys were sent to 59 program directors, 87 current and recently matched colorectal residents, and 119 recent graduates in March 2015. The study was conducted as an anonymous internet survey. Current trends in applying for a colorectal residency, competitiveness of recent colorectal residents, factors considered most important in ranking a candidate highly, and what future colorectal surgeons can expect after finishing their training were measured. The study had an overall response rate of 43%, with 28 (47%) of 59 program directors, 46 (53%) of 87 current and recently matched colorectal residents, and 39 (33%) of 119 recent graduates responding. The majority of program directors felt that a candidate's performance during the interview process was the most important factor in making a candidate competitive, followed by contact from a colleague, letters of recommendation, American Board of Surgery In-Training Exam scores, and number of publications/presentations. The majority of current and recently matched colorectal residents felt that a recommendation/telephone call from a colleague was the most important factor, whereas the majority of recent graduates favored letters of recommendation as the most important factor in ranking a candidate highly. Limitations to the study include its small sample size, selection bias, responder bias, and misclassification bias. There are differences in what program directors and current/recent residents consider most important in making an applicant competitive for colorectal residency.

Risk aversion and willingness to pay for water quality: The case of non-farm rural residents.

PubMed

Larue, Bruno; West, Gale E; Singbo, Alphonse; Tamini, Lota Dabio

2017-07-15

Stated choice experiments are used to investigate the economic valuation of rural residents living in the province of Quebec for water quality improvements. In Quebec, rural residents played an important role in the setting of stricter environmental regulations. Unlike most stated choice experiments about the valuation of improvements in water quality, this study explicitly accounts for risk in the design and analysis of choice experiments. Risk in phosphorus and coliform reductions is introduced through a three-point uniform distribution in the choice sets. The results show greater support for constant absolute risk aversion preferences than for constant relative risk aversion. Rural residents value coliform and phosphorus reductions and the more educated ones are particularly willing to see the government tax farmers and taxpayers to secure such reductions. As the science improves and risk in water quality outcomes decrease and as the political weight of non-farm rural residents increase, it should be easier for governments to replace voluntary cost-share programs by polluter-payer programs. Copyright © 2017 Elsevier Ltd. All rights reserved.

Applicant Characteristics Associated With Selection for Ranking at Independent Surgery Residency Programs.

PubMed

Dort, Jonathan M; Trickey, Amber W; Kallies, Kara J; Joshi, Amit R T; Sidwell, Richard A; Jarman, Benjamin T

2015-01-01

This study evaluated characteristics of applicants selected for interview and ranked by independent general surgery residency programs and assessed independent program application volumes, interview selection, rank list formation, and match success. Demographic and academic information was analyzed for 2014-2015 applicants. Applicant characteristics were compared by ranking status using univariate and multivariable statistical techniques. Characteristics independently associated with whether or not an applicant was ranked were identified using multivariable logistic regression modeling with backward stepwise variable selection and cluster-correlated robust variance estimates to account for correlations among individuals who applied to multiple programs. The Electronic Residency Application Service was used to obtain applicant data and program match outcomes at 33 independent surgery programs. All applicants selected to interview at 33 participating independent general surgery residency programs were included in the study. Applicants were 60% male with median age of 26 years. Birthplace was well distributed. Most applicants (73%) had ≥1 academic publication. Median United States Medical Licensing Exams (USMLE) Step 1 score was 228 (interquartile range: 218-240), and median USMLE Step 2 clinical knowledge score was 241 (interquartile range: 231-250). Residency programs in some regions more often ranked applicants who attended medical school within the same region. On multivariable analysis, significant predictors of ranking by an independent residency program were: USMLE scores, medical school region, and birth region. Independent programs received an average of 764 applications (range: 307-1704). On average, 12% interviews, and 81% of interviewed applicants were ranked. Most programs (84%) matched at least 1 applicant ranked in their top 10. Participating independent programs attract a large volume of applicants and have high standards in the selection process. This information can be used by surgery residency applicants to gauge their candidacy at independent programs. Independent programs offer a select number of interviews, rank most applicants that they interview, and successfully match competitive applicants. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

A review of pediatric dentistry program websites: what are applicants learning about our programs?

PubMed

Lin, Jenn-Yih; Lee, Jung; Davidson, Bo; Farquharson, Kara; Shaul, Cheryl; Kim, Sara

2010-06-01

The purpose of this study was twofold: 1) to examine website content provided by U.S. and Canadian pediatric dentistry residency programs, and 2) to understand aspects of program websites that dental students report to be related to their interests. Sixty-eight program websites were reviewed by five interprofessional evaluators. A thirty-six-item evaluation form was organized into 1) program descriptive items listed on the American Academy of Pediatric Dentistry (AAPD) website (n=21); 2) additional program descriptive items not listed on the AAPD website but of interest (n=9); and 3) items related to website interface design (n=5). We also surveyed fifty-four dental students regarding their interest in various aspects of program descriptions. The results of this study suggest that pediatric dentistry residency programs in general tend to provide identical or less information than what is listed on the AAPD website. The majority of respondents (76 percent) reported that residency program websites would be their first source of information about advanced programs. The greatest gap between the available website information and students' interests exists in these areas: stipend and tuition information, state licensure, and program strengths. Pediatric dentistry residency programs underutilize websites as a marketing and recruitment tool and should incorporate more information in areas of students' priority interests.

Confidence, knowledge, and skills at the beginning of residency. A survey of pathology residents.

PubMed

Hsieh, Cindy M; Nolan, Norris J

2015-01-01

To document the pathology learning experiences of pathology residents prior to residency and to determine how confident they were in their knowledge and technical skills. An online survey was distributed to all pathology residency program directors in the United States, who were requested to forward the survey link to their residents. Data were obtained on pathology electives, grossing experience, and frozen section experience. Likert scale questions assessed confidence level in knowledge and skills. In total, 201 pathology residents responded (8% of residents in the United States). Prior to starting residency, most respondents had exposure to anatomic pathology through elective rotations. Few respondents had work-related experience. Most did not feel confident in their pathology-related knowledge or skills, and many did not understand what pathology resident duties entail. Respondents gained exposure to pathology primarily through elective rotations, and most felt the elective experience prepared them for pathology residency. However, elective time may be enhanced by providing opportunities for students to increase hands-on experience and understanding of resident duties. Copyright© by the American Society for Clinical Pathology.

Dealing with female sexuality: training, attitude, and practice of obstetrics and gynecology residents from a developing country.

PubMed

Vieira, Teresa Cristina Souza Barroso; de Souza, Eduardo; da Silva, Ivaldo; Torloni, Maria Regina; Ribeiro, Meireluci Costa; Nakamura, Mary Uchiyama

2015-05-01

There is little research on how obstetrics and gynecology (Ob/Gyn) residents deal with female sexuality, especially during pregnancy. The aim of this study was to assess the training, attitude, and practice of Ob/Gyn residents about sexuality. A cross-sectional survey of Brazilian Ob/Gyn residents enrolling in an online sexology course was conducted. A questionnaire assessed their training in sexuality during medical school and residency and their attitude and practice on sexual issues during pregnancy. Training, attitude, and practice of Ob/Gyn residents regarding sexuality were the main outcome measures. A total of 197 residents, from 21 different programs, answered the online questionnaire. Mean age was 27.9 ± 2.2, most were female (87%), single (79%), and had graduated in the last 5 years (91%). Almost two-thirds (63%) stated that they did not receive any training at all and 28% reported having only up to 6 hours of training about sexuality in medical school. Approximately half of the respondents (49%) stated that they had received no formal training about sexuality during their residency up to that moment and 29% had received ≤6 hours of training. Over half (56%) never or rarely took a sexual history, 51% stated that they did not feel competent or confident to answer their pregnant patients' questions about sexuality, and 84% attributed their difficulties in dealing with sexual complaints to their lack of specific knowledge on the topic. The vast majority of Brazilian Ob/Gyn residents enrolling in a sexuality course had little previous formal training on this topic in medical school and during their residency programs. Most residents do not take sexual histories of pregnant patients, do not feel confident in answering questions about sexuality in pregnancy, and attribute these difficulties to lack of knowledge. These findings point to a clear need for additional training in sexuality among Brazilian Ob/Gyn residents. © 2015 International Society for Sexual Medicine.

Selection criteria for the integrated model of plastic surgery residency.

PubMed

LaGrasso, Jeffrey R; Kennedy, Debbie A; Hoehn, James G; Ashruf, Salmon; Przybyla, Adrian M

2008-03-01

The purpose of this study was to identify those qualities and characteristics of fourth-year medical students applying for the Integrated Model of Plastic Surgery residency training that will make a successful plastic surgery resident. A three-part questionnaire was distributed to the training program directors of the 20 Integrated Model of Plastic Surgery programs accredited by the Residency Review Committee for Plastic Surgery by the Accreditation Council on Graduate Medical Education. The first section focused on 19 objective characteristics that directors use to evaluate applicants (e.g., Alpha Omega Alpha Honor Society membership, United States Medical Licensing Examination scores). The second section consisted of 20 subjective characteristics commonly used to evaluate applicants during the interview process. The third section consisted of reasons why, if any, residents failed to successfully complete the training program. Fifteen of the 20 program directors responded to the questionnaire. The results showed that they considered membership in the Alpha Omega Alpha Honor Society to be the most important objective criterion, followed by publications in peer-reviewed journals and letters of recommendation from plastic surgeons known to the director. Leadership capabilities were considered the most important subjective criterion, followed by maturity and interest in academics. Reasons residents failed to complete the training program included illness or death, academic inadequacies, and family demands. The authors conclude that applicants who have achieved high academic honors and demonstrate leadership ability with interest in academics were viewed most likely to succeed as plastic surgery residents by program directors of Integrated Model of Plastic Surgery residencies.

Faculty development activities in family medicine: in search of innovation.

PubMed

Lawrence, Elizabeth A; Oyama, Oliver N

2013-01-01

To describe the Accreditation Council for Graduate Medical Education's (ACGME) faculty development requirements, explore the range of faculty development activities and support currently used by family medicine residencies to meet these requirements, and describe one innovative approach to satisfy this need. An electronic survey of faculty development activities and support offered to faculty by residency programs was sent to a random sample of 40 medical school and community based family medicine residency programs across the United States. Data were examined using t-tests, Fisher's exact tests, and Analysis of Variance. Faculty development, beyond traditional clinical CME, was strongly encouraged or required by a large proportion of the sample (73%). Only 58% of programs reported having discussed the ACGME's faculty development component areas (clinical, educational, administrative, leadership, research, and behavioral). In each component area except the "clinical" area, the absence of discussing the ACGME component areas with residency faculty was associated with fewer faculty development activities and support being offered by the program. These results, although preliminary, suggest that family medicine residency programs may value and encourage faculty development. The majority of programs use traditional activities and strategies such as CME, faculty meetings, faculty conferences and workshops; and a smaller number of programs are exploring the utility of mentoring programs, faculty discussion groups, and technology based learning systems. The challenge is to develop faculty development activities tailored to individual program and faculty needs and resources.

Comparison of web-based and face-to-face interviews for application to an anesthesiology training program: a pilot study

PubMed Central

Malkin, Mathew R.; Lenart, John; Stier, Gary R.; Gatling, Jason W.; Applegate II, Richard L.

2016-01-01

Objectives This study compared admission rates to a United States anesthesiology residency program for applicants completing face-to-face versus web-based interviews during the admissions process. We also explored factors driving applicants to select each interview type. Methods The 211 applicants invited to interview for admission to our anesthesiology residency program during the 2014-2015 application cycle were participants in this pilot observational study. Of these, 141 applicants selected face-to-face interviews, 53 applicants selected web-based interviews, and 17 applicants declined to interview. Data regarding applicants' reasons for selecting a particular interview type were gathered using an anonymous online survey after interview completion. Residency program admission rates and survey answers were compared between applicants completing face-to-face versus web-based interviews. Results One hundred twenty-seven (75.1%) applicants completed face-to-face and 42 (24.9%) completed web-based interviews. The admission rate to our residency program was not significantly different between applicants completing face-to-face versus web-based interviews. One hundred eleven applicants completed post-interview surveys. The most common reasons for selecting web-based interviews were conflict of interview dates between programs, travel concerns, or financial limitations. Applicants selected face-to-face interviews due to a desire to interact with current residents, or geographic proximity to the residency program. Conclusions These results suggest that completion of web-based interviews is a viable alternative to completion of face-to-face interviews, and that choice of interview type does not affect the rate of applicant admission to the residency program. Web-based interviews may be of particular interest to applicants applying to a large number of programs, or with financial limitations. PMID:27039029

Pathology resident attitudes and opinions about pathologists' assistants.

PubMed

Grzybicki, Dana Marie; Vrbin, Colleen M

2003-06-01

Changes in health care economics and organization have resulted in increased use of nonphysician providers in most health care settings. Attitudinal acceptance of nonphysician providers is important in the current health care environment. To obtain descriptive information regarding pathology resident attitudes and opinions about pathologists' assistants in anatomic pathology practice and to assess the implications of resident attitudes and opinions for pathology practice and training. A self-administered, mailed, voluntary, anonymous questionnaire was distributed to a cross-sectional sample of pathology residents in the United States (2531 pathology residents registered as resident members of one of the national pathology professional organizations). The questionnaire contained (1) items relating to resident demographics and program characteristics, (2) Likert-scale response items containing positive and negative statements about pathologists' assistants, (3) a multiple-choice item related to pathologists' assistants scope of practice, and (4) an open-ended item inviting additional comments. Both quantitative and qualitative analysis of responses was performed. The overall response rate was 19.4% (n = 490); 50% of the respondents were women, and 77% reported use of pathologists' assistants in their program. Most respondents were 25 to 35 years old and in postgraduate years 3 through 5 of their training, and most were located in the Midwestern United States. The majority of residents expressed overall positive attitudes and opinions about pathologists' assistants and felt that pathologists' assistants enhanced resident training by optimizing resident workload. A minority (10%-20%) of residents expressed negative attitudes or opinions about pathologists' assistants. Additionally, some residents reported a lack of knowledge about pathologists' assistants' training or roles. Increased resident education and open discussion concerning pathologists' assistants may be beneficial for optimizing resident attitudes about and training experiences with pathologists' assistants.

Current Interview Trail Metrics in the Otolaryngology Match.

PubMed

Cabrera-Muffly, Cristina; Chang, C W David; Puscas, Liana

2017-06-01

Objectives To identify how applicants to otolaryngology residency determine how to apply to, interview with, and rank programs on the interview trail and to determine the extent of the financial burden of the otolaryngology interview trail. Study Design Web-based survey distributed in March and April 2016. Setting Otolaryngology residency applicants throughout the United States. Subjects and Methods Applicants to otolaryngology residency during the 2016 match cycle and current otolaryngology residents were surveyed. Results Median number of applications, interview offers, interviews attended, and programs ranked was not different during the 2016 match and the previous 5 match years. The most important factor affecting the number of applications was the need to apply widely to ensure sufficient interview offers. The most common reason for declining an interview offer was scheduling conflict. Applicants during the 2016 match spent a median of $5400 applying and interviewing for otolaryngology residency. Conclusions Median number of applications, interview offers, interviews attended, and programs ranked has not changed. The most cited reason for applying to many programs was to increase the chances of matching, but this is not statistically likely to increase match success. We advocate for continued attempts to make the otolaryngology match process more transparent for both applicants and resident selection committees, but recognize that applicants are likely to continue to overapply for otolaryngology residency positions.

Specialized Training on Addictions for Physicians in the United States

ERIC Educational Resources Information Center

Tontchev, Gramen V.; Housel, Timothy R.; Callahan, James F.; Kunz, Kevin B.; Miller, Michael M.; Blondell, Richard D.

2011-01-01

In the United States accredited residency programs in addiction exist only for psychiatrists specializing in addiction psychiatry (ADP); nonpsychiatrists seeking training in addiction medicine (ADM) can train in nonaccredited "fellowships," or can receive training in some ADP programs, only to not be granted a certificate of completion of…

No Correlation Between Work-Hours and Operative Volumes--A Comparison Between United States and Danish Operative Volumes Achieved During Surgical Residency.

PubMed

Kjærgaard, Jane; Sillesen, Martin; Beier-Holgersen, Randi

2016-01-01

Since 2003, United States residents have been limited to an 80-hour workweek. This has prompted concerns of reduced educational quality, especially inadequate operating exposure. In contrast, the Danish surgical specialty-training program mandates a cap on working hours of 37 per week. We hypothesize that there is no direct correlation between work-hours and operative volume achieved during surgical residency. To test the hypothesis, we compare Danish and US operative volumes achieved during surgical residency training. Retrospective comparative study. The data from the US population was extracted from the Accreditation Council for Graduate Medical Education database for General Surgery residents from 2012 to 2013. For Danish residents, a questionnaire with case categories matching the Accreditation Council for Graduate Medical Education categories were sent to all Danish surgeons graduating the national surgical residency program in 2012 or 2013, 54 in total. In all, 30 graduated residents (55%) responded to the Danish survey. We found no significant differences in mean total major procedures (1002.4 vs 976.9, p = 0.28) performed during residency training, but comparing average major procedures per year, the US residents achieve significantly more (132.3 vs 195.4, p <0.01). When factoring in differences in time spent in training, this amounts to a weekly average difference of 1.2 cases throughout training. In this study, we find no difference in overall surgical volumes between Danes and US residents during their surgical training. When time in training was accounted for, differences between weekly surgical volumes achieved were minor, indicating a lack of direct correlation between weekly work-hours and operative volumes achievable. Factors other than work-hours seem to effect on operative volumes achieved during training. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Associations Among Health Care Workplace Safety, Resident Satisfaction, and Quality of Care in Long-Term Care Facilities.

PubMed

Boakye-Dankwa, Ernest; Teeple, Erin; Gore, Rebecca; Punnett, Laura

2017-11-01

We performed an integrated cross-sectional analysis of relationships between long-term care work environments, employee and resident satisfaction, and quality of patient care. Facility-level data came from a network of 203 skilled nursing facilities in 13 states in the eastern United States owned or managed by one company. K-means cluster analysis was applied to investigate clustered associations between safe resident handling program (SRHP) performance, resident care outcomes, employee satisfaction, rates of workers' compensation claims, and resident satisfaction. Facilities in the better-performing cluster were found to have better patient care outcomes and resident satisfaction; lower rates of workers compensation claims; better SRHP performance; higher employee retention; and greater worker job satisfaction and engagement. The observed clustered relationships support the utility of integrated performance assessment in long-term care facilities.

Operative experience of residents in US general surgery programs: a gap between expectation and experience.

PubMed

Bell, Richard H; Biester, Thomas W; Tabuenca, Arnold; Rhodes, Robert S; Cofer, Joseph B; Britt, L D; Lewis, Frank R

2009-05-01

The purpose of the study was to identify a group of operations which general surgery residency program directors believed residents should be competent to perform by the end of 5 years of training and then ascertain actual resident experience with these procedures during their training. There is concern about the adequacy of training of general surgeons in the United States. The American Board of Surgery and the Association of Program Directors in Surgery undertook a study to determine what operative procedures residency program directors consider to be essential to the practice of general surgery and then we measured the actual operative experience of graduating residents in those procedures, as reported to the Residency Review Committee for Surgery (RRC). An electronic survey was sent to residency program directors at the 254 general surgery programs in the US accredited by the RRC as of spring 2006. The program directors were presented with a list of 300 types of operations. Program directors graded the 300 procedures "A," "B," or "C" using the following criteria: A--graduating general surgery residents should be competent to perform the procedure independently; B--graduating residents should be familiar with the procedure, but not necessarily competent to perform it; and C--graduating residents neither need to be familiar with nor competent to perform the procedure. After ballots were tallied, the actual resident operative experience reported to the RRC by all residents finishing general surgery training in June 2005 was reviewed. One hundred twenty-one of the 300 operations were considered A level procedures by a majority of program directors (PDs). Graduating 2005 US residents (n = 1022) performed only 18 of the 121 A procedures, an average of more than 10 times during residency; 83 of 121 procedures were performed on an average less than 5 times and 31 procedures less than once. For 63 of the 121 procedures, the mode (most commonly reported) experience was 0. In addition, there was significant variation between residents in operative experience for specific procedures. In virtually all cases, the mean reported experience exceeded the mode, suggesting that the mean is a poor measure of typical experience. These data pose important problems for surgical educators. Methods will have to be developed to allow surgeons to reach a basic level of competence in procedures which they are likely to experience only rarely during residency. Even for more commonly performed procedures, the numbers of repetitions are not very robust, stressing the need to determine objectively whether residents are actually achieving basic competency in these operations. Finally, the large variations in experience between individuals in our residency system need to be explored, understood, and remedied.

Adolescent medicine training in pediatric residency programs.

PubMed

Fox, Harriette B; McManus, Margaret A; Klein, Jonathan D; Diaz, Angela; Elster, Arthur B; Felice, Marianne E; Kaplan, David W; Wibbelsman, Charles J; Wilson, Jane E

2010-01-01

The aim of this study was to provide an assessment of pediatric residency training in adolescent medicine. We conducted 2 national surveys: 1 of pediatric residency program directors and the other of faculty who are responsible for the adolescent medicine block rotation for pediatric residents to elicit descriptive and qualitative information concerning the nature of residents' ambulatory care training experience in adolescent medicine and the workforce issues that affect the experience. Required adolescent medicine topics that are well covered pertain to normal development, interviewing, and sexual issues. Those least well covered concern the effects of violence, motor vehicle safety, sports medicine, and chronic illness. Shortages of adolescent medicine specialists, addictions counselors, psychiatrists, and other health professionals who are knowledgeable about adolescents frequently limit pediatric residency training in adolescent medicine. Considerable variation exists in the timing of the mandatory adolescent medicine block rotation, the clinic sites used for ambulatory care training, and the range of services offered at the predominant training sites. In addition, residents' continuity clinic experience often does not include adolescent patients; thus, pediatric residents do not have opportunities to establish ongoing therapeutic relationships with adolescents over time. Both program and rotation directors had similar opinions about adolescent medicine training. Significant variation and gaps exist in adolescent medicine ambulatory care training in pediatric residency programs throughout the United States. For addressing the shortcomings in many programs, the quality of the block rotation should be improved and efforts should be made to teach adolescent medicine in continuity, general pediatric, and specialty clinics. In addition, renewed attention should be given to articulating the core competencies needed to care for adolescents.

Determinants of the 5-Year Retention and Rural Location of Family Physicians: Results from the Iowa Family Medicine Training Network.

PubMed

Nelson, Gregory C; Gruca, Thomas S

2017-06-01

States are seeking ways to retain primary care physicians trained within their borders. We analyzed the 5-year retention and rural Iowa location decisions for 1,645 graduates of the Iowa Family Medicine Training Network (IFMTN)-eight residency programs (in seven different cities) that are affiliated with the Carver College of Medicine (University of Iowa). Data from 1977-2014 includes 98.5% of active graduates. Location in Iowa 5 years after graduation was the dependent variable in a binary logistic regression. A second model used rural location in Iowa as the dependent variable. Independent variables included graduation year cohort, IMG status, sex, undergraduate medical training in Iowa, medical degree, and residency location. Undergraduate medical training in Iowa was strongly related to retention. Compared to graduates of the AMC residency, graduates of six of the seven community-based programs were significantly more likely to be practicing in Iowa. While the overall proportion of graduates practicing in rural Iowa was high (47.3%), women and IMGs were significantly less likely to practice in rural areas. Graduates of the Mason City program were significantly more likely to practice in a rural area after graduation. The experience of the IFMTN suggests that educating family physicians in community-based programs contributes significantly to in-state retention even 5 years after graduation. While all programs contribute to the rural FM workforce in Iowa, the residency program located in a rural community (Mason City) has a disproportionately positive impact.

Evolution of the Pathology Residency Curriculum

PubMed Central

Powell, Suzanne Z.; Black-Schaffer, W. Stephen

2016-01-01

The required medical knowledge and skill set for the pathologist of 2020 are different than in 2005. Pathology residency training curriculum must accordingly change to fulfill the needs of these ever-changing requirements. In order to make rational curricular adjustments, it is important for us to know the current trajectory of resident training in pathology—where we have been, what our actual current training curriculum is now—to understand how that might change in anticipation of meeting the needs of a changing patient and provider population and to fit within the evolving future biomedical and socioeconomic health-care setting. In 2013, there were 143 Accreditation Council for Graduate Medical Education-accredited pathology residency training programs in the United States, with approximately 2400 residents. There is diversity among residency training programs not only with respect to the number of residents but also in training venue(s). To characterize this diversity among pathology residency training programs, a curriculum survey was conducted of pathology residency program directors in 2013 and compared with a similar survey taken almost 9 years previously in 2005 to identify trends in pathology residency curriculum. Clinical pathology has not changed significantly in the number of rotations over 9 years; however, anatomic pathology has changed dramatically, with an increase in the number of surgical pathology rotations coupled with a decline in stand-alone autopsy rotations. With ever-expanding medical knowledge that the graduating pathology resident must know, it is necessary to (1) reflect upon what are the critical need subjects, (2) identify areas that have become of lesser importance, and then (3) prioritize training accordingly. PMID:28725779

36 CFR 59.4 - Residency requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 36 Parks, Forests, and Public Property 1 2012-07-01 2012-07-01 false Residency requirements. 59.4 Section 59.4 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR LAND AND WATER CONSERVATION FUND PROGRAM OF ASSISTANCE TO STATES; POST-COMPLETION COMPLIANCE...

36 CFR 59.4 - Residency requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Residency requirements. 59.4 Section 59.4 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR LAND AND WATER CONSERVATION FUND PROGRAM OF ASSISTANCE TO STATES; POST-COMPLETION COMPLIANCE...

36 CFR 59.4 - Residency requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 36 Parks, Forests, and Public Property 1 2014-07-01 2014-07-01 false Residency requirements. 59.4 Section 59.4 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR LAND AND WATER CONSERVATION FUND PROGRAM OF ASSISTANCE TO STATES; POST-COMPLETION COMPLIANCE...

36 CFR 59.4 - Residency requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 36 Parks, Forests, and Public Property 1 2013-07-01 2013-07-01 false Residency requirements. 59.4 Section 59.4 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR LAND AND WATER CONSERVATION FUND PROGRAM OF ASSISTANCE TO STATES; POST-COMPLETION COMPLIANCE...

36 CFR 59.4 - Residency requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 36 Parks, Forests, and Public Property 1 2011-07-01 2011-07-01 false Residency requirements. 59.4 Section 59.4 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR LAND AND WATER CONSERVATION FUND PROGRAM OF ASSISTANCE TO STATES; POST-COMPLETION COMPLIANCE...

Child Neurology Education for Pediatric Residents.

PubMed

Albert, Dara V F; Patel, Anup D; Behnam-Terneus, Maria; Sautu, Beatriz Cunill-De; Verbeck, Nicole; McQueen, Alisa; Fromme, H Barrett; Mahan, John D

2017-03-01

The aim of this study was to evaluate whether the current state of child neurology education during pediatric residency provides adequate preparation for pediatric practice. A survey was sent to recent graduates from 3 pediatric residency programs to assess graduate experience, perceived level of competence, and desire for further education in child neurology. Responses from generalists versus subspecialists were compared. The response rate was 32%, half in general pediatric practice. Only 22% feel very confident in approaching patients with neurologic problems. This may represent the best-case scenario as graduates from these programs had required neurology experiences, whereas review of Accreditation Council of Graduate Medical Education-accredited residency curricula revealed that the majority of residencies do not. Pediatric neurologic problems are common, and pediatric residency graduates do encounter such problems in practice. The majority of pediatricians report some degree of confidence; however, some clear areas for improvement are apparent.

The Canadian general surgery resident: defining current challenges for surgical leadership.

PubMed

Tomlinson, Corey; Labossière, Joseph; Rommens, Kenton; Birch, Daniel W

2012-08-01

Surgery training programs in Canada and the United States have recognized the need to modify current models of training and education. The shifting demographic of surgery trainees, lifestyle issues and an increased trend toward subspecialization are the major influences. To guide these important educational initiatives, a contemporary profile of Canadian general surgery residents and their impressions of training in Canada is required. We developed and distributed a questionnaire to residents in each Canadian general surgery training program, and residents responded during dedicated teaching time. In all, 186 surveys were returned for analysis (62% response rate). The average age of Canadian general surgery residents is 30 years, 38% are women, 41% are married, 18% have dependants younger than 18 years and 41% plan to add to or start a family during residency. Most (87%) residents plan to pursue postgraduate education. On completion of training, 74% of residents plan to stay in Canada and 49% want to practice in an academic setting. Almost half (42%) of residents identify a poor balance between work and personal life during residency. Forty-seven percent of respondents have appropriate access to mentorship, whereas 37% describe suitable access to career guidance and 40% identify the availability of appropriate social supports. Just over half (54%) believe the stress level during residency is manageable. This survey provides a profile of contemporary Canadian general surgery residents. Important challenges within the residency system are identified. Program directors and chairs of surgery are encouraged to recognize these challenges and intervene where appropriate.

Factors Influencing American Plastic Surgery Residents Toward an Academic Career.

PubMed

Chetta, Matthew D; Sugg, Kristoffer B; Diaz-Garcia, Rafael J; Kasten, Steven J

2018-02-01

Plastic surgery residency program directors have an interest in recruiting applicants who show an interest in an academic practice. Medical school achievements (ie, United States Medical Licensing Examination® scores, publications, and Alpha Omega Alpha status) are metrics assessed to grade applicants but may not correlate with ultimately choosing an academic career. This study was designed to investigate factors influencing residents' choices for or against academic careers. A 25-item online questionnaire was designed to measure baseline interest in academic plastic surgery and factors that influence decisions to continue on or abandon that career path. This questionnaire was disseminated to the integrated/combined plastic surgery residents during the 2013 to 2014 academic year. One hundred twenty-five respondents indicated that they were currently interested in pursuing academic practice (n = 78) or had lost interest in academic practice (n = 47). Among all respondents, 92.8% (n = 116) stated they were interested in academic careers at the time of residency application, but one-third (n = 41) subsequently lost interest. Those residents who retained interest in academic careers indicated resident/medical student educational opportunities (57%) and complexity of patients (52%) as reasons. Those who lost interest cited a lack of autonomy (43%), publishing requirements (32%), and income discrepancy (26%) as reasons. Many residents report losing interest in academics during residency. Traditional metrics valued in the recruitment process may not serve as positive predictors of an academic career path. Reasons why residents lose interest are not easily correctable, but mentorship, adequate career counseling, and research opportunities during training remain factors that can be addressed across all residency programs.

42 CFR 457.320 - Other eligibility standards.

Code of Federal Regulations, 2011 CFR

2011-10-01

... State, if the child is physically located in that State, including as a result of the parent's or... State is the State of residence of the child's custodial parent's or caretaker at the time of placement... (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES State Plan...

42 CFR 457.320 - Other eligibility standards.

Code of Federal Regulations, 2010 CFR

2010-10-01

... State, if the child is physically located in that State, including as a result of the parent's or... State is the State of residence of the child's custodial parent's or caretaker at the time of placement... (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES State Plan...

Assessing and Promoting the Wellness of United States Ophthalmology Residents: A Survey of Program Directors.

PubMed

Tran, Elaine M; Scott, Ingrid U; Clark, Melissa A; Greenberg, Paul B

To report on the status of residency-based wellness initiatives in ophthalmic graduate medical education and identify strategies for promoting ophthalmology resident wellness by surveying US ophthalmology program directors (PDs). The PDs were each sent an e-mail containing a link to an anonymous online 15-question survey. The PDs also received a letter with the survey link and a $1 incentive. After 2 weeks, nonresponders received 2 weekly reminder e-mails and phone calls. Descriptive statistics were used to analyze the multiple choice responses and categorize the free response answers. National survey. All 111 US ophthalmology PDs were invited to participate. Of 111 PDs, 56 (50%) responded; 14 (26%) of 53 respondents reported that their programs faced an issue involving resident depression, burnout, or suicide within the last year; 25 (45%) of 56 reported that their department had a resident wellness program. Respondents without wellness programs reported a shortage of time (19/30; 63%) and lack of training and resources (19/30; 63%) as barriers to instituting these programs. Respondents reported that the Accreditation Council for Graduate Medical Education could better promote resident wellness by providing training resources for burnout and depression screening (35/53; 66%), resilience skills building (38/53; 72%), and wellness program development (36/53; 68%). This survey suggests that there is a substantial burden of burnout and depression among residents in ophthalmic graduate medical education and that this burden can be addressed by promoting the training of educators to recognize the signs of burnout and depression, and providing resources to develop and expand formal wellness programs. Published by Elsevier Inc.

The teaching of anesthesia history in US residency programs: results of a nationwide survey.

PubMed

Desai, Manisha S; Chennaiahgari, Shirish R; Desai, Sukumar P

2012-03-01

To determine the extent to which history of anesthesia-related topics are included in the didactic curriculum of United States residency programs in anesthesiology. Survey instrument. University-affiliated hospital. In addition to information related to the identity of the respondent and institution, we inquired about the presence of faculty members with an interest in the history of anesthesia (HOA), the inclusion of HOA-related lectures in the didactic curriculum, whether the program would consider inviting an outside lecturer for a session devoted to HOA, the inclusion of HOA-related tours, and whether the program would allow residents an elective rotation of one to three months devoted to a research project related to HOA. On the basis of responses from 46 of 132 residency programs (35%), 54% of programs had at least one faculty member with an interest in HOA, and 45% of programs included lectures related to HOA in their didactic curriculum. An encouraging finding was that 83% of programs (without such didactic sessions) were willing to invite visiting professors to deliver lectures on HOA. The vast majority (91%) did not conduct tours related to HOA, while 74% indicated a willingness to allow residents interested in HOA to devote one to three months to undertake such projects. The low rate of interest in HOA among faculty members, and the lower rate of inclusion of lectures related to HOA during residency training, suggests that substantial barriers exist within the academic community towards a wider acceptance of the importance of HOA. Two positive indicators were the willingness to invite outside speakers and the receptivity to allowing residents to devote one to three months to projects related to HOA. Copyright © 2012 Elsevier Inc. All rights reserved.

Program Director Survey: Attitudes Regarding Child Neurology Training and Testing.

PubMed

Valencia, Ignacio; Feist, Terri B; Gilbert, Donald L

2016-04-01

As a result of major clinical and scientific advances and changes in clinical practice, the role of adult neurology training for Child Neurology and Neurodevelopmental Disability (NDD) certification has become controversial. The most recently approved requirements for board eligibility for child neurology and neurodevelopmental disability residents still include 12 months in adult neurology rotations. The objective of this study was to assess United States child neurology and neurodevelopmental disability residency program directors' opinions regarding optimal residency training. The authors developed an 18-item questionnaire and contacted all 80 child neurology and neurodevelopmental disability program directors via e-mail, using SurveyMonkey. A total of 44 program directors responded (55%), representing programs that train 78 categorical and 94 total resident positions, approximately 70% of those filled in the match. Respondents identified multiple areas where child neurology residents need more training, including genetics and neuromuscular disease. A substantial majority (73%) believed child neurology and neurodevelopmental disability residents need less than 12 adult neurology training months; however, most (75%) also believed adult hospital service and man-power needs (55%) and finances (34%) would pose barriers to reducing adult neurology. Most (70%) believed reductions in adult neurology training should be program flexible. A majority believed the written initial certification examination should be modified with more child neurology and fewer basic neuroscience questions. Nearly all (91%) felt the views of child neurology and neurodevelopmental disability program directors are under-represented within the Accreditation Council for Graduate Medical Education Residency Review Committee. The requirement for 12 adult neurology months for Child Neurology and Neurodevelopmental Disability certification is not consistent with the views of the majority of program directors, who favor more training in subspecialized fields of child neurology. Copyright © 2016 Elsevier Inc. All rights reserved.

Do Residency Selection Factors Predict Radiology Resident Performance?

PubMed

Agarwal, Vikas; Bump, Gregory M; Heller, Matthew T; Chen, Ling-Wan; Branstetter, Barton F; Amesur, Nikhil B; Hughes, Marion A

2018-03-01

The purpose of our study is to determine what information in medical student residency applications predicts radiology residency success as defined by objective clinical performance data. We performed a retrospective cohort study of residents who entered our institution's residency program through the National Resident Matching Program as postgraduate year 2 residents and completed the program over the past 2 years. Medical school grades, selection to Alpha Omega Alpha (AOA) Honor Society, United States Medical Licensing Examination (USMLE) scores, publication in peer-reviewed journals, and whether the applicant was from a peer institution were the variables examined. Clinical performance was determined by calculating each resident's cumulative major discordance rate for on-call cases the resident read and gave a preliminary interpretation. A major discordance was defined as a difference between the preliminary resident and the final attending interpretations that could immediately impact the care of the patient. A multivariate logistic regression was performed to determine significant variables. Twenty-seven residents provided preliminary reports on call for 67,145 studies. The mean major discordance rate was 1.08% (range 0.34%-2.54%). Higher USMLE Step 1 scores, publication before residency, and election to AOA Honor Society were all statistically significant predictors of lower major discordance rates (P values 0.01, 0.01,  and <0.001, respectively). Overall resident performance was excellent. There are predictors that help select the better performing residents, namely higher USMLE Step 1 scores, one to two publications during medical school, and election to AOA in the junior year of medical school. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Parental leave for residents and pediatric training programs.

PubMed

2013-02-01

The American Academy of Pediatrics (AAP) is committed to the development of rational, equitable, and effective parental leave policies that are sensitive to the needs of pediatric residents, families, and developing infants and that enable parents to spend adequate and good-quality time with their young children. It is important for each residency program to have a policy for parental leave that is written, that is accessible to residents, and that clearly delineates program practices regarding parental leave. At a minimum, a parental leave policy for residents and fellows should conform legally with the Family Medical Leave Act as well as with respective state laws and should meet institutional requirements of the Accreditation Council for Graduate Medical Education for accredited programs. Policies should be well formulated and communicated in a culturally sensitive manner. The AAP advocates for extension of benefits consistent with the Family Medical Leave Act to all residents and interns beginning at the time that pediatric residency training begins. The AAP recommends that regardless of gender, residents who become parents should be guaranteed 6 to 8 weeks, at a minimum, of parental leave with pay after the infant's birth. In addition, in conformance with federal law, the resident should be allowed to extend the leave time when necessary by using paid vacation time or leave without pay. Coparenting, adopting, or fostering of a child should entitle the resident, regardless of gender, to the same amount of paid leave (6-8 weeks) as a person who takes maternity/paternity leave. Flexibility, creativity, and advanced planning are necessary to arrange schedules that optimize resident education and experience, cultivate equity in sharing workloads, and protect pregnant residents from overly strenuous work experiences at critical times of their pregnancies.

15 CFR 4.21 - Purpose and scope.

Code of Federal Regulations, 2013 CFR

2013-01-01

... citizen of the United States or an alien lawfully admitted for permanent residence into the United States... of retirement benefits, explanations of health and life insurance programs, and explanations of tax...

15 CFR 4.21 - Purpose and scope.

Code of Federal Regulations, 2011 CFR

2011-01-01

... citizen of the United States or an alien lawfully admitted for permanent residence into the United States... of retirement benefits, explanations of health and life insurance programs, and explanations of tax...

15 CFR 4.21 - Purpose and scope.

Code of Federal Regulations, 2014 CFR

2014-01-01

... citizen of the United States or an alien lawfully admitted for permanent residence into the United States... of retirement benefits, explanations of health and life insurance programs, and explanations of tax...

15 CFR 4.21 - Purpose and scope.

Code of Federal Regulations, 2010 CFR

2010-01-01

... citizen of the United States or an alien lawfully admitted for permanent residence into the United States... of retirement benefits, explanations of health and life insurance programs, and explanations of tax...

15 CFR 4.21 - Purpose and scope.

Code of Federal Regulations, 2012 CFR

2012-01-01

... citizen of the United States or an alien lawfully admitted for permanent residence into the United States... of retirement benefits, explanations of health and life insurance programs, and explanations of tax...

42 CFR 505.13 - Conditions for loan forgiveness.

Code of Federal Regulations, 2010 CFR

2010-10-01

... plan that meets the criteria specified in § 505.15: (1) An outreach program for cancer prevention... State or region, including residents of rural areas; (2) An outreach program for cancer prevention...

42 CFR 505.13 - Conditions for loan forgiveness.

Code of Federal Regulations, 2011 CFR

2011-10-01

... plan that meets the criteria specified in § 505.15: (1) An outreach program for cancer prevention... State or region, including residents of rural areas; (2) An outreach program for cancer prevention...

42 CFR 505.13 - Conditions for loan forgiveness.

Code of Federal Regulations, 2014 CFR

2014-10-01

... plan that meets the criteria specified in § 505.15: (1) An outreach program for cancer prevention... State or region, including residents of rural areas; (2) An outreach program for cancer prevention...

42 CFR 505.13 - Conditions for loan forgiveness.

Code of Federal Regulations, 2013 CFR

2013-10-01

... plan that meets the criteria specified in § 505.15: (1) An outreach program for cancer prevention... State or region, including residents of rural areas; (2) An outreach program for cancer prevention...

42 CFR 505.13 - Conditions for loan forgiveness.

Code of Federal Regulations, 2012 CFR

2012-10-01

... plan that meets the criteria specified in § 505.15: (1) An outreach program for cancer prevention... State or region, including residents of rural areas; (2) An outreach program for cancer prevention...

Reducing oral and maxillofacial surgery resident risk exposure: lessons from graduate medical education reform.

PubMed

Buhrow, Suzanne Morse; Buhrow, Jack A

2013-12-01

It is estimated that, in the United States, more than 40,000 patients are injured each day because of preventable medical errors. Although numerous studies examine the causes of medical trainee errors and efforts to mitigate patient injuries in this population, little research exists on adverse events experienced by oral and maxillofacial surgery (OMFS) residents or strategies to improve patient safety awareness in OMFS residency programs. The authors conducted a retrospective literature review of contemporary studies on medical trainees' reported risk exposure and the impact of integrating evidence-based patient safety training into residency curricula. A review of the literature suggests that OMFS residents face similar risks as medical trainees in medical, surgical, and anesthesia residency programs and may benefit from integrating competency-based safety training in the OMFS residency curriculum. OMFS trainees face particular challenges when transitioning from dental student to surgical resident, particularly related to their limited clinical exposure to high-reliability organizations, which may place them at higher risk than other medical trainees. OMFS educators should establish resident competence in patient safety principles and system improvement strategies throughout the training period.

Operative experience in an orthopaedic surgery residency program: the effect of work-hour restrictions.

PubMed

Baskies, Michael A; Ruchelsman, David E; Capeci, Craig M; Zuckerman, Joseph D; Egol, Kenneth A

2008-04-01

The implementation of Section 405 of the New York State Public Health Code and the adoption of similar policies by the Accreditation Council for Graduate Medical Education in 2002 restricted resident work hours to eighty hours per week. The effect of these policies on operative volume in an orthopaedic surgery residency training program is a topic of concern. The purpose of this study was to evaluate the effect of the work-hour restrictions on the operative experiences of residents in a large university-based orthopaedic surgery residency training program in an urban setting. We analyzed the operative logs of 109 consecutive orthopaedic surgery residents (postgraduate years 2 through 5) from 2000 through 2006, representing a consecutive interval of years before and after the adoption of the work-hour restrictions. Following the implementation of the new work-hour policies, there was no significant difference in the operative volume for postgraduate year-2, 3, or 4 residents. However, the average operative volume for a postgraduate year-5 resident increased from 274.8 to 348.4 cases (p = 0.001). In addition, on analysis of all residents as two cohorts (before 2002 and after 2002), the operative volume for residents increased by an average of 46.6 cases per year (p = 0.02). On the basis of the findings of this study, concerns over the potential adverse effects of the resident work-hour polices on operative volume for orthopaedic surgery residents appear to be unfounded.

Assessing the impact of innovative training of family physicians for the patient-centered medical home.

PubMed

Carney, Patricia A; Eiff, M Patrice; Saultz, John W; Lindbloom, Erik; Waller, Elaine; Jones, Samuel; Osborn, Jamie; Green, Larry

2012-03-01

New approaches to enhance access in primary care necessitate change in the model for residency education. To describe instrument design, development and testing, and data collection strategies for residency programs, continuity clinics, residents, and program graduates participating in the Preparing the Personal Physician for Practice (P(4)) project. We developed and pilot-tested surveys to assess demographic characteristics of residents, clinical and operational features of the continuity clinics and educational programs, and attitudes about and implementation status of Patient Centered Medical Home (PCMH) characteristics. Surveys were administered annually to P(4) residency programs since the project started in 2007. Descriptive statistics were used to profile data from the P(4) baseline year. Most P(4) residents were non-Hispanic white women (60.7%), married or partnered, attended medical school in the United States and were the first physicians in their families to attend medical school. Nearly 85% of residency continuity clinics were family health centers, and about 8% were federally qualified health centers. The most likely PCMH features in continuity clinics were having an electronic health record and having fully secure remote access available; both of which were found in more than 50% of continuity clinics. Approximately one-half of continuity clinics used the electronic health record for safety projects, and nearly 60% used it for quality-improvement projects. We created a collaborative evaluation model in all 14 P(4) residencies. Successful implementation of new surveys revealed important baseline features of residencies and residents that are pertinent to studying the effects of new training models for the PCMH.

Back in the Shadows? The DACA Saga Continues

ERIC Educational Resources Information Center

Harney, John O.

2018-01-01

From 2012 to 2017, nearly 15,000 New England residents participated in the Deferred Action for Childhood Arrivals (DACA) program. DACA students are ineligible for federal financial aid programs, but state and institutional aid can flow to undocumented students. As of March 2017, 20 states, including Connecticut and Rhode Island, offered in-state…

District of Columbia: Financial and Program Management Improvements Needed for Tuition Assistance Grant Program. Report to Congressional Committees. GAO-06-14

ERIC Educational Resources Information Center

Government Accountability Office, 2005

2005-01-01

Congress created the District of Columbia Tuition Assistance Grant (DCTAG) program in 1999 to provide D.C. college-bound residents with greater choices among institutions of higher education by affording them the benefits of in-state tuition at state colleges and universities outside the District of Columbia. Congress appropriated $17 million…

Dental Education in Florida. A Study Prepared in Response to Appropriation Item 450 of the 1983 General Appropriations Act (Chapter 83-300, Laws of Florida). 1984--Report 4.

ERIC Educational Resources Information Center

Florida State Postsecondary Education Commission, Tallahassee.

The situation regarding dental education programs in Florida was studied, with attention to the type and size of programs needed to meet state needs, the geographic location of dental programs, funding and tuition policies, and the state's responsibility to provide an opportunity for its residents to participate in these educational programs. It…

Impact of a scholarly track on quality of residency program applicants.

