Biomedical subjects

Sylvia I Etzel

Publications and source records attributed to Sylvia I Etzel.

8 recordsLinked to original sources

PubMed2005

Educational programs in US medical schools, 2004-2005.

CONTEXT: The educational environment affects the outcomes of medical education, including the characteristics and distribution of medical school graduates. OBJECTIVE: To report the status of variables related to medical education that represent areas that recently have been in flux or have potential impact on health care delivery. DESIGN, SETTING, AND PARTICIPANTS: Descriptive survey study comparing selected results of the Liaison Committee on Medical Education Annual Medical School Questionnaire between 2004-2005 and 1994-1995. The questionnaire was sent to the deans of all 125 LCME-accredited medical schools. Response rate was 100% in both years. MAIN OUTCOME MEASURES: Overall trends between 1994-1995 and 2004-2005 in the size and composition of the medical school faculty, the numbers of medical school applicants and students, requirements for passage of the US Medical Licensing Examination, medical student work hours, the use of computers in the educational program, the geographic pipeline from entry to medical school to entry to graduate medical education, and the educational background of medical school deans. RESULTS: The number of full-time faculty members increased from 90 016 in 1994-1995 to 119 025 in 2004-2005 (a 32% increase) while the number of medical students remained constant at about 67 000. In 2004-2005, 11% of medical school deans held MD and PhD degrees, 6% held MD and MBA degrees, 4% held MD and MPH degrees, and 2% held an MD and another degree (such as JD). In 2004-2005, 68% of all first-year medical students were residents of the state in which the medical school is located and a mean of 43% of 2005 graduates remained in the same state as the medical school for graduate medical education; results were similar in 1995. In 2004-2005, 58 schools (46%) required students to have their own computers and 35 (28%) to have their own personal digital assistants. In 2004-2005, night call was less common in the family medicine, internal medicine, pediatrics, and psychiatry clerkships compared with 1994-1995. CONCLUSIONS: Although most students remain in their home state for medical school, most students leave the medical school state for residency. Factors external to the medical school, such as funding mechanisms and regulations from the public and private sectors, may be having an impact on faculty size and composition, and on the geographic pipeline of students into medical school and residency training.

Clinical Clerkship↗

PubMed2005

US graduate medical education, 2004-2005: trends in primary care specialties.

CONTEXT: Over the last decade, the primary care specialties have experienced an ebb and flow in popularity. A description of the future primary care workforce may inform planning for the health care needs of our population. OBJECTIVES: To describe characteristics of physicians training in primary care specialties over the past 9 years and to monitor trends in the characteristics of the entire residency population. DESIGN, SETTING, AND PARTICIPANTS: Descriptive survey study of the National GME Census, conducted by the American Medical Association and Association of American Medical Colleges, which jointly surveyed 8246 allopathic graduate medical education (GME) programs during the academic year 2004-2005 about active, transferred, and graduated residents, as well as about program characteristics. Program directors confirmed the status of 97.3% of active residents. The accompanying program survey was completed by 7163 (87%) of the program directors. MAIN OUTCOME MEASURES: General trends in the numbers and characteristics of all residents, fellows, and training programs, with specific trends for residents and fellows training in the primary care specialties and subspecialties over the past 9 years. RESULTS: The census counted 101 291 physicians-in-training during the 2004-2005 academic year, the largest number ever recorded by this survey. The number of osteopathic medical school graduates (DOs) in allopathic GME decreased from 5838 in 2003-2004 to 5675, following many years of annual increases. The number of residents in primary care specialties reached a peak in the mid 1990s. The number of family medicine residents who are graduates of US allopathic medical schools (USMDs) has fallen from 8232 (77.6%) in 1998-1999 to 4848 (51.7%) in 2004-2005. The number of primary care residents who are graduates of foreign medical schools and US citizens (USIMGs) nearly doubled between 1995-1996 (n = 1768) and 2004-2005 (n = 3304). The number of USIMGs training in internal medicine or pediatrics subspecialties increased by 45.7% between 1995-1996 (n = 622) and 2004-2005 (n = 906). The number of pediatric subspecialty fellows grew 55.7%, mostly because of the near doubling of USMDs, from 813 to 1617. More than half of primary care residents are women (52.5%). All primary care specialties and subspecialties experienced gains in the proportion of female residents, with the greatest in obstetrics/gynecology, which increased by 28.7% (57.9% in 1995-1996 vs 74.5% in 2004-2005). CONCLUSIONS: An increasing proportion of physicians are pursuing subspecialty training, while the number in primary care specialties has leveled off. Trends in GME suggest that the primary care medical workforce of the future will include more women, more IMGs, and more DOs.

Databases as Topic↗

PubMed2004

Educational programs in US medical schools, 2003-2004.

