Cultural dimensions in the transition of overseas medical graduates to the UK workplace.

PubMed

Morrow, Gill; Rothwell, Charlotte; Burford, Bryan; Illing, Jan

2013-10-01

Historically, overseas-qualified doctors have been essential for meeting service needs in the UK National Health Service (NHS). However, these doctors encounter many cultural differences, in relation to training, the healthcare system and the doctor-patient relationship and training. To examine whether Hofstede's cultural model may help us understand the changes doctors from other countries experience on coming to work in the UK, and to identify implications for supervisors and clinical teams. Telephone interviews were conducted with overseas medical graduates before starting work as a Foundation Year One (F1) doctor, followed up after four months and 12 months; and with educational supervisors. Data were analysed using a confirmatory thematic approach. Sixty-four initial interviews were conducted with overseas doctors, 56 after four months, and 32 after 12 months. Twelve interviews were conducted with educational supervisors. The changes doctors experienced related particularly to Hofstede's dimensions of power distance (e.g. in relation to workplace hierarchies and inter-professional relationships), uncertainty avoidance (e.g. regarding ways of interacting) and individualism-collectivism (e.g., regarding doctor-patient/family relationship; assertiveness of individuals). Hofstede's cultural dimensions may help us understand the adaptations some doctors have to make in adjusting to working in the UK NHS. This may promote awareness and understanding and greater 'cultural competence' amongst those working with them or supervising them in their training.

The Academic Backbone: longitudinal continuities in educational achievement from secondary school and medical school to MRCP(UK) and the specialist register in UK medical students and doctors

PubMed Central

2013-01-01

Background Selection of medical students in the UK is still largely based on prior academic achievement, although doubts have been expressed as to whether performance in earlier life is predictive of outcomes later in medical school or post-graduate education. This study analyses data from five longitudinal studies of UK medical students and doctors from the early 1970s until the early 2000s. Two of the studies used the AH5, a group test of general intelligence (that is, intellectual aptitude). Sex and ethnic differences were also analyzed in light of the changing demographics of medical students over the past decades. Methods Data from five cohort studies were available: the Westminster Study (began clinical studies from 1975 to 1982), the 1980, 1985, and 1990 cohort studies (entered medical school in 1981, 1986, and 1991), and the University College London Medical School (UCLMS) Cohort Study (entered clinical studies in 2005 and 2006). Different studies had different outcome measures, but most had performance on basic medical sciences and clinical examinations at medical school, performance in Membership of the Royal Colleges of Physicians (MRCP(UK)) examinations, and being on the General Medical Council Specialist Register. Results Correlation matrices and path analyses are presented. There were robust correlations across different years at medical school, and medical school performance also predicted MRCP(UK) performance and being on the GMC Specialist Register. A-levels correlated somewhat less with undergraduate and post-graduate performance, but there was restriction of range in entrants. General Certificate of Secondary Education (GCSE)/O-level results also predicted undergraduate and post-graduate outcomes, but less so than did A-level results, but there may be incremental validity for clinical and post-graduate performance. The AH5 had some significant correlations with outcome, but they were inconsistent. Sex and ethnicity also had predictive effects on

Combining parenthood with a medical career: questionnaire survey of the UK medical graduates of 2002 covering some influences and experiences.

PubMed

Lambert, Trevor W; Smith, Fay; Goldacre, Michael J

2017-08-23

To report the self-assessed views of a cohort of medical graduates about the impact of having (or wanting to have) children on their specialty choice and the extent to which their employer was supportive of doctors with children. United Kingdom (UK). UK medical graduates of 2002 surveyed by post and email in 2014. The response rate was 64.2% (2057/3205). Most respondents were living with a spouse or partner (86%) and, of these, 49% had a medical spouse. Having children, or wanting to have children, had influenced specialty choice for 47% of respondents; for 56% of doctors with children and 29% of doctors without children; for 59% of women and 28% of men; and for 78% of general practitioners compared with 27% of hospital doctors and 18% of surgeons. 42% of respondents regarded the National Health Service as a family-friendly employer, and 64% regarded their specialty as family-friendly. More general practitioners (78%) than doctors in hospital specialties (56%) regarded their specialty as family-friendly, while only 32% of surgeons did so.Of those who had taken maternity/paternity/adoption leave, 49% rated the level of support they had received in doing so as excellent/good , 32% said it was acceptable and 18% said the support had been poor/very poor . Having children is a major influence when considering specialty choice for many doctors, especially women and general practitioners. Surgeons are least influenced in their career choice by the prospect of parenthood. Almost half of doctors in hospital specialties regard their specialty as family-friendly. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

PLAB and UK graduates’ performance on MRCP(UK) and MRCGP examinations: data linkage study

PubMed Central

Wakeford, Richard

2014-01-01

Objectives To assess whether international medical graduates passing the two examinations set by the Professional and Linguistic Assessments Board (PLAB1 and PLAB2) of the General Medical Council (GMC) are equivalent to UK graduates at the end of the first foundation year of medical training (F1), as the GMC requires, and if not, to assess what changes in the PLAB pass marks might produce equivalence. Design Data linkage of GMC PLAB performance data with data from the Royal Colleges of Physicians and the Royal College of General Practitioners on performance of PLAB graduates and UK graduates at the MRCP(UK) and MRCGP examinations. Setting Doctors in training for internal medicine or general practice in the United Kingdom. Participants 7829, 5135, and 4387 PLAB graduates on their first attempt at MRCP(UK) Part 1, Part 2, and PACES assessments from 2001 to 2012 compared with 18 532, 14 094, and 14 376 UK graduates taking the same assessments; 3160 PLAB1 graduates making their first attempt at the MRCGP AKT during 2007-12 compared with 14 235 UK graduates; and 1411 PLAB2 graduates making their first attempt at the MRCGP CSA during 2010-12 compared with 6935 UK graduates. Main outcome measures Performance at MRCP(UK) Part 1, Part 2, and PACES assessments, and MRCGP AKT and CSA assessments in relation to performance on PLAB1 and PLAB2 assessments, as well as to International English Language Testing System (IELTS) scores. MRCP(UK), MRCGP, and PLAB results were analysed as marks relative to the pass mark at the first attempt. Results PLAB1 marks were a valid predictor of MRCP(UK) Part 1, MRCP(UK) Part 2, and MRCGP AKT (r=0.521, 0.390, and 0.490; all P<0.001). PLAB2 marks correlated with MRCP(UK) PACES and MRCGP CSA (r=0.274, 0.321; both P<0.001). PLAB graduates had significantly lower MRCP(UK) and MRCGP assessments (Glass’s Δ=0.94, 0.91, 1.40, 1.01, and 1.82 for MRCP(UK) Part 1, Part 2, and PACES and MRCGP AKT and CSA), and were more likely to fail assessments

Subject Choice and Earnings of UK Graduates

ERIC Educational Resources Information Center

Chevalier, Arnaud

2011-01-01

Using a survey of a cohort of UK graduates, linked to administrative data on higher education participation, this paper investigates the labour market attainment of recent graduates by subject of study. We document a large heterogeneity in the mean wages of graduates from different subjects and a considerably larger one within subject with…

The Returns to UK Degrees for Foreign-Educated Graduates

ERIC Educational Resources Information Center

Valbuena, Javier; Zhu, Yu

2018-01-01

Exploiting information on foreign qualifications for the first time, we estimate the returns to obtaining UK higher degrees for foreign graduates who migrated to the UK in their 20s. Accounting for direct measures of foreign and UK qualifications and country-of-origin fixed effects, we find substantial returns to obtaining UK (higher) degrees on…

Career choices for geriatric medicine: national surveys of graduates of 1974-2009 from all UK medical schools.

PubMed

Maisonneuve, Jenny J; Pulford, Claire; Lambert, Trevor W; Goldacre, Michael J

2014-07-01

numbers of elderly people are increasing worldwide. This increases the importance of the specialty of geriatric medicine. Recruitment to the specialty may not be keeping pace with need. to report trends in junior doctors' career choices for geriatric medicine, factors that influence career choice, and associations between early career choices and later specialty destinations. questionnaire surveys of all medical qualifiers from all UK medical schools in selected year-of-qualification cohorts (1974-2009). Survey response rates 1, 3 and 5 years after graduation were, respectively, 65.9% (33,972/51,535), 65.5% (29,400/44,879) and 66.1% (22,600/34,197). geriatric medicine was the career choice of 0.9% of medical graduates (0.4% of men, 1.3% of women) 1 year after qualification; and of 1.5% (1.2% of men, 1.9% of women) after 5 years. There was a modest increase in recent cohorts. Important influences on career choice included enthusiasm for and commitment to the specialty, experience of working in geriatric medicine and self-appraisal of own skills. Early career choices were not highly predictive of later destinations. Of practising geriatricians in our surveys, 9% (20/212) had told us that they wanted to be geriatricians in their first year after graduation, as had 36% when in their third year and 74% in their fifth year. a higher percentage of women than men choose geriatric medicine; in recent years its popularity has increased slightly. Early career choice is not highly predictive of an eventual career in the specialty. Flexibility is needed about when doctors can enter training in geriatric medicine. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Choice and rejection of psychiatry as a career: surveys of UK medical graduates from 1974 to 2009.

PubMed

Goldacre, Michael J; Fazel, Seena; Smith, Fay; Lambert, Trevor

2013-03-01

Recruitment of adequate numbers of doctors to psychiatry is difficult. To report on career choice for psychiatry, comparing intending psychiatrists with doctors who chose other clinical careers. Questionnaire studies of all newly qualified doctors from all UK medical schools in 12 qualification years between 1974 and 2009 (33 974 respondent doctors). One, three and five years after graduation, 4-5% of doctors specified psychiatry as their first choice of future career. This was largely unchanged across the 35 years. Comparing intending psychiatrists with doctors who chose other careers, factors with a greater influence on psychiatrists' choice included their experience of the subject at medical school, self-appraisal of their own skills, and inclinations before medical school. In a substudy of doctors who initially considered but then did not pursue specialty choices, 72% of those who did not pursue psychiatry gave 'job content' as their reason compared with 33% of doctors who considered but did not pursue other specialties. Historically, more women than men have chosen psychiatry, but the gap has closed over the past decade. Junior doctors' views about psychiatry as a possible career range from high levels of enthusiasm to antipathy, and are more polarised than views about other specialties. Shortening of working hours and improvements to working practices in other hospital-based specialties in the UK may have reduced the relative attractiveness of psychiatry to women doctors. The extent to which views of newly qualified doctors about psychiatry can be modified by medical school education, and by greater exposure to psychiatry during student and early postgraduate years, needs investigation.

Doctors’ views about their work, education and training three years after graduation in the UK: questionnaire survey

PubMed Central

Smith, Fay; Goldacre, Michael J

2015-01-01

Objectives Doctors who graduated in the UK after 2005 have followed a restructured postgraduate training programme (Modernising Medical Careers) and have experienced the introduction of the European Working Time Regulation and e-portfolios. In this paper, we report the views of doctors who graduated in 2008 three years after graduation and compare these views with those expressed in year 1. Design Questionnaires about career intentions, destinations and views sent in 2011 to all medical graduates of 2008. Participants 3228 UK medical graduates. Main outcome measures Comments on work, education and training. Results Response was 49% (3228/6538); 885 doctors wrote comments. Of these, 21.8% were unhappy with the standard of their training; 8.4% were positive. Doctors made positive comments about levels of supervision, support, morale and job satisfaction. Many doctors commented on poor arrangements for rotas, cover and leave, which had an adverse effect on work-life balance, relationships, morale and health. Some doctors felt pressured into choosing their future specialty too early, with inadequate career advice. Themes raised in year 3 that were seldom raised in year 1 included arrangements for flexible working and maternity leave, obtaining posts in desired locations and having to pay for courses, exams and conferences. Conclusions Many doctors felt training was available, but that European Working Time Regulation, rotas and cover arrangements made it difficult to attend. Three years after graduation, doctors raised similar concerns to those they had raised two years earlier, but the pressures of career decision making, family life and job seeking were new issues. PMID:26664735

Doctors' views about their work, education and training three years after graduation in the UK: questionnaire survey.

PubMed

Lambert, Trevor; Smith, Fay; Goldacre, Michael J

2015-12-01

Doctors who graduated in the UK after 2005 have followed a restructured postgraduate training programme (Modernising Medical Careers) and have experienced the introduction of the European Working Time Regulation and e-portfolios. In this paper, we report the views of doctors who graduated in 2008 three years after graduation and compare these views with those expressed in year 1. Questionnaires about career intentions, destinations and views sent in 2011 to all medical graduates of 2008. 3228 UK medical graduates. Comments on work, education and training. Response was 49% (3228/6538); 885 doctors wrote comments. Of these, 21.8% were unhappy with the standard of their training; 8.4% were positive. Doctors made positive comments about levels of supervision, support, morale and job satisfaction. Many doctors commented on poor arrangements for rotas, cover and leave, which had an adverse effect on work-life balance, relationships, morale and health. Some doctors felt pressured into choosing their future specialty too early, with inadequate career advice. Themes raised in year 3 that were seldom raised in year 1 included arrangements for flexible working and maternity leave, obtaining posts in desired locations and having to pay for courses, exams and conferences. Many doctors felt training was available, but that European Working Time Regulation, rotas and cover arrangements made it difficult to attend. Three years after graduation, doctors raised similar concerns to those they had raised two years earlier, but the pressures of career decision making, family life and job seeking were new issues.

An evaluation of the performance in the UK Royal College of Anaesthetists primary examination by UK medical school and gender

PubMed Central

Bowhay, Andrew R; Watmough, Simon D

2009-01-01

Background There has been comparatively little consideration of the impact that the changes to undergraduate curricula might have on postgraduate academic performance. This study compares the performance of graduates by UK medical school and gender in the Multiple Choice Question (MCQ) section of the first part of the Fellowship of the Royal College of Anaesthetists (FRCA) examination. Methods Data from each sitting of the MCQ section of the primary FRCA examination from June 1999 to May 2008 were analysed for performance by medical school and gender. Results There were 4983 attempts at the MCQ part of the examination by 3303 graduates from the 19 United Kingdom medical schools. Using the standardised overall mark minus the pass mark graduates from five medical schools performed significantly better than the mean for the group and five schools performed significantly worse than the mean for the group. Males performed significantly better than females in all aspects of the MCQ – physiology, mean difference = 3.0% (95% CI 2.3, 3.7), p < 0.001; pharmacology, mean difference = 1.7% (95% CI 1.0, 2.3), p < 0.001; physics with clinical measurement, mean difference = 3.5% (95% CI 2.8, 4.1), p < 0.001; overall mark, mean difference = 2.7% (95% CI 2.1, 3.3), p < 0.001; and standardised overall mark minus the pass mark, mean difference = 2.5% (95% CI 1.9, 3.1), p < 0.001. Graduates from three medical schools that have undergone the change from Traditional to Problem Based Learning curricula did not show any change in performance in any aspects of the MCQ pre and post curriculum change. Conclusion Graduates from each of the medical schools in the UK do show differences in performance in the MCQ section of the primary FRCA, but significant curriculum change does not lead to deterioration in post graduate examination performance. Whilst females now outnumber males taking the MCQ, they are not performing as well as the males. PMID:19563655

Career Progress and Career Barriers: Women MBA Graduates in Canada and the UK

ERIC Educational Resources Information Center

Simpson, Ruth; Sturges, Jane; Woods, Adrian; Altman, Yochanan

2004-01-01

This article explores the career progress of female MBA graduates in Canada and the UK and the nature of career barriers experienced in each context. Results suggest that while Canadian women have similar career profiles to men, women in the UK lag behind their male counterparts after graduation from the course. At the same time, UK women…

From Graduate Employability to Employment: Policy and Practice in UK Higher Education

ERIC Educational Resources Information Center

Minocha, Sonal; Hristov, Dean; Reynolds, Martin

2017-01-01

The purpose of this paper is to enrich the current conceptualization of graduate employability and employment through the lens of policy, academia and practice in UK higher education. We examine the UK policy context that is shaping graduate employability and employment debates before enriching this conceptualization through a discussion of key…

Choice and rejection of psychiatry as a career: surveys of UK medical graduates from 1974 to 2009†

PubMed Central

Goldacre, Michael J.; Fazel, Seena; Smith, Fay; Lambert, Trevor

2013-01-01

Background Recruitment of adequate numbers of doctors to psychiatry is difficult. Aims To report on career choice for psychiatry, comparing intending psychiatrists with doctors who chose other clinical careers. Method Questionnaire studies of all newly qualified doctors from all UK medical schools in 12 qualification years between 1974 and 2009 (33 974 respondent doctors). Results One, three and five years after graduation, 4–5% of doctors specified psychiatry as their first choice of future career. This was largely unchanged across the 35 years. Comparing intending psychiatrists with doctors who chose other careers, factors with a greater influence on psychiatrists’ choice included their experience of the subject at medical school, self-appraisal of their own skills, and inclinations before medical school. In a substudy of doctors who initially considered but then did not pursue specialty choices, 72% of those who did not pursue psychiatry gave ‘job content’ as their reason compared with 33% of doctors who considered but did not pursue other specialties. Historically, more women than men have chosen psychiatry, but the gap has closed over the past decade. Conclusions Junior doctors’ views about psychiatry as a possible career range from high levels of enthusiasm to antipathy, and are more polarised than views about other specialties. Shortening of working hours and improvements to working practices in other hospital-based specialties in the UK may have reduced the relative attractiveness of psychiatry to women doctors. The extent to which views of newly qualified doctors about psychiatry can be modified by medical school education, and by greater exposure to psychiatry during student and early postgraduate years, needs investigation. PMID:23099446

Organisational perspectives on addressing differential attainment in postgraduate medical education: a qualitative study in the UK

PubMed Central

Viney, Rowena; Jayaweera, Hirosha; Griffin, Ann

2018-01-01

Objectives To explore how representatives from organisations with responsibility for doctors in training perceive risks to the educational progression of UK medical graduates from black and minority ethnic groups (BME UKGs), and graduates of non-UK medical schools (international medical graduates (IMGs)). To identify the barriers to and facilitators of change. Design Qualitative semistructured individual and group interview study. Setting Postgraduate medical education in the UK. Participants Individuals with roles in examinations and/or curriculum design from UK medical Royal Colleges. Employees of NHS Employers. Results Representatives from 11 medical Royal Colleges (n=29) and NHS Employers (n=2) took part (55% medically qualified, 61% male, 71% white British/Irish, 23% Asian/Asian British, 6% missing ethnicity). Risks were perceived as significant, although more so for IMGs than for BME UKGs. Participants based significance ratings on evidence obtained largely through personal experience. A lack of evidence led to downgrading of significance. Participants were pessimistic about effecting change, two main barriers being sensitivities around race and the isolation of interventions. Participants felt that organisations should acknowledge problems, but felt concerned about being transparent without a solution; and talking about race with trainees was felt to be difficult. Participants mentioned 63 schemes aiming to address differential attainment, but these were typically local or specialty-specific, were not aimed at BME UKGs and were largely unevaluated. Participants felt that national change was needed, but only felt empowered to effect change locally or within their specialty. Conclusions Representatives from organisations responsible for training doctors perceived the risks faced by BME UKGs and IMGs as significant but difficult to change. Strategies to help organisations address these risks include: increased openness to discussing race (including ethnic

Women in senior post-graduate medicine career roles in the UK: a qualitative study.

PubMed

Curtis, Anthony; Eley, Lizzie; Gray, Selena; Irish, Bill

2016-01-01

This qualitative study sought to elicit the views, experiences, career journeys and aspirations of women in senior post-graduate medical education roles to identify steps needed to help support career progression. In-depth semi-structured telephone interviews. UK. Purposive sample of 12 women in a variety of senior leadership roles in post-graduate medical education in the UK. Self reported motivating influences, factors that helped and hindered progress, key branch points, and key educational factors and social support impacting on participants' career in postgraduate medicine. Respondents often reported that career journeys were serendipitous, rather than planned, formal or well structured. Senior women leaders reported having a high internal locus of control, with very high levels of commitment to the NHS. All reported significant levels of drive, although the majority indicated that they were not ambitious in the sense of a strong drive for money, prestige, recognition or power. They perceived that there was an under-representation of women in senior leadership positions and that high-quality female mentorship was particularly important in redressing this imbalance. Social support, such a spouse or other significant family member, was particularly valued as reaffirming and supporting women's chosen career ambition. Factors that were considered to have hindered career progression included low self-confidence and self-efficacy, the so-called glass ceiling and perceived self-limiting cultural influences. Factors indirectly linked to gender such as part-time versus working full time were reportedly influential in being overlooked for senior leadership roles. Implications of these findings are discussed in the paper. Social support, mentorship and role modelling are all perceived as highly important in redressing perceived gender imbalances in careers in post-graduate medical education.

Career progression of men and women doctors in the UK NHS: a questionnaire study of the UK medical qualifiers of 1993 in 2010/2011

PubMed Central

Svirko, Elena; Goldacre, Michael J

2014-01-01

Summary Objectives To report the career progression of a cohort of UK medical graduates in mid-career, comparing men and women. Design Postal and questionnaire survey conducted in 2010/2011, with comparisons with earlier surveys. Setting UK. Participants In total, 2507 responding UK medical graduates of 1993. Main outcome measures Doctors’ career specialties, grade, work location and working pattern in 2010/2011 and equivalent data in earlier years. Results The respondents represented 72% of the contactable cohort; 90% were working in UK medicine and 7% in medicine outside the UK; 87% were in the UK NHS (87% of men and 86% of women). Of doctors in the NHS, 70.6% of men and 52.0% of women were in the hospital specialties and the great majority of the others were in general practice. Within hospital specialties, a higher percentage of men than women were in surgery, and a higher percentage of women than men were in paediatrics, obstetrics and gynaecology, clinical oncology, pathology and psychiatry. In the NHS, 63% of women and 8% of men were working less-than-full-time (in general practice, 19% of men and 83% of women; and in hospital specialties, 3% of men and 46% of women). Among doctors who had always worked full-time, 94% of men and 87% of women GPs were GP principals; in hospital practice, 96% of men and 93% of women had reached consultant level. Conclusions The 1993 graduates show a continuing high level of commitment to the NHS. Gender differences in seniority lessened considerably when comparing doctors who had always worked full-time. PMID:25408921

Why doctors consider leaving UK medicine: qualitative analysis of comments from questionnaire surveys three years after graduation

PubMed Central

Lambert, Trevor W; Goldacre, Michael J

2017-01-01

Objective To report the reasons why doctors are considering leaving medicine or the UK. Design Questionnaire survey. Setting UK. Participants Questionnaires were sent three years after graduation to all UK medical graduates of 2008 and 2012. Main outcome measures Comments from doctors about their main reasons for considering leaving medicine or the UK (or both). Results The response rate was 46.2% (5291/11,461). Among the 60% of respondents who were not definitely intent on remaining in UK medicine, 50% were considering working in medicine outside the UK and 10% were considering leaving medicine. Among those considering working in medicine outside the UK, the most commonly cited reasons were to gain wider experience, that things would be ‘better’ elsewhere and a negative view of the National Health Service and its culture, state and politics. Other reasons included better training or job opportunities, better pay and conditions, family reasons and higher expectations. Three years after graduation, doctors surveyed in 2015 were significantly more likely than doctors surveyed in 2011 to cite factors related to the National Health Service, to pay and conditions, to their expectations and to effects on work–life balance and patient care. Among those considering leaving medicine, the dominant reason for leaving medicine was a negative view of the National Health Service (mentioned by half of those in this group who commented). Three years after graduation, doctors surveyed in 2015 were more likely than doctors surveyed in 2011 to cite this reason, as well as excessive hours and workload, and financial reasons. Conclusions An increasingly negative view is held by many doctors of many aspects of the experience of being a junior doctor in the National Health Service, and the difficulty of delivering high-quality patient care within what many see as an under-funded system. Policy changes designed to encourage more doctors to remain should be motivated by a desire to

Why doctors consider leaving UK medicine: qualitative analysis of comments from questionnaire surveys three years after graduation.

PubMed

Lambert, Trevor W; Smith, Fay; Goldacre, Michael J

2018-01-01

Objective To report the reasons why doctors are considering leaving medicine or the UK. Design Questionnaire survey. Setting UK. Participants Questionnaires were sent three years after graduation to all UK medical graduates of 2008 and 2012. Main outcome measures Comments from doctors about their main reasons for considering leaving medicine or the UK (or both). Results The response rate was 46.2% (5291/11,461). Among the 60% of respondents who were not definitely intent on remaining in UK medicine, 50% were considering working in medicine outside the UK and 10% were considering leaving medicine. Among those considering working in medicine outside the UK, the most commonly cited reasons were to gain wider experience, that things would be 'better' elsewhere and a negative view of the National Health Service and its culture, state and politics. Other reasons included better training or job opportunities, better pay and conditions, family reasons and higher expectations. Three years after graduation, doctors surveyed in 2015 were significantly more likely than doctors surveyed in 2011 to cite factors related to the National Health Service, to pay and conditions, to their expectations and to effects on work-life balance and patient care. Among those considering leaving medicine, the dominant reason for leaving medicine was a negative view of the National Health Service (mentioned by half of those in this group who commented). Three years after graduation, doctors surveyed in 2015 were more likely than doctors surveyed in 2011 to cite this reason, as well as excessive hours and workload, and financial reasons. Conclusions An increasingly negative view is held by many doctors of many aspects of the experience of being a junior doctor in the National Health Service, and the difficulty of delivering high-quality patient care within what many see as an under-funded system. Policy changes designed to encourage more doctors to remain should be motivated by a desire to address

Women in senior post-graduate medicine career roles in the UK: a qualitative study

PubMed Central

Curtis, Anthony; Eley, Lizzie; Irish, Bill

2016-01-01

Objectives This qualitative study sought to elicit the views, experiences, career journeys and aspirations of women in senior post-graduate medical education roles to identify steps needed to help support career progression. Design In-depth semi-structured telephone interviews. Setting UK. Participants Purposive sample of 12 women in a variety of senior leadership roles in post-graduate medical education in the UK. Main outcome measures Self reported motivating influences, factors that helped and hindered progress, key branch points, and key educational factors and social support impacting on participants' career in postgraduate medicine. Results Respondents often reported that career journeys were serendipitous, rather than planned, formal or well structured. Senior women leaders reported having a high internal locus of control, with very high levels of commitment to the NHS. All reported significant levels of drive, although the majority indicated that they were not ambitious in the sense of a strong drive for money, prestige, recognition or power. They perceived that there was an under-representation of women in senior leadership positions and that high-quality female mentorship was particularly important in redressing this imbalance. Social support, such a spouse or other significant family member, was particularly valued as reaffirming and supporting women’s chosen career ambition. Factors that were considered to have hindered career progression included low self-confidence and self-efficacy, the so-called glass ceiling and perceived self-limiting cultural influences. Factors indirectly linked to gender such as part-time versus working full time were reportedly influential in being overlooked for senior leadership roles. Implications of these findings are discussed in the paper. Conclusion Social support, mentorship and role modelling are all perceived as highly important in redressing perceived gender imbalances in careers in post-graduate medical education

Attrition during graduate medical education: medical school perspective.

PubMed

Andriole, Dorothy A; Jeffe, Donna B; Hageman, Heather L; Klingensmith, Mary E; McAlister, Rebecca P; Whelan, Alison J

2008-12-01

To identify predictors of attrition during graduate medical education (GME) in a single medical school cohort of contemporary US medical school graduates. Retrospective cohort study. Single medical institution. Recent US allopathic medical school graduates. Attrition from initial GME program. Forty-seven of 795 graduates (6%) did not complete the GME in their initial specialty of choice. At bivariate analysis, attrition was associated with election to the Alpha Omega Alpha Honor Medical Society, being an MD-PhD degree holder, and specialty choice (all P < .05). Attrition was not associated with graduation year (P = .91), sex (P = .67), or age (P = .12). In a multivariate logistic regression model, MD-PhD degree holder (odds ratio, 3.43; 95% confidence interval, 1.27-9.26; P = .02), election to Alpha Omega Alpha (2.19; 1.04-4.66; P = .04), choice of general surgery for GME (5.32; 1.98-14.27; P < .001), and choice of 5-year surgical specialty including those surgical specialties with a GME training requirement of 5 years or longer (2.74; 1.16-6.44; P = .02) each independently predicted greater likelihood of attrition. Academically highly qualified graduates and graduates who chose training in general surgery or in a 5-year surgical specialty were at increased risk of attrition during GME.

Adverse effects on health and wellbeing of working as a doctor: views of the UK medical graduates of 1974 and 1977 surveyed in 2014.

PubMed

Smith, Fay; Goldacre, Michael J; Lambert, Trevor W

2017-05-01

Objective To report on any adverse effects on health and wellbeing of working as a doctor, as described by senior doctors. Design Questionnaires sent in 2014 to all medical graduates of 1974 and 1977. Participants 3695 UK medical graduates. Setting United Kingdom. Main outcome measures Statements about adverse effects upon health, wellbeing and career. Results The aggregated response rate from contactable doctors was 84.6% (3695/4369). In response to the question 'Do you feel that working as a doctor has had any adverse effects on your own health or wellbeing?', 44% of doctors answered 'yes'. More GPs (47%) than hospital doctors (42%) specified that this was the case. Three-quarters of doctors who answered 'yes' cited 'stress/work-life balance/workload' as an adverse effect, and 45% mentioned illness. In response to the statement 'The NHS of today is a good employer when doctors become ill themselves', 28% of doctors agreed, 29% neither agreed nor disagreed and 43% disagreed. More women doctors (49%) than men doctors (40%) disagreed with this statement. More general practitioners (49%) disagreed than hospital doctors (37%). Conclusions Chronic stress and illness, which these doctors attributed to their work, were widely reported. Although recent changes may have alleviated some of these issues, there are lessons for the present and future if the NHS is to ensure that its medical workforce receives the support which enables current doctors to enjoy a full and satisfying career and to contribute fully to health service provision in the UK. Older doctors, in particular, need support to be able to continue successfully in their careers.

Adverse effects on health and wellbeing of working as a doctor: views of the UK medical graduates of 1974 and 1977 surveyed in 2014

PubMed Central

Goldacre, Michael J; Lambert, Trevor W

2017-01-01

Summary Objective To report on any adverse effects on health and wellbeing of working as a doctor, as described by senior doctors. Design Questionnaires sent in 2014 to all medical graduates of 1974 and 1977. Participants 3695 UK medical graduates. Setting United Kingdom. Main outcome measures Statements about adverse effects upon health, wellbeing and career. Results The aggregated response rate from contactable doctors was 84.6% (3695/4369). In response to the question ‘Do you feel that working as a doctor has had any adverse effects on your own health or wellbeing?’, 44% of doctors answered ‘yes’. More GPs (47%) than hospital doctors (42%) specified that this was the case. Three-quarters of doctors who answered ‘yes’ cited ‘stress/work–life balance/workload’ as an adverse effect, and 45% mentioned illness. In response to the statement ‘The NHS of today is a good employer when doctors become ill themselves’, 28% of doctors agreed, 29% neither agreed nor disagreed and 43% disagreed. More women doctors (49%) than men doctors (40%) disagreed with this statement. More general practitioners (49%) disagreed than hospital doctors (37%). Conclusions Chronic stress and illness, which these doctors attributed to their work, were widely reported. Although recent changes may have alleviated some of these issues, there are lessons for the present and future if the NHS is to ensure that its medical workforce receives the support which enables current doctors to enjoy a full and satisfying career and to contribute fully to health service provision in the UK. Older doctors, in particular, need support to be able to continue successfully in their careers. PMID:28504070

New UK graduates' knowledge of training and service provision within restorative dentistry - a survey.

PubMed

Kalsi, A S; Kochhar, S; Lewis, N J; Hemmings, K W

2017-06-09

Objective To assess new UK graduates' knowledge of training and service provision within restorative dentistry.Design A national descriptive cross-sectional survey.Subjects and methods An online survey assessing clinicians' knowledge of restorative dentistry, who had graduated within the last four years in the UK, was distributed across the UK via postgraduate dental deaneries. One-hundred responses were accepted as a sample of a potential population of 4,000.Main outcome measure How well respondents understood the service provision and training aspects of the specialty of restorative dentistry.Results The responses were received from graduates from a variety of dental schools across the UK. Of those respondents, 41 reported receiving career guidance within restorative dentistry. 45 new graduates were confident in their understanding of the specialty, while 53 were confident in the differences between restorative dentistry and monospecialty training. The respondents appeared unaware regarding treatment priorities within restorative dentistry departments. Most respondents felt that receiving teaching on restorative dentistry as a specialty and career pathway would be beneficial.Conclusion The results suggest that new graduates may benefit from clarification regarding the specialty of restorative dentistry, however, caution must be taken due to the limitations of the study.

Self-reported extracurricular activity, academic success, and quality of life in UK medical students

PubMed Central

Lumley, Sophie; Ward, Peter; Roberts, Lesley

2015-01-01

Objectives To explore the relationship between academic performance, extracurricular activity, and quality of life at medical school in the UK to aid our understanding of students’ work-life balance. Methods A cross-sectional study, using an electronic questionnaire distributed to UK final year medical students across 20 medical schools (4478 students). Participants reported the hours of self-regulated learning and extracurricular activities undertaken each year at medical school; along with their academic decile (1 = highest, 10 = lowest). Self-reported quality of life (QoL) was assessed using an established screening tool (7 = highest, 1 = lowest). Results Seven hundred responses were obtained, across 20 participating medical schools, response rate 16% (700/4478). Factors associated with higher academic achievement were: graduate entry course students (2 deciles higher, p< 0.0001), more hours academic study during term and revision periods (rho=-0.1, p< 0.01), and involvement in teaching or research. Increased hours of study was associated with lower QoL (rho = -0.13, p<0.01). Conclusions Study skills may be more important than duration spent studying, for academic achievement and QoL. Graduate-entry students attain higher decile scores despite similar self-reported duration of study. PMID:26385285

Self-reported extracurricular activity, academic success, and quality of life in UK medical students.

PubMed

Lumley, Sophie; Ward, Peter; Roberts, Lesley; Mann, Jake P

2015-09-19

To explore the relationship between academic performance, extracurricular activity, and quality of life at medical school in the UK to aid our understanding of students' work-life balance. A cross-sectional study, using an electronic questionnaire distributed to UK final year medical students across 20 medical schools (4478 students). Participants reported the hours of self-regulated learning and extracurricular activities undertaken each year at medical school; along with their academic decile (1 = highest, 10 = lowest). Self-reported quality of life (QoL) was assessed using an established screening tool (7 = highest, 1 = lowest). Seven hundred responses were obtained, across 20 participating medical schools, response rate 16% (700/4478). Factors associated with higher academic achievement were: graduate entry course students (2 deciles higher, p < 0.0001), more hours academic study during term and revision periods (rho=-0.1, p < 0.01), and involvement in teaching or research. Increased hours of study was associated with lower QoL (rho = -0.13, p < 0.01). Study skills may be more important than duration spent studying, for academic achievement and QoL. Graduate-entry students attain higher decile scores despite similar self-reported duration of study.

Organisational perspectives on addressing differential attainment in postgraduate medical education: a qualitative study in the UK.

PubMed

Woolf, Katherine; Viney, Rowena; Rich, Antonia; Jayaweera, Hirosha; Griffin, Ann

2018-03-09

To explore how representatives from organisations with responsibility for doctors in training perceive risks to the educational progression of UK medical graduates from black and minority ethnic groups (BME UKGs), and graduates of non-UK medical schools (international medical graduates (IMGs)). To identify the barriers to and facilitators of change. Qualitative semistructured individual and group interview study. Postgraduate medical education in the UK. Individuals with roles in examinations and/or curriculum design from UK medical Royal Colleges. Employees of NHS Employers. Representatives from 11 medical Royal Colleges (n=29) and NHS Employers (n=2) took part (55% medically qualified, 61% male, 71% white British/Irish, 23% Asian/Asian British, 6% missing ethnicity). Risks were perceived as significant, although more so for IMGs than for BME UKGs. Participants based significance ratings on evidence obtained largely through personal experience. A lack of evidence led to downgrading of significance. Participants were pessimistic about effecting change, two main barriers being sensitivities around race and the isolation of interventions. Participants felt that organisations should acknowledge problems, but felt concerned about being transparent without a solution; and talking about race with trainees was felt to be difficult. Participants mentioned 63 schemes aiming to address differential attainment, but these were typically local or specialty-specific, were not aimed at BME UKGs and were largely unevaluated. Participants felt that national change was needed, but only felt empowered to effect change locally or within their specialty. Representatives from organisations responsible for training doctors perceived the risks faced by BME UKGs and IMGs as significant but difficult to change. Strategies to help organisations address these risks include: increased openness to discussing race (including ethnic differences in attainment among UKGs); better sharing of

Electives in Graduate Medical Education

ERIC Educational Resources Information Center

Kumar, Santosh; Zayapragassarazan, Z.

2013-01-01

Modern curricula have both compulsory portions and electives or portions chosen by students. Electives have been a part of graduate and postgraduate general higher education. Electives are included in various standards for graduate medical education and are also included in proposed Medical Council of India Regulations on Graduate Medical…

Teaching of clinical pharmacology and therapeutics in UK medical schools: current status in 2009.

PubMed

O'Shaughnessy, Lelia; Haq, Inam; Maxwell, Simon; Llewelyn, Martin

2010-07-01

written examinations. 90% of respondents believed that their students were 'fairly' to 'well' prepared for the foundation year but only 37% of schools gather data on the competence of their graduates. CPT teaching in UK medical schools is very diverse. Most schools do not assess the performance of their graduates as prescribers and there is a lack of evidence that many of the teaching approaches employed are suitable for the development of prescribing skills. It is vital that developments in CPT teaching are driven by validated, real-world assessments of the prescribing skills of medical students and newly qualified doctors.

Labour Market Mismatch among UK Graduates: An Analysis Using REFLEX Data

ERIC Educational Resources Information Center

McGuinness, Seamus; Sloane, Peter J.

2011-01-01

There is much disagreement in the literature over the extent to which graduates are mismatched in the labour market and the reasons for this. In this paper we utilise the Flexible Professional in the Knowledge Society (REFLEX) data set to cast light on these issues, based on data for UK graduates. We find substantial pay penalties for…

Changes needed to medicine in the UK before senior UK-trained doctors, working outside the UK, will return: questionnaire surveys undertaken between 2004 and 2015.

PubMed

Lambert, Trevor W; Smith, Fay; Goldacre, Michael J

2017-12-01

To report the changes to UK medicine which doctors who have emigrated tell us would increase their likelihood of returning to a career in UK medicine. Questionnaire survey. UK-trained medical graduates. Questionnaires were sent 11 years after graduation to 7158 doctors who qualified in 1993 and 1996 in the UK: 4763 questionnaires were returned. Questionnaires were sent 17 and 19 years after graduation to the same cohorts: 4554 questionnaires were returned. Comments from doctors working abroad about changes needed to UK medicine before they would return. Eleven years after graduation, 290 (6%) of respondents were working in medicine abroad; 277 (6%) were doing so 17/19 years after graduation. Eleven years after graduation, 53% of doctors working abroad indicated that they did not intend to return, and 71% did so 17/19 years after graduation. These respondents reported a number of changes which would need to be made to UK medicine in order to increase the likelihood of them returning. The most frequently mentioned changes cited concerned 'politics/management/funding', 'pay/pension', 'posts/security/opportunities', 'working conditions/hours', and 'factors outside medicine'. Policy attention to factors including funding, pay, management and particularly the clinical-political interface, working hours, and work-life balance may pay dividends for all, both in terms of persuading some established doctors to return and, perhaps more importantly, encouraging other, younger doctors to believe that the UK and the National Health Service can offer them a satisfying and rewarding career.

Widening access to medical education for under-represented socioeconomic groups: population based cross sectional analysis of UK data, 2002-6.

PubMed

Mathers, Jonathan; Sitch, Alice; Marsh, Jennifer L; Parry, Jayne

2011-02-22

To determine whether new programmes developed to widen access to medicine in the United Kingdom have produced more diverse student populations. Population based cross sectional analysis. 31 UK universities that offer medical degrees. 34,407 UK medical students admitted to university in 2002-6. Age, sex, socioeconomic status, and ethnicity of students admitted to traditional courses and newer courses (graduate entry courses (GEC) and foundation) designed to widen access and increase diversity. The demographics of students admitted to foundation courses were markedly different from traditional, graduate entry, and pre-medical courses. They were less likely to be white and to define their background as higher managerial and professional. Students on the graduate entry programme were older than students on traditional courses (25.5 v 19.2 years) and more likely to be white (odds ratio 3.74, 95% confidence interval 3.27 to 4.28; P<0.001) than those on traditional courses, but there was no difference in the ratio of men. Students on traditional courses at newer schools were significantly older by an average of 2.53 (2.41 to 2.65; P<0.001) years, more likely to be white (1.55, 1.41 to 1.71; P<0.001), and significantly less likely to have higher managerial and professional backgrounds than those at established schools (0.67, 0.61 to 0.73; P<0.001). There were marked differences in demographics across individual established schools offering both graduate entry and traditional courses. The graduate entry programmes do not seem to have led to significant changes to the socioeconomic profile of the UK medical student population. Foundation programmes have increased the proportion of students from under-represented groups but numbers entering these courses are small.

Perceived Advantages and Disadvantages of Being a Female Graduate Student in the US and the UK

ERIC Educational Resources Information Center

Mehta, Clare Marie; Keener, Emily; Shrier, Lydia

2013-01-01

We build on Diana Leonard's work on gender and graduate education by qualitatively investigating the perceived advantages and disadvantages of being a female graduate student in the USA and the UK. We interviewed six female students (ages 22-30) pursuing master's degrees in psychology or social sciences in the USA and the UK. Students from both…

Changes needed to medicine in the UK before senior UK-trained doctors, working outside the UK, will return: questionnaire surveys undertaken between 2004 and 2015

PubMed Central

Lambert, Trevor W; Goldacre, Michael J

2017-01-01

Objective To report the changes to UK medicine which doctors who have emigrated tell us would increase their likelihood of returning to a career in UK medicine. Design Questionnaire survey. Setting UK-trained medical graduates. Participants Questionnaires were sent 11 years after graduation to 7158 doctors who qualified in 1993 and 1996 in the UK: 4763 questionnaires were returned. Questionnaires were sent 17 and 19 years after graduation to the same cohorts: 4554 questionnaires were returned. Main outcome measures Comments from doctors working abroad about changes needed to UK medicine before they would return. Results Eleven years after graduation, 290 (6%) of respondents were working in medicine abroad; 277 (6%) were doing so 17/19 years after graduation. Eleven years after graduation, 53% of doctors working abroad indicated that they did not intend to return, and 71% did so 17/19 years after graduation. These respondents reported a number of changes which would need to be made to UK medicine in order to increase the likelihood of them returning. The most frequently mentioned changes cited concerned ‘politics/management/funding’, ‘pay/pension’, ‘posts/security/opportunities’, ‘working conditions/hours’, and ‘factors outside medicine’. Conclusions Policy attention to factors including funding, pay, management and particularly the clinical–political interface, working hours, and work–life balance may pay dividends for all, both in terms of persuading some established doctors to return and, perhaps more importantly, encouraging other, younger doctors to believe that the UK and the National Health Service can offer them a satisfying and rewarding career. PMID:29230305

The future of graduate medical education in Germany - position paper of the Committee on Graduate Medical Education of the Society for Medical Education (GMA).

PubMed

David, Dagmar M; Euteneier, Alexander; Fischer, Martin R; Hahn, Eckhart G; Johannink, Jonas; Kulike, Katharina; Lauch, Robert; Lindhorst, Elmar; Noll-Hussong, Michael; Pinilla, Severin; Weih, Markus; Wennekes, Vanessa

2013-01-01

The German graduate medical education system is going through an important phase of changes. Besides the ongoing reform of the national guidelines for graduate medical education (Musterweiterbildungsordnung), other factors like societal and demographic changes, health and research policy reforms also play a central role for the future and competitiveness of graduate medical education. With this position paper, the committee on graduate medical education of the Society for Medical Education (GMA) would like to point out some central questions for this process and support the current discourse. As an interprofessional and interdisciplinary scientific society, the GMA has the resources to contribute in a meaningful way to an evidence-based and future-oriented graduate medical education strategy. In this position paper, we use four key questions with regards to educational goals, quality assurance, teaching competence and policy requirements to address the core issues for the future of graduate medical education in Germany. The GMA sees its task in contributing to the necessary reform processes as the only German speaking scientific society in the field of medical education.

Passing MRCP (UK) PACES: a cross-sectional study examining the performance of doctors by sex and country.

PubMed

Unwin, Emily; Potts, Henry W W; Dacre, Jane; Elder, Andrew; Woolf, Katherine

2018-04-06

There is much discussion about the sex differences that exist in medical education. Research from the United Kingdom (UK) and United States has found female doctors earn less, and are less likely to be senior authors on academic papers, but female doctors are also less likely to be sanctioned, and have been found to perform better academically and clinically. It is also known that international medical graduates tend to perform more poorly academically compared to home-trained graduates in the UK, US, and Canada. It is uncertain whether the magnitude and direction of sex differences in doctors' performance is variable by country. We explored the association between doctors' sex and their performance at a large international high-stakes clinical examination: the Membership of the Royal Colleges of Physicians (UK) Practical Assessment of Clinical Examination Skills (PACES). We examined how sex differences varied by the country in which the doctor received their primary medical qualification, the country in which they took the PACES examination, and by the country in which they are registered to practise. Seven thousand six hundred seventy-one doctors attempted PACES between October 2010 and May 2013. We analysed sex differences in first time pass rates, controlling for ethnicity, in three groups: (i) UK medical graduates (N = 3574); (ii) non-UK medical graduates registered with the UK medical regulator, the General Medical Council (GMC), and thus likely to be working in the UK (N = 1067); and (iii) non-UK medical graduates without GMC registration and so legally unable to work or train in the UK (N = 2179). Female doctors were statistically significantly more likely to pass at their first attempt in all three groups, with the greatest sex effect seen in non-UK medical graduates without GMC registration (OR = 1.99; 95% CI = 1.65-2.39; P < 0.0001) and the smallest in the UK graduates (OR = 1.18; 95% CI = 1.03-1.35; P = 0.02). As

Factors influencing the decisions of senior UK doctors to retire or remain in medicine: national surveys of the UK-trained medical graduates of 1974 and 1977

PubMed Central

Smith, Fay; Lachish, Shelly; Goldacre, Michael J

2017-01-01

Objective To report attitudes to retirement of late-career doctors. Design Questionnaires sent in 2014 to all UK medical graduates of 1974 and 1977. Setting United Kingdom. Participants 3695 medical graduates. Main outcome measures Factors which influenced doctors’ decisions to retire and factors which encouraged doctors to remain in work. Results The response rate was 85% (3695/4369). 55% of respondents overall were still working in medicine (whether they had not retired or had retired and returned; 61% of men, 43% of women). Of the retirees, 67% retired when they had originally planned to, and 28% had changed their retirement plans. Fifty per cent of retired doctors cited ‘increased time for leisure/other interests’ as a reason; 43% cited ‘pressure of work’. Women (21%) were more likely than men (11%) to retire for family reasons. Women (27%) were more likely than men (9%) to retire because of the retirement of their spouse. General practitioners (GPs) were more likely than doctors in other specialties to cite ‘pressure of work’. Anaesthetists and GPs were more likely than doctors in other specialties to cite the ‘possibility of deteriorating skill/competence’. Radiologists, surgeons, obstetricians and gynaecologists, and anaesthetists were most likely to cite ‘not wanting to do out-of-hours work’. Doctors who were still working were asked what would encourage them to stay in medicine for longer. Factors cited most frequently were ‘reduced impact of work-related bureaucracy’ (cited by 45%) and ‘workload reduction/shorter hours’ (42%). Men (30%) were more motivated than women (20%) by ‘financial incentivisation’. Surgeons were most motivated by ‘reduction of on-call or emergency commitments’. Conclusions Retention policy should address ways of optimising the clinical contribution of senior doctors while offering reduced workloads in the areas of bureaucracy and working hours, particularly in respect of emergency commitments

Clinician-scientist MB/PhD training in the UK: a nationwide survey of medical school policy.

