Facts about US medical education and the physician workforce.
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STUDY OBJECTIVE: Clerkship directors design and implement educational programs for students. Scholarly productivity is necessary for academic advancement. We define characteristics of emergency medicine clerkship directors and evaluate determinants of scholarly productivity and job satisfaction. METHODS: This is a cross-sectional survey. Clerkship directors for emergency medicine senior rotations completed a confidential online questionnaire. Demographic data were analyzed with descriptive statistics. Scholarly productivity and job satisfaction indices were created for multivariate analysis. RESULTS: One hundred eleven (82%) of 136 directors responded (age 38.9+/-7.0 years; men 72.1%; junior academic rank 72.1%; served as clerkship directors for < or =5 years 77.4%; formal training in education: medical education fellowship 36%, teaching credential 12.7%, emergency medicine subspecialty fellowship 6.3%; support for clerkship director's activities: clinical hours reduction 2.7+/-2.3 weekly; minimal training for clerkship director's role 85.6%; ongoing professional development 40.5%; scholarly productivity: < or =5 peer-reviewed publications 78.4%, grant 28%, textbook chapter 65%; plan to be clerkship director in 5 years 63%; perceived support from supervisor 88%; perceived value from colleagues 81%; perception that clerkship directors is as important as residency director 47.8%). Multivariate regression shows a significant effect of medical education fellowship (P =.013) and subspecialty training (P =.044). Departmental support enhances the effect of medical education (P =.008) or subspecialty (P =.026) fellowships and improves productivity for senior faculty (P =.047). Multivariate regression explaining job satisfaction shows a positive effect of reduced clinical hours (P =.038) and increased faculty development (P =.033). CONCLUSION: Most emergency medicine clerkship directors are junior faculty with minimal release time or training for their positions.
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Until recently, immune regulation was thought to be predominantly mediated by specialized subsets of T lymphocytes. However, although B lymphocytes have previously been shown to have regulatory properties in autoimmunity, a recent report by Knoechel et al. establishes a role for B lymphocytes in the control of pathogenic autoreactive T cell responses arising when the number of lymphocytes is abnormally low (lymphopenia).
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This paper aims to identify and critically analyse the provision and commissioning of relevant training for multidisciplinary mental health practitioners in the South West region of England. Data were collected from 45 education and training providers across the region. A total of 132 courses were examined through analysis of a questionnaire and a further 82 courses were studied in more depth through interviews and focus groups, alongside a textual analysis of course documents. Data generated from the analyses were mapped against the competencies and skills outlined in The Capable Practitioner [SCMH, 2001. The Capable Practitioner, Sainsbury Centre for Mental Health, London.] document and National Occupational Standards for Mental Health [Skills for Health, 2004. National Occupational Standards for Mental Health. Available from: (last accessed 17.11.04).]. The findings confirmed that significant gaps exist in training and education. While some aspects of The Capable Practitioner and National Occupational Standards for Mental Health are covered well by courses provided for mental health practitioners in the region, other aspects are missed completely. Recommendations are made for further research, with the suggestion of using an action research and co-operative enquiry method to identify with participants if courses should be developed to cover these areas or if the standards themselves should be adapted. Reflections on the methodological framework and subsequent limitations of the study are outlined.
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