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Biomedical subjects

B Schepps

Publications and source records attributed to B Schepps.

At least 19 recordsLinked to original sources
PubMed2001

Initial employment experiences of 1997 graduates of radiation oncology training programs.

PURPOSE: To inform the profession of current trends in the job market, the American College of Radiology (ACR) sought to detail the job-hunting experiences and outcomes of 1997 graduates of radiation oncology training programs. METHODS AND MATERIALS: In early 1998, questionnaires were mailed to all graduates; 67% responded. Results were compared with similar surveys of 1996 graduates. RESULTS: Similar to past years, immediately after graduation, 13% of residency graduates and 1 of 10 fellowship graduates encountered serious employment difficulties--that is, spent some time working locums, working outside radiation oncology, or unemployed. By 6-12 months after graduation, approximately 2% of all residency graduates were working outside the profession and approximately 3% were not working at all. Eighty-five percent of residency graduates and 7 of 8 fellowship graduates reported that their employment reasonably matched their training and individual goals. On average, graduates' actual salaries approximately corresponded to expected salaries. Eleven percent of all graduates were in nonownership-track jobs, a significant decline since 1996. For residents and fellows combined, 46% had a job with at least one characteristic some observers associate with a weak job market, but fewer than half of those with one of these characteristics actually disliked it. These percentages are similar to 1996. Women graduates were more likely than men to have spouse-related restrictions on job location but less likely to end up in a self-reportedly undesirable location. CONCLUSION: Unemployment remained low. Some other indicators of the employment market showed improvement, while others did not.

Employment↗
PubMed2001

The status of radiation oncology training programs and their graduates in 1999.

PURPOSE: To keep the profession apprised of current trends in the job market, the American College of Radiology (ACR) studied the employment situation of 1999 radiation oncology graduates and the status and plans of radiation oncology training programs. METHODS AND MATERIALS: During mid-April to the beginning of June 1999, the ACR surveyed all radiation oncology residency directors about the employment situation of their residency and fellowship graduates, changes in their programs, and incoming trainees. Eighty-four percent (74/88) responded. We compared current findings to those of similar surveys conducted over the 1995-1998 period and report statistically significant differences (p < or = 0.05. RESULTS: Directors responded that as of the survey date, 88% (71/81) of all residency graduates had secured commitments for a position, about the same as reported throughout the 1995-1998 period. Planned and accomplished changes in residency program size since 1993 will reduce the annual number of beginning residency slots by approximately 33. This represents about a 20% decrease in the number of graduates relative to the 160 typical during the early 1990s. Residency directors' perceptions of the job market were optimistic, with 40% viewing the market as "somewhat" or "much" better than in recent years vs. 13% viewing it as worse, much as in 1998. On average, directors viewed 1999's residency applicants as, if anything, somewhat better than those who had applied one or three years earlier. CONCLUSION: Directors' perceptions of graduates' job prospects remain optimistic, and the employment situation remains the same as in past years, when reported unemployment was approximately 1%-2% or less by six months after graduation.

Employment↗
PubMed2001

Hiring of diagnostic radiologists in 1998.

OBJECTIVE: We sought to determine the 1998 hiring activities of physician practices with respect to diagnostic radiologists. MATERIALS AND METHODS: A survey was mailed to a sample of 970 radiology practices in the spring through fall of 1999; 73.0% responded. Responses were weighted to represent all practices in the United States providing diagnostic radiology services. Findings were compared with results of similar surveys from previous years. RESULTS: In 1998, multiradiologist groups sought to hire 2299 (+/-148 [standard error]) diagnostic radiologists, an increase of 20% from 1977. Positions offered in 1998 were split almost equally between expansion positions and replacements for those who had left a practice. Another 422 (+/-58) positions had been vacated that practices did not seek to refill. In 1998, 621 (+/-57) diagnostic radiologists left active practice, which is more than the usual number of approximately 400 annually but less than the approximately 800 of 1996 and 1997. There was no significant association between hiring activity and the self-perceived effect of managed care on a group. CONCLUSION: The pace of hiring and turnover of diagnostic radiologists increased in 1998. Positions available continue to exceed radiologists available to fill them; the excess was approximately 330 positions, which is not significantly different from the excess reported for 1997, but is higher than the (not statistically significant) net shortfall of 51 positions estimated for 1996.

Data Collection↗
PubMed2000

The situation of radiation oncology practice training programs and their graduates in 1998.