PubMed

Barnett-Vanes, Ashton; Ho, Guiyi; Cox, Timothy M

2015-12-30

This study surveyed all UK medical schools regarding their Bachelor of Medicine (MB), Doctor of Philosophy (PhD) (MB/PhD) training policy in order to map the current training landscape and to provide evidence for further research and policy development. Deans of all UK medical schools registered with the Medical Schools Council were invited to participate in this survey electronically. The number of medical schools that operate institutional MB/PhD programmes or permit self-directed student PhD intercalation. Medical school recruitment procedures and attitudes to policy guidance. 27 of 33 (81%) registered UK medical schools responded. Four (14%) offer an institutional MB/PhD programme. However, of those without institutional programmes, 17 (73%) permit study interruption and PhD intercalation: two do not (one of whom had discontinued their programme in 2013), three were unsure and one failed to answer the question. Regarding student eligibility, respondents cited high academic achievement in medical studies and a bachelor's or master's degree. Of the Medical schools without institutional MB/PhD programmes, 5 (21%) have intentions to establish a programme, 8 (34%) do not and 3 were unsure, seven did not answer. 19 medical schools (70%) considered national guidelines are needed for future MB/PhD programme development. We report the first national survey of MB/PhD training in the UK. Four medical schools have operational institutional MB/PhD programmes, with a further five intending to establish one. Most medical schools permit study interruption and PhD intercalation. The total number MB/PhD students yet to graduate from medical school could exceed 150, with 30 graduating per year. A majority of medical school respondents to this survey believe national guidelines are required for MB/PhD programme development and implementation. Further research should focus on the MB/PhD student experience. Discussion regarding local and national MB/PhD policies between medical

UK doctors' views on the implementation of the European Working Time Directive as applied to medical practice: a qualitative analysis.

PubMed

Clarke, Rachel T; Pitcher, Alex; Lambert, Trevor W; Goldacre, Michael J

2014-02-06

To report on what doctors at very different levels of seniority wrote, in their own words, about their concerns about the European Working Time Directive (EWTD) and its implementation in the National Health Service (NHS). All medical school graduates from 1993, 2005 and 2009 were surveyed by post and email in 2010. The UK. Using qualitative methods, we analysed free-text responses made in 2010, towards the end of the first year of full EWTD implementation, of three cohorts of the UK medical graduates (graduates of 1993, 2005 and 2009), surveyed as part of the UK Medical Careers Research Group's schedule of multipurpose longitudinal surveys of doctors. Of 2459 respondents who gave free-text comments, 279 (11%) made unprompted reference to the EWTD; 270 of the 279 comments were broadly critical. Key themes to emerge included frequent dissociation between rotas and actual hours worked, adverse effects on training opportunities and quality, concerns about patient safety, lowering of morale and job satisfaction, and attempts reportedly made in some hospitals to persuade junior doctors to collude in the inaccurate reporting of compliance. Further work is needed to determine whether problems perceived with the EWTD, when they occur, are attributable to the EWTD itself, and shortened working hours, or to the way that it has been implemented in some hospitals.

UK doctors’ views on the implementation of the European Working Time Directive as applied to medical practice: a qualitative analysis

PubMed Central

Clarke, Rachel T; Pitcher, Alex; Lambert, Trevor W; Goldacre, Michael J

2014-01-01

Objectives To report on what doctors at very different levels of seniority wrote, in their own words, about their concerns about the European Working Time Directive (EWTD) and its implementation in the National Health Service (NHS). Design All medical school graduates from 1993, 2005 and 2009 were surveyed by post and email in 2010. Setting The UK. Methods Using qualitative methods, we analysed free-text responses made in 2010, towards the end of the first year of full EWTD implementation, of three cohorts of the UK medical graduates (graduates of 1993, 2005 and 2009), surveyed as part of the UK Medical Careers Research Group's schedule of multipurpose longitudinal surveys of doctors. Results Of 2459 respondents who gave free-text comments, 279 (11%) made unprompted reference to the EWTD; 270 of the 279 comments were broadly critical. Key themes to emerge included frequent dissociation between rotas and actual hours worked, adverse effects on training opportunities and quality, concerns about patient safety, lowering of morale and job satisfaction, and attempts reportedly made in some hospitals to persuade junior doctors to collude in the inaccurate reporting of compliance. Conclusions Further work is needed to determine whether problems perceived with the EWTD, when they occur, are attributable to the EWTD itself, and shortened working hours, or to the way that it has been implemented in some hospitals. PMID:24503304

The impact of the European Working Time Directive 10 years on: views of the UK medical graduates of 2002 surveyed in 2013-2014.

PubMed

Lambert, Trevor W; Smith, Fay; Goldacre, Michael J

2016-03-01

To report doctors' views about the European Working Time Directive ('the Directive'). Survey of the medical graduates of 2002 (surveyed in 2013-2014). Medical graduates. UK. Questions on views about the Directive. The response rate was 64% (2056/3196). Twelve per cent of respondents agreed that the Directive had benefited senior doctors, 39% that it benefited junior doctors, and 17% that it had benefited the NHS. More women (41%) than men (35%) agreed that the Directive had benefited junior doctors. Surgeons (6%) and adult medical specialists (8%) were least likely to agree that the Directive had benefited senior doctors. Surgeons (20%) were less likely than others to agree that the Directive had benefited junior doctors, whilst specialists in emergency medicine (57%) and psychiatry (52%) were more likely to agree. Surgeons (7%) were least likely to agree that the Directive had benefited the NHS. Most respondents (62%) reported a positive effect upon work-life balance. With regard to quality of patient care, 45% reported a neutral effect, 40% reported a negative effect, and 15% a positive effect. Most respondents (71%) reported a negative effect of the Directive on continuity of patient care, and 71% felt that the Directive had a negative effect upon junior doctors' training opportunities. Fifty-two per cent reported a negative effect on efficiency in managing patient care. Senior doctors agreed that the Directive benefited doctors' work-life balance. In other respects, they were more negative about it. Surgeons were the least positive about aspects of the Directive.

Implications of aligning full registration of doctors with medical school graduation: a qualitative study of stakeholder perspectives.

PubMed

Mattick, K L; Kaufhold, K; Kelly, N; Cole, J A; Scheffler, G; Rees, C E; Bullock, A; Gormley, G J; Monrouxe, L V

2016-02-23

The Shape of Training report recommended that full registration is aligned with medical school graduation. As part of a General Medical Council-funded study about the preparedness for practice of UK medical graduates, we explored UK stakeholders' views about this proposal using qualitative interviews (30 group and 87 individual interviews) and Framework Analysis. Four UK study sites, one in each country. 185 individuals from eight stakeholder groups: (1) foundation year 1 (F1) doctors (n=34); (2) fully registered trainee doctors (n=33); (3) clinical educators (n=32); (4) undergraduate/postgraduate Deans, and Foundation Programme Directors (n=30); (5) other healthcare professionals (n=13); (6) employers (n=7); (7) policy and government (n=11); (8) patient and public representatives (n=25). We identified four main themes: (1) The F1 year as a safety net: patients were protected by close trainee supervision and 'sign off' to prevent errors; trainees were provided with a safe environment for learning on the job; (2) Implications for undergraduate medical education: if the proposal was accepted, a 'radical review' of undergraduate curricula would be needed; undergraduate education might need to be longer; (3) Implications for F1 work practice: steps to protect healthcare team integration and ensure that F1 doctors stay within competency limits would be required; (4) Financial, structural and political implications: there would be cost implications for trainees; clarification of responsibilities between undergraduate and postgraduate medical education would be needed. Typically, each theme comprised arguments for and against the proposal. A policy change to align the timing of full registration with graduation would require considerable planning and preliminary work. These findings will inform policymakers' decision-making. Regardless of the decision, medical students should take on greater responsibility for patient care as undergraduates, assessment methods in clinical

Perceptions of UK medical graduates’ preparedness for practice: A multi-centre qualitative study reflecting the importance of learning on the job

PubMed Central

2013-01-01

Background There is evidence that graduates of different medical schools vary in their preparedness for their first post. In 2003 Goldacre et al. reported that over 40% of UK medical graduates did not feel prepared and found large differences between graduates of different schools. A follow-up survey showed that levels of preparedness had increased yet there was still wide variation. This study aimed to examine whether medical graduates from three diverse UK medical schools were prepared for practice. Methods This was a qualitative study using a constructivist grounded theory approach. Prospective and cross-sectional data were collected from the three medical schools. A sample of 60 medical graduates (20 from each school) was targeted. They were interviewed three times: at the end of medical school (n = 65) and after four (n = 55) and 12 months (n = 46) as a Year 1 Foundation Programme doctor. Triangulated data were collected from clinicians via interviews across the three sites (n = 92). In addition three focus groups were conducted with senior clinicians who assess learning portfolios. The focus was on identifying areas of preparedness for practice and any areas of lack of preparedness. Results Although selected for being diverse, we did not find substantial differences between the schools. The same themes were identified at each site. Junior doctors felt prepared in terms of communication skills, clinical and practical skills and team working. They felt less prepared for areas of practice that are based on experiential learning in clinical practice: ward work, being on call, management of acute clinical situations, prescribing, clinical prioritisation and time management and dealing with paperwork. Conclusions Our data highlighted the importance of students learning on the job, having a role in the team in supervised practice to enable them to learn about the duties and responsibilities of a new doctor in advance of starting work. PMID:23446055

Perceived causes of differential attainment in UK postgraduate medical training: a national qualitative study

PubMed Central

Viney, Rowena; Needleman, Sarah; Griffin, Ann

2016-01-01

Objectives Explore trainee doctors’ experiences of postgraduate training and perceptions of fairness in relation to ethnicity and country of primary medical qualification. Design Qualitative semistructured focus group and interview study. Setting Postgraduate training in England (London, Yorkshire and Humber, Kent Surrey and Sussex) and Wales. Participants 137 participants (96 trainees, 41 trainers) were purposively sampled from a framework comprising: doctors from all stages of training in general practice, medicine, obstetrics and gynaecology, psychiatry, radiology, surgery or foundation, in 4 geographical areas, from white and black and minority ethnic (BME) backgrounds, who qualified in the UK and abroad. Results Most trainees described difficult experiences, but BME UK graduates (UKGs) and international medical graduates (IMGs) could face additional difficulties that affected their learning and performance. Relationships with senior doctors were crucial to learning but bias was perceived to make these relationships more problematic for BME UKGs and IMGs. IMGs also had to deal with cultural differences and lack of trust from seniors, often looking to IMG peers for support instead. Workplace-based assessment and recruitment were considered vulnerable to bias whereas examinations were typically considered more rigorous. In a system where success in recruitment and assessments determines where in the country you can get a job, and where work–life balance is often poor, UK BME and international graduates in our sample were more likely to face separation from family and support outside of work, and reported more stress, anxiety or burnout that hindered their learning and performance. A culture in which difficulties are a sign of weakness made seeking support and additional training stigmatising. Conclusions BME UKGs and IMGs can face additional difficulties in training which may impede learning and performance. Non-stigmatising interventions should focus on

The impact of the European Working Time Directive 10 years on: views of the UK medical graduates of 2002 surveyed in 2013–2014

PubMed Central

Lambert, Trevor W; Goldacre, Michael J

2016-01-01

Objectives To report doctors’ views about the European Working Time Directive (‘the Directive’). Design Survey of the medical graduates of 2002 (surveyed in 2013–2014). Participants Medical graduates. Setting UK. Main outcome measures Questions on views about the Directive. Results The response rate was 64% (2056/3196). Twelve per cent of respondents agreed that the Directive had benefited senior doctors, 39% that it benefited junior doctors, and 17% that it had benefited the NHS. More women (41%) than men (35%) agreed that the Directive had benefited junior doctors. Surgeons (6%) and adult medical specialists (8%) were least likely to agree that the Directive had benefited senior doctors. Surgeons (20%) were less likely than others to agree that the Directive had benefited junior doctors, whilst specialists in emergency medicine (57%) and psychiatry (52%) were more likely to agree. Surgeons (7%) were least likely to agree that the Directive had benefited the NHS. Most respondents (62%) reported a positive effect upon work–life balance. With regard to quality of patient care, 45% reported a neutral effect, 40% reported a negative effect, and 15% a positive effect. Most respondents (71%) reported a negative effect of the Directive on continuity of patient care, and 71% felt that the Directive had a negative effect upon junior doctors’ training opportunities. Fifty-two per cent reported a negative effect on efficiency in managing patient care. Conclusions Senior doctors agreed that the Directive benefited doctors’ work–life balance. In other respects, they were more negative about it. Surgeons were the least positive about aspects of the Directive. PMID:26981257

A comparison of stress levels, coping styles and psychological morbidity between graduate-entry and traditional undergraduate medical students during the first 2 years at a UK medical school.

PubMed

Zvauya, R; Oyebode, F; Day, E J; Thomas, C P; Jones, L A

2017-02-13

Stress levels and psychological morbidity are high among undergraduate medical students (UGs), but there is a lack of research into the psychological health of UK graduate-entry medical students (GEs). GEs are likely to experience different (perhaps more severe) stressors and to cope with stress differently. We compared stress levels, psychological morbidity and coping styles in GE versus UG medical students studying at the same UK medical school in the same academic year. A cross-sectional self-rated questionnaire study of all first- and second-year GE and UG medical students was conducted. Perceived stress, psychological morbidity, recent adverse life events, stress-related personality traits and coping styles were assessed using standard questionnaires. 75% GEs and 46% UGs responded to the questionnaire. Both groups reported equally high levels, and similar profiles of, perceived stress and psychological morbidity. Levels of recent adverse life events and stress-related personality traits were similar in both groups. Compared to UGs, GEs were more likely to use active coping (p = 0.02) and positive reframing (p = 0.03), but were also more likely to use substances (alcohol and other drugs; p < 0.001) to help them cope. Unlike UGs, second-year GEs showed less perceived stress (p = 0.007) and psychological morbidity (p = 0.006) than first-year GEs although levels of both were still high. Our results show that both GE students and their younger UG counterparts on a traditional medical course have similar profiles of stress symptoms. They do, however, cope with stress differently. GEs are more likely to use active problem-focused coping strategies, and they are also more likely to cope by using substances (alcohol or other drugs). GE students need interventions to prevent maladaptive coping styles and encourage adaptive coping that are tailored to their needs. Such interventions should be targeted at first-year students. It is vital that these students

Easing the transition from student to doctor: how can medical schools help prepare their graduates for starting work?

PubMed

Cave, Judith; Woolf, Katharine; Jones, Alison; Dacre, Jane

2009-05-01

In 2000/1, a survey found that 42% of newly qualified UK doctors felt their medical training had not prepared them well for starting work. To determine factors associated with preparedness. A questionnaire to all 5143 newly qualified doctors in May 2005. The response rate was 2062/4784 = 43.1%. 15% of respondents felt poorly prepared by medical school for starting work. There were no associations between gender or graduate entry status and preparedness. The personality traits of conscientiousness (r=0.14; p < 0.001) and extraversion (r=0.15; p < 0.001) were associated with high preparedness. Neuroticism was associated with low preparedness (r= -0.16; p < 0.001).Respondents who had done shadowing attachments were more likely to feel prepared (58.6% vs 48.5% felt prepared; 2=4.0; p=0.05), as were graduates of problem based learning courses (61.3% vs 56.1%; 2=5.0; p=0.03). Preparedness correlated with agreement with the statements 'My teaching was relevant to real life as a doctor' (rho=0.36; p < 0.001), and 'As a house officer I found it easy to get help when I needed it' (rho=0.29; p < 0.001). Improvements in the preparedness of UK medical school graduates may be due to increased relevance of undergraduate teaching to life as a junior doctor and increased support in the workplace.

National survey of clinical communication assessment in medical education in the United Kingdom (UK)

PubMed Central

2014-01-01

Background All medical schools in the UK are required to be able to provide evidence of competence in clinical communication in their graduates. This is usually provided by summative assessment of clinical communication, but there is considerable variation in how this is carried out. This study aimed to gain insight into the current assessment of clinical communication in UK medical schools. Methods The survey was sent via e-mail to communication leads who then were asked to consult with all staff within their medical school involved in the assessment of communication. Results Results were obtained from 27 out of 33 schools (response rate 82%) and a total of 34 courses. The average number of assessments per year was 2.4 (minimum 0, maximum 10). The Objective Structured Clinical Exam (OSCE) was the most commonly used method of assessment (53%). Other assessments included MCQ and workplace based assessments. Only nine courses used a single method of assessment. Issues raised included, logistics and costs of assessing mainly by OSCE, the robustness and reliability of such exams and integration with other clinical skills. Conclusions It is encouraging that a variety of assessment methods are being used within UK medical schools and that these methods target different components of clinical communication skills acquisition. PMID:24417939

A survey of factors influencing career preference in new-entrant and exiting medical students from four UK medical schools.

PubMed

Cleland, Jennifer A; Johnston, Peter W; Anthony, Micheal; Khan, Nadir; Scott, Neil W

2014-07-23

Workforce planning is a central issue for service provision and has consequences for medical education. Much work has been examined the career intentions, career preferences and career destinations of UK medical graduates but there is little published about medical students career intentions. How soon do medical students formulate careers intentions? How much do these intentions and preferences change during medical school? If they do change, what are the determining factors? Our aim was to compare medical students' career preferences upon entry into and exit from undergraduate medical degree programmes. This was a cross-sectional questionnaire survey. Two cohorts [2009-10, 2010-11] of first and final year medical students at the four Scottish graduating medical schools took part in career preference questionnaire surveys. Questions were asked about demographic factors, career preferences and influencing factors. The response rate was 80.9% [2682/3285]. Significant differences were found across the four schools, most obviously in terms of student origin [Scotland, rest of UK or overseas], age group, and specialty preferences in Year 1 and Year 5. Year 1 and Year 5 students' specialty preferences also differed within each school and, while there were some common patterns, each medical school had a different profile of students' career preferences on exit. When the analysis was adjusted for demographic and job-related preferences, specialty preferences differed by gender, and wish for work-life balance and intellectual satisfaction. This is the first multi-centre study exploring students' career preferences and preference influences upon entry into and exit from undergraduate medical degree programmes. We found various factors influenced career preference, confirming prior findings. What this study adds is that, while acknowledging student intake differs by medical school, medical school itself seems to influence career preference. Comparisons across medical school

A survey of factors influencing career preference in new-entrant and exiting medical students from four UK medical schools

PubMed Central

2014-01-01

Background Workforce planning is a central issue for service provision and has consequences for medical education. Much work has been examined the career intentions, career preferences and career destinations of UK medical graduates but there is little published about medical students career intentions. How soon do medical students formulate careers intentions? How much do these intentions and preferences change during medical school? If they do change, what are the determining factors? Our aim was to compare medical students’ career preferences upon entry into and exit from undergraduate medical degree programmes. Methods This was a cross-sectional questionnaire survey. Two cohorts [2009–10, 2010–11] of first and final year medical students at the four Scottish graduating medical schools took part in career preference questionnaire surveys. Questions were asked about demographic factors, career preferences and influencing factors. Results The response rate was 80.9% [2682/3285]. Significant differences were found across the four schools, most obviously in terms of student origin [Scotland, rest of UK or overseas], age group, and specialty preferences in Year 1 and Year 5. Year 1 and Year 5 students’ specialty preferences also differed within each school and, while there were some common patterns, each medical school had a different profile of students’ career preferences on exit. When the analysis was adjusted for demographic and job-related preferences, specialty preferences differed by gender, and wish for work-life balance and intellectual satisfaction. Conclusions This is the first multi-centre study exploring students’ career preferences and preference influences upon entry into and exit from undergraduate medical degree programmes. We found various factors influenced career preference, confirming prior findings. What this study adds is that, while acknowledging student intake differs by medical school, medical school itself seems to influence

Clinical attachments: fond farewell or new beginning? A survey of the attitudes and practice of medical consultants and international medical graduates

PubMed Central

Wawdhane, Sudhir; Saraf, Vivek; Davidson, Sharon; Trewby, Peter

2007-01-01

Objectives To analyse the experience of clinical attachment (CA) of international medical graduates (IMGs) and consultants. Design Analysis of questionnaires and CVs. Setting and participants 573 IMGs applying for a house officer post and 102 consultant physicians working in North East England. Results IMGs had spent a mean of 16 months unemployed, of which 3.8 months was spent on CAs. The median number of CAs was two and the average number of applications sent before obtaining a CA was 73. 90% of IMGs found their CA helpful and 57% would not take up a post without a CA first. Criticisms related to lack of responsibility, isolation and poor job prospects. 90% would apply for honorary posts if advertised. 73% had received induction at the onset of placement, but only 32% had been assessed at the end. 50% of consultants took CAs and only 4% were thinking of stopping doing so. Those without CAs blamed work pressure (43%) and pressure from their employer (23%). Conclusions There are deficiencies in pastoral care, the application process and assessment, but CAs are valued by IMGs and offered by half the consultants surveyed. New immigration rules will mean fewer IMGs will come to the UK, but CAs will be needed by those that do, as well by refugees and European Economic Area (EEA) graduates. The tradition of CAs for international graduates could be used to accommodate those coming to the UK on exchanges and scholarships and form part of the recently announced Medical Training Initiative for IMGs. PMID:17344576

Predicting fitness to practise events in international medical graduates who registered as UK doctors via the Professional and Linguistic Assessments Board (PLAB) system: a national cohort study.

PubMed

Tiffin, Paul A; Paton, Lewis W; Mwandigha, Lazaro M; McLachlan, John C; Illing, Jan

2017-03-20

International medical graduates working in the UK are more likely to be censured in relation to fitness to practise compared to home graduates. Performance on the General Medical Council's (GMC's) Professional and Linguistic Assessments Board (PLAB) tests and English fluency have previously been shown to predict later educational performance in this group of doctors. It is unknown whether the PLAB system is also a valid predictor of unprofessional behaviour and malpractice. The findings would have implications for regulatory policy. This was an observational study linking data relating to fitness to practise events (referral or censure), PLAB performance, demographic variables and English language competence, as evaluated via the International English Language Test System (IELTS). Data from 27,330 international medical graduates registered with the GMC were analysed, including 210 doctors who had been sanctioned in relation to at least one fitness to practise issue. The main outcome was risk of eventual censure (including a warning). The significant univariable educational predictors of eventual censure (versus no censures or referrals) were lower PLAB part 1 (hazard ratio [HR], 0.99; 95% confidence interval, 0.98 to 1.00) and part 2 scores (HR, 0.94; 0.91 to 0.97) at first sitting, multiple attempts at both parts of the PLAB, lower IELTS reading (HR, 0.79; 0.65 to 0.94) and listening scores (HR, 0.76; 0.62 to 0.93) and higher IELTS speaking scores (HR, 1.28; 1.04 to 1.57). Multiple resits at either part of the PLAB and higher IELTS speaking score (HR, 1.49; 1.20 to 1.84) were also independent predictors of censure. We estimated that the proposed limit of four attempts at both parts of the PLAB would reduce the risk in this entire group by only approximately two censures per 5 years in this group of doctors. Making the PLAB, or any replacement assessment, more stringent and raising the required standards of English reading and listening may result in fewer fitness

Plagiarism in graduate medical education.

PubMed

Cole, Ariel Forrester

2007-06-01

The act of overt plagiarism by graduates of accredited residency programs represents a failure in personal integrity. It also indicates a lack of professionalism, one of the six Accreditation Council for Graduate Medical Education (ACGME) competencies for graduate medical education. A recent experience at one geriatric fellowship indicates that the problem of plagiarism may be more prevalent than previously recognized. A situation was discovered at the geriatric medicine fellowship at Florida Hospital Family Medicine Residency Program in Orlando, Fla, in which three of the personal statements included in a total of 26 applications to the fellowship in the past 2 years contained portions plagiarized from a single Web site. The aim in documenting this plagiarism is to raise awareness among medical educators about the availability of online sources of content and ease of electronic plagiarism. Some students and residents may not recognize copying other resources verbatim as plagiarism. Residency programs should evaluate their own need for education about plagiarism and include this in the training of the competency of professionalism.

Community of Learners: Charting Learning in First Year Graduate Entry Medical Students during Problem-Based Learning (PBL) Study

ERIC Educational Resources Information Center

Orsmond, Paul; Zvauya, R.

2015-01-01

This study considers social learning practices within and outside the overt curriculum. A thematic approach was used to analyse data from six focus group interviews with 11 graduate entry medical students from a UK university over a year of study. The results indicate that: (1) during their first year of study students form a community of learning…

Perceived causes of differential attainment in UK postgraduate medical training: a national qualitative study.

PubMed

Woolf, Katherine; Rich, Antonia; Viney, Rowena; Needleman, Sarah; Griffin, Ann

2016-11-25

Explore trainee doctors' experiences of postgraduate training and perceptions of fairness in relation to ethnicity and country of primary medical qualification. Qualitative semistructured focus group and interview study. Postgraduate training in England (London, Yorkshire and Humber, Kent Surrey and Sussex) and Wales. 137 participants (96 trainees, 41 trainers) were purposively sampled from a framework comprising: doctors from all stages of training in general practice, medicine, obstetrics and gynaecology, psychiatry, radiology, surgery or foundation, in 4 geographical areas, from white and black and minority ethnic (BME) backgrounds, who qualified in the UK and abroad. Most trainees described difficult experiences, but BME UK graduates (UKGs) and international medical graduates (IMGs) could face additional difficulties that affected their learning and performance. Relationships with senior doctors were crucial to learning but bias was perceived to make these relationships more problematic for BME UKGs and IMGs. IMGs also had to deal with cultural differences and lack of trust from seniors, often looking to IMG peers for support instead. Workplace-based assessment and recruitment were considered vulnerable to bias whereas examinations were typically considered more rigorous. In a system where success in recruitment and assessments determines where in the country you can get a job, and where work-life balance is often poor, UK BME and international graduates in our sample were more likely to face separation from family and support outside of work, and reported more stress, anxiety or burnout that hindered their learning and performance. A culture in which difficulties are a sign of weakness made seeking support and additional training stigmatising. BME UKGs and IMGs can face additional difficulties in training which may impede learning and performance. Non-stigmatising interventions should focus on trainee-trainer relationships at work and organisational changes to

The longer road to medical school graduation.

PubMed

Kassebaum, D G; Szenas, P L

1994-10-01

The authors followed the academic progress and graduation rates of students matriculating in U.S. medical schools each year between 1976 and 1988. The four-year graduation rates of medical students in MD programs declined from 91.4% for students who matriculated in 1976 to 81.2% for 1988 matriculants. During the same period, the percentage graduating in five years increased from 5.5% to 10.6%, while those still enrolled or on leaves of absence after five years rose from 1.9% to 4.1%. The lengthening of undergraduate medical education is associated with students' spending extra time on special studies or research, but to a greater extent graduation has been delayed for remediation of academic difficulty or slowing of the pace of education to overcome handicaps in academic preparation and learning skills. Underrepresented minority students, particularly black Americans, have lower four-year graduation rates than majority students, and the rate has fallen steadily across successive classes matriculating between 1976 and 1988. The longer periods of undergraduate medical education since 1984, however, have been accompanied by a reversal of the growing attrition rate for black-American students, probably the result of more appropriate pacing of education over the first year or two and the wider availability of student academic support. The longer road to graduation also accumulates greater educational costs, contributing to the escalation in student indebtedness that has been out of proportion to increases in tuition and fees.(ABSTRACT TRUNCATED AT 250 WORDS)

Graduate Medical Education: A Continuing History

ERIC Educational Resources Information Center

Stevens, Rosemary A.

1978-01-01

Five interweaving themes are discussed: the meaning of graduate education; who should control specialization; the role of residents in filling hospital needs; whether graduate medical education is a university responsibility; and how far the distribution of residencies should match perceived manpower needs. (LBH)

Graduate Medical Education Consortia: Changing the Governance of Graduate Medical Education to Achieve Physician Workforce Objectives. Council on Graduate Medical Education, Ninth Report.

ERIC Educational Resources Information Center

Council on Graduate Medical Education.

Earlier reports and studies have endorsed the consortia concept as a vehicle for reorganizing medical education and restructuring the physician workforce. This report by the Council on Graduate Medical Education, which serves in an advisory capacity to the Secretary of the Department of Health and Human Services and to Congress, concurs in this…

UK medical selection: lottery or meritocracy?

PubMed

Harris, Benjamin H L; Walsh, Jason L; Lammy, Simon

2015-02-01

From senior school through to consultancy, a plethora of assessments shape medical careers. Multiple methods of assessment are used to discriminate between applicants. Medical selection in the UK appears to be moving increasingly towards non-knowledge-based testing at all career stages. We review the evidence for non-knowledge-based tests and discuss their perceived benefits. We raise the question: is the current use of non-knowledge-based tests within the UK at risk of undermining more robust measures of medical school and postgraduate performance? © 2015 Royal College of Physicians.

Learning the law: practical proposals for UK medical education.

PubMed

Margetts, J K

2016-02-01

Ongoing serious breaches in medical professionalism might be avoided if UK doctors rethink their approach to law. UK medical education has a role in creating a climate of change by re-examining how law is taught to medical students. Adopting a more insightful approach in the UK to the impact of The Human Rights Act and learning to manipulate legal concepts, such as conflict of interest, need to be taught to medical students now if UK doctors are to manage complex decision-making in the NHS of the future. The literature is reviewed from a unique personal perspective of a doctor and lawyer, and practical proposals for developing medical education in law in the UK are suggested. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

The UK medical education database (UKMED) what is it? Why and how might you use it?

PubMed

Dowell, Jon; Cleland, Jennifer; Fitzpatrick, Siobhan; McManus, Chris; Nicholson, Sandra; Oppé, Thomas; Petty-Saphon, Katie; King, Olga Sierocinska; Smith, Daniel; Thornton, Steve; White, Kirsty

2018-01-05

Educating doctors is expensive and poor performance by future graduates can literally cost lives. Whilst the practice of medicine is highly evidence based, medical education is much less so. Research on medical school selection, undergraduate progression, Fitness to Practise (FtP) and postgraduate careers has been hampered across the globe by the challenges of uniting the data required. This paper describes the creation, structure and access arrangements for the first UK-wide attempt to do so. A collaborative approach has created a research database commencing with all entrants to UK medical schools in 2007 and 2008 (UKMED Phase 1). Here the content is outlined, governance arrangements considered, system access explained, and the potential implications of this new resource discussed. The data currently include achievements prior to medical school entry, admissions tests, graduation point information and also all subsequent data collected by the General Medical Council, including FtP, career progression, annual National Training Survey (NTS) responses, career choice and postgraduate exam performance data. UKMED has grown since the pilot phase with additional datasets; all subsequent years of students/trainees and stronger governance processes. The inclusion of future cohorts and additional information such as admissions scores or bespoke surveys or assessments is now being piloted. Thus, for instance, new scrutiny can be applied to selection techniques and the effectiveness of educational interventions. Data are available free of charge for approved studies from suitable research groups worldwide. It is anticipated that UKMED will continue on a rolling basis. This has the potential to radically change the volume and types of research that can be envisaged and, therefore, to improve standards, facilitate workforce planning and support the regulation of medical education and training. This paper aspires to encourage proposals to utilise this exciting resource.

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.

An Analysis of Gender Diversity in Urology in the UK and Ireland.

PubMed

O'Connor, E M; Nason, G J; Manecksha, R P

2017-12-18

Traditionally, surgery and certain surgical sub-specialities in particular have been predominantly male orientated. In recent years, there has been an increased proportion of female medical graduates which will ultimately have an effect on speciality choices. The aim of this study was to assess the gender diversity among urologists in the UK and Ireland. The total number and gender breakdown of consultant urologists and trainees in the UK and Ireland was obtained from the British Association of Urological Surgeons (BAUS) and the Irish Society of Urology (ISU) membership offices. The total number and gender breakdown of medical school entrants and graduates in 2015 was obtained from the six medical schools in the Republic of Ireland. There are a total of 1,012 consultant urologists in the UK and Ireland. In the UK, 141 (14.6%) are female compared to four (8.2%) in Ireland, p= 0.531. There was a significant increase in the number of females between consultant urologists and trainees in both the UK (p=0.0001) and Ireland (p=0.015). In recent years, there has been a significant change in the percentage of female trainees in the UK and Ireland (22.8% (n=75) in 2011 vs 31.7% (n=93) in 2014, p=0.019. Between the six medical schools in Ireland, there were significantly more female entrants (n=726, 56.5%) than female graduates (n=521, 51.2%) in 2015, p=0.013.There has been a significant shift in gender diversity in urology in the UK and Ireland. Efforts to increase diversity should be pursued to attract further trainees to urology.

Perceptions of medical graduates and their workplace supervisors towards a medical school clinical audit program.

PubMed

Davis, Stephanie; O'Ferrall, Ilse; Hoare, Samuel; Caroline, Bulsara; Mak, Donna B

2017-07-07

This study explores how medical graduates and their workplace supervisors perceive the value of a structured clinical audit program (CAP) undertaken during medical school. Medical students at the University of Notre Dame Fremantle complete a structured clinical audit program in their final year of medical school.  Semi-structured interviews were conducted with 12 Notre Dame graduates (who had all completed the CAP), and seven workplace supervisors (quality and safety staff and clinical supervisors).  Purposeful sampling was used to recruit participants and data were analysed using thematic analysis. Both graduates and workplace supervisors perceived the CAP to be valuable. A major theme was that the CAP made a contribution to individual graduate's medical practice, including improved knowledge in some areas of patient care as well as awareness of healthcare systems issues and preparedness to undertake scientifically rigorous quality improvement activities. Graduates perceived that as a result of the CAP, they were confident in undertaking a clinical audit after graduation.  Workplace supervisors perceived the value of the CAP beyond an educational experience and felt that the audits undertaken by students improved quality and safety of patient care. It is vital that health professionals, including medical graduates, be able to carry out quality and safety activities in the workplace. This study provides evidence that completing a structured clinical audit during medical school prepares graduates to undertake quality and safety activities upon workplace entry. Other health professional faculties may be interested in incorporating a similar program in their curricula.

Graduate-entry medical students: older and wiser but not less distressed.

PubMed

Casey, Dion; Thomas, Susan; Hocking, Darren R; Kemp-Casey, Anna

2016-02-01

Australia has a growing number of graduate-entry medical courses. It is known that undergraduate medical students have high levels of psychological distress; however, little is known about graduate-entry medical students. We examined whether graduate-entry medical students had higher levels of psychological distress than the same-age general population. Psychological distress was assessed in 122 graduate-entry medical students in an Australian graduate-entry medical school using the 21-item Depression Anxiety and Stress Scale. Mean scores and the proportion of students with scores in the highly distressed range were compared with non-clinical population norms. Scores were also compared across demographic characteristics. Medical students reported higher mean depression, anxiety and stress scores than the general population and were more likely to score in the moderate to extremely high range for anxiety (45% vs. 13%; p<0.001) and stress (17% vs. 13%; p=0.003). Anxiety and stress were higher in students aged ≥30 years than in younger students. Despite their maturity, graduate-entry students experienced high psychological distress. Anxiety and stress were higher, not lower, with increasing age. Our results suggest that graduate-entry medical students warrant the same level of concern as their school-leaving counterparts. Further interventions to support these students during medical school are warranted. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Entry of US Medical School Graduates Into Family Medicine Residencies: 2015-2016.

PubMed

Kozakowski, Stanley M; Travis, Alexandra; Bentley, Ashley; Fetter, Gerald

2016-10-01

This is the 35th national study conducted by the American Academy of Family Physicians (AAFP) that reports retrospectively the percentage of graduates from MD-granting and DO-granting medical schools who entered Accreditation Council for Graduate Medical Education (ACGME)-accredited family medicine residency programs as first-year residents. Approximately 8.7% of the 18,929 students graduating from US MD-granting medical schools and 15.5% of the 5,314 students graduating from DO-granting medical schools between July 2014 and June 2015 entered an ACGME family medicine residency in 2015. Together, 10.2% of graduates of MD- and DO-granting schools entered family medicine. Of the 1,640 graduates of the MD-granting medical schools who entered a family medicine residency in 2015, 80% graduated from 70 of the 134 schools (52%). In 2015, DO-granting medical schools graduated 823 into ACGME-accredited family medicine residencies, 80% graduating from 19 of the 32 schools (59%). In aggregate, medical schools west of the Mississippi River represent less than a third of all MD-granting schools but have a rate of students selecting family medicine that is 40% higher than schools located east of the Mississippi. Fifty-one percent (24/47) of states and territories containing medical schools produce 80% of the graduates entering ACGME-accredited family medicine residency programs. A rank order list of MD-granting medical schools was created based on the last 3 years' average percentage of graduates who became family medicine residents, using the 2015 and prior AAFP census data.

Graduate Recruitment and Selection in the UK: A Study of the Recent Changes in Methods and Expectations

ERIC Educational Resources Information Center

Branine, Mohamed

2008-01-01

Purpose: This paper seeks to examine the changes in the methods of graduate recruitment and selection that have been used by UK-based organisations and to establish the reasons for the main changes and developments in the process of attracting and recruiting graduates. Design/methodology/approach: Data were collected through the use of a…

Pre-internship Nigerian medical graduates lack basic musculoskeletal competency.

PubMed

Nottidge, Timothy Eyo; Ekrikpo, Udeme; Ifesanya, Adeleke Olusegun; Nnabuko, Richard E; Dim, Edwin Maduakonam; Udoinyang, Clement Inyang

2012-04-01

Our aim was to assess the basic musculoskeletal competency of pre-internship graduates from Nigerian medical schools. We administered the Freedman and Bernstein basic musculoskeletal competency examination to 113 pre-internship graduates from seven Nigerian medical schools over a three year period from 2008 to 2010 at the University of Uyo Teaching Hospital. Five specialist residents took the examination to test criteria relevance. All graduates failed this test, obtaining scores ranging from 7% to 67%. The duration of the orthopaedic posting, and observation of operative fracture fixation, were not significant determinants of the score. The two final-year specialist residents each had a marginal pass in the examination. Basic musculoskeletal competency among pre-internship Nigerian medical-school graduates is inadequate.

Military graduate medical education in internal medicine: an outcomes study.

PubMed

Cation, L J; Lenihan, D J; Gutierrez-Nunez, J J

2001-04-01

Military graduate medical education has come under increasing scrutiny in recent years as the size of the military medical force declines. To document the outcomes of military graduate medical education in internal medicine, a cohort of Air Force internal medicine residency graduates from Wright-Patterson Medical Center were studied and their residency performance, staff performance, and active duty retention recorded. The study cohort had an outstanding residency performance, as measured by research experience and board certification rate. They also performed well as military staff physicians, receiving numerous individual military medals while holding important administrative and supervisory positions in the military. Finally, the study cohort had a higher than expected active duty retention rate. These findings support the notion that military graduate medical education in internal medicine produces outstanding military internists.

Ethnic Minority Graduate Entrepreneurs in the UK: Characteristics, Motivation and Access to Finance

ERIC Educational Resources Information Center

Hussain, Javed; Millman, Cindy; Scott, Jonathan; Hannon, Paul; Matlay, Harry

2007-01-01

Small ethnic minority businesses make an important contribution to the UK economy, and this is reflected in their rapid growth over the last decade. A considerable proportion of the growth in new venture creation can be attributed to ethnic minority graduates, who increasingly embark on entrepreneurship as a rewarding and fulfilling alternative to…

Building Faculty Community: Fellowship in Graduate Medical Education Administration

PubMed Central

Edler, Alice A.; Dohn, Ann; Davidson, Heather A.; Grewal, Daisy; Behravesh, Bardia; Piro, Nancy

2009-01-01

Introduction The Department of Graduate Medical Education at Stanford Hospital and Clinics has developed a professional training program for program directors. This paper outlines the goals, structure, and expected outcomes for the one-year Fellowship in Graduate Medical Education Administration program. Background The skills necessary for leading a successful Accreditation Council for Graduate Medical Education (ACGME) training program require an increased level of curricular and administrative expertise. To meet the ACGME Outcome Project goals, program directors must demonstrate not only sophisticated understanding of curricular design but also competency-based performance assessment, resource management, and employment law. Few faculty-development efforts adequately address the complexities of educational administration. As part of an institutional-needs assessment, 41% of Stanford program directors indicated that they wanted more training from the Department of Graduate Medical Education. Intervention To address this need, the Fellowship in Graduate Medical Education Administration program will provide a curriculum that includes (1) readings and discussions in 9 topic areas, (2) regular mentoring by the director of Graduate Medical Education (GME), (3) completion of a service project that helps improve GME across the institution, and (4) completion of an individual scholarly project that focuses on education. Results The first fellow was accepted during the 2008–2009 academic year. Outcomes for the project include presentation of a project at a national meeting, internal workshops geared towards disseminating learning to peer program directors, and the completion of a GME service project. The paper also discusses lessons learned for improving the program. PMID:21975722

What's new in graduate medical education?

PubMed

Hernandez, Raquel G

2016-12-01

The development of new graduate medical education programmes provides both opportunities and challenges. Efforts to address physician workforce shortages as well as a realisation that curricula need to be updated to adjust to our rapidly changing healthcare environment have resulted in more educators considering the "how to" and "what's new" of programme development. Understanding the Next Accreditation System, an accreditation system introduced by the Accreditation Council of Graduate Medical Education in 2012, is critical to the success of new as well as existing residency and fellowship programmes. Although many educators are aware of the general rational for the Next Accreditation System, an in-depth understanding of the meaning of Next Accreditation System is necessary from an experiential and theoretical perspective to be able to successfully launch new programmes and moves towards accreditation. A new paediatric categorical residency programme and a new paediatric surgical programme were developed at our institution immediately following the implementation of Next Accreditation System. We provide a series of insights and perspectives based on our experience relative to what priorities we saw outlined from both the programmatic and the institutional perspective to have our graduate medical education programmes reviewed for accreditation. During this discussion, the following objectives are outlined: to overview the Next Accreditation System as a framework and priorities, to discuss the opportunities and challenges that may exist in developing new programmes, and to discuss future directions in the evaluation of trainees and assessment of training competency. Although challenges are outlined, we hope to relay the continued excitement and opportunities that exist relative to enhancing training curricula for future graduate medical education programme builders.

What do UK medical students value most in their careers? A discrete choice experiment.

PubMed

Cleland, Jennifer A; Johnston, Peter; Watson, Verity; Krucien, Nicolas; Skåtun, Diane

2017-08-01

Many individual- and job-related factors are known to influence medical careers decision making. Previous research has extensively studied medical trainees' (residents') and students' views of the factors that are important. However, how trainees and students trade off these factors at times of important careers-related decision making is under-researched. Information about trade-offs is crucial to the development of effective policies to enhance the recruitment and retention of junior doctors. Our aim was to investigate the strength of UK medical students' preferences for the characteristics of training posts in terms of monetary value. We distributed a paper questionnaire that included a discrete choice experiment (DCE) to final-year medical students in six diverse medical schools across the UK. The main outcome measure was the monetary value of training post characteristics, based on willingness to forgo and willingness to accept extra income for a change in each job characteristic calculated from regression coefficients. A total of 810 medical students answered the questionnaire. The presence of good working conditions was by far the most influential characteristic of a training position. Medical students consider that, as newly graduated doctors, they will require compensation of an additional 43.68% above average earnings to move from a post with excellent working conditions to one with poor working conditions. Female students value excellent working conditions more highly than male students, whereas older medical students value them less highly than younger students. Students on the point of completing medical school and starting postgraduate training value good working conditions significantly more than they value desirable geographical location, unit reputation, familiarity with the unit or opportunities for partners or spouses. This intelligence can be used to address the crisis in workforce staffing that has developed in the UK and opens up fruitful

Perceptions of medical graduates and their workplace supervisors towards a medical school clinical audit program

PubMed Central

O'Ferrall, Ilse; Hoare, Samuel; Caroline, Bulsara; Mak, Donna B.

2017-01-01

Objectives This study explores how medical graduates and their workplace supervisors perceive the value of a structured clinical audit program (CAP) undertaken during medical school. Methods Medical students at the University of Notre Dame Fremantle complete a structured clinical audit program in their final year of medical school.  Semi-structured interviews were conducted with 12 Notre Dame graduates (who had all completed the CAP), and seven workplace supervisors (quality and safety staff and clinical supervisors).  Purposeful sampling was used to recruit participants and data were analysed using thematic analysis. Results Both graduates and workplace supervisors perceived the CAP to be valuable. A major theme was that the CAP made a contribution to individual graduate’s medical practice, including improved knowledge in some areas of patient care as well as awareness of healthcare systems issues and preparedness to undertake scientifically rigorous quality improvement activities. Graduates perceived that as a result of the CAP, they were confident in undertaking a clinical audit after graduation.  Workplace supervisors perceived the value of the CAP beyond an educational experience and felt that the audits undertaken by students improved quality and safety of patient care. Conclusions It is vital that health professionals, including medical graduates, be able to carry out quality and safety activities in the workplace. This study provides evidence that completing a structured clinical audit during medical school prepares graduates to undertake quality and safety activities upon workplace entry. Other health professional faculties may be interested in incorporating a similar program in their curricula.  PMID:28692425

[Work activity of medical graduates at the University of Chile: Analysis per campus and graduation year].

PubMed

Vargas, Patricia; López, Nancy; Urrutia, Leonardo; Acevedo, Jhonny; Sandoval, Daniela; Cortés, Belén

2015-10-01

The University promotes practices and values that influence their students in the pursuit of their occupational interests. To determine working activity features of medical graduates from the University of Chile and their relationship with undergraduate characteristics. Medical graduates of the University of Chile were invited to complete a survey using a virtual server. The survey collected demographic, socioeconomic, work and guild characteristics. Undergraduate data, as campus and graduation years were obtained. The survey was completed by 333 physicians (167 men) aged 29 ± 2 years, graduated from 2007 to 2010. Ninety four percent had a paid work, 59% were employed in public hospitals and 28% in primary care health centers. The predominant type of work activity was performed in the public health service (55%), while 17% worked in private health services. Activity in public health services or primary care were significantly associated with the pursuit of undergraduate clinical activities in specific campuses of the University. The employment rate of medical graduates was high. Differences observed by graduation campus and type of work may be due to the modeling that students receive from teachers.

Leadership and management in UK medical school curricula.

PubMed

Jefferies, Richard; Sheriff, Ibrahim H N; Matthews, Jacob H; Jagger, Olivia; Curtis, Sarah; Lees, Peter; Spurgeon, Peter C; Fountain, Daniel Mark; Oldman, Alex; Habib, Ali; Saied, Azam; Court, Jessica; Giannoudi, Marilena; Sayma, Meelad; Ward, Nicholas; Cork, Nick; Olatokun, Olamide; Devine, Oliver; O'Connell, Paul; Carr, Phoebe; Kotronias, Rafail Angelos; Gardiner, Rebecca; Buckle, Rory T; Thomson, Ross J; Williams, Sarah; Nicholson, Simon J; Goga, Usman

2016-10-10

Purpose Although medical leadership and management (MLM) is increasingly being recognised as important to improving healthcare outcomes, little is understood about current training of medical students in MLM skills and behaviours in the UK. The paper aims to discuss these issues. Design/methodology/approach This qualitative study used validated structured interviews with expert faculty members from medical schools across the UK to ascertain MLM framework integration, teaching methods employed, evaluation methods and barriers to improvement. Findings Data were collected from 25 of the 33 UK medical schools (76 per cent response rate), with 23/25 reporting that MLM content is included in their curriculum. More medical schools assessed MLM competencies on admission than at any other time of the curriculum. Only 12 schools had evaluated MLM teaching at the time of data collection. The majority of medical schools reported barriers, including overfilled curricula and reluctance of staff to teach. Whilst 88 per cent of schools planned to increase MLM content over the next two years, there was a lack of consensus on proposed teaching content and methods. Research limitations/implications There is widespread inclusion of MLM in UK medical schools' curricula, despite the existence of barriers. This study identified substantial heterogeneity in MLM teaching and assessment methods which does not meet students' desired modes of delivery. Examples of national undergraduate MLM teaching exist worldwide, and lessons can be taken from these. Originality/value This is the first national evaluation of MLM in undergraduate medical school curricula in the UK, highlighting continuing challenges with executing MLM content despite numerous frameworks and international examples of successful execution.

