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Biomedical subjects

H K Rabinowitz

Publications and source records attributed to H K Rabinowitz.

At least 19 recordsLinked to original sources
PubMed1994

Admission, recruitment, and retention: finding and keeping the generalist-oriented student. SGIM Task Force on Career Choice in Primary Care and Internal Medicine.

As the country strives to produce larger numbers of generalist physicians, considerable controversy has arisen over whether or not generalist applicants can be identified, recruited, and influenced to keep a generalist-oriented commitment throughout medical training. The authors present new and existing data to show that: 1) preadmission (BA/MD or post-baccalaureate) programs can help to identify generalist-oriented students; 2) characteristics determined at admission to medical school are predictive of future generalist career choice; 3) current inpatient-oriented training programs strongly push students away from a primary care career; 4) women are more likely than men to choose generalist careers, primarily because of those careers' interpersonal orientation; and 5) residency training programs are able to select applicants likely to become generalists. Therefore, to produce more generalists, attempts should be made to encourage generalist-oriented students to enter medical schools and to revise curricula to focus on outpatient settings in which students can establish effective and satisfying relationships with patients. These strategies are most likely to be successful if enacted within the context of governmental and medical school-based changes that allow for more reimbursement and respect for the generalist disciplines.

Adult↗
PubMed1992

Sixteen years' experience with a required third-year family medicine clerkship at Jefferson Medical College.

Jefferson Medical College has developed a program to successfully meet the goal of teaching ambulatory care to all medical students, by providing each of its 223 third-year students with a required six-week clerkship in family medicine. The structured clerkship takes place at one of seven residency-based family practice centers, is supplemented by a formal curriculum, and is based on the active clinical involvement of caring for patients under full-time family medicine faculty supervision. This clerkship has been in existence for 16 years, and has added over 400,000 student-patient encounters to the clinical education of over 3,500 students. Student evaluations of the clerkship have rated it the highest of the six required core clerkships at Jefferson. In addition, over 16% of Jefferson graduates have entered family medicine residency training programs, a rate higher than that of any other school in the northeastern United States, and significantly higher than the average for all U.S. medical schools (12%). Jefferson's experience suggests that ambulatory care can be taught as a core component of the clinical education of all medical students. To be successful, however, strong institutional support, a structured curriculum, an adequate number of patients, a dedicated faculty, a sufficient number of training sites, an appropriate evaluation process, and significant financial support are all necessary.

Academic Medical Centers↗
PubMed1992

Income expectations of first-year students at Jefferson Medical College as a predictor of family practice specialty choice.

The recent decline in the number of medical students choosing careers in the primary care specialties has engendered increasing concern that economic factors are becoming more important in influencing the career choices of medical students. In order to assess the relationship of first-year medical students' income expectations to whether they chose to specialize in family practice, the authors analyzed data from 532 graduates of Jefferson Medical College (classes of 1987-1989), using the Jefferson Longitudinal Study. At entrance to medical school, each student listed his or her initial specialty preference and future expected peak income; the determination of actual specialty choice was based on the first year of postgraduate training. Both expected peak incomes and freshman specialty choices were independent predictors of actual specialty choices. The students who entered family practice residencies had lower initial expected peak incomes than did the students entering other specialties, especially the surgery specialties. In addition, according to logistic regression analysis, the students with relatively lower income expectations and a freshman preference for family practice were predicted to be nine times more likely to enter family practice residencies than were students with higher income expectations and no initial family practice preference (56% versus 6%). This study suggests that a freshman's income expectation is an important predictor of family practice specialty choice, independent of age, sex, degree of indebtedness, and initial specialty preference. The authors discuss their results in light of the decline in the number of medical students choosing family practice and the other primary care specialties.

Career Choice↗
PubMed1990

Upper respiratory tract infections.

Upper respiratory tract infections are among the most common acute infections in humans. This review discusses the clinically important aspects of the epidemiology, etiology, clinical presentation, diagnosis, management, complications, and prevention of the common cold, pharyngitis, otitis media, and sinusitis. Most episodes of the common cold and pharyngitis are of viral origin, and curative therapy is not available. Streptococcal pharyngitis, acute otitis media, and sinusitis are secondary to bacterial infections, and antibiotic therapy is important.

Anti-Bacterial Agents↗
PubMed1988

Evaluation of a selective medical school admissions policy to increase the number of family physicians in rural and underserved areas.