PubMed

Celebi, Julie M; Nguyen, Cathina T; Sattler, Amelia L; Stevens, Michael B; Lin, Steven Y

2016-11-01

It is generally believed that residency programs offering scholarly tracks attract higher quality applicants, although there is little evidence of this in the literature. We explored the impact of a clinician-educator track on the quality of applicants to our residency program by comparing the volume and characteristics of applicants before (2008-2011) and after (2012-2015) the track was introduced. The total number of applications received was compared between the pre-track and post-track years. Among interviewees, data on United States Medical Licensing Examination (USMLE) Step 1 scores, Step 2 Clinical Knowledge (CK) scores, Medical Student Performance Evaluation (MSPE) scores, and proportion of candidates with an advanced degree (e.g. MPH, PhD) were compared. An online survey was administered to all interviewees in 2014-2015 to measure interest in the track. The total number of applications to the residency program increased significantly from the pre-track to the post-track years. Compared to the pre-track years, interviewees during the post-track years had statistically higher USMLE Step 1 and Step 2 CK scores, better MSPE scores, and were more likely to have an advanced degree. Two-thirds of survey respondents reported that the track increased their interest in the residency program. A residency clinician-educator track may be associated with increased overall interest from applicants, higher application volume, and better measures of applicant quality based on USMLE scores, MSPE scores, and proportion of candidates with an advanced degree. Residency programs may consider a potential increase in the quality of their applicants as an added benefit of offering a scholarly track.

Rurality and nursing home quality: evidence from the 2004 National Nursing Home Survey.

PubMed

Kang, Yu; Meng, Hongdao; Miller, Nancy A

2011-12-01

To evaluate the impact of rural geographic location on nursing home quality of care in the United States. The study used cross-sectional observational design. We obtained resident- and facility-level data from 12,507 residents in 1,174 nursing homes from the 2004 National Nursing Home Survey. We used multilevel regression models to predict risk-adjusted rates of hospitalization, influenza and pneumococcal vaccination, and moderate to severe pain while controlling for resident and facility characteristics. Adjusting for covariates, residents in rural facilities were more likely to experience hospitalization (odds ratio [OR] = 1.50, 95% confidence interval [CI] = 1.16-1.94) and moderate to severe pain (OR = 1.68, 95% CI = 1.35-2.09). Significant facility-level predictors of higher quality included higher percentage of Medicaid beneficiaries, accreditation status, and special care programs. Medicare payment findings were mixed. Significant resident-level predictors included dementia diagnosis and being a "long-stay" resident. Rural residents were more likely to reside in facilities without accreditations or special care programs, factors that increased their odds of receiving poorer quality of care. Policy efforts to enhance Medicare payment approaches as well as increase rural facilities' accreditation status and provision of special care programs will likely reduce quality of care disparities in facilities.

Does Timing of Internal Medicine Residency Interview Affect Likelihood of Matching?

PubMed

Heidemann, Danielle L; Thompson, Elizabeth; Drake, Sean M

2016-08-01

Applicants to our internal medicine (IM) residency program consistently have shared concerns about whether the interview date influences their ability to match via the National Residency Matching Program. We performed a retrospective study to assess whether interview timing was associated with successful matching at our IM program. We identified all of the applicants who interviewed for a first-year position with our IM residency program from 2010 to 2014. Each year's interview dates were totaled and divided equally into three categories: early, middle, or late. Baseline demographics, United States Medical Licensing Examination scores, and type of medical school (American or international) were compared among the interview date groups and between those who did and did not match at our program. Of 914 interviewees, 311 interviewed early (October/November), 299 interviewed in the middle (December), and 304 interviewed late (January). The proportion to match at our program was similar in each interview group (12.5%, 18.4%, 15.1%, respectively; P = 0.133). Logistic regression analysis showed that the middle interview group had increased odds to match compared with the early group (odds ratio 1.590; P = 0.044). The late-versus-early group showed no difference (P = 0.362). No significant differences were found with type of medical school or United States Medical Licensing Examination scores. Of all of the interviewees participating in the match, nearly all matched into a program somewhere, with no significant difference based on interview timing. When considering all of the interviewees, interview date showed no major influence on matching. Only the middle interview time period showed a slight increased chance of matching to our IM program, but the significance was marginal.

Health Spending By State 1991-2014: Measuring Per Capita Spending By Payers And Programs.

PubMed

Lassman, David; Sisko, Andrea M; Catlin, Aaron; Barron, Mary Carol; Benson, Joseph; Cuckler, Gigi A; Hartman, Micah; Martin, Anne B; Whittle, Lekha

2017-07-01

As the US health sector evolves and changes, it is informative to estimate and analyze health spending trends at the state level. These estimates, which provide information about consumption of health care by residents of a state, serve as a baseline for state and national-level policy discussions. This study examines per capita health spending by state of residence and per enrollee spending for the three largest payers (Medicare, Medicaid, and private health insurance) through 2014. Moreover, it discusses in detail the impacts of the Affordable Care Act implementation and the most recent economic recession and recovery on health spending at the state level. According to this analysis, these factors affected overall annual growth in state health spending and the payers and programs that paid for that care. They did not, however, substantially change state rankings based on per capita spending levels over the period. Project HOPE—The People-to-People Health Foundation, Inc.

Impact of the Accreditation Council for Graduate Medical Education work-hour regulations on neurosurgical resident education and productivity.

PubMed

Jagannathan, Jay; Vates, G Edward; Pouratian, Nader; Sheehan, Jason P; Patrie, James; Grady, M Sean; Jane, John A

2009-05-01

Recently, the Institute of Medicine examined resident duty hours and their impact on patient safety. Experts have suggested that reducing resident work hours to 56 hours per week would further decrease medical errors. Although some reports have indicated that cutbacks in resident duty hours reduce errors and make resident life safer, few authors have specifically analyzed the effect of the Accreditation Council for Graduate Medical Education (ACGME) duty-hour limits on neurosurgical resident education and the perceived quality of training. The authors have evaluated multiple objective surrogate markers of resident performance and quality of training to determine the impact of the 80-hour workweek. The United States Medical Licensing Examination (USMLE) Step 1 data on neurosurgical applicants entering ACGME-accredited programs between 1998 and 2007 (before and after the implementation of the work-hour rules) were obtained from the Society of Neurological Surgeons. The American Board of Neurological Surgery (ABNS) written examination scores for this group of residents were also acquired. Resident registration for and presentations at the American Association of Neurological Surgeons (AANS) annual meetings between 2002 and 2007 were examined as a measure of resident academic productivity. As a case example, the authors analyzed the distribution of resident training hours in the University of Virginia (UVA) neurosurgical training program before and after the institution of the 80-hour workweek. Finally, program directors and chief residents in ACGME-accredited programs were surveyed regarding the effects of the 80-hour workweek on patient care, resident training, surgical experience, patient safety, and patient access to quality care. Respondents were also queried about their perceptions of a 56-hour workweek. Despite stable mean USMLE Step 1 scores for matched applicants to neurosurgery programs between 2000 and 2008, ABNS written examination scores for residents taking the exam for self-assessment decreased from 310 in 2002 to 259 in 2006 (16% decrease, p < 0.05). The mean scores for applicants completing the written examination for credit also did not change significantly during this period. Although there was an increase in the number of resident registrations to the AANS meetings, the number of abstracts presented by residents decreased from 345 in 2002 to 318 in 2007 (7% decrease, p < 0.05). An analysis of the UVA experience suggested that the 80-hour workweek leads to a notable increase in on-call duty hours with a profound decrease in the number of hours spent in conference and the operating room. Survey responses were obtained from 110 program directors (78% response rate) and 122 chief residents (76% response rate). Most chief residents and program directors believed the 80-hour workweek compromised resident training (96%) and decreased resident surgical experience (98%). Respondents also believed that the 80-hour workweek threatened patient safety (96% of program directors and 78% of chief residents) and access to quality care (82% of program directors and 87% of chief residents). When asked about the effects of a 56-hour workweek, all program directors and 98% of the chief residents indicated that resident training and surgical education would be further compromised. Most respondents (95% of program directors and 84% of chief residents) also believed that additional work-hour restrictions would jeopardize patient care. Neurological surgery continues to attract top-quality resident applicants. Test scores and levels of participation in national conferences, however, indicate that the 80-hour workweek may adversely affect resident training. Subjectively, neurosurgical program directors and chief residents believe that the 80-hour workweek makes neurosurgical training and the care of patients more difficult. Based on experience with the 80-hour workweek, educators think that a 56-hour workweek would further compromise neurosurgical training and patient care in the US.

Scheduling the resident 80-hour work week: an operations research algorithm.

PubMed

Day, T Eugene; Napoli, Joseph T; Kuo, Paul C

2006-01-01

The resident 80-hour work week requires that programs now schedule duty hours. Typically, scheduling is performed in an empirical "trial-and-error" fashion. However, this is a classic "scheduling" problem from the field of operations research (OR). It is similar to scheduling issues that airlines must face with pilots and planes routing through various airports at various times. The authors hypothesized that an OR approach using iterative computer algorithms could provide a rational scheduling solution. Institution-specific constraints of the residency problem were formulated. A total of 56 residents are rotating through 4 hospitals. Additional constraints were dictated by the Residency Review Committee (RRC) rules or the specific surgical service. For example, at Hospital 1, during the weekday hours between 6 am and 6 pm, there will be a PGY4 or PGY5 and a PGY2 or PGY3 on-duty to cover Service "A." A series of equations and logic statements was generated to satisfy all constraints and requirements. These were restated in the Optimization Programming Language used by the ILOG software suite for solving mixed integer programming problems. An integer programming solution was generated to this resource-constrained assignment problem. A total of 30,900 variables and 12,443 constraints were required. A total of man-hours of programming were used; computer run-time was 25.9 hours. A weekly schedule was generated for each resident that satisfied the RRC regulations while fulfilling all stated surgical service requirements. Each required between 64 and 80 weekly resident duty hours. The authors conclude that OR is a viable approach to schedule resident work hours. This technique is sufficiently robust to accommodate changes in resident numbers, service requirements, and service and hospital rotations.

Factors Influencing Radiology Residents' Fellowship Training and Practice Preferences in Canada.

PubMed

Mok, Philip S; Probyn, Linda; Finlay, Karen

2016-05-01

The study aimed to examine the postresidency plans of Canadian radiology residents and factors influencing their fellowship choices and practice preferences, including interest in teaching and research. Institutional ethics approval was obtained at McMaster University. Electronic surveys were sent to second to fifth-year residents at all 16 radiology residency programs across Canada. Each survey assessed factors influencing fellowship choices and practice preferences. A total of 103 (31%) Canadian radiology residents responded to the online survey. Over 89% from English-speaking programs intended to pursue fellowship training compared to 55% of residents from French-speaking programs. The most important factors influencing residents' decision to pursue fellowship training were enhanced employability (46%) and personal interest (47%). Top fellowship choices were musculoskeletal imaging (19%), body imaging (17%), vascular or interventional (14%), neuroradiology (8%), and women's imaging (7%). Respondents received the majority of their fellowship information from peers (68%), staff radiologists (61%), and university websites (58%). Approximately 59% planned on practicing at academic institutions and stated that lifestyle (43%), job prospects (29%), and teaching opportunities (27%) were the most important factors influencing their decisions. A total of 89% were interested in teaching but only 46% were interested in incorporating research into their future practice. The majority of radiology residents plan on pursuing fellowship training and often receive their fellowship information from informal sources such as peers and staff radiologists. Fellowship directors can incorporate recruitment strategies such as mentorship programs and improving program websites. There is a need to increase resident participation in research to advance the future of radiology. Copyright © 2016 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

Assessing Residents' Readiness for OR Autonomy: A Qualitative Descriptive Study of Expert Surgical Teachers' Best Practices.

PubMed

Chen, Xiaodong Phoenix; Sullivan, Amy M; Alseidi, Adnan; Kwakye, Gifty; Smink, Douglas S

Providing resident autonomy in the operating room (OR) is one of the major challenges for surgical educators today. The purpose of this study was to explore what approaches expert surgical teachers use to assess residents' readiness for autonomy in the OR. We particularly focused on the assessments that experts make prior to conducting the surgical time-out. We conducted semistructured in-depth interviews with expert surgical teachers from March 2016 to September 2016. Purposeful sampling and snowball sampling were applied to identify and recruit expert surgical teachers from general surgery residency programs across the United States to represent a range of clinical subspecialties. All interviews were audio-recorded, deidentified, and transcribed. We applied the Framework Method of content analysis, discussed and reached final consensus on the themes. We interviewed 15 expert teachers from 9 institutions. The majority (13/15) were Program or Associate Program Directors; 47% (7/15) primarily performed complex surgical operations (e.g., endocrine surgery). Five themes regarding how expert surgical teachers determine residents' readiness for OR autonomy before the surgical time-out emerged. These included 3 domains of evidence elicited about the resident (resident characteristics, medical knowledge, and beyond the current OR case), 1 variable relating to attending characteristics, and 1 variable composed of contextual factors. Experts obtained one or more examples of evidence, and adjusted residents' initial autonomy using factors from the attending variable and the context variable. Expert surgical teachers' assessments of residents' readiness for OR autonomy included 5 key components. Better understanding these inputs can contribute to both faculty and resident development, enabling increased resident autonomy and preparation for independent practice. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

The virtual practice: using the residents' continuity clinic to teach practice management and systems-based practice.

PubMed

Perez, Jose A; Faust, Cheryl; Kenyon, Angie

2009-09-01

Education in systems-based practice is a required component of all postgraduate medical education programs in the United States. Competency in this area requires that trainees have an understanding of the health care system sufficient to provide optimal care to patients. Most trainees in residency programs have little understanding of the complexities and challenges of present-day practice in the current system of care and consider themselves unprepared to undertake this activity following completion of training. Training in practice management in residency programs has not been emphasized as an important component of systems-based practice. Historically, practice management training in residency programs has been done using a fully didactic model, and residents have expressed a desire to learn this skill by becoming more directly involved in the operations and management of a practice. The patient visit touches many aspects of the health care system, including clinic operations, insurance, quality, and finances. At our institution, we used the residents' continuity clinic practices as a vehicle to provide education in practice management and systems-based practice by creating a curriculum that included the residents' perceived gaps in knowledge regarding going into practice. This is known as the virtual practice. This curriculum is taught using data obtained from residents' practice to illustrate concepts in many areas, including primary practice operations, malpractice insurance, financial benchmarks, and career planning. Resident self-assessed knowledge of these areas increased after participating in the curriculum, and resident testimonials indicate satisfaction with the project. In addition, residents have become engaged and interested in how their effort translates into performance and how they participate in the health care system.

Postinterview communication with residency applicants: a call for clarity!

PubMed

Frishman, Gary N; Matteson, Kristen A; Bienstock, Jessica L; George, Karen E; Ogburn, Tony; Rauk, Phillip N; Schnatz, Peter F; Learman, Lee A

2014-10-01

The residency match is an increasingly competitive process. Communication from medical student applicants to programs varies, and the effect this has on their rank status is unclear. We assessed how obstetrics and gynecology program directors interpret and act on postinterview communication initiated by applicants by conducting an anonymous cross-sectional web-based survey of allopathic obstetrics and gynecology program directors. One hundred thirty-seven program directors (55%) responded to the survey. Twenty-nine percent would consider ranking an applicant more favorably if the applicant expressed interest (beyond a routine thank you) or if a faculty mentor personally known to the program director stated that the applicant was ranking the program first. Fifty-two percent indicated that they would rank an applicant more favorably if a mentor known to them endorsed the applicant as outstanding. Approximately 30% responded that applicants who did not communicate with their program were disadvantaged compared with those who did. Approximately 17% stated it was desirable to create additional specialty-specific guidelines regarding postinterview contact between programs and applications. Based on the wide variation in how program directors interpret and act on postinterview communication from applicants, residency programs should formulate and communicate a clear policy about whether they request and how they respond to postinterview communication from applicants and their mentors. This will establish a more level playing field and eliminate potential inequities resulting from inconsistent communication practices. Copyright © 2014 Elsevier Inc. All rights reserved.

Ophthalmology resident selection: current trends in selection criteria and improving the process.

PubMed

Nallasamy, Sudha; Uhler, Tara; Nallasamy, Nambi; Tapino, Paul J; Volpe, Nicholas J

2010-05-01

To document and assess current ophthalmology resident selection practices as well as to initiate discussion on how best to improve the process. Online survey comprising 56 questions. Program directors, chairpersons, or members of the resident selection committee representing 65 United States ophthalmology residency programs accredited by the Accreditation Council on Graduate Medical Education. Study participants completed an online, anonymous survey consisting primarily of multiple choice questions, with single or multiple answers. Ophthalmology resident selection practices were evaluated and included: screening of applications, interview processes, selection factors, and formation of rank lists; recommendations given to applicants; and respondent satisfaction with the current selection process. As a group, survey respondents deemed the following factors most important in resident selection: interview performance (95.4%), clinical course grades (93.9%), letters of recommendation (83.1%), and board scores (80%). Statistical analyses deemed that the best predictors of resident performance are interviews, clinical course grades, recommendation letters, and ophthalmology rotation performance. Ophthalmology resident selection is a relatively subjective process, continuing to rely heavily on cognitive factors. Because these factors are not always indicative of ultimate resident quality, it would be helpful if ophthalmology training programs improved selection practices to discern who most likely will become a successful resident and future ophthalmologist. Long-term studies correlating applicant attributes with residency and postresidency success are needed to recommend guidelines for a more standardized selection process. Copyright 2010 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

A strategic approach to quality improvement and patient safety education and resident integration in a general surgery residency.

PubMed

O'Heron, Colette T; Jarman, Benjamin T

2014-01-01

To outline a structured approach for general surgery resident integration into institutional quality improvement and patient safety education and development. A strategic plan to address Accreditation Council for Graduate Medical Education (ACGME) Clinical Learning Environment Review assessments for resident integration into Quality Improvement and Patient Safety initiatives is described. Gundersen Lutheran Medical Foundation is an independent academic medical center graduating three categorical residents per year within an integrated multi-specialty health system serving 19 counties over 3 states. The quality improvement and patient safety education program includes a formal lecture series, online didactic sessions, mandatory quality improvement or patient safety projects, institutional committee membership, an opportunity to serve as a designated American College of Surgeons National Surgical Quality Improvement Project and Quality in Training representative, mandatory morbidity and mortality conference attendance and clinical electives in rural surgery and international settings. Structured education regarding and participation in quality improvement and patient safety programs are able to be accomplished during general surgery residency. The long-term outcomes and benefits of these strategies are unknown at this time and will be difficult to measure with objective data. © 2013 Published by Association of Program Directors in Surgery on behalf of Association of Program Directors in Surgery.

Self-reported information needs of anesthesia residency applicants and analysis of applicant-related web sites resources at 131 United States training programs.

PubMed

Chu, Larry F; Young, Chelsea A; Zamora, Abby K; Lowe, Derek; Hoang, Dan B; Pearl, Ronald G; Macario, Alex

2011-02-01

Despite the use of web-based information resources by both anesthesia departments and applicants, little research has been done to assess these resources and determine whether they are meeting applicant needs. Evidence is needed to guide anesthesia informatics research in developing high-quality anesthesia residency program Web sites (ARPWs). We used an anonymous web-based program (SurveyMonkey, Portland, OR) to distribute a survey investigating the information needs and perceived usefulness of ARPWs to all 572 Stanford anesthesia residency program applicants. A quantitative scoring system was then created to assess the quality of ARPWs in meeting the information needs of these applicants. Two researchers independently analyzed all 131 ARPWs in the United States to determine whether the ARPWs met the needs of applicants based on the scoring system. Finally, a qualitative assessment of the overall user experience of ARPWs was developed to account for the subjective elements of the Web site's presentation. Ninety-eight percent of respondents reported having used ARPWs during the application process. Fifty-six percent reported first visiting the Stanford ARPW when deciding whether to apply to Stanford's anesthesia residency program. Multimedia and Web 2.0 technologies were "very" or "most" useful in "learning intangible aspects of a program, like how happy people are" (42% multimedia and Web 2.0 versus 14% text and photos). ARPWs, on average, contained only 46% of the content items identified as important by applicants. The average (SD) quality scores among all ARPWs was 2.06 (0.59) of 4.0 maximum points. The mean overall qualitative score for all 131 ARPWs was 4.97 (1.92) of 10 points. Only 2% of applicants indicated that the majority (75%-100%) of Web sites they visited provided a complete experience. Anesthesia residency applicants rely heavily on ARPWs to research programs, prepare for interviews, and formulate a rank list. Anesthesia departments can improve their ARPWs by including information such as total hours worked and work hours by rotation (missing in 96% and 97% of ARPWs) and providing a valid web address on the Fellowship and Residency Electronic Interactive Database Access System (FREIDA) (missing in 28% of ARPWs).

Rural Water Quality Database: Educational Program to Collect Information.

ERIC Educational Resources Information Center

Lemley, Ann; Wagenet, Linda

1993-01-01

A New York State project created a water quality database for private drinking water supplies, using the statewide educational program to collect the data. Another goal was to develop this program so rural residents could increase their knowledge of water supply management. (Author)

Training in childhood obesity management in the United States: a survey of pediatric, internal medicine-pediatrics and family medicine residency program directors

PubMed Central

2010-01-01

Background Information about the availability and effectiveness of childhood obesity training during residency is limited. Methods We surveyed residency program directors from pediatric, internal medicine-pediatrics (IM-Peds), and family medicine residency programs between September 2007 and January 2008 about childhood obesity training offered in their programs. Results The response rate was 42.2% (299/709) and ranged by specialty from 40.1% to 45.4%. Overall, 52.5% of respondents felt that childhood obesity training in residency was extremely important, and the majority of programs offered training in aspects of childhood obesity management including prevention (N = 240, 80.3%), diagnosis (N = 282, 94.3%), diagnosis of complications (N = 249, 83.3%), and treatment (N = 242, 80.9%). However, only 18.1% (N = 54) of programs had a formal childhood obesity curriculum with variability across specialties. Specifically, 35.5% of IM-Peds programs had a formal curriculum compared to only 22.6% of pediatric and 13.9% of family medicine programs (p < 0.01). Didactic instruction was the most commonly used training method but was rated as only somewhat effective by 67.9% of respondents using this method. The most frequently cited significant barrier to implementing childhood obesity training was competing curricular demands (58.5%). Conclusions While most residents receive training in aspects of childhood obesity management, deficits may exist in training quality with a minority of programs offering a formal childhood obesity curriculum. Given the high prevalence of childhood obesity, a greater emphasis should be placed on development and use of effective training strategies suitable for all specialties training physicians to care for children. PMID:20163732

Training in childhood obesity management in the United States: a survey of pediatric, internal medicine-pediatrics and family medicine residency program directors.

PubMed

Wolff, Margaret S; Rhodes, Erinn T; Ludwig, David S

2010-02-17

Information about the availability and effectiveness of childhood obesity training during residency is limited. We surveyed residency program directors from pediatric, internal medicine-pediatrics (IM-Peds), and family medicine residency programs between September 2007 and January 2008 about childhood obesity training offered in their programs. The response rate was 42.2% (299/709) and ranged by specialty from 40.1% to 45.4%. Overall, 52.5% of respondents felt that childhood obesity training in residency was extremely important, and the majority of programs offered training in aspects of childhood obesity management including prevention (N = 240, 80.3%), diagnosis (N = 282, 94.3%), diagnosis of complications (N = 249, 83.3%), and treatment (N = 242, 80.9%). However, only 18.1% (N = 54) of programs had a formal childhood obesity curriculum with variability across specialties. Specifically, 35.5% of IM-Peds programs had a formal curriculum compared to only 22.6% of pediatric and 13.9% of family medicine programs (p < 0.01). Didactic instruction was the most commonly used training method but was rated as only somewhat effective by 67.9% of respondents using this method. The most frequently cited significant barrier to implementing childhood obesity training was competing curricular demands (58.5%). While most residents receive training in aspects of childhood obesity management, deficits may exist in training quality with a minority of programs offering a formal childhood obesity curriculum. Given the high prevalence of childhood obesity, a greater emphasis should be placed on development and use of effective training strategies suitable for all specialties training physicians to care for children.

Predictors of matching in an ophthalmology residency program.

PubMed

Loh, Allison R; Joseph, Damien; Keenan, Jeremy D; Lietman, Thomas M; Naseri, Ayman

2013-04-01

To examine the characteristics of US medical students applying for ophthalmology residency and to determine the predictors of matching. A retrospective case series. A total of 3435 medical students from the United States who applied to an ophthalmology residency program from 2003 to 2008 were included. Matched and unmatched applicants were compared and stratified by predictor variables, including United States Medical Licensing Examination (USMLE) Step 1 score, Alpha Omega Alpha (AOA) status, medical school reputation, and medical school geographic region. Differences in proportions were analyzed using the Fisher exact test. Logistic regression was used to determine the predictors of successful matching. Successful matching to an ophthalmology program. The majority of applicants (72%, 2486/3435) matched in ophthalmology. In multivariate analysis, AOA membership (odds ratio [OR], 2.6, P<0.0001), USMLE score (OR, 1.6; P<0.0001), presence of an ophthalmology residency at medical school (OR, 1.4; P = 0.01), top 25 medical school (OR, 1.4; P<0.03), top 10 medical school (OR, 1.6; P<0.02), and allopathic degree (OR, 4.0; P<0.0001) were statistically significant predictors of matching. Approximately 60% (1442/2486) of applicants matched to the same geographic region as their medical school. Applicants were more likely to match at a program in the same geographic region as their medical school than would be predicted by chance alone (P<0.0001). In multivariate analysis, higher USMLE score (OR, 0.9; P<0.0001) and top 10 medical school (OR, 0.7; P = 0.027) were statistically significant predictors of matching to outside the geographic region as one's medical school. The majority of applicants applying for an ophthalmology residency position match successfully. Higher performance on quantitative metrics seems to confer an advantage for matching. The majority of applicants match at a residency program within the same geographic region as one's medical school. Copyright © 2013 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Text messaging versus email for emergency medicine residents' knowledge retention: a pilot comparison in the United States.

PubMed

Hoonpongsimanont, Wirachin; Kulkarni, Miriam; Tomas-Domingo, Pedro; Anderson, Craig; McCormack, Denise; Tu, Khoa; Chakravarthy, Bharath; Lotfipour, Shahram

2016-01-01

We evaluated the effectiveness of text messaging versus email, as a delivery method to enhance knowledge retention of emergency medicine (EM) content in EM residents. We performed a multi-centered, prospective, randomized study consisting of postgraduate year (PGY) 1 to PGY 3 & 4 residents in three United States EM residency programs in 2014. Fifty eight residents were randomized into one delivery group: text message or email. Participants completed a 40 question pre- and post-intervention exam. Primary outcomes were the means of pre- and post-intervention exam score differences. Data were analyzed using descriptive statistics, paired t-test, and multiple linear regressions. No significant difference was found between the primary outcomes of the two groups (P=0.51). PGY 2 status had a significant negative effect (P=0.01) on predicted exam score difference. Neither delivery method enhanced resident knowledge retention. Further research on implementation of mobile technology in residency education is required.

Distance Learning Enrollments in Independent Institutions. Feasibility Study.

ERIC Educational Resources Information Center

Washington State Higher Education Coordinating Board, Olympia.

This study investigated the feasibility of collecting enrollment data on distance learning programs sponsored by private institutions within and outside of Washington State. E-commerce developments have allowed in-state independent providers and out-of-state public institutions to serve residents of Washington State, and many nontraditional…

More Learning in Less Time: Optimizing the Resident Educational Experience with Limited Clinical and Educational Work Hours.

PubMed

Sedney, Cara L; Spirou, Eleni; Voelker, Joseph L; Rosen, Charles L

2017-11-01

Resident education in the United States and elsewhere has undergone significant changes in recent years owing to work hour restrictions, requiring didactics to fit within a limited schedule, while being increasingly effective at accomplishing educational goals. A single small program experience in improving the didactic experience of residents is described. Focused mentorship, curricula for intangibles, asynchronous education, and independent curricula all are useful tools in resident education. Residents can be exposed to both clinical material and specialty-specific mores using focused and intentional educational techniques. Copyright © 2017 Elsevier Inc. All rights reserved.

The founding of the Mayo School of Graduate Medical Education.

PubMed

Boes, Christopher J; Long, Timothy R; Rose, Steven H; Fye, W Bruce

2015-02-01

The Mayo Foundation for Medical Education and Research (hereafter the Mayo Foundation), the precursor to the Mayo School of Graduate Medical Education, was incorporated in 1915. The Mayo Foundation, which was affiliated with the University of Minnesota Graduate School, aimed to establish a higher standard for training medical specialists. Together, the University of Minnesota and the Mayo Foundation pioneered a graduate medical education program that allowed residents to earn master's and PhD degrees in clinical medicine and surgery. Unlike elsewhere in the United States, the residency training program was not pyramidal. (In a pyramidal residency program, each training year, some residents are systematically eliminated to reduce the number of more senior trainees.) All those who started the Mayo Foundation residency program had an opportunity to finish depending on their own merits. Louis B. Wilson, the first director of the Mayo Foundation, became a major figure in graduate medical education in the 1920s and 1930s. Although the granting of graduate degrees in medicine and surgery stopped over time, Mayo Clinic ultimately became the largest site of graduate medical education in the world. Copyright © 2015 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Survey of Individual and Institutional Risk Associated with the Use of Social Media.

PubMed

Garg, Manish; Pearson, David A; Bond, Michael C; Runyon, Michael; Pillow, M Tyson; Hopson, Laura; Cooney, Robert R; Khadpe, Jay; Nomura, Jason T; Inboriboon, Pholaphat C

2016-05-01

Residents and faculty in emergency medicine (EM) residency programs might be unaware of the professional and legal risks associated with the use of social media (SM). The objective of this study was to identify and characterize the types and reported incidence of unprofessional SM behavior by EM residents, faculty, and nurses and the concomitant personal and institutional risks. This multi-site study used an 18-question survey tool that was distributed electronically to the leaders of multiple EM residency programs, members of the Council of Emergency Medicine Residency Directors (CORD), and the residents of 14 EM programs during the study period May to June 2013. We received 1,314 responses: 772 from residents and 542 from faculty. Both groups reported encountering high-risk-to-professionalism events (HRTPE) related to SM use by residents and non-resident providers (NRPs), i.e., faculty members and nurses. Residents reported posting of one of the following by a resident peer or nursing colleague: identifiable patient information (26%); or a radiograph, clinical picture or other image (52%). Residents reported posting of images of intoxicated colleagues (84%), inappropriate photographs (66%), and inappropriate posts (73%). Program directors (PDs) reported posting one of the following by NRPs and residents respectively: identifiable patient information (46% and 45%); a radiograph, clinical picture or other image (63% and 58%). PDs reported that NRPs and residents posted images of intoxicated colleagues (64% and 57%), inappropriate photographs (63% and 57%), or inappropriate posts (76% and 67%). The directors also reported that they were aware of or issued reprimands or terminations at least once a year (30% NRPs and 22% residents). Residents were more likely to post photos of their resident peers or nursing colleagues in an intoxicated state than were NRPs (p=0.0004). NRPs were more likely to post inappropriate content (p=0.04) and identifiable patient information (p=0.0004) than were residents. EM residents and faculty members cause and encounter HRTPE frequently while using SM; these events present significant risks to the individuals responsible and their associated institution. Awareness of these risks should prompt responsible SM use and consideration of CORD's Social Media Task Force recommendations.

Postdoctoral periodontal program directors' perspectives of resident selection.

PubMed

Khan, Saba; Carmosino, Andrew J; Yuan, Judy Chia-Chun; Lucchiari, Newton; Kawar, Nadia; Sukotjo, Cortino

2015-02-01

Applications for postdoctoral periodontal programs have recently increased. The National Board Dental Examinations (NBDE) has adopted a pass/fail format. The purpose of this study is to examine the criteria used by accredited postdoctoral periodontal programs in the United States to evaluate potential applicants. A secondary purpose was to determine whether the absence of NBDE scores would change program directors' selection process. Basic demographic information of the program directors was also collected. A questionnaire was sent to all 54 program directors of accredited postdoctoral periodontal programs in the United States. The raw data were compiled, descriptive analyses were performed, and results were tabulated and ranked when applicable. Thirty-five of 54 program directors (64.8%) responded to the survey. The five most important factors in selecting residents were: 1) interview ratings; 2) dental school clinical grades; 3) dental school periodontics grades; 4) personal statement; and 5) letters of recommendation. The majority of the programs (94%; n = 33) require an interview, and many (86%; n = 30) have a committee that makes the final decision on candidate acceptance. More than half of the respondents (56%; n = 17) stated that the pass/fail format of the NBDE would affect the decision-making process. This study describes the criteria used by postdoctoral periodontal programs to help select applicants. Interview ratings, dental school grades, personal statements, and letters of recommendation were found to be the most important factors. Results from this study may be helpful for prospective postdoctoral periodontal program applicants in the United States.

Evaluation of AHRQ's on-time pressure ulcer prevention program: a facilitator-assisted clinical decision support intervention for nursing homes.

PubMed

Olsho, Lauren E W; Spector, William D; Williams, Christianna S; Rhodes, William; Fink, Rebecca V; Limcangco, Rhona; Hurd, Donna

2014-03-01

Pressure ulcers present serious health and economic consequences for nursing home residents. The Agency for Healthcare Research & Quality, in partnership with the New York State Department of Health, implemented the pressure ulcer module of On-Time Quality Improvement for Long Term Care (On-Time), a clinical decision support intervention to reduce pressure ulcer incidence rates. To evaluate the effectiveness of the On-Time program in reducing the rate of in-house-acquired pressure ulcers among nursing home residents. We employed an interrupted time-series design to identify impacts of 4 core On-Time program components on resident pressure ulcer incidence in 12 New York State nursing homes implementing the intervention (n=3463 residents). The sample was purposively selected to include nursing homes with high baseline prevalence and incidence of pressure ulcers and high motivation to reduce pressure ulcers. Differential timing and sequencing of 4 core On-Time components across intervention nursing homes and units enabled estimation of separate impacts for each component. Inclusion of a nonequivalent comparison group of 13 nursing homes not implementing On-Time (n=2698 residents) accounts for potential mean-reversion bias. Impacts were estimated via a random-effects Poisson model including resident-level and facility-level covariates. We find a large and statistically significant reduction in pressure ulcer incidence associated with the joint implementation of 4 core On-Time components (incidence rate ratio=0.409; P=0.035). Impacts vary with implementation of specific component combinations. On-Time implementation is associated with sizable reductions in pressure ulcer incidence.

Utilizing international medical graduates in health care delivery: brain drain, brain gain, or brain waste? A win-win approach at University of California, Los Angeles.

PubMed

Dowling, Patrick T; Bholat, Michelle Anne

2012-12-01

After identifying many unlicensed Hispanic international medical graduates (IMGs) legally residing in southern California, University of California, Los Angeles developed an innovative program to prepare these sidelined physicians to enter family medicine residency programs and become licensed physicians. On completion of a 3-year family medicine residency-training program, these IMGs have an obligation to practice in a federally designated underserved community in the state for 2 to 3 years. As the US health care system moves from physician-centered practices to patient-focused teams, with primary care serving as the foundation for building patient-centered medical homes, attention to educating IMGs in these concepts is crucial. Copyright © 2012 Elsevier Inc. All rights reserved.

Medical school and residency influence on choice of an academic career and academic productivity among neurosurgery faculty in the United States. Clinical article.

PubMed

Campbell, Peter G; Awe, Olatilewa O; Maltenfort, Mitchell G; Moshfeghi, Darius M; Leng, Theodore; Moshfeghi, Andrew A; Ratliff, John K

2011-08-01

Factors determining choice of an academic career in neurological surgery are unclear. This study seeks to evaluate the graduates of medical schools and US residency programs to determine those programs that produce a high number of graduates remaining within academic programs and the contribution of these graduates to academic neurosurgery as determined by h-index valuation. Biographical information from current faculty members of all accredited neurosurgery training programs in the US with departmental websites was obtained. Any individual who did not have an American Board of Neurological Surgery certificate (or was not board eligible) was excluded. The variables collected included medical school attended, residency program completed, and current academic rank. For each faculty member, Web of Science and Scopus h-indices were also collected. Ninety-seven academic neurosurgery departments with 986 faculty members were analyzed. All data regarding training program and medical school education were compiled and analyzed by center from which each faculty member graduated. The 20 medical schools and neurosurgical residency training programs producing the greatest number of graduates remaining in academic practice, and the respective individuals' h-indices, are reported. Medical school graduates of the Columbia University College of Physicians and Surgeons chose to enter academics the most frequently. The neurosurgery training program at the University of Pittsburgh produced the highest number of academic neurosurgeons in this sample. The use of quantitative measures to evaluate the academic productivity of medical school and residency graduates may provide objective measurements by which the subjective influence of training experiences on choice of an academic career may be inferred. The top 3 residency training programs were responsible for 10% of all academic neurosurgeons. The influence of medical school and residency experiences on choice of an academic career may be significant.

Assuring the research competence of orthopedic graduates.

PubMed

Konstantakos, Emmanuel K; Laughlin, Richard T; Markert, Ronald J; Crosby, Lynn A

2010-01-01

To assure that orthopaedic residents have the knowledge needed to critically appraise the medical/surgical literature and the skills needed to design and conduct musculoskeletal and orthopaedic research. Residency program of the Department of Orthopaedic Surgery, Sports Medicine and Rehabilitation at Wright State University Boonshoft School of Medicine, Dayton, Ohio. Established in 2005, members of the residency program's Research Team (RT) include orthopaedic faculty and residents, university faculty and graduate students, community scientists, and department staff. The membership and responsibilities of the Research Team are described. The goals of the three-month research rotation during the second year of residency and the activities of the assigned resident are reported. The work of the two research residents during the second year of their six-year program is explained. Helpful educational resources are noted, the role of the faculty research mentor defined, funding sources listed, and the financial support for RT members and research staff presented. The scholarly activity of orthopaedic surgery residents increased substantially from the five-year period before the implementation of the Research Team (September 2000 through August 2005) to the four-year period after initiation of the RT (September 2005 through November 2009). For peer-reviewed scholarship activity, publications on which residents were authors increased from 1 to 10 per year, national presentations at professional meetings increased from 6 to 11 per year, and local and regional presentations increased from 2 to 4 per year. The Research Team is an effective strategy for assuring that orthopaedic residents have the knowledge and skills to evaluate clinical care evidence and to conduct musculoskeletal and orthopaedic research. Copyright (c) 2010 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Psychotherapy Training for IMGs: Attending to the "How to" and "What to" Teach

ERIC Educational Resources Information Center

Weerasekera, Priyanthy

2012-01-01

International Medical Graduates (IMGs) make up a significant portion of the United States and Canadian workforce, and are well represented in psychiatry residency training programs. A review of the literature indicates that before entering residency training, many IMGs have minimal exposure to the behavioral sciences and poor communication…

Teaching evidence-based medicine: a regional dissemination model.

PubMed

Leipzig, Rosanne M; Wallace, Eleanor Z; Smith, Lawrence G; Sullivant, Jean; Dunn, Kathel; McGinn, Thomas

2003-01-01

Evidence-based medicine (EBM) is a framework for critically appraising medical literature and applying it to the care of individual patients. Lack of faculty skilled in practicing and teaching EBM limits the ability to train residents in this area. A 31/2-day interactive course, called Teaching Evidence-Based Medicine, was given in 1996, 1998, and 1999. The goal of the course was to create a cadre of faculty within New York State's internal medicine residency programs educated in EBM knowledge and skills who could integrate EBM into their training program. Thirty (58.8%) of 51 metropolitan New York internal medicine residency programs and three of 12 upstate programs sent participants. The postcourse ratings showed increased self-rated knowledge and a willingness to apply the teaching methods at their home institutions. There is a high demand for the opportunity to learn EBM skills and in turn to implement EBM at home institutions

Residents' experiences of abuse, discrimination and sexual harassment during residency training. McMaster University Residency Training Programs.

PubMed

Cook, D J; Liutkus, J F; Risdon, C L; Griffith, L E; Guyatt, G H; Walter, S D

1996-06-01

To assess the prevalence of psychological abuse, physical assault, and discrimination on the basis of gender and sexual orientation, and to examine the prevalence and impact of sexual harassment in residency training programs. Self-administered questionnaire. McMaster University, Hamilton, Ont. Residents in seven residency training programs during the academic year from July 1993 to June 1994. Of 225 residents 186 (82.7%) returned a completed questionnaire, and 50% of the respondents were women. Prevalence of psychological abuse, physical assault and discrimination on the basis of gender and sexual orientation experienced by residents during medical training, prevalence and residents' perceived frequency of sexual harassment. Psychological abuse was reported by 50% of the residents. Some of the respondents reported physical assault, mostly by patients and their family members (14.7% reported assaults by male patients and family members, 9.8% reported assaults by female patients and family members), 5.4% of the female respondents reported assault by male supervising physicians. Discrimination on the basis of gender was reported to be common and was experienced significantly more often by female residents than by male residents (p < 0.01). Ten respondents, all female, reported having experienced discrimination on the basis of their sexual orientation. Most of the respondents experienced sexual harassment, especially in the form of sexist jokes, flirtation and unwanted compliments on their dress or figure. On average, 40% of the respondents, especially women (p < 0.01), reported experiencing offensive body language and receiving sexist teaching material and unwanted compliments on their dress. Significantly more female respondents than male respondents stated that they had reported events of sexual harassment to someone (p < 0.001). The most frequent emotional reactions to sexual harassment were embarassment (reported by 24.0%), anger (by 23.4%) and frustration (20.8%). Psychological abuse, discrimination on the basis of gender and sexual harassment are commonly experienced by residents in training programs. A direct, progressive, multidisciplinary approach is needed to label and address these problems.

42 CFR 457.320 - Other eligibility standards.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., if the State is the State of residence of the child's custodial parent or caretaker at the time of... (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES State Plan... children related to— (1) Geographic area(s) served by the plan; (2) Age (up to, but not including, age 19...

42 CFR 457.320 - Other eligibility standards.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., if the State is the State of residence of the child's custodial parent or caretaker at the time of... (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES State Plan... children related to— (1) Geographic area(s) served by the plan; (2) Age (up to, but not including, age 19...

Nationwide survey of US integrated 6-year cardiothoracic surgical residents.

PubMed

Lebastchi, Amir H; Yuh, David D

2014-08-01

Integrated 6-year cardiothoracic surgical residency programs have recently been implemented in the United States. We report the results of the first published nationwide survey assessing the motivations, satisfaction, and ambitions of integrated 6-year residents. A 63-question web-based survey was distributed to 83 residents enrolled in 21 Accreditation Council for Graduate Medical Education-accredited integrated 6-year programs in November 2013. There was an outstanding 69% response rate. The median age of integrated 6-year residents was 29 years with women comprising 24%. A clear majority had faculty mentorship (95%) and significant clinical exposure in medical school. Focused (100%) and abbreviated (74%) training curricula were identified as the top advantages of integrated 6-year programs; the format itself was a significant factor (46%) in career choice. Most integrated 6-year residents (95%) were satisfied with their program; 80.7% were satisfied with their operative experience thus far. Career plans skewed toward adult cardiac surgery (67%), followed by pediatric cardiac (24%) and general thoracic (9%) surgery; 49% were not particularly concerned about future employment, with 65% foreseeing an increase in opportunities. Specialized training (eg, aortic, heart failure, minimally invasive, congenital) was anticipated by 77%. Most integrated 6-year residents envision an academic career (94.7%). This survey takes an important snapshot of the nascent integrated 6-year format. Mentorship and intense clinical exposure are critical in attracting applicants. Purported advantages of the format are holding true among integrated 6-year residents, with the majority satisfied with their programs. These early data indicate that this format holds significant promise in attracting and retaining highly qualified trainees to academic cardiothoracic surgery. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

Evaluation of an Evidence-Based Tobacco Treatment Curriculum for Psychiatry Residency Training Programs

PubMed Central

Prochaska, Judith J.; Fromont, Sebastien C.; Leek, Desiree; Hudmon, Karen Suchanek; Louie, Alan K.; Jacobs, Marc H.; Hall, Sharon M.

2009-01-01

Objective Smokers with mental illness and addictive disorders account for nearly one in two cigarettes sold in the United States and are at high risk for smoking-related deaths and disability. Psychiatry residency programs provide a unique arena for disseminating tobacco treatment guidelines, influencing professional norms, and increasing access to tobacco cessation services among smokers with mental illness. The current study evaluated the Rx for Change in Psychiatry curriculum, developed for psychiatry residency programs and focused on identifying and treating tobacco dependence among individuals with mental illness. Methods The 4-hour curriculum emphasized evidence-based, patient-oriented cessation treatments relevant for all tobacco users, including those not yet ready to quit. The curriculum was informed by comprehensive literature review, consultation with an expert advisory group, faculty interviews, and a focus group with psychiatry residents. This study reports on evaluation of the curriculum in 2005–2006, using a quasi-experimental design, with 55 residents in three psychiatry residency training programs in Northern California. Results The curriculum was associated with improvements in psychiatry residents’ knowledge, attitudes, confidence, and counseling behaviors for treating tobacco use among their patients, with initial changes from pre- to posttraining sustained at 3-months’ follow-up. Residents’ self-reported changes in treating patients’ tobacco use were substantiated through systematic chart review. Conclusion The evidence-based Rx for Change in Psychiatry curriculum is offered as a model tobacco treatment curriculum that can be implemented in psychiatry residency training programs and disseminated widely, thereby effectively reaching a vulnerable and costly population of smokers. PMID:19190293

Video Games to Augment Leisure Programming in a State Hospital Residence for Developmentally Disabled Clients.

ERIC Educational Resources Information Center

Powers, Janet; Ball, Thomas S.

1983-01-01

Three mildly and moderately retarded, physically handicapped institutionalized men (17-30 years old) successfully participated in a recreation program involving adapted videogames. Doubles play fostered cooperative social interaction between players. (CL)

42 CFR 483.10 - Resident rights.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., to refuse to participate in experimental research, and to formulate an advance directive as specified... advocacy groups such as the State survey and certification agency, the State licensure office, the State ombudsman program, the protection and advocacy network, and the Medicaid fraud control unit; and (iv) A...

42 CFR 483.10 - Resident rights.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., to refuse to participate in experimental research, and to formulate an advance directive as specified... advocacy groups such as the State survey and certification agency, the State licensure office, the State ombudsman program, the protection and advocacy network, and the Medicaid fraud control unit; and (iv) A...

Family medicine's search for manpower: the American Osteopathic Association accreditation option.

PubMed

Cummings, Mark; Kunkle, Judith L; Doane, Cheryl

2006-03-01

In recent years, family medicine has encountered problems recruiting and filling its Accreditation Council for Graduate Medical Education (ACGME)-accredited residencies. In addressing these reverses, one increasingly popular strategy has been to acquire American Osteopathic Association (AOA) accreditation as a way to tap into the growing number of osteopathic graduates. This stratagem is founded on assumptions that parallel-accredited postdoctoral programs are attractive to doctor of osteopathy (DO) graduates, that collaboration with sponsoring colleges of osteopathic medicine (COMs) provides direct access to osteopathic students, and that DOs can play an important role in replacing the increasing scarcity of United States medical graduates who are selecting specialty residencies. Within the past 5 years, nearly 10% of all ACGME family medicine residency programs have voluntarily obtained a second level of accreditation to also qualify as AOA-accredited family medicine residency programs. This strategy has produced mixed outcomes, as noted from the results of the osteopathic matching program. The flood of osteopathic graduates into these parallel-accredited programs has not occurred. In addition, recent AOA policy changes now require ACGME-accredited programs to make a deeper educational commitment to osteopathic postdoctoral education. The most successful ACGME/AOA-accredited programs have been those that are closely affiliated with and in near proximity of a COM and also train osteopathic students in required clerkship rotations.

An Update of Oral Health Curricula in US Family Medicine Residency Programs.