Biostatistical and medical statistics graduate education

PubMed Central

2014-01-01

The development of graduate education in biostatistics and medical statistics is discussed in the context of training within a medical center setting. The need for medical researchers to employ a wide variety of statistical designs in clinical, genetic, basic science and translational settings justifies the ongoing integration of biostatistical training into medical center educational settings and informs its content. The integration of large data issues are a challenge. PMID:24472088

Profile of graduates of Israeli medical schools in 1981--2000: educational background, demography and evaluation of medical education programs.

PubMed

Bitterman, Noemi; Shalev, Ilana

2005-05-01

In light of changes in the medical profession, the different requirements placed on physicians and the evolving needs of the healthcare system, the need arose to examine the medical education curriculum in Israel. This survey, conducted by the Samuel Neaman Institute for Science and Technology, summarizes 20 years of medical education in Israel's four medical schools, as the first stage in mapping the existing state of medical education in Israel and providing a basis for decision-making on future medical education programs. To characterize the academic background of graduates, evaluate their attitudes towards current and alternative medical education programs, and examine subgroups among graduates according to gender, medical school, high school education, etc. The survey included graduates from all four Israeli medical schools who graduated between the years 1981 and 2000 in a sample of 1:3. A questionnaire and stamped return envelope were sent to every third graduate; the questionnaire included open and quantitative questions graded on a scale of 1 to 5. The data were processed for the entire graduate population and further analyzed according to subgroups such as medical schools, gender, high school education, etc. The response rate was 41.3%. The survey provided a demographic profile of graduates over a 20 year period, their previous educational and academic background, additional academic degrees achieved, satisfaction, and suggestions for future medical education programs. The profile of the medical graduates in Israel is mostly homogenous in terms of demographics, with small differences among the four medical schools. In line with recommendations of the graduates, and as an expression of the changing requirements in the healthcare system and the medical profession, the medical schools should consider alternative medical education programs such as a bachelor's degree in life sciences followed by MD studies, or education programs that combine medicine with

The trend of governmental support from post-graduated Iranian students in medical fields to study abroad.

PubMed

Haghdoost, Aa; Ghazi, M; Rafiee, Z; Afshari, M

2013-01-01

To explore the trend and composition of post-graduate Iranian students who received governmental scholarship during the last two decades. Detailed information about the awarded scholarships and also about the number of post graduate students in clinical and basic sciences in domestic universities were collected from the related offices within the ministry of health and medical education and their trends were triangulated. A sharp drop was observed in the number of awarded scholarships, from 263 in 1992 to 46 in 2009. In the beginning, almost all of scholarships fully supported students for a whole academic course; while in recent years most of scholarships supported students for a short fellowship or complementary course (more than 80%). Students studied in a wide range of colleges within 30 countries; more than 50% in Europe. Although one third of students studied in UK in the first years, only 4% of students selected this country in recent years. conversely, the number of scholarships to Germany and sweden have increased more than 10 and 3 times during this period. In parallel, the capacity of domestic universities for training of post-graduate students has been expanded dramatically. Although expanding post-graduate education has been one of the main strategic objectives of the ministry of health and medical education in last two decades, it was obtained using different approaches. By time, more attention was to expanding the capacities of Iranian universities, and choosing less but more targeted students to continue their studies abroad.

Burnout and psychiatric morbidity in new medical graduates.

PubMed

Willcock, Simon M; Daly, Michele G; Tennant, Christopher C; Allard, Benjamin J

2004-10-04

To determine the prevalence of psychiatric morbidity and burnout in final-year medical students, and changes in these measures during the intern year. Prospective longitudinal cohort study over 18 months, with assessment of psychiatric morbidity and burnout on six occasions. All 117 students in the first graduating cohort of the University of Sydney Graduate Medical Program were invited to participate in the study; 110 consented. Psychiatric morbidity assessed with the 28-item General Health Questionnaire and burnout assessed with the Maslach Burnout Inventory. The point prevalence of participants meeting criteria for psychiatric morbidity and burnout rose steadily throughout the study period. Internship remains a stressful time for medical graduates, despite initiatives to better support them during this period. The implications for the doctors themselves and for the communities they serve warrant further attention, including programs specifically aimed at reducing the rate of psychological morbidity and burnout during internship.

Prepared for practice? Law teaching and assessment in UK medical schools.

PubMed

Preston-Shoot, Michael; McKimm, Judy

2010-11-01

A revised core curriculum for medical ethics and law in UK medical schools has been published. The General Medical Council requires medical graduates to understand law and ethics and behave in accordance with ethical and legal principles. A parallel policy agenda emphasises accountability, the development of professionalism and patient safety. Given the renewed focus on teaching and learning law alongside medical ethics and the development of professional identity, this survey aimed to identify how medical schools are responding to the preparation of medical students for practice in the future. Questions were asked about the location, content and methods of teaching and assessment of law in undergraduate medical education. Examples of course documentation were requested to illustrate the approaches being taken. A 76% response rate was achieved. Most responding schools integrate law teaching with medical ethics, emphasising both the acquisition of knowledge and its application in a clinical context. Teaching, learning and assessment of law in clinical attachments is much less formalised than that in non-clinical education. Coverage of recommended topic areas varies, raising questions about the degree to which students can embed their knowledge and skills in actual practice. More positively, teaching does not rely on single individuals and clear descriptions were offered for problem-based and small group case-based learning. Further research is required to explore whether there are optimum ways of ensuring that legal knowledge, and skills in its use, form part of the development of professionalism among doctors in training.

Views of senior UK doctors about working in medicine: questionnaire survey.

PubMed

Lambert, Trevor W; Smith, Fay; Goldacre, Michael J

2014-11-01

We surveyed the UK medical qualifiers of 1993. We asked closed questions about their careers; and invited them to give us comments, if they wished, about any aspect of their work. Our aim in this paper is to report on the topics that this senior cohort of UK-trained doctors who work in UK medicine raised with us. Questionnaire survey. 3479 contactable UK-trained medical graduates of 1993. UK. Comments made by doctors about their work, and their views about medical careers and training in the UK. Postal and email questionnaires. Response rate was 72% (2507); 2252 were working in UK medicine, 816 (36%) of whom provided comments. Positive comments outweighed negative in the areas of their own job satisfaction and satisfaction with their training. However, 23% of doctors who commented expressed dissatisfaction with aspects of junior doctors' training, the impact of working time regulations, and with the requirement for doctors to make earlier career decisions than in the past about their choice of specialty. Some doctors were concerned about government health service policy; others were dissatisfied with the availability of family-friendly/part-time work, and we are concerned about attitudes to gender and work-life balance. Though satisfied with their own training and their current position, many senior doctors felt that changes to working hours and postgraduate training had reduced the level of experience gained by newer graduates. They were also concerned about government policy interventions.

Costs of a medical education: comparison with graduate education in law and business.

PubMed

Kerr, Jason R; Brown, Jeffrey J

2006-02-01

The costs of graduate school education are climbing, particularly within the fields of medicine, law, and business. Data on graduate level tuition, educational debt, and starting salaries for medical school, law school, and business school graduates were collected directly from universities and from a wide range of published reports and surveys. Medical school tuition and educational debt levels have risen faster than the rate of inflation over the past decade. Medical school graduates have longer training periods and lower starting salaries than law school and business school graduates, although physician salaries rise after completion of post-graduate education. Faced with an early debt burden and delayed entry into the work force, careful planning is required for medical school graduates to pay off their loans and save for retirement.

Recent trends in psychiatry residency workforce with special reference to international medical graduates.

PubMed

Rao, Nyapati R

2003-01-01

This study examines trends in the supply, distribution, and demographics of psychiatry residents during the 1990s. It evaluates the extent to which the predicted downsizing of psychiatry residency training programs actually occurred and how it affected training programs of different sizes and locations. Data for this study were obtained from the American Medical Association's (AMA) Annual Survey of Graduate Medical Education (GME) Programs, the AMA GME directory, and the APA Graduate Medical Census. The study compares the roles played by international medical graduates (IMGs) in contrast to U.S. medical graduates (USMGs) in these trends. There was a significant decline in the number of residents during the years studied. The median training program size also decreased. International medical graduates found broad acceptance in training programs of all locations and sizes, including medical school based programs. Implications of the findings are discussed regarding the impact of current graduate medical education (GME) and immigration policies on future workforce patterns. The field will have to decide whether it can afford anymore residency downsizing in light of emerging evidence of a shortage of psychiatrists.

Entry of US Medical School Graduates Into Family Medicine Residencies: 2014-2015.

PubMed

Kozakowski, Stanley M; Fetter, Gerald; Bentley, Ashley

2015-10-01

This is the 34th national study conducted by the American Academy of Family Physicians (AAFP) that reports retrospectively the percentage of graduates from US MD-granting and DO-granting medical schools who entered Accreditation Council for Graduate Medical Education (ACGME)-accredited family medicine residency programs as first-year residents in 2014. Approximately 8.5% of the 18,241 students graduating from US MD-granting medical schools between July 2013 and June 2014 entered a family medicine residency. Of the 1,458 graduates of the US MD-granting medical schools who entered a family medicine residency in 2014, 80% graduated from 69 of the 131 schools. Eleven schools lacking departments or divisions of family medicine produced only a total of 26 students entering family medicine. In aggregate, medical schools west of the Mississippi River represent less than a third of all US MD-granting schools but have an aggregate rate of students selecting family medicine that is two-thirds higher than schools to the east of the Mississippi. A rank order list of US MD-granting medical schools was created based on the last 3 years' average percentage of graduates who became family medicine residents, using the 2014 and prior AAFP census data. US MD schools continue to fail to produce a primary care workforce, a key measure of social responsibility as measured by their production of graduates entering into family medicine. DO-granting and international medical school graduates filled the majority of ACGME-accredited family medicine first-year resident positions in 2014.

Do personality traits assessed on medical school admission predict exit performance? A UK-wide longitudinal cohort study.

PubMed

MacKenzie, R K; Dowell, J; Ayansina, D; Cleland, J A

2017-05-01

Traditional methods of assessing personality traits in medical school selection have been heavily criticised. To address this at the point of selection, "non-cognitive" tests were included in the UK Clinical Aptitude Test, the most widely-used aptitude test in UK medical education (UKCAT: http://www.ukcat.ac.uk/ ). We examined the predictive validity of these non-cognitive traits with performance during and on exit from medical school. We sampled all students graduating in 2013 from the 30 UKCAT consortium medical schools. Analysis included: candidate demographics, UKCAT non-cognitive scores, medical school performance data-the Educational Performance Measure (EPM) and national exit situational judgement test (SJT) outcomes. We examined the relationships between these variables and SJT and EPM scores. Multilevel modelling was used to assess the relationships adjusting for confounders. The 3343 students who had taken the UKCAT non-cognitive tests and had both EPM and SJT data were entered into the analysis. There were four types of non-cognitive test: (1) libertariancommunitarian, (2) NACE-narcissism, aloofness, confidence and empathy, (3) MEARS-self-esteem, optimism, control, self-discipline, emotional-nondefensiveness (END) and faking, (4) an abridged version of 1 and 2 combined. Multilevel regression showed that, after correcting for demographic factors, END predicted SJT and EPM decile. Aloofness and empathy in NACE were predictive of SJT score. This is the first large-scale study examining the relationship between performance on non-cognitive selection tests and medical school exit assessments. The predictive validity of these tests was limited, and the relationships revealed do not fit neatly with theoretical expectations. This study does not support their use in selection.

42 CFR 422.324 - Payments to MA organizations for graduate medical education costs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Payments to MA organizations for graduate medical... Medicare Advantage Organizations § 422.324 Payments to MA organizations for graduate medical education costs. (a) MA organizations may receive direct graduate medical education payments for the time that...

42 CFR 422.324 - Payments to MA organizations for graduate medical education costs.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 3 2011-10-01 2011-10-01 false Payments to MA organizations for graduate medical... Medicare Advantage Organizations § 422.324 Payments to MA organizations for graduate medical education costs. (a) MA organizations may receive direct graduate medical education payments for the time that...

[Returning students' perspectives on adjusting to medical graduate school in Korea: an interview study].

PubMed

Park, So Youn; Kwon, Oh Young; Yoon, Tai Young

2015-03-01

The recent trend of switching from medical graduate school to medical school in Korea raises questions about the adjustments that students must make in medical education. We examined the perceptions of medical graduate students with regard to their adaptation in medical education. Sixteen semistructured, in-depth interviews were administered to medical graduate students who received their first degrees in foreign countries. The interviews addressed their perceptions of their experience in medical graduate school and on how well they adjusted to medical education. Students perceived their adaptation to medical graduate school in two dimensions: academic achievement and cultural adjustment. In academic achievement, a limited student-teacher relationship was recognized by students. Students tended to be passive in the classroom due to an uncomfortable atmosphere. They also reported witnessing culture shock in relation to the paucity of information on entrance into medical graduate school. Freshmen voiced many difficulties in adjusting to the unique culture in medical graduate school, in contrast to upper classmen. However, only 32% of students experienced helpful mentoring for their problems. Students' perspectives should guide all decisions made about medical education in an altered educational system.Self-regulated learning and a good mentoring program can help prepare students for medical education and professional life.

UK medical students' perceptions, attitudes, and interest toward medical leadership and clinician managers.

PubMed

Rouhani, Maral J; Burleigh, Eleanor J; Hobbis, Chloe; Dunford, Charlotte; Osman, Nadir I; Gan, Christine; Gibbons, Norma B; Ahmed, Hashim U; Miah, Saiful

2018-01-01

We aimed to determine UK medical students' perceptions and attitudes and interest toward medical leadership and clinician managers. A cross-sectional study was conducted during the academic year 2015-2016. An online questionnaire was distributed to 2,349 final-year students from 10 UK medical schools. Participants were asked to complete a 5-point Likert scale on their current perceptions, attitudes, and interest toward medical leadership and clinician managers. They were also asked to self-rate their leadership competences set by the Medical Leadership Competency Framework and to rate the quality of management and leadership training they received from their medical school. In total, we received 114 complete responses. Only 7.9% of respondents were in agreement (strongly agree or agree) when asked whether they felt they were well informed about what a managerial position in medicine entails. When asked whether clinicians should influence managerial decisions within a clinical setting, 94.7% of respondents were in agreement with the statement. About 85% of respondents were in agreement that it is important for clinicians to have managerial or leadership responsibilities, with 63.2% of students in agreement that they would have liked more management or leadership training during medical school. Over half the respondents rated their management and leadership training they received during medical school as "very poor" or "poor" (54.4%). Our study suggests that UK medical students have an appetite for management and leadership training and appreciate its importance but feel that the training they are receiving is poor. This suggests that there is a gap between the demand for management and leadership training and the quality of training supplied by UK medical schools.

42 CFR 422.324 - Payments to MA organizations for graduate medical education costs.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 3 2013-10-01 2013-10-01 false Payments to MA organizations for graduate medical... Payments to Medicare Advantage Organizations § 422.324 Payments to MA organizations for graduate medical education costs. (a) MA organizations may receive direct graduate medical education payments for the time...

42 CFR 422.324 - Payments to MA organizations for graduate medical education costs.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 3 2014-10-01 2014-10-01 false Payments to MA organizations for graduate medical... Payments to Medicare Advantage Organizations § 422.324 Payments to MA organizations for graduate medical education costs. (a) MA organizations may receive direct graduate medical education payments for the time...

42 CFR 422.324 - Payments to MA organizations for graduate medical education costs.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 3 2012-10-01 2012-10-01 false Payments to MA organizations for graduate medical... Payments to Medicare Advantage Organizations § 422.324 Payments to MA organizations for graduate medical education costs. (a) MA organizations may receive direct graduate medical education payments for the time...

Current status of teaching on spirituality in UK medical schools.

PubMed

Neely, David; Minford, Eunice J

2008-02-01

To investigate the current status of teaching on spirituality in medicine in UK medical schools and to establish if and how medical schools are preparing future doctors to identify patients' spiritual needs. We carried out a national questionnaire survey using a 2-part questionnaire. Section A contained questions relating to the quantity of teaching on spirituality and the topics covered. Section B contained questions relating to teaching on alternative health practices. Medical educators from each of the 32 medical schools in the UK were invited to participate. A response rate of 53% (n = 17) was achieved. A total of 59% (n = 10) of respondents stated that there is teaching on spirituality in medicine in their curricula. On extrapolation, at least 31% and a maximum of 78% of UK medical schools currently provide some form of teaching on spirituality. Of the respondents that teach spirituality, 50% (n = 5) stated that their schools include compulsory teaching on spirituality in medicine, 80% (n = 8) include optional components, and 88% stated that teaching on complementary and alternative medicine is included in the curriculum. Although 59% (n = 10) of respondent medical schools (the actual UK figure lies between 31% and 78%) currently provide some form of teaching on spirituality, there is significant room for improvement. There is little uniformity between medical schools with regard to content, form, amount or type of staff member delivering the teaching. It would be beneficial to introduce a standardised curriculum on spirituality across all UK medical schools.

Foreign Medical Graduates in the 1980s: Trends in Specialization.

ERIC Educational Resources Information Center

Mick, Stephen S.; Worobey, Jacqueline Lowe

1984-01-01

Despite predictions of a physician surplus by 1990, graduates of foreign medical schools (both aliens and U.S. citizens) continue to flow into the United States. Secondary analysis of 1980 data suggests that graduates of foreign schools may secure their presence within the American medical system by selecting specialties where shortages exist. (KH)

Setting Priorities for Graduate Medical Education,

DTIC Science & Technology

1996-02-01

assist the work of these staffs. 14. SUBJECT TERMS Attrition, data bases, education , mathematical models, medical personnel, military medicine, naval...CRM 95-209 / February 1996 Setting Priorities for Graduate Medical Education Neil B. Carey • Marjorie D. Curia • Oliver A. Smith 19960718 027...the tirae for reviewing instructions, searching existing data sources gathering and maintaining the data needed, and reviewing the collection of

75 FR 79006 - Council on Graduate Medical Education; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-17

... Graduate Medical Education; Notice of Meeting In accordance with section 10(a)(2) of the Federal Advisory... Medical Education (COGME). Dates and Times: January 19, 2011, 8:30 a.m.-4 p.m., January 20, 2011, 8:30 a.m... first day will consist of presentations covering various aspects of graduate medical education, Bureau...

The Trend of Governmental Support from Post-Graduated Iranian Students in Medical Fields to Study Abroad

PubMed Central

Haghdoost, AA; Ghazi, M; Rafiee, Z; Afshari, M

2013-01-01

Background: To explore the trend and composition of post-graduate Iranian students who received governmental scholarship during the last two decades. Method: Detailed information about the awarded scholarships and also about the number of post graduate students in clinical and basic sciences in domestic universities were collected from the related offices within the ministry of health and medical education and their trends were triangulated. Results: A sharp drop was observed in the number of awarded scholarships, from 263 in 1992 to 46 in 2009. In the beginning, almost all of scholarships fully supported students for a whole academic course; while in recent years most of scholarships supported students for a short fellowship or complementary course (more than 80%). Students studied in a wide range of colleges within 30 countries; more than 50% in Europe. Although one third of students studied in UK in the first years, only 4% of students selected this country in recent years. conversely, the number of scholarships to Germany and sweden have increased more than 10 and 3 times during this period. In parallel, the capacity of domestic universities for training of post-graduate students has been expanded dramatically. Conclusion: Although expanding post-graduate education has been one of the main strategic objectives of the ministry of health and medical education in last two decades, it was obtained using different approaches. By time, more attention was to expanding the capacities of Iranian universities, and choosing less but more targeted students to continue their studies abroad. PMID:23865032

Building a local medical workforce in Tasmania: where are international fee-paying medical graduates likely to work?

PubMed

Cheek, Colleen; Hays, Richard; Allen, Penny; Walker, Gary; Shires, Lizzi

2017-01-01

Much of regional Australia continues to face challenges in recruitment and retention of medical practitioners, despite the apparently successful rural medical education initiatives funded by the Commonwealth Government. International fee-paying (IFP) medical students are a significant component of Australian medical education, contributing additional income and more diverse learning environments for universities. Their contribution to the Australian medical workforce is harder to determine. After obtaining registration, IFP graduates may apply to remain in Australia as skilled migrants. Since 1999 there has been a 325% increase in the number of international medical students in Australia, with approximately 73% of IFP graduates remaining in Australia for at least some postgraduate training. Recognising the potential contribution of IFP students to the Tasmanian medical workforce, the authors sought better understanding of the career intentions and work locations of IFP graduates from the medical program in Tasmania, Australia, through two studies. Firstly, a quantitative study was conducted of the locations of all IFP graduates from the Tasmanian medical program, and then a qualitative study exploring graduating students' intentions and factors that contribute to their decisions about work location choices. This was a cohort study of IFP students who graduated from the University of Tasmania School of Medicine over the period 2000-2015. Work locations for 2016 were mapped to a Modified Monash rurality classification. Semi-structured interviews were held with 15 final year IFP medical students, exploring career intentions and location preferences. There were 261 IFP graduates, 54.4% male. The most common country of origin was Malaysia (55.2%). In 2016, 189 (72.4 %) were working in Australia, 42 (16.1%) in Tasmania and 126 (66.7%) in areas categorised as Modified Monash 1. Recent graduates in postgraduate year 1/2 (71.3%) were more likely to be working in Tasmania

Impact of a Graduate Entry Programme on a medical school library service.

PubMed

Martin, Sam

2003-03-01

The aim of this study was to compare the use of library facilities by first year undergraduate medical students and Graduate Entry Programme students (GEP). More specifically it tried to determine which library services (if any) were more frequently used by GEP so that this could be taken into account in future Information Services planning. A questionnaire on the use of Library and Information Services was posted to all first year GEP students and undergraduates on the 5-year course. In addition, user statistics of library entry and borrowing were collated from gate readings and the library Unicorn management system. Overall, GEP students were found to make a greater daily/weekly use of library facilities than undergraduates on the 5-year course. The facilities most used by both sets of students were essential texts, e-mail, PCs and study facilities. Computer Aided Learning packages, journals and video facilities were least used. However, on a daily/weekly basis GEP students made 74% more use of journals (P < 0.01), 59% more use of e-journals (P < 0.05), 36% more use photocopiers (P < 0.05), 42% more use of printers (P < 0.05), 56% more use of the library catalogue (P < 0.05) and 50% more use of databases (P < 0.05). This difference in use should be taken into account by LIS providers as there is expected to be an increase in fast-track graduate courses offered by medical schools throughout the UK.

The changing geography of Americans graduating from foreign medical schools.

PubMed

Johnson, Karin; Hagopian, Amy; Veninga, Catherine; Hart, L Gary

2006-02-01

To study U.S.-born international medical graduates in order to analyze changes in their numbers and countries of training from the 1960s and before until the early 2000s. This study was conducted from 2003-2004 at the Center for Health Workforce Studies, University of Washington. The analysis was based on data from March 2002 from the American Medical Association (AMA) for active physicians. AMA data were supplemented with data from several other sources. Descriptive statistics were produced on country of birth, country of medical school training, and year of training for all foreign-trained, patient-care physicians whose birth country was known. At least 17,000 of the foreign-trained physicians practicing in the United States are known to have been born in the United States. American physicians have graduated from foreign medical schools in increasing numbers since the 1960s. The number of U.S.-born physicians who graduated from a foreign medical school peaked in the early 1980s, but the phenomenon endures today. However, the countries in which these physicians chose to attend medical schools have changed significantly from the 1950s to the early 2000s. Over time, U.S.-born physicians have become much less likely to train in Europe and much more likely to train in certain Caribbean countries. U.S.-born physicians who graduate from medical schools abroad tend to train in just a handful of countries and attend a limited number of medical schools.

Views of senior UK doctors about working in medicine: questionnaire survey

PubMed Central

Lambert, Trevor W; Goldacre, Michael J

2014-01-01

Summary Objectives We surveyed the UK medical qualifiers of 1993. We asked closed questions about their careers; and invited them to give us comments, if they wished, about any aspect of their work. Our aim in this paper is to report on the topics that this senior cohort of UK-trained doctors who work in UK medicine raised with us. Design Questionnaire survey Participants 3479 contactable UK-trained medical graduates of 1993. Setting UK. Main outcome measures Comments made by doctors about their work, and their views about medical careers and training in the UK. Method Postal and email questionnaires. Results Response rate was 72% (2507); 2252 were working in UK medicine, 816 (36%) of whom provided comments. Positive comments outweighed negative in the areas of their own job satisfaction and satisfaction with their training. However, 23% of doctors who commented expressed dissatisfaction with aspects of junior doctors’ training, the impact of working time regulations, and with the requirement for doctors to make earlier career decisions than in the past about their choice of specialty. Some doctors were concerned about government health service policy; others were dissatisfied with the availability of family-friendly/part-time work, and we are concerned about attitudes to gender and work-life balance. Conclusions Though satisfied with their own training and their current position, many senior doctors felt that changes to working hours and postgraduate training had reduced the level of experience gained by newer graduates. They were also concerned about government policy interventions. PMID:25408920

Linguistically and Culturally Diverse Students' Perceptions of Successful Classroom Practices in a UK Graduate Program

ERIC Educational Resources Information Center

Rich, Sarah

2005-01-01

In this paper, I present the findings of a longitudinal study into the perceptions of linguistically and culturally diverse practicing teachers in a graduate program in the United Kingdom (UK) with regard to pedagogic practices deemed successful in helping them negotiate access to an academic community of practice. It is argued that an approach…

Importance and benefits of the doctoral thesis for medical graduates

PubMed Central

Giesler, Marianne; Boeker, Martin; Fabry, Götz; Biller, Silke

2016-01-01

Introduction: The majority of medical graduates in Germany complete a doctorate, even though a doctoral degree is not necessary for the practice of medicine. So far, little is known about doctoral candidates’ view on the individual benefit a doctoral thesis has for them. Consequently, this is the subject of the present investigation. Method: Data from surveys with graduates of the five medical faculties of Baden-Württemberg from the graduation years 2007/2008 (N=514) and 2010/2011 (N=598) were analysed. Results: One and a half years after graduating 53% of those interviewed had completed their doctorate. When asked about their motivation for writing a doctoral thesis, participants answered most frequently “a doctorate is usual” (85%) and “improvement of job opportunities” (75%), 36% said that an academic career has been their primary motive. Less than 10% responded that they used their doctoral thesis as a means to apply for a job. The proportion of graduates working in health care is equally large among those who have completed a thesis and those who have not. Graduates who pursued a thesis due to scientific interest are also currently more interested in an academic career and recognise more opportunities for research. An implicit benefit of a medical thesis emerged with regard to the self-assessment of scientific competences as those who completed a doctorate rated their scientific competencies higher than those who have not. Discussion: Although for the majority of physicians research interest is not the primary motivation for completing a doctorate, they might nevertheless achieve some academic competencies. For graduates pursuing an academic career the benefit of completing a medical thesis is more obvious. PMID:26958656

Importance and benefits of the doctoral thesis for medical graduates.

PubMed

Giesler, Marianne; Boeker, Martin; Fabry, Götz; Biller, Silke

2016-01-01

The majority of medical graduates in Germany complete a doctorate, even though a doctoral degree is not necessary for the practice of medicine. So far, little is known about doctoral candidates' view on the individual benefit a doctoral thesis has for them. Consequently, this is the subject of the present investigation. Data from surveys with graduates of the five medical faculties of Baden-Württemberg from the graduation years 2007/2008 (N=514) and 2010/2011 (N=598) were analysed. One and a half years after graduating 53% of those interviewed had completed their doctorate. When asked about their motivation for writing a doctoral thesis, participants answered most frequently "a doctorate is usual" (85%) and "improvement of job opportunities" (75%), 36% said that an academic career has been their primary motive. Less than 10% responded that they used their doctoral thesis as a means to apply for a job. The proportion of graduates working in health care is equally large among those who have completed a thesis and those who have not. Graduates who pursued a thesis due to scientific interest are also currently more interested in an academic career and recognise more opportunities for research. An implicit benefit of a medical thesis emerged with regard to the self-assessment of scientific competences as those who completed a doctorate rated their scientific competencies higher than those who have not. Although for the majority of physicians research interest is not the primary motivation for completing a doctorate, they might nevertheless achieve some academic competencies. For graduates pursuing an academic career the benefit of completing a medical thesis is more obvious.

Feasibility and psychometric analysis of graduate satisfaction survey of medical students graduating from the Royal College of Surgeons in Ireland-Medical University of Bahrain (RCSI Bahrain).

PubMed

Strachan, Kathryn; Ansari, Ahmed Al

2016-01-01

To assess the satisfaction levels of graduates of the Royal College of Surgeons in Ireland University of Bahrain (RCSI Bahrain). The graduate survey was administered to four groups of graduates of the RCSI Bahrain who graduated between the years 2010 and 2014. The graduate survey assessed five major domains and comprised 41 items. The RCSI Bahrain opened its doors in 2004, with the first class graduating in 2010. The graduate cohorts used in this study were working in various countries at the time of survey completion. Out of 599 graduates, 153 responded to the graduate survey. The total mean response rate of the graduate survey was 26 %, including 102 females, 44 males, and 7 students who did not indicate their gender. 49 students graduated in 2012, and 53 students graduated in 2013. Of these graduates, 83 were working in Bahrain at the time of survey administration, 11 in the USA, 4 in Malta, and 3 in the UK; the total number of countries where graduates were working was 14. Reliability analysis found high internal consistency for the instrument (with a Cronbach's α of 0.97). The whole instrument was found to be suitable for factor analysis (KMO = 0.853; Bartlett test significant, p < 0.00). Factor analysis showed that the data on the questionnaire decomposed into five factors, which accounted for 72.3 % of the total variance: future performance, career development, skills development, graduate as collaborator, and communication skills. The survey results found that graduates of the RCSI Bahrain program who responded to this questionnaire are generally satisfied with their experience at the university, feel well prepared to join the field and feel ready to compete with graduates of competing universities. Furthermore, the graduate survey was found to be a reliable instrument and we provided some evidence to support the construct validity of the instrument.

Career Choice of "Fifth Pathway" Graduates from New York State Medical Schools.

ERIC Educational Resources Information Center

Stimmel, Barry; Smith, Harry, Jr.

1985-01-01

Graduates of "fifth pathway" programs at medical schools in New York state between 1976-1978 were studied to determine their professional careers and choice of medical specialties. Fifth pathway graduates, 95 percent from Mexican medical schools, were more likely to select nonprimary care than primary care specialties. (Author/MLW)

Foreign medical graduates in the 1980s: trends in specialization.

PubMed Central

Mick, S S; Worobey, J L

1984-01-01

Secondary analysis of data collected by the American Medical Association and the Graduate Medical Education National Advisory Committee (GMENAC) suggests that measures to diminish the flow of alien Foreign Medical Graduates (FMGs) into the United States have been less effective than planned. Declining trends in the proportion of FMG house officers in the mid- to late-1970s have recently stabilized around 19 per cent. There has also been a dramatic increase in the number of US citizen Foreign Medical Graduates ( USFMGs ) in house officer positions. A pattern of alien FMG and USFMG house officer specialization correlates with specialties designated by the GMENAC as shortage areas by 1990 (r = -.49, p less than .05). Despite the GMENAC prediction of a surplus of physicians by 1990, differential selection of alien FMGs and USFMGs into shortage specialties may assure their substantial future presence in the US health care system. PMID:6742255

Can the academic background of medical graduates be detected during internship?

PubMed Central

Woodward, C. A.; McAuley, R. G.

1983-01-01

Performance ratings were obtained by the clinical supervisors of four graduated classes of McMaster University medical students during internship. The supervisors detected no difference in performance between the graduates who met the "traditional" admissions criteria (both an undergraduate grade point average of 3.1 or greater on a 4-point scale and previous training in biology, general and organic chemistry, and physics) and those who lacked one or both of these prerequisites. These data suggest that medical schools can expand their admissions criteria without fearing that their graduates will perform less well as interns because of a lack of traditional academic preparation for medical school. PMID:6883258

Fair access to medicine? Retrospective analysis of UK medical schools application data 2009-2012 using three measures of socioeconomic status.

PubMed

Steven, Kathryn; Dowell, Jon; Jackson, Cathy; Guthrie, Bruce

2016-01-13

Medical students have historically largely come from more affluent parts of society, leading many countries to seek to broaden access to medical careers on the grounds of social justice and the perceived benefits of greater workforce diversity. The aim of this study was to examine variation in socioeconomic status (SES) of applicants to study medicine and applicants with an accepted offer from a medical school, comparing the four UK countries and individual medical schools. Retrospective analysis of application data for 22 UK medical schools 2009/10-2011/12. Data were analysed for all 32,964 UK-domiciled applicants aged <20 years to 22 non-graduate medical schools requiring applicants to sit the United Kingdom Clinical Aptitude Test (UKCAT). Rates of applicants and accepted offers were compared using three measures of SES: (1) Postcode-assigned Index of Multiple Deprivation score (IMD); (2) School type; (3) Parental occupation measured by the National Statistics Socio Economic Classification (NS-SEC). There is a marked social gradient of applicants and applicants with accepted offers with, depending on UK country of residence, 19.7-34.5% of applicants living in the most affluent tenth of postcodes vs 1.8-5.7% in the least affluent tenth. However, the majority of applicants in all postcodes had parents in the highest SES occupational group (NS-SEC1). Applicants resident in the most deprived postcodes, with parents from lower SES occupational groups (NS-SEC4/5) and attending non-selective state schools were less likely to obtain an accepted offer of a place at medical school further steepening the observed social gradient. Medical schools varied significantly in the percentage of individuals from NS-SEC 4/5 applying (2.3%-8.4%) and gaining an accepted offer (1.2%-7.7%). Regardless of the measure, those from less affluent backgrounds are less likely to apply and less likely to gain an accepted offer to study medicine. Postcode-based measures such as IMD may be

Gender-related perceptions of careers in surgery among new medical graduates: results of a cross-sectional study.

PubMed

Fitzgerald, J Edward F; Tang, Siau-Wei; Ravindra, Pravisha; Maxwell-Armstrong, Charles A

2013-07-01

Despite promotional measures at a national level, female surgeons account for only 10% of the consultant workforce in the United Kingdom. With rising proportions of female medical graduates, it is important that surgery continues to recruit the most able candidates regardless of sex. This study investigates the differing perceptions of surgical careers among recent medical school graduates and identifies factors discouraging female doctors from pursuing a career in surgery. Newly qualified graduates from the University of Nottingham Medical School, Nottingham, UK, were invited to complete a nonmandatory questionnaire investigating career intentions and factors influencing this. Two hundred and eight questionnaires were returned (a 66% response rate). Male respondents were significantly more likely to rate surgery as an attractive or very attractive career (P = .0116). Overall, only 33 (25%) female doctors expressed interest in a surgical career as opposed to 33 (42%) male doctors (P = .010). Frequently cited reasons included no interest in surgery itself (21%) and negative attitudes toward women in surgery among the surgical teams (18%). Irrespective of career interests, 59% of male and 68% of female respondents believed surgery was not a career welcoming women (P = .186). Reasons included difficulty maintaining family life, limited flexible training, and lack of role models. This study identifies significant sex differences in the perception of surgical careers. The majority believes surgery does not welcome female trainees. Future strategies to promote surgery must address attitudes and behaviors in both sexes while taking active steps to support female surgeons during their training and in the workplace. Copyright © 2013 Elsevier Inc. All rights reserved.

Orientation of International Medical Graduates to Canadian Medical Practice

ERIC Educational Resources Information Center

Stenerson, Heather J.; Davis, Penny M.; Labash, Andrea M.; Procyshyn, Mavis M.

2009-01-01

The College of Physicians and Surgeons of Saskatchewan tracked a cohort of 39 international medical graduates (IMGs) in rural Saskatchewan and discovered that 51% left the province within five years (personal communication). A study by Basky, Mathew, Edwards, and Rourke (2007) found that half a cohort of IMGs in rural Newfoundland and Labrador…

42 CFR 413.80 - Direct GME payments: Determination of weighting factors for foreign medical graduates.

Code of Federal Regulations, 2011 CFR

2011-10-01

... factors for foreign medical graduates. 413.80 Section 413.80 Public Health CENTERS FOR MEDICARE & MEDICAID... weighting factors for foreign medical graduates. (a) The weighting factor for a foreign medical graduate is determined under the provisions of § 413.79 if the foreign medical graduate— (1) Has passed FMGEMS; or (2...

42 CFR 413.80 - Direct GME payments: Determination of weighting factors for foreign medical graduates.

Code of Federal Regulations, 2014 CFR

2014-10-01

... factors for foreign medical graduates. 413.80 Section 413.80 Public Health CENTERS FOR MEDICARE & MEDICAID... weighting factors for foreign medical graduates. (a) The weighting factor for a foreign medical graduate is determined under the provisions of § 413.79 if the foreign medical graduate— (1) Has passed FMGEMS; or (2...

42 CFR 413.80 - Direct GME payments: Determination of weighting factors for foreign medical graduates.

Code of Federal Regulations, 2013 CFR

2013-10-01

... factors for foreign medical graduates. 413.80 Section 413.80 Public Health CENTERS FOR MEDICARE & MEDICAID... weighting factors for foreign medical graduates. (a) The weighting factor for a foreign medical graduate is determined under the provisions of § 413.79 if the foreign medical graduate— (1) Has passed FMGEMS; or (2...

42 CFR 413.80 - Direct GME payments: Determination of weighting factors for foreign medical graduates.

Code of Federal Regulations, 2010 CFR

2010-10-01

... factors for foreign medical graduates. 413.80 Section 413.80 Public Health CENTERS FOR MEDICARE & MEDICAID... weighting factors for foreign medical graduates. (a) The weighting factor for a foreign medical graduate is determined under the provisions of § 413.79 if the foreign medical graduate— (1) Has passed FMGEMS; or (2...

42 CFR 413.80 - Direct GME payments: Determination of weighting factors for foreign medical graduates.

Code of Federal Regulations, 2012 CFR

2012-10-01

... factors for foreign medical graduates. 413.80 Section 413.80 Public Health CENTERS FOR MEDICARE & MEDICAID... weighting factors for foreign medical graduates. (a) The weighting factor for a foreign medical graduate is determined under the provisions of § 413.79 if the foreign medical graduate— (1) Has passed FMGEMS; or (2...

Medicare and Graduate Medical Education.

DTIC Science & Technology

1995-09-01

research. The physician counts reported here are based on American Medical Association counts of doctors of medicine (M.D.s). Schools of osteopathy ...whose graduates receive a doctor of osteopathy degree, produce about 5 percent of a more broadly defined physician workforce. Even critics who have...provided insurance, and federal subsi- dies directed toward the supply of physicians. Con- ventional economic analysis would stress that in the

Primary care careers among recent graduates of research-intensive private and public medical schools.

PubMed

Choi, Phillip A; Xu, Shuai; Ayanian, John Z

2013-06-01

Despite a growing need for primary care physicians in the United States, the proportion of medical school graduates pursuing primary care careers has declined over the past decade. To assess the association of medical school research funding with graduates matching in family medicine residencies and practicing primary care. Observational study of United States medical schools. One hundred twenty-one allopathic medical schools. The primary outcomes included the proportion of each school's graduates from 1999 to 2001 who were primary care physicians in 2008, and the proportion of each school's graduates who entered family medicine residencies during 2007 through 2009. The 25 medical schools with the highest levels of research funding from the National Institutes of Health in 2010 were designated as "research-intensive." Among research-intensive medical schools, the 16 private medical schools produced significantly fewer practicing primary care physicians (median 24.1% vs. 33.4%, p < 0.001) and fewer recent graduates matching in family medicine residencies (median 2.4% vs. 6.2%, p < 0.001) than the other 30 private schools. In contrast, the nine research-intensive public medical schools produced comparable proportions of graduates pursuing primary care careers (median 36.1% vs. 36.3%, p = 0.87) and matching in family medicine residencies (median 7.4% vs. 10.0%, p = 0.37) relative to the other 66 public medical schools. To meet the health care needs of the US population, research-intensive private medical schools should play a more active role in promoting primary care careers for their students and graduates.

Why Are Fewer Women than Men from Top UK Universities Still Not Securing Graduate Level Jobs?

ERIC Educational Resources Information Center

Black, Jonathan P.; Turner, Malgorzata

2016-01-01

Research shows that a lower proportion of women than men are in graduate level jobs, six months after leaving seven top UK universities. This paper presents new empirical evidence from a unique dataset on the significantly different attitudes and behaviours between Oxford men and women undergraduates that might explain why women are less likely to…

Obstructive sleep apnea knowledge and attitudes among recent medical graduates training in Ecuador.

PubMed

Chérrez-Ojeda, Iván; Calderón, Juan Carlos; Fernández García, Andrea; Jeffe, Donna B; Santoro, Ilka; Vanegas, Emanuel; Cherrez, Annia; Cano, José; Betancourt, Freddy; Simancas-Racines, Daniel

2018-01-01

We aimed to assess recent Latin American medical school graduates' knowledge and attitudes about OSA and examine whether their knowledge and attitudes about OSA differed from practicing physicians. Recent medical graduates completed the Spanish translation of the OSA Knowledge and Attitudes (OSAKA) questionnaire at the 2013 national primary-care residency-placement meeting in Ecuador. The OSAKA includes 18 knowledge and five attitudinal items about OSA. We compared recent graduates' data with data collected in 2010-2011 from practicing physicians using chi-square tests of associations among categorical variables and analysis of variance of differences in mean knowledge and attitude scores. Unadjusted logistic regression models tested the odds that recent graduates (vs. practicing physicians) answered each item correctly. Of 265 recent graduates, 138 (52.1%) were male, and mean age was 25.9 years. Although mean knowledge was low overall, scores were lower for recent graduates than for the 367 practicing physicians (53.5% vs. 60.4%;  p  < 0.001). Practicing physicians were significantly more likely to answer specific items correctly with one exception-recent graduates were more likely to know that < 5 apneas-hypopneas/h is normal (OR 1.47, 1.03-2.07). Physicians in practice attributed greater importance to OSA as clinical disorder and the need for identifying patients with OSA; but recent graduates reported greater confidence in managing patients with OSA and CPAP. OSA-focused educational interventions during medical school should help to improve recent medical graduates' abilities to diagnose and treat OSA. We recommend a greater number of hours of medical students' exposure to sleep education.

UK medical tourists in Thailand: they are not who you think they are.

PubMed

Noree, Thinakorn; Hanefeld, Johanna; Smith, Richard

2014-05-06

Travel for medical treatment is an aspect of globalization and health that is comparatively less understood. Little is known about volume, characteristic and motivation of medical tourists, limiting understanding of effects on health systems and patients. Thailand is amongst a handful of countries that have positioned themselves as medical tourism destination. This paper examines in unprecedented detail volume and characteristics of medical tourists who travel from the UK to Thailand for treatment. As part of a wider medical tourism study, authors gained access to over 4000 patient records from the five largest private hospitals in Thailand. These included information on country of origin, gender, age, arrival month, hospitalization, diagnosis, procedures, length of stay, medical expenditure and type of payment. Patient records were analysed to understand who travels and findings were triangulated with data from the UK International Passenger Survey (IPS). 104,830 medical tourists visited these hospitals in Thailand in 2010. While patients originate all over the world, UK medical tourists represent the largest group amongst Europeans. The majority UK medical tourists (60%) have comparatively small, elective procedures, costing less than USD 500. A significant minority of patients travel for more serious orthopedic and cardiothoracic procedures. Data of individual patient records from Thailand shows a higher number of UK patients traveled to Thailand than indicated by the IPS. Thailand is attracting a large number of medical tourists including larger numbers of UK patients than previously estimated. However, as many patients travel for comparatively minor procedures treatment may not be their primary motivation for travel. The small but significant proportion of older UK residents traveling for complex procedures may point to challenges within the NHS.

Demographic attributes and knowledge acquisition among graduate-entry medical students.

PubMed

Finucane, Paul; Flannery, Denise; McGrath, Deirdre; Saunders, Jean

2013-01-01

Recent changes to undergraduate (basic) medical education in Ireland have linked an expansion of student numbers with wide-ranging reforms. Medical schools have broadened access by admitting more mature students from diverse backgrounds and have increased their international student numbers. This has resulted in major changes to the demographic profile of students at Irish medical schools. To determine whether the demographic characteristics of students impact on their academic performance and specifically on their rate of knowledge acquisition. As a formative assessment exercise, we administered a progress test to all students twice each year during a 4 year graduate-entry medical programme. We compared scores over time between students from different age cohorts, of different gender, of different nationalities and from different academic backgrounds. In the 1143 tests taken by 285 students to date, there were no significant differences in the rate of knowledge acquisition between the various groups. Early in the course, students from a non-biological science background performed less well than others but outperformed their peers by the time of graduation. Neither age, gender, nationality nor academic background impacts on the rate of knowledge acquisition among graduate-entry medical students.

Ethics curriculum for emergency medicine graduate medical education.

PubMed

Marco, Catherine A; Lu, Dave W; Stettner, Edward; Sokolove, Peter E; Ufberg, Jacob W; Noeller, Thomas P

2011-05-01

Ethics education is an essential component of graduate medical education in emergency medicine. A sound understanding of principles of bioethics and a rational approach to ethical decision-making are imperative. This article addresses ethics curriculum content, educational approaches, educational resources, and resident feedback and evaluation. Ethics curriculum content should include elements suggested by the Liaison Committee on Medical Education, Accreditation Council for Graduate Medical Education, and the Model of the Clinical Practice of Emergency Medicine. Essential ethics content includes ethical principles, the physician-patient relationship, patient autonomy, clinical issues, end-of-life decisions, justice, education in emergency medicine, research ethics, and professionalism. The appropriate curriculum in ethics education in emergency medicine should include some of the content and educational approaches outlined in this article, although the optimal methods for meeting these educational goals may vary by institution. Copyright © 2011 Elsevier Inc. All rights reserved.

A Review of the Medical Education Literature for Graduate Medical Education Teachers

PubMed Central

Locke, Kenneth A.; Bates, Carol K.; Karani, Reena; Chheda, Shobhina G.

2013-01-01

Background A rapidly evolving body of literature in medical education can impact the practice of clinical educators in graduate medical education. Objective To aggregate studies published in the medical education literature in 2011 to provide teachers in general internal medicine with an overview of the current, relevant medical education literature. Review We systematically searched major medical education journals and the general clinical literature for medical education studies with sound design and relevance to the educational practice of graduate medical education teachers. We chose 12 studies, grouped into themes, using a consensus method, and critiqued these studies. Results Four themes emerged. They encompass (1) learner assessment, (2) duty hour limits and teaching in the inpatient setting, (3) innovations in teaching, and (4) learner distress. With each article we also present recommendations for how readers may use them as resources to update their clinical teaching. While we sought to identify the studies with the highest quality and greatest relevance to educators, limitation of the studies selected include their single-site and small sample nature, and the frequent lack of objective measures of outcomes. These limitations are shared with the larger body of medical education literature. Conclusions The themes and the recommendations for how to incorporate this information into clinical teaching have the potential to inform the educational practice of general internist educators as well as that of teachers in other specialties. PMID:24404262

[Current states and future aspects of graduate schools for adult graduate students: experiences of the master's course as a medical technologist].

PubMed

Obara, Takehiro; Suwabe, Akira

2012-12-01

The educational system for medical technologists (MTs) has gradually shifted from a three-year technical school system to a four-year university system. It is worthwhile for MTs to advance to a graduate school, in order to improve their routine-work skills, performances, and also to advance their own research as well as to learn how to direct younger MTs. Recently, MTs who advance to the graduate school as adult graduate students are increasing. In this article, the current states and future aspects of the graduate school of Iwate Medical University are reported. In our Department of Central Clinical Laboratory in Iwate Medical University Hospital, three of my colleagues have completed the master's course of the graduate school as adult graduate students, and three are currently attending the school. Nevertheless, none of them has advanced to the doctor's course yet. The primary reason why they do not advance is the heavy burden on any adult graduate students physically, mentally, and financially to study in the graduate school and carry out routine duties at the same time. Thus, in order to encourage MTs to go or to graduate school education, it is important to arrange systems which will enable MTs to advance to the graduate school as adult graduate students. I believe there are three key elements to make this possible. Firstly, prepare easier access to curriculums for MTs to study special fields and learn special skills. Secondly, arrange an increase in the salary scheme depending on the degree attained from the graduate school. Thirdly, provide financial support for graduate school expenses. In conclusion, it is expected that a large number of MTs will advance to the graduate school if these changes for a better educational environment are made.

Case Reports, Case Series - From Clinical Practice to Evidence-Based Medicine in Graduate Medical Education.

