The European Register of Specialists in Clinical Chemistry and Laboratory Medicine: guide to the Register, version 3-2010

DEFF Research Database (Denmark)

McMurray, Janet; Zérah, Simone; Hallworth, Michael

2010-01-01

In 1997, the European Communities Confederation of Clinical Chemistry and Laboratory Medicine (EC4) set up a Register for European Specialists in Clinical Chemistry and Laboratory Medicine. The operation of the Register is undertaken by a Register Commission (EC4RC). During the last 12 years, more...... than 2200 specialists in Clinical Chemistry and Laboratory Medicine have joined the Register. In 2007, EC4 merged with the Forum of European Societies of Clinical Chemistry and Laboratory Medicine (FESCC) to form the European Federation of Clinical Chemistry and Laboratory Medicine (EFCC). Two previous...

[Master trainer concept "structured specialist further education" : A joint project of the German Professional Associations of Internal Medicine, Surgeons and Orthopedic/Trauma Surgeons].

Science.gov (United States)

Siebolds, M; Ansorg, J; Dittmar, R; Hennes, N; Radau, T; Ruff, S; Denkinger, M D

2017-10-01

The quality requirements in the practice of postgradual medical further education below the normal level of the further education regulations is a barely developed scientific field in Germany. A systematic use of internationally accepted scientific evidence barely exists. This research and development project was initiated in 2001 in order to be able to implement a practical but evidence-based model compatible with the existing structure of postgradual medical education. This project has been supported since 2013 by the Professional Associations of Internal Medicine (BDI), Surgeons (BDC) and Orthopedic and Trauma surgeons (BVOU). The development phase of this complex intervention was based on three stages involving stakeholder interviews from relevant groups, the identification of a theoretical model for the construction and systematic literature reviews to identify the relevant evidence. The basic model for structured specialist further education developed included the creation and implementation of a simple core curriculum for every department, a tool for systematic feedback within the framework of the annual further education interviews and a simple clinical assessment to evaluate the actual clinical performance of physicians in further education. A pilot test of this model was carried out in 150 specialist departments in Germany and continually developed. The project shows that such a program can be systematically developed and pilot studies can be carried out. The central problems in implementation involve the traditional informal further education culture, which as a rule does not implement a systematic elicitation of the state of learning continuously distributed over the whole period of further education and the practical testing of competence development.

Malta’s specialist training programme in family medicine : a pre-implementation evaluation

OpenAIRE

Sammut, Mario R.

2009-01-01

Introduction: As a result of Malta’s EU accession in 2004, family medicine was accepted as a speciality and the Malta College of Family Doctors prepared a Specialist Training Programme in Family Medicine. To facilitate its launch, potential GP trainers and trainees participated in its preimplementation evaluation. Method: Participants’ views were gathered quantitatively through a questionnaire using scales to rate closed statements regarding the programme and its sections. Qualitative openend...

Occupational medicine specialist referral triggers: Mixed-methods analysis of teleconsult cases.

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Eaton, J L; Mohammad, A; Mohr, D C; Brustein, D J; Kirkhorn, S R

2017-12-30

Qualitative analyses can yield critical lessons for learning organizations in healthcare. Few studies have applied these techniques in the field of occupational and environmental medicine (OEM). To describe the characteristics of complex cases referred for OEM subspecialty evaluation and variation by referring provider's training. Using a mixed methods approach, we conducted a content analysis of clinical cases submitted to a national OEM teleconsult service. Consecutive cases entered between April 2014 and July 2015 were screened, coded and analysed. 108 cases were available for analysis. Local Veterans Health Administration (VHA) non-specialist providers entered a primary medical diagnosis in 96% of cases at the time of intake. OEM speciality physicians coded significant medical conditions based on free text comments. Coder inter-rater reliability was 84%. The most frequent medical diagnosis types associated with tertiary OEM referral by non-specialists were endocrine (19%), cardiovascular (18%) and mental health (16%). Concern for usage of controlled and/or sedating medications was cited in 1% of cases. Compared to referring non-specialists, OEM physicians were more likely to attribute case complexity to musculoskeletal (OR: 2.3, 1.68-3.14) or neurological (OR: 1.69, 1.28-2.24) conditions. Medication usage (OR: 2.2, 1.49-2.26) was more likely to be a source of clinical concern among referring providers. The findings highlight the range of triggers for OEM physician subspecialty referral in clinical practice with employee patients. The results of this study can be used to inform development of provider education, standardized clinical practice pathways, and quality review activities for occupational medicine practitioners. Published by Oxford University Press on behalf of The Society of Occupational Medicine 2017.

Update of the ERS international Adult Respiratory Medicine syllabus for postgraduate training.