PubMed

Silk, Hugh; Savageau, Judith A; Sullivan, Kate; Sawosik, Gail; Wang, Min

2018-06-01

National initiatives have encouraged oral health training for family physicians and other nondental providers for almost 2 decades. Our national survey assesses progress of family medicine residency programs on this important health topic since our last survey in 2011. Family medicine residency program directors (PDs) completed an online survey covering various themes including number of hours of oral health (OH) teaching, topics covered, barriers, evaluation, positive influences, and program demographics. Compared to 2011, more PDs feel OH should be addressed by physicians (86% in 2017 vs 79% in 2011), yet fewer programs are teaching OH (81% vs 96%) with fewer hours overall (31% vs 45% with 4 or more hours). Satisfaction with the competence of graduating residents in OH significantly decreased (17% in 2017 vs 32% in 2011). Program directors who report graduates being well prepared to answer board questions on oral health topics are more likely to have an oral health champion (P<0.001) and report satisfaction with the graduates' level of oral health competency (P<0.001). Programs with an oral health champion, or having a relationship with a state or national oral health coalition, or having routine teaching from a dental professional are significantly more likely to have more hours of oral health curriculum (P<0.001). Family medicine PDs are more aware of the importance of oral health, yet less oral health is being taught in residency programs. Developing more faculty oral health champions and connecting programs to dental faculty and coalitions may help reduce this educational void.

Tracking Residents Through Multiple Residency Programs: A Different Approach for Measuring Residents' Rates of Continuing Graduate Medical Education in ACGME-Accredited Programs.

PubMed

Byrne, Lauren M; Holt, Kathleen D; Richter, Thomas; Miller, Rebecca S; Nasca, Thomas J

2010-12-01

Increased focus on the number and type of physicians delivering health care in the United States necessitates a better understanding of changes in graduate medical education (GME). Data collected by the Accreditation Council for Graduate Medical Education (ACGME) allow longitudinal tracking of residents, revealing the number and type of residents who continue GME following completion of an initial residency. We examined trends in the percent of graduates pursuing additional clinical education following graduation from ACGME-accredited pipeline specialty programs (specialties leading to initial board certification). Using data collected annually by the ACGME, we tracked residents graduating from ACGME-accredited pipeline specialty programs between academic year (AY) 2002-2003 and AY 2006-2007 and those pursuing additional ACGME-accredited training within 2 years. We examined changes in the number of graduates and the percent of graduates continuing GME by specialty, by type of medical school, and overall. The number of pipeline specialty graduates increased by 1171 (5.3%) between AY 2002-2003 and AY 2006-2007. During the same period, the number of graduates pursuing additional GME increased by 1059 (16.7%). The overall rate of continuing GME increased each year, from 28.5% (6331/22229) in AY 2002-2003 to 31.6% (7390/23400) in AY 2006-2007. Rates differed by specialty and for US medical school graduates (26.4% [3896/14752] in AY 2002-2003 to 31.6% [4718/14941] in AY 2006-2007) versus international medical graduates (35.2% [2118/6023] to 33.8% [2246/6647]). The number of graduates and the rate of continuing GME increased from AY 2002-2003 to AY 2006-2007. Our findings show a recent increase in the rate of continued training for US medical school graduates compared to international medical graduates. Our results differ from previously reported rates of subspecialization in the literature. Tracking individual residents through residency and fellowship programs provides a better understanding of residents' pathways to practice.

Availability of pediatric rheumatology training in United States pediatric residencies.

PubMed

Mayer, Michelle L; Brogan, Laura; Sandborg, Christy I

2006-12-15

To characterize the availability of pediatric rheumatology training in general pediatric residencies. We surveyed 195 pediatric residency program directors in the US using a combined Web-based and paper-based survey format. The survey asked directors about the availability of an on-site pediatric rheumatologist in their institution, the availability of formal pediatric rheumatology rotations, and the types of physicians involved in teaching curriculum components related to pediatric rheumatology. Survey responses were analyzed using descriptive and bivariate statistics. Of the 195 program directors surveyed, 127 (65%) responded. More than 40% of responding programs did not have a pediatric rheumatologist on site. Programs with on-site pediatric rheumatologists were significantly more likely than those without on-site pediatric rheumatologists to have an on-site pediatric rheumatology rotation available (94% versus 9%; P < 0.001). Although pediatric rheumatologists' involvement in 4 curriculum areas relevant to pediatric rheumatology is nearly universal in programs with on-site pediatric rheumatologists, nearly two-thirds of programs without on-site pediatric rheumatologists rely on internist rheumatologists, general pediatricians, or other physicians to cover these areas. Programs without pediatric rheumatologists on site are less likely to have pediatric rheumatology rotations and are more likely to rely on internist rheumatologists and nonrheumatologists to address rheumatology-related curriculum components. Lack of exposure to pediatric rheumatology during residency may impede general pediatricians' ability to identify and treat children with rheumatic diseases, undermine resident interest in this field, and perpetuate low levels of supply.

Illinois Small Community Tree Programs: Attitudes, Status, and Needs

Treesearch

Thomas L. Green; Timothy J. Howe; Herbert W. Schroeder

1998-01-01

In Illinois, 95% of the state's incorporated communities are classified as small (population less than 25,000), with approximately one-third of the state's citizens (3.6 million of 11.2 million) residing in these small communities. The objective of this survey was to obtain information on the status and needs of programs for managing public shade and street...

Whither the Pulmonary Ward Attending? Preserving Subspecialty Exposure in United States Internal Medicine Residency Training.

PubMed

Santhosh, Lekshmi; Babik, Jennifer; Looney, Mark R; Hollander, Harry

2017-04-01

Twenty years ago, the term "hospitalist" was coined at the University of California-San Francisco (San Francisco, CA), heralding a new specialty focused on the care of inpatients. There are now more than 50,000 hospitalists practicing in the United States. At many academic medical centers, hospitalists are largely replacing subspecialists as attendings on the inpatient medicine wards. At University of California-San Francisco, this has been accompanied by declining percentages of residency graduates who enter subspecialty training in internal medicine. The decline in subspecialty medicine interest can be attributed to many factors, including differences in compensation, decreased subspecialist exposure, and a changing research funding landscape. Although there has not been systematic documentation of this trend in pulmonary and critical care medicine, we have noted previously pulmonary and critical care-bound trainees switching to hospital medicine instead. With our broad, multiorgan system perspective, pulmonary and critical care faculty should embrace teaching general medicine. Residency programs have instituted creative solutions to encourage more internal medicine residents to pursue careers in subspecialty medicine. Some solutions include creating rotations that promote more contact with subspecialists and physician-scientists, creating clinician-educator tracks within fellowship programs, and appointing subspecialists to internal medicine residency leadership positions. We need more rigorous research to track the trends and implications of the generalist-specialist balance of inpatient ward teams on resident career choices, and learn what interventions affect those choices.

The state of pediatrics residency training: a period of transformation of graduate medical education.

PubMed

Sectish, Theodore C; Zalneraitis, Edwin L; Carraccio, Carol; Behrman, Richard E

2004-09-01

Graduate medical education is in a period of transformation. This article reviews the state of pediatrics residency training by summarizing the changing demographics within training programs, examining the new educational paradigm with an emphasis on competency-based education and continuous professional development, and describing forces influencing the workplace and the focus on work-life balance. Strategies are suggested for leaders in graduate medical education to meet the challenges experienced during this period of transformation.

Text messaging versus email for emergency medicine residents’ knowledge retention: a pilot comparison in the United States

PubMed Central

2016-01-01

We evaluated the effectiveness of text messaging versus email, as a delivery method to enhance knowledge retention of emergency medicine (EM) content in EM residents. We performed a multi-centered, prospective, randomized study consisting of postgraduate year (PGY) 1 to PGY 3 & 4 residents in three United States EM residency programs in 2014. Fifty eight residents were randomized into one delivery group: text message or email. Participants completed a 40 question pre- and post-intervention exam. Primary outcomes were the means of pre- and post-intervention exam score differences. Data were analyzed using descriptive statistics, paired t-test, and multiple linear regressions. No significant difference was found between the primary outcomes of the two groups (P=0.51). PGY 2 status had a significant negative effect (P=0.01) on predicted exam score difference. Neither delivery method enhanced resident knowledge retention. Further research on implementation of mobile technology in residency education is required. PMID:27780350

Integrated Behavioral Health Care in Family Medicine Residencies A CERA Survey.

PubMed

Jacobs, Christine; Brieler, Jay A; Salas, Joanne; Betancourt, Renée M; Cronholm, Peter F

2018-05-01

Behavioral health integration (BHI) in primary care settings is critical to mental health care in the United States. Family medicine resident experience in BHI in family medicine residency (FMR) continuity clinics is essential preparation for practice. We surveyed FMR program directors to characterize the status of BHI in FMR training. Using the Council of Academic Family Medicine Educational Research Alliance (CERA) 2017 survey, FMR program directors (n=478, 261 respondents, 54.6% response rate) were queried regarding the stage of BHI within the residency family medicine center (FMC), integration activities at the FMC, and the professions of the BH faculty. BHI was characterized by Substance Abuse and Mental Health Services Agency (SAMHSA) designations within FMRs, and chi-square or ANOVA with Tukey honest significant difference (HSD) post hoc testing was used to assess differences in reported BHI attributes. Program directors reported a high level of BHI in their FMCs (44.1% full integration, 33.7% colocated). Higher levels of BHI were associated with increased use of warm handoffs, same day consultation, shared health records, and the use of behavioral health (BH) professionals for both mental health and medical issues. Family physicians, psychiatrists, and psychologists were most likely to be training residents in BHI. Almost half of FMR programs have colocated BH care or fully integrated BH as defined by SAMHSA. Highly integrated FMRs use a diversity of behavioral professionals and activities. Residencies currently at the collaboration stage could increase BH provider types and BHI practices to better prepare residents for practice. Residencies with full BHI may consider focusing on supporting BHI-trained residents transitioning into practice, or disseminating the model in the general primary care community.

An Analysis of the Effects of Program Structure and Content on Outcomes of Community Leadership Education Programs

ERIC Educational Resources Information Center

Apaliyah, Godwin Tayese

2011-01-01

This study examined community leadership education programs employed in rural communities and organizations of several states to empower both local leaders and residents. In particular, the study investigated the relationships between community leadership education program design and structure (contact hours and content) and six outcome indices of…

The Extended Family: An Educational Program for the Seasonal and Migrant Farm Worker.

ERIC Educational Resources Information Center

Roeske, C. Edward

This paper describes the University of Tennessee's High School Equivalency Program (HEP), one of 21 programs throughout the United States aimed at assisting seasonal and migrant farm workers in improving their level of employment and education. For the first 4 years, the University of Tennessee's HEP was a campus-based residency program, but in…

Commentary: Flexner Redux 2010: graduate medical education in the United States.

PubMed

Whitcomb, Michael E

2009-11-01

The author posits that if Abraham Flexner could be brought back to write a report to address the same question that his 1910 report answered-How are doctors being prepared for practice?-he would not focus on the state of medical students' education, because today's medical students no longer enter practice on graduation from medical school. Instead, he would ask how the country's graduate medical education (GME) system is preparing residents for clinical practice. Such a report is needed because (as concluded by a variety of sources, including recent reports by the Institute of Medicine) GME training must be changed as part of the effort to improve medical care quality. Despite this finding, professional organizations that regulate how GME is designed and conducted have been unwilling to make substantive changes in the ways residents are being prepared for practice. The author reviews the reasons for this, emphasizes the need for a new Flexner-type report to make the public aware of the training deficiencies so the public could exert pressure on government officials to take action, describes groups that have already recognized the problem and proposed solutions (such as having individual programs held accountable for their residents' performance in practice), and makes recommendations, such as (1) having the Medicare program, the single largest payer of GME costs, require certain needed reforms in residents' training, and (2) modernizing state laws so that residents completing training would have to demonstrate that they are adequately prepared to enter practice before being granted licenses.

Program Characteristics Influencing Allopathic Students' Residency Selection.

PubMed

Stillman, Michael D; Miller, Karen Hughes; Ziegler, Craig H; Upadhyay, Ashish; Mitchell, Charlene K

2016-04-01

Medical students must consider many overt variables when entering the National Resident Matching Program. However, changes with the single graduate medical education accreditation system have caused a gap in knowledge about more subtle considerations, including what, if any, influence the presence of osteopathic physician (ie, DO) and international medical graduate (IMG) house officers has on allopathic students' residency program preferences. Program directors and selection committee members may assume students' implicit bias without substantiating evidence. To reexamine which program characteristics affect US-trained allopathic medical students' residency selection, and to determine whether the presence of DO and IMG house officers affects the program choices of allopathic medical students. Fourth-year medical students from 4 allopathic medical schools completed an online survey. The Pearson χ(2) statistic was used to compare demographic and program-specific traits that influence ranking decisions and to determine whether school type (private vs public), valuing a residency program's prestige, or interest in a competitive specialty dictated results. Qualitative data were analyzed using the Pandit variation of the Glaser and Strauss constant comparison. Surveys were completed by 323 of 577 students (56%). Students from private vs public institutions were more likely to value a program's prestige (160 [93%] vs 99 [72%]; P<.001) and research opportunities (114 [66%] vs 57 [42%]; P<.001), and they were less likely to consider their prospects of being accepted (98 [57%] vs 111 [81%]; P<.001). A total of 33 (10%) and 52 (16%) students reported that the presence of DO or IMG trainees, respectively, would influence their final residency selection, and these percentages were largely unchanged among students interested in programs' prestige or in entering a competitive specialty. Open-ended comments were generally optimistic about diversification of the physician workforce, and 4 of the 709 student comments expressed cynicism or hostility to the presence of DOs or IMGs. Both overt and subtle variables influence students' perceptions of residency programs in the United States, but the presence of DO and IMG house officers seems relevant to a small percentage of them.

Training in Tobacco Treatments in Psychiatry: A National Survey of Psychiatry Residency Training Directors

ERIC Educational Resources Information Center

Prochaska, Judith J.; Fromont, Sebastien C.; Louie, Alan K.; Jacobs, Marc H.; Hall, Sharon M.

2006-01-01

Objective: Nicotine dependence is the most prevalent substance abuse disorder among adult psychiatric patients and is a leading cause of death and disability. This study examines training in tobacco treatment in psychiatry residency programs across the United States. Method: The authors recruited training directors to complete a survey of their…

Employment Selections of Resident and Non-Resident Graduates of Physical Therapy Programs in Underserved Western States

ERIC Educational Resources Information Center

Swart, Kathryn D.

2011-01-01

Background and Purpose: Physical therapy (PT) is an essential component of the healthcare system in providing a comprehensive treatment plan for patients with functional limitations. The demand for physical therapy services is projected to expand in the next eight years, leading to an increased need for practicing physical therapists. The Mountain…

The Current State of Genetics Training in Psychiatric Residency: Views of 235 U.S. Educators and Trainees

ERIC Educational Resources Information Center

Hoop, Jinger G.; Savla, Gauri; Roberts, Laura Weiss; Zisook, Sidney; Dunn, Laura B.

2010-01-01

Objective: As researchers make progress in understanding genetic aspects of mental illness and its treatment, psychiatrists will increasingly need to understand and interpret genetic information specific to psychiatric disorders. Little is known about the extent to which residency programs are preparing psychiatrists for this new role. This study…

"Taking Training to the Next Level": The American College of Surgeons Committee on Residency Training Survey.

PubMed

Damewood, Richard B; Blair, Patrice Gabler; Park, Yoon Soo; Lupi, Linda K; Newman, Rachel Williams; Sachdeva, Ajit K

The American College of Surgeons (ACS) appointed a committee of leaders from the ACS, Association of Program Directors in Surgery, Accreditation Council for Graduate Medical Education, and American Board of Surgery to define key challenges facing surgery resident training programs and to explore solutions. The committee wanted to solicit the perspectives of surgery resident program directors (PDs) given their pivotal role in residency training. Two surveys were developed, pilot tested, and administered to PDs following Institutional Review Board approval. PDs from 247 Accreditation Council for Graduate Medical Education-accredited general surgery programs were randomized to receive 1 of the 2 surveys. Bias analyses were conducted, and adjusted Pearson χ 2 tests were used to test for differences in response patterns by program type and size. All accredited general surgery programs in the United States were included in the sampling frame of the survey; 10 programs with initial or withdrawn accreditation were excluded from the sampling frame. A total of 135 PDs responded, resulting in a 54.7% response rate (Survey A: n = 67 and Survey B: n = 68). The respondent sample was determined to be representative of program type and size. Nearly 52% of PD responses were from university-based programs, and 41% had over 6 residents per graduating cohort. More than 61% of PDs reported that, compared to 10 years ago, both entering and graduating residents are less prepared in technical skills. PDs expressed significant concerns regarding the effect of duty-hour restrictions on the overall preparation of graduating residents (61%) and quality of patient care (57%). The current 5-year training structure was viewed as needing a significant or extensive increase in opportunities for resident autonomy (63%), and the greatest barriers to resident autonomy were viewed to be patient preferences not to be cared for by residents (68%), liability concerns (68%), and Centers for Medicare and Medicaid Services regulations (65%). Although 64% of PDs believe that moderate or significant changes are needed in the current structure of residency training, 35% believe that no changes in the structure are needed. When asked for their 1 best recommendation regarding the structure of surgical residency, only 22% of PDs selected retaining the current 5-year structure. The greatest percentage of PDs (28%) selected the "4 + 2" model as their 1 best recommendation for the structure to be used. In the area of faculty development, 56% of PDs supported a significant or extensive increase in Train the Teacher programs, and 41% supported a significant or extensive increase in faculty certification in education. Information regarding the valuable perspectives of PDs gathered through these surveys should help in implementing important changes in residency training and faculty development. These efforts will need to be pursued collaboratively with involvement of key stakeholders, including the organizations represented on this ACS committee. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

SSI recipients in domiciliary care facilities: federally administered optional supplementation, March 1976.

PubMed

Kochhar, S

1977-12-01

Under the supplemental security income program, federally administered payments amounting to $24.7 million were made in March 1976 to 107,000 persons who were residing in domiciliary care facilities and under other supervised living arrangements. These persons were unable to function under totally independent living arrangements but did not require medical or nursing care on a regular basis. Of the total, $9.5 million was represented in Federal SSI payments and $15.2 million came from optional State supplements--with California paying $6.2 million and New York $4.6 million. The average payment to the residents of these facilities was $232 a month. Comparable data for four States show greater caseload growth for persons in domiciliary care facilities and under other supervised living arrangements than for the total SSI population. Nearly two-thirds of the States are adding funds to Federal SSI payments for persons under such care. Data are available, however, only from Social Security Administration program records for those States that have elected Federal administration of their optional programs.

Career interest and perceptions of nephrology: A repeated cross-sectional survey of internal medicine residents.

PubMed

Daniels, Michael N; Maynard, Sharon; Porter, Ivan; Kincaid, Hope; Jain, Deepika; Aslam, Nabeel

2017-01-01

Interest in nephrology careers among internal medicine residents in the United States is declining. Our objective was to assess the impact of the presence of a nephrology fellowship training program on perceptions and career interest in nephrology among internal medicine residents. A secondary objective was to identify commonly endorsed negative perceptions of nephrology among internal medicine residents. This was a repeated cross-sectional survey of internal medicine residents before (Group 1) and 3 years after (Group 2) the establishment of nephrology fellowship programs at two institutions. The primary outcome was the percentage of residents indicating nephrology as a career interest in Group 1 vs. Group 2. Secondary outcomes included the frequency that residents agreed with negative statements about nephrology. 131 (80.9%) of 162 residents completed the survey. 19 (14.8%) residents indicated interest in a nephrology career, with 8 (6.3%) indicating nephrology as their first choice. There was no difference in career interest in nephrology between residents who were exposed to nephrology fellows during residency training (Group 2) and residents who were not (Group 1). The most commonly endorsed negative perceptions of nephrology were: nephrology fellows have long hours/burdensome call (36 [28.1%] of residents agreed or strongly agreed), practicing nephrologists must take frequent/difficult call (35 [27.6%] agreed or strongly agreed), and nephrology has few opportunities for procedures (35 [27.3%] agreed or strongly agreed). More residents in Group 2 agreed that nephrology is poorly paid (8.9% in Group 1 vs. 20.8% in Group 2, P = 0.04), whereas more residents in Group 1 agreed that nephrologists must take frequent/difficult call (40.0% in Group 1 vs. 18.1% in Group 2, P = 0.02). The initiation of a nephrology fellowship program was not associated with an increase in internal medicine residents' interest in nephrology careers. Residents endorsed several negative perceptions of nephrology, which may affect career choice.

A Novel Tool for Assessment of Emergency Medicine Resident Skill in Determining Diagnosis and Management for Emergent Electrocardiograms: A Multicenter Study.

PubMed

Hartman, Nicholas D; Wheaton, Natasha B; Williamson, Kelly; Quattromani, Erin N; Branzetti, Jeremy B; Aldeen, Amer Z

2016-12-01

Reading emergent electrocardiograms (ECGs) is one of the emergency physician's most crucial tasks, yet no well-validated tool exists to measure resident competence in this skill. To assess validity of a novel tool measuring emergency medicine resident competency for interpreting, and responding to, critical ECGs. In addition, we aim to observe trends in this skill for resident physicians at different levels of training. This is a multi-center, prospective study of postgraduate year (PGY) 1-4 residents at five emergency medicine (EM) residency programs in the United States. An assessment tool was created that asks the physician to identify either the ECG diagnosis or the best immediate management. One hundred thirteen EM residents from five EM residency programs submitted completed assessment surveys, including 43 PGY-1s, 33 PGY-2s, and 37 PGY-3/4s. PGY-3/4s averaged 74.6% correct (95% confidence interval [CI] 70.9-78.4) and performed significantly better than PGY-1s, who averaged 63.2% correct (95% CI 58.0-68.3). PGY-2s averaged 69.0% (95% CI 62.2-73.7). Year-to-year differences were more pronounced in management than in diagnosis. Residency training in EM seems to be associated with improved ability to interpret "critical" ECGs as measured by our assessment tool. This lends validity evidence for the tool by correlating with a previously observed association between residency training and improved ECG interpretation. Resident skill in ECG interpretation remains less than ideal. Creation of this sort of tool may allow programs to assess resident performance as well as evaluate interventions designed to improve competency. Copyright © 2016 Elsevier Inc. All rights reserved.

Resident duty hours: a survey of internal medicine program directors.

PubMed

Garg, Megha; Drolet, Brian C; Tammaro, Dominick; Fischer, Staci A

2014-10-01

In 2011, the Accreditation Council for Graduate Medical Education (ACGME) implemented new Common Program Requirements to regulate duty hours of resident physicians, with three goals: improved patient safety, quality of resident education and quality of life for trainees. We sought to assess Internal Medicine program director (IMPD) perceptions of the 2011 Common Program Requirements in July 2012, one year following implementation of the new standards. A cross-sectional study of all IMPDs at ACGME-accredited programs in the United States (N = 381) was performed using a 32-question, self-administered survey. Contact information was identified for 323 IMPDs. Three individualized emails were sent to each director over a 6-week period, requesting participation in the survey. Outcomes measured included approval of duty hours regulations, as well as perceptions of changes in graduate medical education and patient care resulting from the revised ACGME standards. A total of 237 surveys were returned (73% response rate). More than half of the IMPDs (52%) reported "overall" approval of the 2011 duty hour regulations, with greater than 70% approval of all individual regulations except senior resident daily duty periods (49% approval) and 16-hour intern shifts (17% approval). Although a majority feel resident quality of life has improved (55%), most IMPDs believe that resident education (60%) is worse. A minority report that quality (8%) or safety (11%) of patient care has improved. One year after implementation of new ACGME duty hour requirements, IMPDs report overall approval of the standards, but strong disapproval of 16-hour shift limits for interns. Few program directors perceive that the duty hour restrictions have resulted in better care for patients or education of residents. Although resident quality of life seems improved, most IMPDs report that their own workload has increased. Based on these results, the intended benefits of duty hour regulations may not yet have been realized.

The current and ideal state of mental health training: pediatric resident perspectives.

PubMed

Hampton, Elisa; Richardson, Joshua E; Bostwick, Susan; Ward, Mary J; Green, Cori

2015-01-01

PHENOMENON: Mental health (MH) problems are prevalent in the pediatric population, and in a setting of limited resources, pediatricians need to provide MH care in the primary medical home yet are uncomfortable doing so citing a lack of training during residency as one barrier. The purpose of this study is to describe pediatric residents' experiences and perspectives on the current and ideal states of MH training and ideas for curriculum development to bridge this gap. A qualitative study using focus groups of pediatric residents from an urban academic medical center was performed. Audio recordings were transcribed and analyzed using a grounded theory approach. Twenty-six residents participated in three focus groups, which is when thematic saturation was achieved. The team generated five major themes: capabilities, comfort, organizational capacity, coping, and education. Residents expressed uncertainty at every step of an MH visit. Internal barriers identified included low levels of comfort and negative emotional responses. External barriers included a lack of MH resources and mentorship in MH care, or an inadequate organizational capacity. These internal and external barriers resulted in a lack of perceived capability in handling MH issues. In response, residents reported inadequate coping strategies, such as ignoring MH concerns. To build knowledge and skills, residents prefer educational modalities including didactics, experiential learning through collaborations with MH specialists, and tools built into patient care flow. Insights: Pediatric residency programs need to evolve in order to improve resident training in MH care. The skills and knowledge requested by residents parallel the American Academy of Pediatrics statement on MH competencies. Models of collaborative care provide similar modalities of learning requested by residents. These national efforts have not been operationalized in training programs yet may be useful for curriculum development and dissemination to enhance trainees' MH knowledge and skills to provide optimal MH care for children.

Medical-Legal Partnership: Collaborating with Lawyers to Identify and Address Health Disparities

PubMed Central

Cohen, Ellen; Fullerton, Danya Fortess; Retkin, Randye; Weintraub, Dana; Tames, Pamela; Brandfield, Julie

2010-01-01

Introduction Medical-legal partnerships (MLPs) bring together medical professionals and lawyers to address social causes of health disparities, including access to adequate food, housing and income. Setting Eighty-one MLPs offer legal services for patients whose basic needs are not being met. Program Description Besides providing legal help to patients and working on policy advocacy, MLPs educate residents (29 residency programs), health care providers (160 clinics and hospitals) and medical students (25 medical schools) about how social conditions affect health and screening for unmet basic needs, and how these needs can often be impacted by enforcing federal and state laws. These curricula include medical school courses, noon conferences, advocacy electives and CME courses. Program Evaluation Four example programs are described in this paper. Established MLPs have changed knowledge (MLP | Boston—97% reported screening for two unmet needs), attitudes (Stanford reported reduced concern about making patients “nervous” with legal questions from 38% to 21%) and behavior (NY LegalHealth reported increasing resident referrals from 15% to 54%) after trainings. One developing MLP found doctors experienced difficulty addressing social issues (NJ LAMP—67% of residents felt uncomfortable). Discussion MLPs train residents, students and other health care providers to tackle socially caused health disparities. PMID:20352508

Current Status of Nutrition Training in Graduate Medical Education From a Survey of Residency Program Directors: A Formal Nutrition Education Course Is Necessary.

PubMed

Daley, Brian J; Cherry-Bukowiec, Jill; Van Way, Charles W; Collier, Bryan; Gramlich, Leah; McMahon, M Molly; McClave, Stephen A

2016-01-01

Nutrition leaders surmised graduate medical nutrition education was not well addressed because most medical and surgical specialties have insufficient resources to teach current nutrition practice. A needs assessment survey was constructed to determine resources and commitment for nutrition education from U.S. graduate medical educators to address this problem. An online survey of 36 questions was sent to 495 Accreditation Council for Graduate Medical Education (ACGME) Program Directors in anesthesia, family medicine, internal medicine, pediatrics, obstetrics/gynecology, and general surgery. Demographics, resources, and open-ended questions were included. There was a 14% response rate (72 programs), consistent with similar studies on the topic. Most (80%) of the program directors responding were from primary care programs, the rest surgical (17%) or anesthesia (3%). Program directors themselves lacked knowledge of nutrition. While some form of nutrition education was provided at 78% of programs, only 26% had a formal curriculum and physicians served as faculty at only 53%. Sixteen programs had no identifiable expert in nutrition and 10 programs stated that no nutrition training was provided. Training was variable, ranging from an hour of lecture to a month-long rotation. Seventy-seven percent of program directors stated that the required educational goals in nutrition were not met. The majority felt an advanced course in clinical nutrition should be required of residents now or in the future. Nutrition education in current graduate medical education is poor. Most programs lack the expertise or time commitment to teach a formal course but recognize the need to meet educational requirements. A broad-based, diverse universal program is needed for training in nutrition during residency. © 2015 American Society for Parenteral and Enteral Nutrition.

Career interest and perceptions of nephrology: A repeated cross-sectional survey of internal medicine residents

PubMed Central

Daniels, Michael N.; Porter, Ivan; Kincaid, Hope; Jain, Deepika; Aslam, Nabeel

2017-01-01

Background Interest in nephrology careers among internal medicine residents in the United States is declining. Our objective was to assess the impact of the presence of a nephrology fellowship training program on perceptions and career interest in nephrology among internal medicine residents. A secondary objective was to identify commonly endorsed negative perceptions of nephrology among internal medicine residents. Methods This was a repeated cross-sectional survey of internal medicine residents before (Group 1) and 3 years after (Group 2) the establishment of nephrology fellowship programs at two institutions. The primary outcome was the percentage of residents indicating nephrology as a career interest in Group 1 vs. Group 2. Secondary outcomes included the frequency that residents agreed with negative statements about nephrology. Results 131 (80.9%) of 162 residents completed the survey. 19 (14.8%) residents indicated interest in a nephrology career, with 8 (6.3%) indicating nephrology as their first choice. There was no difference in career interest in nephrology between residents who were exposed to nephrology fellows during residency training (Group 2) and residents who were not (Group 1). The most commonly endorsed negative perceptions of nephrology were: nephrology fellows have long hours/burdensome call (36 [28.1%] of residents agreed or strongly agreed), practicing nephrologists must take frequent/difficult call (35 [27.6%] agreed or strongly agreed), and nephrology has few opportunities for procedures (35 [27.3%] agreed or strongly agreed). More residents in Group 2 agreed that nephrology is poorly paid (8.9% in Group 1 vs. 20.8% in Group 2, P = 0.04), whereas more residents in Group 1 agreed that nephrologists must take frequent/difficult call (40.0% in Group 1 vs. 18.1% in Group 2, P = 0.02). Conclusions The initiation of a nephrology fellowship program was not associated with an increase in internal medicine residents’ interest in nephrology careers. Residents endorsed several negative perceptions of nephrology, which may affect career choice. PMID:28207893

[Current status of urological training in Latin America.

PubMed

Angulo, Javier C; Figueroa, Carlos; Gómez, Reynaldo; Martins, Francisco; Corrales, Juan Guillermo; Secin, Fernando; López-Secchi, Gerardo; León, Antonio; Torrico, Marcelo; Reis, Leonardo O; Plata, Mauricio; Sotomayor, Mariano; Gutiérrez-Aceves, Jorge

2018-01-01

Achieving residents' medical training of quality is a constant concern in the Confederación Americana de Urología (CAU), the third Urological Society worldwide. We aim to analyze the diversity of state training programs, with the intention to identify opportunities for global improvement within them and also to analyse the professional reality in different countries. Data from 2nd and 3rd Foro Educativo CAU regarding postgraduate training and labour implications are reviewed. This information is complemented by the opinion of representatives involved with the academic training in Confederación Americana de Urología, who have analyzed the reality and current status of the urological training through a 10-question survey that describes different aspects of residency program in the countries confederated in CAU. A total of 3,000 graduate doctors train as residents in Urology at the CAU environment. Each year 670 residents begin their training program in Latin America, Spain and Portugal, a territory that serves nearly 650 million people, with an active professional force of around 16.800 professionals. Detailed data on training, employment and supporting reality in the countries that comprise the CAU are presented. We also discuss the proportion of residents who carry out research and doctorate during the residency program. Finally, we examine the proportion of professionals who receive specific training at the end of their residence, the relative importance of this training and what are the most popular environments to carry it out. Current postgraduate training in CAU environment is heterogeneous in their programs, as well as in the modes of accreditation and recertification. Academic activities do not seem to be properly valued. However, specific training offers better expectations of professional development.

Testing transferability of willingness to pay for forest fire prevention among three states of California, Florida and Montana

Treesearch

John B. Loomis; Hung Trong Le; Armando Gonzalez-Caban

2005-01-01

The equivalency of willingness to pay between the states of California, Florida and Montana is tested. Residents in California, Florida and Montana have an average willingness to pay of $417, $305, and $382 for prescribed burning program, and $403, $230, and $208 for mechanical fire fuel reduction program, respectively. Due to wide confidence intervals, household WTP...

Variability in spine surgery procedures performed during orthopaedic and neurological surgery residency training: an analysis of ACGME case log data.

PubMed

Daniels, Alan H; Ames, Christopher P; Smith, Justin S; Hart, Robert A

2014-12-03

Current spine surgeon training in the United States consists of either an orthopaedic or neurological surgery residency, followed by an optional spine surgery fellowship. Resident spine surgery procedure volume may vary between and within specialties. The Accreditation Council for Graduate Medical Education surgical case logs for graduating orthopaedic surgery and neurosurgery residents from 2009 to 2012 were examined and were compared for spine surgery resident experience. The average number of reported spine surgery procedures performed during residency was 160.2 spine surgery procedures performed by orthopaedic surgery residents and 375.0 procedures performed by neurosurgery residents; the mean difference of 214.8 procedures (95% confidence interval, 196.3 to 231.7 procedures) was significant (p = 0.002). From 2009 to 2012, the average total spinal surgery procedures logged by orthopaedic surgery residents increased 24.3% from 141.1 to 175.4 procedures, and those logged by neurosurgery residents increased 6.5% from 367.9 to 391.8 procedures. There was a significant difference (p < 0.002) in the average number of spinal deformity procedures between graduating orthopaedic surgery residents (9.5 procedures) and graduating neurosurgery residents (2.0 procedures). There was substantial variability in spine surgery exposure within both specialties; when comparing the top 10% and bottom 10% of 2012 graduates for spinal instrumentation or arthrodesis procedures, there was a 13.1-fold difference for orthopaedic surgery residents and an 8.3-fold difference for neurosurgery residents. Spine surgery procedure volumes in orthopaedic and neurosurgery residency training programs vary greatly both within and between specialties. Although orthopaedic surgery residents had an increase in the number of spine procedures that they performed from 2009 to 2012, they averaged less than half of the number of spine procedures performed by neurological surgery residents. However, orthopaedic surgery residents appear to have greater exposure to spinal deformity than neurosurgery residents. Furthermore, orthopaedic spine fellowship training provides additional spine surgery case exposure of approximately 300 to 500 procedures; thus, before entering independent practice, when compared with neurosurgery residents, most orthopaedic spine surgeons complete as many spinal procedures or more. Although case volume is not the sole determinant of surgical skills or clinical decision making, variability in spine surgery procedure volume does exist among residency programs in the United States. Copyright © 2014 by The Journal of Bone and Joint Surgery, Incorporated.

Can the introduction of a full-service supermarket in a food desert improve residents' economic status and health?

PubMed

Richardson, Andrea S; Ghosh-Dastidar, Madhumita; Beckman, Robin; Flórez, Karen R; DeSantis, Amy; Collins, Rebecca L; Dubowitz, Tamara

2017-12-01

To estimate the impacts of a new supermarket in a low-income desert, on residents' economic status and health. We surveyed a randomly selected cohort in two low-income Pittsburgh neighborhoods before and about 1 year following the opening of a supermarket. We used difference-in-difference approach to test changes across the two neighborhoods in residents' food security, United States Department of Agriculture Supplemental Nutrition Assistance Program and Special Supplemental Nutrition Program for Women Infant and Children participation, employment, income, and self-reported health/chronic disease diagnoses. We observed declines in food insecurity (-11.8%, P < .01), Supplemental Nutrition Assistance Program participation (-12.2%, P < .01), and fewer new diagnoses of high cholesterol (-9.6%, P = .01) and arthritis (-7.4%, P = .02) in the neighborhood with the new supermarket relative to residents of the comparison neighborhood. We also found suggestive evidence that residents' incomes increased more ($1550, P = .09) and prevalence of diabetes increased less in the neighborhood with the supermarket than in the comparison neighborhood (-3.6%, P = .10). Locating a new supermarket in a low-income neighborhood may improve residents' economic well-being and health. Policymakers should consider broad impacts of neighborhood investment that could translate into improved health for residents of underserved neighborhoods. Copyright © 2017 Elsevier Inc. All rights reserved.

The resident-as-teacher educational challenge: a needs assessment survey at the National Autonomous University of Mexico Faculty of Medicine.

PubMed

Sánchez-Mendiola, Melchor; Graue-Wiechers, Enrique L; Ruiz-Pérez, Leobardo C; García-Durán, Rocío; Durante-Montiel, Irene

2010-02-16

The role of residents as educators is increasingly recognized, since it impacts residents, interns, medical students and other healthcare professionals. A widespread implementation of resident-as-teacher courses in developed countries' medical schools has occurred, with variable results. There is a dearth of information about this theme in developing countries. The National Autonomous University of Mexico (UNAM) Faculty of Medicine has more than 50% of the residency programs' physician population in Mexico. This report describes a needs assessment survey for a resident as teacher program at our institution. A cross-sectional descriptive survey was developed based on a review of the available literature and discussion by an expert multidisciplinary committee. The goal was to identify the residents' attitudes, academic needs and preferred educational strategies regarding resident-as-teacher activities throughout the residency. The survey was piloted and modified accordingly. The paper anonymous survey was sent to 7,685 residents, the total population of medical residents in UNAM programs in the country. There was a 65.7% return rate (5,186 questionnaires), a broad and representative sample of the student population. The residents felt they had knowledge and were competent in medical education, but the majority felt a need to improve their knowledge and skills in this discipline. Most residents (92.5%) felt that their role as educators of medical students, interns and other residents was important/very important. They estimated that 45.5% of their learning came from other residents. Ninety percent stated that it was necessary to be trained in teaching skills. The themes identified to include in the educational intervention were mostly clinically oriented. The educational strategies in order of preference were interactive lectures with a professor, small groups with a moderator, material available in a website for self-learning, printed material for self-study and homework, and small group web-based learning. There is a large unmet need to implement educational interventions to improve residents' educational skills in postgraduate educational programs in developing countries. Most perceived needs of residents are practical and clinically oriented, and they prefer traditional educational strategies. Resident as teachers educational interventions need to be designed taking into account local needs and resources.

The resident-as-teacher educational challenge: a needs assessment survey at the National Autonomous University of Mexico Faculty of Medicine

PubMed Central

2010-01-01

Background The role of residents as educators is increasingly recognized, since it impacts residents, interns, medical students and other healthcare professionals. A widespread implementation of resident-as-teacher courses in developed countries' medical schools has occurred, with variable results. There is a dearth of information about this theme in developing countries. The National Autonomous University of Mexico (UNAM) Faculty of Medicine has more than 50% of the residency programs' physician population in Mexico. This report describes a needs assessment survey for a resident as teacher program at our institution. Methods A cross-sectional descriptive survey was developed based on a review of the available literature and discussion by an expert multidisciplinary committee. The goal was to identify the residents' attitudes, academic needs and preferred educational strategies regarding resident-as-teacher activities throughout the residency. The survey was piloted and modified accordingly. The paper anonymous survey was sent to 7,685 residents, the total population of medical residents in UNAM programs in the country. Results There was a 65.7% return rate (5,186 questionnaires), a broad and representative sample of the student population. The residents felt they had knowledge and were competent in medical education, but the majority felt a need to improve their knowledge and skills in this discipline. Most residents (92.5%) felt that their role as educators of medical students, interns and other residents was important/very important. They estimated that 45.5% of their learning came from other residents. Ninety percent stated that it was necessary to be trained in teaching skills. The themes identified to include in the educational intervention were mostly clinically oriented. The educational strategies in order of preference were interactive lectures with a professor, small groups with a moderator, material available in a website for self-learning, printed material for self-study and homework, and small group web-based learning. Conclusions There is a large unmet need to implement educational interventions to improve residents' educational skills in postgraduate educational programs in developing countries. Most perceived needs of residents are practical and clinically oriented, and they prefer traditional educational strategies. Resident as teachers educational interventions need to be designed taking into account local needs and resources. PMID:20156365

How can a successful multi-family residential recycling programme be initiated within Baltimore City, Maryland?

PubMed

Schwebel, Michael B

2012-07-01

Baltimore City formally began recycling in 1989 with all neighbourhoods having residential collection by 1992. Although the city of 637 000 has recycled for approximately 20 years, almost all residents in multi-family residential (MFR) housing have been and are still barred from participating at their residences. Discussions with City officials and residents have verified this antiquated policy of exclusion within MFR housing. Yet, the policy is still observed by the Department of Public Works even though the updated single-stream Code states that the 'Director of Public Works must collect all. . .recyclable materials. . .from all dwellings, including multiple-family dwellings'. The purpose of this study's is to provide policies, regulations, and recommendations for implementing requisite MFR recycling within Baltimore City. The study's methodology follows a case study approach by examining three cities in the United States that currently mandate MFR recycling: Chicago, Illinois; Boston, Massachusetts; and Arlington, Virginia. Post-analysis suggests that while some cities' MFR programmes perform poorly, each city's strengths aid in creating specific proposals that can produce a successful MFR recycling program in Baltimore City. These tenets of a future MFR recycling program form the basis of a successful MFR recycling program that will allow all city residents to participate via initiatives in the categories of both programme, accessibility, and informing and self-review.

[Part-time residency training in Israel].

PubMed

Fishbain, Dana; Levi, Baruch; Borow, Malke; Ashkenazi, Shai; Lindner, Arie

2012-08-01

Full-time work has long been perceived as a cornerstone of medical residency, the consensus being that a resident must apply the bulk of his time and attention to his professional training. Demographic and cultural changes that have taken place over the last several years, specifically the rise in the number of female doctors and the importance of leisure time to the younger generation, have intensified the need to find new and innovative ways to deal with the plight of the resident population. One idea, already in effect in many Western countries, is the institution of part-time residency programs. The possibility of fulfilling residency requirements on a part-time basis is intended to assist medical residents in integrating their professional development with their personal and family life, without compromising the quality of their training. A number of research studies conducted over the last several years in countries that allow part-time residency, among them the United States, England and Switzerland, aimed to examine the quality of part-time training. The various studies evinced a high level of satisfaction from the program both by the residents themselves and their supervisors, and in many aspects those doing residency part-time received higher appraisals than their full-time colleagues. Some of the residents polled noted that they would have totally foregone the practice of medicine had there not been an option to complete residency part-time. In light of the experience throughout the world and the changing landscape in Israel, the Scientific Council of the Israeli Medical Association decided to examine the issue and its various aspects, and weighed all the considerations in favor and against part-time residency. Recently, the Scientific Council approved the launch of a pilot program to allow part-time residency in several fields that were carefully selected according to specific criteria. Once the Ministry of Health completes the LegisLation process, part-time residency will officially begin in Israel.

Teaching methods and surgical training in North American graduate periodontics programs: exploring the landscape.

PubMed

Ghiabi, Edmond; Taylor, K Lynn

2010-06-01

This project aimed at documenting the surgical training curricula offered by North American graduate periodontics programs. A survey consisting of questions on teaching methods employed and the content of the surgical training program was mailed to directors of all fifty-eight graduate periodontics programs in Canada and the United States. The chi-square test was used to assess whether the residents' clinical experience was significantly (P<0.05) influenced by having a) a structured preclinical program or b) another dental residency program in the institution. Thirty-four programs (59 percent) responded to the survey. Twenty-six programs (76 percent of respondents) reported offering a structured preclinical component. Traditional teaching methods such as slides, live demonstration, DVD/CD, and animal cadavers were the most common teaching methods used, whereas online courses, computer simulation, and various surgical mannequins were least commonly used. The most commonly performed surgical procedures were conventional flaps, periodontal plastic procedures, hard tissue grafts, and implants. Furthermore, residents in programs offering a structured preclinical component performed significantly more procedures (P=0.012) using lasers than those in programs not offering a structured preclinical program. Devising new and innovative teaching methods is a clear avenue for future development in North American graduate periodontics programs.

Predictors of future success in otolaryngology residency applicants.

PubMed

Chole, Richard A; Ogden, M Allison

2012-08-01

To evaluate the information available about otolaryngology residency applicants for factors that may predict future success as an otolaryngologist. Retrospective review of residency applications; survey of resident graduates and otolaryngology clinical faculty. Otolaryngology residency program. Otolaryngology program graduates from 2001 to 2010 and current clinical faculty from Barnes-Jewish Hospital/Washington University School of Medicine. Overall ratings of the otolaryngology graduates by clinical faculty (on a 5-point scale) were compared with the resident application attributes that might predict success. The application factors studied are United States Medical Licensing Examination part 1 score, Alpha Omega Alpha Honor Medical Society election, medical school grades, letter of recommendation, rank of the medical school, extracurricular activities, residency interview, experience with acting intern, and extracurricular activities. Forty-six graduates were included in the study. The overall faculty rating of the residents showed good interrater reliability. The objective factors, letters of recommendation, experience as an acting intern, and musical excellence showed no correlation with higher faculty rating. Rank of the medical school and faculty interview weakly correlated with faculty rating. Having excelled in a team sport correlated with higher faculty rating. Many of the application factors typically used during otolaryngology residency candidate selection may not be predictive of future capabilities as a clinician. Prior excellence in a team sport may suggest continued success in the health care team.

The relationship between older Americans act in-home services and low-care residents in nursing homes.

PubMed

Thomas, Kali S

2014-03-01

The aim of the study was to investigate the relationship between supportive services provided under Title III-B of the Older Americans Act (OAA) and the prevalence of low-care residents in nursing homes (NHs). State Program Reports (state-level expenditure and utilization data for each OAA service) and NH facility-level data were analyzed using a two-way fixed effects model. Results suggest that every additional 1% of the population age 65+ that receives personal care services is associated with a 0.8% decrease in the proportion of low-care residents in NHs. Despite efforts to rebalance long-term care, there are still many NH residents who have the functional capacity to live in a less restrictive environment. This is among the first studies to suggest that states that have invested in their in-home supportive services, particularly personal care services provided through the OAA, have proportionally fewer of these people.

Global health training in ophthalmology residency programs.

PubMed

Coombs, Peter G; Feldman, Brad H; Lauer, Andreas K; Paul Chan, Robison V; Sun, Grace

2015-01-01

To assess current global health education and international electives in ophthalmology residency programs and barriers to global health implementation in ophthalmology resident education. A web-based survey regarding participation in global health and international electives was emailed to residency program directors at 116 accredited ophthalmology residency programs via an Association of University Professors in Ophthalmology (AUPO) residency program director listserv. Fifty-nine (51%) ophthalmology residency program directors responded. Thirty-seven program directors (63%) said global health was important to medical students when evaluating residency programs. Thirty-two program directors (55%) reported developing international electives. Reported barriers to resident participation in international electives were: 1) insufficient financial support, 2) inadequate resident coverage at home, and 3) lack of ACGME approval for international electives. Program directors requested more information about resident international electives, funding, and global ophthalmology educational resources. They requested ACGME recognition of international electives to facilitate resident participation. More than half (54%) of program directors supported international electives for residents. This survey demonstrates that program directors believe global health is an important consideration when medical students evaluate training programs. Despite perceived barriers to incorporating global health opportunities into residency training, program directors are interested in development of global health resources and plan to further develop global health opportunities. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Health promotion program: a resident well-being study.