PubMed

Sayre, Jerry W; Toklu, Hale Z; Ye, Fan; Mazza, Joseph; Yale, Steven

2017-08-07

Case reports and case series or case study research are descriptive studies that are prepared for illustrating novel, unusual, or atypical features identified in patients in medical practice, and they potentially generate new research questions. They are empirical inquiries or investigations of a patient or a group of patients in a natural, real-world clinical setting. Case study research is a method that focuses on the contextual analysis of a number of events or conditions and their relationships. There is disagreement among physicians on the value of case studies in the medical literature, particularly for educators focused on teaching evidence-based medicine (EBM) for student learners in graduate medical education. Despite their limitations, case study research is a beneficial tool and learning experience in graduate medical education and among novice researchers. The preparation and presentation of case studies can help students and graduate medical education programs evaluate and apply the six American College of Graduate Medical Education (ACGME) competencies in the areas of medical knowledge, patient care, practice-based learning, professionalism, systems-based practice, and communication. A goal in graduate medical education should be to assist residents to expand their critical thinking, problem-solving, and decision-making skills. These attributes are required in the teaching and practice of EBM. In this aspect, case studies provide a platform for developing clinical skills and problem-based learning methods. Hence, graduate medical education programs should encourage, assist, and support residents in the publication of clinical case studies; and clinical teachers should encourage graduate students to publish case reports during their graduate medical education.

Education, Occupation and Career Expectations: Determinants of the Gender Pay Gap for UK Graduates. CEE DP 69

ERIC Educational Resources Information Center

Chevalier, Arnaud

2006-01-01

A large proportion of the gender wage gap is usually left unexplained. In this paper, we investigate whether the unexplained component is due to misspecification. Using a sample of recent UK graduates, we introduce variables on career expectations and character traits, variables that are typically not observed. The evidence indicates that women…

UK medical tourists in Thailand: they are not who you think they are

PubMed Central

2014-01-01

Background Travel for medical treatment is an aspect of globalization and health that is comparatively less understood. Little is known about volume, characteristic and motivation of medical tourists, limiting understanding of effects on health systems and patients. Thailand is amongst a handful of countries that have positioned themselves as medical tourism destination. This paper examines in unprecedented detail volume and characteristics of medical tourists who travel from the UK to Thailand for treatment. Methods As part of a wider medical tourism study, authors gained access to over 4000 patient records from the five largest private hospitals in Thailand. These included information on country of origin, gender, age, arrival month, hospitalization, diagnosis, procedures, length of stay, medical expenditure and type of payment. Patient records were analysed to understand who travels and findings were triangulated with data from the UK International Passenger Survey (IPS). Results 104,830 medical tourists visited these hospitals in Thailand in 2010. While patients originate all over the world, UK medical tourists represent the largest group amongst Europeans. The majority UK medical tourists (60%) have comparatively small, elective procedures, costing less than USD 500. A significant minority of patients travel for more serious orthopedic and cardiothoracic procedures. Data of individual patient records from Thailand shows a higher number of UK patients traveled to Thailand than indicated by the IPS. Conclusions Thailand is attracting a large number of medical tourists including larger numbers of UK patients than previously estimated. However, as many patients travel for comparatively minor procedures treatment may not be their primary motivation for travel. The small but significant proportion of older UK residents traveling for complex procedures may point to challenges within the NHS. PMID:24885204

Variation in assessment and standard setting practices across UK undergraduate medicine and the need for a benchmark.

PubMed

MacDougall, Margaret

2015-10-31

The principal aim of this study is to provide an account of variation in UK undergraduate medical assessment styles and corresponding standard setting approaches with a view to highlighting the importance of a UK national licensing exam in recognizing a common standard. Using a secure online survey system, response data were collected during the period 13 - 30 January 2014 from selected specialists in medical education assessment, who served as representatives for their respective medical schools. Assessment styles and corresponding choices of standard setting methods vary markedly across UK medical schools. While there is considerable consensus on the application of compensatory approaches, individual schools display their own nuances through use of hybrid assessment and standard setting styles, uptake of less popular standard setting techniques and divided views on norm referencing. The extent of variation in assessment and standard setting practices across UK medical schools validates the concern that there is a lack of evidence that UK medical students achieve a common standard on graduation. A national licensing exam is therefore a viable option for benchmarking the performance of all UK undergraduate medical students.

Vertically integrated medical education and the readiness for practice of graduates.

PubMed

Wijnen-Meijer, Marjo; Ten Cate, Olle; van der Schaaf, Marieke; Burgers, Chantalle; Borleffs, Jan; Harendza, Sigrid

2015-12-21

Medical curricula become more and more vertically integrated (VI) to prepare graduates better for clinical practice. VI curricula show early clinical education, integration of biomedical sciences and focus on increasing clinical responsibility levels for trainees. Results of earlier questionnaire-based studies indicate that the type of the curriculum can affect the perceived preparedness for work as perceived by students or supervisors. The aim of the present study is to determine difference in actual performance of graduates from VI and non-VI curricula. We developed and implemented an authentic performance assessment based on different facets of competence for medical near-graduates in the role of beginning residents on a very busy day. Fifty nine candidates participated: 30 VI (Utrecht, The Netherlands) and 29 non-VI (Hamburg, Germany). Two physicians, one nurse and five standardized patients independently assessed each candidate on different facets of competence. Afterwards, the physicians indicated how much supervision they estimated each candidate would require on nine so called "Entrustable Professional Activities (EPAs)" unrelated to the observed scenarios. Graduates from a VI curriculum received significantly higher scores by the physicians for the facet of competence "active professional development", with features like 'reflection' and 'asking for feedback'. In addition, VI graduates scored better on the EPA "solving a management problem", while the non-VI graduates got higher scores for the EPA "breaking bad news". This study gives an impression of the actual performance of medical graduates from VI and non-VI curricula. Even though not many differences were found, VI graduates got higher scores for features of professional development, which is important for postgraduate training and continuing education.

In Search of Coherence: A View from the Accreditation Council for Graduate Medical Education

ERIC Educational Resources Information Center

Leach, David C.

2005-01-01

The Conjoint Committee on Continuing Medical Education has developed a position paper, a set of recommendations, and next steps in the reform of continuing medical education (CME). The Accreditation Council for Graduate Medical Education (ACGME) sets standards for and accredits residency programs in graduate medical education and is not directly…

Patients of doctors further from medical school graduation have poorer outcomes.

PubMed

Norcini, John J; Boulet, John R; Opalek, Amy; Dauphinee, W Dale

2017-05-01

There is an apparent contradiction between the findings of studies indicating that patient outcomes are better when physicians have a greater volume of practice and those that find outcomes to be worse with increased time since training, which implies greater volume. This study was designed to estimate the adjusted relationships between physicians' characteristics, including recent practice volume and time since medical school graduation, and patient outcomes. This is a retrospective observational study based on all Pennsylvania hospitalisations over 7 years for acute myocardial infarction, congestive heart failure, gastrointestinal haemorrhage, hip fracture and pneumonia. It refers to 694 020 hospitalisations in 184 hospitals attended by 5280 internists and family physicians. Patient severity of illness at admission and in-hospital mortality, hospital location and volume, and the physician's recent practice volume, time since medical school graduation, board certification, and citizenship or medical school location were analysed. After adjustment, recent practice volume did not have a statistically significant association with in-hospital mortality for all of the conditions combined. By contrast, each decade since graduation from medical school was associated with a 4.5% increase in relative risk for patient mortality. Recent practice volume does not mitigate the increase in patient mortality associated with physicians' time since medical school graduation. These findings underscore the need to finds ways to support and encourage learning. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

Higher Education, Graduate Skills and the Skills of Graduates: The Case of Graduates as Residential Sales Estate Agents

ERIC Educational Resources Information Center

Tholen, Gerbrand; Relly, Susan James; Warhurst, Chris; Commander, Joanna

2016-01-01

The UK labour market is subject to significant graduatisation. Yet in the context of an over-supply of graduates, little is known about the "demand" for and "deployment" of graduate skills in previously non-graduate jobs. Moreover, there is little examination of where these skills are developed, save an assumption in higher…

Trends in Pathology Graduate Medical Education Programs and Positions, 2001 to 2017.

PubMed

Petriceks, Aldis H; Salmi, Darren

2018-01-01

The US medical workforce is facing an impending physician shortage. This shortage holds special concern for pathologists, as many senior practitioners are set to retire in the coming years. Indeed, studies indicate a "pathologist gap" may grow through 2030. As such, it is important to understand current and future trends in US pathology. One key factor is graduate medical education. In this study, we analyzed data from the Accreditation Council of Graduate Medical Education, to determine the change in pathology graduate medical education programs and positions, from 2001 to 2017. We found that pathology programs and positions have increased since the 2001 to 2002 academic year, even after adjusting for population growth. However, this increase is much lower than that of total graduate medical education. Furthermore, many pathology subspecialties have declined in population-adjusted levels. Other subspecialties, such as selective pathology, have grown disproportionately. Our findings may be valuable for understanding the state of US pathology, now and in the future. They imply that more resources-or technological innovations-may be needed for specific pathology programs, in hopes of closing the pathologist gap for both this specialty and its subspecialties.

Increasing the graduation rates of minority medical students.

PubMed

Payne, J L; Nowacki, C M; Girotti, J A; Townsel, J; Plagge, J C; Beckham, T W

1986-05-01

The University of Illinois College of Medicine has operated a program since 1969 to recruit minority students into the college and to increase the graduation rates of these students once they enroll. Known as the Medical Opportunities Program (MOP) until 1978, the program was expanded in 1978 and renamed the Urban Health Program (UHP). The authors of the present paper discuss the results of these programs, particularly the effect of granting minority students delays in completing graduation requirements. The MOP (1969 through 1978) increased graduation rates for minority students from 55 percent for those who graduated on time to 81 percent for both on-time and delayed graduates. Under the first seven years of the UHP (1979 through 1985), more minority students have been offered places, and more have enrolled than in the 10 years of the MOP. The retention rate under the UHP, if it holds, will be higher than that under the MOP. For the combined MOP-UHP period, the retention rate for minority students was 88 percent; 69.8 percent of the graduates were on time, and 30.2 were delayed.

International Medical Graduates. Immigration Law and Policy and the U.S. Physician Workforce. Council on Graduate Medical Education Resource Paper. A COGME Panel Discussion (Washington, DC, March 12, 1996).

ERIC Educational Resources Information Center

Health Resources and Services Administration (DHHS/PHS), Rockville, MD. Bureau of Health Professions.

This report includes presentations and discussions by the Council on Graduate Medical Education (COGME) addressing issues related to the current supply of physicians in the United States and the role of international medical graduates (IMGs). The presentations focused on the following areas: the exchange visitor program and the use of waivers, the…

Military medical graduates' perceptions of organizational culture in Turkish military medical school.

PubMed

Ozer, Mustafa; Bakir, Bilal; Teke, Abdulkadir; Ucar, Muharrem; Bas, Turker; Atac, Adnan

2008-08-01

Organizational culture is the term used to describe the shared beliefs, perceptions, and expectations of individuals in organizations. In the healthcare environment, organizational culture has been associated with several elements of organizational experience that contribute to quality, such as nursing care, job satisfaction, and patient safety. A range of tools have been designed to measure organizational culture and applied in industrial, educational, and health care settings. This study has been conducted to investigate the perceptions of military medical graduates on organizational culture at Gülhane Military Medical School. A measurement of organizational culture, which was developed by the researchers from Akdeniz University, was applied to all military medical graduates in 2004. This was a Likert type scale that included 31 items. Designers of the measurement grouped all these items into five main dimensions in their previous study. The items were scored on a five-point scale anchored by 1: strongly agree and 5: strongly disagree. Study participants included all military physicians who were in clerkship training period at Gulhane Military Medical Academy in 2004. A total of 106 graduates were accepted to response the questionnaire. The mean age of participants was 25.2 +/- 1.1. At the time of study only 8 (7.5%) graduates were married. The study results have showed that the measurement tool with 31 items had a sufficient reliability with a Cronbach's alpha value of 0.91. Factor analysis has resulted a final measurement tool of 24 items with five factors. Total score and the scores of five subdimensions have been estimated and compared between groups based on living city and marital status. The study has shown the dimension of symbol received positive perceptions while the dimension of organizational structure and efficiency received the most negative perceptions. GMMS has a unique organizational culture with its weak and strong aspects. Conducting this kind

A Survey of Medical Technology Graduates of Illinois State University: 1972-1979.

ERIC Educational Resources Information Center

Spencer, Charles T.

A sample of 170 graduates of the medical technology program at Illinois State University was surveyed to investigate their educational background and their employment history. A total of 228 questionnaires were mailed to all graduates from 1972 through 1979. The demographic data of the ratio of females to males in the field of medical technology…

Performance of women medical graduates from Medical College, Baroda, 1949--74.

PubMed

Bhatt, R V; Soni, J M; Patel, N F

1976-07-01

Women account for 15% of the total admissions in medicine. 271 women have graduated from Medical College, Baroda in 25 years. The examination results are better in women than in men. Obstetrics and gynaecology is the most common speciality selected by women. Job satisfaction is found in 87% of women. Unmarried women account for 15%, 66% have married a doctor and 19% are married to non-medical spouse. Emigration is to the extent of 39%.

Medication calculation skills of graduating nursing students in Finland.

PubMed

Grandell-Niemi, H; Hupli, M; Leino-Kilpi, H

2001-01-01

The aim of this study was to describe the basic mathematical proficiency and the medication calculation skills of graduating nursing students in Finland. A further concern was with how students experienced the teaching of medication calculation. We wanted to find out whether these experiences were associated with various background factors and the students' medication calculation skills. In spring 1997 the population of graduating nursing students in Finland numbered around 1280; the figure for the whole year was 2640. A convenience sample of 204 students completed a questionnaire specially developed for this study. The instrument included structured questions, statements and a medication calculation test. The response rate was 88%. Data analysis was based on descriptive statistics. The students found it hard to learn mathematics and medication calculation skills. Those who evaluated their mathematical and medication calculation skills as sufficient successfully solved the problems included in the questionnaire. It was felt that the introductory course on medication calculation was uninteresting and poorly organised. Overall the students' mathematical skills were inadequate. One-fifth of the students failed to pass the medication calculation test. A positive correlation was shown between the student's grade in mathematics (Sixth Form College) and her skills in medication calculation.

Graduate Returns, Degree Class Premia and Higher Education Expansion in the UK. CEP Discussion Paper No. 1392

ERIC Educational Resources Information Center

Naylor, Robin; Smith, Jeremy; Telhaj, Shqiponja

2015-01-01

We investigate the extent to which graduate returns vary according to the class of degree achieved by UK university students and examine changes over time in estimated degree class premia. Using a variety of complementary datasets for individuals born in Britain around 1970 and aged between 30 and 40, we estimate an hourly wage premium for a…

Exit competencies in pathology and laboratory medicine for graduating medical students: the Canadian approach.

PubMed

Ford, Jason; Pambrun, Chantale

2015-05-01

Physicians in every medical and surgical field must be able to use pathology concepts and skills in their practice: for example, they must order and interpret the correct laboratory tests, they must use their understanding of pathogenesis to diagnose and treat, and they must work with the laboratory to care for their patients. These important concepts and skills may be ignored by medical schools and even national/international organizations setting graduation expectations for medical students. There is an evolving international consensus about the importance of exit competencies for medical school graduates, which define the measurable or observable behaviors each graduate must be able to demonstrate. The Canadian Association of Pathologists (CAP) Education Group set out to establish the basic competencies in pathology and laboratory medicine which should be expected of every medical graduate: not competencies for pathologists, but for medical graduates who intend to enter any residency program. We defined 4 targets for pathology and laboratory medicine exit competencies: that they represent only measurable behaviors, that they be clinically focused, that they be generalizable to every medical graduate, and that the final competency document be user-friendly. A set of competencies was developed iteratively and underwent final revision at the 2012 CAP annual meeting. These competencies were subsequently endorsed by the CAP executive and the Canadian Leadership Council on Laboratory Medicine. This clinically focused consensus document provides the first comprehensive list of exit competencies in pathology and laboratory medicine for undergraduate medical education. Copyright © 2015 Elsevier Inc. All rights reserved.

Politics and Graduate Medical Education in Internal Medicine: A Dynamic Landscape.

PubMed

Wardrop, Richard M; Berkowitz, Lee R

2017-02-01

The promotion of change and growth within medical education is oftentimes the result of a complex mix of societal, cultural and economic forces. Graduate medical education in internal medicine is not immune to these forces. Several entities and organizations can be identified as having a major influence on internal medicine training and graduate medical education as a whole. We have reviewed how this is effectively accomplished through these entities and organizations. The result is a constantly changing and dynamic landscape for internal medicine training. Copyright © 2017 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

A new model to understand the career choice and practice location decisions of medical graduates.

PubMed

Stagg, P; Greenhill, J; Worley, P S

2009-01-01

Australian medical education is increasingly influenced by rural workforce policy. Therefore, understanding the influences on medical graduates' practice location and specialty choice is crucial for medical educators and medical workforce planners. The South Australian Flinders University Parallel Rural Community Curriculum (PRCC) was funded by the Australian Government to help address the rural doctor workforce shortage. The PRCC was the first community based medical education program in Australia to teach a full academic year of medicine in South Australian rural general practices. The aim of this research was to identify what factors influence the career choices of PRCC graduates. A retrospective survey of all contactable graduates of the PRCC was undertaken. Quantitative data were analysed using SPSS 14.0 for Windows. Qualitative data were entered into NVIVO 7 software for coding, and analysed using content analysis. Usable data were collected from 46 of the 86 contactable graduates (53%). More than half of the respondents (54%) reported being on a rural career path. A significant relationship exists between being on a rural career pathway and making the decision prior to or during medical school (p = 0.027), and between graduates in vocational training who are on an urban career path and making a decision on career specialty after graduation from medical school (p = .004). Graduates in a general practice vocational training program are more likely to be on a rural career pathway than graduates in a specialty other than general practice (p = .003). A key influence on graduates' practice location is geographic location prior to entering medical school. Key influences on graduates choosing a rural career pathway are: having a spouse/partner with a rural background; clinical teachers and mentors; the extended rural based undergraduate learning experience; and a specialty preference for general practice. A lack of rural based internships and specialist training

Medical student satisfaction, coping and burnout in direct-entry versus graduate-entry programmes.

PubMed

DeWitt, Dawn; Canny, Benedict J; Nitzberg, Michael; Choudri, Jennifer; Porter, Sarah

2016-06-01

There is ongoing debate regarding the optimal length of medical training, with concern about the cost of prolonged training. Two simultaneous tracks currently exist in Australia: direct entry from high school and graduate entry for students with a bachelor degree. Medical schools are switching to graduate entry based on maturity, academic preparedness and career-choice surety. We tested the assumption that graduate entry is better by exploring student preferences, coping, burnout, empathy and alcohol use. From a potential pool of 2188 participants, enrolled at five Australian medical schools, a convenience sample of 688 (31%) first and second year students completed a survey in the middle of the academic year. Participants answered questions about demographics, satisfaction and coping and completed three validated instruments. Over 90% of students preferred their own entry-type, though more graduate-entry students were satisfied with their programme (82.4% versus 65.3%, p < 0.001). There was no difference between graduate-entry and direct-entry students in self-reported coping or in the proportion of students meeting criteria for burnout (50.7% versus 51.2%). Direct-entry students rated significantly higher for empathy (concern, p = 0.022; personal distress, p = 0.031). Graduate-entry students reported significantly more alcohol use and hazardous drinking (30.0% versus 22.8%; p = 0.017). Our multi-institution data confirm that students are generally satisfied with their choice of entry pathway and do not confirm significant psychosocial benefits of graduate entry. Overall, our data suggest that direct-entry students cope with the workload and psychosocial challenges of medical school, in the first 2 years, as well as graduate-entry students. Burnout and alcohol use should be addressed in both pathways. Despite studies showing similar academic outcomes, and higher total costs, more programmes in Australia are becoming graduate entry. Further research on

The Attainment of Ethnic Minority Students in UK Higher Education

ERIC Educational Resources Information Center

Richardson, John T. E.

2008-01-01

Recent studies have suggested that academic attainment by ethnic minority graduates at UK institutions of higher education is lower than that by White graduates. This was confirmed using a database of all UK-domiciled graduates from UK higher education institutions in 2004-05. The trend was greater in older students than in younger students, in…

Variation in assessment and standard setting practices across UK undergraduate medicine and the need for a benchmark

PubMed Central

2015-01-01

Objectives The principal aim of this study is to provide an account of variation in UK undergraduate medical assessment styles and corresponding standard setting approaches with a view to highlighting the importance of a UK national licensing exam in recognizing a common standard. Methods Using a secure online survey system, response data were collected during the period 13 - 30 January 2014 from selected specialists in medical education assessment, who served as representatives for their respective medical schools. Results Assessment styles and corresponding choices of standard setting methods vary markedly across UK medical schools. While there is considerable consensus on the application of compensatory approaches, individual schools display their own nuances through use of hybrid assessment and standard setting styles, uptake of less popular standard setting techniques and divided views on norm referencing. Conclusions The extent of variation in assessment and standard setting practices across UK medical schools validates the concern that there is a lack of evidence that UK medical students achieve a common standard on graduation. A national licensing exam is therefore a viable option for benchmarking the performance of all UK undergraduate medical students. PMID:26520472

Restricted career paths for overseas students graduating from Australian medical schools: legal and policy considerations.

PubMed

Elkin, Katie J; Studdert, David M

2010-05-03

A sharp increase in the number of students graduating from Australian medical schools over the next few years looks set to outpace available intern positions. Graduating overseas students will be the first to miss out. While this treatment of overseas students is unlikely to be found unlawful, questions of fairness remain. From a policy standpoint, the bottleneck in intern places could be quite damaging as: it encourages Australian-trained medical graduates with high-quality training and culturally-relevant skills to leave; and it extinguishes a valuable opportunity to steer some of these graduates into geographical areas with the greatest medical workforce needs.

Definition of "Rural" Determines the Placement Outcomes of a Rural Medical Education Program: Analysis of Jichi Medical University Graduates

ERIC Educational Resources Information Center

Matsumoto, Masatoshi; Inoue, Kazuo; Kajii, Eiji

2010-01-01

Purpose: To show the impact of changing the definition of what is "rural" on the outcomes of a rural medical education program. Methods: A cross-sectional sample of 643 graduates under obligatory rural service and 1,699 graduates after serving their obligation, all from Jichi Medical University (JMU), a binding rural education program in…

Brain Drain: Post Graduation Migration Intentions and the influencing factors among Medical Graduates from Lahore, Pakistan.

PubMed

Imran, Nazish; Azeem, Zahra; Haider, Imran I; Amjad, Naeem; Bhatti, Muhammad R

2011-10-17

The increasing migration of health professionals to affluent countries is not a recent phenomenon and has been addressed in literature. However the various facets of physician migration from Pakistan, the third leading source of International medical graduates has not been rigorously evaluated. The objective of the current study was to survey final year students and recent medical graduates in Lahore, Pakistan about their intentions to train abroad, their post training plans as well as to identify the factors responsible for their motivation for international migration. A self administered structured questionnaire was developed to collect respondents' demographic and educational characteristics, intention to train abroad, their preferred destination & post training intentions of returning to Pakistan. Various influencing factors which impact on medical graduate's motivation to train abroad or stay in Pakistan were explored using a 10 point scale. SPSS software was used for data entry and analysis. Of the 400 eligible respondents, 275 responded (response rate 68.7%). One hundred and sixty six respondents (60.4%) intended to train abroad either for a specialty (54.9%) or a subspecialty (5.5%) The United States and United Kingdom were the most preferred destination. While 14.2% intended to return to Pakistan immediately after training, a significant percentage (10%) never intended to return to Pakistan or wished to stay abroad temporarily (37%). Professional excellence and establishing quickly in the competitive market were the most important goal to be achieved by the respondents for intention for postgraduate training abroad. The most common reasons cited for training abroad were the impact of residency training on future career (mean score 8.20 ± 2.3), financial conditions of doctors (mean score 7.97 ± 2.37) and job opportunities (mean score7.90 ± 2.34). An alarming percentage of medical graduates from Lahore, Pakistan intend to migrate for post graduate

Brain Drain: Post Graduation Migration Intentions and the influencing factors among Medical Graduates from Lahore, Pakistan

PubMed Central

2011-01-01

Background The increasing migration of health professionals to affluent countries is not a recent phenomenon and has been addressed in literature. However the various facets of physician migration from Pakistan, the third leading source of International medical graduates has not been rigorously evaluated. The objective of the current study was to survey final year students and recent medical graduates in Lahore, Pakistan about their intentions to train abroad, their post training plans as well as to identify the factors responsible for their motivation for international migration. Method A self administered structured questionnaire was developed to collect respondents' demographic and educational characteristics, intention to train abroad, their preferred destination & post training intentions of returning to Pakistan. Various influencing factors which impact on medical graduate's motivation to train abroad or stay in Pakistan were explored using a 10 point scale. SPSS software was used for data entry and analysis. Results Of the 400 eligible respondents, 275 responded (response rate 68.7%). One hundred and sixty six respondents (60.4%) intended to train abroad either for a specialty (54.9%) or a subspecialty (5.5%) The United States and United Kingdom were the most preferred destination. While 14.2% intended to return to Pakistan immediately after training, a significant percentage (10%) never intended to return to Pakistan or wished to stay abroad temporarily (37%). Professional excellence and establishing quickly in the competitive market were the most important goal to be achieved by the respondents for intention for postgraduate training abroad. The most common reasons cited for training abroad were the impact of residency training on future career (mean score 8.20 ± 2.3), financial conditions of doctors (mean score 7.97 ± 2.37) and job opportunities (mean score7.90 ± 2.34). Conclusion An alarming percentage of medical graduates from Lahore, Pakistan intend

Can we predict 4-year graduation in podiatric medical school using admission data?

PubMed

Sesodia, Sanjay; Molnar, David; Shaw, Graham P

2012-01-01

This study examined the predictive ability of educational background and demographic variables, available at the admission stage, to identify applicants who will graduate in 4 years from podiatric medical school. A logistic regression model was used to identify two predictors of 4-year graduation: age at matriculation and total Medical College Admission Test score. The model was cross-validated using a second independent sample from the same population. Cross-validation gives greater confidence that the results could be more generally applied. Total Medical College Admission Test score was the strongest predictor of 4-year graduation, with age at matriculation being a statistically significant but weaker predictor. Despite the model's capacity to predict 4-year graduation better than random assignment, a sufficient amount of error in prediction remained, suggesting that important predictors are missing from the model. Furthermore, the high rate of false-positives makes it inappropriate to use age and Medical College Admission Test score as admission screens in an attempt to eliminate attrition by not accepting at-risk students.

Non-Medical Prescription Stimulant Use in Graduate Students: Relationship With Academic Self-Efficacy and Psychological Variables.

PubMed

Verdi, Genevieve; Weyandt, Lisa L; Zavras, Brynheld Martinez

2016-09-01

The objective of this study was to examine graduate students' non-medical use of prescription stimulant medication, and the relationship between non-medical use of prescription stimulants with academic self-efficacy, psychological factors (i.e., anxiety, depression, and stress), and internal restlessness. The sample consisted of 807 graduate students from universities located in five geographic regions of the United States. Past-year rates of self-reported non-medical use were determined to be 5.9%, with overall lifetime prevalence of 17.5%. Observed self-reported non-medical use of prescription stimulant medications was significantly correlated with self-reported levels of anxiety and stress, various aspects of internal restlessness, and perceived safety of the medications. Findings support graduate students' motivations of non-medical prescription stimulant use to be both academic and social in nature. Effective prevention and education efforts are needed to help address the non-medical use of prescription stimulants by graduate students on university campuses. © The Author(s) 2014.

Early-career work location of Memorial University medical graduates: Why the decline in rural practice?

PubMed

Mathews, Maria; Ryan, Dana; Samarasena, Asoka

2017-01-01

In a previous study, we found a decline in the proportion of Memorial University of Newfoundland (MUN) medical alumni practising in rural areas, particularly in Newfoundland and Labrador. The current study focused on the work location of recent graduates and examined the predictors of working in rural Canada and in rural Newfoundland and Labrador within the first 15 years following graduation. We linked data from graduating class lists and the alumni and postgraduate databases with Scott's Medical Database to create a record of all graduates from 1973 to 2008, including their work location. We identified differences and significant predictors for each outcome and then described and compared the characteristics of 4 cohorts of graduating classes. In their early career, 127/1113 (11.4%) MUN medical graduates were working in rural Canada, and 57 (5.1%) were working in rural Newfoundland and Labrador. Having a rural background and being a family physician were predictors of working in rural Canada, and having a rural background, doing at least part of the residency at MUN, being from Newfoundland and Labrador and being a family physician were predictors of working in rural Newfoundland and Labrador. Seventy-four (13.6%) and 33 (6.1%) of 1989-1998 graduates worked in rural Canada and rural Newfoundland and Labrador, respectively, compared to 53 (9.3%) and 24 (4.2%), respectively, of 1999-2008 graduates. The proportion of MUN medical graduates who worked in rural communities early in their career decreased among recent cohorts. The results show the impact of changes in the characteristics of MUN medical graduates, who increasingly opt for specialist practice and residency training outside the province, and the important role of local postgraduate training.

Predicting medical students' intentions to take up rural practice after graduation.

PubMed

Jones, Michael; Humphreys, John; Prideaux, David

2009-10-01

Using a novel longitudinal tracking project, this study develops and evaluates the performance of a predictive model and index of rural medical practice intention based on the characteristics of incoming medical students. Medical school entry survey data were obtained from the Medical Schools Outcome Database (MSOD) project implemented in all Australian and New Zealand medical schools and coordinated through Medical Deans Australia and New Zealand, the representative body for the Deans of 18 Australian and two New Zealand medical schools and faculties. The medical school commencement survey collects data on students' education and family background, including rural upbringing, personal circumstances and scholarships, and on their practice intentions in terms of location and specialty. The MSOD will also allow tracking of medical graduates after graduation. Logistic regression modelling was used to develop a predictive model of rural practice intention. Split-sample validation was used to gain some insight into the stability of performance of the model. Response rates to the MSOD survey exceeded 90% on average. The model findings confirm and extend previous research examining the association of medical student characteristics with intention to take up rural medical practice. The statistically significant independent factors in the model included students' rural backgrounds, financial arrangements and intentions regarding specialist versus generalist practice upon graduation. Model performance was good, with an area under the receiver-operator characteristics curve of 0.86, and reproducible, with an area in a validation sample of 0.83. The model and related index provide important insights into individual factors associated with rural practice intention among students commencing medical studies. The model can also provide a means for optimising the use of scarce medical programme resources, thereby helping to improve the supply of rural medical practitioners. This

Financing graduate medical education to meet the needs of children and the future pediatrician workforce.

PubMed

Shipman, Scott A; Pan, Richard J D

2008-04-01

This policy statement articulates the positions of the American Academy of Pediatrics on graduate medical education and the associated costs and funding mechanisms. It reaffirms the policy of the American Academy of Pediatrics that graduate medical education is a public good and is an essential part of maintaining a high-quality physician workforce. The American Academy of Pediatrics advocates for lifelong learning across the continuum of medical education. This policy statement focuses on the financing of one component of this continuum, namely residency education. The statement calls on federal and state governments to continue their support of residency education and advocates for stable means of funding such as the establishment of an all-payer graduate medical education trust fund. It further proposes a portable authorization system that would allocate graduate medical education funds for direct medical education costs to accredited residency programs on the basis of the selection of the program by qualified student or residents. This system allows the funding to follow the residents to their program. Recognizing the critical workforce needs of many pediatric medical subspecialties, pediatric surgical specialties, and other pediatric specialty disciplines, this statement maintains that subspecialty fellowship training and general pediatrics research fellowship training should receive adequate support from the graduate medical education financing system, including funding from the National Institutes of Health and other federal agencies, as appropriate. Furthermore, residency education that is provided in freestanding children's hospitals should receive a level of support equivalent to that of other teaching hospitals. The financing of graduate medical education is an important and effective tool to ensure that the future pediatrician workforce can provide optimal heath care for infants, children, adolescents, and young adults.

The impact of socially-accountable, community-engaged medical education on graduates in the Central Philippines: Implications for the global rural medical workforce.

PubMed

Siega-Sur, J L; Woolley, T; Ross, S J; Reeve, C; Neusy, A-J

2017-10-01

Developing and retaining a high quality medical workforce, especially within low-resource countries has been a world-wide challenge exacerbated by a lack of medical schools, the maldistribution of doctors towards urban practice, health system inequities, and training doctors in tertiary centers rather than in rural communities. To describe the impact of socially-accountable health professional education on graduates; specifically: their motivation towards community-based service, preparation for addressing local priority health issues, career choices, and practice location. Cross-sectional survey of graduates from two medical schools in the Philippines: the University of Manila-School of Health Sciences (SHS-Palo) and a medical school with a more conventional curriculum. SHS-Palo graduates had significantly (p < 0.05) more positive attitudes to community service. SHS-Palo graduates were also more likely to work in rural and remote areas (p < 0.001) either at district or provincial hospitals (p = 0.032) or in rural government health services (p < 0.001) as Municipal or Public Health Officers (p < 0.001). Graduates also stayed longer in both their first medical position (p = 0.028) and their current position (p < 0.001). SHS-Palo medical graduates fulfilled a key aim of their socially-accountable institution to develop a health professional workforce willing and able, and have a commitment to work in underserved rural communties.

Medicare Financing of Graduate Medical Education

PubMed Central

Rich, Eugene C; Liebow, Mark; Srinivasan, Malathi; Parish, David; Wolliscroft, James O; Fein, Oliver; Blaser, Robert

2002-01-01

The past decade has seen ongoing debate regarding federal support of graduate medical education, with numerous proposals for reform. Several critical problems with the current mechanism are evident on reviewing graduate medical education (GME) funding issues from the perspectives of key stakeholders. These problems include the following: substantial interinstitutional and interspecialty variations in per-resident payment amounts; teaching costs that have not been recalibrated since 1983; no consistent control by physician educators over direct medical education (DME) funds; and institutional DME payments unrelated to actual expenditures for resident education or to program outcomes. None of the current GME reform proposals adequately address all of these issues. Accordingly, we recommend several fundamental changes in Medicare GME support. We propose a re-analysis of the true direct costs of resident training (with appropriate adjustment for local market factors) to rectify the myriad problems with per-resident payments. We propose that Medicare DME funds go to the physician organization providing resident instruction, keeping DME payments separate from the operating revenues of teaching hospitals. To ensure financial accountability, we propose that institutions must maintain budgets and report expenditures for each GME program. To establish educational accountability, Residency Review Committees should establish objective, annually measurable standards for GME program performance; programs that consistently fail to meet these minimum standards should lose discretion over GME funds. These reforms will solve several long-standing, vexing problems in Medicare GME funding, but will also uncover the extent of undersupport of GME by most other health care payers. Ultimately, successful reform of GME financing will require “all-payer” support. PMID:11972725

"Exit exams" for medical graduates: a guarantee of quality?

PubMed

Dehury, Ranjit Kumar; Samal, Janmejaya

2017-01-01

Despite a great deal of opposition from many segments of the medical community, the Medical Council of India (MCI) has proposed to the Ministry of Health and Family Welfare, Government of India that a pan-India exit examination be introduced for graduating MBBS doctors. Whether the proposal should be put forward was considered twice, once in 2010 and again in 2013, and finally the plan was ready to be taken forward seriously in 2015. The proposal has elicited appreciation and criticism from different segments of the medical community. It aims to improve the quality of medical professionals and create an all-India chapter of doctors. People are ready to welcome the move if it is integrated with the final year MBBS examination and licentiate examination and serves as an entrance examination for medical graduates. Further, the Supreme Court's order that the National Eligibility and Entrance Test (NEET) be made compulsory aims to create a fair, transparent and non-exploitative system. This move has the potential to reduce corruption and foster a merit-based system of medical education. However, making NEET compulsory would have an impact on the proposed exit examination. Given this background, we analyse the pros and cons of the new initiative on the basis of articles published in newspapers and journals, with a special focus on its impact on improving the standards of quality in the medical profession.

Fifth pathway in New Jersey. House officer preparatory course for US foreign medical graduates.

PubMed

McGrough, W E

1975-06-09

The Fifth Channel in New Jersey is a Fifth Pathway program for US foreign medical graduates. In its third year, 83 percent of its 81 graduates are house officers at 18 US medical school-affiliated hospitals. Performance as house officers is characterized as competitive with peers, including US graduates. Positive attitudes toward work load, fellow workers, and patients compared with those of fellow house staff are noted. Quality of performance as house officers correlates most strongly with the change in mean scores of two batteries of clinical National Board examinations taken during the Fifth Pathway and less strongly with mean scores of single batteries of National Boards, Intelligence quotient, Educational Council for Foreign Medical Graduates (ECFMG) examination, ang age. Recommendations concerning the implementing of similar programs in other states are presented.

Predicting In-State Workforce Retention After Graduate Medical Education Training.

PubMed

Koehler, Tracy J; Goodfellow, Jaclyn; Davis, Alan T; Spybrook, Jessaca; vanSchagen, John E; Schuh, Lori

2017-02-01

There is a paucity of literature when it comes to identifying predictors of in-state retention of graduate medical education (GME) graduates, such as the demographic and educational characteristics of these physicians. The purpose was to use demographic and educational predictors to identify graduates from a single Michigan GME sponsoring institution, who are also likely to practice medicine in Michigan post-GME training. We included all residents and fellows who graduated between 2000 and 2014 from 1 of 18 GME programs at a Michigan-based sponsoring institution. Predictor variables identified by logistic regression with cross-validation were used to create a scoring tool to determine the likelihood of a GME graduate to practice medicine in the same state post-GME training. A 6-variable model, which included 714 observations, was identified. The predictor variables were birth state, program type (primary care versus non-primary care), undergraduate degree location, medical school location, state in which GME training was completed, and marital status. The positive likelihood ratio (+LR) for the scoring tool was 5.31, while the negative likelihood ratio (-LR) was 0.46, with an accuracy of 74%. The +LR indicates that the scoring tool was useful in predicting whether graduates who trained in a Michigan-based GME sponsoring institution were likely to practice medicine in Michigan following training. Other institutions could use these techniques to identify key information that could help pinpoint matriculating residents/fellows likely to practice medicine within the state in which they completed their training.

America's medical school: 5,000 graduates since the "first class".

PubMed

Artino, Anthony R; Gilliland, William R; Cruess, David F; Durning, Steven J

2015-04-01

In 1980, the Uniformed Services University of the Health Sciences (USU) graduated its first class of medical students. As a national university intended to produce "career-committed" military officers and future leaders of the Military Health System, USU functions as the service academy for military medicine and public health. More than 40 years after the school's charter and 5,000 graduates since the first class, we describe the original purpose of USU and provide an update on its achievements. In particular, we address the question of the "staying power" of the University's alumni-the degree to which graduation from the nation's military medical school is associated with long years of devoted service to military medicine. At a time when the MHS is confronting the challenge of extended deployments, rising health care costs, and a growing array of threats to our nation's health, we suggest that America needs USU now more than ever. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

Student career choice in psychiatry: findings from 18 UK medical schools.

PubMed

Halder, Neel; Hadjidemetriou, Christiana; Pearson, Rachel; Farooq, Kitty; Lydall, Gregory J; Malik, Amit; Bhugra, Dinesh

2013-08-01

Psychiatry recruitment continues to be a problem in the UK and large-scale studies are required to understand the factors surrounding this. A quantitative, cross-sectional online survey, incorporating demographics, career choices, teaching exposure, attitudes to psychiatry and personality factors, was administered to final-year UK medical students. A total of 484 students from 18 medical schools responded (66% women). Sixteen (16%) had chosen psychiatry at medical school entry. By final year, 15 respondents (3%) had decided to pursue a career in psychiatry, while another 78 (17%) were seriously considering it. There was little difference in the quality ratings of lectures and small group teaching between those interested in psychiatry and those not. Experience of 'enrichment activities' (psychiatry special study modules or components, psychiatric research, university psychiatry clubs, and psychiatry electives) were significantly more likely to take up psychiatry. Causality cannot, however, be determined in this study. The study identified several distinct groups of UK students: those deciding on psychiatry before medical school and maintaining that career choice, those deciding on psychiatry during medical school, and those interested in other fields. Addressing psychiatry teaching and exposure may improve recruitment into the speciality.

Burns teaching in UK medical schools: Is it enough?

PubMed

Zinchenko, Ruslan; Perry, Fiona M; Dheansa, Baljit S

2016-02-01

Burns are frequently seen and managed in non-specialist settings. The crowding of the UK medical undergraduate curriculum may have resulted in the reduction of teaching on burns. To determine the burns education experience and the level of competence among UK final year medical students in assessing and acutely managing patients with burns. An online questionnaire was circulated among UK final year medical students. There was a total of 348 respondents. The majority of the respondents (70%) have not received any specific teaching on how to manage patients with burns. Nearly two-thirds of the students (66%) have never seen a patient being managed for burns throughout their training. Over 90% of respondents stated that they would not feel confident in initially managing a burn in the emergency department. The majority of the respondents (57%) have not heard of the criteria for referring a burns patient for further specialist management. There was almost universal agreement about the importance of knowing how to manage a burn initially. There seems to be a lack of consistent undergraduate training in burns management and final year students lack the experience and knowledge to initially manage burns. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Definition of "rural" determines the placement outcomes of a rural medical education program: analysis of Jichi Medical University graduates.

PubMed

Matsumoto, Masatoshi; Inoue, Kazuo; Kajii, Eiji

2010-01-01

To show the impact of changing the definition of what is "rural" on the outcomes of a rural medical education program. A cross-sectional sample of 643 graduates under obligatory rural service and 1,699 graduates after serving their obligation, all from Jichi Medical University (JMU), a binding rural education program in Japan, were used as the data source. Communities were divided into decile groups according to population density, and the cut-off for "rural/nonrural" was altered in order to study its impact on the data. The rural practice rate of obliged graduates had its peak in the decile groups with the lowest population densities, while the peak rates of postobligation graduates and non-JMU physicians were at the decile groups with the highest population densities. Rural practice rates of all of the 3 groups of physicians increased with the increase in inclusiveness of rural definition. The ratio of rural practice rate of obliged graduates to that of non-JMU physicians ("relative effectiveness") increased remarkably with the increase in exclusiveness of rural definition. The relative effectiveness of postobligation graduates did not substantially increase after the cut-off exceeded a certain point of exclusiveness. Definition of "rural" largely determined the rural practice rate and relative effectiveness of JMU graduates. The results suggest that results of past outcome studies of rural medical education programs are potentially biased depending on how rural is defined.

Entrustable Professional Activities for Pathology: Recommendations From the College of American Pathologists Graduate Medical Education Committee.

PubMed

McCloskey, Cindy B; Domen, Ronald E; Conran, Richard M; Hoffman, Robert D; Post, Miriam D; Brissette, Mark D; Gratzinger, Dita A; Raciti, Patricia M; Cohen, David A; Roberts, Cory A; Rojiani, Amyn M; Kong, Christina S; Peterson, Jo Elle G; Johnson, Kristen; Plath, Sue; Powell, Suzanne Zein-Eldin

2017-01-01

Competency-based medical education has evolved over the past decades to include the Accreditation Council for Graduate Medical Education Accreditation System of resident evaluation based on the Milestones project. Entrustable professional activities represent another means to determine learner proficiency and evaluate educational outcomes in the workplace and training environment. The objective of this project was to develop entrustable professional activities for pathology graduate medical education encompassing primary anatomic and clinical pathology residency training. The Graduate Medical Education Committee of the College of American Pathologists met over the course of 2 years to identify and define entrustable professional activities for pathology graduate medical education. Nineteen entrustable professional activities were developed, including 7 for anatomic pathology, 4 for clinical pathology, and 8 that apply to both disciplines with 5 of these concerning laboratory management. The content defined for each entrustable professional activity includes the entrustable professional activity title, a description of the knowledge and skills required for competent performance, mapping to relevant Accreditation Council for Graduate Medical Education Milestone subcompetencies, and general assessment methods. Many critical activities that define the practice of pathology fit well within the entrustable professional activity model. The entrustable professional activities outlined by the Graduate Medical Education Committee are meant to provide an initial framework for the development of entrustable professional activity-related assessment and curricular tools for pathology residency training.

Exploring the influence of workplace supports and relationships on safe medication practice: A pilot study of Australian graduate nurses.

PubMed

Sahay, Ashlyn; Hutchinson, Marie; East, Leah

2015-05-01

Despite the growing awareness of the benefits of positive workplace climates, unsupportive and disruptive workplace behaviours are widespread in health care organisations. Recent graduate nurses, who are often new to a workplace, are particularly vulnerable in unsupportive climates, and are also recognised to be at higher risk for medication errors. Investigate the association between workplace supports and relationships and safe medication practice among graduate nurses. Exploratory study using quantitative survey with a convenience sample of 58 nursing graduates in two Australian States. Online survey focused on graduates' self-reported medication errors, safe medication practice and the nature of workplace supports and relationships. Spearman's correlations identified that unsupportive workplace relationships were inversely related to graduate nurse medication errors and erosion of safe medication practices, while supportive Nurse Unit Manager and supportive work team relationships positively influenced safe medication practice among graduates. Workplace supports and relationships are potentially both the cause and solution to graduate nurse medication errors and safe medication practices. The findings develop further understanding about the impact of unsupportive and disruptive behaviours on patient safety and draw attention to the importance of undergraduate and continuing education strategies that promote positive workplace behaviours and graduate resilience. Copyright © 2015 Elsevier Ltd. All rights reserved.

Improving the Return on Investment of Graduate Medical Education in North Carolina.

PubMed

Newton, Warren; Wouk, Noah; Spero, Julie C

2016-01-01

The National Academy of Medicine has called for fundamental reform in the governance and accountability of graduate medical education, but how to implement this change is unclear. We describe the North Carolina graduate medical education system, and we propose tracking outcomes and aligning residency stipends with outcomes such as specialty choice, practice in North Carolina, and acceptance of new Medicaid and Medicare patients. ©2016 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.

Research Ethics Education in Post-Graduate Medical Curricula in I.R. Iran.

PubMed

Nikravanfard, Nazila; Khorasanizadeh, Faezeh; Zendehdel, Kazem

2017-08-01

Research ethics training during post-graduate education is necessary to improve ethical standards in the design and conduct of biomedical research. We studied quality and quantity of research ethics training in the curricula of post-graduate programs in the medical science in I.R. Iran. We evaluated curricula of 125 post-graduate programs in medical sciences in I.R. Iran. We qualitatively studied the curricula by education level, including the Master and PhD degrees and analyzed the contents and the amount of teaching allocated for ethics training in each curriculum. We found no research ethics training in 72 (58%) of the programs. Among the 53 (42%) programs that considered research ethics training, only 17 programs had specific courses for research ethics and eight of them had detailed topics on their courses. The research ethics training was optional in 25% and mandatory in 76% of the programs. Post-graduate studies that were approved in the more recent years had more attention to the research ethics training. Research ethics training was neglected in most of the medical post-graduate programs. We suggest including sufficient amount of mandatory research ethics training in Master and PhD programs in I.R. Iran. Further research about quality of research ethics training and implementation of curricula in the biomedical institutions is warranted. © 2016 John Wiley & Sons Ltd.

Exploring cultural and linguistic influences on clinical communication skills: a qualitative study of International Medical Graduates.