PURPOSE: To keep the profession apprised of current trends in the job market, the American College of Radiology (ACR) studied the employment situation of 1998 radiation oncology graduates and the status and plans of radiation oncology training programs in the United States. METHODS AND MATERIALS: In April-May 1998, and again in a December 1998-January 1999 follow-up, the ACR surveyed all radiation oncology residency directors in the U.S. about the employment situation of their 1998 residency and fellowship graduates as well as changes in their programs. Eighty-five percent (71/84) of those surveyed responded. We compare current findings with similar 1997 and earlier surveys and report statistically significant differences (p < or = 0.05). RESULTS: By 6 months after graduation, there were no graduating residents or fellows who had not secured a position, although the status of two was unknown. At that time, about 93% of all graduates had secured positions that directors said reasonably matched graduates' training and personal goals. Program directors reported that accomplished and planned changes in their programs will reduce the annual number of residency graduates by about one-fifth since 1993. However, the number of beginning residency positions offered in 1998 was 149, up from 116 in 1997 and only a few percent below the 1993 level. By the December 1998-January 1999 follow-up, fill rates for offered training positions were 94% for residencies and 80% for fellowships, figures that are similar to those reported for past years. Directors' perceptions of the job market are much more positive. For example, only 11% of residency directors viewed the market as more difficult this year than typical of recent years, as against 48% in 1997 and 82% in 1996. CONCLUSION: Unemployment continues to be low, and another, "softer" indicator, the job market perceptions of residency program directors, continues to improve. Possibly as a result, plans for program reductions are evaporating.

Employment↗
PubMed2000

In memoriam

Explore the source record for details and available documents.

Journal Article↗
PubMed2000

The status of diagnostic radiology training programs and their graduates in 1999.

OBJECTIVE: To address job market concerns, the American College of Radiology studied the employment of 1999 graduates from diagnostic radiology training programs and the programs' status and plans. MATERIALS AND METHODS: In late April to the beginning of June 1999, the American College of Radiology surveyed a 50% random sample of diagnostic radiology residency directors about the employment status of their 1999 residency and fellowship graduates as well as about plans for their training programs. Seventy-seven percent responded. We compared findings from the 1999 survey with similar findings from earlier surveys using a p value of less than or equal to 0.05 to define statistical significance. RESULTS: As of the survey, 95% of residency graduates and 96% of fellowship graduates were reported to have commitments for positions. Ninety-two percent of graduating residents and 95% of graduating fellows reportedly had commitments for positions that reasonably matched their training and personal goals. Completed plus planned changes in residency program size since 1993 would, if implemented, lead to an 8% reduction. Similar to previous years, 96% of the beginning-year residency slots were filled. Program directors reported that the job market had improved compared with that of recent years. The percentage of graduating fellows with commitments for positions was similar in almost all fields. CONCLUSION: Fellows found jobs earlier than in past years, when unemployment among graduates decreased to 1-2% by 6 months after graduation. Results in 1999 should be at least as good. Employment prospects across all subspecialties are about the same. Planned program reductions are much smaller than those reported in 1998 and may continue to evaporate.

Education, Medical, Graduate↗
PubMed2000

1997 Graduates Speak: initial employment experiences of residency and fellowship graduates.

OBJECTIVE: The American College of Radiology sought to detail the initial employment experience of 1997 diagnostic radiology graduates and recent trends. MATERIALS AND METHODS: In early 1998, questionnaires were mailed to all graduates; 65% responded. Results were compared with similar surveys of 1995 and 1996 graduates. RESULTS: Much as in past years, immediately after graduation 4% of residency graduates and 9% of fellowship graduates spent some time working as a locum tenens, working outside radiology, or unemployed, but by 6-12 months after graduation, 2% or fewer were not employed. The median fellowship graduate's salary was 5% greater than in 1996. Twelve percent of fellowship graduates were in non-ownership-track jobs, much the same as in earlier years. Thirty-two percent had one or more of 12 possibly undesirable job characteristics, down from 39% in 1996; 14% not only had, but actually disliked, one or more of these characteristics, much the same as in 1996, but down from 23% in 1995. Multivariate analysis showed that women graduates were more likely than men to have had serious employment difficulties in the immediate postgraduation months; and that graduates having a spouse who also had to find a job in the same area were more likely than others to be in a putatively "seriously undesirable" location or in "holding pattern" employment while looking for something better or more permanent. CONCLUSION: Unemployment remained very low. Some other indicators of the employment market showed improvement. Factors expected to affect employment outcomes-for example, training program quality or having major non-spouse-related restrictions on job location-had surprisingly little effect.

Education, Medical, Graduate↗
PubMed1999

The situation of radiation oncology training programs and their graduates in 1997.