PubMed

Watson, David T; Long, William J; Yen, David; Pichora, David R

2009-01-01

Surgical training places unique stresses on residents that can lead to decreased levels of presenteeism. We hypothesized that presenteeism levels could be positively influenced by improving workplace hygiene. a cohort of surgical residents was asked to complete the Stanford Presenteeism Scale: Health Status and Employee Productivity (SPS-6) questionnaire before, and one year after the implementation of a workplace health promotion program. Twenty-six of thirty-three residents responded to the initial survey and reported a mean SPS-6 score of 17.3 +/- 4.5, well below population normative value of 24 +/- 3 (p < 0.0001). At one-year post intervention 25 of 32 residents responded, reporting a mean SPS-6 score of 18.3+/- 4.6. The mean SPS-6 score improved by 1.2+/- 3.8 (p = 0.35). Subgroup analysis showed a trend toward improved SPS-6 in those who participated in the health promotion program (p = 0.15) and a significant difference when junior residents were compared to seniors (p = 0.034). Overall, results were limited by our small sample size. Presenteeism scores for surgical residents at our institution are well below population values. Use of validated tools such as the SPS-6 may allow for more objective analysis and decision making when planning for resident education and workload. PRESENTEEISM: the ability while on the job to produce quality work at maximum productivity. DECREASED PRESENTEEISM: a state of decreased productivity and below-normal work quality related to health/workplace distracters.

Advanced ultrasound training for fourth-year medical students: a novel training program at The Ohio State University College of Medicine.

PubMed

Bahner, David P; Royall, Nelson A

2013-02-01

Ultrasound training and education in medical schools is rare, and the foci of current ultrasound curricula are limited. There is a significant need for advanced ultrasound training models in medical school curricula to reduce educational burdens for physician residency programs and improve overall physician competency.The authors describe and evaluate the advanced ultrasound training program developed at The Ohio State University College of Medicine (OSU COM). The OSU COM program is a longitudinal advanced ultrasound curriculum for fourth-year medical students pursuing specialties that require frequent use of focused ultrasound. One hundred fifty student participants have completed the yearlong program to date. Participants engage in didactic lectures, journal club sessions, hands-on training, teaching and patient-modeling activities, and complete a final project. Experienced Ohio State University Medical Center faculty are recruited from specialties that frequently use ultrasound (e.g., emergency medicine, internal medicine, obstetrics-gynecology). A multimodal instructional assessment approach ensures that ultrasound training yields experience with cognitive, behavioral, and constructive learning components. The authors discuss the benefits of the program as well as its challenges and future directions.The advanced ultrasound training program at OSU COM demonstrates a novel approach to providing ultrasound training for medical students, offering a feasible model for meeting training guidelines without increasing the educational requirements for residency programs.

What Is the Current Role and Factors for Success of the Journal Club in Podiatric Foot and Ankle Surgery Residency Training Programs?

PubMed

So, Eric; Hyer, Christopher F; Richardson, Marcus P; Thomas, Randall C

The journal club (JC) is a traditional part of postgraduate medical education, although little has been written on its current role in podiatric surgical training programs. The goal of the present study was to determine how JCs are conducted and the factors associated with their success. Anonymous electronic surveys were distributed to all podiatric foot and ankle surgical training program directors in the United States with a valid e-mail address. A total of 202 surveys were initially e-mailed to training program directors, with a second and third round sent to those who did not respond. The eventual response rate was 47.5%. The variables associated with success included high faculty attendance, dissemination of articles in advance, and regularly scheduled meetings. Of the residency programs that responded, 39.0% provided some type of handout or supplemental session and 39.8% provided supplemental session or handouts regarding the process of critical review, epidemiology, or biostatistics. A structured review instrument or checklist was used to guide critical appraisal in 21.5% of the JCs, and 11.8% of the programs provided feedback to residents. The JC was perceived by residency directors to be valuable and worthy of maintaining. Residency directors perceived the following factors to be associated with a successful JC: faculty participation, a designated leader, mandatory attendance, dissemination of materials in advance, and regularly scheduled meetings. Areas cited for improvement included implementation of a structured review instrument, delineation of clear goals, and periodic evaluation. We believe these findings could aid residency directors interested in maximizing the educational benefits of their JC. Copyright © 2017 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

General medicine vs subspecialty career plans among internal medicine residents.

PubMed

West, Colin P; Dupras, Denise M

2012-12-05

Current medical training models in the United States are unlikely to produce sufficient numbers of general internists and primary care physicians. Differences in general internal medicine (GIM) career plans between internal medicine residency program types and across resident demographics are not well understood. To evaluate the general medicine career plans of internal medicine residents and how career plans evolve during training. A study of US internal medicine residents using an annual survey linked to the Internal Medicine In-Training Examination taken in October of 2009-2011 to evaluate career plans by training program, sex, and medical school location. Of 67,207 US eligible categorical and primary care internal medicine residents, 57,087 (84.9%) completed and returned the survey. Demographic data provided by the National Board of Medical Examiners were available for 52,035 (77.4%) of these residents, of whom 51,390 (76.5%) responded to all survey items and an additional 645 (1.0%) responded to at least 1 survey item. Data were analyzed from the 16,781 third-year residents (32.2%) in this sample. Self-reported ultimate career plans of internal medicine residents. A GIM career plan was reported by 3605 graduating residents (21.5%). A total of 562 primary care program (39.6%) and 3043 categorical (19.9%) residents reported GIM as their ultimate career plan (adjusted odds ratio [AOR], 2.76; 99% CI, 2.35-3.23; P < .001). Conversely, 10 008 categorical (65.3%) and 745 primary care program (52.5%) residents reported a subspecialty career plan (AOR, 1.90; 99% CI, 1.62-2.23; P < .001). GIM career plans were reported more frequently by women than men (26.7% vs 17.3%, respectively; AOR, 1.69; 99% CI, 1.53-1.87; P < .001). US medical graduates were slightly more likely to report GIM career plans than international medical graduates (22.0% vs 21.1%, respectively; AOR, 1.76; 99% CI, 1.50-2.06; P < .001). Within primary care programs, US medical graduates were much more likely to report GIM career plans than international medical graduates (57.3% vs 27.3%, respectively; AOR, 3.48; 99% CI, 2.58-4.70; P < .001). Compared with their counterparts, maintaining a first-year GIM career plan over the course of their training was more likely among primary care program residents (68.2% vs 52.3%; AOR, 1.81; 99% CI, 1.25-2.64; P < .001), women (62.4% vs 47.2%; AOR, 1.75; 99% CI, 1.34-2.29; P < .001), and US medical graduates (60.9% vs 49.2%; AOR, 1.48; 99% CI, 1.13-1.93; P < .001). Reported GIM career plans were markedly less common than subspecialty career plans among internal medicine residents, including those in primary care training programs, and differed according to resident sex, medical school location, and program type.

Alabama Commission on Higher Education. Annual Report 1987-88.

ERIC Educational Resources Information Center

Alabama State Commission on Higher Education, Montgomery.

Activities of the Alabama State Commission on Higher Education are described. Three sections discuss the following: (1) planning and coordination activities (unified budget recommendation, statewide planning process, research and service program inventory, new program approval, off-campus instruction, non-resident institutional review, conference…

Identifying an Education Gap in Wound Care Training in United States Dermatology.

PubMed

Ruiz, Emily Stamell; Ingram, Amber; Landriscina, Angelo; Tian, Jiaying; Kirsner, Robert S; Friedman, Adam

2015-07-01

As restoration of the integument is paramount to wound healing, dermatologists should be central to managing wounds; yet this is often not the case. If a training gap exists during residency training, this may account for the observed discrepancy. To identify United States (US) dermatology residents' impressions regarding their preparedness to care for wounds, and to assess the amount and type of training devoted to wound care during residency. An online survey among current US dermatology residents enrolled in a residency training program. The primary goal was to determine whether dermatology residents believe more wound care education is needed, evaluate preparedness to care for wounds, and identify future plans to manage wounds. Responses were received from 175 of 517 (33.8%) US Dermatology residents contacted. The majority of residents did not feel prepared to manage acute (78.3%) and chronic (84.6%) wounds. Over three quarters (77.1%) felt that more education is needed. Fewer than half (49.1% and 35.4%) of residents planned to care for acute and chronic wounds, respectively, when in practice. There is a gap in wound care education in US dermatology residency training. This translates to a low percentage of dermatology residents planning to care for wounds in future practice. Dermatology residents need to receive focused wound care training in order to translate the underpinnings of wound healing biology and ultimately better serve patients.

Internal medicine residency training for unhealthy alcohol and other drug use: recommendations for curriculum design

PubMed Central

2010-01-01

Background Unhealthy substance use is the spectrum from use that risks harm, to use associated with problems, to the diagnosable conditions of substance abuse and dependence, often referred to as substance abuse disorders. Despite the prevalence and impact of unhealthy substance use, medical education in this area remains lacking, not providing physicians with the necessary expertise to effectively address one of the most common and costly health conditions. Medical educators have begun to address the need for physician training in unhealthy substance use, and formal curricula have been developed and evaluated, though broad integration into busy residency curricula remains a challenge. Discussion We review the development of unhealthy substance use related competencies, and describe a curriculum in unhealthy substance use that integrates these competencies into internal medicine resident physician training. We outline strategies to facilitate adoption of such curricula by the residency programs. This paper provides an outline for the actual implementation of the curriculum within the structure of a training program, with examples using common teaching venues. We describe and link the content to the core competencies mandated by the Accreditation Council for Graduate Medical Education, the formal accrediting body for residency training programs in the United States. Specific topics are recommended, with suggestions on how to integrate such teaching into existing internal medicine residency training program curricula. Summary Given the burden of disease and effective interventions available that can be delivered by internal medicine physicians, teaching about unhealthy substance use must be incorporated into internal medicine residency training, and can be done within existing teaching venues. PMID:20230607

Global Diversity and Academic Success of Foreign-Trained Academic Neurosurgeons in the United States.

PubMed

Mistry, Akshitkumar M; Ganesh Kumar, Nishant; Reynolds, Rebecca A; Hale, Andrew T; Wellons, John C; Naftel, Robert P

2017-08-01

To quantify the proportion of academic neurosurgeons practicing in the United States who acquired residency training outside of the United States and compare their training backgrounds and academic success with those who received their residency training in the United States. We identified 1338 clinically active academic neurosurgeons from 104 programs that participated in the neurosurgery residency match in the United States in January-February 2015. Their training backgrounds, current academic positions, and history of National Institutes of Health (NIH) grant awards between 2005 and 2014 were retrieved from publicly accessible sources. Eighty-four U.S. academic neurosurgeons (6.3%) received their residency training in 20 different countries outside of the United States/Puerto Rico, representing all major regions of the world. The majority trained in Canada (n = 48). We found no major differences between the foreign-trained and U.S.-trained neurosurgeons in male:female ratio, year of starting residency, proportion with positions in medical schools ranked in the top 15 by the U.S. News and World Report, general distribution of academic positions, and proportion with an NIH grant. Compared with U.S.-trained academic neurosurgeons, foreign-trained academic neurosurgeons had a significantly higher proportion of Ph.D. degrees (32.1% vs. 12.3%; P < 0.0001) and held more associate professorships (34.5% vs. 23.1%; P = 0.02). The academic practices of the foreign-trained neurosurgeons were widely distributed throughout the United States. A small group of U.S. academic neurosurgeons (6.3%) have acquired residency training outside of the United States, representing all major regions of the world. Their general demographic data and academic accomplishments are comparable to those of U.S.-trained neurosurgeons. Copyright © 2017 Elsevier Inc. All rights reserved.

Pine Ridge Indian Health Service Primary Care Resident Rotation: a summary.

PubMed

Jerde, O M; Vogt, H B

1996-10-01

The Pine Ridge Indian Health Service Primary Care Resident Rotation was officially established in January 1992 and operated through May 1996. Sponsored by an Indian Health Service grant, the rotation was conceived in an effort to help address the problem of recruitment and retention of physicians at Pin Ridge in the long term, while offering a unique educational experience for residents. Fifty-eight residents from 40 Family Practice, General Internal Medicine and General Pediatric Residency Programs in 18 states completed the rotation. Four of the rotation "graduates" are currently employed by the IHS at Pine Ridge and two other sites. A fifth physician provided short term service to a fourth site.

Dual Autonomies, Divergent Approaches: How Stratification in Medical Education Shapes Approaches to Patient Care.

PubMed

Jenkins, Tania M

2018-06-01

The United States relies on international and osteopathic medical graduates ("non-USMDs") to fill one third of residency positions because of a shortage of American MD graduates ("USMDs"). Non-USMDs are often informally excluded from top residency positions, while USMDs tend to fill the most prestigious residencies. Little is known, however, about whether the training in these different settings is comparable or how it impacts patients. Drawing on 23 months of ethnographic fieldwork and 123 interviews, I compare training at two internal medicine programs: a community hospital staffing 90% non-USMDs and a university hospital staffing 99% USMDs. The community program's structure lent itself to a hands-off approach resulting in "inconsistent autonomy." In contrast, the university hospital supervised its residents much more regularly, resulting in "supported autonomy." I conclude that medicine may be stratified in unexpected ways between USMDs and non-USMDs and that stratification may matter for patients.

Mobile technology in radiology resident education.

PubMed

Korbage, Aiham C; Bedi, Harprit S

2012-06-01

The authors hypothesized that ownership of a mobile electronic device would result in more time spent learning radiology. Current trends in radiology residents' studying habits, their use of electronic and printed radiology learning resources, and how much of the funds allotted to them are being used toward printed vs electronic education tools were assessed in this study. A survey study was conducted among radiology residents across the United States from June 13 to July 5, 2011. Program directors listed in the Association of Program Directors in Radiology e-mail list server received an e-mail asking for residents to participate in an online survey. The questionnaire consisted of 12 questions and assessed the type of institution, the levels of training of the respondents, and book funds allocated to residents. It also assessed the residents' study habits, access to portable devices, and use of printed and electronic radiology resources. Radiology residents are adopters of new technologies, with 74% owning smart phones and 37% owning tablet devices. Respondents spend nearly an equal amount of time learning radiology from printed textbooks as they do from electronic resources. Eighty-one percent of respondents believe that they would spend more time learning radiology if provided with tablet devices. There is considerable use of online and electronic resources and mobile devices among the current generation of radiology residents. Benefits, such as more study time, may be obtained by radiology programs that incorporate tablet devices into the education of their residents. Copyright © 2012 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Pediatric dermatology workforce shortage: perspectives from academia.

PubMed

Craiglow, Brittany G; Resneck, Jack S; Lucky, Anne W; Sidbury, Robert; Yan, Albert C; Resnick, Steven D; Antaya, Richard J

2008-12-01

The pediatric dermatology workforce has not been systematically evaluated since recent changes in board certification requirements. To quantify and characterize the workforce of academic pediatric dermatologists and examine issues related to training, hiring, and retention. Dermatology chairpersons and residency directors in the United States and Canada completed a 30-question survey. Eighty of 132 programs (61%) responded to the survey. More than two thirds of programs (56/80) employed a pediatric dermatologist, and 34 programs were recruiting a pediatric dermatologist. The number of residents that pursue careers in pediatric dermatology is significantly associated with the number of pediatric dermatologists on faculty at their institution. Self-reported data, which may have been reflected by recall bias, and 61% response rate. At a majority of academic centers, the current pool of pediatric dermatology faculty is neither adequate to meet academic nor clinical demands. Methods to increase exposure to pediatric dermatology among medical students and residents must be sought.

Residents' experiences of abuse, discrimination and sexual harassment during residency training. McMaster University Residency Training Programs.

PubMed Central

Cook, D J; Liutkus, J F; Risdon, C L; Griffith, L E; Guyatt, G H; Walter, S D

1996-01-01

OBJECTIVE: To assess the prevalence of psychological abuse, physical assault, and discrimination on the basis of gender and sexual orientation, and to examine the prevalence and impact of sexual harassment in residency training programs. DESIGN: Self-administered questionnaire. SETTING: McMaster University, Hamilton, Ont. PARTICIPANTS: Residents in seven residency training programs during the academic year from July 1993 to June 1994. Of 225 residents 186 (82.7%) returned a completed questionnaire, and 50% of the respondents were women. OUTCOME MEASURES: Prevalence of psychological abuse, physical assault and discrimination on the basis of gender and sexual orientation experienced by residents during medical training, prevalence and residents' perceived frequency of sexual harassment. RESULTS: Psychological abuse was reported by 50% of the residents. Some of the respondents reported physical assault, mostly by patients and their family members (14.7% reported assaults by male patients and family members, 9.8% reported assaults by female patients and family members), 5.4% of the female respondents reported assault by male supervising physicians. Discrimination on the basis of gender was reported to be common and was experienced significantly more often by female residents than by male residents (p < 0.01). Ten respondents, all female, reported having experienced discrimination on the basis of their sexual orientation. Most of the respondents experienced sexual harassment, especially in the form of sexist jokes, flirtation and unwanted compliments on their dress or figure. On average, 40% of the respondents, especially women (p < 0.01), reported experiencing offensive body language and receiving sexist teaching material and unwanted compliments on their dress. Significantly more female respondents than male respondents stated that they had reported events of sexual harassment to someone (p < 0.001). The most frequent emotional reactions to sexual harassment were embarassment (reported by 24.0%), anger (by 23.4%) and frustration (20.8%). CONCLUSION: Psychological abuse, discrimination on the basis of gender and sexual harassment are commonly experienced by residents in training programs. A direct, progressive, multidisciplinary approach is needed to label and address these problems. PMID:8646653

Primary language and cultural background as factors in resident burnout in medical specialties: a study in a bilingual US city.

PubMed

Afzal, Khalid I; Khan, Farhan M; Mulla, Zuber; Akins, Ralista; Ledger, Elizabeth; Giordano, Frank L

2010-07-01

The aim of this study was to identify the degree of burnout among resident physicians enrolled in seven postgraduate training programs at Texas Tech University Health Sciences Center (TTUHSC), Paul L. Foster School of Medicine, El Paso, Texas, as it related to residents' age, gender, marital status, number of hours worked per week, primary language, race/ethnicity, and cultural background. : The Maslach Burnout Inventory Human Service Survey (MBI) was administered to measure the level of burnout according to the prevalence of emotional exhaustion (EE), depersonalization (DP), and reduced personal accomplishment (PA). : Eighty-one percent of the residents at TTUHSC participated in the study. Residents raised in the United States or Canada comprised 28% and 35% of the study, and all reported English as their primary language. The EE scale was significant for obstetrics/gynecology (OB/GYN) residents (prevalence odds ratio [POR] = 13.55, P = 0.02) and psychiatry (PSY) residents (POR = 6.50, P = 0.03). Emergency medicine (EM) residents (POR = 23.35, P = 0.002), OB/GYN (POR = 10.89, P = 0.02), and general surgery (GS) (POR = 6.24, P = 0.03) residents had high DP. Internal medicine (IM) residents (primarily Spanish-speaking) reported significantly low EE (POR = 0.22, P = 0.03) and PA (POR = 0.09, P = 0.001) scores. Residents from the United States or Canada who reported English as their primary language and noted their race as white, had high EE (POR = 3.06, P = 0.03; POR = 5.61, P = 0.0001; POR = 2.91, P = 0.004), DP (POR = 3.19, P = 0.02; POR = 8.34, P < or = 0.0001; POR = 4.70, P < or = 0.0001) and PA (POR = 2.61, P = 0.02; POR = 2.35, P = 0.05, POR 0.29, P = 0.3) scores. Using valid measures, this pilot study identified a statistically significant relationship between burnout and residents' race/ethnicity, primary language, and cultural background. Larger studies with similar focus would be necessary to generalize these findings. At-risk residents in bilingual locations should be provided with cultural awareness workshops, language assistance programs, as well as senior resident and faculty mentors.

Residency training in physiatry during a time of change: funding of graduate medical education and other issues.

PubMed

DeLisa, J A; Jain, S S; Kirshblum, S

1998-01-01

Decision makers at the federal and state level are considering, and some states have enacted, a reduction in total United States residency positions, a shift in emphasis from specialist to generalist training, a need for programs to join together in training consortia to determine local residency position allocation strategy, a reduction in funding of international medical graduates, and a reduction in funding beyond the first certificate or a total of five years. A 5-page, 24-item questionnaire was sent to all physiatry residency training directors. The objective was to discern a descriptive database of physiatry training programs and how their institutions might respond to cuts in graduate medical education funding. Fifty-eight (73%) of the questionnaires were returned. Most training directors believe that their primary mission is to train general physiatrists and, to a much lesser extent, to train subspecialty or research fellows. Directors were asked how they might handle reductions in house staff such as using physician extenders, shifting clinical workload to faculty, hiring additional faculty, and funding physiatry residents from practice plans and endowments. Physiatry has had little experience (29%; 17/58) with voluntary graduate medical education consortiums, but most (67%; 34/58) seem to feel that if a consortium system is mandated, they would favor a local or regional over a national body because they do not believe the specialty has a strong enough national stature. The major barriers to a consortium for graduate medical education allocation were governance, academic, fiscal, bureaucratic, and competition.

Effectiveness of a Core-Competency-based Program on Residents' Learning and Experience.

PubMed

Charles, Lesley; Triscott, Jean; Dobbs, Bonnie; Tian, Peter George; Babenko, Oksana

2016-06-01

The Care of the Elderly (COE) Diploma Program is a six-to-twelve-month enhanced skills program taken after two years of core residency training in Family Medicine. In 2010, we developed and implemented a core-competency-based COE Diploma program (CC), in lieu of one based on learning objectives (LO). This study assessed the effectiveness of the core-competency-based program on residents' learning and their training experience as compared to residents trained using learning objectives. The data from the 2007-2013 COE residents were used in the study, with nine and eight residents trained in the LO and CC programs, respectively. Residents' learning was measured using preceptors' evaluations of residents' skills/abilities throughout the program (118 evaluations in total). Residents' rating of training experience was measured using the Graduate's Questionnaire which residents completed after graduation. For residents' learning, overall, there was no significant difference between the two programs. However, when examined as a function of the four CanMEDS roles, there were significant increases in the CC residents' scores for two of the CanMEDS roles: Communicator/Collaborator/Manager and Scholar compared to residents in the LO program. With respect to residents' training experience, seven out of ten program components were rated by the CC residents higher than by the LO residents. The implementation of a COE CC program appears to facilitate resident learning and training experience.

Academic rhinology: a survey of residency programs and rhinology faculty in the United States.

PubMed

Tabaee, Abtin; Chen, Leon; Smith, Timothy L; Hwang, Peter H; Schaberg, Madeleine; Raithatha, Roheen; Brown, Seth M

2014-04-01

Rhinology has rapidly evolved as a subspecialty over the past decade. The professional activities of rhinology faculty in otolaryngology residency programs is an important defining feature of this process but remains incompletely understood. An examination of faculty profiles of otolaryngology residency programs in the United States was performed to examine the professional activities of rhinologists. An anonymous, web-based survey of rhinology faculty was also performed to query professional activities and career satisfaction. Nine percent of chairmen and 12% of residency program directors were rhinologists. The number of full-time rhinology faculty members varied significantly among departments (mean 1; range, 0-4). Rhinology faculty members were noted to have a high number of scientific publications over the past 5 years (mean 15 per faculty), a high level of membership to the American Rhinologic Society (90%) and modest levels of membership to other societies. As reported by the 45 respondents who successfully completed the survey, higher percentages of professional time was devoted to clinical medicine when compared with administrative and research activities. Inflammatory sinusitis represented the most common clinical condition treated, and there was variability with respect to other disorders and procedures. Career satisfaction scores were highest for medical and surgical care, teaching activities, financial and emotional well being, and overall career to date. Lower satisfaction scores were noted for research and administrative activities and for balance of personal life with work. This study further defines the professional, clinical, and surgical activities of academic rhinologists. Continued analysis of the subspecialization of rhinology is required. © 2014 ARS-AAOA, LLC.

New Challenges in Developing High School and Post High School Programs in Agricultural Occupations. Conference Report. Resident Instruction Series No. 5.

ERIC Educational Resources Information Center

New Mexico State Univ., University Park. Coll. of Agriculture and Home Economics.

A special 2-week conference designed to assist nine participating states in developing plans for new educational programs in agricultural occupations was hosted by the New Mexico State University, July 20-31, 1964. Major papers presented to the 35 participants were: (1) Purpose of the Conference, (2) Where We Have Been--and Where We Are Now, (3)…

Tracking Residents Through Multiple Residency Programs: A Different Approach for Measuring Residents' Rates of Continuing Graduate Medical Education in ACGME-Accredited Programs

PubMed Central

Byrne, Lauren M.; Holt, Kathleen D.; Richter, Thomas; Miller, Rebecca S.; Nasca, Thomas J.

2010-01-01

Background Increased focus on the number and type of physicians delivering health care in the United States necessitates a better understanding of changes in graduate medical education (GME). Data collected by the Accreditation Council for Graduate Medical Education (ACGME) allow longitudinal tracking of residents, revealing the number and type of residents who continue GME following completion of an initial residency. We examined trends in the percent of graduates pursuing additional clinical education following graduation from ACGME-accredited pipeline specialty programs (specialties leading to initial board certification). Methods Using data collected annually by the ACGME, we tracked residents graduating from ACGME-accredited pipeline specialty programs between academic year (AY) 2002–2003 and AY 2006–2007 and those pursuing additional ACGME-accredited training within 2 years. We examined changes in the number of graduates and the percent of graduates continuing GME by specialty, by type of medical school, and overall. Results The number of pipeline specialty graduates increased by 1171 (5.3%) between AY 2002–2003 and AY 2006–2007. During the same period, the number of graduates pursuing additional GME increased by 1059 (16.7%). The overall rate of continuing GME increased each year, from 28.5% (6331/22229) in AY 2002–2003 to 31.6% (7390/23400) in AY 2006–2007. Rates differed by specialty and for US medical school graduates (26.4% [3896/14752] in AY 2002–2003 to 31.6% [4718/14941] in AY 2006–2007) versus international medical graduates (35.2% [2118/6023] to 33.8% [2246/6647]). Conclusion The number of graduates and the rate of continuing GME increased from AY 2002–2003 to AY 2006–2007. Our findings show a recent increase in the rate of continued training for US medical school graduates compared to international medical graduates. Our results differ from previously reported rates of subspecialization in the literature. Tracking individual residents through residency and fellowship programs provides a better understanding of residents' pathways to practice. PMID:22132288

Close to Home: Employment Outcomes for Recent Radiation Oncology Graduates

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ahmed, Awad A.; Holliday, Emma B.; Ileto, Jan

Purpose: To characterize the practice type and location of radiation oncology (RO) residents graduating in 2013. Methods and Materials: Graduates completing RO residency in 2013 were identified, and for each, postgraduate practice setting (academic vs private practice) and location were identified. Characteristics of the graduates, including details regarding their institutions of medical school and residency education, were collected and analyzed. Results: Data were obtained from 146 of the 154 RO graduates from the class of 2013. Employment data were available for 142 graduates. Approximately one-third of graduates were employed in the same state as residency (36.6%), approximately two-thirds (62.0%) in themore » same region as residency, and nearly three-fourths (73.9%) in the same region as medical school or residency completion. Of the 66 graduates (46.5%) working in academics, 40.9% were at the same institution where they completed residency. Most trainees (82.4%) attended medical schools with RO residency programs. Conclusions: Although personal factors may attract students to train in a particular area, the location of medical school and residency experiences may influence RO graduate practice location choice. Trends in the geographic distribution of graduating radiation oncologists can help identify and better understand disparities in access to RO care. Steps to improve access to RO care may include interventions at the medical student or resident level, such as targeting students at medical schools without associated residency programs and greater resident exposure to underserved areas.« less

Close to Home: Employment Outcomes for Recent Radiation Oncology Graduates.

PubMed

Ahmed, Awad A; Holliday, Emma B; Ileto, Jan; Yoo, Stella K; Green, Michael; Orman, Amber; Deville, Curtiland; Jagsi, Reshma; Haffty, Bruce G; Wilson, Lynn D

2016-07-01

To characterize the practice type and location of radiation oncology (RO) residents graduating in 2013. Graduates completing RO residency in 2013 were identified, and for each, postgraduate practice setting (academic vs private practice) and location were identified. Characteristics of the graduates, including details regarding their institutions of medical school and residency education, were collected and analyzed. Data were obtained from 146 of the 154 RO graduates from the class of 2013. Employment data were available for 142 graduates. Approximately one-third of graduates were employed in the same state as residency (36.6%), approximately two-thirds (62.0%) in the same region as residency, and nearly three-fourths (73.9%) in the same region as medical school or residency completion. Of the 66 graduates (46.5%) working in academics, 40.9% were at the same institution where they completed residency. Most trainees (82.4%) attended medical schools with RO residency programs. Although personal factors may attract students to train in a particular area, the location of medical school and residency experiences may influence RO graduate practice location choice. Trends in the geographic distribution of graduating radiation oncologists can help identify and better understand disparities in access to RO care. Steps to improve access to RO care may include interventions at the medical student or resident level, such as targeting students at medical schools without associated residency programs and greater resident exposure to underserved areas. Copyright © 2016 Elsevier Inc. All rights reserved.

Chief of Residents for Quality Improvement and Patient Safety: A Recipe for a New Role in Graduate Medical Education.

PubMed

Ferraro, Kelly; Zernzach, Randall; Maturo, Stephen; Nagy, Christopher; Barrett, Rebecca

2017-03-01

The San Antonio Uniformed Services Health Education Consortium (SAUSHEC) is the largest group of residency programs in the Department of Defense. In an effort to provide improved Quality Improvement and Patient Safety (QI/PS) training for its residents, SAUSHEC created the position of Chief of QI/PS for Residents in the academic year 2014-2015. The Chief of QI/PS for Residents was based in the Internal Medicine residency program but also assisted with SAUSHEC-wide QI/PS projects. This is the first such job in the Department of Defense. Here, we detail the accomplishments during this first academic year, including the alignment of the job with the stated QI/PS-related goals of the Accreditation Council for Graduate Medical Education Clinical Learning Environment Review. Efforts focused within the Internal Medicine residency program included QI/PS curriculum development, improvement upon monthly morbidity and mortality (M&M) conferences, and facilitating resident participation in QI projects. The 2014-2015 academic year Internal Medicine residency QI/PS project focused on increasing comfort and discussions with patients regarding advance directives; this also served to emphasize the humanistic side of potential QI/PS projects. The Chief of QI/PS for Residents also spearheaded hospital-wide initiatives, including the creation of a quarterly hospital-wide M&M conference, coordinating resident involvement in QI/PS-related committees, and facilitating feedback of patient safety report responses to trainees. We focus on the portion of the QI/PS curriculum involving the presentation of a mock Root Cause Analysis (RCA) and provide the results of a pre- and postpresentation survey of resident knowledge of RCAs. In order to quantify the efforts over the entire academic year, we also report the results of a resident self-assessment of QI/PS aptitude and competencies, including changes in these measures over the academic year. Finally, we discuss challenges faced and outline future goals for the position. The SAUSHEC Chief of QI/PS for Residents is the first such designated position in the Department of Defense. As QI/PS continues to increase as a focus area for physician training, we anticipate that other programs will create similar positions. We provide ideas for how a Chief of QI/PS for Residents can be involved at a program and hospital-wide level and quantify the success of different efforts. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

Pediatric dermatology training during residency: a survey of the 2014 graduating residents.

PubMed

Akhavan, Alaleh; Murphy-Chutorian, Blair; Friedman, Adam

2015-01-01

Knowledge of pediatric dermatology is considered a core competency of dermatology training and should be expected of all practicing dermatologists. While the numbers of both pediatric dermatology fellowships and board certified pediatric dermatologists in the workforce have increased over the years, recent reports suggest that there is a gap in pediatric dermatology education during dermatology residency. The goal of this study is to assess the current state of pediatric education during residency, as well as the clinical experience, satisfaction and expectations of graduating dermatology residents. A 31-question self-report survey was distributed electronically to 294 third-year dermatology residents with questions pertaining to demographics, didactic education, resident experience in pediatric dermatology training, satisfaction with pediatric training and future plans. One hundred and twenty-three residents responded (41.8% response rate) representing approximately 29.1% of the total number of graduating residents. 69 (56.1%) residents reported academic time specifically devoted to pediatric dermatology, the majority (79.7%) of which was led by pediatric dermatologists. 82% of residents reported dedicated pediatric dermatology clinics at their program. 86.8% of respondents felt that their training in pediatric dermatology will allow them to confidently see pediatric dermatology patients in practice. This survey highlights a promising state of pediatric dermatology training among current graduating dermatology residents. The majority of current graduating dermatology residents are satisfied with their pediatric dermatology education, feel confident treating pediatric patients, and plan to see pediatric patients in clinical practice. © 2015 Wiley Periodicals, Inc.

A novel resident-as-teacher training program to improve and evaluate obstetrics and gynecology resident teaching skills.

PubMed

Ricciotti, Hope A; Dodge, Laura E; Head, Julia; Atkins, K Meredith; Hacker, Michele R

2012-01-01

Residents play a significant role in teaching, but formal training, feedback, and evaluation are needed. Our aims were to assess resident teaching skills in the resident-as-teacher program, quantify correlations of faculty evaluations with resident self-evaluations, compare resident-as-teacher evaluations with clinical evaluations, and evaluate the resident-as-teacher program. The resident-as-teacher training program is a simulated, videotaped teaching encounter with a trained medical student and standardized teaching evaluation tool. Evaluations from the resident-as-teacher training program were compared to evaluations of resident teaching done by faculty, residents, and medical students from the clinical setting. Faculty evaluation of resident teaching skills in the resident-as-teacher program showed a mean total score of 4.5 ± 0.5 with statistically significant correlations between faculty assessment and resident self-evaluations (r = 0.47; p < 0.001). However, resident self-evaluation of teaching skill was lower than faculty evaluation (mean difference: 0.4; 95% CI 0.3-0.6). When compared to the clinical setting, resident-as-teacher evaluations were significantly correlated with faculty and resident evaluations, but not medical student evaluations. Evaluations from both the resident-as-teacher program and the clinical setting improved with duration of residency. The resident-as-teacher program provides a method to train, give feedback, and evaluate resident teaching.

New Professionalism Challenges in Medical Training: An Exploration of Social Networking

PubMed Central

Kesselheim, Jennifer C.; Batra, Maneesh; Belmonte, Frank; Boland, Kimberly A.; McGregor, Robert S.

2014-01-01

Background Innovative online technology can enhance the practice of medicine, yet it also may be a forum for unprofessional behavior. Objective We surveyed program directors regarding their perceptions and experiences with residents' use of social networking sites (SNS). Methods In September 2011, we sent an online survey to program directors and associate program directors of pediatrics residency programs within the United States who are members of the Association of Pediatric Program Directors. Results A total of 162 program directors or associate program directors (representing 50% of residency programs) responded to the survey. One-third of respondents are “very familiar” with SNS and 23% use them “daily or often.” Most respondents (70%) rated “friending” peers as “completely appropriate,” whereas only 1% of respondents rated “friending” current or past patients as “completely appropriate.” More than one half of respondents believe inappropriate behavior on SNS is “somewhat” or “very” prevalent, and 91% are “somewhat” or “very” concerned that the prevalence of inappropriate behavior on SNS may increase. The most commonly reported problematic online activity was posting inappropriate comments about the workplace. Posting of inappropriate comments about self, patients, and staff also was observed. Residency programs commonly educate trainees about SNS during intern orientation (45%), or using written guidelines (29%) and ad hoc remediation (16%). Conclusions As educators teach trainees principles of online professionalism, appropriate use of SNS needs to be included in the training process. Curricular efforts may be hindered by some program directors' lack of familiarity with SNS. PMID:24701318

Differential factors that influence applicant selection of a prosthodontic residency program.

PubMed

Blissett, Ryan; Lee, Meng-Chieh; Jimenez, Monik; Sukotjo, Cortino

2009-04-01

The main objectives of this study were to identify current prosthodontic resident demographics and to analyze factors that may influence applicants in selecting prosthodontics as a career, as well as a specific prosthodontic program. We also investigated the influence of age, gender, relationship status, and year in program on applicant decisions. Two questionnaires were mailed to all prosthodontic residents (N = 304) registered with the American College of Prosthodontists (ACP) Central Office. Part I assessed resident demographics and factors influencing choice of specialty. Part II assessed factors influencing the selection of a specific prosthodontic program. Completed surveys were obtained from 193 of 304 (63.4%) of all prosthodontic residents registered at the ACP Central Office. The completed surveys represented approximately 48% of the total population of prosthodontic residents in the United States. Demographic data revealed that 37% and 62% of the respondents were female and male, respectively (1% did not report gender). The mean age of the respondents was 30.3 years. More residents reported being married than either single or in a relationship. Most residents were accepted to their top choice program. Part I of the survey revealed that the complexity and challenge of treatment planning/treatment, ability to lead multidisciplinary cases, possession of skills/talents suited to the specialty, enjoyment of clinical work, and the intellectual content of the specialty were reported to be the five most influential factors in choosing prosthodontics as a career. Part II demonstrated that applicants place a high emphasis on clinical education, their impression of the program director, advice from predoctoral mentors, their impression of resident satisfaction and happiness, and the opportunity to place dental implants. The factors of least importance are climate and opportunities to moonlight, teach, and conduct research. Dental students consider the complexity and challenge of treatment planning and execution of prosthodontic treatment to be the most important factors in the decision to specialize in prosthodontics. Mentors and predoctoral instructors also strongly influence students. Applicants consider clinical education to be the most important determinant in program selection, but are also influenced by their impression of the program director and his/her philosophy of training. Faculty board certification and the opportunity to place dental implants are also important factors. Relationship status can significantly affect an applicant's choice of program. Teaching and research opportunities appear to be of minor importance to applicants. These findings can be used by the ACP and/or program directors to understand which factors are important to students, enabling them to assess the compatibility of their programs with applicants and modify existing curricula to make their programs more attractive to top candidates.

Good Choices in Hard Times: Fifteen Ideas for States To Reduce Hunger and Stimulate the Economy.

ERIC Educational Resources Information Center

Albee, Michelle; Cates, Jessica; Hayes, Louise; Henchy, Geri; Hess, Doug; Odell, Denise; Parker, Lynn; Phelps, Anne; Schwartz, Sonya; Vollinger, Ellen; Weedall, Crystal; Weill, Jim; Woo, Nicole

This resource guide puts forth 15 ideas for actions in food stamp and other child nutrition programs that states, schools, and cities can implement to feed more hungry low-income residents, especially children, and provide a direct federal economic stimulus for the state and its businesses. The guide asserts that states risk accelerating a…

A Roadmap for Observership Programs in Psychiatry for International Medical Graduates

ERIC Educational Resources Information Center

Hamoda, Hesham M.; Sacks, Diane; Sciolla, Andres; Dewan, Mantosh; Fernandez, Antony; Gogineni, Rama Rao; Goldberg, Jeffrey; Kramer, Milton; Saunders, Ramotse; Sperber, Jacob; Rao, Nyapati R.

2012-01-01

Objective: International medical graduates (IMGs) constitute a significant proportion of the psychiatric workforce in the United States. Observership programs serve an important role in preparing IMGs for U.S. residency positions; yet there are limited resources with information available on establishing these observerships, and none specific to…

Contingent valuation of fuel hazard reduction treatments

Treesearch

John B. Loomis; Armando Gonzalez-Caban

2008-01-01

This chapter presents a stated preference technique for estimating the public benefits of reducing wildfires to residents of California, Florida, and Montana from two alternative fuel reduction programs: prescribed burning, and mechanical fuels reduction. The two fuel reduction programs under study are quite relevant to people living in California, Florida, and...

Access to Care: Overcoming the Rural Physician Shortage.

ERIC Educational Resources Information Center

Baldwin, Fred D.

1999-01-01

Describes three state-initiated programs that address the challenge of providing access to health care for Appalachia's rural residents: a traveling pediatric diabetes clinic serving eastern Kentucky; a telemedicine program operated out of Knoxville, Tennessee; and a new medical school in Kentucky dedicated to training doctors from Appalachia for…

The development of a TED-Ed online resident research training program.

PubMed

Moreau, Katherine A; Pound, Catherine M; Peddle, Beth; Tokarewicz, Jaclyn; Eady, Kaylee

2014-01-01

Pediatric health research is important for improving the health and well-being of children and their families. To foster the development of physicians' research competencies, it is vital to integrate practical and context-specific research training into residency programs. To describe the development of a resident research training program at one tertiary care pediatric academic health sciences center in Ontario, Canada. We surveyed residents and pediatricians/research staff to establish the need and content for a resident research training program. Residents and resident research supervisors agreed or strongly agreed that research training is important for residents. However, few residents and supervisors believed that their academic health sciences center provided adequate training and resources to support resident research. As such, an online resident research training program was established. Residents and supervisors agreed that the program should focus on the following topics: 1) critically evaluating research literature, 2) writing a research proposal, 3) submitting an application for research funding, and 4) writing a manuscript. This highly accessible, context-specific, and inexpensive online program model may be of interest and benefit to other residency programs as a means to enhance residents' scholarly roles. A formal evaluation of the research training program is now underway.

Canadian Neurosurgery Educators' Views on Stereotactic Radiosurgery in Residency Training.

PubMed

Samuel, Nardin; Philteos, Justine; Alotaibi, Naif M; Ahuja, Christopher; Mansouri, Alireza; Kulkarni, Abhaya V

2018-04-01

Despite the increasing prominence of stereotactic radiosurgery (SRS) in treating intracranial and spinal pathologies, there is currently a dearth of exposure to this modality in the neurosurgical residency. To address this gap, the aim of this study is to assess neurosurgery educators' views regarding the current state of SRS exposure, and to identify potential approaches to improve residency education in this domain. Qualitative thematic analysis and constructivist grounded theory methodology were employed. Semistructured telephone-based interviews were conducted with current or past residency program directors, as well as current departmental chairs across neurosurgical departments in Canada. Interviews were transcribed and subjected to thematic analysis using open and axial coding. Of the 34 eligible participants, the overall response rate was 41.1% (14/34), with a 35.3% participation rate (12/34). Participants represented 9 of the 12 Canadian institutions surveyed. The majority of participants were current program directors (n = 8), followed by past program directors (n = 2), and departmental chairs (n = 2). Most respondents 75% (9/12) view an increasing role for SRS in neurosurgery. Unanimously, respondents endorse greater exposure to SRS during residency through formal residency rotations and engagement in interdisciplinary tumor boards to facilitate involvement in clinical decision-making. This is the first study to systematically collate neurosurgery educators' views on SRS in residency in Canada and demonstrates recognition of the discordance between SRS in practice and residency training. Neurosurgery educators broadly endorse increased exposure to this modality. Future work is needed to delineate the requirements necessary to achieve adequate competency in SRS. Copyright © 2018 Elsevier Inc. All rights reserved.

Oral and maxillofacial surgery residents have poor understanding of biostatistics.

PubMed

Best, Al M; Laskin, Daniel M

2013-01-01

The purpose of this study was to evaluate residents' understanding of biostatistics and interpretation of research results. A questionnaire previously used in internal medicine residents was modified to include oral and maxillofacial surgery (OMS) examples. The survey included sections to identify demographic and educational characteristics of residents, attitudes and confidence, and the primary outcome-knowledge of biostatistics. In 2009 an invitation to the Internet survey was sent to all 106 program directors in the United States, who were requested to forward it to their residents. One hundred twelve residents responded. The percentage of residents who had taken a course in epidemiology was 53%; biostatistics, 49%; and evidence-based dentistry, 65%. Conversely, 10% of OMS residents had taken none of these classes. Across the 6-item test of knowledge of statistical methods, the mean percentage of correct answers was 38% (SD, 22%). Nearly half of the residents (42%) could not correctly identify continuous, ordinal, or nominal variables. Only 21% correctly identified a case-control study, but 79% correctly identified that the purpose of blinding was to reduce bias. Only 46% correctly interpreted a clinically unimportant and statistically nonsignificant result. None of the demographic or experience factors of OMS residents were related to statistical knowledge. Overall, OMS resident knowledge was below that of internal medicine residents (P<.0001). However, OMS residents were overconfident in their claim to understand most statistical terms. OMS residents lack knowledge in biostatistics and the interpretation of research and are thus unprepared to interpret the results of published clinical research. Residency programs should include effective biostatistical training in their curricula to prepare residents in evidence-based dentistry. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Elective time during dermatology residency: A survey of residents and program directors.

PubMed

Uppal, Pushpinder; Shantharam, Rohini; Kaufmann, Tara Lynn

2017-12-15

Elective time during residency training provides residents with exposure to different subspecialties. This opportunity gives residents the chance tonurture growth in particular areas of interest and broaden their knowledge base in certain topics in dermatology by having the chance to work withexperts in the field. The purpose of this study was to assess the views of residency program directors and dermatology residents on the value of elective time through a cross sectional survey. An eight-questionIRB exempt survey was sent out to 113 residency program directors via email through the American Professors of Dermatology (APD) program director listserv. Program directors were asked to forward a separate set of 9 questions to their residents. The majority of programs that responded allowed for some elective time within their schedule, often duringthe PGY 4 (3rd year of dermatology training), but the amount of time allowed widely varied among many residency programs. Overall, residents and program directors agree that elective is important in residencytraining, but no standardization is established across programs.

The Effectiveness of Nurse Residency Programs on Retention: A Systematic Review.

PubMed

Van Camp, Jennifer; Chappy, Sharon

2017-08-01

New graduates account for the highest numbers of nurses entering and exiting the profession. Turnover is costly, especially in specialty settings. Nurse residency programs are used to retain new graduates and assist with their transition to nursing practice. The purpose of this systematic review of the literature was to examine new graduate nurse residency programs, residents' perceived satisfaction, and retention rates, and to make recommendations for implementation in perioperative settings. Results indicate increased retention rates for new graduates participating in residency programs and that residency participants experienced greater satisfaction with their orientation than those not participating in residency programs. Residency participants also perceived the residency as beneficial. Because residency programs vary in curricula and length, effectively comparing outcomes is difficult. More longitudinal data are needed. Data on residency programs specific to perioperative nursing are lacking. Considering the aging perioperative nursing workforce, residency programs could address critical needs for succession planning. Copyright © 2017 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Valuing the Benefits of the Education Provided by Public Universities: A Case Study of Minnesota

ERIC Educational Resources Information Center

Damon, Amy; Glewwe, Paul

2011-01-01

This study estimates the value of the private and public benefits that accrue to Minnesota residents from state government subsidies to higher education. In 2005, the University of Minnesota and the Minnesota State Colleges and Universities system received $832 million from Minnesota's state government to support educational programs. These…

Black belt landowners respond to State-sponsored wildland fire mitigation policies and programs

Treesearch

Cassandra Johnson; Jianbang Gan; Adam Jarrett; Miriam S. Wyman; Sparkle Malone; Keenan J. Adams; J.M. Bowker; Taylor V. Stein

2011-01-01

This investigation focused on nonindustrial private forest (NIPF) landowners in selected counties across five States in the Southeastern United States (Alabama, Florida, Georgia, Mississippi, and South Carolina). These counties are located in the Southern Black Belt region, which has higher than average percentages of African-American residents and higher poverty rates...