PubMed

Verma, Anju; Griffin, Ann; Dacre, Jane; Elder, Andrew

2016-06-10

International Medical Graduates (IMGs) are known to perform less well in many postgraduate medical examinations when compared to their UK trained counterparts. This "differential attainment" is observed in both knowledge-based and clinical skills assessments. This study explored the influence of culture and language on IMGs clinical communication skills, in particular, their ability to seek, detect and acknowledge patients' concerns in a high stakes postgraduate clinical skills examination. Hofstede's cultural dimensions framework was used to look at the impact of culture on examination performance. This was a qualitative, interpretative study using thematic content analysis of video-recorded doctor-simulated patient consultations of candidates sitting the MRCP(UK) PACES examination, at a single examination centre in November 2012. The research utilised Hofstede's cultural dimension theory, a framework for comparing cultural factors amongst different nations, to help understand the reasons for failure. Five key themes accounted for the majority of communication failures in station 2, "history taking" and station 4, "communication skills and ethics" of the MRCP(UK) PACES examination. Two themes, the ability to detect clues and the ability to address concerns, related directly to the overall construct managing patients' concerns. Three other themes were found to impact the whole consultation. These were building relationships, providing structure and explanation and planning. Hofstede's cultural dimensions may help to contextualise some of these observations. In some cultures doctor and patient roles are relatively inflexible: the doctor may convey less information to the patient (higher power distance societies) and give less attention to building rapport (high uncertainty avoidance societies.) This may explain why cues and concerns presented by patients were overlooked in this setting. Understanding cultural differences through Hofstede's cultural dimensions theory

78 FR 52537 - Council on Graduate Medical Education; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-23

... Graduate Medical Education; Notice of Meeting In accordance with section 10(a)(2) of the Federal Advisory... Medical Education (COGME). Date and Time: September 9, 2013 (8:30 a.m.-5:00 p.m.), September 10, 2013 (8... financing of medical education training, and the development of performance measures and longitudinal...

Exploring Perception and Use of Everyday Language and Medical Terminology among International Medical Graduates in a Medical ESP Course in Australia

ERIC Educational Resources Information Center

Dahm, Maria R.

2011-01-01

Language and communication skills are among the greatest challenges that non-native-English speaking international medical graduates (IMGs) face in English medical consultations. Especially when patients use unfamiliar everyday expressions or attach different meanings to medical terminology, the communicative burden on doctor-patient communication…

International Medical Graduates in the US Physician Workforce and Graduate Medical Education: Current and Historical Trends.

PubMed

Ahmed, Awad A; Hwang, Wei-Ting; Thomas, Charles R; Deville, Curtiland

2018-04-01

Data show that international medical graduates (IMGs), both US and foreign born, are more likely to enter primary care specialties and practice in underserved areas. Comprehensive assessments of representation trends for IMGs in the US physician workforce are limited. We reported current and historical representation trends for IMGs in the graduate medical education (GME) training pool and US practicing physician workforce. We compared representation for the total GME and active practicing physician pools with the 20 largest residency specialties. A 2-sided test was used for comparison, with P  < .001 considered significant. To assess significant increases in IMG GME trainee representation for the total pool and each of the specialties from 1990-2015, the slope was estimated using simple linear regression. IMGs showed significantly greater representation among active practicing physicians in 4 specialties: internal medicine (39%), neurology (31%), psychiatry (30%), and pediatrics (25%). IMGs in GME showed significantly greater representation in 5 specialties: pathology (39%), internal medicine (39%), neurology (36%), family medicine (32%), and psychiatry (31%; all P  < .001). Over the past quarter century, IMG representation in GME has increased by 0.2% per year in the total GME pool, and 1.1% per year for family medicine, 0.5% for obstetrics and gynecology and general surgery, and 0.3% for internal medicine. IMGs make up nearly a quarter of the total GME pool and practicing physician workforce, with a disproportionate share, and larger increases over our study period in certain specialties.

Prepared to practice? Perception of career preparation and guidance of recent medical graduates at two campuses of a transnational medical school: a cross-sectional study.

PubMed

Kassim, Sameer S; McGowan, Yvonne; McGee, Hannah; Whitford, David L

2016-02-09

Graduating medical students enter the workforce with substantial medical knowledge and experience, yet little is known about how well they are prepared for the transition to medical practice in diverse settings. We set out to compare perceptions of medical school graduates' career guidance with their perceptions of preparedness to practice as interns. We also set out to compare perceptions of preparedness for hospital practice between graduates from two transnational medical schools. This was a cross-sectional study. A Preparedness for Hospital Practice (PHPQ) survey and career guidance questionnaire was sent to recent medical graduates, incorporating additional free text responses on career preparation. Data was analyzed using descriptive statistics and tests of association including Chi-square, Mann-Whitney U and Kruskal-Wallis H tests. Forty three percent (240/555) of graduates responded to the survey: 39 % of respondents were domestic (Dublin, Ireland or Manama, Kingdom of Bahrain) and interning locally; 15 % were overseas students interning locally; 42 % were overseas students interning internationally and 4 % had not started internship. Two variables explained 13 % of the variation in preparedness for hospital practice score: having planned postgraduate education prior to entering medical school and having helpful career guidance in medical school. Overseas graduates interning internationally were more likely to have planned their postgraduate career path prior to entering medical school. Dublin graduates found their career guidance more helpful than Bahrain counterparts. The most cited shortcomings were lack of structured career advice and lack of advice on the Irish and Bahraini postgraduate systems. This study has demonstrated that early consideration of postgraduate career preparation and helpful medical school career guidance has a strong association with perceptions of preparedness of medical graduates for hospital practice. In an era of increasing

Gamification as a tool for enhancing graduate medical education

PubMed Central

Nevin, Christa R; Westfall, Andrew O; Rodriguez, J Martin; Dempsey, Donald M; Cherrington, Andrea; Roy, Brita; Patel, Mukesh; Willig, James H

2014-01-01

Introduction The last decade has seen many changes in graduate medical education training in the USA, most notably the implementation of duty hour standards for residents by the Accreditation Council of Graduate Medical Education. As educators are left to balance more limited time available between patient care and resident education, new methods to augment traditional graduate medical education are needed. Objectives To assess acceptance and use of a novel gamification-based medical knowledge software among internal medicine residents and to determine retention of information presented to participants by this medical knowledge software. Methods We designed and developed software using principles of gamification to deliver a web-based medical knowledge competition among internal medicine residents at the University of Alabama (UA) at Birmingham and UA at Huntsville in 2012–2013. Residents participated individually and in teams. Participants accessed daily questions and tracked their online leaderboard competition scores through any internet-enabled device. We completed focus groups to assess participant acceptance and analysed software use, retention of knowledge and factors associated with loss of participants (attrition). Results Acceptance: In focus groups, residents (n=17) reported leaderboards were the most important motivator of participation. Use: 16 427 questions were completed: 28.8% on Saturdays/Sundays, 53.1% between 17:00 and 08:00. Retention of knowledge: 1046 paired responses (for repeated questions) were collected. Correct responses increased by 11.9% (p<0.0001) on retest. Differences per time since question introduction, trainee level and style of play were observed. Attrition: In ordinal regression analyses, completing more questions (0.80 per 10% increase; 0.70 to 0.93) decreased, while postgraduate year 3 class (4.25; 1.44 to 12.55) and non-daily play (4.51; 1.50 to 13.58) increased odds of attrition. Conclusions Our software

[Selection of medical graduates for residency posts. A comparative study of the methodologies used in different countries].

PubMed

Lobato, Ramiro D; Lagares, Alfonso; Villena, Victoria; García Seoane, Jorge; Jiménez-Roldán, Luis; Munarriz, Pablo M; Castaño-Leon, Ana M; Alén, José F

2015-01-01

The design of an appropriate method for the selection of medical graduates for residency posts is extremely important, not only for the efficiency of the method itself (accurate identification of most competent candidates), but also for its influence on the study and teaching methodologies operating in medical schools. Currently, there is a great variation in the criteria used in different countries and there is no definitively appropriate method. The use of isolated or combined criteria, such as the marks obtained by students in medical schools, their performance in tests of theoretical knowledge and evaluations of clinical competence, or personal interviews, have a limited value for identifying those candidates who will perform better during the residency and later on during independent practice. To analyse the variability in the methodologies used for the selection of residents employed in different countries, in particular those used in the United Kingdom and USA, where external agencies and medical schools make systematic analyses of curriculum development. The advantages and disadvantages of national or transnational licensing examinations on the process of convergence and harmonization of medical degrees and residency programmes through Europe are discussed. The present analysis is used to design a new and more efficient multi-criteria methodology for resident selection in Spain, which will be published in the next issue of this journal. Since the multi-criteria methods used in UK and USA appear to be most consistent, these have been employed for designing the new methodology that could be applied in Spain. Although many experts in medical education reject national examinations for awarding medical degrees or ranking candidates for residency posts, it seems that, when appropriately designed, they can be used to verify the level of competence of graduating students without necessarily distorting curriculum implementation or improvement. Copyright © 2014

Vocal Health Education and Medical Resources for Graduate-Level Vocal Performance Students.

PubMed

Latham, Katherine; Messing, Barbara; Bidlack, Melissa; Merritt, Samantha; Zhou, Xian; Akst, Lee M

2017-03-01

Most agree that education about vocal health and physiology can help singers avoid the development of vocal disorders. However, little is known about how this kind of education is provided to singers as part of their formal training. This study describes the amount of instruction in these topics provided through graduate-level curricula, who provides this instruction, and the kinds of affiliations such graduate singing programs have with medical professionals. This is an online survey of music schools with graduate singing programs. Survey questions addressed demographics of the programs, general attitudes about vocal health instruction for singers, the amount of vocal health instruction provided and by whom it was taught, perceived barriers to including more vocal health instruction, and any affiliations the voice program might have with medical personnel. Eighty-one survey responses were received. Instruction on vocal health was provided in 95% of the schools. In 55% of the schools, none of this instruction was given by a medical professional. Limited time in the curriculum, lack of financial support, and lack of availability of medical professional were the most frequently reported barriers to providing more instruction. When programs offered more hours of instruction, they were more likely to have some of that instruction given by a medical professional (P = 0.008) and to assess the amount of instruction provided positively (P = 0.001). There are several perceived barriers to incorporating vocal health education into graduate singing programs. Opportunity exists for more collaboration between vocal pedagogues and medical professionals in the education of singers about vocal health. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Medical students’ characteristics as predictors of career practice location: retrospective cohort study tracking graduates of Nepal’s first medical college

PubMed Central

Shakya, Rabina; Pokhrel, Bharat M; Eyal, Nir; Rijal, Basista P; Shrestha, Ratindra N; Sayami, Arun

2012-01-01

Objective To determine, in one low income country (Nepal), which characteristics of medical students are associated with graduate doctors staying to practise in the country or in its rural areas. Design Observational cohort study. Setting Medical college registry, with internet, phone, and personal follow-up of graduates. Participants 710 graduate doctors from the first 22 classes (1983-2004) of Nepal’s first medical college, the Institute of Medicine. Main outcome measures Career practice location (foreign or in Nepal; in or outside of the capital city Kathmandu) compared with certain pre-graduation characteristics of medical student. Results 710 (97.7%) of the 727 graduates were located: 193 (27.2%) were working in Nepal in districts outside the capital city Kathmandu, 261 (36.8%) were working in Kathmandu, and 256 (36.1%) were working in foreign countries. Of 256 working abroad, 188 (73%) were in the United States. Students from later graduating classes were more likely to be working in foreign countries. Those with pre-medical education as paramedics were twice as likely to be working in Nepal and 3.5 times as likely to be in rural Nepal, compared with students with a college science background. Students who were academically in the lower third of their medical school class were twice as likely to be working in rural Nepal as those from the upper third. In a regression analysis adjusting for all variables, paramedical background (odds ratio 4.4, 95% confidence interval 1.7 to 11.6) was independently associated with a doctor remaining in Nepal. Rural birthplace (odds ratio 3.8, 1.3 to 11.5) and older age at matriculation (1.1, 1.0 to 1.2) were each independently associated with a doctor working in rural Nepal. Conclusions A cluster of medical students’ characteristics, including paramedical background, rural birthplace, and lower academic rank, was associated with a doctor remaining in Nepal and with working outside the capital city of Kathmandu. Policy

A Graduate Academic Program in Medical Information Science.

ERIC Educational Resources Information Center

Blois, Marsden S., Jr.; Wasserman, Anthony I.

A graduate academic program in medical information science has been established at the University of California, San Francisco, for the education of scientists capable of performing research and development in information technology in the health care setting. This interdisciplinary program, leading to a Doctor of Philosophy degree, consists of an…

A survey of manual vacuum aspiration’s experiences among the new medical graduates in Thailand

PubMed Central

2013-01-01

Background Despite Thai laws permitting abortion conducted by registered medical practitioners, unsafe abortion still kills and maims Thai women as a result of inadequate access to safe abortion services. Surgical evacuation of the uterus by manual vacuum aspirator (MVA) is a safe and effective technique recommended by the World Health Organization (WHO) guidelines. This study assessed new medical graduates’ MVA experiences during their clinical years in medical schools. Methods Cross-sectional questionnaire surveys on all new medical graduates participating in the annual assembly arranged by the Ministry of Public Health in 2010 and 2012 were applied. Descriptive and inferential statistics were employed for data analysis. Results The significant minority of new graduates (44% and 43% in 2010 and 2012 batches) had seen but never used MVA. The proportion of graduates who had ‘never seen’ reduced from 32% in 2010 to 23% in 2012 while the proportion of ‘ever used’ had noticeably increased from 24% to 34% in corresponding years. Graduates from medical schools outside Bangkok and vicinity and those reporting confidence in their surgical skills tended to have more MVA experience. The 2012 graduation year was also positively related to higher experience on MVA. Conclusion Though the proportion of graduates who had ever used MVA was still low in 2012, a positive change from that in 2010 was observed. Medical schools outside Bangkok and vicinity provided more opportunities for learning MVA. It is recommended that medical schools, especially in Bangkok and vicinity should provide more MVA learning opportunities for students. Adequate training and regular hands-on MVA practice should be incorporated into a wide range of clinical practice. PMID:24025699

Factors Influencing Choice of Medical Specialty of Preresidency Medical Graduates in Southeastern Nigeria

PubMed Central

Eze, Boniface Ikenna; Okoye, Onochie Ike; Maduka-Okafor, Ferdinand Chinedu; Aguwa, Emmanuel Nwabueze

2011-01-01

Background This study examined the determinants of specialty choice of preresidency medical graduates in southeastern Nigeria. Methods We used a comparative cross-sectional survey of preresidency medical graduates who took the Basic Sciences Examination of the Postgraduate Medical College in Enugu, southeastern Nigeria, in March 2007. Data on participants' demographics and specialty selected, the timing of the decision, and factors in specialty selection were collected using a questionnaire. Data were examined using descriptive and analytical statistics. P < .05 was considered significant. Results The survey response rate was 90.8% (287 of 316). The sample included 219 men and 68 women, ranging in age from 24 to 53 years and with a mean age of 33.5 ± 1.1 (SD) years. Career choice was more frequently influenced by personal interest (66.6%), career prospects (9.1%), and appraisal of own skills/aptitudes (5.6%), and it was least affected by altruistic motives (1.7%) and influence of parents/relations (1.7%). The respondents selected specialties at different rates: obstetrics and gynecology (22.6%), surgery (19.6%), pediatrics (16.0%), anesthesiology (3.1%), psychiatry (0.3%), and dentistry (0.0%). Most (97.2%) participants had decided on specialty choice by the end of their fifth (of a total 16 years) postgraduate year. The participants significantly more frequently preferred surgery and pediatrics to other disciplines (P < .002, after Bonferroni correction for multiple comparisons). Conclusions Preresidency medical graduates in southeastern Nigeria were influenced by personal interest, career prospects, and personal skills/aptitude in deciding which specialty training to pursue. The most frequently chosen specialties were surgery and pediatrics. These findings have implications for Nigeria's education and health care policy makers. PMID:22942964

Training-related harassment and drinking outcomes in medical residents versus graduate students.

PubMed

Shinsako, S A; Richman, J A; Rospenda, K M

2001-12-01

This study examined the prevalence of sexual harassment and generalized workplace abuse, and their differential effects on drinking behaviors in medical residents and graduate students at an urban American university. While medical residents had greater odds of experiencing harassment and abuse in their training programs, it was found that in most cases their deleterious drinking behaviors decreased, whereas graduate student drinking behaviors increased as a consequence of these experiences. The drinking outcomes of men were more affected by harassment and abuse than those of women.

Admission factors associated with international medical graduate certification success: a collaborative retrospective review of postgraduate medical education programs in Ontario.

PubMed

Grierson, Lawrence E M; Mercuri, Mathew; Brailovsky, Carlos; Cole, Gary; Abrahams, Caroline; Archibald, Douglas; Bandiera, Glen; Phillips, Susan P; Stirrett, Glenna; Walton, J Mark; Wong, Eric; Schabort, Inge

2017-11-24

The failure rate on certification examinations of The College of Family Physicians of Canada (CFPC) and the Royal College of Physicians and Surgeons of Canada (RCPSC) is significantly higher for international medical graduates than for Canadian medical school graduates. The purpose of the current study was to generate evidence that supports or refutes the validity of hypotheses proposed to explain the lower success rates. We conducted retrospective analyses of admissions and certification data to determine the factors associated with success of international medical graduate residents on the certification examinations. International medical graduates who entered an Ontario residency program between 2005 and 2012 and had written a certification examination by the time of the analysis (2015) were included in the study. Data available at the time of admission for each resident, including demographic characteristics, previous experiences and previous professional experiences, were collected from each of the 6 Ontario medical schools and matched with certification examination results provided by The CFPC and the RCPSC. We developed logistic regression models to determine the association of each factor with success on the examinations. Data for 900 residents were analyzed. The models revealed resident age to be strongly associated with performance across all examinations. Fluency in English, female sex and the Human Development Index value associated with the country of medical school training had differential associations across the examinations. The findings should contribute to an improved understanding of certification success by international medical graduates, help residency programs identify at-risk residents and underpin the development of specific educational and remedial interventions. In considering the results, it should be kept in mind that some variables are not amenable to changes in selection criteria. Copyright 2017, Joule Inc. or its licensors.

Teaching, learning and assessment of medical ethics at the UK medical schools.

PubMed

Brooks, Lucy; Bell, Dominic

2017-09-01

To evaluate the UK undergraduate medical ethics curricula against the Institute of Medical Ethics (IME) recommendations; to identify barriers to teaching and assessment of medical ethics and to evaluate perceptions of ethics faculties on the preparation of tomorrow's doctors for clinical practice. Questionnaire survey of the UK medical schools enquiring about content, structure and location of ethics teaching and learning; teaching and learning processes; assessment; influences over institutional approach to ethics education; barriers to teaching and assessment; perception of student engagement and perception of student preparation for clinical practice. The lead for medical ethics at each medical school was invited to participate (n=33). Completed responses were received from 11/33 schools (33%). 73% (n=8) teach all IME recommended topics within their programme. 64% (n=7) do not include ethics in clinical placement learning objectives. The most frequently cited barrier to teaching was lack of time (64%, n=7), and to assessment was lack of time and suitability of assessments (27%, n=3). All faculty felt students were prepared for clinical practice. IME recommendations are not followed in all cases, and ethics teaching is not universally well integrated into clinical placement. Barriers to assessment lead to inadequacies in this area, and there are few consequences for failing ethics assessments. As such, tomorrow's patients will be treated by doctors who are inadequately prepared for ethical decision making in clinical practice; this needs to be addressed by ethics leads with support from medical school authorities. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Medical graduates' early career choices of specialty and their eventual specialty destinations: UK prospective cohort studies.

PubMed

Goldacre, Michael J; Laxton, L; Lambert, T W

2010-07-06

To report on doctors' early choices of specialty at selected intervals after qualification, and eventual career destinations. Questionnaire surveys. United Kingdom. Total of 15 759 doctors who qualified in 1974, 1977, 1983, 1993, and 1996, and their career destinations 10 years after graduation. 15 759 doctors were surveyed one and three years after graduation and 12 108 five years after graduation. Career preferences at years 1, 3, and 5, and destinations at 10 years, were known for, respectively, 64% (n=10 154), 62% (n=9702), and 61% (n=7429) of the survey population. In the 1993 and 1996 cohorts, career destinations matched with year 1 choices for 54% (1890/3508) of doctors in year 1, 70% (2494/3579) in year 3, and 83% (2916/3524) in year 5. Corresponding results for the earlier cohorts (1974-83) were similar: 53% (3310/6264), 74% (4233/5752), and 82% (2976/3646). The match rates varied by specialty; for example, the rates were consistently high for surgery. Career destinations matched with year 1 choices for 74% (722/982) of doctors who specified a definite (rather than probable or uncertain) specialty choice in their first postgraduate year. About half of those who chose a hospital specialty but did not eventually work in it were working in general practice by year 10. Ten years after qualification about a quarter of doctors were working in a specialty that was different from the one chosen in their third year after graduation. This stayed reasonably constant across graduation cohorts despite the changes in training programmes over time. Subject to the availability of training posts, postgraduate training should permit those who have made early, definite choices to progress quickly into their chosen specialty, while recognising the need for flexibility for those who choose later.

Valued experiences of graduate students in their role as educators in undergraduate training in Ugandan medical schools.

PubMed

Rukundo, Godfrey Zari; Kasozi, Jannat; Burani, Aluonzi; Byona, Wycliff; Kirimuhuzya, Claude; Kiguli, Sarah

2017-11-25

In most medical schools, graduate students, sometimes referred to as graduate teaching assistants, often participate in the training of undergraduate students. In developing countries like Uganda, are typically involved in undergraduate training. However, prior to this study there were no standard guidelines for this involvement. At the same time, the views and experiences of the graduate students in their role as educators had not been documented. Therefore, the aim of this study was to explore the views and experiences of graduate students about their involvement in undergraduate training in three Ugandan medical schools. The findings of this study will contribute to the development of policies for training in Ugandan medical schools. This was a qualitative study in which thirty in-depth-interviews were conducted among second and third year graduate students in three Ugandan medical schools in the MESAU consortium (Medical Education Services to all Ugandans) including Mbarara University of Science and Technology, Makerere College of Health Sciences and Kampala International University, Western Campus. All graduate students from all the three medical schools viewed their involvement in undergraduate training as important. The study also revealed that graduate students increase available human resources and often compensate for the teaching missed when senior educators were absent. The graduate students expressed important views that need to be considered in the design of educational programs where they are to be involved. The respondents also reported a number of challenges in this undertaking that included lack of motivation, lack of orientation and having heavy workloads. The presence and commitment of senior educators to guide and support the graduate students in teaching activities was viewed as one significant intervention that would increase the effectiveness of their educational contributions. Graduate students enjoy their involvement in the training of

Assessing curriculum effectiveness: a survey of Uniformed Services University medical school graduates.

PubMed

Picho, Katherine; Gilliland, William R; Artino, Anthony R; DeZee, Kent J; Dong, Ting; McManigle, John E; Cruess, David F; Durning, Steven J

2015-04-01

This study assessed alumni perceptions of their preparedness for clinical practice using the Accreditation Council for Graduate Medical Education (ACGME) competencies. We hypothesized that our alumni's perception of preparedness would be highest for military-unique practice and professionalism and lowest for system-based practice and practice-based learning and improvement. 1,189 alumni who graduated from the Uniformed Services University (USU) between 1980 and 2001 completed a survey modeled to assess the ACGME competencies on a 5-point, Likert-type scale. Specifically, self-reports of competencies related to patient care, communication and interpersonal skills, medical knowledge, professionalism, systems-based practice, practice-based learning and improvement, and military-unique practice were evaluated. Consistent with our expectations as the nation's military medical school, our graduates were most confident in their preparedness for military-unique practice, which included items assessing military leadership (M = 4.30, SD = 0.65). USU graduates also indicated being well prepared for the challenges of residency education in the domain of professionalism (M = 4.02, SD = 0.72). Self-reports were also high for competencies related to patient care (M = 3.86, SD = 0.68), communication and interpersonal skills (M = 3.88, SD = 0.66), and medical knowledge (M = 3.78, SD = 0.73). Consistent with expectations, systems-based practice (M = 3.50, SD = 0.70) and practice-based learning and improvement (M = 3.57, SD = 0.62) were the lowest rated competencies, although self-reported preparedness was still quite high. Our findings suggest that, from the perspective of our graduates, USU is providing both an effective military-unique curriculum and is preparing trainees for residency training. Further, these results support the notion that graduates are prepared to lead and to practice medicine in austere environments. Compared to other competencies that were assessed, self

Domestic violence teaching in UK medical schools: a cross-sectional study.

PubMed

Potter, Lucy C; Feder, Gene

2017-10-06

Domestic violence and abuse (DVA) is a leading contributor to the physical and mental ill health of women. Recent international guidance recommends that undergraduate medical curricula should include DVA. We do not know what is currently taught about DVA to medical students in the UK. Recent international guidance recommends that undergraduate medical curricula should include DVA METHOD: Teaching leads from all UK medical schools (n = 34) were invited to participate in an 18-item online survey about what DVA education is provided, their views of this provision and any feedback provided by students. Descriptive statistics were used to analyse the data. A total of 25 out of 34 medical schools participated in the survey (74%). All respondents felt that there should be formal teaching on DVA in the medical curriculum. Eighty-four per cent of respondents reported that there was some formal teaching in their medical school, and 90% of these reported that it was mandatory. Of those who delivered some teaching, 52% reported that the provision was 0-2 hours in total. Most commonly content was delivered in year 4. DVA teaching was delivered in different modules, by different methods and delivered by a range of different providers. Seventy-five per cent of respondents reported that they felt the provision at their medical school was inadequate or not enough. Barriers to providing DVA education identified included time constraints, failure to perceive it as a medical problem and the assumption that it will be covered elsewhere. Most medical students in the UK receive a small amount of teaching on DVA towards the end of the curriculum. This is perceived as inadequate. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

Job requirements compared to medical school education: differences between graduates from problem-based learning and conventional curricula.

PubMed

Schlett, Christopher L; Doll, Hinnerk; Dahmen, Janosch; Polacsek, Ole; Federkeil, Gero; Fischer, Martin R; Bamberg, Fabian; Butzlaff, Martin

2010-01-14

Problem-based Learning (PBL) has been suggested as a key educational method of knowledge acquisition to improve medical education. We sought to evaluate the differences in medical school education between graduates from PBL-based and conventional curricula and to what extent these curricula fit job requirements. Graduates from all German medical schools who graduated between 1996 and 2002 were eligible for this study. Graduates self-assessed nine competencies as required at their day-to-day work and as taught in medical school on a 6-point Likert scale. Results were compared between graduates from a PBL-based curriculum (University Witten/Herdecke) and conventional curricula. Three schools were excluded because of low response rates. Baseline demographics between graduates of the PBL-based curriculum (n = 101, 49% female) and the conventional curricula (n = 4720, 49% female) were similar. No major differences were observed regarding job requirements with priorities for "Independent learning/working" and "Practical medical skills". All competencies were rated to be better taught in PBL-based curriculum compared to the conventional curricula (all p < 0.001), except for "Medical knowledge" and "Research competence". Comparing competencies required at work and taught in medical school, PBL was associated with benefits in "Interdisciplinary thinking" (Delta + 0.88), "Independent learning/working" (Delta + 0.57), "Psycho-social competence" (Delta + 0.56), "Teamwork" (Delta + 0.39) and "Problem-solving skills" (Delta + 0.36), whereas "Research competence" (Delta--1.23) and "Business competence" (Delta--1.44) in the PBL-based curriculum needed improvement. Among medical graduates in Germany, PBL demonstrated benefits with regard to competencies which were highly required in the job of physicians. Research and business competence deserve closer attention in future curricular development.

Present and future of the undergraduate ophthalmology curriculum: a survey of UK medical schools

PubMed Central

Hill, Sophie; Dennick, Reg

2017-01-01

Objectives To investigate the current undergraduate ophthalmology curricula provided by the UK medical schools, evaluate how they compare with the guidelines of the Royal College of Ophthalmologists (RCOphth) and International Council for Ophthalmology (ICO), and determine the views of the UK ophthalmology teaching leads on the future direction of the curriculum. Methods A cross-sectional questionnaire was sent to teaching leads in 31 medical schools across the UK. The questionnaire evaluated eight themes of the curriculum: content and learning outcomes, communication of learning outcomes, organisation of the curriculum, assessment, educational resources, teaching methods used, and the educational environment. The ophthalmology teaching leads were also asked their opinion on the current and future management of the curriculum. These were compared with RCOphth and ICO guidelines and descriptive statistical analysis performed. Results A response rate of 93% (n=29/31) was achieved. The knowledge and clinical skills taught by the UK medical schools match the  RCOphth guidelines, but fail to meet the ICO recommendations. A diverse range of assessment methods are used by UK medical schools during ophthalmology rotations. Variation was also observed in the organisation and methods of ophthalmology teaching.  However, a significant consensus about the future direction of the curriculum was reported by teaching leads. Conclusions Comprehensive RCOphth guidance, and resource sharing between medical schools could help to ensure ophthalmology’s continuing presence in the medical curriculum and improve the effectiveness of undergraduate ophthalmology teaching, while reducing the workload of local teaching departments and medical schools.  PMID:29103017

A pre-admission program for underrepresented minority and disadvantaged students: application, acceptance, graduation rates and timeliness of graduating from medical school.

PubMed

Strayhorn, G

2000-04-01

To determine whether students' performances in a pre-admission program predicted whether participants would (1) apply to medical school, (2) get accepted, and (3) graduate. Using prospectively collected data from participants in the University of North Carolina at Chapel Hill's Medical Education Development Program (MEDP) and data from the Association of American Colleges Student and Applicant Information Management System, the author identified 371 underrepresented minority (URM) students who were full-time participants and completed the program between 1984 and 1989, prior to their acceptance into medical school. Logistic regression analysis was used to determine whether MEDP performance significantly predicted (after statistically controlling for traditional predictors of these outcomes) the proportions of URM participants who applied to medical school and were accepted, the timeliness of graduating, and the proportion graduating. Odds ratios with 95% confidence intervals were calculated to determine the associations between the independent and outcome variables. In separate logistic regression models, MEDP performance predicted the study's outcomes after statistically controlling for traditional predictors with 95% confidence intervals. Pre-admission programs with similar outcomes can improve the diversity of the physician workforce and the access to health care for underrepresented minority and economically disadvantaged populations.

Specialty Choices of Kuwaiti Medical Graduates during the Last Three Decades

ERIC Educational Resources Information Center

Al-Jarallah, Khaled F.; Moussa, Mohamed A. A.

2003-01-01

Introduction: This study examined postgraduate specialty training of Kuwaiti medical graduates during 1968 to 1999 and identified their attained professional qualifications to reveal scarcity in some specialties. Method: A survey was carried out involving review of the records maintained at the Kuwait Institute for Medical Specialization (KIMS)…

Female military medical school graduates entering surgical internships: are we keeping up with national trends?

PubMed

Vertrees, Amy; Laferriere, Nicole; Elster, Eric; Shriver, Craig D; Rich, Norman M

2014-10-01

Ratios of women graduating from the only US military medical school and entering surgical internships were reviewed and compared with national trends. Data were obtained from the Uniformed Services University of the Health Sciences graduation announcements from 2002 to 2012. There were 1,771 graduates from 2002 to 2012, with 508 female (29%) and 1,263 male (71%) graduates. Female graduates increased over time (21% to 39%; P = .014). Female general surgery interns increased from 3.9% to 39% (P = .025). Female overall surgical subspecialty interns increased from 20% in 2002 to 36% in 2012 (P = .046). Women were represented well in obstetrics (57%), urology (44%), and otolaryngology (31%), but not in neurosurgery, orthopedics, and ophthalmology (0% to 20%). The sex disparity between military and civilian medical students occurs before entry. Once in medical school, women are just as likely to enter general surgery or surgical subspecialty as their male counterparts. Increased ratio of women in the class is unlikely to lead to a shortfall except in specific subspecialties. Published by Elsevier Inc.

Views of UK medical graduates about flexible and part-time working in medicine: a qualitative study.

PubMed

Evans, J; Goldacre, M J; Lambert, T W

2000-05-01

To report on the views of doctors about flexible and part-time working in medicine. As part of ongoing studies of doctors' careers, postal questionnaires were sent in 1995 and 1996 to all doctors who qualified from UK medical schools in 1977, 1988 and 1993. Structured questions about recipients' careers were accompanied by a form which invited free-text comment. Comments about flexible and part-time working were extracted for analysis. All respondents who commented on flexible and part-time working. Most doctors who commented believed there were insufficient opportunities to meet demand. They also commonly commented that there was not enough information about flexible training opportunities. Some men, as well as women, expressed a wish to work part-time. The most frequently cited reasons for part-time working were to balance career with family responsibilities, and to reduce work-related stress. Cited disadvantages of part-time working were mainly financial and included the problems of paying for childcare and professional subscriptions when on a reduced income. Some respondents perceived negative attitudes towards doctors in part-time jobs. It is well-recognised that more flexible medical career structures are needed so that doctors can vary their time commitment according to their needs at particular stages in their lives. Until recently, needs have not been adequately met. Changes in arrangements for flexible training accompanying the implementation of the specialist registrar grade may have begun to alleviate some of the problems, but others, such as negative attitudes towards part-time work, may take time to change.

Selecting, training and assessing new general practice community teachers in UK medical schools.

PubMed

Hydes, Ciaran; Ajjawi, Rola

2015-09-01

Standards for undergraduate medical education in the UK, published in Tomorrow's Doctors, include the criterion 'everyone involved in educating medical students will be appropriately selected, trained, supported and appraised'. To establish how new general practice (GP) community teachers of medical students are selected, initially trained and assessed by UK medical schools and establish the extent to which Tomorrow's Doctors standards are being met. A mixed-methods study with questionnaire data collected from 24 lead GPs at UK medical schools, 23 new GP teachers from two medical schools plus a semi-structured telephone interview with two GP leads. Quantitative data were analysed descriptively and qualitative data were analysed informed by framework analysis. GP teachers' selection is non-standardised. One hundred per cent of GP leads provide initial training courses for new GP teachers; 50% are mandatory. The content and length of courses varies. All GP leads use student feedback to assess teaching, but other required methods (peer review and patient feedback) are not universally used. To meet General Medical Council standards, medical schools need to include equality and diversity in initial training and use more than one method to assess new GP teachers. Wider debate about the selection, training and assessment of new GP teachers is needed to agree minimum standards.

Gamification as a tool for enhancing graduate medical education.

PubMed

Nevin, Christa R; Westfall, Andrew O; Rodriguez, J Martin; Dempsey, Donald M; Cherrington, Andrea; Roy, Brita; Patel, Mukesh; Willig, James H

2014-12-01

The last decade has seen many changes in graduate medical education training in the USA, most notably the implementation of duty hour standards for residents by the Accreditation Council of Graduate Medical Education. As educators are left to balance more limited time available between patient care and resident education, new methods to augment traditional graduate medical education are needed. To assess acceptance and use of a novel gamification-based medical knowledge software among internal medicine residents and to determine retention of information presented to participants by this medical knowledge software. We designed and developed software using principles of gamification to deliver a web-based medical knowledge competition among internal medicine residents at the University of Alabama (UA) at Birmingham and UA at Huntsville in 2012-2013. Residents participated individually and in teams. Participants accessed daily questions and tracked their online leaderboard competition scores through any internet-enabled device. We completed focus groups to assess participant acceptance and analysed software use, retention of knowledge and factors associated with loss of participants (attrition). Acceptance: In focus groups, residents (n=17) reported leaderboards were the most important motivator of participation. Use: 16 427 questions were completed: 28.8% on Saturdays/Sundays, 53.1% between 17:00 and 08:00. Retention of knowledge: 1046 paired responses (for repeated questions) were collected. Correct responses increased by 11.9% (p<0.0001) on retest. Differences per time since question introduction, trainee level and style of play were observed. Attrition: In ordinal regression analyses, completing more questions (0.80 per 10% increase; 0.70 to 0.93) decreased, while postgraduate year 3 class (4.25; 1.44 to 12.55) and non-daily play (4.51; 1.50 to 13.58) increased odds of attrition. Our software-enabled, gamification-based educational intervention was well accepted

Job requirements compared to medical school education: differences between graduates from problem-based learning and conventional curricula

PubMed Central

2010-01-01

Background Problem-based Learning (PBL) has been suggested as a key educational method of knowledge acquisition to improve medical education. We sought to evaluate the differences in medical school education between graduates from PBL-based and conventional curricula and to what extent these curricula fit job requirements. Methods Graduates from all German medical schools who graduated between 1996 and 2002 were eligible for this study. Graduates self-assessed nine competencies as required at their day-to-day work and as taught in medical school on a 6-point Likert scale. Results were compared between graduates from a PBL-based curriculum (University Witten/Herdecke) and conventional curricula. Results Three schools were excluded because of low response rates. Baseline demographics between graduates of the PBL-based curriculum (n = 101, 49% female) and the conventional curricula (n = 4720, 49% female) were similar. No major differences were observed regarding job requirements with priorities for "Independent learning/working" and "Practical medical skills". All competencies were rated to be better taught in PBL-based curriculum compared to the conventional curricula (all p < 0.001), except for "Medical knowledge" and "Research competence". Comparing competencies required at work and taught in medical school, PBL was associated with benefits in "Interdisciplinary thinking" (Δ + 0.88), "Independent learning/working" (Δ + 0.57), "Psycho-social competence" (Δ + 0.56), "Teamwork" (Δ + 0.39) and "Problem-solving skills" (Δ + 0.36), whereas "Research competence" (Δ - 1.23) and "Business competence" (Δ - 1.44) in the PBL-based curriculum needed improvement. Conclusion Among medical graduates in Germany, PBL demonstrated benefits with regard to competencies which were highly required in the job of physicians. Research and business competence deserve closer attention in future curricular development. PMID:20074350

Defining the structure of undergraduate medical leadership and management teaching and assessment in the UK.

PubMed

Stringfellow, Thomas D; Rohrer, Rebecca M; Loewenthal, Lola; Gorrard-Smith, Connor; Sheriff, Ibrahim H N; Armit, Kirsten; Lees, Peter D; Spurgeon, Peter C

2014-10-10

Abstract Medical leadership and management (MLM) skills are essential in preventing failings of healthcare; it is unknown how these attitudes can be developed during undergraduate medical education. This paper aims to quantify interest in MLM and recommends preferred methods of teaching and assessment at UK medical schools. Two questionnaires were developed, one sent to all UK medical school faculties, to assess executed and planned curriculum changes, and the other sent to medical students nationally to assess their preferences for teaching and assessment. Forty-eight percent of UK medical schools and 260 individual student responses were recorded. Student responses represented 60% of UK medical schools. 65% of schools valued or highly valued the importance of teaching MLM topics, compared with 93.2% of students. Students' favoured teaching methods were seminars or lectures (89.4%) and audit and quality improvement (QI) projects (77.8%). Medical schools preferred portfolio entries (55%) and presentations (35%) as assessment methods, whilst simulation exercises (76%) and audit reports (61%) were preferred by students. Preferred methods encompass experiential learning or simulation and a greater emphasis should be placed on encouraging student audit and QI projects. The curriculum changes necessary could be achieved via further integration into future editions of Tomorrow's Doctors.

75 FR 34464 - Council on Graduate Medical Education; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-17

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Council on Graduate Medical Education; Notice of Meeting In accordance with section 10(a)(2) of the Federal Advisory... Medical Education (COGME). Dates and Times: July 13, 2010, 12 p.m.-2 p.m. EST. Place: This meeting will be...

Specialising in radiology in Switzerland: still attractive for medical school graduates?

PubMed

Buddeberg-Fischer, B; Hoffmann, A; Christen, S; Weishaupt, D; Kubik-Huch, R A

2012-07-01

To gain insight into the professional characteristics of radiologists in Switzerland and to determine how to enhance the attractiveness of radiology to medical graduates as a specialty. Data from 262 members of the Swiss Society of Radiology (m:f = 76:24%) obtained in a questionnaire survey were analysed regarding socio-demographic variables, working status, specialty, main fields of interest, career success, mentoring and reasons for the shortage of radiologists. 35 (56.4%) female and 85 (45.5%) male radiologists were aged ≤ 45 years. 228 (87%) were board-certified; 44 (17.9%) had completed a sub-specialisation. Men worked part-time mostly just before retirement, while women worked part-time at a younger age. As reasons for specialty choice, the wide range of clinical work and the combination of technology and medicine were ranked highest. Women reported significantly less career success and support. To improve the attractiveness of radiology to graduates, radiology should be visible on medical school curricula. In Switzerland, more female radiologists work part-time than male ones, and there is less career success and support for women. In order to make radiology more attractive to medical graduates as a specialty, structured residency programmes and reliable gender-respecting career support are needed. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Do the Personalities of International and U.S. Medical Graduates in Psychiatry Differ? A Preliminary Study

ERIC Educational Resources Information Center

Vaidya, Nutan; Sierles, Frederick S.; Sandu, Ioana C.; Silberman, Edward K.

2006-01-01

Objective: To compare personality traits of psychiatry residents with various characteristics. Method: The authors administered Cloninger's personality inventory to residents at two schools. Results: There were no trait differences between international medical graduates (IMGs) and U.S. medical graduates (USMGs) or those for whom psychiatry was a…

77 FR 38071 - Council on Graduate Medical Education; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-26

... graduate medical education, evaluation of teaching programs especially in terms of meeting community needs...' development of performance measures and methods of longitudinal evaluation specific to the training programs...

International Medical Graduates and the Discursive Patterns of Patient-Centred Communication

ERIC Educational Resources Information Center

Woodward-Kron, Robyn

2016-01-01

In many Western countries such as Australia, international medical graduates (IMGs) play a crucial role in meeting health workforce needs. For doctors for whom English is an additional language and who have received their medical education in non-Western settings, a challenge is the patient-centred approach to communication, which is well…

78 FR 27407 - Council on Graduate Medical Education; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-10

... Graduate Medical Education; Notice of Meeting In accordance with section 10(a)(2) of the Federal Advisory... Medical Education (COGME). Date and Time: May 30, 2013, 10:00 a.m.-5:00 p.m. Eastern Time. Place: Webinar... Education provides advice and recommendations to the Secretary of the Department of Health and Human...

Factors associated with less-than-full-time working in medical practice: results of surveys of five cohorts of UK doctors, 10 years after graduation.

PubMed

Lachish, Shelly; Svirko, Elena; Goldacre, Michael J; Lambert, Trevor

2016-10-13

The greater participation of women in medicine in recent years, and recent trends showing that doctors of both sexes work fewer hours than in the past, present challenges for medical workforce planning. In this study, we provide a detailed analysis of the characteristics of doctors who choose to work less-than-full-time (LTFT). We aimed to determine the influence of these characteristics on the probability of working LTFT. We used data on working patterns obtained from long-term surveys of 10,866 UK-trained doctors. We analysed working patterns at 10 years post-graduation for doctors of five graduating cohorts, 1993, 1996, 1999, 2000 and 2002 (i.e. in the years 2003, 2006, 2009, 2010 and 2012, respectively). We used multivariable binary logistic regression models to examine the influence of a number of personal and professional characteristics on the likelihood of working LTFT in male and female doctors. Across all cohorts, 42 % of women and 7 % of men worked LTFT. For female doctors, having children significantly increased the likelihood of working LTFT, with greater effects observed for greater numbers of children and for female doctors in non-primary care specialties (non-GPs). While >40 % of female GPs with children worked LTFT, only 10 % of female surgeons with children did so. Conversely, the presence of children had no effect on male working patterns. Living with a partner increased the odds of LTFT working in women doctors, but decreased the odds of LTFT working in men (independently of children). Women without children were no more likely to work LTFT than were men (with or without children). For both women and men, the highest rates of LTFT working were observed among GPs (~10 and 6 times greater than non-GPs, respectively), and among those not in training or senior positions. Family circumstances (children and partner status) affect the working patterns of women and men differently, but both sexes respond similarly to the constraints of their

Funding of Graduate Medical Education in a Market-Based Healthcare System.

PubMed

Schuster, Barbara L

2017-02-01

The graduate medical education (GME) process in the United States is considered the most respected model for high-quality education of graduate physicians in the world. With substantial funding through government and private insurers and through structured educational accreditation standards, the American Board of Medical Specialists-certified physicians are recognized for their expertise in delivering high-quality medical care. However, under fiscal constraints and changing social expectations, questions are continually posed about the process of funding and whether the "physician outcomes" are sufficient to continue with the investment. This article reviews the history of postgraduate physician education, the multiple funding pathways, disruptions to a placid educational system and changing social expectations. The ultimate issues involve the core goals of GME and how much GME should shoulder responsibility for changing the healthcare system. Copyright © 2017 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

Physicians' exodus: why medical graduates leave Austria or do not work in clinical practice.

PubMed

Scharer, Sebastian; Freitag, Andreas

2015-05-01

Austria has the highest number of medical graduates of all Organisation for Economic Co-operation and Development (OECD) countries in relation to its population size, but over 30% choose not to pursue a career as physicians in the country. This article describes under- and postgraduate medical education in Austria and analyses reasons for the exodus of physicians. In Austria, medicine is a 5- or 6-year degree offered at four public and two private medical schools. Medical graduates have to complete training in general medicine or a speciality to attain a licence to practice. While not compulsory for speciality training, board certification in general medicine has often been regarded as a prerequisite for access to speciality training posts. Unstructured postgraduate training curricula, large amounts of administrative tasks, low basic salaries and long working hours present for incentives for medical graduates to move abroad or to work in a non-clinical setting. The scope of current reforms, such as the establishment of a new medical faculty and the implementation of a common trunk, is possibly insufficient in addressing the issue. Extensive reforms regarding occupational conditions and the structure of postgraduate medical education are necessary to avoid a further exodus of junior doctors.

Realization of entry-to-practice milestones by Canadians who studied medicine abroad and other international medical graduates: a retrospective cohort study.

PubMed

Mathews, Maria; Kandar, Rima; Slade, Steve; Yi, Yanqing; Beardall, Sue; Bourgeault, Ivy

2017-06-19

International medical graduates must realize a series of milestones to obtain full licensure. We examined the realization of milestones by Canadian and non-Canadian graduates of Western or Caribbean medical schools, and Canadian and non-Canadian graduates from other medical schools. Using the National IMG Database (data available for 2005-2011), we created 2 cohorts: 1) international medical graduates who had passed the Medical Council of Canada Qualifying Examination Part I between 2005 and 2010 and 2) those who had first entered a family medicine postgraduate program between 2005 and 2009, or had first entered a specialty postgraduate program in 2005 or 2006. We examined 3 entry-to-practice milestones; obtaining a postgraduate position, passing the Medical Council of Canada Qualifying Examination Part II and obtaining a specialty designation. Of the 6925 eligible graduates in cohort 1, 2144 (31.0%) had obtained a postgraduate position. Of the 1214 eligible graduates in cohort 2, 1126 (92.8%) had passed the Qualifying Examination Part II, and 889 (73.2%) had obtained a specialty designation. In multivariate analyses, Canadian graduates of Western or Caribbean medical schools (odds ratio [OR] 4.69, 95% confidence interval [CI] 3.82-5.71) and Canadian graduates of other medical schools (OR 1.49, 95% CI 1.31-1.70) were more likely to obtain a postgraduate position than non-Canadian graduates of other (not Western or Caribbean) medical schools. There was no difference among the groups in passing the Qualifying Examination Part II or obtaining a specialty designation. Canadians who studied abroad were more likely than other international medical graduates to obtain a postgraduate position; there were no differences among the groups in realizing milestones once in a postgraduate program. These findings support policies that do not distinguish postgraduate applicants by citizenship or permanent residency status before medical school. Copyright 2017, Joule Inc. or its

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.

Do Personality Traits Assessed on Medical School Admission Predict Exit Performance? A UK-Wide Longitudinal Cohort Study

ERIC Educational Resources Information Center

MacKenzie, R. K.; Dowell, J.; Ayansina, D.; Cleland, J. A.

2017-01-01

Traditional methods of assessing personality traits in medical school selection have been heavily criticised. To address this at the point of selection, "non-cognitive" tests were included in the UK Clinical Aptitude Test, the most widely-used aptitude test in UK medical education (UKCAT: http://www.ukcat.ac.uk/). We examined the…

Anxiety in medical students: is preparation for full-time clinical attachments more dependent upon differences in maturity or on educational programmes for undergraduate and graduate entry students?