PURPOSE: In light of concerns about the job market, the American College of Radiology (ACR) studied the employment situation of 1997 radiation oncology graduates, and the status and plans of radiation oncology training programs. METHODS AND MATERIALS: In April-May 1997, and in a December follow-up, the ACR surveyed all radiation oncology residency directors about the employment situation of their 1997 residency and fellowship graduates and about their programs. Ninety-four percent of those surveyed responded. We compared findings with surveys from 1995 and 1996. Differences were assessed with p < or = 0.05 as the test of statistical significance. RESULTS: By six months after graduation, 98% of residency graduates and all fellowship graduates were employed. Program directors reported approximately 95% of graduates had positions that reasonably matched their training and personal employment goals. Programs have reduced beginning residency slots by 22% over the past three years, and further reductions are planned. Many observers were disappointed with fill rates in the 1997 National Match, but by the December follow-up, 96% of beginning-year residency slots were filled. CONCLUSION: Unemployment continues to be low, and one "softer" indicator, the job market perceptions of residency program directors, showed improvement.

Employment↗
PubMed1999

Hiring of diagnostic radiologists in 1997.

OBJECTIVE: We sought to determine the hiring activities of physician groups with respect to diagnostic radiologists. MATERIALS AND METHODS: A survey was mailed to a stratified, random sample of 589 groups of physicians in the autumn of 1997; 76% responded. Responses were weighted to represent all practices in the United States that have more than one radiologist. Findings were compared with results of similar, previous surveys. RESULTS: In the 12 months before the survey, groups sought to hire 1909 (+/-111[SE]) diagnostic radiologists; 888 (+/-77) of these jobs were new positions, the rest were replacements for radiologists who left groups. Groups did not seek to refill another 366 (+/-57) positions that had been vacated during these 12 months. Groups succeeded in hiring 1488 (+/-92) diagnostic radiologists. Generally, the percentage of available positions that groups succeeded in filling did not differ among subspecialty fields. A greater perceived effect of managed care on a group was associated with fewer expansion positions and less likelihood that positions were offered on a partnership-track basis but otherwise was unrelated to hiring activity. Eighty-one percent of available positions were in groups that preferred recently trained radiologists to those with 10-20 years' experience; 28% of full-time positions in private nonacademic groups were not partnership-track. CONCLUSION: The decline in hiring evident during 1991-1995 has reversed. In the year ending in the autumn of 1997, for the first time in recent years, positions available exceeded radiologists to fill them; the excess was approximately 278 positions.

Data Collection↗
PubMed1999

The situation of diagnostic radiology training programs and their graduates in 1998.

OBJECTIVE: In light of concerns about the job market, the American College of Radiology studied the employment situation of 1998 graduates from diagnostic radiology training programs and the status and plans of the programs. MATERIALS AND METHODS: In April and May 1998, the American College of Radiology surveyed a 50% random sample of diagnostic radiology residency directors about the employment situation of their 1998 residency and fellowship graduates and about their programs. Ninety-one percent of those surveyed responded. We compared findings from the 1998 survey with similar findings from the 1997 survey, with a p value less than or equal to .05 representing statistical significance. RESULTS: Similar to 1997, 96% of residency graduates and 89% of fellowship graduates had commitments for posttraining jobs or fellowships as of the survey date. Approximately 92% of graduates had positions that directors believed reasonably matched their training and personal employment goals. The percentage of fellows with positions was similar across subspecialty fields. Completed plus planned changes in program size for residents would gradually lead to a 21 % reduction in the annual number of graduates within the next 4 years. Much as in previous years, by late April to mid May 1998, 94% of beginning-year residency slots were filled. Residency program directors were more optimistic in 1998 about graduates' job prospects than in the previous 3 years. CONCLUSION: In past years, unemployment of graduates was less than 1% by 6 months after graduation, and that is the likely outcome for 1998 graduates. Employment prospects across all subspecialty areas are approximately equal.

Employment↗
PubMed1998

Initial employment experience of 1996 graduates of diagnostic radiology and radiation oncology training programs.

OBJECTIVE: The American College of Radiology sought to detail the initial employment experience of 1996 diagnostic radiology and radiation oncology graduates, the actual effect of factors expected to generate poor employment outcomes, and trends since 1995. MATERIALS AND METHODS: In autumn 1996, questionnaires were mailed to all graduates; 69% responded. The results were compared with a similar survey of 1995 graduates. RESULTS: After graduation, 3-10% of graduates, depending on their field (diagnostic radiology or radiation oncology) and level (residency or fellowship), spent some time working as a locum tenens, working outside their field, or unemployed. However, by a year after graduation, working outside one's field and unemployment had virtually disappeared, even among graduates unable or unwilling to relocate. The Professional Bureau of the American College of Radiology was the most widely used major job search method and drew relatively favorable ratings. At least 15-22% of graduates in posttraining employment had, and disliked, one or more of 11 job characteristics many observers regard unfavorably. Most commonly, the graduates' objection was to having too few patients to remain busy. Relatively poor job outcomes were associated with having a spouse who had to find a job in the same locality as the graduate (only salaries were impaired) but not with other locational constraints, with inadequacy of a major aspect of the training program (as reported by the graduate), and with being female. Changes from 1995 were few, and median salaries were approximately the same as in 1995. CONCLUSION: The employment situation is basically stable, but salaries seem to be lagging behind inflation. Female graduates' poorer employment outcomes are worrisome, especially because studies of women in other professions generally find, unlike our study, that women start their careers even with men.