CONTEXT: US medical schools continue to change their organizational structures, staffing patterns, and educational programs. OBJECTIVE: To review the status of US medical school educational programs in the 2003-2004 academic year, compared with 1993-1994. DATA SOURCES: The Liaison Committee on Medical Education (LCME) Annual Medical School Questionnaire for 2003-2004 and the Association of American Medical Colleges Directory of American Medical Education for the years 1983-1984, 1993-1994, and 2003-2004. DATA SYNTHESIS: The number of full-time faculty members in the 126 LCME-accredited medical schools increased from 90 975 in 1993-1994 to 114 549 in 2003-2004 (+26%), whereas the number of enrolled students remained essentially unchanged (66 453 in 1993-1994 and 67 166 in 2003-2004). In 2003-2004, 48% of medical school deans held another title at the medical center or university level, such as vice president for health affairs. There are 94 medical schools that have a comprehensive clinical examination using the standardized patient/objective structured clinical examination format; 59 schools require students to pass this examination for graduation. As of spring 2004, 58 schools will require students in the class of 2005 to pass the new US Medical Licensing Examination Step 2 Clinical Skills examination. CONCLUSIONS: The role of the medical school dean has expanded over time and is associated with the creation of a discrete administrative structure for the educational program. The number of full-time medical school faculty continues to increase, whereas the number of enrolled students remains steady. Considerable variability exists among medical schools in their use of standardized clinical evaluations.

Adult↗

PubMed2004

US graduate medical education, 2003-2004.

CONTEXT: Information about recent graduates of medical schools and the characteristics of physicians training in graduate medical education (GME) portends the size and composition of the US physician workforce of the near future. OBJECTIVES: To examine trends in training programs and career choices of graduating male and female residents and to monitor trends in the size of the entire residency population. DESIGN, SETTING, AND PARTICIPANTS: The American Medical Association and Association of American Medical Colleges jointly surveyed residency programs during the academic year 2003-2004 about active, transferred, and graduated residents, as well as about program characteristics. The 8192 programs confirmed the status of 94.6% of residents. Nearly 86% of program directors (n = 7040) completed the accompanying program survey. MAIN OUTCOME MEASURES: Overall trends during the last 6 years in the number and characteristics of residents and programs, as well as the specialty of male and female graduating residents. RESULTS: There were 99,964 active residents during the 2003-2004 academic year, the highest ever recorded by the National GME Census. The number of residents (n = 22,444) entering US graduate medical education programs for the first time is also the highest on record. In 1999, 28,773 physicians completed training, 10,546 (36.7%) of whom were women. In 2003, there were 29,745 graduates, 11,681 (39.3%) of whom were women, representing a 10.8% increase. The number of obstetrics/gynecology male graduates decreased 31.3%, while female graduates increased 18.2%. Other specialties that lost men and gained women were dermatology, family medicine, internal medicine, ophthalmology, pathology, psychiatry, and general surgery. The proportion of graduates who pursued additional training increased; percentages were 27.2% in 1999, 29.6% in 2001, and 32.1% in 2003. In 2000, 35.7% of programs provided opportunities to develop cultural competence; the percentage in 2003 was 50.7%. The percentage of programs with complementary/alternative medicine curriculum has held steady at 24%. CONCLUSIONS: The number of physicians in GME is at its highest, and nearly one third of physicians completing training in one program continue on in another. The choices of female residents parallel those of male residents in many respects, but there are important differences.

Adult↗

PubMed2003

Educational programs in US medical schools, 2002-2003.

CONTEXT: To better provide medical students with the knowledge, skills, attitudes, and values they will need as physicians, US medical schools continue to make ongoing changes to their staffing and curricula. OBJECTIVE: To review the status of US medical education in the 2002-2003 academic year, compared with 1997-1998. DATA SOURCES: The Liaison Committee on Medical Education (LCME) Annual Medical School Questionnaire, the Association of American Medical Colleges (AAMC) Databook, and the AAMC Data Warehouse: Applicant Matriculant File. Data evaluated included those on medical school faculty, applicants, and students; curriculum hours devoted to new multidisciplinary or nontraditional subject areas (eg, cultural diversity, evidence-based medicine, medical ethics, medical informatics); and methods used to evaluate student learning. DATA SYNTHESIS: The number of full-time faculty members in the 126 LCME-accredited medical schools increased from 96 773 in 1997-1998 to 109 526 in 2002-2003 (+13.2%). The number of applicants entering decreased from 43 016 in 1997-1998 to 33 625 in 2002-2003 (-21.8%). The number of enrollees remained virtually unchanged from 1997-1998 (66 748) to 2002-2003 (66 677). Most medical schools have incorporated new subject areas into their curricula, although time devoted to these areas varies across schools. Schools typically use written examinations (National Board of Medical Examiners subject tests and/or internally prepared examinations) to assess factual knowledge, and observations by faculty members and residents to assess clinical skills. Use of standardized methods (eg, an objective structured clinical examination [OSCE]) to assess clinical skills is variable; 82 schools use a final third- or fourth-year comprehensive OSCE; 53 require a passing OSCE score for graduation. CONCLUSIONS: While the number of applicants to US medical schools has continued to decline, student numbers are constant. The number of full-time faculty members has increased. Schools are incorporating new subject areas into their curricula, and the use of standardized methods of assessing clinical skills, while variable, is generally increasing.