PubMed

Hayes, K; Feather, A; Hall, A; Sedgwick, P; Wannan, G; Wessier-Smith, A; Green, T; McCrorie, P

2004-11-01

The transition to full-time clinical studies holds anxieties for most medical students. While graduate entry medical education has only recently begun in the UK, the parallel undergraduate and graduate entry MBBS courses taught at our school allowed us to study how 2 differently prepared groups perceived this vital time at a comparable stage in their training. An anonymous questionnaire collected demographic data and graded anxiety in 13 statements relating to starting full-time clinical attachments. Two open questions allowed free text comment on the most positive and negative influences perceived during this time. Both a statistical analysis and a qualitative assessment were performed to compare the 2 groups of students. The 2 groups were similar with respect to gender but the graduate entry students were significantly older. The graduate entry students were significantly less anxious about most aspects of the transition period compared to the undergraduates. These course differences remained after adjusting for age and sex. When adjusted for course and age, male students expressed less anxiety. The main positive qualitative statements related to continual clinical and communication skills training in the graduate entry group. The main qualitative concerns in both groups related to 'fitting in' and perceived lack of factual knowledge. These data support the early introduction of clinical skills teaching, backed up by a fully integrated clinically relevant curriculum with continued assessment, in preparing students and reducing levels of anxiety before they start full-time clinical attachments. These course design differences appear to be more important than any differences in maturity between the 2 groups.

Twenty-first-century medical microbiology services in the UK.

PubMed

Duerden, Brian

2005-12-01

With infection once again a high priority for the UK National Health Service (NHS), the medical microbiology and infection-control services require increased technology resources and more multidisciplinary staff. Clinical care and health protection need a coordinated network of microbiology services working to consistent standards, provided locally by NHS Trusts and supported by the regional expertise and national reference laboratories of the new Health Protection Agency. Here, I outline my thoughts on the need for these new resources and the ways in which clinical microbiology services in the UK can best meet the demands of the twenty-first century.

Critical factors in career decision making for women medical graduates.

PubMed

Lawrence, Joanna; Poole, Phillippa; Diener, Scott

2003-04-01

Within the next 30 years there will be equal numbers of women and men in the medical workforce. Indications are that women are increasing their participation in specialties other than general practice, although at a slower rate than their participation in the workforce as a whole. To inform those involved in training and employment of medical women, this study investigated the influencing factors in career decision making for female medical graduates. A total of 305 women medical graduates from the University of Auckland responded to a mail survey (73% response rate) which examined influences on decision making, in both qualitative and quantitative ways, as part of a larger survey. Most women were satisfied with their careers. The principal component analysis of the influencing factors identified four distinct factors important in career choice - interest, flexibility, women friendliness and job security, although the first two of these were rated more highly than the others. Barriers to full participation by medical women in training and employment need to be systematically examined and removed. This is not only to allow women themselves to reach their full potential, but for workforce and socio-economic reasons. Initiatives that allow and value more flexible training and work practices, particularly through the years of child raising, are necessary for women and the health care workforce at large.

State of the Plastic Surgery Workforce and the Impact of Graduate Medical Education Reform on Training of Plastic Surgeons.

PubMed

Janes, Lindsay; Lanier, Steven T; Evans, Gregory R D; Kasten, Steven J; Hume, Keith M; Gosain, Arun K

2017-08-01

Although recent estimates predict a large impending shortage of plastic surgeons, graduate medical education funding through the Centers for Medicare and Medicaid Services remains capped by the 1997 Balanced Budget Act. The authors' aim was to develop a plan to stimulate legislative action. The authors reviewed responses of the American Society of Plastic Surgeons, American College of Surgeons, and American Medical Association from January of 2015 to a House Energy & Commerce Committee request for input on graduate medical education funding. In addition, all program directors in plastic surgery were surveyed through the American Council of Academic Plastic Surgeons to determine their graduate medical education funding sources. All three organizations agree that current graduate medical education funding is inadequate to meet workforce needs, and this has a significant impact on specialty selection and distribution for residency training. All agreed that funding should be tied to the resident rather than to the institution, but disagreed on whether funds should be divided between direct (allocated to residency training) and indirect (allocated to patient care) pools, as is currently practiced. Program directors' survey responses indicated that only 38 percent of graduate medical education funds comes from the Centers for Medicare and Medicaid Services. Organized medicine is at risk of losing critically needed graduate medical education funding. Specific legislation to support additional graduate medical education positions and funding (House Resolutions 1180 and 4282) has been proposed but has not been universally endorsed, in part because of a lack of collaboration in organized medicine. Collaboration among major organizations can reinvigorate these measures and implement real change in funding.

Generic versus specific competencies of entry-level public health graduates: employers' perceptions in Poland, the UK, and the Netherlands.

PubMed

Biesma, Regien G; Pavlova, Milena; Vaatstra, Rina; van Merode, Godefridus G; Czabanowska, Katarzyna; Smith, Tony; Groot, Wim

2008-08-01

Constant changes in society and the public health domain force public health professionals into new roles and the development of new competencies. Public health professionals will need to be trained to respond to this challenge. The aim of this comparative study among Poland, the UK and the Netherlands is to identify competence needs for Master of Public Health graduates entering the labour market from a European perspective. A self-administered questionnaire was sent to employers in the three countries, rating the importance of competency in public health on a master's level. In all three countries, interpersonal competencies, like team working and communication skills, are rated as highly important. However, employers in the UK and Poland generally rate public health specific competencies as much more important than their Dutch colleagues. It is concluded that while public health specific knowledge is providing a useful starting point for entry-level public health professionals, employers increasingly recognise the value of generic competencies such as communication and team working skills. The results suggest a stronger emphasis on teaching methods that encourage active learning and the integration of skills, which is crucial for enhancing graduates' employability, and foster an open attitude to multidisciplinary working, which is essential in modern health care.

'Why not you?' Discourses of widening access on UK medical school websites.

PubMed

Alexander, Kirsty; Fahey Palma, Tania; Nicholson, Sandra; Cleland, Jennifer

2017-06-01

In the UK, applications to medicine from those in lower socio-economic groups remain low despite significant investments of time, interest and resources in widening access (WA) to medicine. This suggests that medical schools' core messages about WA may be working to embed or further reinforce marginalisation, rather than to combat this. Our objective was to investigate how the value of WA is communicated by UK medical schools through their websites, and how this may create expectations regarding who is 'suitable' for medicine. We conducted a critical discourse analysis of the webpages of UK medical schools in relation to WA. Our conceptual framework was underpinned by a Foucauldian understanding of discourse. Analysis followed an adapted version of Hyatt's analytical framework. This involved contextualising the data by identifying drivers, levers and warrants for WA, before undertaking a systematic investigation of linguistic features to reveal the discourses in use, and their assumptions. Discourses of 'social mobility for the individual' justified WA as an initiative to support individuals with academic ability and commitment to medicine, but who were disadvantaged by their background in the application process. This meritocratic discourse communicated the benefits of WA as flowing one way, with medical schools providing opportunities to applicants. Conversely, discourses justifying WA as an initiative to benefit patient care were marginalised and largely excluded. Alternative strengths typically attributed to students from lower socio-economic groups were not mentioned, which implies that these were not valued. Current discourses of WA on UK medical school websites do not present non-traditional applicants as bringing gains to medicine through their diversity. This may work as a barrier to attracting larger numbers of diverse applicants. Medical schools should reflect upon their website discourses, critically evaluate current approaches to encouraging

International Medical Graduates: Learning for Practice in Alberta, Canada

ERIC Educational Resources Information Center

Lockyer, Jocelyn; Hofmeister, Marianna; Crutcher, Rodney; Klein, Douglas; Fidler, Herta

2007-01-01

Introduction: There is little known about the learning that is undertaken by physicians who graduate from a World Health Organization-listed medical school outside Canada and who migrate to Canada to practice. What do physicians learn and what resources do they access in adapting to practice in Alberta, a province of Canada? Methods: Telephone…

Proposing a Model of Co-Regulated Learning for Graduate Medical Education.

PubMed

Rich, Jessica V

2017-08-01

Primarily grounded in Zimmerman's social cognitive model of self-regulation, graduate medical education is guided by principles that self-regulated learning takes place within social context and influence, and that the social context and physical environment reciprocally influence persons and their cognition, behavior, and development. However, contemporary perspectives on self-regulation are moving beyond Zimmerman's triadic reciprocal orientation to models that consider social transactions as the central core of regulated learning. Such co-regulated learning models emphasize shared control of learning and the role more advanced others play in scaffolding novices' metacognitive engagement.Models of co-regulated learning describe social transactions as periods of distributed regulation among individuals, which instrumentally promote or inhibit the capacity for individuals to independently self-regulate. Social transactions with other regulators, including attending physicians, more experienced residents, and allied health care professionals, are known to mediate residents' learning and to support or hamper the development of their self-regulated learning competence. Given that social transactions are at the heart of learning-oriented assessment and entrustment decisions, an appreciation for co-regulated learning is likely important for advancing medical education research and practice-especially given the momentum of new innovations such as entrustable professional activities.In this article, the author explains why graduate medical educators should consider adopting a model of co-regulated learning to complement and extend Zimmerman's models of self-regulated learning. In doing so, the author suggests a model of co-regulated learning and provides practical examples of how the model is relevant to graduate medical education research and practice.

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.

Singapore's proposed graduate medical school--an expensive medical tutorial college or an opportunity for transforming Singapore medicine?

PubMed

Soo, K C

2005-07-01

The proposed Graduate Medical School at the Outram Campus will open in 2007. The main value of this medical school is the transformation of the medical institutions in the campus and SingHealth into Academic Medical Centres. Such centres will train and host quality physicians and physician-scientists. It will help push the development of translational research, complementing the country's investment in Biopolis. It will also underpin Singapore's push into regional medical tourism and its development as an educational hub in the biomedical sciences.

The under-representation of minority ethnic groups in UK medical research.

PubMed

Smart, Andrew; Harrison, Eric

2017-02-01

Objectives . The paper investigates differences in engagement with medical research between White British and Black, Asian and Minority Ethnic (BAME) groups in the UK, using data from the Wellcome Trust Monitor (WTM). The study used two waves of the WTM (n = 2575) to examine associations between ethnic group and participation in medical research, and willingness to participate (WP) in medical research. Logistic regression models controlled for socio-economic and demographic factors, and relevant outlooks and experiences that are assumed to be markers of engagement. Respondents from the BAME group were less likely to have participated in medical research compared to those from the White British group, but there was only patchy evidence of small ethnic group differences in WP. Influences on engagement with medical research varied somewhat between the White British and BAME groups, in particular in relation to occupation, education, health, attitudes to medical science and belief. These findings consolidate previously context-specific evidence of BAME group under-representation in the UK, and highlight heterogeneity in that group. Efforts to address the under-representation of those from BAME groups might benefit from targeted strategies for recruitment and advocacy, although improved data sets are required to fully understand ethnic differences in engagement with medical research.

The Time Is Now: Using Graduates' Practice Data to Drive Medical Education Reform.

PubMed

Triola, Marc M; Hawkins, Richard E; Skochelak, Susan E

2018-06-01

Medical educators are not yet taking full advantage of the publicly available clinical practice data published by federal, state, and local governments, which can be attributed to individual physicians and evaluated in the context of where they attended medical school and residency training. Understanding how graduates fare in actual practice, both in terms of the quality of the care they provide and the clinical challenges they face, can aid educators in taking an evidence-based approach to medical education. Although in their infancy, efforts to link clinical outcomes data to educational process data hold the potential to accelerate medical education research and innovation. This approach will enable unprecedented insight into the long-term impact of each stage of medical education on graduates' future practice. More work is needed to determine best practices, but the barrier to using these public data is low, and the potential for early results is immediate. Using practice data to evaluate medical education programs can transform how the future physician workforce is trained and better align continuously learning medical education and health care systems.

Socioeconomic Characteristics and Motivations for Entering a Medical College--Differences between Graduate and Undergraduate Saudi Medical Students

ERIC Educational Resources Information Center

AL-Jahdali, Hamdan; Alqarni, Turki; AL-Jahdali, Sarah; Baharoon, Salim A.; AL-Harbi, Abdullah S.; Binsalih, Salih A.; Alshimemeri, Abdulah; Al Sayyari, Abdullah A.

2014-01-01

Objective: The aim of this study is to investigate the reasons for and the factors associated with deciding to enter a medical school in our graduate and undergraduate medical students and whether differ between the two groups. Method: This is a cross-sectional study. The survey we developed to investigate demographic and socioeconomic data and…

The road to an academic medicine career: a national cohort study of male and female U.S. medical graduates.

PubMed

Andriole, Dorothy A; Jeffe, Donna B

2012-12-01

To explore the relationship between gender and full-time faculty appointment in a national cohort of contemporary U.S. medical school graduates. The authors analyzed deidentified, individual records for the 1998-2004 national cohort of U.S. medical graduates using multivariate logistic regression to identify predictors of full-time faculty appointment through July 2009. They reported adjusted odds ratios (aOR) significant at P < .05. Of 66,889 graduates, 12,038 (18.0%) had held full-time faculty appointments. Among all graduates, women (aOR = 1.21) were more likely than men to have held faculty appointments. Among only male graduates, those who participated in research during college (aOR = 1.08), who entered medical school with greater planned career involvement in research (aOR = 1.08), and who authored/coauthored a research paper during medical school (aOR = 1.12) were more likely, and those with higher debt were less likely (aOR = 0.96), to have held faculty appointments. Among only faculty appointees, higher proportions of men than women had participated in medical school research electives (63.5% [3,899/6,138] versus 54.2% [3,197/5,900]; P < .001) and authored/coauthored research papers during medical school (44.1% [2,707/6,138] versus 33.6% [1,981/5,900]; P < .001); female faculty had reported higher debt at medical school graduation than had male faculty (P = .014). In this national cohort of U.S. medical graduates, women were more likely than men to have held full-time faculty appointments. However, male and female faculty appointees entered academic medicine with different research experiences and debt, possibly impacting their academic medicine career trajectories.

Preferred practice location at medical school commencement strongly determines graduates' rural preferences and work locations.

PubMed

Herd, Marie S; Bulsara, Max K; Jones, Michael P; Mak, Donna B

2017-02-01

To identify factors influencing whether Australian medical graduates prefer to, or actually, work rurally. Secondary analysis of longitudinal data from Medical Schools Outcomes Database (MSOD) using univariate and multivariate logistic regression. Twenty Australian medical schools. Australian or New Zealand citizens and Australian permanent residents who completed MSOD questionnaires between 2006 and 2013. Preferred and actual work locations 1 (PGY1) and 3 (PGY3) years postgraduation. Of 20 784 participants, 4028 completed a PGY1 or PGY3 questionnaire. Self-reported preference for rural practice location at medical school commencement was the most consistent independent predictor of whether a graduate would have a rural location preference at PGY1 (odds ratio (OR) 6.07, 95% confidence interval (CI) 4.91-7.51) and PGY3 (OR 7.95, 95% CI 4.93-12.84), and work rurally during PGY1 (OR 1.38, 95% CI 1.01-1.88) and PGY3 (OR 1.86, 95% CI 1.30-2.64). The effect of preferred practice location at medical school commencement is independent of, and enhances the effect of, rural background. Graduates of graduate-entry programs or with dependent children were less likely to have worked rurally during PGY1 and PGY3 respectively. The most consistent factor associated with rural preferences and work location was students' preferred location of practice at medical school commencement; this association is independent of, and enhances the effect of, rural background. Better understanding of what determines rural preference at medical school commencement and its influence on rural workplace outcomes beyond PGY3 is required to inform Australian medical school selection policies and rural health curricula. © 2016 National Rural Health Alliance Inc.

Performances of U.S. Osteopathic and Canadian Medical School Graduates on the American Board of Internal Medicine Certifying Examinations, 1984-1988.

ERIC Educational Resources Information Center

Shea, Judy A.; And Others

1990-01-01

A study compared the 1984-88 test performances of United States osteopathic medical school graduates and Canadian medical school graduates with those of U.S. and foreign medical school graduates during the same period. Findings, limitations, and implications for recruitment and training of internal medicine specialists are discussed. (Author/MSE)

Advancing Resident Assessment in Graduate Medical Education

PubMed Central

Swing, Susan R.; Clyman, Stephen G.; Holmboe, Eric S.; Williams, Reed G.

2009-01-01

Background The Outcome Project requires high-quality assessment approaches to provide reliable and valid judgments of the attainment of competencies deemed important for physician practice. Intervention The Accreditation Council for Graduate Medical Education (ACGME) convened the Advisory Committee on Educational Outcome Assessment in 2007–2008 to identify high-quality assessment methods. The assessments selected by this body would form a core set that could be used by all programs in a specialty to assess resident performance and enable initial steps toward establishing national specialty databases of program performance. The committee identified a small set of methods for provisional use and further evaluation. It also developed frameworks and processes to support the ongoing evaluation of methods and the longer-term enhancement of assessment in graduate medical education. Outcome The committee constructed a set of standards, a methodology for applying the standards, and grading rules for their review of assessment method quality. It developed a simple report card for displaying grades on each standard and an overall grade for each method reviewed. It also described an assessment system of factors that influence assessment quality. The committee proposed a coordinated, national-level infrastructure to support enhancements to assessment, including method development and assessor training. It recommended the establishment of a new assessment review group to continue its work of evaluating assessment methods. The committee delivered a report summarizing its activities and 5 related recommendations for implementation to the ACGME Board in September 2008. PMID:21975993

Teaching fellowships for UK foundation doctors.

PubMed

Qureshi, Shaun

2015-01-01

Teaching Fellowships for junior doctors in their second post-graduate (FY2) year should be considered by medical students and junior doctors in UK. FY2 Teaching Fellowships are available in many foundation schools as part of the UK Academic Foundation Programme. Although programme structures differ between schools, they are designed to allow junior trainees to take time out from clinical practice to develop their teaching skills and gain insights into medication education careers. The advantages of an FY2 teaching fellowship include valuable experience of teaching and formal feedback not available to other trainees; the opportunity to further develop your portfolio; further development of the trainee's own knowledge and skills; the stimulation of working with students. Potential drawbacks to be considered are reduced direct clinical contact; reduced salary; difficulty carrying out education research in the allocated time frame; occasional difficulties establishing the teacher-student relationship while the trainee is at a relatively junior level. Experience of medical education as an FY2 trainee provides a helpful stepping stone whether or not the trainee further pursues education as a career, because the teaching skills are transferable to any specialty, and the unique experience enhances the trainee's confidence as a role model for junior colleagues.

Association between proportion of US medical graduates and program characteristics in gastroenterology fellowships.

PubMed

Atsawarungruangkit, Amporn

2017-01-01

Gastroenterology is one of the most competitive internal medicine fellowship. However, factors that associated with program competitiveness have not been documented. The objective of this study was to evaluate associations between characteristics of gastroenterology fellowship programs and their competitiveness through the proportion of US medical graduates for the academic year 2016/17. This study used a retrospective, cross-sectional design with data obtained from the American Medical Association. The proportion of US medical graduates in gastroenterology fellowships was used as an indicator of program competitiveness. Using both univariate and multivariate linear regression analyses, we analyzed the association between the proportion of medical graduates in each program and 27 program characteristics based on a significance level of 0.05. In total, 153 out of 171 gastroenterology fellowship programs satisfied the inclusion criteria. A multivariate analysis revealed that a higher proportion of US medical graduates was significantly associated with five program characteristics: that it was a university-based program (p < 0.001), the ratio of full-time paid faculty to fellow positions (p < 0.001), the proportion of females in the program (p = 0.002), location in the Pacific region (p = 0.039), and a non-smoker hiring policy (p = 0.042). Among the five significant factors, being university based, located in the Pacific, and having a non-smoker hiring policy were likely to remain unchanged over a long period. However, program directors and candidates should pay attention to equivalence between full-time paid faculty and fellowship positions, and the proportion of women in the program. The former indicates the level of supervision while the latter has become increasingly important owing to the higher proportion of women in medicine.

Selection Factors among International Medical Graduates and Psychiatric Residency Performance

ERIC Educational Resources Information Center

Shiroma, Paulo R.; Alarcon, Renato D.

2010-01-01

Objective: The authors examine the association between the selection factors used in a psychiatric residency program and subsequent clinical and academic performance among international medical graduate (IMG) candidates. Methods: The authors completed a retrospective review of application files and residency evaluations of 50 IMG residents who…

Accrediting Graduate Medical Education in Psychiatry: Past, Present, and Future.

PubMed

Johnson, Toni; John, Nadyah Janine; Lang, Michael; Shelton, P G

2017-06-01

The current terminology, goals, and general competency framework systematically utilized in the education of residents regardless of specialty is almost unrecognizable and quite foreign to those who trained before 2010. For example, the clinical and professional expectations for physicians-in-training have been placed onto a developmental framework of milestones. The expectations required during training have been expanded to include leadership and team participation skills, proficiency in the use of information technology, systems-based knowledge including respect of resources and cost of care, patient safety, quality improvement, population health and sensitivity to diversity for both individual and populations of patients. With these additions to physician training, the Accreditation Council for Graduate Medical Education (ACGME) hopes to remain accountable to the social contract between medicine and the public. With a focus on psychiatric practice, this article provides a general background and overview of the major overhaul of the accreditation process and educational goals for graduate medical education and briefly highlights possibilities for the future.

The Single Graduate Medical Education (GME) Accreditation System Will Change the Future of the Family Medicine Workforce.

PubMed

Peabody, Michael R; O'Neill, Thomas R; Eden, Aimee R; Puffer, James C

2017-01-01

Due to the Accreditation Council for Graduate Medical Education (ACGME)/American Osteopathic Association (AOA) single-accreditation model, the specialty of family medicine may see as many as 150 programs and 500 trainees in AOA-accredited programs seek ACGME accreditation. This analysis serves to better understand the composition of physicians completing family medicine residency training and their subsequent certification by the American Board of Family Medicine. We identified residents who completed an ACGME-accredited or dual-accredited family medicine residency program between 2006 and 2016 and cross-tabulated the data by graduation year and by educational background (US Medical Graduate-MD [USMG-MD], USMG-DO, or International Medical Graduate-MD [IMG-MD]) to examine the cohort composition trend over time. The number and proportion of osteopaths completing family medicine residency training continues to rise concurrent with a decline in the number and proportion of IMGs. Take Rates for USMG-MDs and USMG-IMGs seem stable; however, the Take Rate for the USMG-DOs has generally been rising since 2011. There is a clear change in the composition of graduating trainees entering the family medicine workforce. As the transition to a single accreditation system for graduate medical education progresses, further shifts in the composition of this workforce should be expected. © Copyright 2017 by the American Board of Family Medicine.

A Case Study of the Impact of a Sytematic Evaluation Process in a Graduate Medical Education Residency Program

ERIC Educational Resources Information Center

Kromrei, Heidi T.

2014-01-01

The Accreditation Council for Graduate Medical Education has charged institutions that sponsor accredited Graduate Medical Education programs (residency and fellowship specialty programs) with overseeing implementation of mandatory annual program evaluation efforts to ensure compliance with regulatory requirements. Physicians receive scant, if…

Mystery behind the match: an undergraduate medical education–graduate medical education collaborative approach to understanding match goals and outcomes

PubMed Central

Nagler, Alisa; Engle, Deborah L.; Rudd, Mariah; Chudgar, Saumil M.; Weinerth, John L.; Kuhn, Catherine M.; Buckley, Edward; Grochowski, Colleen O’Connor

2016-01-01

Background There is a paucity of information regarding institutional targets for the number of undergraduate medical education (UME) graduates being matched to graduate medical education (GME) programs at their home institutions. At our institution, the Duke University, the number of UME graduates matched to GME programs declined dramatically in 2011. To better understand why this decline may have happened, we sought to identify perceived quality metrics for UME and GME learners, evaluate trends in match outcomes and educational program characteristics, and explore whether there is an ideal retention rate for UME graduates in their home institutions’ GME programs. Methods We analyzed the number of Duke University UME graduates remaining at Duke for GME training over the past 5 years. We collected data to assess for changing characteristics of UME and GME, and performed descriptive analysis of trends over time to investigate the potential impact on match outcomes. Results A one-sample t-test analysis showed no statistically significant difference in the number of Duke UME graduates who stayed for GME training. For both UME and GME, no significant changes in the characteristics of either program were found. Discussion We created a process for monitoring data related to the characteristics or perceived quality of UME and GME programs and developed a shared understanding of what may impact match lists for both UME graduates and GME programs, leaving the Match somewhat less mysterious. While we understand the trend of graduates remaining at their home institutions for GME training, we are uncertain whether setting a goal for retention is reasonable, and so some mystery remains. We believe there is an invaluable opportunity for collaboration between UME and GME stakeholders to facilitate discussion about setting shared institutional goals. PMID:27702432

Mystery behind the match: an undergraduate medical education-graduate medical education collaborative approach to understanding match goals and outcomes.

PubMed

Nagler, Alisa; Engle, Deborah L; Rudd, Mariah; Chudgar, Saumil M; Weinerth, John L; Kuhn, Catherine M; Buckley, Edward; Grochowski, Colleen O'Connor

2016-01-01

There is a paucity of information regarding institutional targets for the number of undergraduate medical education (UME) graduates being matched to graduate medical education (GME) programs at their home institutions. At our institution, the Duke University, the number of UME graduates matched to GME programs declined dramatically in 2011. To better understand why this decline may have happened, we sought to identify perceived quality metrics for UME and GME learners, evaluate trends in match outcomes and educational program characteristics, and explore whether there is an ideal retention rate for UME graduates in their home institutions' GME programs. We analyzed the number of Duke University UME graduates remaining at Duke for GME training over the past 5 years. We collected data to assess for changing characteristics of UME and GME, and performed descriptive analysis of trends over time to investigate the potential impact on match outcomes. A one-sample t -test analysis showed no statistically significant difference in the number of Duke UME graduates who stayed for GME training. For both UME and GME, no significant changes in the characteristics of either program were found. We created a process for monitoring data related to the characteristics or perceived quality of UME and GME programs and developed a shared understanding of what may impact match lists for both UME graduates and GME programs, leaving the Match somewhat less mysterious. While we understand the trend of graduates remaining at their home institutions for GME training, we are uncertain whether setting a goal for retention is reasonable, and so some mystery remains. We believe there is an invaluable opportunity for collaboration between UME and GME stakeholders to facilitate discussion about setting shared institutional goals.

The Graduate Teaching Assistant (GTA): Lessons from North American Experience

ERIC Educational Resources Information Center

Park, Chris

2004-01-01

The employment of graduate students on a part-time basis to help with the teaching of undergraduates is growing in the UK and many higher education institutions are confronted with challenges about how best to do this. UK institutions have much to learn from North American experience of appointing graduate teaching assistants (GTAs), and this…

A review of cost-effectiveness, cost-containment and economics curricula in graduate medical education.

PubMed

Varkey, Prathibha; Murad, Mohammad H; Braun, Chad; Grall, Kristi J H; Saoji, Vivek

2010-12-01

Numerous studies performed over the last 30 years suggest that doctors have poor knowledge of the costs of medical care. In most graduate medical education programmes, trainees do not receive formal training in cost-effective medical practice. Comprehensive literature search of electronic bibliographic databases for articles that describe health economics, cost-containment and cost-effectiveness curricula in graduate medical education. Critical appraisal of the literature and qualitative description is presented. Heterogeneity of curricula precluded quantitative summary of data. We identified 40 articles that met the inclusion criteria for this review. Internal medicine residents were the targeted learners in 27 studies (68%); Family Medicine and Surgery residents were each targeted in five studies (13%); Rehabilitation, Paediatrics and Emergency Medicine residents were each targeted in one study. In general, the methodological quality of the included studies was poor to moderate and mostly targeted knowledge of health economics or cost-containment as opposed to targeting cost-effectiveness. In terms of describing the standard curricular components, studies sufficiently described the different educational strategies (e.g. didactics, interactive, experiential, self-directed) and the component of learner assessment, but lacked the description of other elements such as needs assessment and curriculum evaluation. Cost-effectiveness curricula in graduate medical education are lacking and clearly needed. © 2010 Blackwell Publishing Ltd.

Changing the Graduate Medical Education Funding Path to Reduce the Price of Health Care Services.

PubMed

Martin, Ralph A

2015-01-01

An analysis of the current Graduate Medical Education (GME) funding stream reveals undesired aspects that limit the number of graduates and may tend to raise the price of health care services. The author shows that a different model of GME funding changes the economic dynamics and takes advantage of economic forces to increase the supply of graduates, while potentially reducing the price of health care services.

Early career retention of Malawian medical graduates: a retrospective cohort study.

PubMed

Mandeville, Kate L; Ulaya, Godwin; Lagarde, Mylene; Gwesele, Lyson; Dzowela, Titha; Hanson, Kara; Muula, Adamson S

2015-01-01

There have been longstanding concerns over Malawian doctors migrating to high-income countries. Early career is a particularly vulnerable period. After significant policy changes, we examined the retention of recent medical graduates within Malawi and the public sector. We obtained data on graduates between 2006 and 2012 from the University of Malawi College of Medicine and Malawi Ministry of Health. We utilised the alumni network to triangulate official data and contacted graduates directly for missing or uncertain data. Odds ratios and chi-squared tests were employed to investigate relationships by graduation year and gender. We traced 256 graduates, with complete information for more than 90%. Nearly 80% of registered doctors were in Malawi (141/178, 79.2%), although the odds of emigration doubled with each year after graduation (odds ratio = 1.98, 95% CI = 1.54-2.56, P < 0.0001). Of the 37 graduates outside Malawi (14.5%), 23 (62.2%) were training in South Africa under a College of Medicine sandwich programme. More than 80% of graduates were working in the public sector (185/218, 82.6%), with the odds declining by 27% for each year after graduation (odds ratio = 0.73, 95% CI = 0.61-0.86, P < 0.0001). While most doctors remain in Malawi and the public sector during their early careers, the odds of leaving both increase with time. The majority of graduates outside Malawi are training in South Africa under visa restrictions, reflecting the positive impact of postgraduate training in Malawi. Concerns over attrition from the public sector are valid and require further exploratory work. © 2014 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

Graduate Medical Education Viewed from the National Intern and Resident Matching Program

ERIC Educational Resources Information Center

Graettinger, John S.

1976-01-01

The total number of applicants for first-year programs in graduate medical education through the National Intern and Resident Matching Program in 1976 exceeded the number of positions offered for the second consecutive year. There were deficits in the number of openings offered in the primary care specialties and surfeits in medical and surgical…

The impact of site of graduate medical education training and other factors on physician employee retention.

PubMed

Petrou, Steven P; Lee, Marian D; Griffis, Julie; Rawal, Bhupendra; Robinson, Nell; Murray, Peter M

2014-01-01

This study sought to determine if the site of graduate medical training or other factors impact the length of institutional employment. Physician hires for the home institution were catalogued from January 1, 1996, through December 31, 2006. In analyzing the 253 physician hires, we found no statistically significant advantage in employee retention associated with hiring "one's own" or with U.S. medical school graduates.

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

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

A critical review of the core medical training curriculum in the UK: A medical education perspective.

PubMed

Laskaratos, Faidon-Marios; Gkotsi, Despoina; Panteliou, Eleftheria

2014-01-01

This paper represents a systematic evaluation of the Core Medical Training Curriculum in the UK. The authors critically review the curriculum from a medical education perspective based mainly on the medical education literature as well as their personal experience of this curriculum. They conclude in practical recommendations and suggestions which, if adopted, could improve the design and implementation of this postgraduate curriculum. The systematic evaluation approach described in this paper is transferable to the evaluation of other undergraduate or postgraduate curricula, and could be a helpful guide for medical teachers involved in the delivery and evaluation of any medical curriculum.

Psychiatric Residents' Attitudes toward and Experiences with the Clinical-Skills Verification Process: A Pilot Study on U.S. and International Medical Graduates

ERIC Educational Resources Information Center

Rao, Nyapati R.; Kodali, Rahul; Mian, Ayesha; Ramtekkar, Ujjwal; Kamarajan, Chella; Jibson, Michael D.

2012-01-01

Objective: The authors report on a pilot study of the experiences and perceptions of foreign international medical graduate (F-IMG), United States international medical graduate (US-IMG), and United States medical graduate (USMG) psychiatric residents with the newly mandated Clinical Skills Verification (CSV) process. The goal was to identify and…

Variables Associated with Full-time Faculty Appointment among Contemporary U.S. Medical School Graduates: Implications for Academic Medicine Workforce Diversity

PubMed Central

Andriole, Dorothy A.; Jeffe, Donna B.; Hageman, Heather L.; Ephgrave, Kimberly; Lypson, Monica L.; Mavis, Brian; McDougle, Leon; Roberts, Nicole K.

2011-01-01

Purpose The authors sought to identify variables independently associated with full-time faculty appointment among recent medical graduates. Method With institutional review board approval, the authors developed a database of individualized records for six midwestern medical schools’ 1997–2002 graduates. Using multivariate logistic regression, they identified variables independently associated with full-time faculty appointment from among demographic, medical-school-related, and career-intention variables. They report adjusted odds ratios (OR) and 95% confidence intervals (CI). Results Of 1,965 graduates in the sample, 263 (13.4%) held full-time faculty appointments in 2007–2008, including 14.4% (123/853) of women graduates and 8.6% (17/198) of underrepresented minority (URM) graduates. Women (OR: 1.386, 95% CI: 1.023–1.878), MD/PhD program graduates (OR: 2.331, 95% CI: 1.160–4.683), and graduates who reported a career-setting preference for “full-time university faculty” on the Association of American Medical Colleges’ Graduation Questionnaire (OR: 3.164, 95% CI: 2.231–4.486) were more likely to have a full-time faculty appointment. Graduates who chose family medicine (OR: 0.433, 95% CI: 0.231–0.811) and surgical specialties (OR: 0.497, 95% CI: 0.249–0.994) were less likely to have a full-time faculty appointment. URM race/ethnicity was not independently associated with full-time faculty appointment (OR: 0.788; 95% CI: 0.452–1.375). Conclusions Efforts to increase representation of women graduates in academic medicine seem to have met with greater success than efforts to increase representation of URM graduates. Greater participation of URM students in MD/PhD programs and in interventions during medical school that promote interest in academic-medicine careers may increase URM graduates’ representation in academic medicine. PMID:20592523

Predictors of fitness to practise declarations in UK medical undergraduates.

PubMed

Paton, Lewis W; Tiffin, Paul A; Smith, Daniel; Dowell, Jon S; Mwandigha, Lazaro M

2018-04-05

Misconduct during medical school predicts subsequent fitness to practise (FtP) events in doctors, but relatively little is known about which factors are associated with such issues during undergraduate education. This study exploits the newly created UK medical education database (UKMED), with the aim of identifying predictors of conduct or health-related issues that could potentially impair FtP. The findings would have implications for policies related to both the selection and support of medical students. Data were available for 14,379 students obtaining provisional registration with the General Medical Council who started medical school in 2007 and 2008. FtP declarations made by students were available, as were various educational and demographic predictor variables, including self-report 'personality measures' for students who participated in UK Clinical Aptitude Test (UKCAT) pilot studies. Univariable and multivariable logistic regression models were developed to evaluate the predictors of FtP declarations. Significant univariable predictors (p < 0.05) for conduct-related declarations included male gender, white ethnicity and a non-professional parental background. Male gender (OR 3.07) and higher 'self-esteem' (OR 1.45) were independently associated with an increased risk of a conduct issue. Female gender, a non-professional background, and lower self-reported 'confidence' were, among others, associated with increased odds of a health-related declaration. Only 'confidence' was a significant independent predictor of a health declaration (OR 0.69). Female gender, higher UKCAT score, a non-professional background and lower 'confidence' scores were significant predictors of reported depression, and the latter two variables were independent predictors of declared depression. White ethnicity and UK nationality were associated with increased odds of both conduct and health-related declarations, as were certain personality traits. Students from non

Career destinations, views and future plans of the UK medical qualifiers of 1988.

PubMed

Taylor, Kathryn; Lambert, Trevor; Goldacre, Michael

2010-01-01

To report the career destinations, views and future plans of a cohort of senior doctors who qualified in the 1980s. Postal questionnaire survey of all doctors who qualified from all UK medical schools in 1988. The response rate was 69%. We estimated that 81% of the total cohort was working in the NHS, 16 years after qualification; and that at least 94% of graduates who, when students, were from UK homes, were working in medicine. Of NHS doctors, 30% worked part-time. NHS doctors rated their job satisfaction highly (median score 19.9, scale 5-25) but were less satisfied with the amount of leisure time available to them (median score 5.4, scale 1-10). NHS doctors were very positive about their careers, but were less positive about working hours and some other aspects of the NHS. Women were more positive than men about working conditions; general practitioners were more positive than hospital doctors. Twenty-five percent reported unmet needs for further training or career-related advice, particularly about career development. Twenty-nine percent intended to reduce their hours in future, while 6%, mainly part-time women, planned to increase their hours. Overall, 10% of NHS doctors planned to do more service work in future and 24% planned to do less; among part-time women, 18% planned to do more and only 14% less. These NHS doctors, now in their 40s, had a high level of satisfaction with their jobs and their careers but were less satisfied with some other aspects of their working environment. A substantial percentage had expectations about future career development and change.

Career destinations, views and future plans of the UK medical qualifiers of 1988

PubMed Central

Taylor, Kathryn; Lambert, Trevor; Goldacre, Michael

2010-01-01

Summary Objectives To report the career destinations, views and future plans of a cohort of senior doctors who qualified in the 1980s. Methods Postal questionnaire survey of all doctors who qualified from all UK medical schools in 1988. Results The response rate was 69%. We estimated that 81% of the total cohort was working in the NHS, 16 years after qualification; and that at least 94% of graduates who, when students, were from UK homes, were working in medicine. Of NHS doctors, 30% worked part-time. NHS doctors rated their job satisfaction highly (median score 19.9, scale 5–25) but were less satisfied with the amount of leisure time available to them (median score 5.4, scale 1–10). NHS doctors were very positive about their careers, but were less positive about working hours and some other aspects of the NHS. Women were more positive than men about working conditions; general practitioners were more positive than hospital doctors. Twenty-five percent reported unmet needs for further training or career-related advice, particularly about career development. Twenty-nine percent intended to reduce their hours in future, while 6%, mainly part-time women, planned to increase their hours. Overall, 10% of NHS doctors planned to do more service work in future and 24% planned to do less; among part-time women, 18% planned to do more and only 14% less. Conclusions These NHS doctors, now in their 40s, had a high level of satisfaction with their jobs and their careers but were less satisfied with some other aspects of their working environment. A substantial percentage had expectations about future career development and change. PMID:20056666

The emotions of graduating medical students about prior patient care experiences.

PubMed

Clay, Alison S; Ross, Elizabeth; Chudgar, Saumil M; Grochowski, Colleen O'Connor; Tulsky, James A; Shapiro, Dan

2015-03-01

To determine the emotional responses to patient care activities described by fourth year medical students. Qualitative content analysis for emerging themes in letters written by graduating medical students to patients during a Capstone Course. The patient need not be alive and the letter would never be sent. Six themes emerged from student letters: (1) Sorrow for the depths of patient suffering; (2) Gratitude towards patients and their families; (3) Personal responsibility for care provided to patients; (4) Regret for poor care provided by the student or student's team; (5) Shattered expectations about medicine and training; and (6) Anger towards patients. Students expressed sensitivity to vulnerable patients, including those who were alone, unable to communicate, or for whom care was biased. Students' expressed powerlessness (inability to cure, managing a work-life balance, and challenges with hierarchy) in some essays. At graduation, medical students describe strong emotions about previous patient care experiences, including difficulty witnessing suffering, disappointment with medicine, and gratitude to patients and their families Providing regular opportunities for writing throughout medical education would allow students to recognize their emotions, reflect upon them and promote wellness that would benefit students and their patients. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Graduate Medical Education: Trends in Training and Student Debt. GAO-09-438R

ERIC Educational Resources Information Center

King, Kathleen M.; Scott, George A.

2009-01-01

The federal government invests significantly in medical education through various programs to help ensure that the anticipated supply of new physicians meets the nation's health care needs. Medicare, the federal health care program for elderly and certain disabled people, subsidizes training for medical school graduates in hospitals and other…

A UK medical devices regulator's perspective on registries.

PubMed

Wilkinson, John; Crosbie, Andy

2016-04-01

Registries are powerful tools to support manufacturers in the fulfilment of their obligations to perform post-market surveillance and post-market clinical follow-up of implantable medical devices. They are also a valuable resource for regulators in support of regulatory action as well as in providing information around the safety of new and innovative technologies. Registries can provide valuable information on the relative performance of both generic types and manufacturer's individual products and they complement other sources of information about device performance such as post-market clinical studies and adverse incident reporting. This paper describes the experience of the UK medical device regulator - the Medicines and Healthcare Products Regulatory Agency (MHRA) - of working with registries to monitor the safety and performance of medical devices. Based upon this experience, the authors identify a number of attributes for a registry which they consider to be key if the registry is to contribute effectively to the work of regulators on patient safety monitoring and medical device regulation.

A Policy Prospectus for Graduate Medical Education in New Jersey.

ERIC Educational Resources Information Center

New Jersey State Dept. of Higher Education, Trenton.

A study was undertaken to develop guidelines for the future course of graduate medical education (GME) in New Jersey. General findings were that the current array and total number of hospital-based GME offerings by specialty and location appear sufficient, although attention must be paid to appropriate distribution; that the major basis of funding…

Mediators of Racial/Ethnic Disparities in Mentored K Award Receipt Among U.S. Medical School Graduates.

PubMed

Andriole, Dorothy A; Yan, Yan; Jeffe, Donna B

2017-10-01

Mentored K (K01/K08/K23) career development awards are positively associated with physicians' success as independent investigators; however, individuals in some racial/ethnic groups are less likely to receive this federal funding. The authors sought to identify variables that explain (mediate) the association between race/ethnicity and mentored K award receipt among U.S. Liaison Committee for Medical Education-accredited medical school graduates who planned research-related careers. The authors analyzed deidentified data from the Association of American Medical Colleges and the National Institutes of Health Information for Management, Planning, Analysis, and Coordination II grants database for a national cohort of 28,690 graduates from 1997-2004 who planned research-related careers, followed through August 2014. The authors examined 10 potential mediators (4 research activities, 2 academic performance measures, medical school research intensity, degree program, debt, and specialty) of the association between race/ethnicity and mentored K award receipt in models comparing underrepresented minorities in medicine (URM) and non-URM graduates. Among 27,521 graduates with complete data (95.9% of study-eligible graduates), 1,147 (4.2%) received mentored K awards (79/3,341 [2.4%] URM; 1,068/24,180 [4.4%] non-URM). All variables except debt were significant mediators; together they explained 96.2% (95%, CI 79.1%-100%) of the association between race/ethnicity and mentored K award. Research-related activities during/after medical school and standardized academic measures largely explained the association between race/ethnicity and mentored K award in this national cohort. Interventions targeting these mediators could mitigate racial/ethnic disparities in the federally funded physician-scientist research workforce.

Preparing Medical Graduates for an Interconnected World: Current Practices and Future Possibilities for Internationalizing the Medical Curriculum in Different Contexts

ERIC Educational Resources Information Center

Stütz, Alexander; Green, Wendy; McAllister, Lindy; Eley, Diann

2015-01-01

Preparing medical graduates who are competent to work in a global environment requires broad integration of international and intercultural perspectives throughout the medical curriculum. Employing Leask and Bridge's "conceptual framework of internationalisation of the curriculum," this article first highlights the emphasis placed on…

Theory and practice in the design and conduct of graduate medical education.

PubMed

Hodges, Brian David; Kuper, Ayelet

2012-01-01

Medical education practice is more often the result of tradition, ritual, culture, and history than of any easily expressed theoretical or conceptual framework. The authors explain the importance and nature of the role of theory in the design and conduct of graduate medical education. They outline three groups of theories relevant to graduate medical education: bioscience theories, learning theories, and sociocultural theories. Bioscience theories are familiar to many medical educators but are often misperceived as truths rather than theories. Theories from such disciplines as neuroscience, kinesiology, and cognitive psychology offer insights into areas such as memory formation, motor skills acquisition, diagnostic decision making, and instructional design. Learning theories, primarily emerging from psychology and education, are also popular within medical education. Although widely employed, not all learning theories have robust evidence bases. Nonetheless, many important notions within medical education are derived from learning theories, including self-monitoring, legitimate peripheral participation, and simulation design enabling sustained deliberate practice. Sociocultural theories, which are common in the wider education literature but have been largely overlooked within medical education, are inherently concerned with contexts and systems and provide lenses that selectively highlight different aspects of medical education. They challenge educators to reconceptualize the goals of medical education, to illuminate maladaptive processes, and to untangle problems such as career choice, interprofessional communication, and the hidden curriculum.Theories make visible existing problems and enable educators to ask new and important questions. The authors encourage medical educators to gain greater understanding of theories that guide their educational practices.

Nutrition and public health in medical education in the UK: reflections and next steps.

PubMed

Broad, Jonathan; Wallace, Megan

2018-04-30

Doctors play an important role in the identification of nutritional disorders and as advocates for a healthy diet, and although the key tenets of good nutrition education for medical students have been discussed, reports on implementation are sparse. The present commentary responds to a gap in UK medical students' understanding of nutrition and public health and suggests ways to improve it. We review literature about nutrition education in medical schools and discuss a 6-week elective in public health nutrition for medical students. We discuss suggested competencies in nutrition and compare means of students' confidence and knowledge before and after. A nutrition and public health elective in a UK medical school, discussing advocacy, motivational interviewing, supplements, nutritional deficits, parenteral nutrition, obesity services. We utilised multidisciplinary teaching approaches including dietitians, managers and pharmacists, and students implemented a public health activity in a local school. Fifteen final-year medical students were enrolled; sixty school pupils participated in the public health activity. The students were not confident in nutrition competencies before and were taught less than European counterparts. Students enjoyed the course, had improved knowledge, and felt more confident in interviewing and prescribing supplements. Feedback from the local school was positive. Students in our UK medical school were not confident in their required competencies within the confines of the current educational programme. An elective course can improve medical students' knowledge. Similar courses could be implemented in other medical schools to improve nutrition and public health knowledge and practice in future doctors.

The role that graduate medical education must play in ensuring health equity and eliminating health care disparities.

PubMed

Maldonado, Maria E; Fried, Ethan D; DuBose, Thomas D; Nelson, Consuelo; Breida, Margaret

2014-05-01

Despite the 2002 Institute of Medicine report that described the moral and financial impact of health care disparities and the need to address them, it is evident that health care disparities persist. Recommendations for addressing disparities include collecting and reporting data on patient race and ethnicity, supporting language interpretation services, increasing awareness of health care disparities through education, requiring cultural competency training for all health care professionals, and increasing diversity among those delivering health care. The Accreditation Council on Graduate Medical Education places strong emphasis on graduate medical education's role in eliminating health care disparities by asking medical educators to objectively evaluate and report on their trainees' ability to practice patient-centered, culturally competent care. Moreover, one of the objectives of the Accreditation Council on Graduate Medical Education Clinical Learning Environment Review visits as part of the Next Accreditation System is to identify how sponsoring institutions engage residents and fellows in the use of data to improve systems of care, reduce health care disparities, and improve patient outcomes. Residency and fellowship programs should ensure the delivery of meaningful curricula on cultural competency and health care disparities, for which there are numerous resources, and ensure resident assessment of culturally competent care. Moreover, training programs and institutional leadership need to collaborate on ensuring data collection on patient satisfaction, outcomes, and quality measures that are broken down by patient race, cultural identification, and language. A diverse physician workforce is another strategy for mitigating health care disparities, and using strategies to enhance faculty diversity should also be a priority of graduate medical education. Transparent data about institutional diversity efforts should be provided to interested medical students

Use of structured musculoskeletal examination routines in undergraduate medical education and postgraduate clinical practice - a UK survey.

PubMed

Baker, Kenneth F; Jandial, Sharmila; Thompson, Ben; Walker, David; Taylor, Ken; Foster, Helen E

2016-10-21

Structured examination routines have been developed as educational resources for musculoskeletal clinical skills teaching, including Gait-Arms-Legs-Spine (GALS), Regional Examination of the Musculoskeletal System (REMS) and paediatric GALS (pGALS). In this study, we aimed to assess the awareness and use of these examination routines in undergraduate medical teaching in UK medical schools and UK postgraduate clinical practice. Electronic questionnaires were distributed to adult and paediatric musculoskeletal teaching leads at UK medical schools and current UK doctors in training. Responses were received from 67 tutors representing teaching at 22/33 [67 %] of all UK medical schools, and 70 trainee doctors across a range of postgraduate training specialities. There was widespread adoption, at responding medical schools, of the adult examination routines within musculoskeletal teaching (GALS: 14/16 [88 %]; REMS: 12/16 [75 %]) and assessment (GALS: 13/16 [81 %]; REMS: 12/16 [75 %]). More trainees were aware of GALS (64/70 [91 %]) than REMS (14/67 [21 %]). Of the 39 trainees who used GALS in their clinical practice, 35/39 [90 %] reported that it had improved their confidence in musculoskeletal examination. Of the 17/22 responding medical schools that included paediatric musculoskeletal examination within their curricula, 15/17 [88 %] used the pGALS approach and this was included within student assessment at 4 medical schools. We demonstrate the widespread adoption of these examination routines in undergraduate education and significant uptake in postgraduate clinical practice. Further study is required to understand their impact upon clinical performance.