Factors Influencing the Gender Breakdown of Academic Radiology Residency Programs.

PubMed

Campbell, James C; Yoon, Sora C; Cater, Sarah Wallace; Grimm, Lars J

2017-07-01

To determine the gender distribution of radiology residency programs and identify associations with radiology departmental factors. The residency programs affiliated with the top 50 research medical school from US News and World Report were identified. The gender of all radiology residency graduates from each program from 2011 to 2015 were collected. Radiology departmental factors were collected: gender of chairperson, gender of program director, gender of faculty, geographic location, and city population of the residency program. The median percentage of female radiology faculty and residents were calculated and classified as above or below the median. Comparisons were made between residency programs and departmental factors via a Pearson χ 2 univariate test or logistic regression. There were 618 (27.9%) female and 1,598 (72.1%) male residents in our study, with a median female representation of 26.4% in each program. Programs with a female residency program director were significantly more likely to have an above-median percentage of female residents versus a male program director (68.4% versus 38.7%, P = .04). Programs in the Northeast (70.6%) and West (70.0%) had higher above-median female representation than the South (10.0%) and Midwest (38.5%, P < .01). There was no association with city population size (P = .40), gender of faculty (P = .40), residency size (P = .91), or faculty size (P = .15). Radiology residency programs with a female residency program director and those in the Northeast or West have a greater concentration of female residents. Residency programs that aim to increase female representation should investigate modifiable factors that can improve their recruitment practices. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Quality in-training initiative--a solution to the need for education in quality improvement: results from a survey of program directors.

PubMed

Kelz, Rachel R; Sellers, Morgan M; Reinke, Caroline E; Medbery, Rachel L; Morris, Jon; Ko, Clifford

2013-12-01

The Next Accreditation System and the Clinical Learning Environment Review Program will emphasize practice-based learning and improvement and systems-based practice. We present the results of a survey of general surgery program directors to characterize the current state of quality improvement in graduate surgical education and introduce the Quality In-Training Initiative (QITI). In 2012, a 20-item survey was distributed to 118 surgical residency program directors from ACS NSQIP-affiliated hospitals. The survey content was developed in collaboration with the QITI to identify program director opinions regarding education in practice-based learning and improvement and systems-based practice, to investigate the status of quality improvement education in their respective programs, and to quantify the extent of resident participation in quality improvement. There was a 57% response rate. Eighty-five percent of program directors (n = 57) reported that education in quality improvement is essential to future professional work in the field of surgery. Only 28% (n = 18) of programs reported that at least 50% of their residents track and analyze their patient outcomes, compare them with norms/benchmarks/published standards, and identify opportunities to make practice improvements. Program directors recognize the importance of quality improvement efforts in surgical practice. Subpar participation in basic practice-based learning and improvement activities at the resident level reflects the need for support of these educational goals. The QITI will facilitate programmatic compliance with goals for quality improvement education. Copyright © 2013 American College of Surgeons. All rights reserved.

Financial Aid for Students Workbook, 1994-95 School Year = Ayuda Financiera para Estudiantes, Libreta del Ano Escolar 1994-95.

ERIC Educational Resources Information Center

California Student Aid Commission, Sacramento.

Presented in both English and Spanish language formats, this workbook explains how California residents can qualify for and obtain student financial aid in the form of federal and state grants and loans, work-study programs, institutional grants, federal campus-based programs, and the Federal Family Education Loan Program loans. A calendar of…

A Review of Information on Institutionalized Youths and the ECIA Chapter I Neglected or Delinquent Program.

ERIC Educational Resources Information Center

Marks, Ellen L.

This paper reviews and summarizes available information on the neglected or delinquent youth population, on education programs for delinquent youth, and on the Neglected or Delinquent (N or D) program funded under Chapter 1 of the Education Consolidation and Improvement Act that serves a portion of that population residing in state-operated or…

Orthopaedic resident and program director opinions of resident duty hours: a national survey.

PubMed

Mir, Hassan R; Cannada, Lisa K; Murray, Jayson N; Black, Kevin P; Wolf, Jennifer M

2011-12-07

The Accreditation Council for Graduate Medical Education (ACGME) established national guidelines for resident duty hours in July 2003. Following an Institute of Medicine report in December 2008, the ACGME recommended further restrictions on resident duty hours that went into effect in July 2011. We conducted a national survey to assess the opinions of orthopaedic residents and of directors of residency and fellowship programs in the U.S. regarding the 2003 and 2011 ACGME resident duty-hour regulations and the effects of these regulations on resident education and patient care. A fifteen-item questionnaire was electronically distributed by the Candidate, Resident, and Fellow Committee of the American Academy of Orthopaedic Surgeons (AAOS) to all U.S. orthopaedic residents (n = 3860) and directors of residency programs (n = 184) and fellowship programs (n = 496) between January and April 2011. Thirty-four percent (1314) of the residents and 27% (185) of the program directors completed the questionnaire. Statistical analyses were performed to detect differences between the responses of residents and program directors and between the responses of junior and senior residents. The responses of orthopaedic residents and program directors differed significantly (p < 0.001) for fourteen of the fifteen survey items. The responses of residents and program directors were divergent for questions regarding the 2003 rules. Overall, 71% of residents thought that the eighty-hour work week was appropriate, whereas only 38% of program directors agreed (p < 0.001). Most program directors (70%) did not think that the 2003 duty-hour rules had improved patient care, whereas only 24% of residents responded in the same way (p < 0.001). The responses of residents and program directors to questions regarding the 2011 duty-hour rules were generally compatible, but the degree to which they perceived the issues was different. Only 18% of residents and 19% of program directors thought that the suggested strategic five-hour evening rest period implemented in July 2011 for on-call residents was appropriate (p > 0.05), and both groups (84% of residents and 74% of program directors) also disagreed with the limitation of intern shifts to sixteen hours (p < 0.001). Seventy percent of residents and 79% of program directors thought that the new duty-hour regulations would result in an increased number of handoffs that would be detrimental to patient care (p < 0.001). The mean responses of junior residents and senior residents differed for eight of the fifteen survey items (p < 0.001), with the responses of senior residents more closely resembling those of program directors on six of these eight questions. The mean responses and percentiles for the survey items did not differ significantly between residency directors and fellowship directors (p > 0.05). This national survey indicated significant differences between the opinions of orthopaedic residents and program (residency and fellowship) directors regarding the 2003 ACGME resident duty-hour regulations and the effects of these regulations on resident education and patient care. However, both residents and program directors agreed that the further reductions in duty hours in the 2011 rules may be detrimental to resident education and patient care.

Distribution of scholarly publications among academic radiology departments.

PubMed

Morelli, John N; Bokhari, Danial

2013-03-01

The aim of this study was to determine whether the distribution of publications among academic radiology departments in the United States is Gaussian (ie, the bell curve) or Paretian. The search affiliation feature of the PubMed database was used to search for publications in 3 general radiology journals with high Impact Factors, originating at radiology departments in the United States affiliated with residency training programs. The distribution of the number of publications among departments was examined using χ(2) test statistics to determine whether it followed a Pareto or a Gaussian distribution more closely. A total of 14,219 publications contributed since 1987 by faculty members in 163 departments with residency programs were available for assessment. The data acquired were more consistent with a Pareto (χ(2) = 80.4) than a Gaussian (χ(2) = 659.5) distribution. The mean number of publications for departments was 79.9 ± 146 (range, 0-943). The median number of publications was 16.5. The majority (>50%) of major radiology publications from academic departments with residency programs originated in <10% (n = 15 of 178) of such departments. Fifteen programs likewise produced no publications in the surveyed journals. The number of publications in journals with high Impact Factors published by academic radiology departments more closely fits a Pareto rather than a normal distribution. Copyright © 2013 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Toward a new paradigm in graduate medical education in the United States: elimination of the 24-hour call.

PubMed

Mautone, Susan G

2009-12-01

Sleep deprivation negatively affects resident performance, education, and safety. Concerns over these effects have prompted efforts to reduce resident hours. This article describes the design and implementation of a scheduling system with no continuous 24-hour calls. Aims included meeting Accreditation Council for Graduate Medical Education work hour requirements without increasing resident complement, maximizing continuity of learning and patient care, maintaining patient care quality, and acceptance by residents, faculty, and administration. Various coverage options were formulated and discussed. The final schedule was the product of consensus. After re-engineering the master rotation schedule, service-specific conversion of on-call schedules was initiated in July 2003 and completed in July 2004. Annual in-training and certifying examination performance, length of stay, patient mortalities, resident motor vehicle accidents/near misses, and resident satisfaction with the new scheduling system were tracked. Continuous 24-hour call has been eliminated from the program since July 2004, with the longest assigned shift being 14 hours. Residents have at least 1 free weekend per month, a 10-hour break between consecutive assigned duty hours, and a mandatory 4-hour "nap" break if assigned a night shift immediately following a day shift. Program-wide, duty hours average 66 hours per week for first-year residents, 63 hours per week for second-year residents, and 60 hours per week for third-year residents. Self-reported motor vehicle accidents and/or near misses of accidents significantly decreased (P < .001) and resident satisfaction increased (P  =  .42). The change was accomplished at no additional cost to the institution and with no adverse patient care or educational outcomes. Pediatric residency training with restriction to 14 consecutive duty hours is effective and well accepted by stakeholders. Five years later, the re-engineered schedule has become the new "normal" for our program.

An Analysis of Research Quality and Productivity at Six Academic Orthopaedic Residencies.

PubMed

Osborn, Patrick M; Ames, S Elizabeth; Turner, Norman S; Caird, Michelle S; Karam, Matthew D; Mormino, Matthew A; Krueger, Chad A

2018-06-06

It remains largely unknown what factors impact the research productivity of residency programs. We hypothesized that dedicated resident research time would not affect the quantity and quality of a program's peer-reviewed publication within orthopedic residencies. These findings may help programs improve structure their residency programs to maximize core competencies. Three hundred fifty-nine residents and 240 staff from six different US orthopedic residency programs were analyzed. All publications published by residents and faculty at each program from January 2007 to December 2015 were recorded. SCImago Journal Rankings (SJR) were found for each journal. There were no significant differences in publications by residents at each program (p > 0.05). Faculty with 10+ years of on staff, had significantly more publications than those with less than 10years (p < 0.01). Programs with increased resident research time did not consistently produce publications with higher SJR than those without dedicated research time. Increased dedicated resident research time did not increase resident publication rates or lead to publications with higher SJR. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Cooperative learning as applied to resident instruction in radiology reporting.

PubMed

Mueller, Donald; Georges, Alexandra; Vaslow, Dale

2007-12-01

The study is designed to evaluate the effectiveness of an active form of resident instruction, cooperative learning, and the residents' response to that form of instruction. The residents dictated three sets of reports both before and after instruction in radiology reporting using the cooperative learning method. The reports were evaluated for word count, Flesch-Kincaid grade level, advancement on clinical spectrum, clarity, and comparison to prior reports. The reports were evaluated for changes in performance characteristics between the pre- and postinstruction dictations. The residents' response to this form of instruction was evaluated by means of a questionnaire. The instruction was effective in changing the resident dictations. The results became shorter (P<.035), more complex (P<.0126), and demonstrated increased advancement on clinical spectrum (P<.0204). The resident response to this form of instruction was positive. One hundred percent or respondents indicated enjoyment working with their groups. Seventy-five percent stated they would like to participate in more cooperative learning activities. The least positive responses related to the amount of time devoted to the project. Sixty-three percent of respondents stated that the time devoted to the project was appropriate. Cooperative learning can be an effective tool in the setting of the radiology residency. Instructional time requirements must be strongly considered in designing a cooperative learning program.

A Survey of Graduates of Combined Emergency Medicine-Pediatrics Residency Programs: An Update.

PubMed

Strobel, Ashley M; Chasm, Rose M; Woolridge, Dale P

2016-10-01

In 1998, emergency medicine-pediatrics (EM-PEDS) graduates were no longer eligible for the pediatric emergency medicine (PEM) sub-board certification examination. There is a paucity of guidance regarding the various training options for medical students who are interested in PEM. We sought to to determine attitudes and personal satisfaction of graduates from EM-PEDS combined training programs. We surveyed 71 graduates from three EM-PEDS residences in the United States. All respondents consider their combined training to be an asset when seeking a job, 92% find it to be an asset to their career, and 88% think it provided added flexibility to job searches. The most commonly reported shortcoming was their ineligibility for the PEM sub-board certification. The lack of this designation was perceived to be a detriment to securing academic positions in dedicated children's hospitals. When surveyed regarding which training offers the better skill set for the practice of PEM, 90% (44/49) stated combined EM-PEDS training. When asked which training track gives them the better professional advancement in PEM, 52% (23/44) chose combined EM-PEDS residency, 27% (12/44) chose a pediatrics residency followed by a PEM fellowship, and 25% (11/44) chose an EM residency then a PEM fellowship. No EM-PEDS respondents considered PEM fellowship training after the completion of the dual training program. EM-PEDS graduates found combined training to be an asset in their career. They felt that it provided flexibility in job searches, and that it was ideal training for the skill set required for the practice of PEM. EM-PEDS graduates' practices varied, including mixed settings, free-standing children's hospitals, and community emergency departments. Copyright © 2016 Elsevier Inc. All rights reserved.

Plagiarism in residency application essays.

PubMed

Segal, Scott; Gelfand, Brian J; Hurwitz, Shelley; Berkowitz, Lori; Ashley, Stanley W; Nadel, Eric S; Katz, Joel T

2010-07-20

Anecdotal reports suggest that some residency application essays contain plagiarized content. To determine the prevalence of plagiarism in a large cohort of residency application essays. Retrospective cohort study. 4975 application essays submitted to residency programs at a single large academic medical center between 1 September 2005 and 22 March 2007. Specialized software was used to compare residency application essays with a database of Internet pages, published works, and previously submitted essays and the percentage of the submission matching another source was calculated. A match of more than 10% to an existing work was defined as evidence of plagiarism. Evidence of plagiarism was found in 5.2% (95% CI, 4.6% to 5.9%) of essays. The essays of non-U.S. citizens were more likely to demonstrate evidence of plagiarism. Other characteristics associated with the prevalence of plagiarism included medical school location outside the United States and Canada; previous residency or fellowship; lack of research experience, volunteer experience, or publications; a low United States Medical Licensing Examination Step 1 score; and non-membership in the Alpha Omega Alpha Honor Medical Society. The software database is probably incomplete, the 10%-match threshold for defining plagiarism has not been statistically validated, and the study was confined to applicants to 1 institution. Evidence of matching content in an essay cannot be used to infer the applicant's intent and is not sensitive to variations in the cultural context of copying in some societies. Evidence of plagiarism in residency application essays is more common in international applicants but was found in those by applicants to all specialty programs, from all medical school types, and even among applicants with significant academic honors. No external funding.

42 CFR 441.472 - Budget methodology.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Budget methodology. 441.472 Section 441.472 Public... Self-Directed Personal Assistance Services Program § 441.472 Budget methodology. (a) The State shall set forth a budget methodology that ensures service authorization resides with the State and meets the...

Macro-Level Profile of Hawai'i's Schools Participating in the Significant Bilingual Instructional Features Study.

ERIC Educational Resources Information Center

Gavieres, Milagros; And Others

This document contains six chapters: (1) The introduction discusses the State of Hawaii, its residents, and major industries. (2) "Education in Hawaii" presents the state's education plan, Department of Education rules and regulations, and student services. (3) "Bilingual Education Program Data" describes Hawaii's bilingual…

Views of radiology program directors on the role of mentorship in the training of radiology residents.

PubMed

Donovan, Andrea

2010-03-01

The successful mentoring of resident physicians has been linked to several beneficial outcomes for trainees including increased research productivity, improved career satisfaction, and retention in academics. Female residents may have greater difficulty establishing mentoring relationships than male residents. The purpose of this study was to assess the attitudes of radiology residency program directors toward the subject of mentorship, to determine the prevalence of formal mentoring programs, and to evaluate several issues specifically pertaining to the mentoring of female residents. An anonymous, voluntary survey was sent to 156 members of the Association of Program Directors in Radiology. The survey assessed views on mentorship during residency training, the potential role of mentorship in resident career development, and the prevalence of mentorship programs in residency programs. Subanalyses evaluated survey responses according to program director sex. Seventy program directors (45%) responded to the survey. The majority of respondents (85%) agreed it is important for residents to have mentors, but only 52% thought that current residents had identified mentors. Compared with male program directors, female program directors differed in their views on the role of mentorship and of the importance of female resident access to female mentors. Program directors consider mentoring relationships to be an important resource for resident professional development and a potential resource to increase the proportion of residents pursuing academic careers and positions of leadership. Female residents may have specific mentoring needs that should be explored with further study.

Resident work-hour rules: a survey of residents' and program directors' opinions and attitudes.

PubMed

Immerman, Igor; Kubiak, Erik N; Zuckerman, Joseph D

2007-12-01

In July 2003, the Accreditation Council for Graduate Medical Education (ACGME) established nationwide guidelines for resident working environments and duty hours. Following these guidelines became a requirement for all accredited residency programs. Two years after implementation, we conducted a national survey to assess the opinions and attitudes of orthopedic residents and program directors toward the ACGME work-hour regulations and the effects of these regulations on resident education, resident quality of life, and patient care. Nine hundred seventy-six residents (30% response rate) and 85 program directors (56% response rate) completed the questionnaire. For resident education, junior residents were more likely than senior residents and program directors to perceive the work-hour regulations as having a positive effect on education. There was overall agreement among the 3 groups that resident quality of life had improved as a result of work-hour regulations. For patient care, junior residents viewed the new regulations positively for surgical training and patient care, whereas senior residents and program directors disagreed. This survey showed meaningful differences in the attitudes and opinions of junior residents, senior residents, and program directors toward the new ACGME work-hour regulations.

Integration of international medical graduates in u.s. Psychiatry: the role of acculturation and social support.

PubMed

Atri, Ashutosh; Matorin, Anu; Ruiz, Pedro

2011-01-01

the authors investigated whether social support and acculturation could predict the mental health of international medical graduates pursuing psychiatric residencies in the United States. a 55-item online survey was assembled by combining three validated instruments for mental health, social support, and acculturation. A link to the survey was e-mailed to training directors of all psychiatric residency and fellowship programs. Directors were requested to forward the survey to their international medical graduate residents for completion between December 2008 and February 2009. one hundred eight international medical graduates from 70 different psychiatric residencies and fellowships completed the entire survey. Respondents' mental health scores were normally distributed. The vast majority scored very high on survey items related to mental health. Acculturation, social support, and postgraduate training year were significant predictors of mental health. residency training programs should attempt to incorporate measures that would help boost the social support and acculturation of international medical graduates (especially junior-level trainees). Acculturation could be improved by language training and courses in American history, culture, and customs, and social support could be expanded by mentoring relationships.

The development of a TED-Ed online resident research training program.

PubMed

Moreau, Katherine A; Pound, Catherine M; Peddle, Beth; Tokarewicz, Jaclyn; Eady, Kaylee

2014-01-01

Background Pediatric health research is important for improving the health and well-being of children and their families. To foster the development of physicians' research competencies, it is vital to integrate practical and context-specific research training into residency programs. Purpose To describe the development of a resident research training program at one tertiary care pediatric academic health sciences center in Ontario, Canada. Methods We surveyed residents and pediatricians/research staff to establish the need and content for a resident research training program. Results Residents and resident research supervisors agreed or strongly agreed that research training is important for residents. However, few residents and supervisors believed that their academic health sciences center provided adequate training and resources to support resident research. As such, an online resident research training program was established. Residents and supervisors agreed that the program should focus on the following topics: 1) critically evaluating research literature, 2) writing a research proposal, 3) submitting an application for research funding, and 4) writing a manuscript. Discussion This highly accessible, context-specific, and inexpensive online program model may be of interest and benefit to other residency programs as a means to enhance residents' scholarly roles. A formal evaluation of the research training program is now underway.

Higher clinical performance during a surgical clerkship is independently associated with matriculation of medical students into general surgery.

PubMed

Daly, Shaun C; Deal, Rebecca A; Rinewalt, Daniel E; Francescatti, Amanda B; Luu, Minh B; Millikan, Keith W; Anderson, Mary C; Myers, Jonathan A

2014-04-01

The purpose of our study was to determine the predictive impact of individual academic measures for the matriculation of senior medical students into a general surgery residency. Academic records were evaluated for third-year medical students (n = 781) at a single institution between 2004 and 2011. Cohorts were defined by student matriculation into either a general surgery residency program (n = 58) or a non-general surgery residency program (n = 723). Multivariate logistic regression was performed to evaluate independently significant academic measures. Clinical evaluation raw scores were predictive of general surgery matriculation (P = .014). In addition, multivariate modeling showed lower United States Medical Licensing Examination Step 1 scores to be independently associated with matriculation into general surgery (P = .007). Superior clinical aptitude is independently associated with general surgical matriculation. This is in contrast to the negative correlation United States Medical Licensing Examination Step 1 scores have on general surgery matriculation. Recognizing this, surgical clerkship directors can offer opportunities for continued surgical education to students showing high clinical aptitude, increasing their likelihood of surgical matriculation. Copyright © 2014 Elsevier Inc. All rights reserved.

Resident selection: how we are doing and why?

PubMed

Thordarson, David B; Ebramzadeh, Edward; Sangiorgio, Sophia N; Schnall, Stephen B; Patzakis, Michael J

2007-06-01

Selection of the best applicants for orthopaedic residency programs remains a difficult problem. Most quantifiable factors for residency selection evaluate test-taking ability and grades rather than other aspects, such as patient care, professionalism, moral reasoning, and integrity. Four current department members on our resident selection committee ranked four consecutive classes of orthopaedic residents interviewed for residency. We ranked incoming residents in order of best to least qualified and compared those rankings with rank lists by the same faculty on completion of residency. Rankings also were compared with the residents' United States Medical Licensing Examination (USMLE) Part I scores, American Board of Orthopaedic Surgery (ABOS) Part I scores, and fourth-year Orthopaedic-in-Training Examination (OITE) scores. We found fair or poor correlations between the residents' initial rankings, rankings on graduation, and their USMLE, ABOS, and OITE scores. The only relatively strong correlation found was between the OITE and ABOS scores. Despite the faculty's consensus regarding selection criteria, interviewers did not agree in their rankings of residents on graduation. Additional work is necessary to refine the inexact yet important science of selecting residency applicants.

Progressive Entrustment to Achieve Resident Autonomy in the Operating Room: A National Qualitative Study With General Surgery Faculty and Residents.

PubMed

Sandhu, Gurjit; Magas, Christopher P; Robinson, Adina B; Scally, Christopher P; Minter, Rebecca M

2017-06-01

The purpose of this study was to identify behaviors that faculty and residents exhibit during intraoperative interactions, which support or inhibit progressive entrustment leading to operative autonomy. In the operating room, a critical balance is sought between direct faculty supervision and appropriate increase in resident autonomy with indirect faculty supervision. Little is known regarding perspectives of faculty and residents about how attendings increasingly step back and safely delegate autonomy to trainees. Understanding the context in which these decisions are made is critical to achieving a safe strategy for imparting progressive responsibility. A qualitative study was undertaken from January 2014 to February 2015. Semistructured interviews were conducted with 37 faculty and 59 residents from 14 and 41 institutions, respectively. Participants were selected using stratified random sampling from general surgery residency programs across the United States to represent a range of university, university-affiliated, and community programs, and geographic regions. Audio recordings of interviews were transcribed, iteratively analyzed, and emergent themes identified. Six themes were identified as influencing progressive entrustment in the operating room: optimizing faculty intraoperative feedback; policies and regulations affecting role of resident in the operating room; flexible faculty teaching strategies; context-specific variables; leadership opportunities for resident in the case; and safe struggle for resident when appropriate. Perspectives of faculty and residents while overlapping were different in emphasis. Better understanding faculty-resident interactions, individual behaviors, contextual influences, and national regulations that influence intraoperative education have the potential to significantly affect progressive entrustment in training paradigms.

Didactic teaching conferences for IM residents: who attends, and is attendance related to medical certifying examination scores?

PubMed

FitzGerald, John D; Wenger, Neil S

2003-01-01

Didactic teaching conferences are a cornerstone of residents' training in internal medicine, yet these programs have received little formal evaluation. This study determines the factors associated with residents' attendance at didactic teaching conferences and the relationship of attendance to residents' scores on medical certification examinations. The attendance of 81 residents was recorded at 199 conferences at one university hospital's internal medicine residency program during the 1996-97 academic year. Characteristics of the conferences were recorded, including the date, whether lunch was provided, the daily census on the medicine general wards, daily ambient temperature, and conference type. Residents' scores on the United States Medical Licensing Examination (USMLE) Step 2 and American Board of Internal Medicine (ABIM) certification examination were collected. Residents' attendance at conferences was 34% overall or 54% excluding excused absences. Adjusting for the conferences' and residents' characteristics, attendance declined by one third as the year progressed. Providing lunch at noon conferences enhanced residents' attendance (odds ratio [OR] 1.26 overall and OR 1.64 for residents on inpatient rotations). Higher attendance was not associated with improvement in standardized medical knowledge test scores. Absenteeism and waning attendance through the year have important implications for structuring didactic internal medicine teaching. Providing lunch improves attendance, but this incentive should be weighed against the potential burdens of the pharmaceutical industry's funding of these lunches. The lack of relationship between attendance and residents' adjusted board scores calls for a better understanding of the value of this high-intensity medical education intervention.

Impact of the Libby Zion case on graduate medical education in internal medicine.

PubMed

Brensilver, J M; Smith, L; Lyttle, C S

1998-09-01

Residency training in New York State was substantially altered by the Libby Zion case. Work-hour limitations and augmented supervisory requirements changed the patterns of training--particularly in internal medicine--but with uncertain impacts on the quality of education and patient care. In this historical analysis, we review another major effect of the case: a substantial augmentation of the number of trainees. The need to maintain adequate inpatient staffing--within the ground rules of the Residency Review Committee, and in consideration of the reimbursement formulae and financial climate of New York State--conspired to promote substantial residency program expansion. Similar forces contributed to a national trend to increase the number of trainees. The history, cost and impact of these personnel changes are reviewed.

Physician training in critical care in the United States: Update 2018.

PubMed

Napolitano, Lena M; Rajajee, Venkatakrishna; Gunnerson, Kyle J; Maile, Michael D; Quasney, Michael; Hyzy, Robert C

2018-06-01

Critical care fellowship training in the United States differs based on specific specialty and includes medicine, surgery, anesthesiology, pediatrics, emergency medicine, and neurocritical care training pathways. We provide an update regarding the number and growth of US critical care fellowship training programs, on-duty residents and certified diplomates, and review the different critical care physician training pathways available to residents interested in pursuing a fellowship in critical care. Data were obtained from the Accreditation Council for Graduate Medical Education and specialty boards (American Board of Internal Medicine, American Board of Surgery, American Board of Anesthesiology, American Board of Pediatrics American Board of Emergency Medicine) and the United Council for Neurologic Subspecialties for the last 16 years (2001-2017). The number of critical care fellowship training programs has increased 22.6%, with a 49.4% increase in the number of on-duty residents annually, over the last 16 years. This is in contrast to the period of 1995 to 2000 when the number of physicians enrolled in critical care fellowship programs had decreased or remained unchanged. Although more than 80% of intensivists in the US train in internal medicine critical care Accreditation Council for Graduate Medical Education-approved fellowships, there has been a significant increase in the number of residents from surgery, anesthesiology, pediatrics, emergency medicine, and other specialties who complete specialty fellowship training and certification in critical care. Matriculation in neurocritical care fellowships is rapidly rising with 60 programs and over 1,200 neurocritical care diplomates. Critical care is now an increasingly popular fellowship in all specialties. This rapid growth of all critical care specialties highlights the magnitude of the heterogeneity that will exist between intensivists in the future.

The Supply of Physicians Waivered to Prescribe Buprenorphine for Opioid Use Disorders in the United States: A State-Level Analysis.

PubMed

Knudsen, Hannah K

2015-07-01

The U.S. Food and Drug Administration's approval of buprenorphine in 2002 expanded options for treating opioid use disorder (OUD). Physicians who intend to treat OUD patients with buprenorphine must seek a waiver to prescribe it, which may contribute to state-by-state variation in the supply of waivered physicians. This study integrates data extracted from the U.S. Drug Enforcement Agency's database of waivered physicians with state-level indicators of the macro environment, health-related resources, and treatment demand. In December 2013, the average state had 8.0 waivered physicians per 100,000 residents (SD = 5.2). Large regional differences between states in the Northeast relative to states in the Midwest, South, and West were observed. The percentage of residents covered by Medicaid as well as the population-adjusted availability of opioid treatment programs and substance use disorder treatment facilities were positively associated with buprenorphine physician supply. Buprenorphine physician supply was positively correlated with states' rates of overdose deaths, suggesting that physicians may seek the waiver in response to the magnitude of the opioid problem in their state. States with greater health-related resources, particularly in terms of the supply of opioid treatment programs and substance use disorder treatment programs, had more waivered physicians in 2013. The finding regarding Medicaid coverage suggests that states implementing Medicaid expansion under health reform may experience additional growth in buprenorphine physician supply. However, large regional disparities in the supply of waivered physicians may impede access to care for many Americans with OUD.

78 FR 47935 - Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-06

... corresponding terms in alphabetical order below: AIDS Acquired Immune Deficiency Syndrome ARD Assessment... resource-intensive than SNF residents, especially SNF post-acute care patients. These commenters stated...

A Proactive Alcohol and Drug Abuse Prevention Program.

ERIC Educational Resources Information Center

Sallett, Alphonse J.

Anticipating a resident population by 1991, the State University of New York Institute of Technology at Utica/Rome is establishing a proactive alcohol and drug abuse prevention program with links to the surrounding community. According to a recent study, the college student population exceeds national norms for alcohol and drug consumption, and…

Increasing Digital Media and Learning in Classrooms through School-University Partnerships

ERIC Educational Resources Information Center

Herro, Danielle; Qian, Meihua; Jacques, Lorraine

2017-01-01

This article describes findings from a faculty-in-residence program at a Southern middle school in the United States. The goal of the school-university partnership was to increase digital media and learning (DML) integration in classrooms and provide the university with contextualized experiences to strengthen its teacher education programs.…

Increasing Work Opportunities for Low-Income Workers through TANF and Economic Development Programs.

ERIC Educational Resources Information Center

Friedman, Pamela

2002-01-01

The numerous layoffs of low-income workers that occurred when the nation's economy slowed in 2001 have created numerous challenges for local Temporary Assistance for Needy Families (TANF) programs. By increasing collaboration between community economic development and workforce development efforts to serve low-income residents, states and…

Camp Chinkapin.

ERIC Educational Resources Information Center

Crook County School District, Prineville, OR.

The Camp Chinkapin program, begun in 1957-58 as a pilot program for the State of Oregon, provides all sixth grade students in Crook County (Oregon) with a 5-day session in a resident camp setting in the early summer. The book serves as an introduction to and workbook for students attending the Crook County Outdoor Classroom at Suttle Lake. The…

Resident Program Manual for Teachers and Administrators. First Edition.

ERIC Educational Resources Information Center

Skliar, Norman

Since 1976, the Board of Cooperative Educational Services (BOCES) of Nassau County, New York, has utilized a 1600 acre site at Caumsett State Park for its Outdoor and Environmental Education Program. Once the estate of Marshall Field III, the center retains many historic buildings and provides a unique combination of natural habitats: fields,…

Does resident ranking during recruitment accurately predict subsequent performance as a surgical resident?

PubMed

Fryer, Jonathan P; Corcoran, Noreen; George, Brian; Wang, Ed; Darosa, Debra

2012-01-01

While the primary goal of ranking applicants for surgical residency training positions is to identify the candidates who will subsequently perform best as surgical residents, the effectiveness of the ranking process has not been adequately studied. We evaluated our general surgery resident recruitment process between 2001 and 2011 inclusive, to determine if our recruitment ranking parameters effectively predicted subsequent resident performance. We identified 3 candidate ranking parameters (United States Medical Licensing Examination [USMLE] Step 1 score, unadjusted ranking score [URS], and final adjusted ranking [FAR]), and 4 resident performance parameters (American Board of Surgery In-Training Examination [ABSITE] score, PGY1 resident evaluation grade [REG], overall REG, and independent faculty rating ranking [IFRR]), and assessed whether the former were predictive of the latter. Analyses utilized Spearman correlation coefficient. We found that the URS, which is based on objective and criterion based parameters, was a better predictor of subsequent performance than the FAR, which is a modification of the URS based on subsequent determinations of the resident selection committee. USMLE score was a reliable predictor of ABSITE scores only. However, when we compared our worst residence performances with the performances of the other residents in this evaluation, the data did not produce convincing evidence that poor resident performances could be reliably predicted by any of the recruitment ranking parameters. Finally, stratifying candidates based on their rank range did not effectively define a ranking cut-off beyond which resident performance would drop off. Based on these findings, we recommend surgery programs may be better served by utilizing a more structured resident ranking process and that subsequent adjustments to the rank list generated by this process should be undertaken with caution. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Orthopedic Surgery Applicants: What They Want in an Interview and How They Are Influenced by Post-Interview Contact.

PubMed

Camp, Christopher L; Sousa, Paul L; Hanssen, Arlen D; Karam, Matthew D; Haidukewych, George J; Oakes, Daniel A; Turner, Norman S

2016-01-01

Common strategies for orthopedic residency programs to attract competitive applicants include optimizing the interview day and contacting favorably ranked applicants postinterview. The purpose of this work was to determine (1) applicants' perspectives on the ideal interview day, (2) how frequently applicants are contacted postinterview, and (3) the influence of this contact on rank order lists (ROL). Prospective Comparative Survey Mayo Clinic Department of Orthopedic Surgery, Rochester, MN, USA PARTICIPANTS: A survey was completed by 312 successfully matched orthopedic surgery residency applicants following the 2015 match regarding their views of the ideal interview day, components they valued most, post-interview contact, and how that contact influenced their ROL. Applicants stated they preferred interviews that lasted 15 (55%) minutes, a mean of 1.7 (range: 1-5) interviewers present per interview, 5 total interviews (range: 1-10) in a day, an interview with residents (96%), and interviews days lasting only a half day (88%). The majority (94%) desire a social event attended by only residents (54%) or staff and residents (46%). Few wanted an assessment of surgical skills (36%) or orthopedic knowledge (23%). The interview day was rated very valuable in determining their ROL (4.4 out of 5.0). Applicants told a mean of 1.7 (range: 0-11) programs they were "ranking the program highly" and 0.8 (range: 0-5) programs they were "going to rank them #1." Of the 116 (40%) applicants contacted by programs following interviews, 24 (21%) moved programs higher and 3 (3%) moved programs lower on their ROL. Orthopedic Surgery applicants have clear preferences for what they consider to be the ideal interview day and many alter their ROL following post-interview contact. These data may be beneficial to programs looking to optimize the interview experience for applicants. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Curriculum Design and Implementation of the Emergency Medicine Chief Resident Incubator.

PubMed

Gisondi, Michael A; Chou, Adaira; Joshi, Nikita; Sheehy, Margaret K; Zaver, Fareen; Chan, Teresa M; Riddell, Jeffrey; Sifford, Derek P; Lin, Michelle

2018-02-24

Background Chief residents receive minimal formal training in preparation for their administrative responsibilities. There is a lack of professional development programs specifically designed for chief residents. Objective In 2015, Academic Life in Emergency Medicine designed and implemented an annual, year-long, training program and virtual community of practice for chief residents in emergency medicine (EM). This study describes the curriculum design process and reports measures of learner engagement during the first two cycles of the curriculum. Methods Kern's Six-Step Approach for curriculum development informed key decisions in the design and implementation of the Chief Resident Incubator. The resultant curriculum was created using constructivist social learning theory, with specific objectives that emphasized the needs for a virtual community of practice, longitudinal content delivery, mentorship for participants, and the facilitation of multicenter digital scholarship. The 12-month curriculum included 11 key administrative or professional development domains, delivered using a combination of digital communications platforms. Primary outcomes measures included markers of learner engagement with the online curriculum, recognized as modified Kirkpatrick Level One outcomes for digital learning. Results An average of 206 chief residents annually enrolled in the first two years of the curriculum, with an overall participation by 33% (75/227) of the allopathic EM residency programs in the United States (U.S.). There was a high level of learner engagement, with an average 13,414 messages posted per year. There were also 42 small group teaching sessions held online, which included 39 faculty and 149 chief residents. The monthly e-newsletter had a 50.7% open rate. Digital scholarship totaled 23 online publications in two years, with 67 chief resident co-authors and 21 faculty co-authors. Conclusions The Chief Resident Incubator is a virtual community of practice that provides longitudinal training and mentorship for EM chief residents. This incubator conceptual framework may be used to design similar professional development curricula across various health professions using an online digital platform.

Curriculum Design and Implementation of the Emergency Medicine Chief Resident Incubator

PubMed Central

Chou, Adaira; Joshi, Nikita; Sheehy, Margaret K; Zaver, Fareen; Chan, Teresa M; Riddell, Jeffrey; Sifford, Derek P; Lin, Michelle

2018-01-01

Background Chief residents receive minimal formal training in preparation for their administrative responsibilities. There is a lack of professional development programs specifically designed for chief residents. Objective In 2015, Academic Life in Emergency Medicine designed and implemented an annual, year-long, training program and virtual community of practice for chief residents in emergency medicine (EM). This study describes the curriculum design process and reports measures of learner engagement during the first two cycles of the curriculum. Methods Kern’s Six-Step Approach for curriculum development informed key decisions in the design and implementation of the Chief Resident Incubator. The resultant curriculum was created using constructivist social learning theory, with specific objectives that emphasized the needs for a virtual community of practice, longitudinal content delivery, mentorship for participants, and the facilitation of multicenter digital scholarship. The 12-month curriculum included 11 key administrative or professional development domains, delivered using a combination of digital communications platforms. Primary outcomes measures included markers of learner engagement with the online curriculum, recognized as modified Kirkpatrick Level One outcomes for digital learning. Results An average of 206 chief residents annually enrolled in the first two years of the curriculum, with an overall participation by 33% (75/227) of the allopathic EM residency programs in the United States (U.S.). There was a high level of learner engagement, with an average 13,414 messages posted per year. There were also 42 small group teaching sessions held online, which included 39 faculty and 149 chief residents. The monthly e-newsletter had a 50.7% open rate. Digital scholarship totaled 23 online publications in two years, with 67 chief resident co-authors and 21 faculty co-authors. Conclusions The Chief Resident Incubator is a virtual community of practice that provides longitudinal training and mentorship for EM chief residents. This incubator conceptual framework may be used to design similar professional development curricula across various health professions using an online digital platform. PMID:29696101

[Student program, congress grants and their potential influence on surgical career selection].

PubMed

Jähne, J; Mittelstädt, A; Götzky, K

2017-11-01

Due to a decreased interest in surgical training the German Society of Surgery (GSS) has provided a specially sponsored student program at its annual clinical congress for many years in order to increase the number of applicants for a career in surgery. It remains unclear if this goal is reached because an evaluation has not yet been performed. At the clinical congress in 2014, 200 medical students participated in a special student program with the aid of a congress grant totaling 100,000 €. By means of a questionnaire it was asked how many of the participants in this special program have started a residency in surgery. Almost 17% of the participants of the student program answered and 13 students (6.5% of all participants) stated that they had started a surgical residency. All of these students claimed an interest in surgery even before participation in the congress. Those students who had not yet decided what kind of residency they should choose did not vote for surgery despite their visit to the congress. The student program and the congress grant at the annual clinical congress of the GSS do not result in an increased number of applicants for a residency in surgery. Both incentives might be not more than a strategic marketing instrument. An increased number of medical students applying for a residency in surgery is only to be expected if social developments (e. g. attention to a work-life balance) and their concomitant challenges are reflected in surgical day to day work.

An evaluation of geographic trends in the otolaryngology residency match: home is where the heart is.

PubMed

Johnson, Andrew P; Svider, Peter F; Folbe, Adam J; Raza, Syed N; Shkoukani, Mahdi; Eloy, Jean Anderson; Zuliani, Giancarlo

2015-05-01

Securing an otolaryngology residency position has become an increasingly competitive endeavor in recent years. Recent studies have investigated the applicant criteria used by residency programs as part of the ranking process. However, to our knowledge, no studies have comprehensively investigated the role of geographic location in the match process. To evaluate geographic trends in the otolaryngology national residency match process. We conducted a cross-sectional examination of 56 otolaryngology residency programs including 810 residents to determine resident demographic information, including matriculated medical schools. The geographic locations of residency programs and the residents' matriculated medical schools were evaluated for trends. Residents' program locations were compared with the locations of their medical schools of matriculation, and the numbers of residents attending a program affiliated with their medical schools were also identified. Overall, 810 residents were identified from the 56 programs included in our study. Of these, 169 residents (20.9%) attended the program affiliated with their medical school. The Midwest had the highest proportion of residents graduating from the affiliated medical school (25.7%), and the West had the lowest proportion (12.5%) (P = .008). A total of 473 residents attended a program within the same region as their medical school (58.4%). The South had the highest proportion of residents from the same region (68.2%), and the West had the lowest proportion (31.3%) (P < .001). While it is not clear why a geographic bias was identified, a significant proportion of residents in our study attended a program in the same region as their medical school. This geographic association was strongest in the Midwest and South. Furthermore, a significant proportion of residents attended the program affiliated with their medical schools. This information is valuable to all future applicants as they choose where to apply, and to all residency programs as they decide how geographic location factors in to whom they decide to interview.

The development of a TED-Ed online resident research training program

PubMed Central

Moreau, Katherine A.; Pound, Catherine M.; Peddle, Beth; Tokarewicz, Jaclyn; Eady, Kaylee

2014-01-01

Background Pediatric health research is important for improving the health and well-being of children and their families. To foster the development of physicians’ research competencies, it is vital to integrate practical and context-specific research training into residency programs. Purpose To describe the development of a resident research training program at one tertiary care pediatric academic health sciences center in Ontario, Canada. Methods We surveyed residents and pediatricians/research staff to establish the need and content for a resident research training program. Results Residents and resident research supervisors agreed or strongly agreed that research training is important for residents. However, few residents and supervisors believed that their academic health sciences center provided adequate training and resources to support resident research. As such, an online resident research training program was established. Residents and supervisors agreed that the program should focus on the following topics: 1) critically evaluating research literature, 2) writing a research proposal, 3) submitting an application for research funding, and 4) writing a manuscript. Discussion This highly accessible, context-specific, and inexpensive online program model may be of interest and benefit to other residency programs as a means to enhance residents’ scholarly roles. A formal evaluation of the research training program is now underway. PMID:25526717

Global Women's Health Education in Canadian Obstetrics and Gynaecology Residency Programs: A Survey of Program Directors and Senior Residents.

PubMed

Millar, Heather C; Randle, Elizabeth A; Scott, Heather M; Shaw, Dorothy; Kent, Nancy; Nakajima, Amy K; Spitzer, Rachel F

2015-10-01

To become culturally competent practitioners with the ability to care and advocate for vulnerable populations, residents must be educated in global health priorities. In the field of obstetrics and gynaecology, there is minimal information about global women's health (GWH) education and interest within residency programs. We wished to determine within obstetrics and gynaecology residency programs across Canada: (1) current GWH teaching and support, (2) the importance of GWH to residents and program directors, and (3) the level of interest in a national postgraduate GWH curriculum. We conducted an online survey across Canada of obstetrics and gynaecology residency program directors and senior obstetrics and gynaecology residents. Of 297 residents, 101 (34.0%) responded to the survey and 76 (26%) completed the full survey. Eleven of 16 program directors (68.8%) responded and 10/16 (62.5%) provided complete responses. Four of 11 programs (36.4%) had a GWH curriculum, 2/11 (18.2%) had a GWH budget, and 4/11 (36.4%) had a GWH chairperson. Nine of 10 program directors (90%) and 68/79 residents (86.1%) felt that an understanding of GWH issues is important for all Canadian obstetrics and gynaecology trainees. Only 1/10 program directors (10%) and 11/79 residents (13.9%) felt that their program offered sufficient education in these issues. Of residents in programs with a GWH curriculum, 12/19 (63.2%) felt that residents in their program who did not undertake an international elective would still learn about GWH, versus only 9/50 residents (18.0%) in programs without a curriculum (P < 0.001). Obstetrics and gynaecology residents and program directors feel that GWH education is important for all trainees and is currently insufficient. There is a high level of interest in a national postgraduate GWH educational module.

Feasibility of a web-based dementia feeding skills training program for nursing home staff.

PubMed

Batchelor-Murphy, Melissa; Amella, Elaine J; Zapka, Jane; Mueller, Martina; Beck, Cornelia

2015-01-01

Nursing home (NH) staff do not receive adequate training for providing feeding assistance to residents with dementia who exhibit aversive feeding behaviors (e.g., clamping mouth shut). The result is often low meal intake for these residents. This feasibility study tested a web-based dementia feeding skills program for staff in two United States NHs. Randomly assigned, the intervention staff received web-based dementia feeding skills training with coaching. Both groups participated in web-based pre-/post-tests assessing staff knowledge and self-efficacy; and meal observations measured NH staff and resident feeding behaviors, time for meal assistance, and meal intake. Aversive feeding behaviors increased in both groups of residents; however, the intervention NH staff increased the amount of time spent providing assistance and meal intake doubled. In the control group, less time was spent providing assistance and meal intake decreased. This study suggests that training staff to use current clinical practice guidelines improves meal intake. Copyright © 2015 Elsevier Inc. All rights reserved.

Applying Expectancy Theory to residency training: proposing opportunities to understand resident motivation and enhance residency training

PubMed Central

Shweiki, Ehyal; Martin, Niels D; Beekley, Alec C; Jenoff, Jay S; Koenig, George J; Kaulback, Kris R; Lindenbaum, Gary A; Patel, Pankaj H; Rosen, Matthew M; Weinstein, Michael S; Zubair, Muhammad H; Cohen, Murray J

2015-01-01

Medical resident education in the United States has been a matter of national priority for decades, exemplified initially through the Liaison Committee for Graduate Medical Education and then superseded by the Accreditation Council for Graduate Medical Education. A recent Special Report in the New England Journal of Medicine, however, has described resident educational programs to date as prescriptive, noting an absence of innovation in education. Current aims of contemporary medical resident education are thus being directed at ensuring quality in learning as well as in patient care. Achievement and work-motivation theories attempt to explain people’s choice, performance, and persistence in tasks. Expectancy Theory as one such theory was reviewed in detail, appearing particularly applicable to surgical residency training. Correlations between Expectancy Theory as a work-motivation theory and residency education were explored. Understanding achievement and work-motivation theories affords an opportunity to gain insight into resident motivation in training. The application of Expectancy Theory in particular provides an innovative perspective into residency education. Afforded are opportunities to promote the development of programmatic methods facilitating surgical resident motivation in education. PMID:25995656

Applying Expectancy Theory to residency training: proposing opportunities to understand resident motivation and enhance residency training.

