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Performance of United States citizens with foreign medical education on standardized medical examinations.

To enter the mainstream of American medicine, United States students who enroll in foreign medical schools must either transfer to a United States medical school (usually after passing Part I of the NMBE examination) or complete their studies abroad and then pass FLEX and usually ECFMG examinations. Half those applying for transfer fail Part I. Although virtually all who succeed in transferring subsequently pass Parts II and III, their scores are below the mean of the reference group, and their relative performance progressively deteriorates. Sixty per cent of USFMG's fail the medical portion of the ECFMG examination as compared to an expected failure rate for United States medical students of only 2 to 3 per cent. Thirty-eight per cent of USFMG's who take both ECFMG and FLEX examinations fail the latter. The mean weighted score for USFMG's on FLEX is 75.8, while that for United States graduates is 80.1 and for FMG's 74.7. These preliminary data suggest that United States students who go abroad, regardless of where they complete their studies, do not perform as well on standard tests after they return home as do those who have had their entire education in United States schools. This question needs more systematic study.

Education, Medical

Changing attitudes of medical teachers towards medical education.

If medical education is to improve, this is largely dependent upon the attitudes of clinical teachers towards their own teaching and their students' learning. The aims and objectives of our workshop method of medical teacher training therefore includes some in the affective domain. Based on the theory of cognitive dissonance the experience-linked practical problem solving approach of the workshop encourages behaviour change, presuming this to cause 'attitude change'. Testing by means of a specially constructed and validated Likert-type attitude scale shows that attitudes do improve significantly and consistently over the 5 days of our workshops. A follow-up study shows these effects to be maintained and taken back to the participants' own medical schools.

Attitude of Health Personnel

Quality assurance in undergraduate medical education at the Medical College of Ohio.

This paper reports a four-year experience in teaching evaluation of care at a three-year medical school, the Medical College of Ohio at Toledo. Informal patient care evaluation evolved to more structured medical care evaluation in seminars and by chart audits. The introduction of professional standards review organizations prompted the teaching and evaluation of the quality and cost of primary care, especially as it applies to learning clinical tasks.

Attitude of Health Personnel