Practice transition in graduate medical education.

PubMed

Shaffer, Robyn; Piro, Nancy; Katznelson, Laurence; Gephart, Melanie Hayden

2017-10-01

Debt repayment, professional negotiation and practice management skills are vital to a successful medical practice, yet are undervalued and seldom taught in graduate medical education. Medical residents need additional training to confidently transition to independent practice, requiring the development of novel curricula. Medical residents need additional training to confidently transition to independent practice METHODS: We developed a trial practice management curriculum to educate senior residents and fellows through voluntary workshops. Topics discussed in the workshops included debt repayment, billing compliance, medical malpractice, contract negotiations, and lifestyle and financial management. Resident self-confidence was assessed, and feedback was obtained through voluntary survey responses before and after attendance at a workshop, scored using a Likert scale. Twenty-five residents from 20 specialties attended a 1-day session incorporating all lectures; 53 residents from 17 specialties attended a re-designed quarterly session with one or two topics per session. Survey evaluations completed before and after the workshop demonstrated an improvement in residents' self-assessment of confidence in contract negotiations (p < 0.001) and their first year in practice (p < 0.001): after the curriculum, 94 per cent (n = 42) of respondents felt confident participating in contract negotiations, and 93 per cent (n = 38) of respondents felt confident about their first year in practice. One hundred per cent of respondents agreed that the presentation objectives were relevant to their needs as residents. Participant responses indicated a need for structured education in practice management for senior trainees. Senior residents and fellows will benefit most from curricula, but have high familial and professional demands on their schedules. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

Impact of the Rural Clinical School of Western Australia on work location of medical graduates.

PubMed

Playford, Denese E; Evans, Sharon F; Atkinson, David N; Auret, Kirsten A; Riley, Geoffrey J

2014-02-03

To determine whether completing a year of the Rural Clinical School of Western Australia (RCSWA) program is associated with entering the rural medical workforce. Cohort study of graduates from the University of Western Australia who completed Year 5 of medical school between 2002 and 2009, comparing work location (identified from the Australian Health Practitioner Regulation Agency database in March-June 2013) between those who participated in the RCSWA (RCSWA graduates) and those who did not (controls). Rural or urban work location of graduates. Of 1116 eligible graduates, 1017 (91.1%) could be traced and were included in the study. Of 258 RCSWA graduates, 42 (16.3%) were working rurally compared with 36 of 759 controls (4.7%). Of 195 RCSWA graduates from urban backgrounds, 29 (14.9%) were working rurally compared with 26 of 691 urban-background controls (3.8%). Of 63 rural-background RCSWA graduates, 13 (20.6%) were working rurally, compared with 10 of 68 rural-background controls (14.7%). Using logistic regression, RCSWA participation had a strong relationship with working rurally (rural-background RCSWA graduates: odds ratio [OR], 7.5; 95% CI, 3.5-15.8; urban-background RCSWA graduates: OR, 5.1; 95% CI, 2.9-9.1). Rural background without RCSWA participation (OR, 4.2; 95% CI, 1.8-9.2) and older age (age in 2012, 30-39 years: OR, 2.2; 95% CI, 1.3-3.7 v ≥ 40 years: OR, 6.6; 95% CI, 2.8-15.0) were also significant factors for working rurally. Participation in the RCSWA is strongly associated with greater likelihood of working rurally. Graduates from urban backgrounds who participated in the RCSWA were much more likely to work in rural areas than those who did not. These data substantiate the RCSWA as an effective rural workforce strategy.

Palliative care education for medical students: Differences in course evolution, organisation, evaluation and funding: A survey of all UK medical schools.

PubMed

Walker, Steven; Gibbins, Jane; Paes, Paul; Adams, Astrid; Chandratilake, Madawa; Gishen, Faye; Lodge, Philip; Wee, Bee; Barclay, Stephen

2017-06-01

A proportion of newly qualified doctors report feeling unprepared to manage patients with palliative care and end-of-life needs. This may be related to barriers within their institution during undergraduate training. Information is limited regarding the current organisation of palliative care teaching across UK medical schools. To investigate the evolution and structure of palliative care teaching at UK medical schools. Anonymised, web-based questionnaire. Settings/participants: Results were obtained from palliative care course organisers at all 30 UK medical schools. The palliative care course was established through active planning (13/30, 43%), ad hoc development (10, 33%) or combination of approaches (7, 23%). The place of palliative care teaching within the curriculum varied. A student-selected palliative care component was offered by 29/30 (97%). All medical schools sought student feedback. The course was reviewed in 26/30 (87%) but not in 4. Similarly, a course organiser was responsible for the palliative care programme in 26/30 but not in 4. A total of 22 respondents spent a mean of 3.9 h (median 2.5)/week in supporting/delivering palliative care education (<1-16 h). In all, 17/29 (59%) had attended a teaching course or shared duties with a colleague who had done so. Course organisers received titular recognition in 18/27 (67%; no title 9 (33%); unknown 3 (11%)). An academic department of Palliative Medicine existed in 12/30 (40%) medical schools. Funding was not universally transparent. Palliative care teaching was associated with some form of funding in 20/30 (66%). Development, organisation, course evaluation and funding for palliative care teaching at UK medical schools are variable. This may have implications for delivery of effective palliative care education for medical students.

Ethnicity and academic performance in UK trained doctors and medical students: systematic review and meta-analysis.

PubMed

Woolf, Katherine; Potts, Henry W W; McManus, I C

2011-03-08

To determine whether the ethnicity of UK trained doctors and medical students is related to their academic performance. Systematic review and meta-analysis. Online databases PubMed, Scopus, and ERIC; Google and Google Scholar; personal knowledge; backwards and forwards citations; specific searches of medical education journals and medical education conference abstracts. The included quantitative reports measured the performance of medical students or UK trained doctors from different ethnic groups in undergraduate or postgraduate assessments. Exclusions were non-UK assessments, only non-UK trained candidates, only self reported assessment data, only dropouts or another non-academic variable, obvious sampling bias, or insufficient details of ethnicity or outcomes. Results 23 reports comparing the academic performance of medical students and doctors from different ethnic groups were included. Meta-analyses of effects from 22 reports (n = 23,742) indicated candidates of "non-white" ethnicity underperformed compared with white candidates (Cohen's d = -0.42, 95% confidence interval -0.50 to -0.34; P<0.001). Effects in the same direction and of similar magnitude were found in meta-analyses of undergraduate assessments only, postgraduate assessments only, machine marked written assessments only, practical clinical assessments only, assessments with pass/fail outcomes only, assessments with continuous outcomes only, and in a meta-analysis of white v Asian candidates only. Heterogeneity was present in all meta-analyses. Ethnic differences in academic performance are widespread across different medical schools, different types of exam, and in undergraduates and postgraduates. They have persisted for many years and cannot be dismissed as atypical or local problems. We need to recognise this as an issue that probably affects all of UK medical and higher education. More detailed information to track the problem as well as further research into its causes is required. Such

Medical Colleges in Saudi Arabia: Can We Predict Graduate Numbers?

ERIC Educational Resources Information Center

Althubaiti, Alaa; Alkhazim, Mohammad

2014-01-01

The shortage of Physicians is a major problem in many countries. Medical colleges are often encouraged to increase the graduate numbers. In the Kingdom of Saudi Arabia, Saudi physicians form only 37.89% of the physician manpower. The remainder of the physicians are expatriates. It was recently estimated that the Kingdom would need 29,128…

Teaching leadership: the medical student society model.

PubMed

Matthews, Jacob H; Morley, Gabriella L; Crossley, Eleanor; Bhanderi, Shivam

2018-04-01

All health care professionals in the UK are expected to have the medical leadership and management (MLM) skills necessary for improving patient care, as stipulated by the UK General Medical Council (GMC). Newly graduated doctors reported insufficient knowledge about leadership and quality improvement skills, despite all UK medical schools reporting that MLM is taught within their curriculum. A medical student society organised a series of extracurricular educational events focusing on leadership topics. The society recognised that the events needed to be useful and interesting to attract audiences. Therefore, clinical leaders in exciting fields were invited to talk about their experiences and case studies of personal leadership challenges. The emphasis on personal stories, from respected leaders, was a deliberate strategy to attract students and enhance learning. Evaluation data were collected from the audiences to improve the quality of the events and to support a business case for an intercalated degree in MLM. When leadership and management concepts are taught through personal stories, students find it interesting and are prepared to give up their leisure time to engage with the subject. Students appear to recognise the importance of MLM knowledge to their future careers, and are able to organise their own, and their peers', learning and development. Organising these events and collecting feedback can provide students with opportunities to practise leadership, management and quality improvement skills. These extracurricular events, delivered through a student society, allow for subjects to be discussed in more depth and can complement an already crowded undergraduate curriculum. Newly graduated doctors reported insufficient knowledge about leadership and quality improvement skills. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

Examination outcomes and work locations of international medical graduate family medicine residents in Canada.

PubMed

Mathews, Maria; Kandar, Rima; Slade, Steve; Yi, Yanqing; Beardall, Sue; Bourgeault, Ivy

2017-10-01

To describe the postgraduate medical education (PGME) examination outcomes and work locations of international medical graduates (IMGs); and to identify differences between Canadians studying abroad (CSAs) and non-CSAs. Cohort study using data from the National IMG Database and Scott's Medical Database. Canada. All IMGs who had first entered a family medicine residency program between 2005 and 2009, with the exclusion of US graduates, visa trainees, and fellowship trainees. We examined 4 outcomes: passing the Medical Council of Canada Qualifying Examination Part 2 (MCCQE2), obtaining Certification in Family Medicine (CCFP), working in Canada within 2 years of completing PGME training, and working in Canada in 2015. Of the 876 residents in the study, 96.1% passed the MCCQE2, 78.1% obtained a specialty designation, 37.7% worked in Canada within 2 years after their PGME, and 91.2% worked in Canada in 2015. Older graduates were more likely (odds ratio [OR] = 3.45; 95% CI 1.52 to 7.69) than recent graduates were to pass the MCCQE2, and residents who participated in a skills assessment program before their PGME training were more likely (OR = 9.60; 95% CI 1.29 to 71.63) than those who had not were to pass the MCCQE2. Women were more likely (OR = 1.67; 95% CI 1.20 to 2.33) to obtain a specialty designation than men were. Recent graduates were more likely (OR = 1.36; 95% CI 1.03 to 1.79) than older graduates were to work in Canada following training. Residents who were eligible for a full licence were more likely (OR = 3.72; 95% CI 2.30 to 5.99) to work in Canada in 2015 than those who were not eligible for a full licence were. While most IMGs who entered the family medicine PGME program passed the MCCQE2, 1 in 5 did not obtain Certification. Most IMG residents remain in Canada. Canadians studying abroad and non-CSA IMGs share similar examination success rates and retention rates. Copyright© the College of Family Physicians of Canada.

Aspects of medical migration with particular reference to the United Kingdom and the Netherlands.

PubMed

Herfs, Paul G P

2014-10-14

In most countries of the European Economic Area (EEA), there is no large-scale migration of medical graduates with diplomas obtained outside the EEA, which are international medical graduates (IMGs). In the United Kingdom however, health care is in part dependent on the influx of IMGs. In 2005, of all the doctors practising in the UK, 31% were educated outside the country. In most EEA-countries, health care is not dependent on the influx of IMGs.The aim of this study is to present data relating to the changes in IMG migration in the UK since the extension of the European Union in May 2004. In addition, data are presented on IMG migration in the Netherlands. These migration flows show that migration patterns differ strongly within these two EU-countries. This study makes use of registration data on migrating doctors from the General Medical Council (GMC) in the UK and from the Dutch Department of Health. Moreover, data on the ratio of medical doctors in relation to a country's population were extracted from the World Health Organization (WHO). The influx of IMGs in the UK has changed in recent years due to the extension of the European Union in 2004, the expansion of UK medical schools and changes in the policy towards non-EEA doctors.The influx of IMGs in the Netherlands is described in detail. In the Netherlands, many IMGs come from Afghanistan, Iraq and Surinam. There are clear differences between IMG immigration in the UK and in the Netherlands. In the UK, the National Health Service continues to be very reliant on immigration to fill shortage posts, whereas the number of immigrant doctors working in the Netherlands is much smaller. Both the UK and the Netherlands' regulatory bodies have shared great concerns about the linguistic and communication skills of both EEA and non-EEA doctors seeking to work in these countries. IMG migration is a global and intricate problem. The source countries, not only those where English is the first or second language, experience

Research-oriented medical education for graduate medical students.

PubMed

Deo, Madhav G

2013-01-01

rating of 8.1 on a scale of 1 to 10. This cost-effective, 'in-study' module of short-duration 'mobile' workshops can be used to educate graduate medical students in basic research procedures employed in clinical and laboratory medicine research. The module is suitable for resource-strapped developing nations. Copyright 2013, NMJI.

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…

Differential determination of perceived stress in medical students and high-school graduates due to private and training-related stressors.

PubMed

Erschens, Rebecca; Herrmann-Werner, Anne; Keifenheim, Katharina Eva; Loda, Teresa; Bugaj, Till Johannes; Nikendei, Christoph; Lammerding-Köppel, Maria; Zipfel, Stephan; Junne, Florian

2018-01-01

Numerous studies from diverse contexts have confirmed high stress levels and stress-associated health impairment in medical students. This study aimed to explore the differential association of perceived stress with private and training-related stressors in medical students according to their stage of medical education. Participants were high-school graduates who plan to study medicine and students in their first, third, sixth, or ninth semester of medical school or in practical medical training. The self-administered questionnaire included items addressing demographic information, the Perceived Stress Questionnaire, and items addressing potential private and training-related stressors. Results confirmed a substantial burden of perceived stress in students at different stages of their medical education. In particular, 10-28% of students in their third or ninth semesters of medical school showed the highest values for perceived stress. Training-related stressors were most strongly associated with perceived stress, although specific stressors that determined perceived stress varied across different stages of students' medical education. High-school graduates highly interested in pursuing medical education showed specific stressors similar to those of medical students in their third, sixth, or ninth semesters of medical school, as well as stress structures with heights of general stress rates similar to those of medical students at the beginning of practical medical training. High-school graduates offer new, interesting information about students' fears and needs before they begin medical school. Medical students and high-school graduates need open, comprehensive information about possible stressors at the outset of and during medical education. Programmes geared toward improving resilience behaviour and teaching new, functional coping strategies are recommended.

Academic and Professional Career Outcomes of Medical School Graduates Who Failed USMLE Step 1 on the First Attempt

ERIC Educational Resources Information Center

McDougle, Leon; Mavis, Brian E.; Jeffe, Donna B.; Roberts, Nicole K.; Ephgrave, Kimberly; Hageman, Heather L.; Lypson, Monica L.; Thomas, Lauree; Andriole, Dorothy A.

2013-01-01

This study sought to determine the academic and professional outcomes of medical school graduates who failed the United States Licensing Examination Step 1 on the first attempt. This retrospective cohort study was based on pooled data from 2,003 graduates of six Midwestern medical schools in the classes of 1997-2002. Demographic, academic, and…

Collision course: the privatization of graduate medical education at one university.

PubMed

Klasko, Stephen K; Ekarius, John C

2007-03-01

On December 18, 2003, Tenet Healthcare Corporation, an investor-owned hospital corporation, announced the closure of Medical College of Pennsylvania Hospital, a historic institution that was home to many of Drexel University College of Medicine's (DUCOM's) faculty, residents, and medical students. The authors summarize the steps that were taken and lessons learned to avoid a disruption in the education of over 200 residents. The authors highlight the response by the medical school; the concerns of the Accreditation Council for Graduate Medical Education (ACGME); the interaction between the Center for Medicare and Medicaid Services (CMS) and the ACGME; the importance of the designated institutional official (DIO) in a crisis situation; and the role of residents as students versus employees when their employer wishes to move or "trade" them to another institution. Through the lens of the DUCOM experience, the authors explore the legal, political, and educational conflicts that occur when an investor-owned company or private hospital employs residents but another entity holds moral and academic accountability for their future. Finally, the authors outline five lessons learned: (1) the important role the ACGME plays as the educational conscience of graduate medical education (GME), (2) the dramatically different roles that the ACGME and the CMS play in regulating and funding the national GME system, (3) the need for constant communication with the affected residents, (4) the important role that the DIO plays in GME, and (5) the need for medical school leaders to remain focused on their educational mission and responsibilities to young physicians.

Funding Instability Reduces the Impact of the Federal Teaching Health Center Graduate Medical Education Program.

PubMed

Kurz, Troy; Liaw, Winston; Wingrove, Peter; Petterson, Stephen; Bazemore, Andrew

2017-01-01

The Teaching Health Center Graduate Medical Education (THCGME) program is a decentralized residency training component of the Affordable Care Act, created to combat critical shortages and maldistribution of primary care physicians. The Accreditation Council of Graduate Medical Education and federal data reveal that the THCGME program accounted for 33% of the net increase in family medicine residency positions between 2011 and 2015. However, amid concerns about the program's stability, the contribution of the THCGME program to the net increase fell to 7% after 2015. © Copyright 2017 by the American Board of Family Medicine.

Emotional intelligence assessment in a graduate entry medical school curriculum

PubMed Central

2013-01-01

Background The management of emotions in the workplace is a skill related to the ability to demonstrate empathic behaviour towards patients; to manage emotional reactions in oneself and to lead others as part of a team. This ability has been defined as emotional intelligence (EI) and doctor’s EI may be related to communication skills and to patient satisfaction levels. This study reports on the use of two assessments of EI as part of a course on Personal and Professional Development (PPD) in a graduate medical school curriculum. Methods Fifty one graduate entry medical students completed an eight session course on PPD between December 2005 and January 2006. Students completed two measures of EI: self-report (EQ-i) and ability (MSCEIT V2.0) over a two year study period. The data gathered were used to explore the relationship between self-report and ability EI and between EI and student demographics, academic performance and change over time. Results Analysis of the EI data demonstrated that self-report EI did not change over time and was not related to ability EI. Females scored higher than males on a number of self-report and ability EI scores. Self-reported self-awareness was found to deteriorate in males and females over time. High self-reported EI was found to be associated with poor performance on clinical competency assessments but with good performance on a number of bio-medical knowledge based assessments. Conclusions This report concludes that assessments of EI can be incorporated into a medical school curriculum as part of a PPD programme and that the concept of EI may be associated with performance in medical school. PMID:23497237

Emotional intelligence assessment in a graduate entry medical school curriculum.

PubMed

Doherty, Eva M; Cronin, Patricia A; Offiah, Gozie

2013-03-07

The management of emotions in the workplace is a skill related to the ability to demonstrate empathic behaviour towards patients; to manage emotional reactions in oneself and to lead others as part of a team. This ability has been defined as emotional intelligence (EI) and doctor's EI may be related to communication skills and to patient satisfaction levels. This study reports on the use of two assessments of EI as part of a course on Personal and Professional Development (PPD) in a graduate medical school curriculum. Fifty one graduate entry medical students completed an eight session course on PPD between December 2005 and January 2006. Students completed two measures of EI: self-report (EQ-i) and ability (MSCEIT V2.0) over a two year study period. The data gathered were used to explore the relationship between self-report and ability EI and between EI and student demographics, academic performance and change over time. Analysis of the EI data demonstrated that self-report EI did not change over time and was not related to ability EI. Females scored higher than males on a number of self-report and ability EI scores. Self-reported self-awareness was found to deteriorate in males and females over time. High self-reported EI was found to be associated with poor performance on clinical competency assessments but with good performance on a number of bio-medical knowledge based assessments. This report concludes that assessments of EI can be incorporated into a medical school curriculum as part of a PPD programme and that the concept of EI may be associated with performance in medical school.

Toward graduate medical education (GME) accountability: measuring the outcomes of GME institutions.

PubMed

Chen, Candice; Petterson, Stephen; Phillips, Robert L; Mullan, Fitzhugh; Bazemore, Andrew; O'Donnell, Sarah D

2013-09-01

Graduate medical education (GME) plays a key role in the U.S. health care workforce, defining its overall size and specialty distribution and influencing physician practice locations. Medicare provides nearly $10 billion annually to support GME and faces growing policy maker interest in creating accountability measures. The purpose of this study was to develop and test candidate GME outcome measures related to physician workforce. The authors performed a secondary analysis of data from the American Medical Association Physician Masterfile, National Provider Identifier file, Medicare claims, and National Health Service Corps, measuring the number and percentage of graduates from 2006 to 2008 practicing in high-need specialties and underserved areas aggregated by their U.S. GME program. Average overall primary care production rate was 25.2% for the study period, although this is an overestimate because hospitalists could not be excluded. Of 759 sponsoring institutions, 158 produced no primary care graduates, and 184 produced more than 80%. An average of 37.9% of internal medicine residents were retained in primary care, including hospitalists. Mean general surgery retention was 38.4%. Overall, 4.8% of graduates practiced in rural areas; 198 institutions produced no rural physicians, and 283 institutions produced no Federally Qualified Health Center or Rural Health Clinic physicians. GME outcomes are measurable for most institutions and training sites. Specialty and geographic locations vary significantly. These findings can inform educators and policy makers during a period of increased calls to align the GME system with national health needs.

Genomics education for medical professionals - the current UK landscape.

PubMed

Slade, Ingrid; Subramanian, Deepak N; Burton, Hilary

2016-08-01

Genomics education in the UK is at an early stage of development, and its pace of evolution has lagged behind that of the genomics research upon which it is based. As a result, knowledge of genomics and its applications remains limited among non-specialist clinicians. In this review article, we describe the complex landscape for genomics education within the UK, and highlight the large number and variety of organisations that can influence, direct and provide genomics training to medical professionals. Postgraduate genomics education is being shaped by the work of the Health Education England (HEE) Genomics Education Programme, working in conjunction with the Joint Committee on Genomics in Medicine. The success of their work will be greatly enhanced by the full cooperation and engagement of the many groups, societies and organisations involved with medical education and training (such as the royal colleges). Without this cooperation, there is a risk of poor coordination and unnecessary duplication of work. Leadership from an organisation such as the HEE Genomics Education Programme will have a key role in guiding the formulation and delivery of genomics education policy by various stakeholders among the different disciplines in medicine. © 2016 Royal College of Physicians.

Interpretation of medical information acts by UK occupational physicians.

PubMed

Batty, Lucia; Glozier, Nick; Holland-Elliott, Kevin

2009-05-01

Difficulties arise in applying the Data Protection Act 1998 and the Access to Medical Reports Act 1988 in occupational health practice. There is no guidance on detailed aspects of applying these Acts in practice and consistent advice has proved difficult to obtain. To audit the understanding and practice of UK occupational physicians to see if a consensus view existed. A postal questionnaire sent to all UK-based Society of Occupational Medicine (SOM) members between December 2005 and June 2006. Responses were analysed using the SPSS 13.0 software. Responses were received from 726 SOM members, a response rate of 48%. The study revealed wide variation and a limited consensus in practice. Significant differences existed between doctors with a Diploma in Occupational Medicine and those with higher Faculty qualifications, between part-time and full-time practitioners and between doctors who qualified pre- and post-1974. The audit revealed wide variation in responding to clinical scenarios in relation to both the Access to Medical Reports and the Data Protection Acts. The findings have implications for clinical practice, policy and research. The majority of respondents reported that national guidance is needed.

Provision of undergraduate otorhinolaryngology teaching within General Medical Council approved UK medical schools: what is current practice?

PubMed

Khan, M M; Saeed, S R

2012-04-01

Despite longstanding concern, provision of undergraduate ENT teaching has not improved in response to the aims of the UK General Medical Council's initiative Tomorrow's Doctors. Previous studies have demonstrated poor representation of ENT within the undergraduate curriculum. We aimed to identify current practice in order to establish undergraduate ENT experience across UK medical schools, a timely endeavour in light of the General Medical Council's new 2011-2013 education strategy. Questionnaires were sent to ENT consultants, medical school deans and students. All schools with a clinical curriculum were anonymously represented. Our outcome measures were the provision of mandatory or optional ENT placements, and their duration and content. A compulsory ENT placement was available to over half (53 per cent) of the students. Ten of the 26 participating schools did not offer an ENT attachment. The mean mandatory placement was 8 days. Overall, 38 per cent of students reported a satisfactory compulsory ENT placement. Most ENT consultants questioned considered that newly qualified doctors were not proficient in managing common ENT problems that did not require specialist referral. Little improvement in the provision of undergraduate ENT teaching was demonstrated. An increase in the proportion of students undertaking ENT training is necessary. Time and curriculum constraints on medical schools mean that optimisation of available resources is required.

Career preferences of graduating medical students in China: a nationwide cross-sectional study.

PubMed

Hou, Jianlin; Xu, Maoyi; Kolars, Joseph C; Dong, Zhe; Wang, Weimin; Huang, Amy; Ke, Yang

2016-05-06

China faces major challenges in the distribution of health professionals with serious shortages in rural areas and in the development of Primary Care Providers (PCPs). This study investigates the career preferences of medical students in China and the impact of rural backgrounds on these preferences. Medical students in the final year of their program in 16 medical schools across China completed a 58-item survey that included questions regarding their demographic characteristics, attitudes toward practice in low resource areas, postgraduate planning, self-assessed competency, university facilities assessment, and financial situation. Descriptive calculation and Logit model were used for the analysis. Completed surveys from 3020 students were included in the analysis. Upon graduation, 48.5% of the medical students preferred to work in urban public hospitals and this percentage rose to 73.6% when students were asked to state their anticipated preference five years after graduation. Students' top three ranked reasons for preferred careers were "good career prospects", "living close to parents/families", and "remuneration". Those who preferred to work in rural areas upon graduation were more likely to be those who lived in rural areas when 1-15 years old (β = 2.05, p < 0.001), had high school in rural areas (β = 1.73, p < 0.001), or had parents' place of current residence in rural areas (β = 2.12, p < 0.001). Similar results were found for those students who preferred to work in PCPs. To address the serious shortages of health professionals in rural areas and PCPs, medical schools should consider strategies to recruit more medical applicants with rural backgrounds and to orient students to rural and primary care interests.

Correlation of admissions statistics to graduate student success in medical physics

PubMed Central

McSpadden, Erin; Rakowski, Joseph; Nalichowski, Adrian; Yudelev, Mark; Snyder, Michael

2014-01-01

The purpose of this work is to develop metrics for evaluation of medical physics graduate student performance, assess relationships between success and other quantifiable factors, and determine whether graduate student performance can be accurately predicted by admissions statistics. A cohort of 108 medical physics graduate students from a single institution were rated for performance after matriculation based on final scores in specific courses, first year graduate Grade Point Average (GPA), performance on the program exit exam, performance in oral review sessions, and faculty rating. Admissions statistics including matriculating program (MS vs. PhD); undergraduate degree type, GPA, and country; graduate degree; general and subject GRE scores; traditional vs. nontraditional status; and ranking by admissions committee were evaluated for potential correlation with the performance metrics. GRE verbal and quantitative scores were correlated with higher scores in the most difficult courses in the program and with the program exit exam; however, the GRE section most correlated with overall faculty rating was the analytical writing section. Students with undergraduate degrees in engineering had a higher faculty rating than those from other disciplines and faculty rating was strongly correlated with undergraduate country. Undergraduate GPA was not statistically correlated with any success metrics investigated in this study. However, the high degree of selection on GPA and quantitative GRE scores during the admissions process results in relatively narrow ranges for these quantities. As such, these results do not necessarily imply that one should not strongly consider traditional metrics, such as undergraduate GPA and quantitative GRE score, during the admissions process. They suggest that once applicants have been initially filtered by these metrics, additional selection should be performed via the other metrics shown here to be correlated with success. The parameters used

Results of physician licence examination and scholarship contract compliance by the graduates of regional quotas in Japanese medical schools: a nationwide cross-sectional survey

PubMed Central

Matsumoto, Masatoshi; Takeuchi, Keisuke; Owaki, Tetsuhiro; Iguchi, Seitaro; Inoue, Kazuo; Kashima, Saori; Tazuma, Susumu; Maeda, Takahiro

2017-01-01

Objectives Responding to the serious shortage of physicians in rural areas, the Japanese government has aggressively increased the number of entrants to medical schools since 2008, mostly as a chiikiwaku, entrants filling a regional quota. The quota has spread to most medical schools, and these entrants occupied 16% of all medical school seats in 2016. Most of these entrants were admitted to medical school with a scholarship with the understanding that after graduation they will practise in designated areas of their home prefectures for several years. The quota and scholarship programmes will be revised by the government starting in 2018. This study evaluates the intermediate outcomes of these programmes. Design Cross-sectional survey to all prefectural governments and medical schools every year from 2014 to 2017 to obtain data on medical graduates. Settings Nationwide. Participants All quota and non-quota graduates with prefecture scholarship in each prefecture, and all the quota graduates without scholarship in each medical school. Primary outcome measures Passing rate of the National License Examination for Physicians and the percentage of graduates who have not bought out the scholarship contract after graduation. Results Most prefectures and medical schools in Japan participated in this study (97.8%–100%). Quota graduates with scholarship were significantly more likely to pass the National License Examination for Physicians than the other medical graduates in Japan at all the years (97.9%, 96.7%, 97.4% and 94.7% vs 93.9%, 94.5%, 94.3% and 91.8%, respectively). The percentage of quota graduates with scholarship who remained in the scholarship contract 3 years after graduation was 92.2% and 89.9% for non-quota graduates with scholarship. Conclusions Quota entrants showed better academic performance than their peers. Most of the quota graduates remained in the contractual workforce. The imminent revision of the national policy regarding quota and scholarship

Determinants of the generalist career intentions of 1995 graduating medical students.

PubMed

Kassebaum, D G; Szenas, P L; Schuchert, M K

1996-02-01

Using national databases of the Association of American Medical College, the authors employed logistic regression analysis to show the relative predictive influences of selected demographic, structural, attitudinal, and educational variables on the specialty careers choices of 1995 U.S. medical school graduates. Plans to pursue certification in family practice or an unspecified generalist career could be predicted with moderate success, while choices of general internal medicine and general pediatrics could not. The intentions of the 1995 graduates to pursue generalist specialty, were significantly associated with demographic factors such as female gender, older student age, and rural hometown; early interest in the generalist specialties; attitudes favoring helping people over seeking opportunities for leadership, intellectual challenge, or research; the presence of a department of family medicine in the medical school; and ambulatory care experiences in the third and fourth years. In the multiple-regression models used in this study, a number of factors widely touted as important to the cultivation of generalism were not significant predictors of generalist decisions; an institutional mission statement expressly addressing the cultivation of generalist careers; giving admission preferences to applicants who vowed an interest in generalism; public (versus private) school sponsorship; discrete organization units for general internal medical or general pediatrics; the proportion of institutional faculty in the general specialty of medicine and pediatrics; the level of educational debt; the students; clinical experiences in the first and second years of medical school. The authors acknowledge the danger of inferring causal relationships from analyses of this kind, and described how the power of previous associations--e.g., that between a required third-year clerkship in family medicine and graduates' family practice career choices--may be weakened when the

Trends in gender, employment, salary, and debt of graduates of US veterinary medical schools and colleges.

PubMed

Chieffo, Carla; Kelly, Alan M; Ferguson, James

2008-09-15

To characterize trends in gender, employment, starting salaries, and educational debt of graduates of US veterinary medical schools and colleges from 1988 to 2007. Meta-analysis. Sample Population-Veterinary medical graduates from 26 or 27 of 27 US veterinary schools and colleges from 1988 through 2007. Data were obtained from surveys published in the JAVMA. A chi2 test for trend was used to analyze trends in choices of employment and educational indebtedness for the veterinary graduate populations over time. The greatest changes in employment occurred in predominantly large animal practice, which attracted 10.7% of new graduates in 1989 but only 2.2% in 2007, and in advanced study, which attracted 15.2% of new graduates in 1989 and 36.8% in 2007. In 2007, 75% of graduates were women, but this gender shift was not associated with the decline in the percentage of graduates entering rural practice. From 1989 through 2007, starting salaries in private practice increased at a rate of 4.60%/y. During the same period, educational debt increased at an annual rate of 7.36%, or 60% higher than the rate of increases for starting salaries. As a result, debt at graduation increased from 1.1 times the starting salary in 1989 to 2.0 times the starting salary in 2007. Veterinary students are now more in debt than they have ever been. This trend together with a substantial increase in the rate of interest charged for government-backed education loans create conditions for new graduates that appear unsustainable.

Cross-sectional study of the financial cost of training to the surgical trainee in the UK and Ireland

PubMed Central

O’Callaghan, John; Mohan, Helen M; Sharrock, Anna; Gokani, Vimal; Fitzgerald, J Edward; Williams, Adam P; Harries, Rhiannon L

2017-01-01

Objectives Applications for surgical training have declined over the last decade, and anecdotally the costs of training at the expense of the surgical trainee are rising. We aimed to quantify the costs surgical trainees are expected to cover for postgraduate training. Design Prospective, cross-sectional, questionnaire-based study. Setting/Participants A non-mandatory online questionnaire for UK-based trainees was distributed nationally. A similar national questionnaire was distributed for Ireland, taking into account differences between the healthcare systems. Only fully completed responses were included. Results There were 848 and 58 fully completed responses from doctors based in the UK and Ireland, respectively. Medical students in the UK reported a significant increase in debt on graduation by 55% from £17 892 (2000–2004) to £27 655 (2010–2014) (p<0.01). 41% of specialty trainees in the UK indicated that some or all of their study budget was used to fund mandatory regional teaching. By the end of training, a surgical trainee in the UK spends on average £9105 on courses, £5411 on conferences and £4185 on exams, not covered by training budget. Irish trainees report similarly high costs. Most trainees undertake a higher degree during their postgraduate training. The cost of achieving the mandatory requirements for completion of training ranges between £20 000 and £26 000 (dependent on specialty), except oral and maxillofacial surgery, which is considerably higher (£71 431). Conclusions Medical students are graduating with significantly larger debt than before. Surgical trainees achieve their educational requirements at substantial personal expenditure. To encourage graduates to pursue and remain in surgical training, urgent action is required to fund the mandatory requirements and annual training costs for completion of training and provide greater transparency to inform doctors of what their postgraduate training costs will be. This is necessary

First Employment of British Pharmacology Graduates

ERIC Educational Resources Information Center

Hollingsworth, Michael; Markham, Anthony

2006-01-01

A survey was conducted in UK Universities to identify the employment of pharmacology graduates (BSc, MSc and PhD) 6 months after graduation in 2003. The aim was to provide data for the British Pharmacological Society (BPS) so they could offer advice to interested bodies and to University staff for careers information. 85% of 52 Universities…

Differential determination of perceived stress in medical students and high-school graduates due to private and training-related stressors

PubMed Central

Herrmann–Werner, Anne; Keifenheim, Katharina Eva; Loda, Teresa; Bugaj, Till Johannes; Nikendei, Christoph; Lammerding–Köppel, Maria; Zipfel, Stephan; Junne, Florian

2018-01-01

Objective Numerous studies from diverse contexts have confirmed high stress levels and stress-associated health impairment in medical students. This study aimed to explore the differential association of perceived stress with private and training-related stressors in medical students according to their stage of medical education. Methods Participants were high-school graduates who plan to study medicine and students in their first, third, sixth, or ninth semester of medical school or in practical medical training. The self-administered questionnaire included items addressing demographic information, the Perceived Stress Questionnaire, and items addressing potential private and training-related stressors. Results Results confirmed a substantial burden of perceived stress in students at different stages of their medical education. In particular, 10–28% of students in their third or ninth semesters of medical school showed the highest values for perceived stress. Training-related stressors were most strongly associated with perceived stress, although specific stressors that determined perceived stress varied across different stages of students’ medical education. High-school graduates highly interested in pursuing medical education showed specific stressors similar to those of medical students in their third, sixth, or ninth semesters of medical school, as well as stress structures with heights of general stress rates similar to those of medical students at the beginning of practical medical training. Conclusions High-school graduates offer new, interesting information about students’ fears and needs before they begin medical school. Medical students and high-school graduates need open, comprehensive information about possible stressors at the outset of and during medical education. Programmes geared toward improving resilience behaviour and teaching new, functional coping strategies are recommended. PMID:29385180

The incidence of medically reported work-related ill health in the UK construction industry.

PubMed

Stocks, S J; McNamee, R; Carder, M; Agius, R M

2010-08-01

Self-reported work-related ill health (SWI) data show a high incidence of occupational ill health and a high burden of cancer attributable to occupational factors in the UK construction industry. However, there is little information on the incidence of medically reported work-related ill health (WRI) within this industry. This study aims to examine the incidence of WRI within the UK construction industry. Standardised incidence rate ratios (SRRs) were used to compare incidence rates of reports of medically certified work-related ill health returned to The Health and Occupation Reporting network (THOR) within the UK construction industry with all other UK industries combined. Male UK construction industry workers aged under 65 years had significantly raised SRRs for respiratory (3.8, 95% CI 3.5 to 4.2), skin (1.6, 1.4 to 1.8) and musculoskeletal disorders (MSD; 1.9, 1.6 to 2.2). These SRRs were further raised for those working within a construction trade. The increased SRRs for skin disease within male construction industry workers were due to contact dermatitis (1.4, 1.2 to 1.6) and neoplasia (4.2, 3.3 to 5.3). For respiratory disease, the increased SRRs were due to non-malignant pleural disease (7.1, 6.3 to 8.1), mesothelioma (7.1, 6.0 to 8.3), lung cancer (5.4, 3.2 to 8.9) and pneumoconiosis (5.5, 3.7 to 8.0), but the SRRs for asthma (0.09, 0.06 to 0.11) and mental ill health (0.3, 0.1 to 0.4) were significantly reduced. The significantly raised SRRs for medically reported MSD and significantly reduced SRRs for mental ill health in construction workers confirm self-reported UK data. These SRRs provide a baseline of the incidence of WRI in the UK construction industry from which to monitor the effects of changes in policy or exposures.

Longitudinal rural clerkships: increased likelihood of more remote rural medical practice following graduation.

PubMed

Playford, Denese E; Nicholson, Asha; Riley, Geoffrey J; Puddey, Ian B

2015-03-21

Extended rural clerkships clearly increase the likelihood of rural practice post-graduation. What has not been determined is whether such rural interventions increase the likelihood of graduates practicing in more remote, versus inner regional, locations. The Australian Health Practitioner Regulation Agency database was used to identify the current workplace of every graduate of the Medical School of Western Australia, 1980 to 2011. There were 324 graduates working in a primary practice location defined by the Australian Standard Geographical Classification as inner regional to very remote. They were divided into 3 groups - 200 graduates who entered medical school before commencement of the Rural Clinical School of Western Australia (RCSWA), 63 who entered after the RCSWA had started, but not participated in RCSWA, and 61 who participated in the RCSWA. The RCSWA offers a longitudinal rural clinical clerkship throughout level 5 of the MBBS course. The two groups not participating in the RCSWA had 45.5% and 52.4% of subjects in outer regional/very remote locations, respectively. In comparison, 78.7% of those who had participated in the RCSWA were currently practicing in outer regional/very remote locations. When the 3 groups were compared, the significant predictors of working in a more remote practice compared to working in an inner regional area were being female (OR 1.75 95% CI 1.13, 2.72, P = 0.013) and participating in the RCSWA (OR 4.42, 95% CI 2.26, 8.67, P < 0.001). In multivariate logistic regression that corrected for gender and remoteness of rural address before entry to medical school, participation in the RCSWA still predicted a more than 4-fold increase in the odds of practicing in a more remote area (OR 4.11, 95% CI 2.04, 8.30, P < 0.001). Extended rural clinical clerkship during an undergraduate MBBS course is related to a much greater likelihood of practicing in more remote, under-serviced rural locations.

Medical student selection criteria as predictors of intended rural practice following graduation.

PubMed

Puddey, Ian B; Mercer, Annette; Playford, Denese E; Pougnault, Sue; Riley, Geoffrey J

2014-10-14

Recruiting medical students from a rural background, together with offering them opportunities for prolonged immersion in rural clinical training environments, both lead to increased participation in the rural workforce after graduation. We have now assessed the extent to which medical students' intentions to practice rurally may also be predicted by either medical school selection criteria and/or student socio-demographic profiles. The study cohort included 538 secondary school-leaver entrants to The University of Western Australia Medical School from 2006 to 2011. On entry they completed a questionnaire indicating intention for either urban or rural practice following graduation. Selection factors (standardised interview score, percentile score from the Undergraduate Medicine and Health Sciences Admission Test (UMAT) and prior academic performance (Australian Tertiary Admissions Rank), together with socio-demographic factors (age, gender, decile for the Index of Relative Socioeconomic Advantage and Disadvantage (IRSAD) and an index of rurality) were examined in relation to intended rural or urban destination of practice. In multivariate logistic regression, students from a rural background had a nearly 8-fold increase in the odds of intention to practice rurally after graduation compared to those from urban backgrounds (OR 7.84, 95% CI 4.10, 14.99, P < 0.001). Those intending to be generalists rather than specialists had a more than 4-fold increase in the odds of intention to practice rurally (OR 4.36, 95% CI 1.69, 11.22, P < 0.001). After controlling for these 2 factors, those with rural intent had significantly lower academic entry scores (P = 0.002) and marginally lower interview scores (P = 0.045). UMAT percentile scores were no different. Those intending to work in a rural location were also more likely to be female (OR 1.93, 95% CI 1.08, 3.48, P = 0.027), to come from the lower eight IRSAD deciles (OR 2.52, 95% CI 1.47, 4.32, P = 0

Competencies for Food Graduate Careers: Developing a Language Tool

ERIC Educational Resources Information Center

Weston, Emma; Crilly, Jim; Mossop, Liz; Foster, Tim

2017-01-01

Unlike many other graduate career pathways in the UK, the food industry does not have a cohesive competency framework to support employers, students and degree providers. Food sciences-based technical graduates are a significant proportion of the industry's graduate intake; this study aims to provide such a framework. Initial work involving a…

Graduates from a traditional medical curriculum evaluate the effectiveness of their medical curriculum through interviews.

PubMed

Watmough, Simon; O'Sullivan, Helen; Taylor, David

2009-10-26

In 1996 The University of Liverpool reformed its medical course from a traditional lecture-based course to an integrated PBL curriculum. A project has been underway since 2000 to evaluate this change. Part of this project has involved gathering retrospective views on the relevance of both types of undergraduate education according to graduates. This paper focuses on the views of traditional Liverpool graduates approximately 6 years after graduation. From February 2006 to June 2006 interviews took place with 46 graduates from the last 2 cohorts to graduate from the traditional Liverpool curriculum. The graduates were generally happy with their undergraduate education although they did feel there were some flaws in their curriculum. They felt they had picked up good history and examination skills and were content with their exposure to different specialties on clinical attachments. They were also pleased with their basic science teaching as preparation for postgraduate exams, however many complained about the overload and irrelevance of many lectures in the early years of their course, particular in biochemistry. There were many different views about how they integrated this science teaching into understanding disease processes and many didn't feel it was made relevant to them at the time they learned it. Retrospectively, they felt that they hadn't been clinically well prepared for the role of working as junior doctor, particularly the practical aspects of the job nor had enough exposure to research skills. Although there was little communication skills training in their course they didn't feel they would have benefited from this training as they managed to pick up had the required skills on clinical attachments. These interviews offer a historical snapshot of the views of graduates from a traditional course before many courses were reformed. There was some conflict in the interviews about the doctors enjoying their undergraduate education but then saying that they

Perceptions of the preparedness of medical graduates for internship responsibilities in district hospitals in Kenya: a qualitative study.

PubMed

Muthaura, Patricia N; Khamis, Tashmin; Ahmed, Mushtaq; Hussain, Syeda Ra'ana

2015-10-21

Aga Khan University is developing its undergraduate medical education curriculum for East Africa. In Kenya, a 1 year internship is mandatory for medical graduates' registration as practitioners. The majority of approved internship training sites are at district hospitals. The purposes of this study were to determine: (1) whether recent Kenyan medical graduates are prepared for their roles as interns in district hospitals upon graduation from medical school; (2) what working and training conditions and social support interns are likely to face in district hospital; and (3) what aspects of the undergraduate curriculum need to be addressed to overcome perceived deficiencies in interns' competencies. Focus group discussions and semi-structured interviews were conducted with current interns and clinical supervisors in seven district hospitals in Kenya. Perceptions of both interns and supervisors regarding interns' responsibilities and skills, working conditions at district hospitals, and improvements required in medical education were obtained. Findings included agreement across informants on deficiencies in interns' practical skills and experience of managing clinical challenges. Supervisors were generally critical regarding interns' competencies, whereas interns were more specific about their weaknesses. Supervisor expectations were higher in relation to surgical procedures than those of interns. There was agreement on the limited learning, clinical facilities and social support available at district hospitals including, according to interns, inadequate supervision. Supervisors felt they provided adequate supervision and that interns lacked the ability to initiate communication with them. Both groups indicated transition challenges from medical school to medical practice attributable to inadequate practical experience. They indicated the need for more direct patient care responsibilities and clinical experience at a district hospital during undergraduate training

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.

Ethnicity and academic performance in UK trained doctors and medical students: systematic review and meta-analysis

PubMed Central

Potts, Henry W W; McManus, I C

2011-01-01

Objective To determine whether the ethnicity of UK trained doctors and medical students is related to their academic performance. Design Systematic review and meta-analysis. Data sources Online databases PubMed, Scopus, and ERIC; Google and Google Scholar; personal knowledge; backwards and forwards citations; specific searches of medical education journals and medical education conference abstracts. Study selection The included quantitative reports measured the performance of medical students or UK trained doctors from different ethnic groups in undergraduate or postgraduate assessments. Exclusions were non-UK assessments, only non-UK trained candidates, only self reported assessment data, only dropouts or another non-academic variable, obvious sampling bias, or insufficient details of ethnicity or outcomes. Results 23 reports comparing the academic performance of medical students and doctors from different ethnic groups were included. Meta-analyses of effects from 22 reports (n=23 742) indicated candidates of “non-white” ethnicity underperformed compared with white candidates (Cohen’s d=−0.42, 95% confidence interval −0.50 to −0.34; P<0.001). Effects in the same direction and of similar magnitude were found in meta-analyses of undergraduate assessments only, postgraduate assessments only, machine marked written assessments only, practical clinical assessments only, assessments with pass/fail outcomes only, assessments with continuous outcomes only, and in a meta-analysis of white v Asian candidates only. Heterogeneity was present in all meta-analyses. Conclusion Ethnic differences in academic performance are widespread across different medical schools, different types of exam, and in undergraduates and postgraduates. They have persisted for many years and cannot be dismissed as atypical or local problems. We need to recognise this as an issue that probably affects all of UK medical and higher education. More detailed information to track the problem

The lifetime cost to English students of borrowing to invest in a medical degree: a gender comparison using data from the Office for National Statistics.