PubMed

Shweiki, Ehyal; Martin, Niels D; Beekley, Alec C; Jenoff, Jay S; Koenig, George J; Kaulback, Kris R; Lindenbaum, Gary A; Patel, Pankaj H; Rosen, Matthew M; Weinstein, Michael S; Zubair, Muhammad H; Cohen, Murray J

2015-01-01

Medical resident education in the United States has been a matter of national priority for decades, exemplified initially through the Liaison Committee for Graduate Medical Education and then superseded by the Accreditation Council for Graduate Medical Education. A recent Special Report in the New England Journal of Medicine, however, has described resident educational programs to date as prescriptive, noting an absence of innovation in education. Current aims of contemporary medical resident education are thus being directed at ensuring quality in learning as well as in patient care. Achievement and work-motivation theories attempt to explain people's choice, performance, and persistence in tasks. Expectancy Theory as one such theory was reviewed in detail, appearing particularly applicable to surgical residency training. Correlations between Expectancy Theory as a work-motivation theory and residency education were explored. Understanding achievement and work-motivation theories affords an opportunity to gain insight into resident motivation in training. The application of Expectancy Theory in particular provides an innovative perspective into residency education. Afforded are opportunities to promote the development of programmatic methods facilitating surgical resident motivation in education.

Resident and program director gender distribution by specialty.

PubMed

Long, Timothy R; Elliott, Beth A; Warner, Mary Ellen; Brown, Michael J; Rose, Steven H

2011-12-01

Although enrollment of women in U.S. medical schools has increased, women remain less likely to achieve senior academic rank, lead academic departments, or be appointed to national leadership positions. The purpose of this paper is to compare the gender distribution of residency program directors (PDs) with residents and faculty in the 10 largest specialties. The gender distribution of residents training in the 10 specialties with the largest enrollment was obtained from the annual education issue of Journal of the American Medical Association. The gender distribution of the residents was compared with the gender distribution of PDs and medical school faculty. The number of programs and the names of the PDs were identified by accessing the Accreditation Council for Graduate Medical Education web site. Gender was confirmed through electronic search of state medical board data, program web sites, or by using internet search engines. The gender distribution of medical school faculty was determined using the Association of American Medical Colleges faculty roster database (accessed June 15, 2011). The correlation between female residents and PDs was assessed using Pearson's product-moment correlation. The gender distribution of female PDs appointed June 1, 2006, through June 1, 2010, was compared with the distribution appointed before June 1, 2006, using chi square analysis. Specialties with higher percentages of female PDs had a higher percentage of female residents enrolled (r=0.81, p=0.005). The number of female PDs appointed from July 1, 2006, through June 30, 2010, was greater than the number appointed before July 1, 2006, in emergency medicine (p<0.001), family medicine (p=0.02), and for all PDs (p=0.005). Female PDs were fewer than expected based on the gender distribution of medical school faculty in 7 of the 10 specialties. Women remain underrepresented in PD appointments relative to the proportion of female medical school faculty and female residents. Mechanisms to address gender-based barriers to advancement should be considered.

Professionalization of anesthesiologists and critical care specialists in humanitarian action: a nationwide poll among italian residents.

PubMed

Ripoll Gallardo, Alba; Ingrassia, Pier Luigi; Ragazzoni, Luca; Djalali, Ahmadreza; Carenzo, Luca; Burkle, Frederick M; Della Corte, Francesco

2015-02-01

Over the last decades, humanitarian crises have seen a sharp upward trend. Regrettably, physicians involved in humanitarian action have often demonstrated incomplete preparation for these compelling events which have proved to be quite different from their daily work. Responders to these crises have included an unpredictable mix of beginner-level, mid-level, and expert-level providers. The quality of care has varied considerably. The international humanitarian community, in responding to international calls for improved accountability, transparency, coordination, and a registry of professionalized international responders, has recently launched a call for further professionalization within the humanitarian assistance sector, especially among academic-affiliated education and training programs. As anesthetists have been involved traditionally in medical relief operations, and recent disasters have seen a massive engagement of young physicians, the authors conducted, as a first step, a poll among residents in Anesthesia and Critical Care Medicine in Italy to evaluate their interest in participating in competency-based humanitarian assistance education and in training incorporated early in residencies. The Directors of all the 39 accredited anesthesia/critical care training programs in Italy were contacted and asked to submit a questionnaire to their residents regarding the objectives of the poll study. After acceptance to participate, residents were enrolled and asked to complete a web-based poll. A total of 29 (74%) of the initial training programs participated in the poll. Out of the 1,362 questionnaires mailed to residents, 924 (68%) were fully completed and returned. Only 63(6.8%) of the respondents voiced prior participation in humanitarian missions, but up to 690 (74.7%) stated they were interested in participating in future humanitarian deployments during their residency that carried over into their professional careers. Countrywide, 896 (97%) favored prior preparation for residents before participating in humanitarian missions, while the need for a specific, formal, professionalization process of the entire humanitarian aid sector was supported by 889 (96.2%). In Italy, the majority of anesthesia/critical care residents, through a formal poll study, affirmed interest in participating in humanitarian assistance missions and believe that further professionalization within the humanitarian aid sector is required. These results have implications for residency training programs worldwide.

Resident partnerships: an effective strategy for training in primary care.

PubMed

Adam, P; Williamson, H A; Zweig, S C; Delzell, J E

1997-06-01

To facilitate resident training in the ambulatory setting, a few family practice residency programs use a partnership system to train residents. Partnerships are pairs of residents from the same year that rotate together on inpatient services. We identified and characterized the advantages and disadvantages of partnership programs in family practice residencies. We conducted a national survey of family practice residencies, followed by phone interviews with residency directors of programs with partnerships. A total of 305 of 407 (75%) residencies responded; 10 programs fit our definition of partnership. Program directors were positive about resident partnerships. Benefits included improved outpatient continuity, enhanced medical communication skills, and emotional and intellectual support. Disadvantages were decreased inpatient exposure and difficulty coordinating residents' schedules. Directors were favorable about partnerships, which seem to be an underutilized technique to improve residency training.

Identifying Gaps and Launching Resident Wellness Initiatives: The 2017 Resident Wellness Consensus Summit.

PubMed

Zaver, Fareen; Battaglioli, Nicole; Denq, William; Messman, Anne; Chung, Arlene; Lin, Michelle; Liu, Emberlynn L

2018-03-01

Burnout, depression, and suicidality among residents of all specialties have become a critical focus for the medical education community, especially among learners in graduate medical education. In 2017 the Accreditation Council for Graduate Medical Education (ACGME) updated the Common Program Requirements to focus more on resident wellbeing. To address this issue, one working group from the 2017 Resident Wellness Consensus Summit (RWCS) focused on wellness program innovations and initiatives in emergency medicine (EM) residency programs. Over a seven-month period leading up to the RWCS event, the Programmatic Initiatives workgroup convened virtually in the Wellness Think Tank, an online, resident community consisting of 142 residents from 100 EM residencies in North America. A 15-person subgroup (13 residents, two faculty facilitators) met at the RWCS to develop a public, central repository of initiatives for programs, as well as tools to assist programs in identifying gaps in their overarching wellness programs. An online submission form and central database of wellness initiatives were created and accessible to the public. Wellness Think Tank members collected an initial 36 submissions for the database by the time of the RWCS event. Based on general workplace, needs-assessment tools on employee wellbeing and Kern's model for curriculum development, a resident-based needs-assessment survey and an implementation worksheet were created to assist residency programs in wellness program development. The Programmatic Initiatives workgroup from the resident-driven RWCS event created tools to assist EM residency programs in identifying existing initiatives and gaps in their wellness programs to meet the ACGME's expanded focus on resident wellbeing.

Simulation Training in Obstetrics and Gynaecology Residency Programs in Canada.

PubMed

Sanders, Ari; Wilson, R Douglas

2015-11-01

The integration of simulation into residency programs has been slower in obstetrics and gynaecology than in other surgical specialties. The goal of this study was to evaluate the current use of simulation in obstetrics and gynaecology residency programs in Canada. A 19-question survey was developed and distributed to all 16 active and accredited obstetrics and gynaecology residency programs in Canada. The survey was sent to program directors initially, but on occasion was redirected to other faculty members involved in resident education or to senior residents. Survey responses were collected over an 18-month period. Twelve programs responded to the survey (11 complete responses). Eleven programs (92%) reported introducing an obstetrics and gynaecology simulation curriculum into their residency education. All respondents (100%) had access to a simulation centre. Simulation was used to teach various obstetrical and gynaecological skills using different simulation modalities. Barriers to simulation integration were primarily the costs of equipment and space and the need to ensure dedicated time for residents and educators. The majority of programs indicated that it was a priority for them to enhance their simulation curriculum and transition to competency-based resident assessment. Simulation training has increased in obstetrics and gynaecology residency programs. The development of formal simulation curricula for use in obstetrics and gynaecology resident education is in early development. A standardized national simulation curriculum would help facilitate the integration of simulation into obstetrics and gynaecology resident education and aid in the shift to competency-based resident assessment. Obstetrics and gynaecology residency programs need national collaboration (between centres and specialties) to develop a standardized simulation curriculum for use in obstetrics and gynaecology residency programs in Canada.

A young surgeon's perspective on alternate surgical training pathways.

PubMed

Sutherland, Michael J

2007-02-01

Most residents in training today are in focused on their training, and the thoughts of changing the structure of residencies and fellowships is something that they are ambivalent about or have never heard anything about. The small minority who are vocal on these issues represent an activist group supporting change. This group is very vocal and raises many of the excellent questions we have examined. In discussion with residents, some feel that shortened training will help with the financial issues facing residents. However, many people today add additional years to their training with research years or "super" fellowships. The residents demonstrate that they want to get the skill sets that they desire despite the added length of training. This is unlikely to change even if the minimum number of years of training changes with the evolution of tracked training programs. Medical students, in the Resident and Associate Society of the American College of Surgeons survey, did not indicate that shortened training would have an affect on decision to pursue or not pursue a surgical career. If the focus of these changes is to encourage medical students to pursue a residency in surgical specialties, we may need to look at other options to increase medical student interest. Medical students indicated that lifestyle issues, types of clinical problems, stress-related concerns, and interactions with the surgical faculty were far more important in their decision to enter a surgical specialty than work hours or duration of training. If we are to make a difference in the quality and quantity of applicants for surgical residencies, then changes in the structure of residencies do not seem to be the most effective way to accomplish this. We should possibly focus more on faculty and medical student interaction and the development of positive role models for medical students to see surgeons with attractive practices that minimize some of the traditionally perceived negative stereotypes. Residents in general surgery training programs often do not make decisions on the type of fellowship that they will pursue until late in their residency. Many residents are apprehensive about these types of tracked training programs because it will accelerate the timeline for choosing a track. Changes in the structure of residency and fellowships would result in residents having to decide and "match" in their second or third postgraduate years of training instead of the fourth or fifth postgraduate year time frame. Many residents will not have been exposed to all of the types of tracks by their third postgraduate year and many voice concerns over being ready to make this decision that early in their training. Acceptance and enthusiasm about this concept among all residents will likely depend on the final version of any planned changes. A wholesale rewrite of surgical training in the United States would likely not be well received. However, the addition of alternate pathways, on a limited scale and under close scrutiny and supervision, could evaluate interest and ease into this type of program. Before embarking on massive changes in surgical training, scientific, statistically valid research determining the interest of residents in these types of programs will target changes to make these programs successful.

Awareness about clostridium difficile infection among internal medicine residents in the United States.

PubMed

Navaneethan, U; Schauer, D; Giannella, R

2011-09-01

Clostridium difficile infection (CDI) is the leading infective cause of antibiotic associated diarrhea. The principal objective of this study was to assess the knowledge and awareness of internal medicine (IM) residents regarding the epidemiology, clinical recognition, diagnosis and management of CDI. A 20-question survey was distributed to 90 IM residents in all three years of their post graduate training in a university-based program. The survey instrument assessed the resident's knowledge of the current epidemiological trend, clinical recognition and presentation, diagnosis and management of CDI. Forty two out of 90 (48%) residents completed the questionnaire. Only 10/42 (23.8%) of the residents recommended the gold standard investigation for diagnosing CDI. The majority of residents 29/42 (69%) were not aware of the existence of CDI in the outpatient setting and would not test for CDI. Only 50% of the residents were aware of the worse outcome of CDI in inflammatory bowel disease patients and only 12/42 (28.6%) would appropriately risk stratify and treat patients. Almost all of the residents (97.6%) knew about the appropriate time to consult surgery. There was no significant difference in the awareness with respect to the year of training (interns vs. residents), their career choices (primary care vs. fellowship) nor did the knowledge correlate with the United States medical licensing examination (USMLE) scores. IM residents had suboptimal knowledge of many aspects of the common problem of CDI. Educational efforts should be directed at IM residents, many of whom plan careers as primary care/hospitalists, who will encounter patients with CDI.

California Deficit Clouds Picture for K-12 Funding

ERIC Educational Resources Information Center

Cavanagh, Sean

2011-01-01

Not long after he took office in January, California Governor Jerry Brown presented residents of his state with a simple, stark plan for correcting the state's massive budget imbalance. The Democrat called for making deep and painful cuts to programs across government, while sparing schools. To raise revenue, he proposed allowing the public to…

The State of Sexual Health Education in U.S. Medicine

ERIC Educational Resources Information Center

Criniti, S.; Andelloux, M.; Woodland, M. B.; Montgomery, O. C.; Hartmann, S. Urdaneta

2014-01-01

Although studies have shown that patients want to receive sexual health services from their physicians, doctors often lack the knowledge and skills to discuss sexual health with their patients. There is little consistency among medical schools and residency programs in the United States regarding comprehensiveness of education on sexual health.…

Federal support for state and local response operations - PHE

Science.gov Websites

Nutrition Service hosted a media event at the Flint Farmer's Market on Tuesday, April 26 to increase awareness of all the ways residents can leverage USDA's nutrition programs to mitigate the effects of lead on their health. The event featured presentations by state and local USDA nutrition assistance

Evaluation of Community Residential Programs for Mentally Retarded Persons.

ERIC Educational Resources Information Center

Minnesota State Office of the Legislative Auditor, St. Paul. Program Evaluation Div.

The report evaluates how Minnesota plans, regulates, and finances residential services for mentally retarded persons. The first chapter reviews descriptive findings about the mentally retarded population in the state and notes that despite a decline in the number of state hospital residents, the total number of retarded persons in long-term care…

Experiences of International Female Students in U.S. Graduate Programs

ERIC Educational Resources Information Center

Contreras-Aguirre, Hilda Cecilia; Gonzalez Y Gonzalez, Elsa

2017-01-01

International students enrolled in American institutions of higher education have been increasing during the past decades. The current study addresses the experiences of international female graduate students in the United States, in terms of difficulties as students at a southern American university and temporal residents of the United States.…

Identifying areas of weakness in thoracic surgery residency training: a comparison of the perceptions of residents and program directors.

PubMed

Edwards, Janet P; Schofield, Adam; Paolucci, Elizabeth Oddone; Schieman, Colin; Kelly, Elizabeth; Servatyari, Ramin; Dixon, Elijah; Ball, Chad G; Grondin, Sean C

2014-01-01

To identify core thoracic surgery procedures that require increased emphasis during thoracic surgery residency for residents to achieve operative independence and to compare the perspectives of residents and program directors in this regard. A modified Delphi process was used to create a survey that was distributed electronically to all Canadian thoracic surgery residents (12) and program directors (8) addressing the residents' ability to perform 19 core thoracic surgery procedures independently after the completion of residency. Residents were also questioned about the adequacy of their operative exposure to these 19 procedures during their residency training. A descriptive summary including calculations of frequencies and proportions was conducted. The perceptions of the 2 groups were then compared using the Fisher exact test employing a Bonferroni correction. The relationship between residents' operative exposure and their perceived operative ability was explored in the same fashion. The response rate was 100% for residents and program directors. No statistical differences were found between residents' and program directors' perceptions of residents' ability to perform the 19 core procedures independently. Both groups identified lung transplantation, first rib resection, and extrapleural pneumonectomy as procedures for which residents were not adequately prepared to perform independently. Residents' subjective ratings of operative exposure were in good agreement with their reported operative ability for 13 of 19 procedures. This study provides new insight into the perceptions of thoracic surgery residents and their program directors regarding operative ability. This study points to good agreement between residents and program directors regarding residents' surgical capabilities. This study provides information regarding potential weaknesses in thoracic surgery training, which may warrant an examination of the curricula of existing programs as well as a reconsideration of what the scope of practice of a general thoracic surgeon should entail. © 2013 Published by Association of Program Directors in Surgery on behalf of Association of Program Directors in Surgery.

Resident Autonomy in the Operating Room: How Faculty Assess Real-time Entrustability.

PubMed

Chen, Xiaodong Phoenix; Sullivan, Amy M; Smink, Douglas S; Alseidi, Adnan; Bengtson, Joan M; Kwakye, Gifty; Dalrymple, John L

2018-02-20

This study aimed to identify the empirical processes and evidence that expert surgical teachers use to determine whether to take over certain steps or entrust the resident with autonomy to proceed during an operation. Assessing real-time entrustability is inherent in attending surgeons' determinations of residents' intraoperative autonomy in the operating room. To promote residents' autonomy, it is necessary to understand how attending surgeons evaluate residents' performance and support opportunities for independent practice based on the assessment of their entrustability. We conducted qualitative semi-structured interviews with 43 expert surgical teachers from 21 institutions across 4 regions of the United States, using purposeful and snowball sampling. Participants represented a range of program types, program size, and clinical expertise. We applied the Framework Method of content analysis to iteratively analyze interview transcripts and identify emergent themes. We identified a 3-phase process used by most expert surgical teachers in determining whether to take over intraoperatively or entrust the resident to proceed, including 1) monitoring performance and "red flags," 2) assessing entrustability, and 3) granting autonomy. Factors associated with individual surgeons (eg, level of comfort, experience, leadership role) and the context (eg, patient safety, case, and time) influenced expert surgical teachers' determinations of entrustability and residents' final autonomy. Expert surgical teachers' 3-phase process of decisions on take-over provides a potential framework that may help surgeons identify appropriate opportunities to develop residents' progressive autonomy by engaging the resident in the determination of entrustability before deciding to take over.

Initial review of Electronic Residency Application Service charts by orthopaedic residency faculty members. Does applicant gender matter?

PubMed

Scherl, S A; Lively, N; Simon, M A

2001-01-01

Orthopaedic surgery is a male-dominated field. As of 1998, women accounted for 42% of medical school graduates, yet only 6.9% of the total number of orthopaedic residents were female. The purpose of our study was to determine whether the Electronic Residency Application Service charts of female candidates for orthopaedic residencies are ranked lower by faculty reviewers than are those of male candidates with similar qualifications. After we obtained permission from the applicants, the Electronic Residency Application Service applications submitted by ninety male and ten female candidates for admission to a university orthopaedic residency program for the 1998 National Residency Matching Program were randomly divided into ten groups, consisting of the charts of nine male candidates and one female candidate. Each chart from a female candidate was altered into a "male" version, in which all names and personal pronouns were changed but which was otherwise identical to the original female version. Therefore, each group of ten charts existed as a paired set: one containing the true female chart and one, the altered "male" chart. The paired sets acted as their own control. One hundred and twenty-one faculty reviewers from fourteen orthopaedic residency programs around the United States each reviewed either the "male" or the female version of one set, without knowledge of the goals of the study, and ranked the ten charts in the order in which they would like to have the candidates as residents in their own programs. Each version of the sets was reviewed by at least five separate reviewers. Reviewers at a given institution were randomized to review different sets, so that there was no overlap among them. The rankings of the female-"male" pairs were compared with use of a standard paired t test. No significant difference was detected in the rankings of the female and "male" charts (p = 0.5). The mean difference in rankings was -0.33, with a 95% confidence interval ranging from -1.41 (favoring females) to 0.74 (favoring "males"). The low percentage of female residents is not due to bias against female applicants in the initial chart-review phase of the orthopaedic residency selection process. It is possible that bias is introduced in other stages of the selection process, such as the interview.

Palliative Care Education in Emergency Medicine Residency Training: A Survey of Program Directors, Associate Program Directors, and Assistant Program Directors.

PubMed

Kraus, Chadd K; Greenberg, Marna R; Ray, Daniel E; Dy, Sydney Morss

2016-05-01

Emergency medicine (EM) residents perceive palliative care (PC) skills as important and want training, yet there is a general lack of formal PC training in EM residency programs. A clearer definition of the PC educational needs of EM trainees is a research priority. To assess PC competency education in EM residency programs. This was a mixed-mode survey of residency program directors, associate program directors, and assistant program directors at accredited EM residency programs, evaluating four educational domains: 1) importance of specific competencies for senior EM residents, 2) senior resident skills in PC competencies, 3) effectiveness of educational methods, and 4) barriers to training. Response rate was 50% from more than 100 residency programs. Most respondents (64%) identified PC competencies as important for residents to learn, and 59% reported that they teach7 PC skills in their residency program. In Domains 1 and 2, crucial conversations, management of pain, and management of the imminently dying had the highest scores for importance and residents' skill. In Domain 3, bedside teaching, mentoring from hospice and palliative medicine faculty, and case-based simulation were the most effective educational methods. In Domain 4, lack of PC expertise among faculty and lack of interest by faculty and residents were the greatest barriers. There were differences between competency importance and senior resident skill level for management of the dying child, withdrawal/withholding of nonbeneficial interventions, and ethical/legal issues. There are specific barriers and opportunities for PC competency training and gaps in resident skill level. Specifically, there are discrepancies in competency importance and residency skill in the management of the dying child, nonbeneficial interventions, and ethical and legal issues that could be a focus for educational interventions in PC competency training in EM residencies. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Emergency medicine residency applicant perceptions of unethical recruiting practices and illegal questioning in the match.

PubMed

Thurman, R Jason; Katz, Eric; Carter, Wallace; Han, Jin; Kayala, Eve; McCoin, Nicole; Storrow, Alan B

2009-06-01

The authors hypothesized that unethical recruiting practices and illegal questioning occur during emergency medicine (EM) resident recruitment. The objectives were to estimate the prevalence of specific unethical recruiting practices and illegal questioning by EM programs based on the perceptions of residency applicants and to measure the effect of these perceptions on applicant appraisal of programs. This was a cross-sectional survey of all applicants who matched to U.S. EM programs in 2005 and 2006. The survey questionnaire was developed by the study authors and was validated by pretesting on a small group representative of the study population. The survey addressed specific questions regarding program recruiting behaviors and interview questioning. The hyperlink to the secure anonymous online survey questionnaire was distributed to all EM program directors, asking them in turn to forward the hyperlink to their newly matched incoming residency class. All data were calculated with Score method with continuity correction and reported in proportions with 95% confidence intervals (CIs). The authors received 671 survey responses. Among respondents, 56 (8.3%, 95% CI = 6.4% to 10.7%) stated that they were specifically asked to disclose at least one program's position on their rank list by a program representative, and 44 (6.6%, 95% CI = 4.9% to 8.9%) reported that they matched at a program residing lower on their rank list than at least one other program that had informed the applicant they were ranked to match. Furthermore, 201 respondents (30.0%, 95% CI = 26.5% to 33.7%) believed that they were asked at least one illegal question during their interviews, the most common of which was inquiry into their marital status (189 respondents: 28.2%, 95% CI = 24.8% to 31.9%). Respondents were 11 times more likely to move a program to a lower position of preference on their rank order list (12.2%, 95% CI = 9.8% to 15.0%) rather than a higher position (1.1%, 95% CI = 0.5% to 2.3%) as a result of perceiving unethical recruiting behaviors or illegal questioning. These results demonstrate that among survey respondents, some perceived unethical recruiting behaviors and illegal questioning in the 2005 and 2006 Match. Perceptions of such behaviors appeared to have a negative impact on applicant appraisal of EM residency programs.

Factors affecting orthopedic residency selection: a cross-sectional survey.

PubMed

Strelzow, Jason; Petretta, Robert; Broekhuyse, Henry M

2017-06-01

Annually, orthopedic residency programs rank and recruit the best possible candidates. Little evidence exists identifying factors that potential candidates use to select their career paths. Recent literature from nonsurgical programs suggests hospital, social and program-based factors influence program selection. We sought to determine what factors influence the choice of an orthopedic career and a candidate's choice of orthopedic residency program. We surveyed medical student applicants to orthopedic programs and current Canadian orthopedic surgery residents (postgraduate year [PGY] 1-5). The confidential online survey focused on 3 broad categories of program selection: educational, program cohesion and noneducation factors. Questions were graded on a Likert Scale and tailed for mean scores. In total, 139 residents from 11 of 17 Canadian orthopedic programs (49% response rate) and 23 medical student applicants (88% response rate) completed our survey. Orthopedic electives and mandatory rotations were reported by 71% of participants as somewhat or very important to their career choice. Collegiality among residents (4.70 ± 0.6), program being the "right fit" (4.65 ± 0.53) and current resident satisfaction with their chosen program (4.63 ±0.66) were ranked with the highest mean scores on a 5-point Likert scale. There are several modifiable factors that residency programs may use to attract applicants, including early availability of clerkship rotations and a strong mentorship environment emphasizing both resident-resident and resident-staff cohesion. Desirable residency programs should develop early access to surgical and operative skills. These must be balanced with a continued emphasis on top-level orthopedic training.

Internal Medicine Residents' Perceived Responsibility for Patients at Hospital Discharge: A National Survey.

PubMed

Young, Eric; Stickrath, Chad; McNulty, Monica C; Calderon, Aaron J; Chapman, Elizabeth; Gonzalo, Jed D; Kuperman, Ethan F; Lopez, Max; Smith, Christopher J; Sweigart, Joseph R; Theobald, Cecelia N; Burke, Robert E

2016-12-01

Medical residents are routinely entrusted with transitions of care, yet little is known about the duration or content of their perceived responsibility for patients they discharge from the hospital. To examine the duration and content of internal medicine residents' perceived responsibility for patients they discharge from the hospital. The secondary objective was to determine whether specific individual experiences and characteristics correlate with perceived responsibility. Multi-site, cross-sectional 24-question survey delivered via email or paper-based form. Internal medicine residents (post-graduate years 1-3) at nine university and community-based internal medicine training programs in the United States. Perceived responsibility for patients after discharge as measured by a previously developed single-item tool for duration of responsibility and novel domain-specific questions assessing attitudes towards specific transition of care behaviors. Of 817 residents surveyed, 469 responded (57.4 %). One quarter of residents (26.1 %) indicated that their responsibility for patients ended at discharge, while 19.3 % reported perceived responsibility extending beyond 2 weeks. Perceived duration of responsibility did not correlate with level of training (P = 0.57), program type (P = 0.28), career path (P = 0.12), or presence of burnout (P = 0.59). The majority of residents indicated they were responsible for six of eight transitional care tasks (85.1-99.3 % strongly agree or agree). Approximately half of residents (57 %) indicated that it was their responsibility to directly contact patients' primary care providers at discharge. and 21.6 % indicated that it was their responsibility to ensure that patients attended their follow-up appointments. Internal medicine residents demonstrate variability in perceived duration of responsibility for recently discharged patients. Neither the duration nor the content of residents' perceived responsibility was consistently associated with level of training, program type, career path, or burnout, suggesting there may be unmeasured factors such as professional role modeling that shape these perceptions.

The Advanced Trauma Operative Management course in a Canadian residency program

PubMed Central

Ali, Jameel; Ahmed, Najma; Jacobs, Lenworth M.; Luk, Stephen S.

2008-01-01

Background The Advanced Trauma Operative Management (ATOM) course was first introduced into Canada in 2003 at the University of Toronto, with senior general surgery residents being the primary focus. We present an assessment of the course in this Canadian general surgery residency program. Methods We compared trainees' pre-and postcourse self-efficacy scores and multiple choice question (MCQ) examination results, using paired t tests and resident (n = 24) and faculty (n = 7) course ratings made according to a 10-item, 5-point Likert scale. Faculty were previously trained as ATOM instructors. Results Mean pre-and postcourse self-efficacy scores were 68.9 (standard deviation [SD] 24.0) and 101.4 (SD 14.8), respectively (p < 0.001). Mean pre-and post-MCQ scores were 16.4 (SD 3.2) and 18.8 (SD 2.7), respectively (p = 0.006). On the Likert scale (1 = strongly disagree, 5 = strongly agree), all faculty and residents rated the following items as 4–5: objectives were met; knowledge, skills, clinical training, judgment and confidence improved; the live animal is a useful representation of clinical trauma; and the course should be continued but would be more appropriate for the fourth rather than the fifth year of residency. Residents rated as 1–2 the item that the human cadaver would be preferable for learning the surgical skills. Of 24 residents, 20 rated as 3 or less the item stating that the course prepares them for trauma management more adequately than their regular training program. Conclusion Self-efficacy, trauma knowledge and skills improved significantly with ATOM training. Preference was expressed for the live animal versus cadaver model, for ATOM training in the fourth rather than fifth year of residency and for the view that it complements general surgery trauma training. The data suggest that including ATOM training in Canadian general surgical residency should be considered. PMID:18682791

Protected Resident Research Time Does Not Increase the Quantity or Quality of Residency Program Research Publications: A Comparison of 3 Orthopedic Residencies.

PubMed

Krueger, Chad A; Hoffman, Jeffery D; Balazs, George C; Johnson, Anthony E; Potter, Benjamin K; Belmont, Philip J

The effect of dedicated resident research time in terms of residency program research productivity remains largely unknown. We hypothesize that the quantity and quality of a residency program's peer-reviewed publications (PRPs) increase proportionately with the amount of dedicated research time given to residents. Three residency programs (P1, P2, and P3) were examined. P1 has a mandatory research year for all residents between postgraduate years 3 and 4. P2 has an elective research year for 1 resident between postgraduate years 2 and 3. P3 has no dedicated research time for residents. All publications produced by residents and staff at each program from January 2007 through December were recorded from PUBMED. SCImago Journal Rankings were used as a proxy to measure research quality. There was no significant difference in the number of publications produced between the institutions on a per-staff (p = 0.27) and per-resident (p = 0.80) basis. There were no residents at P3 who graduated without at least 1 PRP, whereas there were 7 residents from P1 and 8 residents from P2 who graduated without a PRP. There were no significant differences between programs in terms of the SCImago Journal Ranking for the journals containing their publications (p = 0.135). Residency programs with dedicated research time did not produce significantly (p > 0.05) more, or higher quality, PRPs than residencies without dedicated research time. It may be that the quantity and quality of PRPs is related more to faculty engagement, research interest, and mentorship at individual programs rather than the number of residents given dedicated time to complete research. Level 3. Published by Elsevier Inc.

Alternate methods to teach history of anesthesia.

PubMed

Desai, Manisha S; Desai, Sukumar P

2014-02-01

Residency programs in anesthesiology in the United States struggle to balance the conflicting needs of formal didactic sessions, clinical teaching, and clinical service obligations. As a consequence of the explosion in knowledge about basic and applied sciences related to our specialty, residents and fellows are expected to make substantial efforts to supplement formal lectures with self-study. There is strong evidence to suggest that members of the younger generation use nontraditional methods to acquire information. Although training programs are not required to include topics related to history of anesthesia (HOA) in the didactic curriculum, and despite the fact that such knowledge does not directly impact clinical care, many programs include such lectures and discussions. We describe and discuss our experience with 3 alternate modalities of teaching HOA.First, we provide brief descriptions of HOA-related historical narratives and novels within the domain of popular literature, rather than those that might be considered textbooks. Second, we analyze content in movies and videodiscs dealing with HOA and determine their utility as educational resources. Third, we describe HOA tours to sites in close proximity to our institutions, as well as those in locations elsewhere in the United States and abroad.We suggest that informal HOA teaching can be implemented by every residency program without much effort and without taking away from the traditional curriculum. Participating in this unique and enriching experience may be a means of academic advancement. It is our hope and expectation that graduates from programs that incorporate such exposure to HOA become advocates of history and may choose to devote a part of their academic career toward exploration of HOA.

Association of General Surgery Resident Remediation and Program Director Attitudes With Resident Attrition.

PubMed

Schwed, Alexander C; Lee, Steven L; Salcedo, Edgardo S; Reeves, Mark E; Inaba, Kenji; Sidwell, Richard A; Amersi, Farin; Are, Chandrakanth; Arnell, Tracey D; Damewood, Richard B; Dent, Daniel L; Donahue, Timothy; Gauvin, Jeffrey; Hartranft, Thomas; Jacobsen, Garth R; Jarman, Benjamin T; Melcher, Marc L; Mellinger, John D; Morris, Jon B; Nehler, Mark; Smith, Brian R; Wolfe, Mary; Kaji, Amy H; de Virgilio, Christian

2017-12-01

Previous studies of resident attrition have variably included preliminary residents and likely overestimated categorical resident attrition. Whether program director attitudes affect attrition has been unclear. To determine whether program director attitudes are associated with resident attrition and to measure the categorical resident attrition rate. This multicenter study surveyed 21 US program directors in general surgery about their opinions regarding resident education and attrition. Data on total resident complement, demographic information, and annual attrition were collected from the program directors for the study period of July 1, 2010, to June 30, 2015. The general surgery programs were chosen on the basis of their geographic location, previous collaboration with some coauthors, prior work in surgical education and research, or a program director willing to participate. Only categorical surgical residents were included in the study; thus, program directors were specifically instructed to exclude any preliminary residents in their responses. Five-year attrition rates (2010-2011 to 2014-2015 academic years) as well as first-time pass rates on the General Surgery Qualifying Examination and General Surgery Certifying Examination of the American Board of Surgery (ABS) were collected. High- and low-attrition programs were compared. The 21 programs represented different geographic locations and 12 university-based, 3 university-affiliated, and 6 independent program types. Programs had a median (interquartile range [IQR]) number of 30 (20-48) categorical residents, and few of those residents were women (median [IQR], 12 [5-17]). Overall, 85 of 966 residents (8.8%) left training during the study period: 15 (17.6%) left after postgraduate year 1, 34 (40.0%) after postgraduate year 2, and 36 (42.4%) after postgraduate year 3 or later. Forty-four residents (51.8%) left general surgery for another surgical discipline, 21 (24.7%) transferred to a different surgery program, and 18 (21.2%) exited graduate medical education altogether. Each program had an annual attrition rate ranging from 0.73% to 6.0% (median [IQR], 2.5% [1.5%-3.4%]). Low-attrition programs were more likely than high-attrition programs to use resident remediation (21.0% vs 6.8%; P < .001). Median (IQR) Qualifying Examination pass rates (93% [90%-98%] vs 92% [86%-100%]; P = .92) and Certifying Examination pass rates (83% [68%-84%] vs 81% [71%-86%]; P = .47) were similar. Program directors at high-attrition programs were more likely than their counterparts at low-attrition programs to agree with this statement: "I feel that it is my responsibility as a program director to redirect residents who should not be surgeons." The overall 5-year attrition rate of 8.8% was significantly lower than previously reported. Program directors at low-attrition programs were more likely to use resident remediation. Variations in attrition may be explained by program director attitudes, although larger studies are needed to further define program factors affecting attrition.

Personal and Professional Well-Being of Surgical Residents in New England.

PubMed

Yoo, Peter S; Tackett, John J; Maxfield, Mark W; Fisher, Rosemarie; Huot, Stephen J; Longo, Walter E

2017-06-01

Although there is increasing literature about burnout and attrition among surgeons, little is known about personal and professional well-being of surgical trainees. General surgery residents from the 6 New England states participated in a cross-sectional, qualitative, self-reported survey to assess the domains of personal health maintenance, personal finance, work environment, and fatigue management as they relate to surgical training. All surgical residency programs in the New England region were invited to participate. Of these 19 programs, 10 elected to participate in the study. Three hundred and sixty-three total trainees were contacted with requests to participate, and 166 completed responses to the survey, resulting in a response rate of 44.9%. Ninety percent of respondents identified their programs as "university or academic." Substantial cohorts reported that during training they lacked basic healthcare maintenance visits (54%) and had undesired weight gain (44%). Although most found their stipends adequate, three-quarters worried about their finances (75%) and reported substantial educational debt (45%). Most residents enjoyed coming to work; however, the vast majority reported that work-related stress is moderate to extreme (92%). Most also reported that work-related stress negatively affects their overall well-being (72%). The mean Epworth Sleepiness Scale score among respondents was 14, consistent with moderate excessive daytime sleepiness. Surgical trainee well-being is critical to optimal patient care, career development, and burnout reduction. Surgical residents attend to their own preventive health maintenance, finances, sleep, and stress reduction with variable success. Residency programs should make modest programmatic accommodations to allow trainees to tend to various aspects of their personal well-being. Copyright © 2017. Published by Elsevier Inc.

Motivators for physical activity among ambulatory nursing home older residents.

PubMed

Chen, Yuh-Min; Li, Yueh-Ping

2014-01-01

The purpose of this study was to explore self-identified motivators for regular physical activity among ambulatory nursing home older residents. A qualitative exploratory design was adopted. Purposive sampling was performed to recruit 18 older residents from two nursing homes in Taiwan. The interview transcripts were analyzed by qualitative content analysis. Five motivators of physical activity emerged from the result of analysis: eagerness for returning home, fear of becoming totally dependent, improving mood state, filling empty time, and previously cultivated habit. Research on physical activity from the perspectives of nursing home older residents has been limited. An empirically grounded understanding from this study could provide clues for promoting and supporting lifelong engagement in physical activity among older residents. The motivators reported in this study should be considered when designing physical activity programs. These motivators can be used to encourage, guide, and provide feedback to support older residents in maintaining physical activity.

The effect of resident duty hour restriction on trauma center outcomes in teaching hospitals in the state of Pennsylvania.

PubMed

Helling, Thomas S; Kaswan, Sumesh; Boccardo, Justin; Bost, James E

2010-09-01

Resident duty hour restriction was instituted to improve patient safety, but actual impact on patient care is unclear. We sought to determine the effect of duty hour restriction on trauma outcomes in Level I trauma centers (TCs; surgery residency programs) versus Level II TCs (those with no surgery residency programs) within the state of Pennsylvania, using noninferiority as our hypothesis testing. Outcomes (mortality and length of stay [LOS]) were compared in Level II TCs without surgery residencies (n = 7) with Level I TCs (with surgery residencies; n = 14) PRE80 (2001-2003) and POST80 (2004-2007). The subcategories of critically injured patients, Injury Severity Score (ISS) >15, ISS >25, Trauma and Injury Severity Score (TRISS) ≤ 50, Abbreviated Injury Scale (AIS) head/chest/abdomen score >3, age >65 years, mechanism, and shock, functioned as outcome predictors. There was a decrease in mortality overall PRE80 to POST80 for Level I and II TCs. There was a decrease in mortality in Level I TCs POST80 in ISS >15 (16.5% vs. 14.8%, p = 0.0001), AIS (head) score >3 (20.8% vs. 17.8%, p < 0.0001), age >65 years (12.2% vs. 10.7%, p = 0.0013), and blunt mechanism (5.2% vs. 4.6%, p = 0.0004). LOS was reduced in ISS >15, AIS (head) score >3, age >65 years, and penetrating mechanism in Level I TCs POST80. A similar but more profound decrease was also seen in Level II TCs PRE80 and POST80 (ISS >15, 25; AIS (head) score; shock; blunt mechanism; and TRISS ≤ 50). Testing for inhomogeneity identified less-severely injured patients at Level II TCs POST80 compared with Level I TCs in certain subcategories (ISS >15, 25; AIS (head) score; shock; blunt mechanism; and TRISS ≤ 50) regarding mortality and LOS (TRISS >50%). Decreases in mortality and LOS during the study periods were likely not related to resident work hour restriction but rather to overall improvement in outcomes seen at Level II (no residents) and Level I (residents) TCs. Resident work hour restrictions had no discernible effect on patient care (noninferiority).

The Partnerships Project: Linking Educational Opportunity and Community Development To Revitalize Rural Communities into Global Villages. Final Report.

ERIC Educational Resources Information Center

Emery, Mary E.

Lewis-Clark State College, Idaho, developed a model program, Partnerships Project, designed to provide rural community residents with access to higher education and to assist communities in increasing their local capacity for development. In pursuing these objectives, the program helped to change the nature of the postsecondary undertaking in…

Cognitive Learning in the Out-of-doors. A Thesis in Recreation and Parks.

ERIC Educational Resources Information Center

Kaplan, Jay Bernard

Fifth and sixth grade students from the State College Area School District (Pennsylvania) participated in a 5-day resident outdoor education program to investigate the effectiveness of such a program on the development of cognitive learning processes. Students were divided into experimental and control groups of one fifth and one sixth grade class…

Reading Refugee Stories: Five Common Themes among Picture Books with Refugee Characters

ERIC Educational Resources Information Center

Nath, Lopita; Grote-Garcia, Stephanie

2017-01-01

The U.S. Refugee Resettlement Program offers a quick path to permanent residency and adjustment to the United States, with the major objectives of economic success, community involvement, and local integration. The success of the program partly depends on the response of the American community towards refugees. Using the foundational idea that…

Extending the Dream: A Report of the 1975 Artists-in-Schools National Conference.

ERIC Educational Resources Information Center

Gross, Ronald

The document reports on a conference which reviewed progress of the Artists-in-Schools (AIS) program. Sponsored by the National Endowment for the Arts, the program places professional artists in elementary and secondary schools for residencies of several days to a full year. Artists, educators, and AIS state coordinators who participated in the…

WE-D-204-04: Learning the Ropes: Clinical Immersion in the First Month of Residency

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dieterich, S.

Speakers in this session will present overview and details of a specific rotation or feature of their Medical Physics Residency Program that is particularly exceptional and noteworthy. The featured rotations include foundational topics executed with exceptional acumen and innovative educational rotations perhaps not commonly found in Medical Physics Residency Programs. A site-specific clinical rotation will be described, where the medical physics resident follows the physician and medical resident for two weeks into patient consultations, simulation sessions, target contouring sessions, planning meetings with dosimetry, patient follow up visits, and tumor boards, to gain insight into the thought processes of the radiationmore » oncologist. An incident learning rotation will be described where the residents learns about and practices evaluating clinical errors and investigates process improvements for the clinic. The residency environment at a Canadian medical physics residency program will be described, where the training and interactions with radiation oncology residents is integrated. And the first month rotation will be described, where the medical physics resident rotates through the clinical areas including simulation, dosimetry, and treatment units, gaining an overview of the clinical flow and meeting all the clinical staff to begin the residency program. This session will be of particular interest to residency programs who are interested in adopting or adapting these curricular ideas into their programs and to residency candidates who want to learn about programs already employing innovative practices. Learning Objectives: To learn about exceptional and innovative clinical rotations or program features within existing Medical Physics Residency Programs. To understand how to adopt/adapt innovative curricular designs into your own Medical Physics Residency Program, if appropriate.« less

WE-D-204-00: Session in Memory of Franca Kuchnir: Excellence in Medical Physics Residency Education

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

Speakers in this session will present overview and details of a specific rotation or feature of their Medical Physics Residency Program that is particularly exceptional and noteworthy. The featured rotations include foundational topics executed with exceptional acumen and innovative educational rotations perhaps not commonly found in Medical Physics Residency Programs. A site-specific clinical rotation will be described, where the medical physics resident follows the physician and medical resident for two weeks into patient consultations, simulation sessions, target contouring sessions, planning meetings with dosimetry, patient follow up visits, and tumor boards, to gain insight into the thought processes of the radiationmore » oncologist. An incident learning rotation will be described where the residents learns about and practices evaluating clinical errors and investigates process improvements for the clinic. The residency environment at a Canadian medical physics residency program will be described, where the training and interactions with radiation oncology residents is integrated. And the first month rotation will be described, where the medical physics resident rotates through the clinical areas including simulation, dosimetry, and treatment units, gaining an overview of the clinical flow and meeting all the clinical staff to begin the residency program. This session will be of particular interest to residency programs who are interested in adopting or adapting these curricular ideas into their programs and to residency candidates who want to learn about programs already employing innovative practices. Learning Objectives: To learn about exceptional and innovative clinical rotations or program features within existing Medical Physics Residency Programs. To understand how to adopt/adapt innovative curricular designs into your own Medical Physics Residency Program, if appropriate.« less

WE-D-204-03: CAMPEP Residencies in a Canadian Context: Comprehensive Cancer Centers and Integrated Learning Environments

DOE Office of Scientific and Technical Information (OSTI.GOV)

Parker, W.

Speakers in this session will present overview and details of a specific rotation or feature of their Medical Physics Residency Program that is particularly exceptional and noteworthy. The featured rotations include foundational topics executed with exceptional acumen and innovative educational rotations perhaps not commonly found in Medical Physics Residency Programs. A site-specific clinical rotation will be described, where the medical physics resident follows the physician and medical resident for two weeks into patient consultations, simulation sessions, target contouring sessions, planning meetings with dosimetry, patient follow up visits, and tumor boards, to gain insight into the thought processes of the radiationmore » oncologist. An incident learning rotation will be described where the residents learns about and practices evaluating clinical errors and investigates process improvements for the clinic. The residency environment at a Canadian medical physics residency program will be described, where the training and interactions with radiation oncology residents is integrated. And the first month rotation will be described, where the medical physics resident rotates through the clinical areas including simulation, dosimetry, and treatment units, gaining an overview of the clinical flow and meeting all the clinical staff to begin the residency program. This session will be of particular interest to residency programs who are interested in adopting or adapting these curricular ideas into their programs and to residency candidates who want to learn about programs already employing innovative practices. Learning Objectives: To learn about exceptional and innovative clinical rotations or program features within existing Medical Physics Residency Programs. To understand how to adopt/adapt innovative curricular designs into your own Medical Physics Residency Program, if appropriate.« less

Academic Productivity of US Neurosurgery Residents as Measured by H-Index: Program Ranking with Correlation to Faculty Productivity.

PubMed

Sarkiss, Christopher A; Riley, Kyle J; Hernandez, Christopher M; Oermann, Eric K; Ladner, Travis R; Bederson, Joshua B; Shrivastava, Raj K

2017-06-01

Engagement in research and academic productivity are crucial components in the training of a neurosurgeon. This process typically begins in residency training. In this study, we analyzed individual resident productivity as it correlated to publications across all Accreditation Council for Graduate Medical Education (ACGME)-accredited neurosurgery training programs in an attempt to identify how programs have developed and fostered a research culture and environment. We obtained a list of current neurosurgery residents in ACGME-accredited programs from the American Association of Neurological Surgeons database. An expanded PubMed and Scopus search was conducted for each resident through the present time. We tabulated all articles attributed to each resident. We then categorized the publications based on each neurosurgical subspecialty while in residency. A spreadsheet-based statistical analysis was performed. This formulated the average number of resident articles, h-indices, and most common subspecialty categories by training program. We analyzed 1352 current neurosurgery residents in 105 programs. There were a total of 10 645 publications, of which 3985 were resident first-author publications during the period of study. The most common subspecialties among all resident publications were vascular (24.9%), spine (16.9%), oncology (16.1%), pediatric (5.6%), functional (4.9%), and trauma (3.8%). The average resident published 2.9 first-author papers with average of 38.0 first-author publications by total residents at each program (range 0-241). The average h-index per resident is 2.47 ± 3.25. When comparing previously published faculty h-index program rankings against our resident h-index rankings, there is a strong correlation between the 2 datasets with a clear delineation between Top-20 productivity and that of other programs (average h-index 4.2 vs 1.7, respectively, P < .001). Increasing program size leads to a clear increase in academic productivity on both the resident and faculty level (average h-index 1.6, 1.9, 3.9 for 1, 2, and 3 resident per year programs, respectively, P < .001). Resident first-author publications correlated with recently described academic departmental productivity. Subspecialty resident publications are highest in cerebrovascular surgery. Resident research and publication is a key metric for assessing the productivity of academic neurosurgery programs and is consistent with one of the core foci of neurosurgical training. Copyright © 2017 by the Congress of Neurological Surgeons.

