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PubMed1990

An applicant's evaluation of an emergency medicine internship and residency.

Applicants to emergency medicine residencies face an increasingly difficult task of evaluating a greater number of training programs. High-quality information must be obtained by applicants prior to their submission of a ranking list to the National Intern and Residency Matching Program. Resources to assist applicants in this task have been limited; personal interviews are critical in this process. In the relatively new specialty of emergency medicine, medical students may fail to obtain optimal information during interviews. A list of suggested interview questions is provided. Judicious use of appropriate questions can help applicants obtain the proper information. Residency program directors and staff may also use these questions to assist applicants.

Emergency Medicine↗
PubMed1970

Canadian-trained physicians in United States internships and residencies: "Operation Retrieval" and Report of Statistics, 1966-1968.

In response to a shortage of medical teachers and scientists, A.C.M.C. began "Operation Retrieval" in 1967 in an effort to contact and to survey graduates of Canadian medical schools who are interns and residents in the United States. This paper describes the publications produced for these graduates, and the concerns of graduates as discovered by on-site visits to Los Angeles, Boston and New York. These concerns centre around difficulties in communication with Canada. This paper also gives a statistical report on the numbers of graduates who are interns and residents in the United States, and the locations, fields of specialization and years of graduation of residents. The decreasing numbers are believed to reflect improving Canadian facilities as well as difficulties associated with the American military draft.

Canada↗
PubMed1995

[An evaluation of the clinical competence of a population of specialist physicians educated by the medical internship and residency system].

BACKGROUND: The quality of physicians who have undergone resident official training (MIR) should logically be better than that of the remaining physicians who were not able to enter into this official training. The present study was designed with the aim of verifying this hypothesis. METHODS: A sample of physicians who underwent the MIR examination in 1982 and who upon passing the same were permitted to initiate the MIR training in 1983 was selected. The group was subdivided into MIR and no MIR and according to the specialty followed. When the physicians were practicing as specialists two types of surveys were carried out with one being by telephone and the other personal in which the personal characteristics, preparation for the MIR test, professional satisfaction and personal motivation were analyzed. The pharmaceutic prescriptions of both groups were analyzed according to indicators of the Servei Català de la Salut (Catalonian Health Service) and the opinion of colleagues of each of the members of each group was evaluated with another questionnaire. The written resolution of hypothetical clinical cases were given to each of the individuals included. A level of global competence defined as a percentage for the following components was identified using: curricular evaluation (10%), professional satisfaction (20%), personal motivation (10%), hypothetical case resolution (35%) and peer opinion (25%). RESULTS: The global competence of the physicians trained under the MIR system was greater than that of the no MIR group (p < 0.01). On analysis by sections the differences of greatest note were observed in the resolution of hypothetical cases (p < 0.0001), curricular evaluation (p < 0.0001) and the quality of pharmaceutical prescription (p < 0.0001). The differences were less of note in comparison of personal motivation (p < 0.02) and professional satisfaction (p < 0.02). No differences were observed in peer opinion. CONCLUSIONS: The professional quality of physicians trained by MIR who presented for the 1982 examination in Catalonia and practiced in medical specialties is greater than that of a comparable group with regard to professional practice.

Adult↗
PubMed1992

Support services for family practice residents.

BACKGROUND: Internship and residency are stressful experiences for physicians in training. Residency programs vary in their provision of supportive services for residents. METHODS: A random sample of 50% of the nation's family practice residency programs was surveyed to determine the prevalence of 19 support services, 10 of which were assessed a decade previously. Programs were also asked about on-call frequency, vacation benefits, and program size. RESULTS: Approximately 91% of the programs responded. The surveys indicated that residents were on call an average of once every four nights, a 10% decrease from a decade ago. The prevalence of three support services had increased over the last decade: seminars and speakers on the stresses and conflicts of being a physician, support groups for residents, and child care services. "Night-float" rotations and part-time residencies are the least offered support services of those studied. CONCLUSIONS: Support for family practice residents is increasing, yet in many cases remains inadequate.

Family Practice↗
PubMed1999

Library residencies and internships as indicators of success: evidence from three programs.