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Tabin, Nathalie; Mitchell, Sharon; O'Connell, Elaine; Stolz, Daiana; Rohde, Gernot

2018-03-01

First published in 2006, the first European core syllabus in Adult Respiratory Medicine was developed with the intention of harmonising education and training throughout Europe. Internationally recognised by the European Union of Medical Specialists and identified as the first document of its kind in respiratory medicine, it has provided a comprehensive guide for both local and national institutions in the development of adult respiratory training programmes. Like all fields in education, respiratory medicine is an ever-changing area and as such, respective syllabi, curricula and training programmes must adapt and diversify in line with the evolution of core medical concepts. Given the proven importance of the Adult Respiratory Medicine syllabus from both a national and international standpoint, it is of equal importance that said syllabus remains abreast of emerging trends so as to sustain the synchronisation of respiratory medicine in Europe. In order to develop an updated programme, a comprehensive review process of the current syllabus is a necessary endeavour and a step that the European Respiratory Society (ERS) has undertaken through the process of a needs assessment.

Professional Training of Specialists in International Marketing in Poland

Science.gov (United States)

Zukowski, Wojciech

2015-01-01

Polish experience in training specialists in international marketing in the context of globalization and integration processes has been studied. A range of theoretical resources, namely Market Entry Strategy for Poland; the articles dedicated to international marketing and economy development (W. Grzegorczyk, M. Viachevskyi, M. Urbanetst); program…

Nuclear medicine training and practice in the Czech Republic

International Nuclear Information System (INIS)

Kaminek, Milan; Koranda, Pavel

2014-01-01

Nuclear medicine in the Czech Republic is a full specialty with an exclusive practice. Since the training program was organized and structured in recent years, residents have had access to the specialty of nuclear medicine, starting with a two-year general internship (in internal medicine or radiology). At present, nuclear medicine services are provided in 45 departments. In total, 119 nuclear medicine specialists are currently registered. In order to obtain the title of Nuclear Medicine Specialist, five years of training are necessary; the first two years consist of a general internship in internal medicine or radiology. The remaining three years consist of training in the nuclear medicine specialty itself, but includes three months of practice in radiology. Twenty-one physicians are currently in nuclear medicine training and a mean of three specialists pass the final exam per year. The syllabus is very similar to that of the European Union of Medical Specialists (UEMS), namely concerning the minimum recommended numbers for diagnostic and therapeutic procedures. In principle, the Czech law requires continuous medical education for all practicing doctors. The Czech Medical Chamber has provided a continuing medical education (CME) system. Other national CMEs are not accepted in Czech Republic. (orig.)

Nuclear medicine training and practice in the Czech Republic

Energy Technology Data Exchange (ETDEWEB)

Kaminek, Milan; Koranda, Pavel [University Hospital Olomouc, Department of Nuclear Medicine, Olomouc (Czech Republic)

2014-08-15

Nuclear medicine in the Czech Republic is a full specialty with an exclusive practice. Since the training program was organized and structured in recent years, residents have had access to the specialty of nuclear medicine, starting with a two-year general internship (in internal medicine or radiology). At present, nuclear medicine services are provided in 45 departments. In total, 119 nuclear medicine specialists are currently registered. In order to obtain the title of Nuclear Medicine Specialist, five years of training are necessary; the first two years consist of a general internship in internal medicine or radiology. The remaining three years consist of training in the nuclear medicine specialty itself, but includes three months of practice in radiology. Twenty-one physicians are currently in nuclear medicine training and a mean of three specialists pass the final exam per year. The syllabus is very similar to that of the European Union of Medical Specialists (UEMS), namely concerning the minimum recommended numbers for diagnostic and therapeutic procedures. In principle, the Czech law requires continuous medical education for all practicing doctors. The Czech Medical Chamber has provided a continuing medical education (CME) system. Other national CMEs are not accepted in Czech Republic. (orig.)

Geriatrics education is associated with positive attitudes toward older people in internal medicine residents: a multicenter study.

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Tufan, Fatih; Yuruyen, Mehmet; Kizilarslanoglu, Muhammet Cemal; Akpinar, Timur; Emiksiye, Sirhan; Yesil, Yusuf; Ozturk, Zeynel Abidin; Bozbulut, Utku Burak; Bolayir, Basak; Tasar, Pinar Tosun; Yavuzer, Hakan; Sahin, Sevnaz; Ulger, Zekeriya; Ozturk, Gulistan Bahat; Halil, Meltem; Akcicek, Fehmi; Doventas, Alper; Kepekci, Yalcin; Ince, Nurhan; Karan, Mehmet Akif

2015-01-01

The number of older people is growing fast in Turkey. In this context, internal medicine residents and specialists contact older people more frequently. Thus, healthcare providers' knowledge and attitudes toward older people is becoming more important. Studies that specifically investigate internal medicine residents' attitudes toward the elderly are scarce. We aimed to investigate the attitudes of internal medicine residents toward older people. This cross-sectional multicenter study was undertaken in the internal medicine clinics of six university state hospitals that provide education in geriatric care. All internal medicine residents working in these hospitals were invited to participate in this questionnaire study between March 2013 and December 2013. We recorded the participants' age, sex, duration of internal medicine residency, existence of relatives older than 65 years, history of geriatrics course in medical school, geriatrics rotation in internal medicine residency, and nursing home visits. A total of 274 (82.3%) of the residents participated in this study, and 83.6% of them had positive attitudes toward older people. A geriatrics rotation during internal medicine residency was the only independent factor associated with positive attitudes toward the elderly in this multivariate analysis. A geriatrics course during medical school was associated with positive attitudes in the univariate analysis, but only tended to be so in the multivariate analysis. Geriatrics rotation during internal medicine residency was independently associated with positive attitudes toward older people. Generalization of geriatrics education in developing countries may translate into a better understanding and improved care for older patients. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Evaluation of a diabetes nurse specialist prescribing project.

