The developing physician--becoming a professional.
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Biomedical subjects
Publications and source records attributed to Maxine Papadakis.
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OBJECTIVE: Medical students face pressures ranging from the need to create a social network to learning vast amounts of scientific material. Students often feel isolated in this system and lack mentorship. In order to counteract feelings of bureaucratic anonymity and isolation, the University of California San Francisco has created an advisory college to foster the professional and personal growth and well being of students. DESCRIPTION: UCSF has developed a formal structure to advise medical students. A selection committee, chaired by the associate dean of student affairs, appointed five faculty mentors to head advisory colleges. These five colleges serve as the advising and well-being infrastructure for the students. Mentors were chosen from a balanced range of clinical disciplines, both primary and specialty. The disciplines are obstetrics-gynecology, otolaryngology/head and neck surgery, medicine, pediatrics, and psychiatry. The mentors have demonstrated excellence in advising and counseling of students. Mentors meet individually at the beginning of the academic year with incoming first-year and second-year students. They then have bimonthly meetings with eight to ten students within each college throughout the academic year. Curricula for these group sessions include well-being discussions and coping techniques, sessions on the hidden and informal curriculum of professionalism, and discussions on career choices and strategies. For third-year students, advisory college meetings are scheduled during intersessions, which are weeklong courses that occur between the eight-week clerkship blocks. Mentors are available throughout the year to meet with students on an as-needed basis, and advisory colleges may hold group social activities. The dean's office supports each mentor with 20% salary and provides administrative support for the group college activities. DISCUSSION: Historically, UCSF students feel they receive an excellent education and appropriate job opportunities, but they do not feel they receive adequate advising and mentoring. This may have as its root cause the financial, clinical, and research pressures placed upon a faculty who are also responsible for mentoring residents and fellows. The advisory colleges begin by providing an infrastructure for developing a relationship for the student with a single faculty member. The advisory college system is incorporated into the academic schedule rather than relying on ad-hoc activities from well-meaning but inconsistently available faculty. In the early part of medical school, the advisory college relationship concentrates on assimilation into the new environment and provides the student with advice pertaining to mastering academic material. The college also serves as a sounding board for problems that can then be relayed to course directors to improve the educational experience. For students encountering academic difficulty, the college advisor can provide discreet advice about tutoring resources and can direct the student to a separately staffed Student Well-being Program. As time progresses, the mentors can direct students to key people in different fields of interest such as program directors and keep the students on track to make career decisions in a timely manner. The college system can help transform an anonymous medical school experience into a supportive, rich environment.
BACKGROUND: The abuse of medical students on clinical rotations is a recognized problem, but the effects on students and their responses warrant further study. PURPOSE: To determine the severity of student abuse and the effects of abuse on students during the internal medicine clerkship. METHODS: Internal medicine clerks at 11 medical schools (N = 1,072) completed an exit survey. Students were asked whether they had been abused. If they had, they were asked about the severity of the abuse, whether they reported it, and its effects on them. RESULTS: Of the responding students, 123 (11%) believed they had been abused. Only 31% of the students who felt abused reported the episodes to someone. The most common consequences of the events included poor learning environments, lack of confidence, and feelings of depression, anger, and humiliation. CONCLUSION: Students described a variety of personal and educational effects of abuse. They generally did not report abuse because of fear of retaliation and the belief that reporting is pointless.