Alternative approaches to ambulatory training: internal medicine residents' and program directors' perspectives.

PubMed

Thomas, Kris G; West, Colin P; Popkave, Carol; Bellini, Lisa M; Weinberger, Steven E; Kolars, Joseph C; Kogan, Jennifer R

2009-08-01

Internal medicine ambulatory training redesign, including recommendations to increase ambulatory training, is a focus of national discussion. Residents' and program directors' perceptions about ambulatory training models are unknown. To describe internal medicine residents' and program directors' perceptions regarding ambulatory training duration, alternative ambulatory training models, and factors important for ambulatory education. National cohort study. Internal medicine residents (N = 14,941) and program directors (N = 222) who completed the 2007 Internal Medicine In-Training Examination (IM-ITE) Residents Questionnaire or Program Directors Survey, representing 389 US residency programs. A total of 58.4% of program directors and 43.7% of residents preferred one-third or more training time in outpatient settings. Resident preferences for one-third or more outpatient training increased with higher levels of training (48.3% PGY3), female sex (52.7%), primary care program enrollment (64.8%), and anticipated outpatient-focused career, such as geriatrics. Most program directors (77.3%) and residents (58.4%) preferred training models containing weekly clinic. Although residents and program directors reported problems with competing inpatient-outpatient responsibilities (74.9% and 88.1%, respectively) and felt that absence of conflict with inpatient responsibilities is important for good outpatient training (69.4% and 74.2%, respectively), only 41.6% of residents and 22.7% of program directors supported models eliminating ambulatory sessions during inpatient rotations. Residents' and program directors' preferences for outpatient training differ from recommendations for increased ambulatory training. Discordance was observed between reported problems with conflicting inpatient-outpatient responsibilities and preferences for models maintaining longitudinal clinic during inpatient rotations. Further study regarding benefits and barriers of ambulatory redesign is needed.

Enablers of and barriers to abortion training.

PubMed

Guiahi, Maryam; Lim, Sahnah; Westover, Corey; Gold, Marji; Westhoff, Carolyn L

2013-06-01

Since the legalization of abortion services in the United States, provision of abortions has remained a controversial issue of high political interest. Routine abortion training is not offered at all obstetrics and gynecology (Ob-Gyn) training programs, despite a specific training requirement by the Accreditation Council for Graduate Medical Education. Previous studies that described Ob-Gyn programs with routine abortion training either examined associations by using national surveys of program directors or described the experience of a single program. We set out to identify enablers of and barriers to Ob-Gyn abortion training in the context of a New York City political initiative, in order to better understand how to improve abortion training at other sites. We conducted in-depth qualitative interviews with 22 stakeholders from 7 New York City public hospitals and focus group interviews with 62 current residents at 6 sites. Enablers of abortion training included program location, high-capacity services, faculty commitment to abortion training, external programmatic support, and resident interest. Barriers to abortion training included lack of leadership continuity, leadership conflict, lack of second-trimester abortion services, difficulty obtaining mifepristone, optional rather than routine training, and antiabortion values of hospital personnel. Supportive leadership, faculty commitment, and external programmatic support appear to be key elements for establishing routine abortion training at Ob-Gyn residency training programs.

Undocumented and uninsured: aftereffects of the Patient Protection and Affordable Care Act.

PubMed

Agabin, Nataly; Coffin, Janis

2015-01-01

Although with the implementation of the Patient Protection and Affordable Care Act millions of previously uninsured American residents will gain access to healthcare coverage, millions more will remain uninsured due to the lack of mandatory state Medicaid expansion as well as mandates that forbid undocumented immigrants and legal residents of less than five years from purchasing insurance through the newly available market exchange. With limited options for healthcare coverage due to employment and lack of citizen status, undocumented immigrants rely heavily on funds provided by both Emergency Medicaid and Disproportionate Share Hospital programs. Through reevaluation of current funding, mandates forbidding access to market exchanges, and plans to further enable access to affordable health coverage, states have the unique opportunity to both aid their residents and relieve the financial burden on healthcare facilities and Emergency Medicaid funds.

Interactive distance learning for orthodontic residents: utilization and acceptability.

PubMed

Klein, Katherine P; Hannum, Wallace M; Koroluk, Lorne D; Proffit, William R

2012-03-01

Sharing resources through distance education has been proposed as 1 way to deal with a lack of full-time faculty in orthodontic residency programs. To keep distance education for orthodontic residents as cost-effective as possible while retaining interaction, we developed a "blended" interactive distance learning approach that combines observation of Web-based seminars with live postseminar discussions. For the 2009-2010 academic year, a grant from the American Association of Orthodontists opened access to the blended learning experience to all orthodontic programs in the United States and Canada. The specific aims of this project were to (1) measure programmatic interest in using blended distance learning, (2) determine resident and faculty interest, (3) determine the seminars' perceived usefulness, and (4) elicit feedback regarding future use. Participants in this project were expected to (1) read all assigned articles before viewing a recorded seminar, (2) watch a 1 to 1.5 hour recording of an actual interactive seminar on a Web site, and (3) participate in a 30-minute follow-up discussion immediately after watching the recorded seminar either with a faculty member at the participating institution or via a videoconference with the leader of the Web-based seminar. The residents and faculty then completed surveys about the experience. Half (52%) of the 63 orthodontic programs in the United States fully participated in this project. The blended approach to distance learning was judged to be effective and enjoyable; faculty members were somewhat more enthusiastic about the experience than were residents. Most residents were not adequately prepared for the seminars (only 14% read all preparatory articles in depth); this impacted their perception of the effectiveness and enjoyability of the experience (P = 0.0016). Prepared residents reported a greater ability to learn from the seminars (P = 0.0035) than those who did not read, and also indicated that they were more likely to use the seminars again (P = 0.0018). Despite feedback regarding the need for technologic improvements of the recorded seminars, such as better editing, more frequent slides, quicker pace, and improved sound quality, most residents and faculty agreed that they would like to use this approach to distance learning again. Blended distance learning is an acceptable method of instruction that allows residents to access various experts, supplement traditional instructor-led training, and ease the strain of current faculty shortages. The content of the recorded seminars needs to remain evidence-based, and some technologic aspects of the recordings should be improved. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Child abuse training and knowledge: a national survey of emergency medicine, family medicine, and pediatric residents and program directors.

PubMed

Starling, Suzanne P; Heisler, Kurt W; Paulson, James F; Youmans, Eren

2009-04-01

The objective of this study was to determine the level of knowledge, comfort, and training related to the medical management of child abuse among pediatrics, emergency medicine, and family medicine residents. Surveys were administered to program directors and third-year residents at 67 residency programs. The resident survey included a 24-item quiz to assess knowledge regarding the medical management of physical and sexual child abuse. Sites were solicited from members of a network of child abuse physicians practicing at institutions with residency programs. Analyzable surveys were received from 53 program directors and 462 residents. Compared with emergency medicine and family medicine programs, pediatric programs were significantly larger and more likely to have a medical provider specializing in child abuse pediatrics, have faculty primarily responsible for child abuse training, use a written curriculum for child abuse training, and offer an elective rotation in child abuse. Exposure to child abuse training and abused patients was highest for pediatric residents and lowest for family medicine residents. Comfort with managing child abuse cases was lowest among family medicine residents. On the knowledge quiz, pediatric residents significantly outperformed emergency medicine and family medicine residents. Residents with high knowledge scores were significantly more likely to come from larger programs and programs that had a center, provider, or interdisciplinary team that specialized in child abuse pediatrics; had a physician on faculty responsible for child abuse training; used a written curriculum for child abuse training; and had a required rotation in child abuse pediatrics. By analyzing the relationship between program characteristics and residents' child abuse knowledge, we found that pediatric programs provide far more training and resources for child abuse education than emergency medicine and family medicine programs. As leaders, pediatricians must establish the importance of this topic in the pediatric education of residents of all specialties.

Long-Term Care Ombudsman Program Annual Report: Oct. 1, 1989 through Sept. 30. 1990.

ERIC Educational Resources Information Center

Oklahoma State Dept. of Human Services, Oklahoma City.

This annual report of the Long-Term Care Ombudsmen Program of the Oklahoma Department of Human Services begins by stating the purpose of the program: to improve the quality of life and the quality of care of older residents of long-term care facilities in Oklahoma. It is noted that the Long-Term Care Ombudsman advocates for the rights of long-term…

A theory-informed, process-oriented Resident Scholarship Program.

PubMed

Thammasitboon, Satid; Darby, John B; Hair, Amy B; Rose, Karen M; Ward, Mark A; Turner, Teri L; Balmer, Dorene F

2016-01-01

The Accreditation Council for Graduate Medical Education requires residency programs to provide curricula for residents to engage in scholarly activities but does not specify particular guidelines for instruction. We propose a Resident Scholarship Program that is framed by the self-determination theory (SDT) and emphasize the process of scholarly activity versus a scholarly product. The authors report on their longitudinal Resident Scholarship Program, which aimed to support psychological needs central to SDT: autonomy, competence, and relatedness. By addressing those needs in program aims and program components, the program may foster residents' intrinsic motivation to learn and to engage in scholarly activity. To this end, residents' engagement in scholarly processes, and changes in perceived autonomy, competence, and relatedness were assessed. Residents engaged in a range of scholarly projects and expressed positive regard for the program. Compared to before residency, residents felt more confident in the process of scholarly activity, as determined by changes in increased perceived autonomy, competence, and relatedness. Scholarly products were accomplished in return for a focus on scholarly process. Based on our experience, and in line with the SDT, supporting residents' autonomy, competence, and relatedness through a process-oriented scholarship program may foster the curiosity, inquisitiveness, and internal motivation to learn that drives scholarly activity and ultimately the production of scholarly products.

The relationship between communication scores from the USMLE Step 2 Clinical Skills examination and communication ratings for first-year internal medicine residents.

PubMed

Winward, Marcia L; Lipner, Rebecca S; Johnston, Mary M; Cuddy, Monica M; Clauser, Brian E

2013-05-01

This study extends available evidence about the relationship between scores on the Step 2 Clinical Skills (CS) component of the United States Medical Licensing Examination and subsequent performance in residency. It focuses on the relationship between Step 2 CS communication and interpersonal skills scores and communication skills ratings that residency directors assign to residents in their first postgraduate year of internal medicine training. It represents the first large-scale evaluation of the extent to which Step 2 CS communication and interpersonal skills scores can be extrapolated to examinee performance in supervised practice. Hierarchical linear modeling techniques were used to examine the relationships among examinee characteristics, residency program characteristics, and residency-director-provided ratings. The sample comprised 6,306 examinees from 238 internal medicine residency programs who completed Step 2 CS for the first time in 2005 and received ratings during their first year of internal medicine residency training. Although the relationship is modest, Step 2 CS communication and interpersonal skills scores predict communication skills ratings for first-year internal medicine residents after accounting for other factors. The results of this study make a reasonable case that Step 2 CS communication and interpersonal skills scores provide useful information for predicting the level of communication skill that examinees will display in their first year of internal medicine residency training. This finding demonstrates some level of extrapolation from the testing context to behavior in supervised practice, thus providing validity-related evidence for using Step 2 CS communication and interpersonal skills scores in high-stakes decisions.

The pathology milestones and the next accreditation system.

PubMed

Naritoku, Wesley Y; Alexander, C Bruce; Bennett, Betsy D; Black-Schaffer, W Stephen; Brissette, Mark D; Grimes, Margaret M; Hoffman, Robert D; Hunt, Jennifer L; Iezzoni, Julia C; Johnson, Rebecca; Kozel, Jessica; Mendoza, Ricardo M; Post, Miriam D; Powell, Suzanne Z; Procop, Gary W; Steinberg, Jacob J; Thorsen, Linda M; Nestler, Steven P

2014-03-01

In the late 1990s, the Accreditation Council for Graduate Medical Education developed the Outcomes Project and the 6 general competencies with the intent to improve the outcome of graduate medical education in the United States. The competencies were used as the basis for developing learning goals and objectives and tools to evaluate residents' performance. By the mid-2000s the stakeholders in resident education and the general public felt that the Outcomes Project had fallen short of expectations. To develop a new evaluation method to track trainee progress throughout residency using benchmarks called milestones. A change in leadership at the Accreditation Council for Graduate Medical Education brought a new vision for the accreditation of training programs and a radically different approach to the evaluation of residents. The Pathology Milestones Working Group reviewed examples of developing milestones in other specialties, the literature, and the Accreditation Council for Graduate Medical Education program requirements for pathology to develop pathology milestones. The pathology milestones are a set of objective descriptors for measuring progress in the development of competency in patient care, procedural skill sets, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practice. The milestones provide a national standard for evaluation that will be used for the assessment of all residents in Accreditation Council for Graduate Medical Education-accredited pathology training programs.

Insurance coverage and prenatal care among low-income pregnant women: an assessment of states' adoption of the "Unborn Child" option in Medicaid and CHIP.

PubMed

Jarlenski, Marian P; Bennett, Wendy L; Barry, Colleen L; Bleich, Sara N

2014-01-01

The "Unborn Child" (UC) option provides state Medicaid/Children's Health Insurance Program (CHIP) programs with a new strategy to extend prenatal coverage to low-income women who would otherwise have difficulty enrolling in or would be ineligible for Medicaid. To examine the association of the UC option with the probability of enrollment in Medicaid/CHIP during pregnancy and probability of receiving adequate prenatal care. We use pooled cross-sectional data from the Pregnancy Risk Assessment Monitoring System from 32 states between 2004 and 2010 (n = 81,983). Multivariable regression is employed to examine the association of the UC option with Medicaid/CHIP enrollment during pregnancy among eligible women who were uninsured preconception (n = 45,082) and those who had insurance (but not Medicaid) preconception (n = 36,901). Multivariable regression is also employed to assess the association between the UC option and receipt of adequate prenatal care, measured by the Adequacy of Prenatal Care Utilization Index. Residing in a state with the UC option is associated with a greater probability of Medicaid enrollment during pregnancy relative to residing in a state without the policy both among women uninsured preconception (88% vs. 77%, P < 0.01) and among women insured (but not in Medicaid) preconception (40% vs. 31%, P < 0.01). Residing in a state with the UC option is not significantly associated with receiving adequate prenatal care, among both women with and without insurance preconception. The UC option provides states a key way to expand or simplify prenatal insurance coverage, but further policy efforts are needed to ensure that coverage improves access to high-quality prenatal care.

Creating objective and measurable postgraduate year 1 residency graduation requirements.

PubMed

Starosta, Kaitlin; Davis, Susan L; Kenney, Rachel M; Peters, Michael; To, Long; Kalus, James S

2017-03-15

The process of developing objective and measurable postgraduate year 1 (PGY1) residency graduation requirements and a progress tracking system is described. The PGY1 residency accreditation standard requires that programs establish criteria that must be met by residents for successful completion of the program (i.e., graduation requirements), which should presumably be aligned with helping residents to achieve the purpose of residency training. In addition, programs must track a resident's progress toward fulfillment of residency goals and objectives. Defining graduation requirements and establishing the process for tracking residents' progress are left up to the discretion of the residency program. To help standardize resident performance assessments, leaders of an academic medical center-based PGY1 residency program developed graduation requirement criteria that are objective, measurable, and linked back to residency goals and objectives. A system for tracking resident progress relative to quarterly progress targets was instituted. Leaders also developed a focused, on-the-spot skills assessment termed "the Thunderdome," which was designed for objective evaluation of direct patient care skills. Quarterly data on residents' progress are used to update and customize each resident's training plan. Implementation of this system allowed seamless linkage of the training plan, the progress tracking system, and the specified graduation requirement criteria. PGY1 residency requirements that are objective, that are measurable, and that attempt to identify what skills the resident must demonstrate in order to graduate from the program were developed for use in our residency program. A system for tracking the residents' progress by comparing residents' performance to predetermined quarterly benchmarks was developed. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Experiential leadership training for pediatric chief residents: impact on individuals and organizations.

PubMed

Doughty, Robert A; Williams, Patricia D; Brigham, Timothy P; Seashore, Charles

2010-06-01

The past decade has seen a proliferation of leadership training programs for physicians that teach skills outside the graduate medical education curriculum. To determine the perceived value and impact of an experiential leadership training program for pediatric chief residents on the chief residents and on their programs and institutions. The authors conducted a retrospective study. Surveys were sent to chief residents who completed the Chief Resident Training Program (CRTP) between 1988 and 2003 and to their program directors and department chairs asking about the value of the program, its impact on leadership capabilities, as well as the effect of chief resident training on programs and institutions. Ninety-four percent of the chief residents and 94% of program directors and department chairs reported that the CRTP was "very" or "somewhat" relevant, and 92% of the chief residents indicated CRTP had a positive impact on their year as chief resident; and 75% responded it had a positive impact beyond residency. Areas of greatest positive impact included awareness of personality characteristics, ability to manage conflict, giving and receiving feedback, and relationships with others. Fifty-six percent of chief residents reported having held a formal leadership position since chief residency, yet only 28% reported having received additional leadership training. The study demonstrates a perceived positive impact on CRTP participants and their programs and institutions in the short and long term.

Remediation of problematic residents--A national survey.

PubMed

Bhatti, Nasir I; Ahmed, Aadil; Stewart, Michael G; Miller, Robert H; Choi, Sukgi S

2016-04-01

Despite careful selection processes, residency programs face the challenge of training residents who fall below minimal performance standards. Poor performance of a resident can endanger both patient safety and the reputation of the residency program. It is important, therefore, for a program to identify such residents and implement strategies for their successful remediation. The purpose of our study was to gather information on evaluation and remediation strategies employed by different otolaryngology programs. Cross-sectional survey. We conducted a national survey, sending a questionnaire to the program directors of 106 otolaryngology residency programs. We collected information on demographics of the program, identification of problematic residents, and remediation strategies. The response rate was 74.5%, with a 2% cumulative incidence of problematic residents in otolaryngology programs during the past 10 years. The most frequently reported deficiencies of problematic residents were unprofessional behavior with colleagues/staff (38%), insufficient medical knowledge (37%), and poor clinical judgment (34%). Personal or professional stress was the most frequently identified underlying problem (70.5%). Remediation efforts included general counseling (78%), frequent feedback sessions (73%), assignment of a mentor (58%), and extra didactics (47%). These remediation efforts failed to produce improvement in 23% of the identified residents, ultimately leading to their dismissal. The apparent deficiencies, underlying causes, and remediation strategies vary among otolaryngology residency programs. Based on the results of this survey, we offer recommendations for the early identification of problematic residents and a standardized remediation plan. NA. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

Instruction in teaching and teaching opportunities for residents in US dermatology programs: Results of a national survey.

PubMed

Burgin, Susan; Homayounfar, Gelareh; Newman, Lori R; Sullivan, Amy

2017-04-01

Dermatology residents routinely teach junior co-residents and medical students. Despite the importance of teaching skills for a successful academic career, no formal teaching instruction programs for dermatology residents have been described to our knowledge, and the extent of teaching opportunities for dermatology residents is unknown. We sought to describe the range of teaching opportunities and instruction available to dermatology residents and to assess the need for additional teaching training from the perspective of dermatology residency program directors nationwide. A questionnaire was administered to 113 US dermatology residency program directors or their designees. Descriptive statistics were used to analyze questionnaire item responses. The response rate was 55% (62/113). All program directors reported that their residents teach; 59% (33/56) reported offering trainees teaching instruction; 11% (7/62) of programs offered a short-term series of formal sessions on teaching; and 7% (4/62) offered ongoing, longitudinal training. Most program directors (74%, 40/54) believed that their residents would benefit from more teaching instruction. Response rate and responder bias are potential limitations. Dermatology residents teach in a broad range of settings, over half receive some teaching instruction, and most dermatology residency program directors perceive a need for additional training for residents as teachers. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Clinical decision-making among new graduate nurses attending residency programs in Saudi Arabia.

PubMed

Al-Dossary, Reem Nassar; Kitsantas, Panagiota; Maddox, P J

2016-02-01

This study examined the impact of residency programs on clinical decision-making of new Saudi graduate nurses who completed a residency program compared to new Saudi graduate nurses who did not participate in residency programs. This descriptive study employed a convenience sample (N=98) of new graduate nurses from three hospitals in Saudi Arabia. A self-administered questionnaire was used to collect data. Clinical decision-making skills were measured using the Clinical Decision Making in Nursing Scale. Descriptive statistics, independent t-tests, and multiple linear regression analysis were utilized to examine the effect of residency programs on new graduate nurses' clinical decision-making skills. On average, resident nurses had significantly higher levels of clinical decision-making skills than non-residents (t=23.25, p=0.000). Enrollment in a residency program explained 86.9% of the variance in total clinical decision making controlling for age and overall grade point average. The findings of this study support evidence in the nursing literature conducted primarily in the US and Europe that residency programs have a positive influence on new graduate nurses' clinical decision-making skills. This is the first study to examine the impact of residency programs on clinical decision-making among new Saudi graduate nurses who completed a residency program. The findings of this study underscore the need for the development and implementation of residency programs for all new nurses. Copyright © 2015 Elsevier Inc. All rights reserved.

WE-D-204-02: Errors and Process Improvements in Radiation Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fontenla, D.

2016-06-15

Speakers in this session will present overview and details of a specific rotation or feature of their Medical Physics Residency Program that is particularly exceptional and noteworthy. The featured rotations include foundational topics executed with exceptional acumen and innovative educational rotations perhaps not commonly found in Medical Physics Residency Programs. A site-specific clinical rotation will be described, where the medical physics resident follows the physician and medical resident for two weeks into patient consultations, simulation sessions, target contouring sessions, planning meetings with dosimetry, patient follow up visits, and tumor boards, to gain insight into the thought processes of the radiationmore » oncologist. An incident learning rotation will be described where the residents learns about and practices evaluating clinical errors and investigates process improvements for the clinic. The residency environment at a Canadian medical physics residency program will be described, where the training and interactions with radiation oncology residents is integrated. And the first month rotation will be described, where the medical physics resident rotates through the clinical areas including simulation, dosimetry, and treatment units, gaining an overview of the clinical flow and meeting all the clinical staff to begin the residency program. This session will be of particular interest to residency programs who are interested in adopting or adapting these curricular ideas into their programs and to residency candidates who want to learn about programs already employing innovative practices. Learning Objectives: To learn about exceptional and innovative clinical rotations or program features within existing Medical Physics Residency Programs. To understand how to adopt/adapt innovative curricular designs into your own Medical Physics Residency Program, if appropriate.« less

WE-D-204-01: Site-Specific Clinical Rotation: Into the Minds of the Radiation Oncologists

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hendrickson, K.

2016-06-15

Speakers in this session will present overview and details of a specific rotation or feature of their Medical Physics Residency Program that is particularly exceptional and noteworthy. The featured rotations include foundational topics executed with exceptional acumen and innovative educational rotations perhaps not commonly found in Medical Physics Residency Programs. A site-specific clinical rotation will be described, where the medical physics resident follows the physician and medical resident for two weeks into patient consultations, simulation sessions, target contouring sessions, planning meetings with dosimetry, patient follow up visits, and tumor boards, to gain insight into the thought processes of the radiationmore » oncologist. An incident learning rotation will be described where the residents learns about and practices evaluating clinical errors and investigates process improvements for the clinic. The residency environment at a Canadian medical physics residency program will be described, where the training and interactions with radiation oncology residents is integrated. And the first month rotation will be described, where the medical physics resident rotates through the clinical areas including simulation, dosimetry, and treatment units, gaining an overview of the clinical flow and meeting all the clinical staff to begin the residency program. This session will be of particular interest to residency programs who are interested in adopting or adapting these curricular ideas into their programs and to residency candidates who want to learn about programs already employing innovative practices. Learning Objectives: To learn about exceptional and innovative clinical rotations or program features within existing Medical Physics Residency Programs. To understand how to adopt/adapt innovative curricular designs into your own Medical Physics Residency Program, if appropriate.« less

Teaching Health Center Graduate Medical Education Locations Predominantly Located in Federally Designated Underserved Areas.

PubMed

Barclift, Songhai C; Brown, Elizabeth J; Finnegan, Sean C; Cohen, Elena R; Klink, Kathleen

2016-05-01

Background The Teaching Health Center Graduate Medical Education (THCGME) program is an Affordable Care Act funding initiative designed to expand primary care residency training in community-based ambulatory settings. Statute suggests, but does not require, training in underserved settings. Residents who train in underserved settings are more likely to go on to practice in similar settings, and graduates more often than not practice near where they have trained. Objective The objective of this study was to describe and quantify federally designated clinical continuity training sites of the THCGME program. Methods Geographic locations of the training sites were collected and characterized as Health Professional Shortage Area, Medically Underserved Area, Population, or rural areas, and were compared with the distribution of Centers for Medicare and Medicaid Services (CMS)-funded training positions. Results More than half of the teaching health centers (57%) are located in states that are in the 4 quintiles with the lowest CMS-funded resident-to-population ratio. Of the 109 training sites identified, more than 70% are located in federally designated high-need areas. Conclusions The THCGME program is a model that funds residency training in community-based ambulatory settings. Statute suggests, but does not explicitly require, that training take place in underserved settings. Because the majority of the 109 clinical training sites of the 60 funded programs in 2014-2015 are located in federally designated underserved locations, the THCGME program deserves further study as a model to improve primary care distribution into high-need communities.

Pharmacists teaching in family medicine residency programs

PubMed Central

Jorgenson, Derek; Muller, Andries; Whelan, Anne Marie; Buxton, Kelly

2011-01-01

Abstract Objective To determine the percentage of family medicine residency programs that have pharmacists directly involved in teaching residents, the types and extent of teaching provided by pharmacists in family medicine residency programs, and the primary source of funding for the pharmacists. Design Web-based survey. Setting One hundred fifty-eight resident training sites within the 17 family medicine residency programs in Canada. Participants One hundred residency program directors who were responsible for overseeing the training sites within the residency programs were contacted to determine the percentage of training sites in which pharmacists were directly involved in teaching. Pharmacists who were identified by the residency directors were invited to participate in the Web-based survey. Main outcome measures The percentage of training sites for family medicine residency that have pharmacists directly involved in teaching residents. The types and the extent of teaching performed by the pharmacists who teach in the residency programs. The primary source of funding that supports the pharmacists’ salaries. Results More than a quarter (25.3%) of family medicine residency training sites include direct involvement of pharmacist teachers. Pharmacist teachers reported that they spend a substantial amount of their time teaching residents using a range of teaching modalities and topics, but have no formal pharmacotherapy curriculums. Nearly a quarter (22.6%) of the pharmacists reported that their salaries were primarily funded by the residency programs. Conclusion Pharmacists have a role in training family medicine residents. This is a good opportunity for family medicine residents to learn about issues related to pharmacotherapy; however, the role of pharmacists as educators might be optimized if standardized teaching methods, curriculums, and evaluation plans were in place. PMID:21918131

Geographic Trends in the Plastic Surgery Match.

PubMed

Silvestre, Jason; Lin, Ines C; Serletti, Joseph M; Chang, Benjamin

2016-01-01

The integrated plastic surgery match is among the most competitive residency matches in recent years. Although previous studies have correlated applicant characteristics with successful match outcomes, none have comprehensively investigated the role of geography in the match. This study elucidates regional biases in the match. Plastic surgery residents who matched during 2011-2015 were eligible for study inclusion. Names of residents were obtained from official residency program websites and cross-referenced with data obtained from the Student Doctor Network. For each resident, region of residency program and medical school were compared. From 67 programs, 622 residents were identified. Most graduated from US medical schools (97.9%). A total of 94 residents matched at a home institution (15.1%). Half of the residents matched in the same region as their medical school (48.9%). Programs in the South matched the greatest number of residents from the same region (60.8%), whereas West programs matched the least (30.8%, p < 0.001). No regional differences existed regarding residents matching at their home institution (p = 0.268). More women matched at West programs (43.1%) versus East programs (30.6%, p < 0.05). A significant number of residents matched at their home institution. Roughly, half matched at a program in the same region as their medical school. Whether this regional phenomenon stems from applicant or program factors remains unknown. Yet, given the limited number of interviews and the high costs of interviewing, applicants and programs can use these data to help optimize the match process. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Reflections on forty years of rendering medical care to women.

PubMed Central

Stuermer, V. M.

1995-01-01

This paper provides a brief account of events leading to the establishment of the constitutional right to privacy in the case known as Griswold vs. State of Connecticut. It also discusses changes in the training of residents in the Department of Obstetrics and Gynecology at Yale University School of Medicine and the evolving role of women in the residency program. It concludes with reflections and speculations about new directions in medical care for women. PMID:8903042

An evaluation of the availability, accessibility, and quality of online content of vascular surgery training program websites for residency and fellowship applicants.

PubMed

Huang, Bryant Y; Hicks, Taylor D; Haidar, Georges M; Pounds, Lori L; Davies, Mark G

2017-12-01

Vascular surgery residency and fellowship applicants commonly seek information about programs from the Internet. Lack of an effective web presence curtails the ability of programs to attract applicants, and in turn applicants may be unable to ascertain which programs are the best fit for their career aspirations. This study was designed to evaluate the presence, accessibility, comprehensiveness, and quality of vascular surgery training websites (VSTW). A list of accredited vascular surgery training programs (integrated residencies and fellowships) was obtained from four databases for vascular surgery education: the Accreditation Council for Graduate Medical Education, Electronic Residency Application Service, Fellowship and Residency Electronic Interactive Database, and Society for Vascular Surgery. Programs participating in the 2016 National Resident Matching Program were eligible for study inclusion. Accessibility of VSTW was determined by surveying the Accreditation Council for Graduate Medical Education, Electronic Residency Application Service, and Fellowship and Residency Electronic Interactive Database for the total number of programs listed and for the presence or absence of website links. VSTW were analyzed for the availability of recruitment and education content items. The quality of VSTW was determined as a composite of four dimensions: content, design, organization, and user friendliness. Percent agreements and kappa statistics were calculated for inter-rater reliability. Eighty-nine of the 94 fellowship (95%) and 45 of the 48 integrated residencies (94%) programs participating in the 2016 Match had a VSTW. For program recruitment, evaluators found an average of 12 of 32 content items (35.0%) for fellowship programs and an average of 12 of 32 (37%) for integrated residencies. Only 47.1% of fellowship programs (53% integrated residencies) specified the number of positions available for the 2016 Match, 20% (13% integrated residencies) indicated alumni career placement, 34% (38% integrated residencies) supplied interview dates, and merely 17% (18% integrated residencies) detailed the selection process. For program education, fellowship websites provided an average of 5.1 of 15 content items (34.0%), and integrated residency websites provided 5 of 14 items (34%). Of the fellowship programs, 66% (84.4% integrated residencies) provided a rotation schedule, 65% (56% integrated residencies) detailed operative experiences, 38% (38% integrated residencies) posted conference schedules, and just 16% (28.9% integrated residencies) included simulation training. The web presence of vascular surgery training programs lacks sufficient accessibility, content, organization, design, and user friendliness to allow applicants to access information that informs them sufficiently. There are opportunities to more effectively use VSTW for the benefit of training programs and prospective applicants. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Documentation of quality improvement exposure by internal medicine residency applicants.

PubMed

Kolade, Victor O; Sethi, Anuradha

2016-01-01

Quality improvement (QI) has become an essential component of medical care in the United States. In residency programs, QI is a focus area of the Clinical Learning Environment Review visits conducted by the Accreditation Council for Graduate Medical Education. The readiness of applicants to internal medicine residency to engage in QI on day one is unknown. To document the reporting of QI training or experience in residency applications. Electronic Residency Application Service applications to a single internal medicine program were reviewed individually looking for reported QI involvement or actual projects in the curriculum vitae (CVs), personal statements (PSs), and letters of recommendation (LORs). CVs were also reviewed for evidence of education in QI such as completion of Institute for Healthcare Improvement (IHI) modules. Of 204 candidates shortlisted for interview, seven had QI items on their CVs, including one basic IHI certificate. Three discussed their QI work in their PSs, and four had recommendation letters describing their involvement in QI. One applicant had both CV and LOR evidence, so that 13 (6%) documented QI engagement. Practice of or instruction in QI is rarely mentioned in application documents of prospective internal medicine interns.

Feasibility and Usability of Tele-interview for Medical Residency Interview

PubMed Central

Pourmand, Ali; Lee, Hayoung; Fair, Malika; Maloney, Kaylah; Caggiula, Amy

2018-01-01

Every year in the United States, medical students and residency programs dedicate millions of dollars to the residency matching process. On-site interviews for training positions involve tremendous financial investment, and time spent detracts from educational pursuits and clinical responsibilities. Students are usually required to fund their own travel and accommodations, adding additional financial burdens to an already costly medical education. Similarly, residency programs allocate considerable funds to interview-day meals, tours, staffing, and social events. With the rapid onslaught of innovations and advancements in the field of telecommunication, technology has become ubiquitous in the practice of medicine. Internet applications have aided our ability to deliver appropriate, evidence-based care at speeds previously unimagined. Wearable medical tech allows physicians to monitor patients from afar, and telemedicine has emerged as an economical means by which to provide care to all corners of the world. It is against this backdrop that we consider the integration of technology into the residency application process. This article aims to assess the implementation of technology in the form of web-based interviewing as a viable means by which to reduce the costs and productivity losses associated with traditional in-person interview days. PMID:29383060

Splash Safety During Dermatologic Procedures Among US Dermatology Residents.

PubMed

Korta, Dorota Z; Chapman, Lance W; Lee, Patrick K; Linden, Kenneth G

2017-07-01

Dermatologists are at potential risk of acquiring infections from contamination of the mucous membranes by blood and body fluids. However, there are little data on splash safety during procedural dermatology. To determine dermatology resident perceptions about splash risk during dermatologic procedures and to quantify the rate of protective equipment use. An anonymous on-line survey was sent to 108 United States ACGME-approved dermatology residency programs assessing frequency of facial protection during dermatologic procedures, personal history of splash injury, and, if applicable, reasons for not always wearing facial protection. A total of 153 dermatology residents responded. Rates of facial protection varied by procedure, with the highest rates during surgery and the lowest during local anesthetic injection. Over 54% of respondents reported suffering facial splash while not wearing facial protection during a procedure. In contrast, 88.9% of respondents correctly answered that there is a small risk of acquiring infection from mucosal splash. Residency program recommendations for facial protection seem to vary by procedure. The authors' results demonstrate that although facial splash is a common injury, facial protection rates and protective recommendations vary significantly by procedure. These data support the recommendation for enhanced facial protection guidelines during procedural dermatology.

How Prospective Physical Medicine and Rehabilitation Trainees Rank Residency Training Programs.

PubMed

Auriemma, Michael J; Whitehair, Curtis L

2018-03-01

Since the inception of the National Resident Matching Program, multiple studies have investigated the factors applicants consider important to ranking prospective residency programs. However, only 2 previous studies focused on prospective physical medicine and rehabilitation (PM&R) trainees, and the most recent of these studies was published in 1993. It is unknown whether these previous studies are reflective of current prospective PM&R residents. To assess various factors that contribute to prospective PM&R residents' decision making in choosing a residency program and compare these findings with previous studies. An anonymous, voluntary questionnaire. A single PM&R residency program. All applicants to a single PM&R residency program. All applicants to our PM&R residency program were invited to participate in a 44-item, 5-point Likert-based questionnaire. Applicants were asked to rate the importance of various factors as they related to constructing their residency rank list. Means and standard deviations were calculated for items included in the survey. A response rate of 26% was obtained, with the responses of 98 applicants (20%) ultimately analyzed. The highest rated factors included "perceived happiness of current residents," "opportunities for hands-on procedure training," "perceived camaraderie among current residents," "perceived camaraderie among faculty and current residents," "perceived quality of current residents," and "perceived work/life balance among current residents." Although male and female respondents demonstrated similar ranking preferences, an apparent difference was detected between how genders rated the importance of "whether the program projects a favorable environment for women" and "whether the program projects a favorable environment for minorities." As compared with previous PM&R applicants, current prospective trainees seem to place greater importance on skill acquisition over didactic teaching. Prospective PM&R residents highly value subjective perceptions of prospective PM&R training programs and the ability to obtain hands-on procedural experience. Not applicable. Copyright © 2018 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Considerations for Residency Programs Regarding Accepting Undocumented Students Who Are DACA Recipients.

PubMed

Nakae, Sunny; Rojas Marquez, Denisse; Di Bartolo, Isha Marina; Rodriguez, Raquel

2017-11-01

The Deferred Action for Childhood Arrivals (DACA) initiative provides for the temporary deferral of enforcement of immigration laws for certain undocumented individuals brought to the United States before age 16. More than 50 medical schools now consider applicants who are DACA recipients, and medical school graduates with DACA are eligible to continue their training in graduate medical education. In this article, the authors summarize current policy and provide data on DACA recipients in medical school. They then review the implications for considering DACA recipients in graduate medical education, including employment guidelines, employer responsibilities, training at Veterans Affairs facilities, research funding, and professional licensure. They conclude by discussing the future of the DACA program and best practices for supporting students who are DACA recipients.First, there are no employment restrictions for DACA recipients with valid work authorization documents as long as their employers use Form I-9 Employment Eligibility Verification. Second, unlike H-1B or J-1 visa holders, DACA recipients do not generate additional immigration-related costs for their residency programs. Next, provisions in the Civil Rights Act prohibit employers from discriminating against applicants based on national origin or, in some cases, citizenship status. Furthermore, trainees with DACA are eligible to rotate through Veterans Affairs facilities. Finally, some states, like California and New York, have adopted policies and regulations allowing trainees with DACA who meet all professional requirements to receive a medical license. Given this state of affairs, DACA recipients should have equal standing to their peers when being evaluated for residency positions.

Recruiting researchers in psychiatry: the influence of residency vs. early motivation.

PubMed

Silberman, Edward K; Belitsky, Richard; Bernstein, Carol Ann; Cabaniss, Deborah L; Crisp-Han, Holly; Dickstein, Leah J; Kaplan, Alan S; Hilty, Donald M; Nadelson, Carol C; Scheiber, Stephen C

2012-03-01

The declining numbers of clinician-researchers in psychiatry and other medical specialties has been a subject of growing concern. Residency training has been cited as an important factor in recruiting new researchers, but there are essentially no data to support this assertion. This study aimed to explore which factors have influenced motivation to conduct research among senior psychiatry residents. The authors surveyed senior residents, inquiring about their level of interest in research, demographics, background, research experiences, and factors influencing motivation for research. The authors had confirmed participation from 16 of 33 residency programs with a class size of 10 or more. They received 127 responses, a 67% response rate, from participating programs. Residents with high stated interest in research differed from those with low and moderate interest in their research-intense post-residency plans. They were more likely to have graduate degrees. Those planning research careers had a consistent pattern of interest and involvement in research, starting well before residency. The majority of residents had had research exposure in college, but research involvement of those with very high versus lower interest diverged sharply thereafter. Those with high research interest were overwhelmingly male and tended to have lower debt than those with less interest. The great majority of residents appear to have decided whether or not to pursue a research career by the time they reached residency, and few of those with less than the highest research interest were enrolled in research tracks. Efforts to increase recruitment into research should center on identifying early developmental influences, eliminating barriers specific to women, and ensuring adequate funding to provide secure careers for talented potential researchers.

The predictive value of pre-recruitment achievement on resident performance in anesthesiology.

PubMed

Chen, Fei; Arora, Harendra; Martinelli, Susan M; Teeter, Emily; Mayer, David; Zvara, David A; Passannante, Anthony; Smith, Kathleen A

2017-06-01

Selecting candidates for residency positions is challenging and there is little research on the correlation between commonly used selection criteria and subsequent performance in anesthesiology. This study examined the association between the selection measures and post-recruitment performance in residency. Retrospective review of archival data. Anesthesiology residency program at a large academic anesthesiology department. Residents who were matched to the anesthesiology program over 9years (graduation classes of 2006 to 2014). None. The pre-recruitment achievements included a comprehensive list of measures obtained from residents' application portfolios in conjunction with interview performance. The post-recruitment examination outcomes consisted of the in-training examination (ITE) scores in the three clinical anesthesia (CA) years and first-attempt success on the written board certification examination administered by the American Board of Anesthesiology (ABA). Scholarly output during residency was measured by publication record. Clinical performance at the conclusion of residency was independently rated by three faculty members. Bivariate analysis and regression models were conducted to examine association between predictors and outcomes. High United States Medical Licensing Examination (USMLE) scores, class rank in medical school and interview performance were predictive of high examination scores in residency and good clinical performance. Class rank appeared to be the best predictor of scholarly publication and pursuing an academic career beyond residency. Comparative performance with classmates (i.e., class rank) in medical school appeared to be an effective predictor of overall performance in residency, which warrants more attention in future study. Although interview performance is subject to recruitment team members' interpretation, it is an important measure to include in recruitment decisions. Copyright © 2017 Elsevier Inc. All rights reserved.

Program Director Perceptions of Proficiency in the Core Entrustable Professional Activities.

PubMed

Pearlman, R Ellen; Pawelczak, Melissa; Yacht, Andrew C; Akbar, Salaahuddin; Farina, Gino A

2017-10-01

The Association of American Medical Colleges describes 13 core entrustable professional activities (EPAs) that every graduating medical student should be expected to perform proficiently on day 1 of residency, regardless of chosen specialty. Studies have shown wide variability in program director (PD) confidence in interns' abilities to perform these core EPAs. Little is known regarding comparison of United States Medical Licensing Examination (USMLE) scores with proficiency in EPAs. We determined if PDs from a large health system felt confident in their postgraduate year 1 residents' abilities to perform the 13 core EPAs, and compared perceived EPA proficiency with USMLE Step 1 and Step 2 scores. The PDs were asked to rate their residents' proficiency in each EPA and to provide residents' USMLE scores. Timing coincided with the reporting period for resident milestones. Surveys were completed on 204 of 328 residents (62%). PDs reported that 69% of residents (140 of 204) were prepared for EPA 4 (orders/prescriptions), 61% (117 of 192) for EPA 7 (form clinical questions), 68% (135 of 198) for EPA 8 (handovers), 63% (116 of 185) for EPA 11 (consent), and 38% (49 of 129) for EPA 13 (patient safety). EPA ratings and USMLE 1 and 2 were negatively correlated ( r (101) = -0.23, P  = .031). PDs felt that a significant percentage of residents were not adequately prepared in order writing, forming clinical questions, handoffs, informed consent, and promoting a culture of patient safety. We found no positive association between USMLE scores and EPA ratings.

Preliminary Data: An Adapted Hospital Elder Life Program to Prevent Delirium and Reduce Complications of Acute Illness in Long-Term Care Delivered by Certified Nursing Assistants.

PubMed

Boockvar, Kenneth S; Teresi, Jeanne A; Inouye, Sharon K

2016-05-01

Nursing home (NH) residents have a high prevalence of delirium risk factors, experience two to four acute medical conditions (e.g., infections) each year, and have an incidence of delirium during these conditions similar to that of hospitalized older adults. Many NH residents with delirium do not return to their prior level of cognitive function. They are more likely to die, be hospitalized, and less likely to be discharged home than those without delirium. Research on the prevention or treatment of delirium in NHs is limited. This article describes the development and pilot testing of a multicomponent delirium prevention intervention in the NH setting adapted from the Hospital Elder Life Program (HELP-LTC). Activities to reduce the risk of delirium that were appropriate for functionally impaired NH residents were developed and delivered during treatment for and recovery from acute illness, a novel resident-targeting approach. Expertly trained certified nursing assistants (CNAs - a total of 1.4 full-time equivalent (FTE) positions-) visited residents throughout the facility and delivered the activities. The current study reports on incident delirium, delirium remission, cognitive and physical function change, hospitalization, and death associated with acute medical conditions as ascertained by a program coordinator. The integration and acceptance of the CNAs' activities by residents and staff are also reported on. Hospitalization and death were ascertained in a nonintervention comparison group. Findings support a test of the intervention in a controlled trial. The potential effect is great; there are approximately 1.4 million NH residents in the United States and an estimated 1 million with dementia or cognitive impairment, an important delirium risk factor. An intervention would be broadly adoptable if a reduction in healthcare costs through prevention of hospitalization offset the cost of the program's CNAs. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

26 CFR 301.6362-6 - Requirements relating to residence.

Code of Federal Regulations, 2013 CFR

2013-04-01

... degree program at a college in State Y. During the 9-month academic year, C lives on the college campus... $1,200. For purposes of determining the identity of the principal contributor to the trust and the...

26 CFR 301.6362-6 - Requirements relating to residence.

Code of Federal Regulations, 2012 CFR

2012-04-01

... degree program at a college in State Y. During the 9-month academic year, C lives on the college campus... $1,200. For purposes of determining the identity of the principal contributor to the trust and the...

26 CFR 301.6362-6 - Requirements relating to residence.

Code of Federal Regulations, 2014 CFR

2014-04-01

... degree program at a college in State Y. During the 9-month academic year, C lives on the college campus... $1,200. For purposes of determining the identity of the principal contributor to the trust and the...

26 CFR 301.6362-6 - Requirements relating to residence.

Code of Federal Regulations, 2011 CFR

2011-04-01

... degree program at a college in State Y. During the 9-month academic year, C lives on the college campus... $1,200. For purposes of determining the identity of the principal contributor to the trust and the...

Use of social media by residency program directors for resident selection.

PubMed

Cain, Jeff; Scott, Doneka R; Smith, Kelly

2010-10-01

Pharmacy residency program directors' attitudes and opinions regarding the use of social media in residency recruitment and selection were studied. A 24-item questionnaire was developed, pilot tested, revised, and sent to 996 residency program directors via SurveyMonkey.com. Demographic, social media usage, and opinions on social media data were collected and analyzed. A total of 454 residency program directors completed the study (response rate, 46.4%). The majority of respondents were women (58.8%), were members of Generation X (75.4%), and worked in a hospital or health system (80%). Most respondents (73%) rated themselves as either nonusers or novice users of social media. Twenty percent indicated that they had viewed a pharmacy residency applicant's social media information. More than half (52%) had encountered e-professionalism issues, including questionable photos and posts revealing unprofessional attitudes, and 89% strongly agreed or agreed that information voluntarily published online was fair game for judgments on character, attitudes, and professionalism. Only 4% of respondents had reviewed applicants' profiles for residency selection decisions. Of those respondents, 52% indicated that the content had no effect on resident selection. Over half of residency program directors were unsure whether they will use social media information for future residency selection decisions. Residency program directors from different generations had different views regarding social media information and its use in residency applicant selections. Residency program directors anticipated using social media information to aid in future decisions for resident selection and hiring.

Training at a faith-based institution matters for obstetrics and gynecology residents: results from a regional survey.