PubMed

Ercolani, Marco G; Vohra, Ravinder S; Carmichael, Fiona; Mangat, Karanjit; Alderson, Derek

2015-04-21

To evaluate this impact on male and female English medical graduates by estimating the total time and amount repaid on loans taken out with the UK's Student Loans Company (SLC). UK. 4286 respondents with a medical degree in the Labour Force Surveys administered by the Office for National Statistics (ONS) between 1997 and 2014. Age-salary profiles were generated to estimate the repayment profiles for different levels of initial graduate debt. 2195 female and 2149 male medical graduates were interviewed by the ONS. Those working full-time (73.1% females and 96.1% males) were analysed in greater depth. Following standardisation to 2014 prices, average full-time male graduates earned up to 35% more than females by the age of 55. The initial graduate debt from tuition fees alone amounts to £39,945.69. Owing to interest charges on this debt the average full-time male graduate repays £57,303 over 20 years, while the average female earns less and so repays £61,809 over 26 years. When additional SLC loans are required for maintenance, the initial graduate debt can be as high as £81,916 and, as SLC debt is written off 30 years after graduation, the average female repays £75,786 while the average male repays £110,644. Medical graduates on an average salary are unlikely to repay their SLC debt in full. This is a consequence of higher university fees and as SLC debt is written off 30 years after graduation. This results in the average female graduate repaying more when debt is low, but a lower amount when debt is high compared to male graduates. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The lifetime cost to English students of borrowing to invest in a medical degree: a gender comparison using data from the Office for National Statistics

PubMed Central

Ercolani, Marco G; Vohra, Ravinder S; Carmichael, Fiona; Mangat, Karanjit; Alderson, Derek

2015-01-01

Objective To evaluate this impact on male and female English medical graduates by estimating the total time and amount repaid on loans taken out with the UK's Student Loans Company (SLC). Setting UK. Participants 4286 respondents with a medical degree in the Labour Force Surveys administered by the Office for National Statistics (ONS) between 1997 and 2014. Outcomes Age-salary profiles were generated to estimate the repayment profiles for different levels of initial graduate debt. Results 2195 female and 2149 male medical graduates were interviewed by the ONS. Those working full-time (73.1% females and 96.1% males) were analysed in greater depth. Following standardisation to 2014 prices, average full-time male graduates earned up to 35% more than females by the age of 55. The initial graduate debt from tuition fees alone amounts to £39 945.69. Owing to interest charges on this debt the average full-time male graduate repays £57 303 over 20 years, while the average female earns less and so repays £61 809 over 26 years. When additional SLC loans are required for maintenance, the initial graduate debt can be as high as £81 916 and, as SLC debt is written off 30 years after graduation, the average female repays £75 786 while the average male repays £110 644. Conclusions Medical graduates on an average salary are unlikely to repay their SLC debt in full. This is a consequence of higher university fees and as SLC debt is written off 30 years after graduation. This results in the average female graduate repaying more when debt is low, but a lower amount when debt is high compared to male graduates. PMID:25900463

Prevalence of pain medication prescriptions in France, Germany, and the UK - a cross-sectional study including 4,270,142 patients.

PubMed

Jacob, Louis; Kostev, Karel

2018-01-01

The goal of the present study was to analyze the prevalence of pain medication prescriptions in general practices in France, Germany, and the UK. This study included all patients aged ≥18 years followed in 2016 in general practitioner practices in France, Germany and the UK. The primary outcome was the prevalence of patients receiving prescriptions for pain medications in France, Germany, and the UK in 2016. The following drugs were included in the analysis: anti-inflammatory and antirheumatic products, non-steroids and analgesics including opioids, antimigraine preparations, and other analgesics and antipyretics. Demographic variables included age and gender. This study included 4,270,142 patients. The prevalences of pain medication prescriptions were 57.3% in France, 29.6% in Germany, and 21.7% in the UK. Although this prevalence generally remained consistent between age groups in France (54.3%-60.3%), it increased with age in Germany (18-30 years: 23.8%; >70 years: 35.8%) and in the UK (18-30 years: 9.3%; >70 years: 43.8%). Finally, the prevalence of pain medication prescriptions was higher in women than in men in all three countries. Paracetamol was prescribed to 82.3% and 60.1% of patients receiving pain medication in France and the UK, respectively, whereas ibuprofen was prescribed to 46.5% of individuals in Germany. The prevalence of pain medication prescriptions was higher in France than in Germany and the UK. Further research is needed to gain a better understanding of the differences in the prescription patterns between these three European countries.

Stress, burnout and doctors' attitudes to work are determined by personality and learning style: a twelve year longitudinal study of UK medical graduates.

PubMed

McManus, I C; Keeling, A; Paice, E

2004-08-18

The study investigated the extent to which approaches to work, workplace climate, stress, burnout and satisfaction with medicine as a career in doctors aged about thirty are predicted by measures of learning style and personality measured five to twelve years earlier when the doctors were applicants to medical school or were medical students. Prospective study of a large cohort of doctors. The participants were first studied when they applied to any of five UK medical schools in 1990. Postal questionnaires were sent to all doctors with a traceable address on the current or a previous Medical Register. The current questionnaire included measures of Approaches to Work, Workplace Climate, stress (General Health Questionnaire), burnout (Maslach Burnout Inventory), and satisfaction with medicine as a career and personality (Big Five). Previous questionnaires had included measures of learning style (Study Process Questionnaire) and personality. Doctors' approaches to work were predicted by study habits and learning styles, both at application to medical school and in the final year. How doctors perceive their workplace climate and workload is predicted both by approaches to work and by measures of stress, burnout and satisfaction with medicine. These characteristics are partially predicted by trait measures of personality taken five years earlier. Stress, burnout and satisfaction also correlate with trait measures of personality taken five years earlier. Differences in approach to work and perceived workplace climate seem mainly to reflect stable, long-term individual differences in doctors themselves, reflected in measures of personality and learning style.

Factors affecting residency rank-listing: a Maxdiff survey of graduating Canadian medical students.

PubMed

Wang, Tao; Wong, Benson; Huang, Alexander; Khatri, Prateek; Ng, Carly; Forgie, Melissa; Lanphear, Joel H; O'Neill, Peter J

2011-08-25

In Canada, graduating medical students consider many factors, including geographic, social, and academic, when ranking residency programs through the Canadian Residency Matching Service (CaRMS). The relative significance of these factors is poorly studied in Canada. It is also unknown how students differentiate between their top program choices. This survey study addresses the influence of various factors on applicant decision making. Graduating medical students from all six Ontario medical schools were invited to participate in an online survey available for three weeks prior to the CaRMS match day in 2010. Max-Diff discrete choice scaling, multiple choice, and drop-list style questions were employed. The Max-Diff data was analyzed using a scaled simple count method. Data for how students distinguish between top programs was analyzed as percentages. Comparisons were made between male and female applicants as well as between family medicine and specialist applicants; statistical significance was determined by the Mann-Whitney test. In total, 339 of 819 (41.4%) eligible students responded. The variety of clinical experiences and resident morale were weighed heavily in choosing a residency program; whereas financial incentives and parental leave attitudes had low influence. Major reasons that applicants selected their first choice program over their second choice included the distance to relatives and desirability of the city. Both genders had similar priorities when selecting programs. Family medicine applicants rated the variety of clinical experiences more importantly; whereas specialty applicants emphasized academic factors more. Graduating medical students consider program characteristics such as the variety of clinical experiences and resident morale heavily in terms of overall priority. However, differentiation between their top two choice programs is often dependent on social/geographic factors. The results of this survey will contribute to a better

Graduates of Lebanese medical schools in the United States: an observational study of international migration of physicians.

PubMed

Akl, Elie A; Maroun, Nancy; Major, Stella; Chahoud, Bechara; Schünemann, Holger J

2007-04-05

As healthcare systems around the world are facing increasing physician shortages, more physicians are migrating from low to high income countries. As an illustrative case of international migration of physicians, we evaluated the current number and historical trends of Lebanese medical graduates (LMG) in the US, and compared their characteristics to those of US medical graduates (USMG) and other international medical graduates (IMG). We evaluated the number of LMG using the 2004 the American Medical Association Physicians' Professional Data (AMA-PPD) and then compared it to the number of graduates of other countries. We evaluated the historical trends using the 1978-2004 historical files of the AMA-PPD. We analyzed the characteristics of all LMG and compared them to a random sample of 1000 USMG and a random sample of 1000 IMG using the 2004 AMA-PPD. In 2004, there were 2,796 LMG in the US, constituting 1.3% of all IMG. Compared to other foreign countries contributing to the US physician workforce, Lebanon ranked 2nd after adjusting for country population size (about 4 million) and 21st overall. About 40% of those who graduated from Lebanese medical schools in the last 25 years are currently active physicians in the US. Since 1978, the number of LMG in the US showed a consistent upward trend at a rate of approximately 71 additional graduates per year. Compared with USMG and IMG, LMG were more likely to work in medical research (OR = 2.31; 95% Confidence Interval (CI) = 1.21; 4.43 and OR = 2.63; 95% CI = 1.34; 5.01, respectively) and to be board certified (OR = 1.43; 95% CI = 1.14; 1.78 and OR = 2.04; 95% CI = 1.65;2.53, respectively) and less likely to be in family practice (OR = 0.14; 95% CI = 0.10; 0.19 and OR = 0.18; 95% CI = 0.12; 0.26, respectively). Given the magnitude and historical trends of migration of LMG to the US, further exploration of its causes and impact is warranted. High income countries should consider the consequences of their human resources

Implementation of the medical research curriculum in graduate medical school.

PubMed

Park, Kwi Hwa; Kim, Tae-Hee; Chung, Wook-Jin

2011-06-01

The purpose of this study was to analyze the effect of the medical research curriculum on the students' satisfaction and the research self-efficacy. The curriculum was implemented to 79 graduate medical school students who entered in 2007 and 2008. This curriculum is implemented through 3 years consisting of 5 different sub-courses: Research design, Research ethics, Medical statistics, Writing medical paper, and Presentation. The effect of this program was measured with 2 self-administered surveys to students: the course satisfaction survey and the self-efficacy inventories. The Research Self-Efficacy Scale consisted of 18 items from 4 categories: Research design, Research ethics, Data analysis, and Result presentation. The descriptive statistics, paired t-test, and analysis of covariance (ANCOVA) were implemented. The average point of satisfaction of the course was 2.74 out of 4, which told us that students generally satisfied with the course. The frequencies of tutoring for research course were 2 or 3 times on average and each session of tutorial lasted 1.5 to 2 hours. The research self-efficacy in three categories (Research design, Research ethics, and Result presentation) increased significantly (p<0.1). The self-efficacy of the male students was higher than females' one. The self-efficacy was not significantly different by the experience of research paper writing at undergraduate level. The curriculum showed positive results in cultivating research self-efficacy of students. There is a need for improvement of the class of Statistical analysis as students reported that it was difficult.

A new model for graduate education and innovation in medical technology.

PubMed

Yazdi, Youseph; Acharya, Soumyadipta

2013-09-01

We describe a new model of graduate education in bioengineering innovation and design- a year long Master's degree program that educates engineers in the process of healthcare technology innovation for both advanced and low-resource global markets. Students are trained in an iterative "Spiral Innovation" approach that ensures early, staged, and repeated examination of all key elements of a successful medical device. This includes clinical immersion based problem identification and assessment (at Johns Hopkins Medicine and abroad), team based concept and business model development, and project planning based on iterative technical and business plan de-risking. The experiential, project based learning process is closely supported by several core courses in business, design, and engineering. Students in the program work on two team based projects, one focused on addressing healthcare needs in advanced markets and a second focused on low-resource settings. The program recently completed its fourth year of existence, and has graduated 61 students, who have continued on to industry or startups (one half), additional graduate education, or medical school (one third), or our own Global Health Innovation Fellowships. Over the 4 years, the program has sponsored 10 global health teams and 14 domestic/advanced market medtech teams, and launched 5 startups, of which 4 are still active. Projects have attracted over US$2.5M in follow-on awards and grants, that are supporting the continued development of over a dozen projects.

The problems program directors inherit: medical student distress at the time of graduation.

PubMed

Dyrbye, Liselotte N; Moutier, Christine; Durning, Steven J; Massie, F Stanford; Power, David V; Eacker, Anne; Harper, William; Thomas, Matthew R; Satele, Daniel; Sloan, Jeff A; Shanafelt, Tait D

2011-01-01

Distress is prevalent among residents and often attributed to rigors of training. To explore the prevalence of burnout and depression and measured mental quality of life (QOL) among graduating medical students shortly before they began residency. Pooled analysis of data from 1428 fourth year medical students who responded to 1 of 3 multi-institutional studies. Students completed the Maslach Burnout Inventory, PRIME MD, and SF-8 to measure burnout, depression, and low mental QOL (defined as mean mental SF-8 scores ½ a standard deviation below the population norm) and answered demographic items. Shortly before beginning residency, 49% of responding medical students had burnout, 38% endorsed depressive symptoms, and 34% had low mental QOL. While no differences in the prevalence of distress was observed by residency specialty area, there were subtle differences in the manifestation of burnout by specialty. Medical students entering surgical fields had lower mean emotional scores, students entering primary care fields had lower mean depersonalization scores, and students entering non-primary care/non-surgical fields reported the lowest mean personal accomplishment scores (all p ≤ 0.03). Our results indicate a high prevalence of distress among graduating medical students across all specialty disciplines before they even begin residency training.

Gender Comparisons of Young Physicians' Perceptions of Their Medical Education, Professional Life, and Practice: A Follow-Up Study of Jefferson Medical College Graduates.

ERIC Educational Resources Information Center

Hojat, Mohammadreza; And Others

1995-01-01

A survey of 530 male and 137 female graduates of Jefferson Medical College (Pennsylvania) found numerous gender differences in their assessments of selected areas of the medical school curriculum, issues of medical practice and professional life, and specialty choices, professional activities, and research productivity. (Author/MSE)

Essential professional duties for the sub-Saharan medical/dental graduate: An Association of Medical Schools of Africa initiative.

PubMed

Olapade-Olaopa, E O; Sewankambo, N; Iputo, J E; Rugarabamu, P; Amlak, A H; Mipando, M; Monekosso G L

2016-09-01

BACKGROUND - Globally, human resources for health are being optimized to address the increasing health burden and concomitant increased demands on health professionals. These demands are even more exacting in Sub-SaharanAfrica considering the shortage of health care workers, especially physicians. The noteworthy efforts at deploying task-shifting to address this situation not-withstanding, the situation also signals the need to re-define the objectives of medical instruction to ensure effective and contemporary medical practice in a mostly physician-led health workforce across the sub-continent. In this regard, medical and dental graduates must be educated to perform certain minimum essential professional duties competently. Essential Professional Duties are locally relevant professional activities of international standard that represent identifiable outcomes against which the effectiveness of physicians in a specific community can be measured to ensure social accountability. PROCEDURE AND PRODUCT - The Association of Medical Schools of Africa has developed the 'Essential Professional Duties for sub-Saharan medical and dental graduates' to ensure these physicians provide safe and effective contemporary medical/dental practice on the sub-continent. The duties have been grouped into those required for basic patient care, basic administrative skills, basic emergency care, communication, inter-professional relationships, self-directed learning and social responsibilities. Their relevance and suitability have been evaluated prior to their adoption by the Association. CONCLUSION; These Essential Physician Duties have been developed to serve as targets for health professionals training instruments and thus give direction to health system strategies. It is hoped that they will be adopted by medical and dental schools across sub-,. Saharan Africa.

Attitudes of medical laboratory technology graduates towards the internship training period at king faisal university.

PubMed

Bashawri, Layla A M; Ahmed, Mirghani A; Bahnassy, Ahmed A L; Al-Salim, Jawaher A

2006-05-01

The objective of this present survey was to look into the attitudes of medical laboratory technology (MLT) graduates towards the internship training period of the MLT Department, College of Applied Medical Sciences, King Faisal University. A self-administered questionnaire was designed and distributed for this purpose. The study period was from December 1(st) 2002 - 31(st) December 2004. Two-hundred questionnaires were distributed to recent graduates, and 115 were returned completed. All respondents agreed with the importance and necessity of the internship period, and felt it should not be reduced or eliminated. The most favorite laboratory where they liked to work was microbiology (70%). They all agreed that evaluation report with hospital staff and laboratory set up were vital in achieving the goals of the internship period. The majority stressed the significance of safety precautions and the application of theoretical knowledge before performing technical assignments. The respondents had very positive attitudes towards the internship-training period stressing its importance. The most favorite laboratory rotations were in rank order: Microbiology, Serology followed by Histotechnology, Hematology, Blood Banking and finally Clinical Chemistry. The majority of graduates had a very positive attitude also towards medical laboratory technology as a profession.

Post-graduate education for medical specialists focused on patients with medically unexplained physical symptoms; development of a communication skills training programme.

PubMed

Weiland, Anne; Blankenstein, Annette H; Willems, Mariëtte H A; Van Saase, Jan L C M; Van der Molen, Henk T; Van Dulmen, Alexandra M; Arends, Lidia R

2013-09-01

Stepwise description of the development of a post-graduate communication skills training programme for medical specialists focused on patients with medically unexplained physical symptoms (MUPS) to improve specialist interaction with MUPS patients. Using the 'intervention mapping approach' we accomplished a needs assessment (literature study and pilot) to formulate intervention objectives and identify methods and techniques for a MUPS-focused communication skills training programme for medical specialists. A 14-h training programme which consists of experiential learning, role-play and feedback. Using skills from Cognitive Behavioural Therapy, medical specialists are stimulated to explore interrelating factors that reinforce symptoms, to reassure patients effectively and to provide plausible and understandable explanations for MUPS. Dealing with complex referrals and informing GPs properly are also practiced. By applying the 'intervention mapping approach' we were able to create a feasible and promising intervention to improve specialist interaction with MUPS patients. Intervention effects are currently being assessed in a randomized controlled trial. If the RCT demonstrates sufficient effectiveness and efficiency of the MUPS focused communication skills training programme for medical specialists the intervention could be embedded in post-graduate education of medical specialists and residents. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

E-health in graduate and postgraduate medical education: illusions, expectations and reality.

PubMed

Bari, Ferenc; Forczek, Erzsébet; Hantos, Zoltán

2011-01-01

With the overall growth of informatics, the medical education system should also provide programs at both graduate and post-graduate levels. While there is a wide consensus as to the importance of this urgent need, several factors slow down the construction and operation of effective education programs in medical and nursing schools. The increasing need for better and more comprehensive training in informatics is strongly limited by several factors including undefined output skills, tight time frame etc. An efficient development of partnerships within the health care system assumes that all professionals involved must possess strong informatics and interpersonal knowledge, and skills reaching beyond their own individual fields. There is an emerging need to define the basic skills and knowledge for each level of the health care education. Trans-border cooperation offers a unique opportunity for the establishment of common criteria for basic skills and knowledge, via joint discussions, collaborative thinking and concerted action.

Consensus statement on an updated core communication curriculum for UK undergraduate medical education.

PubMed

Noble, Lorraine M; Scott-Smith, Wesley; O'Neill, Bernadette; Salisbury, Helen

2018-04-22

Clinical communication is a core component of undergraduate medical training. A consensus statement on the essential elements of the communication curriculum was co-produced in 2008 by the communication leads of UK medical schools. This paper discusses the relational, contextual and technological changes which have affected clinical communication since then and presents an updated curriculum for communication in undergraduate medicine. The consensus was developed through an iterative consultation process with the communication leads who represent their medical schools on the UK Council of Clinical Communication in Undergraduate Medical Education. The updated curriculum defines the underpinning values, core components and skills required within the context of contemporary medical care. It incorporates the evolving relational issues associated with the more prominent role of the patient in the consultation, reflected through legal precedent and changing societal expectations. The impact on clinical communication of the increased focus on patient safety, the professional duty of candour and digital medicine are discussed. Changes in the way medicine is practised should lead rapidly to adjustments to the content of curricula. The updated curriculum provides a model of best practice to help medical schools develop their teaching and argue for resources. Copyright © 2018 Elsevier B.V. All rights reserved.

Operation GRITROCK: the Defence Medical Services' story and emerging lessons from supporting the UK response to the Ebola crisis.

PubMed

Bricknell, Martin; Hodgetts, T; Beaton, K; McCourt, A

2016-06-01

This paper is a record of the UK Defence Medical Services (DMS) contribution to the UK response to the Ebola crisis in West Africa from the start of planning in July 2014 to the closure of the Ministry of Defence Ebola Virus Disease Treatment Unit at the end of June 2015. The context and wider UK government decisions are summarised. This paper describes the decisions and processes that resulted in the deployment of a DMS delivered Ebola Treatment Unit in conjunction with the Department for International Development and Save the Children. It covers arrangements for medical care for disease and non-battle injury, the Air Transportable Isolator and Force Health Protection policy, and finally, considers the medical lessons from this deployment. The core message is that the UK DMS are the only part of the UK health sector that is trained, equipped, manned and available to rapidly deploy and operate a complete medical unit as part of an international response to a health crisis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Transition to life--a sendoff to the real world for graduating medical students.

PubMed

Coates, Wendy C; Spector, Tahlia S; Uijtdehaage, Sebastian

2012-01-01

Graduating medical students will enter the workforce, often for the first time. Many have spent the past 20 years as students, receiving financial support from parents, and have not managed real-life issues such as financial planning, real estate, balancing well-being with employment, and integrating into a new community with stressful working conditions. To address a perceived need, we designed an intervention to introduce graduating medical students to financial planning, real estate choices, physician wellness during relocation/internship, and traits of efficient interns. The objectives of this study are to (a) assess baseline experience, knowledge, and comfort of seniors about "real-life" experiences, and (b) assess the efficacy of a 4-hr educational intervention on perceptions of understanding financial planning, real estate choices, intern preparedness, and physician wellness. Acute Care College seniors (classes of 2009 and 2010) attended the intervention after match day and completed a survey to gather demographic data and assess preexisting knowledge and a postintervention survey (1-7 Likert scale). Forty-nine students (45% male; M age = 25.5 years) participated. Prior experiences: 43% no break in education, 51% no full-time job, 38% never signed a rental lease and 94% had not purchased real estate, 90% did not have (or were not aware of having) disability insurance, and 82% had educational debt exceeding $50,000. Following the workshop, students felt more confident in their understanding of life skills topics (real estate, 83%; financial planning, 94%; well-being, 86%). Our workshop assisted in preparing for life after medical school for 98% of the participants. Graduating medical students can gain knowledge about real-life responsibilities and confidence during an educational session prior to starting residency.

The current provision of community-based teaching in UK medical schools: an online survey and systematic review

PubMed Central

Lee, Sandra W W; Clement, Naomi; Tang, Natalie; Atiomo, William

2014-01-01

Objective To evaluate the current provision and outcome of community-based education (CBE) in UK medical schools. Design and data sources An online survey of UK medical school websites and course prospectuses and a systematic review of articles from PubMed and Web of Science were conducted. Articles in the systematic review were assessed using Rossi, Lipsey and Freeman's approach to programme evaluation. Study selection Publications from November 1998 to 2013 containing information related to community teaching in undergraduate medical courses were included. Results Out of the 32 undergraduate UK medical schools, one was excluded due to the lack of course specifications available online. Analysis of the remaining 31 medical schools showed that a variety of CBE models are utilised in medical schools across the UK. Twenty-eight medical schools (90.3%) provide CBE in some form by the end of the first year of undergraduate training, and 29 medical schools (93.5%) by the end of the second year. From the 1378 references identified, 29 papers met the inclusion criteria for assessment. It was found that CBE mostly provided advantages to students as well as other participants, including GP tutors and patients. However, there were a few concerns regarding the lack of GP tutors’ knowledge in specialty areas, the negative impact that CBE may have on the delivery of health service in education settings and the cost of CBE. Conclusions Despite the wide variations in implementation, community teaching was found to be mostly beneficial. To ensure the relevance of CBE for ‘Tomorrow's Doctors’, a national framework should be established, and solutions sought to reduce the impact of the challenges within CBE. Strengths and limitations of this study This is the first study to review how community-based education is currently provided throughout Medical Schools in the UK. The use of Rossi, Lipsey and Freeman's method of programme evaluation means that the literature was analysed

The current provision of community-based teaching in UK medical schools: an online survey and systematic review.

PubMed

Lee, Sandra W W; Clement, Naomi; Tang, Natalie; Atiomo, William

2014-12-01

To evaluate the current provision and outcome of community-based education (CBE) in UK medical schools. An online survey of UK medical school websites and course prospectuses and a systematic review of articles from PubMed and Web of Science were conducted. Articles in the systematic review were assessed using Rossi, Lipsey and Freeman's approach to programme evaluation. Publications from November 1998 to 2013 containing information related to community teaching in undergraduate medical courses were included. Out of the 32 undergraduate UK medical schools, one was excluded due to the lack of course specifications available online. Analysis of the remaining 31 medical schools showed that a variety of CBE models are utilised in medical schools across the UK. Twenty-eight medical schools (90.3%) provide CBE in some form by the end of the first year of undergraduate training, and 29 medical schools (93.5%) by the end of the second year. From the 1378 references identified, 29 papers met the inclusion criteria for assessment. It was found that CBE mostly provided advantages to students as well as other participants, including GP tutors and patients. However, there were a few concerns regarding the lack of GP tutors' knowledge in specialty areas, the negative impact that CBE may have on the delivery of health service in education settings and the cost of CBE. Despite the wide variations in implementation, community teaching was found to be mostly beneficial. To ensure the relevance of CBE for 'Tomorrow's Doctors', a national framework should be established, and solutions sought to reduce the impact of the challenges within CBE. This is the first study to review how community-based education is currently provided throughout Medical Schools in the UK. The use of Rossi, Lipsey and Freeman's method of programme evaluation means that the literature was analysed in a consistent and comprehensive way. However, a weakness is that data from the online survey was obtained from

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

Are Michigan State University medical school (MSU-CHM) alumni more likely to practice in the region of their graduate medical education primary care program compared to non-MSU-CHM alumni?

PubMed

Switzer, Richard; VandeZande, Luke; Davis, Alan T; Koehler, Tracy J

2018-05-24

Over the past 10 years, three new MD schools have been created in the state of Michigan, while the Michigan State University College of Human Medicine (MSU-CHM) has increased their class size to 850 students. The aim of this study was to determine if MSU-CHM alumni who graduate from an MSU-affiliated primary care residency from a single graduate medical education (GME) training program in Michigan are more likely to go on to practice in close proximity to the location of their training program immediately after graduation compared to non MSU-CHM alumni. Changes over time in the proportion of primary care graduates who received fellowship training immediately following residency were also compared between these groups. A review of historical data was performed for all 2000-2016 primary care (Family Medicine, FM; Internal Medicine, IM; Internal Medicine-Pediatrics, IMP; Pediatrics, Peds) program graduates sponsored by Grand Rapids Medical Education Partners (GRMEP). Study variables included primary care program, gender, age at graduation, fellowship training, practice location immediately after graduation and undergraduate medical education location. Summary statistics were calculated for the data. Comparisons were made using the chi-square test or Fisher's Exact test when appropriate. Significance was assessed at p < 0.05. There were 478 primary care program graduates who went into practice immediately following graduation, 102 of whom also graduated from MSU-CHM. Just over half of the graduates were female and the average age at graduation was 32 years. There were 152 FM, 150 IM, 50 IMP and 126 Peds graduates. Those that graduated from both MSU-CHM and GRMEP were more likely to practice in Michigan immediately after residency training (79.4% vs 52.0%; p < 0.001), as well as within 100 miles of GRMEP (71.6% vs 46.4%; p < 0.001). There were 8% of MSU-CHM primary care graduates who went on to fellowship training from 2000 to 2009, increasing to 34% from

Council on Graduate Medical Education First Report of the Council. Volume I.

ERIC Educational Resources Information Center

Health Resources and Services Administration (DHHS/PHS), Rockville, MD. Bureau of Health Professions.

The report contains 44 recommendations on issues related to both undergraduate and graduate medical education. Among 10 principles identified are: the goal increased representation of minorities in the health professions and the importance of considering effects of total health care costs in the Nation. Initial chapters are concerned with…

Psychodynamic Psychotherapy Training as Acculturative Experience for International Medical Graduates: A Commentary

ERIC Educational Resources Information Center

Rao, Nyapati R.

2012-01-01

"Preparing International Medical Graduates (IMGs) for Psychiatry Residency: A Multi-Site Needs Assessment" (1) addresses the needs of IMGs entering psychiatry residency training in Canada. On the basis of a survey of five psychiatric residency training programs, the authors report that respondents ranked (in order of importance)…

General surgery residency after graduation from U.S. medical schools: visa-related challenges for the international citizen.

PubMed

Datta, Jashodeep; Zaydfudim, Victor; Terhune, Kyla P

2013-03-01

International-United States medical graduates (I-USMGs) are non-US citizen graduates of U.S. medical schools. Although academically equivalent to US-citizen peers, they are subject to the same visa requirements as non-US citizen international medical graduates. We hypothesized that visa sponsorship policies of general surgery programs (GSPs) may be discordant with the enrollment patterns of I-USMGs. A total of 196 GSPs participated in a telephone survey regarding visa sponsorship policies. Whereas GSPs preferred J-1 to H-1B sponsorship (64.2% vs. 32.6%), I-USMG enrollment favored programs supporting H-1B sponsorship (72.1% vs. 7.5%) (P = .01). University-affiliated programs were more likely to sponsor H1-Bs than independent programs (39.6% vs. 24.4%) (P = .03) and trained a greater proportion of I-USMGs than independent programs (40.6% vs. 14.0%) (P < .01). Restrictive policies against H-1B sponsorship may limit GSPs' I-USMG applicant pool and restrict I-USMGs' surgical training options.

International medical graduates and the cardiology workforce.

PubMed

Kostis, John B; Ahmad, Busharat

2004-09-15

Recent publications have expressed the view that there is a shortage of cardiologists and it is growing worse. Both an increasing demand and a diminishing supply of cardiologists have been projected. An increase in the number of international medical graduates (IMGs) who enter cardiology practice has been proposed as a remedy for a projected shortage. The IMGs have to overcome challenges including clinical practice, language proficiency, and cultural differences before they are incorporated into the fabric of U.S. cardiology. With hard work, perseverance, excellence,compassionate care and support and mentoring, many have contributed to scientific and clinical cardiology in the U.S. Whether in the absence of a present crisis the projected shortage of cardiologists necessitates change in U.S. immigration policy is an open question.

Stress, burnout and doctors' attitudes to work are determined by personality and learning style: A twelve year longitudinal study of UK medical graduates

PubMed Central

McManus, IC; Keeling, A; Paice, E

2004-01-01

Background The study investigated the extent to which approaches to work, workplace climate, stress, burnout and satisfaction with medicine as a career in doctors aged about thirty are predicted by measures of learning style and personality measured five to twelve years earlier when the doctors were applicants to medical school or were medical students. Methods Prospective study of a large cohort of doctors. The participants were first studied when they applied to any of five UK medical schools in 1990. Postal questionnaires were sent to all doctors with a traceable address on the current or a previous Medical Register. The current questionnaire included measures of Approaches to Work, Workplace Climate, stress (General Health Questionnaire), burnout (Maslach Burnout Inventory), and satisfaction with medicine as a career and personality (Big Five). Previous questionnaires had included measures of learning style (Study Process Questionnaire) and personality. Results Doctors' approaches to work were predicted by study habits and learning styles, both at application to medical school and in the final year. How doctors perceive their workplace climate and workload is predicted both by approaches to work and by measures of stress, burnout and satisfaction with medicine. These characteristics are partially predicted by trait measures of personality taken five years earlier. Stress, burnout and satisfaction also correlate with trait measures of personality taken five years earlier. Conclusions Differences in approach to work and perceived workplace climate seem mainly to reflect stable, long-term individual differences in doctors themselves, reflected in measures of personality and learning style. PMID:15317650

Evolution of osteopathic graduate medical education: integration of osteopathic principles and practice in postdoctoral training.

PubMed

Lemley, William W; Steele, Karen M; Shires, William E; McMahan, Richard M

2007-11-01

Osteopathic principles and practice (OPP) are considered the core, distinguishing elements of the osteopathic medical profession. As such, the American Osteopathic Association introduced Osteopathic Postdoctoral Training Institutions (OPTIs) in 1995 to further incorporate OPP into osteopathic graduate medical education. The current study describes the evolution of the OPP teaching programs at the West Virginia School of Osteopathic Medicine (WVSOM) in Lewisburg in conjunction with its OPTI consortium, the Mountain State OPTI. Developments in distance-learning technology, lecture and workshop curricula for graduate and undergraduate students, and faculty training are described. In addition, elements of "telehealth" technology, including administrative support, and trainee and student evaluations of the programs are examined. It is hoped that the description of WVSOM's curricular evolution and the emphasis on meeting the needs of OPP program attendees will assist other osteopathic medical schools in developing their own unique OPP programs.

Challenges in Teaching the Mechanics of Breathing to Medical and Graduate Students

ERIC Educational Resources Information Center

West, John B.

2008-01-01

The mechanics of breathing has always been a difficult topic for some medical and graduate students. The subject is very quantitative and contains a number of concepts that some students have trouble with, including physical principles such as pressure, flow, volume, resistance, elasticity, and compliance. Apparently, present-day students find the…

Preparing International Medical Graduates for Psychiatry Residency: A Multi-Site Needs Assessment

ERIC Educational Resources Information Center

Sockalingam, Sanjeev; Hawa, Raed; Al-Battran, Mazin; Abbey, Susan E.; Zaretsky, Ari

2012-01-01

Objective: Despite the growing number of international medical graduates (IMGs) training in medicine in Canada and the United States, IMG-specific challenges early in psychiatry residency have not been fully explored. Therefore, the authors conducted a needs-assessment survey to determine the needs of IMGs transitioning into psychiatry residency.…

Positive impacts on rural and regional workforce from the first seven cohorts of James Cook University medical graduates.

PubMed

Sen Gupta, T; Woolley, T; Murray, R; Hays, R; McCloskey, T

2014-01-01

The regionally-based James Cook University (JCU) School of Medicine aims to meet its mission to address the health needs of the region by combining selection and curriculum strategies shown to increase rural career recruitment outcomes. The School has graduated 536 students in its first seven cohorts from 2005 to 2011. This paper presents the early career practice locations and the specialty training undertaken by these cohorts, and describes the association between later practice location with both hometown at application and internship location. Hometown at application' data for JCU Bachelor of Medicine, Bachelor of Surgery (MBBS) graduates was retrieved from administrative databases held by the university, while postgraduate location and career data were obtained either from personal contact via email, telephone, Facebook or electronically from the Australian Health Practitioner Regulation Authority website. Practice location was described across Australian Standard Geographical Classification Remoteness Area (RA) categories. Data for the primary practice location of 536 JCU MBBS graduates across postgraduate years (PGY) 1 to 7 is 99% complete. A total of 65% of JCU graduates undertook their internship in non-metropolitan locations including 20% in RA 2 and 44% in RA 3-5, a pattern of practice different to that of other Australian clinicians. For the internship year, 'non-metropolitan-origin' JCU MBBS graduates predominantly worked in RA 2-5 locations, while 'metropolitan origin' graduates were more likely to work in major cities. However, by PGY 7, the distribution of 'rural' and 'metropolitan' origin JCU graduates across RA categories was similar. The RA category of internship location - either 'metropolitan (RA 1) or 'non-metropolitan' (RA 2-5) - was associated with the location of subsequent practice across PGY 2-7. This comprehensive data set provides the first real evidence from one of Australia's new medical schools on actual postgraduate practice

The Medical Boomerang: will it come back?

PubMed

McDermott, Cian; Sheridan, Michael; Moore, Katie; Gosbell, Andrew

2015-04-01

To explore the increasing numbers of emergency medicine (EM) registrars that obtained their primary medical degree from UK or Irish universities, who work in emergency departments (ED) throughout Australia and New Zealand. The Victorian Emergency Registrar Study was published at the Australasian College for Emergency Medicine (ACEM) annual scientific meeting in Adelaide in November 2013. As a follow on, ACEM provided the authors with data regarding country of primary degree for international medical graduates (IMG) working as registrars in Australasian EDs. UK and Irish EM registrars make up the largest proportion of IMGs working in Australian and New Zealand EDs. These figures have increased from 34% in 2008 to 45% in 2013. In 2013, there was the highest yearly intake of UK and Irish ED IMG registrars, representing 41% of registrars joining the Australasian EM training programme. Current data show that >25% of all ED registrars working in Australasian EDs studied for their primary medical degree in a university either in Ireland or the UK. While there have been anecdotal reports of increased outflow of junior EM doctors from the UK and Ireland, we provide quantitative data on the extent of the recent (5-year trend data) emigration of UK/Irish EM trainees to Australia and New Zealand and discuss the impact of this on both the UK/Irish and Australasian health systems. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Encouragers and discouragers affecting medical graduates' choice of regional and rural practice locations.

PubMed

McKillop, Ann; Webster, Craig; Bennett, Win; O'Connor, Barbara; Bagg, Warwick

2017-12-01

Access to health care as near to where people live as possible is desirable. However, not enough medical graduates choose to work in rural and regional areas, especially in general practice. The career decisions of recent medical graduates are known to be affected by a variety of professional, societal and personal factors. Internationally, medical programmes have exposed students to regional and rural experiences partly to encourage them to seek employment in these areas after graduation. As such, the Pūkawakawa Programme is a year-long regional and rural experience for selected Year 5 students from the University of Auckland‘s Medical Programme in New Zealand in partnership with the Northland District Health Board and two Primary Health Organisations. A lack of clarity about the drivers of rural and regional career decisions underpinned this study, which aimed to explore the barriers and encouragers for students of the programme to return as resident medical officers to the regional hospital where they had gained clinical experience. A mixed-method, descriptive design was used, including a short survey, followed by participation in a focus-group discussion or a one-on-one interview. Survey data were summarised in tabular form and inductive, thematic analysis was applied to transcripts of focus groups and interviews. Nineteen doctors in their first or second year following graduation participated: 15 who had returned to the hospital where they had clinical experience in the programme and four who were employed elsewhere. 'A match of personal goals and intended career intentions' was the reason most frequently selected for junior doctors’ choice of early career employment. Other frequently selected reasons were lifestyle, friends and family close by, and the reputation and experience of the Pūkawakawa Programme. Qualitative data revealed that the learning experience, the unique design of the curriculum and associated support from clinicians were

Predictors of professional behaviour and academic outcomes in a UK medical school: A longitudinal cohort study.

PubMed

Adam, Jane; Bore, Miles; Childs, Roy; Dunn, Jason; Mckendree, Jean; Munro, Don; Powis, David

2015-01-01

Over the past 70 years, there has been a recurring debate in the literature and in the popular press about how best to select medical students. This implies that we are still not getting it right: either some students are unsuited to medicine or the graduating doctors are considered unsatisfactory, or both. To determine whether particular variables at the point of selection might distinguish those more likely to become satisfactory professional doctors, by following a complete intake cohort of students throughout medical school and analysing all the data used for the students' selection, their performance on a range of other potential selection tests, academic and clinical assessments throughout their studies, and records of professional behaviour covering the entire five years of the course. A longitudinal database captured the following anonymised information for every student (n = 146) admitted in 2007 to the Hull York Medical School (HYMS) in the UK: demographic data (age, sex, citizenship); performance in each component of the selection procedure; performance in some other possible selection instruments (cognitive and non-cognitive psychometric tests); professional behaviour in tutorials and in other clinical settings; academic performance, clinical and communication skills at summative assessments throughout; professional behaviour lapses monitored routinely as part of the fitness-to-practise procedures. Correlations were sought between predictor variables and criterion variables chosen to demonstrate the full range of course outcomes from failure to complete the course to graduation with honours, and to reveal clinical and professional strengths and weaknesses. Student demography was found to be an important predictor of outcomes, with females, younger students and British citizens performing better overall. The selection variable "HYMS academic score", based on prior academic performance, was a significant predictor of components of Year 4 written and

Postgraduate career intentions of medical students and recent graduates in Malawi: a qualitative interview study.

PubMed

Bailey, Nicola; Mandeville, Kate L; Rhodes, Tim; Mipando, Mwapatsa; Muula, Adamson S

2012-09-14

In 2004, the Malawian Ministry of Health declared a human resource crisis and launched a six year Emergency Human Resources Programme. This included salary supplements for key health workers and a tripling of doctors in training. By 2010, the number of medical graduates had doubled and significantly more doctors were working in rural district hospitals. Yet there has been little research into the views of this next generation of doctors in Malawi, who are crucial to the continuing success of the programme. The aim of this study was to explore the factors influencing the career plans of medical students and recent graduates with regard to four policy-relevant aspects: emigration outside Malawi; working at district level; private sector employment and postgraduate specialisation. Twelve semi-structured interviews were conducted with fourth year medical students and first year graduates, recruited through purposive and snowball sampling. Key informant interviews were also carried out with medical school faculty. Recordings were transcribed and analysed using a framework approach. Opportunities for postgraduate training emerged as the most important factor in participants' career choices, with specialisation seen as vital to career progression. All participants intended to work in Malawi in the long term, after a period of time outside the country. For nearly all participants, this was in the pursuit of postgraduate study rather than higher salaries. In general, medical students and young doctors were enthusiastic about working at district level, although this is curtailed by their desire for specialist training and frustration with resource shortages. There is currently little intention to move into the private sector. Future resourcing of postgraduate training opportunities is crucial to preventing emigration as graduate numbers increase. The lesser importance put on salary by younger doctors may be an indicator of the success of salary supplements. In order to

Career Plans and Debt Levels of Graduating U.S. Medical Students, 1981-1986.

ERIC Educational Resources Information Center

Tudor, Cynthia

1988-01-01

Trends in students' responses to the annual graduation questionnaire of the Association of American Medical Colleges from 1981 to 1986 were examined. Changes in career activity reflected increasing interest in full-time academic appointments and decreasing interest in solo, private practices. (Author/MLW)

Patterns of Change in U.K. Graduate Unemployment, 1962-87.

ERIC Educational Resources Information Center

Bee, Malcolm; Dolton, Peter

1990-01-01

In this paper, unemployment trends in aggregate, by faculty and by subject are examined, using data from the annual First Destination Return, first compiled for the 1961-62 university graduates, and the 1970 and 1980 graduate cohort surveys. Differences related to gender and type of institution of study are identified. (Author/MLW)

Association between rural clinical clerkship and medical students' intentions to choose rural medical work after graduation: A cross-sectional study in western China.

PubMed

Liu, Jinlin; Zhu, Bin; Mao, Ying

2018-01-01

A large number of programs have been implemented in many countries to increase the healthcare workforce recruitment in rural and remote areas. Rural early exposure programs for medical students have been shown to be effective strategies. However, no related studies have been reported before in China. This study was carried out to determine the association between medical students' participation in rural clinical clerkships and their intentions to choose rural medical work after graduation from western medical schools in China. Based on a two-stage random sampling method, the cross-sectional survey was carried out in ten western provinces in China. A brief questionnaire filled in by medical students was used for data collection. A total of 4278 medical students participated in the study. The response rate was approximately 90.34%. Pearson's chi-squared tests and binary logistic regression analyses were performed for data analyses. Approximately 52.0% of medical students disclosed intentions to work in rural medical institutions after graduation. Only one in five participants had experience with a rural clinical clerkship. Rural clinical clerkships were significantly associated with medical students' intentions to work in rural medical institutions (OR: 1.24, 95%CI: 1.05-1.46); further analyses indicated that such clerkships only had a significant impact among the medical students with an urban background (OR: 2.10, 95%CI: 1.48-2.97). In terms of the sociodemographic characteristics, younger age, low level of parental education, majoring in general practice, and studying in low-level medical schools increased the odds of having intentions to engage in rural medical work among medical students; however, rural origins was the only positive univariate predictor. In addition, the predictors of intentions to choose rural medical work were different between medical students with a rural background and those with an urban background. Rural clinical clerkship is likely to

Association between rural clinical clerkship and medical students’ intentions to choose rural medical work after graduation: A cross-sectional study in western China

PubMed Central

Zhu, Bin; Mao, Ying

2018-01-01

Background A large number of programs have been implemented in many countries to increase the healthcare workforce recruitment in rural and remote areas. Rural early exposure programs for medical students have been shown to be effective strategies. However, no related studies have been reported before in China. This study was carried out to determine the association between medical students’ participation in rural clinical clerkships and their intentions to choose rural medical work after graduation from western medical schools in China. Methods Based on a two-stage random sampling method, the cross-sectional survey was carried out in ten western provinces in China. A brief questionnaire filled in by medical students was used for data collection. A total of 4278 medical students participated in the study. The response rate was approximately 90.34%. Pearson’s chi-squared tests and binary logistic regression analyses were performed for data analyses. Results Approximately 52.0% of medical students disclosed intentions to work in rural medical institutions after graduation. Only one in five participants had experience with a rural clinical clerkship. Rural clinical clerkships were significantly associated with medical students’ intentions to work in rural medical institutions (OR: 1.24, 95%CI: 1.05–1.46); further analyses indicated that such clerkships only had a significant impact among the medical students with an urban background (OR: 2.10, 95%CI: 1.48–2.97). In terms of the sociodemographic characteristics, younger age, low level of parental education, majoring in general practice, and studying in low-level medical schools increased the odds of having intentions to engage in rural medical work among medical students; however, rural origins was the only positive univariate predictor. In addition, the predictors of intentions to choose rural medical work were different between medical students with a rural background and those with an urban background

How do United Kingdom (UK) medical schools identify and support undergraduate medical students who ‘fail’ communication assessments? A national survey

PubMed Central

2013-01-01

Background The doctor’s ability to communicate effectively (with patients, relatives, advocates and healthcare colleagues) relates directly to health outcomes, and so is core to clinical practice. The remediation of medical students’ clinical communication ability is rarely addressed in medical education literature. There is nothing in the current literature reporting a contemporary national picture of how communication difficulties are managed, and the level of consequence (progression implications) for students of performing poorly. This survey aimed to consolidate practices for identifying and processes for managing students who ‘fail’ communication assessments across all UK medical schools. Methods Data were collected via an email survey to all leads for clinical communication in all UK Medical Schools for the UK Council for Clinical Communication in Undergraduate Medical Education. Results All but two participating Schools reported some means of support and/or remediation in communication. There was diversity of approach, and variance in the level of systemisation adopted. Variables such as individuality of curricula, resourcing issues, student cohort size and methodological preferences were implicated as explaining diversity. Support is relatively ad hoc, and often in the hands of a particular dedicated individual or team with an interest in communication delivery with few Schools reporting robust, centralised, school level processes. Conclusions This survey has demonstrated that few Medical Schools have no identifiable system of managing their students’ clinical communication difficulties. However, some Schools reported ad hoc approaches and only a small number had a centralised programme. There is scope for discussion and benchmarking of best practice across all Schools with allocation of appropriate resources to support this. PMID:23834990

On your marks, get set, go!-lessons from the UK in enhancing employability of graduates and postgraduates.

PubMed

Fahnert, Beatrix

2015-10-01

Employers expect graduates and postgraduates to demonstrate their education through more than good grades. Learning activities that develop subject skills during formalized programmes of undergraduate and postgraduate study also develop employability skills, if the curriculum is suitably aligned, and developmental planning is supported. Only little extra provision is required, but all development needs to be explicitly signposted to the learner, and the curriculum should be developed in consultation with employers. This review aims to raise awareness of current issues in the context of enhancing employability that arise from an increased global competition on the job market and the expectation of the Higher Education sector to produce work-ready graduates and postgraduates that are well equipped to adapt to a quickly changing work environment particularly due to transferable skills. In the context of lessons from the UK, these current issues and employability are discussed, and approaches to Personal Development Planning that prepare students for lifelong learning and that enable communicating and evidencing achievement are addressed. Issues specific to postgraduates, how actual work experience should be maximized as well as other career influences such as learned societies and social networking are highlighted. © FEMS 2015. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Can I be a student again? How medical graduates make the decision to return to dental school prior to a career in oral and maxillofacial surgery.

PubMed

Tahim, A S; Payne, K F B; Goodson, A M C; Cabot, L B; Fan, K

2014-05-01

Oral and maxillofacial surgery (OMFS) trainees in the UK have traditionally completed their dental undergraduate studies prior to returning to medical school. Recently, there have been increasing numbers of medical graduates who return to dental school before embarking on OMFS specialist training. There is limited research into the career motivation within this group and little guidance on how they may integrate the dental undergraduate course into their postgraduate training path. This study aims to evaluate these factors in more detail. Questionnaires and focus groups were used to evaluate prior surgical experience of qualified medics who return to dental school with the intention of pursuing a career in OMFS, along with the factors that affect the timing of their return to dental school. The average age of medical graduates entering dental school decreased during the study period. The average number of months each cohort of students spent as a practicing doctor prior to starting dentistry also reduced. Postgraduate experience in OMFS was highly variable, but the numbers of students who received alternative exposure to OMFS, such as undergraduate special study modules, medical school elective or taster weeks, increased. The key barriers that were carefully considered by these trainees before returning to university included the perceived increase in the length of training, trainees' prior surgical experience, financial implications and the impact on quality of life. A trainee's decision to return to study dentistry is a multifactorial process. Understanding when trainees decide to return to sit their dental degree is vital not only to provide guidance for future trainees but also to assist future workforce planning, thus aiding training, education and development within OMFS. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.