This paper discusses post-master's degree internships in three very different organizations; the University of Illinois at Chicago, the National Library of Medicine, and the Library of Congress. It discusses the internships using several questions. Do the programs serve as a recruitment strategy? Do the programs develop key competencies needed by the participant or organization? Do the programs develop leaders and managers? Is acceptance into a program an indicator of future career success? A survey was mailed to 520 persons who had completed internships in one of the three programs. There was a 49.8% response rate. Responses to fifty-four questions were tabulated and analyzed for each program and for the total group. The results confirm the value of internships to the career of participants.

Adult↗
PubMed2006

BEME systematic review: predictive values of measurements obtained in medical schools and future performance in medical practice.

BACKGROUND: Effectiveness of medical education programs is most meaningfully measured as performance of its graduates. OBJECTIVES: To assess the value of measurements obtained in medical schools in predicting future performance in medical practice. METHODS SEARCH STRATEGY: The English literature from 1955 to 2004 was searched using MEDLINE, Embase, Cochrane's EPOC (Effective Practice and Organization of Care Group), Controlled Trial databases, ERIC, British Education Index, Psych Info, Timelit, Web of Science and hand searching of medical education journals. INCLUSION & EXCLUSIONS: Selected studies included students assessed or followed up to internship, residency and/or practice after postgraduate training. Assessment systems and instruments studied (Predictors) were the National Board Medical Examinations (NBME) I and II, preclinical and clerkship grade-point average, Observed Standardized Clinical Examination scores and Undergraduate Dean's rankings and honors society. Outcome measures were residency supervisor ratings, NBME III, residency in-training examinations, American Specialty Board examination scores, and on-the-job practice performance. DATA EXTRACTION: Data were extracted by using a modification of the BEME data extraction form study objectives, design, sample variables, statistical analysis and results. All included studies are summarized in a tabular form. DATA ANALYSIS AND SYNTHESIS: Quantitative meta-analysis and qualitative approaches were used for data analysis and synthesis including the methodological quality of the studies included. RESULTS: Of 569 studies retrieved with our search strategy, 175 full text studies were reviewed. A total of 38 studies met our inclusion criteria and 19 had sufficient data to be included in a meta-analysis of correlation coefficients. The highest correlation between predictor and outcome was NBME Part II and NBME Part III, r = 0.72, 95% CI 0.30-0.49 and the lowest between NBME I and supervisor rating during residency, r = 0.22, 95% CI 0.13-0.30. The approach to studying the predictive value of assessment tools varied widely between studies and no consistent approach could be identified. Overall, undergraduate grades and rankings were moderately correlated with internship and residency performance. Performance on similar instruments was more closely correlated. Studies assessing practice performance beyond postgraduate training programs were few. CONCLUSIONS: There is a need for a more consistent and systematic approach to studies of the effectiveness of undergraduate assessment systems and tools and their predictive value. Although existing tools do appear to have low to moderate correlation with postgraduate training performance, little is known about their relationship to longer-term practice patterns and outcomes.

Clinical Competence↗
PubMed1988

Management education focuses on new leadership ideas.

A widely accepted new leadership approach concerns transactional and transformational leadership. Transactional leadership consists of planning, implementation, and evaluation. Transformational leadership consists of charisma, intellectual stimulation, and individualized consideration that can motivate followers. The six orientations that characterize the Catholic healthcare ministry imply both types of leadership. Fundamental values, knowledge, and skills required for healthcare organization management are acquired through health administration education. The themes prevalent in today's Catholic healthcare ministry and the leadership qualities they imply are addressed by all aspects of such education: degree programs, field experience, continuing education, and research and consultation. Much of a master's degree program concentrates on transactional leadership because its content is better formulated and easier to teach. The development of transformational leadership qualities during master's study primarily provides a foundation on which students can build. Health administration programs in cooperation with healthcare organizations have created three models for field experience: internships, residencies, and fellowships. Many master's programs deliver continuing education programs for both types of leadership, and research and consultation contribute to this education.

Catholicism↗
PubMed1998

Prevalence and correlates of harassment among US women physicians.

