Biomedical subjects

Dorothy A Andriole

Publications and source records attributed to Dorothy A Andriole.

8 recordsLinked to original sources

PubMed2006

Who are our future surgeons? Characteristics of medical school graduates planning surgical careers: analysis of the 1997 to 2004 Association of American Medical Colleges' Graduation Questionnaire National Database.

BACKGROUND: Identification of correlates of contemporary US medical graduates' surgical career plans can provide insights about the emerging surgical workforce composition and inform future recruitment efforts. STUDY DESIGN: We analyzed individualized records of 95,176 graduates who completed the 1997 to 2004 Association of American Medical Colleges Graduation Questionnaire for associations between planning a general-surgery or a surgical-specialty (orthopaedic surgery, neurologic surgery, plastic surgery, urology, or otolaryngology) career and a set of medical-school experience, professional-setting preference, and demographic variables. RESULTS: Graduates who reported better quality of their surgery clerkship experience and career-setting preference of "university faculty" compared with "nonuniversity clinical practice" were more likely to plan general-surgery or surgical-specialty careers compared with nonsurgical careers (each p < 0.001). Women and graduates from combined MD/PhD programs and those who planned to practice in underserved areas were less likely to plan general-surgery or surgical-specialty careers compared with nonsurgical careers (each p < 0.001). Graduates of nonwhite race or ethnicity and from combined MD/other-degree (non-PhD) programs were more likely to plan general-surgery careers (p < 0.001). Compared with 1997 graduates, 1998 to 2004 graduates were less likely to plan general-surgery careers than surgical-specialty careers (each p < or = 0.001), and 1999 to 2004 graduates were more likely to plan surgical-specialty careers than nonsurgical careers (each p < or = 0.006). CONCLUSIONS: Contemporary graduates planning surgical careers represent a relatively narrow spectrum of US medical graduates, and those planning general-surgery careers differ in numerous ways from those planning surgical-specialty careers. Targeted efforts are warranted to recruit US medical graduates qualified to meet the nation's future health-care needs and advance the profession of surgery.

Career Choice↗

PubMed2006

Which U.S. medical graduates plan to become specialty-board certified? Analysis of the 1997-2004 national association of American Medical Colleges Graduation Questionnaire database.

BACKGROUND: Predictors of U.S. allopathic medical-school graduates' board-certification plans have not been characterized. METHOD: Using multivariable logistic regression, graduates' responses to 11 questions on the 1997-2004 Association of American Medical Colleges Graduation Questionnaire were analyzed to identify independent predictors of plans for specialty-board certification. RESULTS: The proportion of 108,408 graduates planning specialty-board certification decreased from 97.3% in 1997 to 88.4% in 2004. Among 101,805 (93.9%) graduates with complete data, graduates who were Hispanic, rated their clinical clerkships, quality of medical education, and confidence in clinical skills more highly, had any debt, and planned "University-faculty" careers were more likely to plan becoming board certified. Females, Asians/Pacific Islanders, and graduates who planned to practice in underserved areas, planned "other" nonclinical-practice careers, and graduated with MD/other (non-PhD) degrees were less likely to plan becoming board certified. CONCLUSION: Specialty-board certification does not appear to be among the professional goals for a growing proportion of U.S. medical graduates.

Career Choice↗

PubMed2005

What predicts USMLE Step 3 performance?

BACKGROUND: Academic and other student-specific variables associated with United States Medical Licensing Examination (USMLE) Step 3 performance have not been fully defined. METHOD: We analyzed Step 3 scores in association with medical school academic-performance measures, gender, residency specialty, and first postgraduate year (PGY-l) of training program-director performance evaluations. RESULTS: There were significant first-order associations between Step 3 scores and each of USMLE Step 1 and Step 2 scores, third-year clerkships' grade point average (GPA), Alpha Omega Alpha election, Medical Scientist Training Program graduation, broad-based specialty residency training, and PGY-l performance evaluation score. In a multiple linear regression model accounting for over 50% of the total variance in Step 3 scores, Step 2 scores, broad-based-specialty residency training, and GPA independently predicted Step 3 scores. CONCLUSIONS: Individualized Step 3 scores provide medical schools with additional means to externally validate their educational programs and to enhance the scope of outcomes assessments for their graduates.

Clinical Clerkship↗

PubMed2004

What predicts surgical internship performance?

BACKGROUND: Variables associated with postgraduate year 1 (PGY-l) performance in surgical training have not been fully defined. METHODS: Mean composite PGY-l evaluation scores were calculated from responses to questionnaires mailed to surgical program directors of 87 surgical graduates from 1997 to 2001. We analyzed evaluation scores for associations with sex, surgical specialty choice, United States Medical Licensing Examination (USMLE) step 1 and step 2 scores, Alpha Omega Alpha (AOA) election, and third-year clerkships' grade point average (GPA). RESULTS: There were significant first-order associations between PGY-l performance evaluation score and each of USMLE step 2 score and GPA. In a multiple linear regression model that included sex, surgical specialty choice, USMLE step l and step 2 scores, AOA, and GPA, USMLE step 2 score was the only significant predictor of PGY-l performance. CONCLUSIONS: Multiinstitutional studies are warranted to determine the predictive value of USMLE step 2 scores in residency performance beyond PGY-l and to identify other predictors of surgical PGY-l performance.

