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A T Trott

Publications and source records attributed to A T Trott.

9 recordsLinked to original sources
PubMed1994

Role of emergency medicine residency programs in determining emergency medicine career choice among medical students.

STUDY OBJECTIVE: To characterize the role of emergency medicine residency programs in determining emergency medicine career choice among medical students. DESIGN: Observational, cross-sectional, descriptive study. Information on student career choice was obtained through a targeted query of the National Resident Matching Program data base, simultaneously stratified by specialty and school, and adjusted for class size. PARTICIPANTS: All accredited emergency medicine residency programs and four-year allopathic medical schools. RESULTS: Fifty-two schools (42%) had a closely affiliated emergency medicine residency program, ie, one based primarily at the institution's main teaching hospital(s). This configuration was associated with a 70% increase in the median proportion of students choosing emergency medicine as a career when compared to the 73 schools with no closely affiliated emergency medicine residency (5.1% vs 3.0%, P < .0001). When institutions were stratified by overall commitment to emergency medicine, the median proportion of students choosing emergency medicine as a career was 2.9% for institutions with a minimal commitment to emergency medicine (neither an academic department of emergency medicine nor a closely affiliated emergency medicine residency), 4.1% for institutions with a moderate commitment to emergency medicine (either a department of emergency medicine or an emergency medicine residency, but not both), and 5.7% for institutions with a substantial commitment to emergency medicine (a department of emergency medicine and an emergency medicine residency) (P < .0001). When institutional commitment to emergency medicine was examined in a simple multivariate model, only the presence of an emergency medicine residency was associated independently with student career choice (P < .001). CONCLUSION: An emergency medicine residency program that is closely affiliated with a medical school is strongly and independently associated with a quantitatively and statistically significant increase in the proportion of students from that school who choose a career in emergency medicine. These data support the proposition that, if emergency medicine is to meet national manpower shortage needs by attracting students to the specialty, it must establish residency programs within the primary teaching hospital(s) of medical schools. Such a configuration does not currently exist in the majority of schools.

Career Choice↗
PubMed1992

Academic emergency medicine in United States medical schools.

OBJECTIVE: To determine the current standing of academic units of emergency medicine in allopathic medical schools and to measure the attitudes of medical school deans toward the specialty. DESIGN: An investigator-blinded survey of the senior deans of 123 allopathic medical schools in the United States. RESULTS: Ninety-four of 123 (76%) survey instruments were completed. Fifty-six medical schools reported having academic units of emergency medicine (five divisions of the dean's office, 16 full departments, 35 divisions/sections of other departments). Twenty-five of 56 units were reported to be academically less productive when compared with other specialty academic units of similar size. When overall mission (academic plus clinical/administrative) was considered, 46 of 56 units were reported as adequately fulfilling or exceeding mission expectations. Thirty-eight schools reported not having an academic unit of emergency medicine. Only ten of the 38 reported have no institutional support or plans for academic emergency medicine. CONCLUSION: Medical school deans are generally satisfied with the clinical/administrative performance of academic emergency medicine units but are less so with academic productivity. Despite the small numbers of full departments and disparate status of established units, it is noteworthy that only ten of the 94 respondents to this survey reported no support whatsoever for academic emergency medicine.

Emergency Medicine↗
PubMed1988

Toxic shock syndrome: a review.

TSS is a recently described acute febrile illness characterized by hypotension, rash, desquamation, and multisystemic involvement. While most common in menstruating women, TSS also occurs in men and non-menstruating women. It is now known that the disease is caused by one or more toxins produced by the S aureus organism. Treatment of TSS consists primarily of fluid resuscitation and supportive care. Anti-staphylococcal antibiotics are indicated primarily to reduce the rate of recurrence in menstrually related cases. In wound-related TSS, antibiotics are necessary to treat the primary wound infection and to prevent recurrent disease. Currently, the case fatality rate is stable at less than 3% and the major long-term complication of survivors is the risk of recurrence.

Emergencies↗
PubMed1988

Microbiology of adult cellulitis.

Needle aspiration of cellulitis sites is commonly advocated to assist in the identification of causative organisms. Twenty-five nondiabetic, adult patients with a clinical diagnosis of cellulitis had site aspirations and blood cultures obtained before antibiotic therapy was initiated. Site cultures were positive in 6 of 25 patients. Blood cultures were positive in 4 of 25 patients. All organisms except one (Enterobacter agglomerans) were staphylococci or streptococci. The gram-negative bacilli were not believed to be a pathogen based on the patient's prompt response to nafcillin. In adult patients who do not have complications, the use of needle aspiration was not supported. Empiric treatment of cellulitis aimed at gram-positive cocci appears to be sufficient.

Adult↗
PubMedDate not supplied

Current status of academic emergency medicine within academic medicine in the United States.

OBJECTIVE: To characterize the status of emergency medicine within U.S. academic medical centers. METHODS: All accredited emergency medicine residency programs and all four-year allopathic medical schools in the United States were identified. Institutions were defined as academic medical centers based upon NIH research grant funding. These institutions were ranked using five measures of academic stature: a survey of medical school deans, a survey of internal medicine residency directors, level of research funding, characteristics of the student body, and an unweighted composite variable reflecting overall academic stature. The relationship between institutional academic stature and an empiric scale of institutional affiliation with emergency medicine was assessed. RESULTS: Sixty-two institutions were designated academic medical centers. These medical schools captured 90% of all NIH grant monies awarded in fiscal year 1990. Twenty-six of 87 emergency medicine residency programs (30%) were closely affiliated with one of these medical schools. Within academic medical centers, the presence of a residency or an academic department of emergency medicine was inversely associated with the medical school deans' ranking (p < 0.005), research rank (p < 0.001), and composite academic rank (p < 0.001). CONCLUSION: The majority of emergency medicine residency programs (70%) are not closely affiliated with institutions receiving the bulk (90%) of NIH resources for research. Within the institutions receiving the majority of NIH funding, there is a quantitatively and statistically significant inverse association of institutional emergency medicine affiliation and institutional academic rank.

Academic Medical Centers↗