BACKGROUND: Despite concerns about its prevalence and ramifications, harassment has not been well quantified among physicians. Previous published studies have been small, have surveyed only 1 site or a convenience sample, and have suffered from selection bias. METHODS: Our database is the Women Physicians' Health Study, a large (4501 respondents; response rate, 59%), nationally distributed questionnaire study. We analyzed responses concerning gender-based and sexual harassment. RESULTS: Overall, 47.7% of women physicians reported ever experiencing gender-based harassment, and 36.9% reported sexual harassment. Harassment was more common while in medical school (31% of gender-based and 20% for sexual harassment) or during internship, residency, or fellowship (29% for gender-based and 19% for sexual harassment) than in practice (25% for gender-based and 11% for sexual harassment). Respondents more likely to report gender-based harassment were physicians who were now divorced or separated and those specializing in historically male specialties, whereas those of Asian and other (nonwhite, nonblack, non-Asian, non-Hispanic) ethnicity, those living in the East, and those self-characterized as politically very conservative were less likely to report gender-based harassment. Being younger, born in the United States, or divorced or separated were correlated with reporting ever experiencing sexual harassment; those who were Asian or who were currently working in group or government settings were less likely to report it. Those who felt in control of their work environments, were satisfied with their careers, and would choose again to become physicians reported lower prevalences of ever experiencing harassment. Those with histories of depression or suicide attempts were more likely to report ever having been harassed. CONCLUSIONS: Women physicians commonly perceive that they have been harassed. Experiences of and sensitivity to harassment differ among individuals, and there may be substantial professional and personal consequences of harassment. Since reported rates of sexual harassment are higher among younger physicians, the situation may not be improving.

Adult↗
PubMed2003

Collaborative environment for clinical reasoning and distance learning sessions.

BACKGROUND: The medical curriculum has changed with the adoption of the student-centered learning paradigm. Clinical reasoning learning (CRL) is used in order to develop and improve students' clinical reasoning and problem-solving skills. PURPOSE: We have observed that, in complement to traditional CRL sessions, students commonly consult resources available on the internet. Based on this observation, our objective is to create computer tools to coordinate CRL sessions at distance, integrating these electronic resources at every step of the reasoning process. MATERIAL AND METHODS: In order to create the system, we elaborated an object-oriented model of a computer-supported collaborative learning environment. The proposed system includes a local web-server to store electronic resources and a relational database to store their electronic addresses (urls). JAVA was used as the programming language. RESULTS: We developed a set of cooperative platform-independent tools. This environment includes a communication tool. Multimedia data exchange is possible. Information is shared thanks to an electronic notepad and whiteboard tools. PERSPECTIVES: This learning environment will be integrated in the French Virtual Medical University project, and is intended to be used for undergraduate, internships, residency or continuing medical education.

Computers, Handheld↗
PubMed2005

Epidemiological study of the characteristics of veterinarians who pursue a research career: part I.

This retrospective, matched case-control study compared the characteristics of veterinary surgeons employed in veterinary research with those who had never held a research post. The cases were randomly selected from graduates of veterinary schools in Great Britain or Ireland who were employed at universities or institutes that conduct research and who played a major role in veterinary research projects during 2001 to 2003. The controls were veterinary surgeons who had not held any post that was primarily a research post since they graduated. The cases and controls were matched by year of graduation and data were obtained for 173 matched sets. Graduates who were significantly (P<0.05) more likely to have a career involving research included male graduates, graduates who had completed a summer studentship, graduates who had completed an internship, residency or houseman's programme, graduates who held a veterinary diploma, and graduates who had intended to pursue a career in research or academia when they graduated from veterinary school. A career involving research was significantly (P<0.05) more likely to be associated with full-time employment and a lower salary than a career that did not involve research.

Animals↗
PubMed1995

Graduate health administration field experiences: a university and health service delivery systems partnership.

The importance of experiential components of education to professional preparation has been evidenced in the curricula of academic institutions in several disciplines. Graduate programs in health administration offer a variety of alternative residency, internship, and other field experiences for students to apply academic theory to practical phenomena. Using a case study approach, this article presents the advantages of field experience options to both students and health care delivery sites. Components of a model of experiential alternatives in a graduate health administration program are described.

Curriculum↗
PubMed1969

A retraining program for inactive physicians.

During the past two years a pilot project was conducted in which 19 inactive physicians were retrained in preparation for resumption of active practice. The initial program consisted of a flexible training program of six months to one year patterned after conventional internship-residency concepts. During the second year the program was modified by providing an initial condensed indoctrination period of two months' duration especially designed for this purpose, followed by a preceptorship type of training. The project was considered successful in permitting trainees to enter some form of active medical work, or to enroll in formal specialty training. The observations made by the faculty of the program and its accomplishments are discussed in the light of the effort expended and the cost of the project.

Education, Medical↗