Jefferson Medical College initiated the Physician Shortage Area Program (PSAP) in 1974; this program preferentially admits medical school applicants from rural backgrounds who intend to practice family medicine in rural and underserved areas. Evaluation of the program has shown that PSAP graduates from the classes of 1978 to 1985 have performed slightly less well than their peers (non-PSAP) during medical school, although there was no difference in attrition between the two groups. Nor did the performance of PSAP and non-PSAP graduates differ during their postgraduate training. PSAP graduates from the classes of 1978 to 1981 were almost five times as likely as non-PSAP graduates to practice family medicine (59.6 vs. 12.6 percent, P less than 0.001), three times as likely to practice in rural areas (37.8 to 42.2 percent vs. 10.0 to 11.8 percent, P less than 0.001), and two four times as likely to practice in areas where there is a physician shortage (26.7 to 40.0 percent vs. 9.2 to 11.2 percent, P less than 0.01). They were 7 to 10 times as likely as their peers to combine a career in family medicine with practice in a rural or underserved area (24.4 to 31.1 percent vs. 3.1 to 3.9 percent, P less than 0.001), thereby fulfilling the goals of the PSAP. This study concludes that the medical school admissions process can have a major influence on the specialty choice and geographic practice location of physicians, and suggests one mechanism for increasing the number of family physicians in rural and underserved areas.

Career Choice↗
PubMed1988

Relationship between US medical school admission policy and graduates entering family practice.

Rural areas in the United States continue to lack an adequate supply of primary care doctors, particularly family physicians, despite the oversupply of physicians nationally. Previous studies have provided strong evidence that students from rural backgrounds, as well as those who expressed an interest at the time of medical school admission for a career in family medicine, are significantly more likely to eventually practise family medicine in rural areas than their peers. US medical schools were classified into three groups based on their written selection factors for preferentially admitting students into the graduating class of 1982. Of those schools with selection factors for students from both a rural background and an interest in a future career in family medicine, 23.7% of their graduates entered family medicine training programmes. This compares with 14.5% of graduates from schools with a preference for students from a rural background, and 12.4% from all other schools (P less than 0.001). Coupled with previous data which shows that family physicians from rural areas are more likely to eventually practise in rural areas than their peers, preferentially admitting students from rural backgrounds interested in a career in family medicine could help to solve the problem of the shortage of primary care physicians in rural areas in the US.

Career Choice↗
PubMed1988

Rural applicants.

Explore the source record for details and available documents.

Education, Medical, Undergraduate↗
PubMed1988

Cueing in multiple choice questions: a reliable, valid and economical solution.

Test questions dealing with diagnosis and management were administered to medical students in both multiple-choice format and an open-ended form which can be scored by computer. Open-ended questions are feasible to administer, equally reliable and may be more valid in certain domains than multiple-choice questions.

Clinical Competence↗
PubMed1987

The modified essay question: an evaluation of its use in a family medicine clerkship.

This paper describes the extensive experience of the Department of Family Medicine at Jefferson Medical College in utilizing the modified essay question (MEQ) as a final examination for its required third-year clerkship in family medicine. The results of a preliminary study are presented, comparing the MEQ as a method of evaluation with the multiple choice question (MCQ) format on similar content material. MCQ performance was found to be a better predictor of National Board Part I and II scores, but neither format was found to be a good predictor of postgraduate performance. The data were statistically significant (P less than 0.05) that MEQ performance was related to postgraduate performance in the area of professional attitude while the MCQ was not; however, the number of students in the analysis was small. Additional studies are planned to test this hypothesis further.

Clinical Clerkship↗
PubMed1986

The modified essay question: effect of author location on student performance.

The Department of Family Medicine at Jefferson Medical College, Philadelphia has utilized the modified essay question (MEQ) as an evaluative instrument in its required third-year clerkship since 1976. Previous analysis had indicated that students who participated in their clerkship at the university family practice centre (FPC) consistently performed at a higher level on their MEQ examinations than students who participated in clerkship activities at affiliated FPCs. In order to test the hypothesis that university-taught students had higher final examination scores because university teachers developed and graded the examinations, MEQs were developed by affiliate teachers and used for one half of five final examinations during the 1982-83 academic year. Students at the university-trained site continued to perform better than affiliated-trained students, even on MEQs developed by their own teachers. These results, as well as the significant administrative time involved in the project, have caused the Department of Family Medicine to revert to its previous policy of university teachers being responsible for the final examination.

Authorship↗
PubMed1983

A program to recruit and educate medical students to practice family medicine in underserved areas.

In an attempt to address the problem of physician maldistribution, Jefferson Medical College initiated the Physician Shortage Area Program (PSAP) in 1974, a special admissions program that preferentially selects applicants who intend to practice family medicine in physician shortage areas in Pennsylvania. Forty-seven students in four classes have been graduated from the program. Evaluation of these students during medical school shows that their academic performance has been similar to their classmates. Follow-up evaluation indicates that PSAP graduates are five times as likely as their peers (non-PSAP) to enter a family medicine residency program during the first postgraduate year (62% v 12%), and almost twice as likely to enter family medicine as a comparable group of non-PSAP students who originally entered Jefferson with plans of becoming a family physician (62% v 33%).

Career Choice↗