Adult↗

PubMed2003

Recent trends in match process outcomes for U.S. senior medical students.

PURPOSE: It is difficult to compare match outcomes across specialties because they may change over time and data are not reported in uniform formats. METHOD: Recent U.S. student match outcomes were analyzed for 16 specialties. RESULTS: On the basis of student match rates, three specialties were consistently competitive, eight were consistently noncompetitive, and five were in flux. Unfilled position rates increased for five specialties and remained stable or decreased for 11. CONCLUSIONS: Many specialties, both competitive and noncompetitive, recently have become increasingly desirable to match participants, whereas primary care specialties have become less desirable to both U.S. students and other match participants.

Career Choice↗

PubMed2002

How competitive is my surgical specialty?

BACKGROUND: It is difficult to determine relative competitiveness of surgical training positions: there is no single source for matching process results and specialty-specific competitiveness may change over time. This study was undertaken to address these issues. METHODS: Numbers of matched/unmatched students and positions offered/filled for surgical specialties were analyzed for specialty-specific trends in match rates and differences among specialty match rates over time. RESULTS: From 1996 to 2000, match rates increased for neurological surgery, general surgery and otolaryngology; decreased for ophthalmology and urology and were unchanged for orthopedic surgery. Although the "most competitive" and "least competitive" specialties changed each year, unmatched student numbers uniformly exceeded unfilled position numbers. CONCLUSIONS: Match rates changed over time; no single specialty was consistently most or least competitive. Unmatched students were unlikely to successfully "scramble" for an advanced/categorical training position in any surgical specialty because of the uniformly very high fill rates.

Adult↗

PubMedDate not supplied

Diversity in general surgery: a period of progress.

OBJECTIVE: Although 1996 to 2002 was a period of declining interest in general surgery (GS) among U.S. medical students (USS), most categorical general surgery (C-GS) training positions offered in the National Residency Matching Program (NRMP) continued to fill. We measured the impact of the decreasing U.S. student applicant volume on C-GS match outcomes and GS resident workforce composition over this time period. DESIGN: Match outcomes were analyzed for 7 applicant categories. Subsequent GS resident workforce compositions were analyzed for proportions of U.S. allopathic medical school graduates (USG), osteopathic medical graduates (OMG), Canadian MG (CMG), foreign MG (FMG), female physicians, and African-American physicians. Mantel-Haenzel chi-square tests measured trends in match percentages, C-GS positions filled, and GS workforce composition. All p-values are 2-sided. RESULTS: Increasing match percentages for USS applicants (p < 0.0001) and USG (p = 0.001), with a decreasing percentage of C-GS positions filled by these applicants (p < 0.0001), were from declining applicant volumes. Increasing match percentage for non-U.S. allopathic medical applicants reflected increases in both applicant volumes and matched applicants, with an increasing percentage of C-GS positions filled by these applicants (p < 0.0001). The subsequent resident workforce included increasing proportions of FMGs and OMGs (each p < 0.001); proportions of USG MDs and CMGs decreased (p < 0.0001 and p < 0.02, respectively). Concurrently, there were increasing numbers and proportions of female physicians (p < 0.0001) and African-American physicians (p < 0.0001) in the general surgery resident workforce. CONCLUSIONS: Declining interest among U.S. students in GS has resulted in a workforce comprised of residents from a broad range of educational backgrounds, but also it has provided an opportunity for progress toward achievement of a GS resident physician workforce more equitably representative of the racial and gender composition of our society at large.

Adult↗

PubMedDate not supplied

Do general surgery applicants really want to be general surgeons?

OBJECTIVE: The authors sought to compare categorical general surgery applicants with applicants in other specialties regarding their final specialty-choice ranking for residency positions. METHOD: The authors analyzed the 2004-match year applicant-pool data from the Electronic Residency Application Service and Common Application Service as well as rank-list data from the National Resident Matching Program (NRMP), the Urology Match Program, and the San Francisco Matching Program for 20 different specialties. Two-tailed chi-square tests measured differences between the proportions of applicants who ultimately ranked programs in categorical general surgery and each of 19 other specialties and between the proportions of U.S. students who ranked categorical general surgery and each of 19 other specialties as a non-preferred choice. A Bonferroni-adjusted alpha was set at 0.0013 to reduce the likelihood of a type I error. RESULTS: The proportion of applicants ranking each specialty ranged from 42% (786/1859) in pathology to 91% (282/31l) in neurological surgery. The proportion of categorical general surgery applicants ranking categorical general surgery programs was 51% (2004/3900), which was significantly lower than the proportions ranking 12 of 19 other specialties (each p < 0.001). Of the 2004 categorical general surgery applicants ranking categorical general surgery programs, 278 (278/2004, 14%) ranked categorical general surgery as a non-preferred specialty. Among 1230 U.S. students ranking categorical general surgery programs, 144 (12%) did so as a non-preferred specialty-a proportion significantly higher compared with U.S. students ranking 15 of 19 other specialties as non-preferred (each p < 0.001). CONCLUSIONS: In 2004, the categorical general surgery applicant pool was relatively uncommitted to the specialty of general surgery. The number of applicants ranking categorical general surgery as a non-preferred specialty was likely even higher than these data indicate, as unmatched applicants in non-NRMP matches who then ranked categorical general surgery programs in the NRMP were tabulated by the NRMP as having ranked categorical general surgery as their preferred specialty.

Career Choice↗