PubMed

Guiahi, Maryam; Westhoff, Carolyn L; Summers, Sondra; Kenton, Kimberly

2013-06-01

Prior data suggest that opportunities in family planning training may be limited during obstetrics and gynecology (Ob-Gyn) residency training, particularly at faith-based institutions with moral and ethical constraints, although this aspect of the Ob-Gyn curriculum has not been formally studied to date. We compared Ob-Gyn residents' self-rated competency and intentions to provide family planning procedures at faith-based versus those of residents at non-faith-based programs. We surveyed residents at all 20 Ob-Gyn programs in Illinois, Indiana, Iowa, and Wisconsin from 2008 to 2009. Residents were queried about current skills and future plans to perform family planning procedures. We examined associations based on program and residents' personal characteristics and performed multivariable logistic regression analysis. A total of 232 of 340 residents (68%) from 17 programs (85%) returned surveys. Seven programs were faith-based. Residents from non-faith-based programs were more likely to be completely satisfied with family planning training (odds ratio [OR]  =  3.4, 95% confidence limit [CI], 1.9-6.2) and to report they "understand and can perform on own" most procedures. Most residents, regardless of program type, planned to provide all surveyed family planning services. Despite similar intentions to provide family planning procedures after graduation, residents at faith-based training programs were less satisfied with their family planning training and rate their ability to perform family planning services lower than residents at non-faith-based training programs.

The 80-hour work week for residents: views from obstetric and gynecology program directors.

PubMed

Janoo, Jabin; Hashmi, Mahreen; Seybold, Dara J; Shapiro, Robert; Calhoun, Byron C; Bush, Stephen H

2014-01-01

In 2003, the Accreditation Council for Graduate Medical Education mandated an 80-hour work week restriction for residency programs. We examined program directors' views on how this mandate affects the education of Obstetrics and Gynecology residents. A 25 question survey was administered via Survey Monkey to Obstetrics and Gynecology program directors in the United States over three months in 2011. Fifty program directors (response rate of 28%) completed it with more men (62%) than women (38%) respondents. Overall, only 28% (14/50) responded that the program had improved, with significantly fewer men (5/14; 16.1%) than women (47.4% 9/19; p < 0.0169) directors reporting this. There was little perceived improvement in any of the six core ACGME performance objectives and in the CREOG scores, with the improvement ranging from 8% to 12%. In fact, while we observed the percentage of women directors reporting improvement in patient care and interpersonal and communication skills significantly higher compared with their male counterparts, the majority of women still reported either no improvement or a decline in these areas. Though our sample size was small, we found some significant difference between the views of male and female program directors. Both groups nonetheless responded with the majority with a decline or no change rather than a perceived improvement in any of the educational endeavors studied.

The 80-hour Work Week for Residents: Views from Obstetric and Gynecology Program Directors

PubMed Central

Janoo, Jabin; Hashmi, Mahreen; Seybold, Dara J.; Shapiro, Robert; Calhoun, Byron C.; Bush, Stephen H.

2015-01-01

In 2003, the Accreditation Council for Graduate Medical Education mandated an 80-hour work week restriction for residency programs. We examined program directors’ views on how this mandate affects the education of Obstetrics and Gynecology residents. A 25 question survey was administered via Survey Monkey to Obstetrics and Gynecology program directors in the United States over three months in 2011. Fifty program directors (response rate of 28%) completed it with more men (62%) than women (38%) respondents. Overall, only 28% (14/50) responded that the program had improved, with significantly fewer men (5/14; 16.1%) than women (47.4% 9/19; p<0.0169) directors reporting this. There was little perceived improvement in any of the six core ACGME performance objectives and in the CREOG scores, with the improvement ranging from 8% to 12%. In fact, while we observed the percentage of women directors reporting improvement in patient care and interpersonal and communication skills significantly higher compared with their male counterparts, the majority of women still reported either no improvement or a decline in these areas. Though our sample size was small, we found some significant difference between the views of male and female program directors. Both groups nonetheless responded with the majority with a decline or no change rather than a perceived improvement in any of the educational endeavors studied. PMID:25643470

Applicant Perspectives on the Otolaryngology Residency Application Process.

PubMed

Ward, Matthew; Pingree, Christian; Laury, Adrienne M; Bowe, Sarah N

2017-08-01

It has been nearly 25 years since medical students were queried regarding their perspectives on otolaryngology-head and neck surgery (OHNS) residency selection. Understanding this viewpoint is critical to improving the current application process. To evaluate the perceptions of 2016 OHNS residency applicants regarding the application process and offer suggestions for reform. In this cross-sectional study of anonymous online survey data, a 14-question survey was designed based on resources obtained from a computerized PubMed, Ovid, and GoogleScholar database search of the English language from January 1, 1990, through December 31, 2015, was conducted using the following search terms: (medical student OR applicant) AND (application OR match) AND otolaryngology. The survey was administered to 2016 OHNS residency applicants to examine 4 primary areas: current attitudes toward the match, effect of the new Otolaryngology Program Directors Organization personal statement mandate, sources of advice and information, and suggestions for improvement. In January 2016, an email was sent to 100 program directors asking them to distribute the survey to current OHNS applicants at their institution. One follow-up reminder email was sent in February 2016. A link to the survey was posted on the Otomatch.com homepage on January 28, 2016, with the last response received on March 28, 2016. Survey responses regarding the residency application process. A total of 150 of 370 residency applicants (40.5%) responded to the survey. Of these, 125 respondents (90.6%) noted applying to programs in which they had no specific interest simply to improve their chances of matching. Applicants intended to apply to more programs than they actually did (63.6 vs 60.8; r = 0.19; 95% CI, -0.03 to 0.40). Program directors advised fewer applications than other sources; however, 58 respondents (38.7%) did not receive advice from a program director. A total of 121 respondents (80.7%) found online program information to be insufficient. Finally, 90 of 140 respondents (64.3%) noted that they would agree to a hard cap on applications, among other suggestions for improvement. Several main themes emerged from the data, providing a foundation for process improvement opportunities: careful consideration to applicant mentorship, including peers; uniform set of criteria for residency program websites; and investigating alternative match platforms, which may allow hard caps, flagging programs of higher interest, or wave application cycles. Overall, the otolaryngology applicant provides a unique perspective regarding the current state of the match and potential opportunities for system-wide improvement.

Preimplementation predictors of website use: preliminary findings from the SCORE portal pilot study.

PubMed

Schmitz, Connie C; Risucci, Donald; Plass, Jan; Jones, Andrew; Darosa, Debra A

2011-01-01

in 2008, the Surgical Council on Resident Education selected 33 residency programs to pilot its General Surgery Resident Curriculum Website Portal. The portal aims to reduce program variability in curricula, align teaching and learning with essential content, and improve resident study and performance. two online surveys were sent to all program directors and their residents before releasing the portal. Data from 32 programs and 899 residents (84%) were analyzed to determine the extent to which preimplementation characteristics supported the portal's rationale and illuminated barriers to its use and impact on learning. the need for curriculum content and access to online texts varied markedly across programs. Residents had easy onsite access to the Internet and used it heavily for immediate purposes. Fewer residents used the Web for planned activities and proactive study. On average, residents reported studying an hour or less a day. the portal appears to serve curricular resource needs and may better direct resident study. Programs are advised to consciously integrate the SCORE curriculum and portal into residency training and faculty development. 2011 Elsevier Inc. All rights reserved.

Practical Implications for an Effective Radiology Residency Quality Improvement Program for Milestone Assessment.

PubMed

Leddy, Rebecca; Lewis, Madelene; Ackerman, Susan; Hill, Jeanne; Thacker, Paul; Matheus, Maria; Tipnis, Sameer; Gordon, Leonie

2017-01-01

Utilization of a radiology resident-specific quality improvement (QI) program and curriculum based on the Accreditation Council for Graduate Medical Education (ACGME) milestones can enable a program's assessment of the systems-based practice component and prepare residents for QI implementation post graduation. This article outlines the development process, curriculum, QI committee formation, and resident QI project requirements of one institution's designated radiology resident QI program. A method of mapping the curriculum to the ACGME milestones and assessment of resident competence by postgraduate year level is provided. Sample projects, challenges to success, and lessons learned are also described. Survey data of current trainees and alumni about the program reveal that the majority of residents and alumni responders valued the QI curriculum and felt comfortable with principles and understanding of QI. The most highly valued aspect of the program was the utilization of a resident education committee. The majority of alumni responders felt the residency quality curriculum improved understanding of QI, assisted with preparation for the American Board of Radiology examination, and prepared them for QI in their careers. In addition to the survey results, outcomes of resident project completion and resident scholarly activity in QI are evidence of the success of this program. It is hoped that this description of our experiences with a radiology resident QI program, in accordance with the ACGME milestones, may facilitate the development of successful QI programs in other diagnostic radiology residencies. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

The value of internship in graduate medical education: survey of emergency medicine residents and program directors.

PubMed

Ray, Adam M

2007-01-01

To assess the opinions of emergency medicine (EM) residents and program directors about the value of completing a nonrequired 1-year internship before entering an EM residency program accredited by the Accreditation Council for Graduate Medical Education (ACGME). An eight-question, self-administered online survey was e-mailed to EM residents who had completed a nonrequired internship before entering ACGME-accredited residency programs. A separate, six-question survey was e-mailed to program directors of ACGME-accredited programs that do not require an internship who had ever had a resident who had completed a nonrequired internship. Forty-six (27 [59%] osteopathic, 19 [41%] allopathic) of 113 residents and 40 of 124 program directors responded to the survey questions. Less than 4% of residents completed a separate nonrequired 1-year internship. The most common reason for completing a nonrequired internship was to obtain licensure by the American Osteopathic Association (19 [41%]). Most residents believed that they were more proficient with history-taking and physical examinations (38 [83%]) and procedures (34 [74%]) during the first year of residency than their colleagues who did not complete an internship, but this percentage decreased over time. The program directors had similar opinions. Most osteopathic residents who completed the internship for osteopathic licensure would not have done so if it were not required. Most (39 of 40) program directors would not recommend taking a nonrequired internship. Completing a 1-year internship before entering an EM residency program may better prepare physicians for their first year of residency in terms of basic clinical competancy, but further study is needed in this area.

Enhancing pediatric residents’ scholar role: the development of a Scholarly Activity Guidance and Evaluation program

PubMed Central

Pound, Catherine M.; Moreau, Katherine A.; Ward, Natalie; Eady, Kaylee; Writer, Hilary

2015-01-01

Background Research training is essential to the development of well-rounded physicians. Although many pediatric residency programs require residents to complete a research project, it is often challenging to integrate research training into educational programs. Objective We aimed to develop an innovative research program for pediatric residents, called the Scholarly Activity Guidance and Evaluation (SAGE) program. Methods We developed a competency-based program which establishes benchmarks for pediatric residents, while providing ongoing academic mentorship. Results Feedback from residents and their research supervisors about the SAGE program has been positive. Preliminary evaluation data have shown that all final-year residents have met or exceeded program expectations. Conclusions By providing residents with this supportive environment, we hope to influence their academic career paths, increase their research productivity, promote evidence-based practice, and ultimately, positively impact health outcomes. PMID:26059213

Factors Influencing Job Satisfaction of New Graduate Nurses Participating in Nurse Residency Programs: A Systematic Review

PubMed Central

Lin, Patrice S.; Viscardi, Molly Kreider; McHugh, Matthew D.

2016-01-01

Nurse residency programs are designed to increase competence and skill, and ease the transition from student to new graduate nurse. These programs also offer the possibility to positively influence the job satisfaction of new graduate nurses, which could decrease poor nursing outcomes. However, little is known about the impact of participation in a nurse residency program on new graduate nurses’ satisfaction. This review examines factors that influence job satisfaction of nurse residency program participants. Eleven studies were selected for inclusion, and seven domains influencing new graduate nurses’ satisfaction during participation in nurse residency programs were identified: extrinsic rewards, scheduling, interactions and support, praise and recognition, professional opportunities, work environment, and hospital system. Within these domains, the evidence for improved satisfaction with nurse residency program participation was mixed. Further research is necessary to understand how nurse residency programs can be designed to improve satisfaction and increase positive nurse outcomes. PMID:25280192

Maternity policy and practice during surgery residency: how we do it.

PubMed

Carty, Sally E; Colson, Yolonda L; Garvey, Laura S; Schuchert, Vaishali D; Schwentker, Ann; Tzeng, Edith; Corcoran, Noreen A; Simmons, Richard L; Webster, Marshall W; Billiar, Timothy R

2002-10-01

Pregnancy during general surgery residency has traditionally been discouraged. In 2001, using an approved protocol, we anonymously surveyed 25 residents (PGY3 level or greater) concerning their experiences working with each other during episodes of resident pregnancy and maternity leave. From 1995 to 2001, 13 of 59 residents in general surgery were female (22%). While training, 6 of 13 residents reported 8 pregnancies with 2 miscarriages. Five residents (39%) gave birth to 6 children and adopted 1 child. Residents worked until the day of term delivery in 5 of 6 cases; 1 pregnancy was complicated by placental abruption at 33 weeks. Residents were off work postpartum for a median of 6 weeks (range 2-6). Nursing was universal for > or = 3 months but at-work problems with privacy and stress were frequent. On survey, all resident mothers believed they had been treated very fairly, and 94% of surveyed male peers stated that the coworker's status had no effect or a positive effect on their own work life. Fatherhood was reported to occur during residency by 42% of male respondents. Parenthood during residency is frequent. The complexities of resident maternity can be handled with mutual safety, equity, and satisfaction by the residents and faculty of a surgical training program.

Can a Clinician-Scientist Training Program Develop Academic Orthopaedic Surgeons? One Program's Thirty-Year Experience.

PubMed

Brandt, Aaron M; Rettig, Samantha A; Kale, Neel K; Zuckerman, Joseph D; Egol, Kenneth A

2017-10-25

Clinician-scientist numbers have been stagnant over the past few decades despite awareness of this trend. Interventions attempting to change this problem have been seemingly ineffective, but research residency positions have shown potential benefit. We sought to evaluate the effectiveness of a clinician-scientist training program (CSTP) in an academic orthopedic residency in improving academic productivity and increasing interest in academic careers. Resident training records were identified and reviewed for all residents who completed training between 1976 and 2014 (n = 329). There were no designated research residents prior to 1984 (pre-CSTP). Between 1984 and 2005, residents self-selected for the program (CSTP-SS). In 2005, residents were selected by program before residency (CSTP-PS). Residents were also grouped by program participation, research vs. clinical residents (RR vs. CR). Data were collected on academic positions and productivity through Internet-based and PubMed search, as well as direct e-mail or phone contact. Variables were then compared based on the time duration and designation. Comparing all RR with CR, RR residents were more likely to enter academic practice after training (RR, 34%; CR, 20%; p = 0.0001) and were 4 times more productive based on median publications (RR, 14; CR, 4; p < 0.0001). Furthermore, 42% of RR are still active in research compared to 29% of CR (p = 0.04), but no statistical difference in postgraduate academic productivity identified. The CSTP increased academic productivity during residency for the residents and the program. However, this program did not lead to a clear increase in academic productivity after residency and did not result in more trainees choosing a career as clinician-scientists. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

NRC/AMRMC Resident Research Associateship Program

DTIC Science & Technology

2017-04-01

final report. The productivity of these Associates is listed in the technical report. 15. SUBJECT TERMS- Associateship program, post -doc, awards 16...granting institutions in the United States; 4) posting announcements on internet job sites, electronic newsletters and professional society websites; 5...implemented in the testing and evaluation of medical countermeasures. SCHOLARLY PRODUCTIVITY ARTICLES - PEER REVIEWED Bixler, Sandra L; Bearss, Jeremy J

Predicting Success of Preliminary Surgical Residents: A Multi-Institutional Study.

PubMed

Al Fayyadh, Mohammed J; Heller, Stephanie F; Rajab, Taufiek Konrad; Gardner, Aimee K; Bloom, Jordan P; Rawlings, Jeremy A; Mullen, John T; Smink, Douglas S; Farley, David R; Willis, Ross E; Dent, Daniel L

A nondesignated preliminary surgery (NDPS) position encompasses 1 year of training provided by many general surgery residencies. Our aim was to assess factors predicting success and provide evidence for program directors to support career guidance to preliminary residents. Retrospective cohort study of 221 NDPS residents who entered 5 university-based institutions were identified from 2009 to 2013. Records for trainees were reviewed. We defined primary success as obtaining a categorical position in the specialty of choice and secondary success as obtaining a categorical position in any specialty immediately after finishing their NDPS training. Statistical evaluation was performed using chi-square analysis, independent t-test and logistic regression using α <0.05. Of the 221 NDPS residents, 217 (98%) completed postgraduate year (PGY)-1 and 65 (29%) completed PGY-2. Totally, 90 (41%) obtained categorical general surgery positions, 89 (40%) obtained categorical positions in other specialties, and 42 (19%) failed to obtain a categorical position immediately after their NDPS years. Ultimately, 139 (63%) of residents achieved primary success and 40 (18%) additional residents obtained categorical positions in specialties other than their first choice, resulting in a total of 179 (81%) of residents obtaining categorical positions. Mean United States Medical Licensing Examination step 1 and step 2 scores for those who obtained secondary success were 227 and 234 vs. 214 and 219, respectively, for those who failed to secure a categorical position (p < 0.01). United States Medical Licensing Examination step 2 score was a significant predictor of primary (p < 0.03) and secondary success (p < 0.02). Of 65 PGY-2 NDPS residents, 32 (49%) achieved primary success, and 11 (17%) others achieved secondary success for a total of 43 (66%). For PGY-2 NDPS, American Board of Surgery In-Training Examination was the only significant predictor of primary and secondary success (p < 0.02 and p < 0.05). NDPS training provides a viable and successful opportunity for at least 81% of young physicians to pursue their career goals even after an unsuccessful first match. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Perceived value and outcomes of residency projects.

PubMed

Murphy, J E; Downhour, N

2001-05-15

Residency program directors' attitudes toward residency projects were studied. A questionnaire about the residency project experience was mailed in January 2000 to 446 pharmacy practice residency program and specialty residency program directors in the program database of the American Society of Health-System Pharmacists. Recipients responded to opinion statements on a 5-point scale. Responses to the opinion statements were separated into seven categories for analysis. A total of 278 usable questionnaires were returned, for a raw response rate of 63.6%. During the preceding three years, residency directors had served as primary advisors on 917 projects; 171 had served as advisor on at least one of every type of project allowed in the accreditation standards. Of the 917 projects, 364 were presented at national professional meetings, 124 were published, and 484 were believed to have resulted in a positive change in pharmacy services. There were no significant differences in total response scores among any of the subgroups analyzed. There was strong agreement that residency projects were valuable and should continue to be part of the residency program experience. The directors' views of the importance of original research as a project option were more neutral. Overall residency program directors had positive perceptions of the value of residency projects to both residents and institutions and believed that they should continue to be a requirement of residency programs.

Pregnancy among residents enrolled in general surgery: a nationwide survey of attitudes and experiences.

PubMed

Merchant, Shaila J; Hameed, S Morad; Melck, Adrienne L

2013-10-01

Medical student interest in general surgery has declined, and the lack of adequate accommodation for pregnancy and parenting during residency training may be a deterrent. We explored resident and program director experiences with these issues in general surgery programs across Canada. Using a web-based tool, residents and program directors from 16 Canadian general surgery programs were surveyed regarding their attitudes toward and experiences with pregnancy during residency. One hundred seventy-six of 600 residents and 8 of 16 program directors completed the survey (30% and 50% response rate, respectively). Multiple issues pertaining to pregnancy during surgical residency were reported including the lack of adequate policies for maternity/parenting, the major obstacles to breast-feeding, and the increased workload for fellow resident colleagues. All program directors reported the lack of a program-specific maternity/parenting policy. General surgery programs lack program-specific maternity/parenting policies. Several issues have been highlighted in this study emphasizing the importance of creating and implementing such a policy. Copyright © 2013 Elsevier Inc. All rights reserved.

Recent trends in internal medicine education: a brief update.

PubMed

Flannery, Michael T

2014-03-01

This perspective attempts to bring graduate medical offices, residency programs and medical students interested in categorical internal medicine (CIM) a brief update on the American Board of Internal Medicine (ABIM), Accreditation Council for Graduate Medical Education (ACGME) and the National Registry for Medical Programs (NRMP) changes for the past 3-5 years in the United States (US). The US model for certification and recertification may serve as a homogenous example for other countries. This model will be described so that there is an understanding of the importance of such changes in the American system and its effect on resident education. This is critical knowledge for both teachers and learners in internal medicine in preparation for a lifetime career and requirements for certification/credentialing for both programs and their residents/fellows. Data from the review indicate a small increase in the number of applicants but a concordant decrease in ABIM initial certification exams. Programs should well be aware of the new focus on outcomes via the Next Accreditation System (NAS) being put forth by the ACGME. Copyright © 2014 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Does Person-Centered Care Improve Residents' Satisfaction With Nursing Home Quality?

PubMed

Poey, Judith L; Hermer, Linda; Cornelison, Laci; Kaup, Migette L; Drake, Patrick; Stone, Robyn I; Doll, Gayle

2017-11-01

Person-centered care (PCC) is meant to enhance nursing home residents' quality of life (QOL). Including residents' perspectives is critical to determining whether PCC is meeting residents' needs and desires. This study examines whether PCC practices promote satisfaction with QOL and quality of care and services (QOC and QOS) among nursing home residents. A longitudinal, retrospective cohort study using an in-person survey. Three hundred twenty nursing homes in Kansas enrolled or not enrolled in a pay-for-performance program, Promoting Excellent Alternatives in Kansas (PEAK 2.0), to promote PCC in nursing homes. A total of 6214 nursing home residents in 2013-2014 and 5538 residents in 2014-2015, with a Brief Interview for Mental Status score ≥8, participated in face-to-face interviews. Results were aggregated to the nursing home level. My InnerView developed a Resident Satisfaction Survey for Kansas composed of 32 questions divided into QOL, QOC, QOS, and global satisfaction subdomains. After controlling for facility characteristics, satisfaction with overall QOL and QOC was higher in homes that had fully implemented PCC. Although some individual measures in the QOS domain (eg, food) showed greater satisfaction at earlier levels of implementation, high satisfaction was observed primarily in homes that had fully implemented PCC. These findings provide evidence for the effectiveness of PCC implementation on nursing home resident satisfaction. The PEAK 2.0 program may provide replicable methods for nursing homes and states to implement PCC systematically. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Development of an Online Learning Module to Improve Pediatric Residents' Confidence and Knowledge of the Pubertal Examination.

PubMed

Ens, Andrea; Janzen, Katharine; Palmert, Mark R

2017-03-01

Pediatric residents must know how to perform pubertal examinations. The initial objective of this study was to evaluate pediatric resident knowledge and comfort related to the pubertal examination and to determine whether and why these examinations are avoided. The subsequent objective was to develop and assess a learning module (LM) addressing identified education gaps. A learning needs assessment (LNA) was administered to residents in four Canadian pediatric training programs. Identified themes and knowledge gaps were used to develop an online, case-based LM. A randomized assessment of the LM was conducted among residents from nine training programs across Canada. Sixty-four residents completed the LNA. About 52% reported discomfort introducing the pubertal examination, 50% reported a lack of confidence related to the examination, and 56% reported having avoided a warranted examination. Ninety-seven residents participated in the LM assessment. The baseline results were similar to those from the LNA in terms of discomfort, lack of confidence, and avoidance related to pubertal examinations. However, the intervention group showed improvement on a knowledge assessment compared with control group (p < .001). Confidence levels also improved in the intervention group LM (p < .01). Most residents (95%) stated they found the LM to be useful. Residents report being uncomfortable with and avoiding the pubertal examination and have significant knowledge gaps. The online, case-based LM used in this study improved the knowledge and confidence related to this aspect of pediatric care and may be an effective adjunct to pediatric training. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Orthopaedic Surgery Residency: Perspectives of Applicants and Program Directors on Medical Student Away Rotations.

PubMed

O'Donnell, Seth W; Drolet, Brian C; Brower, Jonathan P; LaPorte, Dawn; Eberson, Craig P

2017-01-01

Senior medical students frequently rotate at orthopaedic residency programs away from their home medical schools. However, to our knowledge, the perspective of program directors (PDs) and applicants on the value, objectives, and costs of these rotations has not been studied. Surveys evaluating the frequency, costs, benefits, and objectives of away rotations were distributed to all orthopaedic residency PDs in the United States and applicants in the 2014-2015 Match cycle. Data analysis was conducted to perform inferential and descriptive statistics; comparisons were made between and among PD and applicant groups using two-tailed means Student t-test and analysis of variance. A total of 74 PD (46.0%) and 524 applicant (49.3%) responses were obtained from a national distribution. Applicants completed an average of 2.4 away rotations, with an average cost of $2,799. When stratified on self-reported likelihood of Matching, there were no substantial differences in the total number of rotations performed. The only marked differences between these groups were the United States Medical Licensing Examination Step 1 score and the number of applications to residency programs. PDs reported that significantly fewer rotations should be allowed, whereas applicants suggested higher limits (2.42 rotations versus 6.24, P < 0.001). PDs and applicants had similar perspectives on the value of away rotations; both groups reported more value in finding a "good fit" and making a good impression at the program and placed less value on the educational impact. The value of orthopaedic away rotations appears more utilitarian than educational for both PDs and applicants. Rotations are performed regardless of perceived likelihood of Matching and are used by students and programs to identify a "good fit." Therefore, given the portion of an academic year that is spent on orthopaedic rotations, findings showing perceived low educational value and marked discrepancies between the expected number of rotations by PDs and applicants indicate that the current structure of away rotations may not be well aligned with the mission of undergraduate medical education. V.

Media education in pediatric residencies: a national survey.

PubMed

Christakis, Dimitri A; Frintner, Mary Pat; Mulligan, Deborah A; Fuld, Gilbert L; Olson, Lynn M

2013-01-01

Little is known about the current state of residency education with respect to counseling parents about media usage and whether trainees consider it to be adequate. A national survey of graduating pediatric residents was conducted in the United States to determine the amount of training they receive on traditional and new media, their perceptions of its quality, and their self-reported practices regarding talking to families about media usage. A 58% response rate was achieved with no evidence of response bias based on age or gender. Only 38% rated their residency program as "very good" or "excellent" in preparing them to provide anticipatory guidance on the effects of media on children and adolescents. In logistic regression analyses, controlling for demographic characteristics, more training on media issues was a significant predictor for usually/always advising families on traditional, passive media (adjusted odds ratio = 3.29; 95% confidence interval 2.26-4.81) and usually/always advising families on new, interactive media use (adjusted odds ratio = 3.96; 95% confidence interval 2.61-6.00) during well-child visits. The majority of residents believe their training on children in media is inadequate. Enhanced training on media is needed in US pediatric residencies. Copyright © 2013 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

The University of North Carolina Medical Center pharmacy resident leadership certificate program.

PubMed

Lyons, Kayley; Griggs, Danielle; Lebovic, Rachel; Roth, Mary E; South, David A; Hatfield, Chad

2017-03-15

The development and implementation of a certificate program for pharmacy residents are described. University of North Carolina (UNC) Medical Center met the call for increased efforts in the area of pharmacy residency leadership training through the design, implementation, and evaluation of a leadership certificate program. The purpose of the UNC certificate program is to develop leaders who will serve others, improve their communities, and advance the profession. The program is designed to (1) foster self-awareness, social awareness, and altruism, (2) provide transferable and individualized leadership experiences, (3) enrich other residency components through integration of leadership development opportunities, and (4) create role models for departmental leadership. A team of preceptors and residents implemented the certificate program by integrating program components into the existing pharmacy residency infrastructure. The certificate program includes required and flexible components to allow residents to set and achieve their determined leadership development goals. Overall, residents are satisfied with the program and perceive it as worthwhile. During the first 3 years since implementation of the certification initiative, program facilitators improved the feasibility of, participant engagement in, and sustainability of the program. Future directions include an effectiveness evaluation and a "scale-up" to other institutions. The need for a pharmacy residency leadership certificate was met by designing, implementing, and evaluating such a program at UNC. Through its first 3 years, the program was feasible, sustainable, and valued by program participants. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Relational Mindfulness for Psychiatry Residents: a Pilot Course in Empathy Development and Burnout Prevention.

PubMed

Bentley, Paige Greason; Kaplan, Sebastian G; Mokonogho, Josephine

2018-04-13

Psychiatry residents face challenges daily that test their capacity to be empathic and attuned to their own self-care. This can have a deleterious impact not only on the residents but also on patient-care. Training to manage the challenges of the work and cultivate stronger patient relationships is needed but often missing in medical education. This study aimed to pilot an empathy training course based in relational mindfulness and assess the impact on burnout and empathy. Seven first-year psychiatry residents (PGY-1) at an academic medical center in a mid-size city in the southeast participated in an eight-week pilot program created by the authors that integrated relational mindfulness and empathy training. Data were gathered from the seven PGY-1s on measures of burnout and empathy and on their experience of the training. The PGY-1s demonstrated a downward trend in means on all three burnout subscales and significant improvement on the measure of empathy (f = 8.98; p = .02). Overall, the PGY-1s reported an increased awareness of their cognitive and emotional experiences and stated that the skills learned in the program increased their ability to care for themselves, their patients, and their families. Training in intrapersonal and interpersonal attunement is often overlooked in medical training, leading to resident burnout and negative patient outcomes. An empathy course based in relational mindfulness may be a viable strategy for programs looking to attend to their residents' emotional health and bridge the empathy training gap.

The Global Education Network for Retinopathy of Prematurity (Gen-Rop): Development, Implementation, and Evaluation of A Novel Tele-Education System (An American Ophthalmological Society Thesis).

PubMed

Chan, R V Paul; Patel, Samir N; Ryan, Michael C; Jonas, Karyn E; Ostmo, Susan; Port, Alexander D; Sun, Grace I; Lauer, Andreas K; Chiang, Michael F

2015-01-01

To describe the design, implementation, and evaluation of a tele-education system developed to improve diagnostic competency in retinopathy of prematurity (ROP) by ophthalmology residents. A secure Web-based tele-education system was developed utilizing a repository of over 2,500 unique image sets of ROP. For each image set used in the system, a reference standard ROP diagnosis was established. Performance by ophthalmology residents (postgraduate years 2 to 4) from the United States and Canada in taking the ROP tele-education program was prospectively evaluated. Residents were presented with image-based clinical cases of ROP during a pretest, posttest, and training chapters. Accuracy and reliability of ROP diagnosis (eg, plus disease, zone, stage, category) were determined using sensitivity, specificity, and the kappa statistic calculations of the results from the pretest and posttest. Fifty-five ophthalmology residents were provided access to the ROP tele-education program. Thirty-one ophthalmology residents completed the program. When all training levels were analyzed together, a statistically significant increase was observed in sensitivity for the diagnosis of plus disease, zone, stage, category, and aggressive posterior ROP (P<.05). Statistically significant changes in specificity for identification of stage 2 or worse (P=.027) and pre-plus (P=.028) were observed. A tele-education system for ROP education is effective in improving diagnostic accuracy of ROP by ophthalmology residents. This system may have utility in the setting of both healthcare and medical education reform by creating a validated method to certify telemedicine providers and educate the next generation of ophthalmologists.

Factors affecting orthopedic residency selection: a cross-sectional survey

PubMed Central

Strelzow, Jason; Petretta, Robert; Broekhuyse, Henry M.

2017-01-01

Background Annually, orthopedic residency programs rank and recruit the best possible candidates. Little evidence exists identifying factors that potential candidates use to select their career paths. Recent literature from nonsurgical programs suggests hospital, social and program-based factors influence program selection. We sought to determine what factors influence the choice of an orthopedic career and a candidate’s choice of orthopedic residency program. Methods We surveyed medical student applicants to orthopedic programs and current Canadian orthopedic surgery residents (postgraduate year [PGY] 1–5). The confidential online survey focused on 3 broad categories of program selection: educational, program cohesion and noneducation factors. Questions were graded on a Likert Scale and tailed for mean scores. Results In total, 139 residents from 11 of 17 Canadian orthopedic programs (49% response rate) and 23 medical student applicants (88% response rate) completed our survey. Orthopedic electives and mandatory rotations were reported by 71% of participants as somewhat or very important to their career choice. Collegiality among residents (4.70 ± 0.6), program being the “right fit” (4.65 ± 0.53) and current resident satisfaction with their chosen program (4.63 ±0.66) were ranked with the highest mean scores on a 5-point Likert scale. Conclusion There are several modifiable factors that residency programs may use to attract applicants, including early availability of clerkship rotations and a strong mentorship environment emphasizing both resident–resident and resident–staff cohesion. Desirable residency programs should develop early access to surgical and operative skills. These must be balanced with a continued emphasis on top-level orthopedic training. PMID:28327273

Factors associated with general surgery residents' desire to leave residency programs: a multi-institutional study.

PubMed

Gifford, Edward; Galante, Joseph; Kaji, Amy H; Nguyen, Virginia; Nelson, M Timothy; Sidwell, Richard A; Hartranft, Thomas; Jarman, Benjamin; Melcher, Marc; Reeves, Mark; Reid, Christopher; Jacobsen, Garth R; Thompson, Jonathan; Are, Chandrakanth; Smith, Brian; Arnell, Tracey; Hines, Oscar J; de Virgilio, Christian

2014-09-01

General surgical residency continues to experience attrition. To date, work hour amendments have not changed the annual rate of attrition. To determine how often categorical general surgery residents seriously consider leaving residency. At 13 residency programs, an anonymous survey of 371 categorical general surgery residents and 10-year attrition rates for each program. Responses from those who seriously considered leaving surgical residency were compared with those who did not. Factors associated with the desire to leave residency. The survey response rate was 77.6%. Overall, 58.0% seriously considered leaving training. The most frequent reasons for wanting to leave were sleep deprivation on a specific rotation (50.0%), an undesirable future lifestyle (47.0%), and excessive work hours on a specific rotation (41.4%). Factors most often cited that kept residents from leaving were support from family or significant others (65.0%), support from other residents (63.5%), and perception of being better rested (58.9%). On univariate analysis, older age, female sex, postgraduate year, training in a university program, the presence of a faculty mentor, and lack of Alpha Omega Alpha status were associated with serious thoughts of leaving surgical residency. On multivariate analysis, only female sex was significantly associated with serious thoughts of leaving residency (odds ratio, 1.2; 95% CI, 1.1-1.3; P = .003). Eighty-six respondents were from historically high-attrition programs, and 202 respondents were from historically low-attrition programs (27.8% vs 8.4% 10-year attrition rate, P = .04). Residents from high-attrition programs were more likely to seriously consider leaving residency (odds ratio, 1.8; 95% CI, 1.0-3.0; P = .03). A majority of categorical general surgery residents seriously consider leaving residency. Female residents are more likely to consider leaving. Thoughts of leaving seem to be associated with work conditions on specific rotations rather than with overall work hours and are more prevalent among programs with historically high attrition rates.

The accelerated residency program: the Marshall University family practice 9-year experience.

PubMed

Petrany, Stephen M; Crespo, Richard

2002-10-01

In 1989, the American Board of Family Practice (ABFP) approved the first of 12 accelerated residency programs in family practice. These experimental programs provide a 1-year experience for select medical students that combines the requirements of the fourth year of medical school with those of the first year of residency, reducing the total training time by 1 year. This paper reports on the achievements and limitations of the Marshall University accelerated residency program over a 9-year period that began in 1992. Several parameters have been monitored since the inception of the accelerated program and provide the basis for comparison of accelerated and traditional residents. These include initial resident characteristics, performance outcomes, and practice choices. A total of 16 students were accepted into the accelerated track from 1992 through 1998. During the same time period, 44 residents entered the traditional residency program. Accelerated resident tended to be older and had more career experience than their traditional counterparts. As a group, the accelerated residents scored an average of 30 points higher on the final in-training exams provided by the ABFP. All residents in both groups remained at Marshall to complete the full residency training experience, and all those who have taken the ABFP certifying exam have passed. Accelerated residents were more likely to practice in West Virginia, consistent with one of the initial goals for the program. In addition, accelerated residents were more likely to be elected chief resident and choose an academic career than those in the traditional group. Both groups opted for small town or rural practice equally. The Marshall University family practice 9-year experience with the accelerated residency track demonstrates that for carefully selected candidates, the program can provide an overall shortened path to board certification and attract students who excel academically and have high leadership potential. Reports from other accelerated programs are needed to fully assess the outcomes of this experiment in postgraduate medical education.

The pediatric resident training on tobacco project: baseline findings from the Parent/Guardian Tobacco Survey.

PubMed

Hymowitz, Norman; Schwab, Joseph; Haddock, Christopher keith; Pyle, Sara; Moore, Glenisha; Meshberg, Sarah

2005-07-01

Pediatricians have an important and unique role to play in the anti-tobacco arena. They may prevent relapse to smoking in women who stopped smoking during pregnancy, encourage parents to protect infants and young children from environmental tobacco smoke (ETS), prevent the onset of smoking in children and adolescents, and help patients and parents who smoke or use other forms of tobacco to quit. Unfortunately, few pediatricians intervene on tobacco use or ETS, and few pediatric residency training programs prepare residents to address tobacco. The Pediatric Residency Training on Tobacco Project is a 4-year randomized prospective study of the effectiveness of training pediatric residents to intervene on tobacco in patients and parents. In this paper, we present findings from the Baseline Parent/Guardian Tobacco Survey. Fifteen pediatric residency training programs participated in the Pediatric Residency Training on Tobacco Project, and they were assigned randomly to special and standard training conditions. The Baseline Parent/Guardian Tobacco Survey was administered to 1770 participants, a minimum of 100 from each site. The Parent/Guardian Survey was designed to describe the population under study. It addressed demographic information, family tobacco use, rules concerning smoking in the home and elsewhere, smoking behavior and beliefs, and parent/guardian reports of resident intervention on tobacco. Data analyses described the population served by Continuity Clinics associated with the pediatric residency training programs and determined the degree to which residents addressed tobacco in parents/guardians. The parents/guardians were primarily low-income African American and Hispanic females. Approximately 20% reported that they smoked cigarettes, and about 60% prohibited smoking in their home. Seventy percent of the parents reported that the resident asked about cigarette smoking, and about half indicated that the resident talked with them about ETS. However, only about 10% of the smokers stated that the doctor offered to help them stop smoking, and just 25% of all parents/guardians indicated that the doctor offered to help them stop exposing their children to ETS in the home or elsewhere. Parents of children brought to Continuity Clinic may benefit from advice and assistance on quitting cigarette smoking and protecting their children from ETS. While pediatric residents offer advice and encouragement, few provide the assistance parents require. These findings underscore the importance of training pediatric residents to address tobacco with the parents/guardians of the patients they serve.

Homicide Rates of Transgender Individuals in the United States: 2010-2014.

PubMed

Dinno, Alexis

2017-09-01

To estimate homicide rates of transgender US residents and relative risks (RRs) of homicide with respect to cisgender comparators intersected with age, gender, and race/ethnicity. I estimated homicide rates for transgender residents and transfeminine, Black, Latin@, and young (aged 15-34 years) subpopulations during the period 2010 to 2014 using Transgender Day of Remembrance and National Coalition of Anti-Violence Programs transgender homicide data. I used estimated transgender prevalences to estimate RRs using cisgender comparators. I performed a sensitivity analysis to situate all results within assumptions about underreporting of transgender homicides and assumptions about the prevalence of transgender residents. The overall homicide rate of transgender individuals was likely to be less than that of cisgender individuals, with 8 of 12 RR estimates below 1.0. However, the homicide rates of young transfeminine Black and Latina residents were almost certainly higher than were those of cisfeminine comparators, with all RR estimates above 1.0 for Blacks and all above 1.0 for Latinas. Antiviolence public health programs should identify young and Black or Latina transfeminine women as an especially vulnerable population.

California's county hospitals and the University of California graduate medical education system. Current issues and future directions.

PubMed

Jameson, W J; Pierce, K; Martin, D K

1998-05-01

California's county hospitals train 45% of the state's graduate medical residents, including 33% of residents in the University of California system. This paper describes the interrelationships of California's county hospitals and the University of California (UC) graduate medical education (GME) programs, highlighting key challenges facing both systems. The mission of California's county health care systems is to serve all who need health care services regardless of ability to pay. Locating UC GME programs in county hospitals helps serve the public missions of both institutions. Such partnerships enhance the GME experience of UC residents, provide key primary care training opportunities, and ensure continued health care access for indigent and uninsured populations. Only through affiliation with university training programs have county hospitals been able to run the cost-effective, quality programs that constitute an acceptable safety net for the poor. Financial stress, however, has led county hospitals and UC's GME programs to advocate for reform in both GME financing and indigent care funding. County hospitals must participate in constructing strategies for GME reform to assure that GME funding mechanisms provide for equitable compensation of county hospitals' essential role. Joint advocacy will also be essential in achieving significant indigent care policy reform.

Preparing health professionals to provide care to individuals with disabilities.

PubMed

Holder, Matt; Waldman, H Barry; Hood, Henry

2009-06-01

To review the perceptions of dental/medical educators and their students in the United States on the adequacy of didactic and clinical preparation to provide service for individuals with disabilities. An e-mailed questionnaire with follow-up was sent to 198 deans of dental/medical schools, 1,628 directors of residency programs in nine medical/dental residency programs, 427 medical students in 12 medical schools, and 368 health related organizations, facilities and programs. More than half (58%) of the responding deans of reported that a curriculum for patients with disabilities was not a high priority at their school. A majority (61%) of deans of medical schools, and 47% of the deans of dental schools, reported that their graduates were competent to treat patients with disabilities. However, majorities of dental/medical school seniors and graduates expressed inadequate competency in the care of these patients. A majority of the directors of medical/dental residencies indicated a need for additional training for their residents. There is need for increased didactic and clinical preparation of dental/medical school graduates in the care of individuals with special health needs. The interest expressed by health profession educators in an effort to develop appropriate curriculum modules provides an opportunity to prepare new graduates for the care of an increasing population of individuals with disabilities.

Creating a Culture of Wellness in Residency.

PubMed

Edmondson, Emma K; Kumar, Anupam A; Smith, Stephanie M

2018-04-17

Despite increased awareness and recognition of the prevalence of physician burnout and the associated risks of depression and suicide, there is a paucity of actionable guidelines for residency programs to mitigate these risks for their residents. In this Invited Commentary, the authors acknowledge that, although there are inherent barriers to resident wellness, there are numerous modifiable barriers that present opportunities for programs to enable culture change and improve resident wellbeing. The authors frame the discussion with a personal narrative written by a resident in their internal medicine program who experienced burnout, depression, and suicidality during his intern year. They aim to inspire residency programs and hospital leadership to identify and intervene upon the modifiable barriers to wellness for residents in their programs in order to shape meaningful cultural change.

Curriculum emphasis and resident preparation in postgraduate general dentistry programs.

PubMed

Lefever, Karen H; Atchison, Kathryn A; Mito, Ronald S; Lin, Sylvia

2002-06-01

In 1999 HRSA contracted with the UCLA School of Dentistry to evaluate the impact of federal funding on postgraduate general dentistry programs. Part of that evaluation analyzed curriculum emphasis and preparation of incoming residents in advanced general dentistry programs over a five-year period. Directors of 208 civilian AEGD and GPR programs were surveyed about the curriculum content of their programs, increased or decreased emphasis in thirty subject areas, and resident preparation and quality (GPA and National Board scores). Results indicate that curriculum changes in AEGD and GPR programs over the time period have been responsive to the changing nature of general practice. At least half of all program directors reported that their residents were less than adequately prepared in fourteen curriculum areas. Sub-analyses were conducted for AEGD/GPR programs and HRSA-funded versus nonfunded programs. Multivariate regression identified lower student quality as the most important program variable in predicting a perceived need for resident remediation. Logistic regression showed that programs with higher resident GPA and National Board Part I scores had less difficulty filling resident positions.

Residency Program Directors' View on the Value of Teaching.

PubMed

Korte, Catherine; Smith, Andrew; Pace, Heather

2016-08-01

There is no standardization for teaching activities or a requirement for residency programs to offer specific teaching programs to pharmacy residents. This study will determine the perceived value of providing teaching opportunities to postgraduate year 1 (PGY-1) pharmacy residents in the perspective of the residency program director. The study will also identify the features, depth, and breadth of the teaching experiences afforded to PGY-1 pharmacy residents. A 20-question survey was distributed electronically to 868 American Society of Health-System Pharmacists-accredited PGY-1 residency program directors. The survey was completed by 322 program directors. Developing pharmacy educators was found to be highly valued by 57% of the program directors. Advertisement of teaching opportunities was found to be statistically significant when comparing program directors with a high perceived value for providing teaching opportunities to program demographics. Statistically significant differences were identified associating development of a teaching portfolio, evaluation of Advanced Pharmacy Practice Experiences students, and delivery of didactic lectures with program directors who highly value developing pharmacy educators. Future residency candidates interested in teaching or a career in academia may utilize these findings to identify programs that are more likely to value developing pharmacy educators. The implementation of a standardized teaching experience among all programs may be difficult. © The Author(s) 2015.

An Assessment of Radiology Residency Program Websites.

PubMed

Hansberry, David R; Bornstein, Jonathan; Agarwal, Nitin; McClure, Kristen E; Deshmukh, Sandeep P; Long, Suzanne

2018-04-01

When prospective radiology residents decide where to apply to residency, many will use the Internet as a resource to garner information. Therefore, it is important for residency programs to produce and maintain an informative and comprehensive website. Here, we review 179 radiology residency program websites for 19 criteria including various aspects related to the residency application process, benefits, didactics, research, clinical training, and faculty leadership. We evaluated 179 radiology residency program websites for the inclusion of 19 different criteria. Criteria for information not available directly on the website and links with no information were considered not present. Only 12 of the 179 (6.7%) program websites had at least 80% of the 19 criteria. In addition, 41 programs (23%) had less than 50% of the criteria listed on their websites. Websites ranged from having 16% of the criteria to as much as 95%. Although previous studies have shown that prospective radiology resident applicants are influenced by intangibles like current resident satisfaction and academic reputation, they have also shown that applicants are influenced by the educational curriculum, clinical training, program resources, research opportunities, and quality of faculty. Therefore, it is imperative to provide online resources for prospective candidates in an attempt for residency programs to remain competitive in recruiting high-quality US medical student graduates. These findings suggest there is room for improving the comprehensiveness of information provided on radiology residency program websites. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Mentorship Programs in Radiation Oncology Residency Training Programs: A Critical Unmet Need

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dhami, Gurleen; Gao, Wendy; Gensheimer, Michael F.

Purpose: To conduct a nationwide survey to evaluate the current status of resident mentorship in radiation oncology. Methods and Materials: An anonymous electronic questionnaire was sent to all residents and recent graduates at US Accreditation Council for Graduate Medical Education–accredited radiation oncology residency programs, identified in the member directory of the Association of Residents in Radiation Oncology. Factors predictive of having a mentor and satisfaction with the mentorship experience were identified using univariate and multivariate analyses. Results: The survey response rate was 25%, with 85% of respondents reporting that mentorship plays a critical role in residency training, whereas only 53%more » had a current mentor. Larger programs (≥10 faculty, P=.004; and ≥10 residents, P<.001) were more likely to offer a formal mentorship program, which makes it more likely for residents to have an active mentor (88% vs 44%). Residents in a formal mentoring program reported being more satisfied with the overall mentorship experience (univariate odds ratio 8.77, P<.001; multivariate odds ratio 5, P<.001). On multivariate analysis, women were less likely to be satisfied with the mentorship experience. Conclusions: This is the first survey focusing on the status of residency mentorship in radiation oncology. Our survey highlights the unmet need for mentorship in residency programs.« less