Adult↗

PubMed2003

US graduate medical education, 2002-2003.

CONTEXT: By selecting a specialty to train in, physicians entering graduate medical education (GME) training provide advance information about the future physician workforce. OBJECTIVE: To determine trends in the residency choices of medical school graduates entering GME training. DESIGN, SETTING, AND PARTICIPANTS: The American Medical Association and Association of American Medical Colleges jointly surveyed active programs as well as combined programs in academic year 2002-2003 about active, transferred, and graduated residents. In 2002 the survey was sent to 8064 program directors; 84.2% of them confirmed the status of all active residents and 82.6% completed the program survey. MAIN OUTCOME MEASURES: In addition to overall trends, the specialty choices of graduates of osteopathic schools (DOs) and international medical graduates (IMGs). Also, where native US citizen resident physicians attended medical school if not in the United States, with a focus on Hispanic ethnicity and Spanish-language facility. RESULTS: The census counted 98 258 resident physicians in GME programs in academic year 2002-2003, similar to 5 years ago and reversing a decline over the past few years. There were 23 443 residents in graduate year 1 (GY1) positions, for which prior GME training is not required, a slight increase from 2001-2002. The proportion of GY1 residents without prior GME increased slightly compared with 2001-2002 (92.3% to 93.3%). In 1996-1997, 624 DOs were GY1 residents without prior GME (2.9%); their numbers increased to 1312 (6.0%) in 2002-2003. The number of IMGs in GY1 positions without prior GME also increased over this period, from 5033 (23.5%) to 5623 (25.7%). Over the past 6 years the number of IMG and DO GY1 residents without prior GME in specialties such as general surgery, obstetrics and gynecology, and emergency medicine has increased disproportionately faster than the overall rate. Hispanic native US citizens are more likely to be IMGs than non-Hispanic native US citizens (9.6% vs 5.0%). One third of Hispanic native US citizen IMGs received their medical education in Spanish vs less than 3% of non-Hispanic native US citizen IMGs. CONCLUSIONS: Nearly 25% of physicians in US allopathic training programs in 2002-2003 were IMGs, and the percentage of DOs continues to increase. The number of residents conversant in Spanish could serve a need for a large US minority population.

Career Choice↗

PubMed2002

Educational programs in US medical schools, 2001-2002.

We used data mainly from the 2001-2002 Liaison Committee on Medical Education Annual Medical School Questionnaire, which had a 100% response rate, to describe the status of US medical education programs. In 2001-2002, the number of full-time medical school faculty members was 104 949, a 2.4% increase from 1999-2000. The 34,859 applicants for the class entering in 2001 represented a 9.5% decrease from the number of applicants in 1999-2000. There were 2 applicants for every acceptance, and the academic qualifications of medical students entering in 2001 were unchanged from 1999. Women comprised 47.8% of entering students in 2001, and 13.1% were members of underrepresented minority groups. Of all first-year students, 67% were in-state residents. Most medical schools had mandatory required night call during at least some required clinical clerkships, but only 17 had formal policies on medical student work hours. In 74 schools (60%), medical students were required to pass Steps 1 and 2 of the United States Medical Licensing Examination to advance or graduate.

Curriculum↗

PubMed2002

US graduate medical education, 2001-2002: changing dynamics.

The National Graduate Medical Education (GME) Census, jointly administered by the American Medical Association and the Association of American Medical Colleges, completed its second year as an online survey of all GME programs accredited by the Accreditation Council for Graduate Medical Education as well as combined specialty programs approved by their corresponding medical specialty boards. Continuing trends include the growing number of subspecialty programs, which increased by 65 since last year to 3822, and a smaller number of specialty programs, which decreased by 25 to 4203. There were corresponding shifts in the number of residents training in them. The number of graduates from osteopathic medical schools in allopathic GME has increased from 3288 in 1996-1997 to 4658 in 2001-2002, an increase of 42%. Overall, the total number of residents in GME has declined slightly, to an estimated 96 410 this year. The number of residents in graduate year 1 (GY1) positions (entry positions in GME, for which prior training is not required) has also decreased, although the proportion of residents in GY1 positions who have not had prior GME has increased. The number of international medical graduates (IMGs) in GY1 positions has decreased from a high of 6727 in 1999-2000 to 5898 in 2001-2002, a decrease of 12.3%. However, the number who have entered GME immediately on graduation has grown from 310 in 1996-1997 to 936 in 2001-2002. Most of these IMGs were citizens or permanent residents of the United States and attended medical schools in the Caribbean. New race and ethnicity questions, which parallel those of the US Census, continue to reveal disparities in the racial/ethnic distribution of the training physician population relative to the US population. Despite continued interest in resident work hours, there was no decrease in reported hours worked between 2000-2001 and 2001-2002. Physicians training in surgical specialties are reported to work the most hours per week, while internal medicine and pediatrics allow for the most consecutive time on duty, at 30 hours or more. Specialties and subspecialties with limited on-call schedules, such as forensic psychiatry and pediatric pathology, have, on average, the lowest number of duty hours.

Curriculum↗