Adult↗
PubMed1998

The situation of diagnostic radiology training programs and their graduates in 1997.

OBJECTIVE: In light of concerns about the job market, the American College of Radiology studied the employment situation of 1997 graduates from diagnostic radiology training programs and the status and plans of these programs. MATERIALS AND METHODS: In an April-May 1997 survey and in a December 1997 follow-up, the American College of Radiology asked a 50% random sample of diagnostic radiology residency directors about their programs and about the employment situation of their 1997 residency and fellowship graduates. Of those surveyed, 89% responded. We compared these findings with those from a similar 1996 survey. The test of statistical significance was p < or = .05. RESULTS: All diagnostic residency and fellowship graduates who wanted to work were employed within 6 months after graduation. Approximately 95% of graduates had positions that directors believed to reasonably match their training and personal employment goals. Outcomes were similar across all fellowship fields except nuclear medicine, a field in which graduates had greater difficulty finding jobs. The completed plus planned changes in program size will lead to a 13-14% reduction in the annual number of graduates. As in previous years, by late April to mid May 1997, 93% of beginning-year residency slots were filled. However, the percentage of beginning residents who are international medical graduates increased. In 1997, residency program directors were more optimistic about graduates' job prospects than in 1996, and there was a statistically significant increase from 1996 in the proportion of fellowship graduates, according to directors, who had found jobs that fit their goals and training. CONCLUSION: Unemployment continues to be low. The 1997 job market has improved over the 1996 job market, but job prospects in nuclear medicine continue to be more problematic than in other subspecialties.

Employment↗
PubMed1997

Is surgical management compromised in elderly patients with breast cancer?

OBJECTIVE: The suggestion that breast cancer management is compromised in elderly patients had prompted our review of the results of policies regarding screening and early detection of breast cancer and the adequacy of primary treatment in older women (> or = 65 years of age) compared to younger women (40 to 64 years of age). SUMMARY BACKGROUND DATA: Although breast cancer in elderly patients is considered biologically less aggressive than similar staged cancer in younger counterparts, outcome still is a matter of stage and adequate treatment of primary cancer. For many reasons, physicians appear reluctant to treat elderly patients according to the same standards used for younger patients. There is even government-mandated alterations in early detection programs. Thus, since 1993, Medicare has mandated screening mammography on a biennial basis for women older than 65 year of age compared to the current accepted standard of yearly mammograms for women older than 50 years of age. Using State Health Department and tumor registry data, the authors reviewed screening practice and management of elderly patients with primary breast cancer to determine the effects of age on screening, detection policies (as reflected in stage at diagnosis), treatment strategies, and outcome. METHODS: Data were analyzed from 5962 patients with breast cancer recorded in the state-wide Tumor Registry of the Hospital Association of Rhoda Island between 1987 and 1995. The focus of the data collection was nine institutions with established tumor registries using AJCC classified tumor data. Additional data were provided by the State Health Department on screening mammography practice in 2536 women during the years 1987, 1989, and 1995. RESULTS: The frequency of mammographic screening for all averaged 40% in 1987, 52% in 1987, and 63% in 1995. In the 65-year-old and older patients, the frequency of screening was 34% in 1987, 45% in 1989, and 48% in 1995, whereas in the 40- to 49-year-old age group, the frequency of mammography was 47% in 1987, 61% in 1989, and 74% in 1995 (p < 0.001). There was a lower detection rate of preinvasive cancer in the 65-year-old and older patients, 8.8% versus 13.7% in patients within the 40- to 64-year-old age group (p < 0.001). There was a higher percentage of treatment by limited surgery among elderly patients with highly curable Stage IA and IB cancer with 26.6% having lumpectomy alone versus 9.4% in the younger patients. Five-year survival in that group was significantly worse (63%) than in patients treated by mastectomy (80%) or lumpectomy with axillary dissection and radiation (95%, < 0.001). A similar effect was seen in patients with Stage II cancer. CONCLUSIONS: Breast cancer management appears compromised in elderly patients (older than 65 years of age). Frequency of mammography screening is significantly less in elderly women older than 65 years of age. Early detection of preinvasive (curative cancers) is significantly less than in younger patients. The recent requirement by Medicare of mammography every other year may further reduce the opportunity to detect potentially curable cancers. Approximately 20% of patients had inferior treatment of favorable stage early primary cancer with worsened survival. Detection and treatment strategy changes are needed to remedy these deficiencies.

Adult↗