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Wilkinson, Jill; Carryer, Jenny; Adams, Jeffery

2014-08-01

To evaluate the diabetes nurse specialist prescribing project with the aim of determining whether diabetes nurse specialist prescribing is safe and effective and to inform the implementation and extension of registered nurse prescribing. Registered nurses in many countries are able to prescribe medicines, but in New Zealand, prior to the diabetes nurse specialist project, nurse practitioners were the only nurses who could prescribe medicines. New regulations allowed the nurses to prescribe a limited number of prescription medicines. The study was a process and outcome clinical programme evaluation. The project took place between April-September 2011 and involved 12 diabetes nurse specialist in four localities. Quantitative data were collected from clinical records maintained by the diabetes nurse specialist for the project (1274 patients and 3402 prescribing events), from surveys with stakeholders (general practitioners, n = 30; team members, n = 19; and patients, n = 89) and audits from patient notes (n = 117) and prescriptions (n = 227), and qualitative data from interviews with project participants (n = 18) and patients (n = 19). All data were analysed descriptively. Diabetes nurse specialist prescribing was determined to be safe, of high quality and appropriate. It brought important benefits to the effectiveness of specialist diabetes services, was acceptable to patients and was supported by the wider healthcare team. These findings are consistent with the findings reported in the international literature about nurse prescribing in a range of different practice areas. Clarification of the education and competence requirements and resourcing for the ongoing supervision of nurses is recommended if the prescribing model is to be extended. Diabetes nurse specialist prescribing improved access to medicines by providing a more timely service. Nurses felt more satisfied with their work because they could independently provide a complete episode of care

The European Register of Specialists in Clinical Chemistry and Laboratory Medicine: Code of Conduct, Version 2--2008.

LENUS (Irish Health Repository)

McMurray, Janet

2009-01-01

In 1997, the European Communities Confederation of Clinical Chemistry and Laboratory Medicine (EC4) set up a Register for European Specialists in Clinical Chemistry and Laboratory Medicine. The operation of the Register is undertaken by a Register Commission (EC4RC). During the last 10 years, more than 2000 specialists in Clinical Chemistry and Laboratory Medicine have joined the Register. In 2007, EC4 merged with the Federation of European Societies of Clinical Chemistry and Laboratory Medicine (FESCC) to form the European Federation of Clinical Chemistry and Laboratory Medicine (EFCC). A Code of Conduct was adopted in 2003 and a revised and updated version, taking account particularly of the guidelines of the Conseil Européen des Professions Libérales (CEPLIS) of which EFCC is a member, is presented in this article. The revised version was approved by the EC4 Register Commission and by the EFCC Executive Board in Paris on 6 November, 2008.

Female specialists in intensive care medicine: job satisfaction, challenges and work-life balance.

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Hawker, Felicity H

2016-06-01

Women are under-represented in the intensive care medicine (ICM) specialist workforce. I aimed to better understand the challenges these women face so they can be considered in the training and support of ICM specialists. All female Fellows of the College of Intensive Care Medicine (CICM) of Australia and New Zealand were surveyed using an online questionnaire. The study was approved by the Cabrini Human Research Ethics Committee. Thirty respondents with children volunteered to complete a second questionnaire. I surveyed demographic and workforce data and women's experiences in the ICM specialist workforce in the first survey, and experiences with child-rearing in the second survey. The response rate was 80.3% (127/158). The median age bracket was 40-45 years, and 118 respondents were practising ICM, 85 full-time in a tertiary intensive care unit. Eighteen were ICU directors and 23 were CICM-appointed supervisors of training. Sixty-five women were mothers, and 70% returned to full-time work after their maternity leave. Child care was most commonly undertaken by family members or a nanny. Overall, 81% were satisfied with their experiences, but 37% felt they had been disadvantaged because of their sex. Fewer women with leadership roles felt disadvantaged. Their major challenges included the on-call work affecting child-rearing and family life, sexism in the workplace and difficulties with academic advancement. The participation and satisfaction rates of women working in the ICM specialist workforce are encouraging. Although challenges exist, women contemplating a career in ICM should see it as achievable and rewarding.

[What is Internal Medicine?].

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Reyes, Humberto

2006-10-01

Internal Medicine can be defined as a medical specialty devoted to the comprehensive care of adult patients, focused in the diagnosis and non surgical treatment of diseases affecting internal organs and systems (excluding gyneco-obstetrical problems) and the prevention of those diseases. This position paper reviews the history of Internal Medicine, the birth of its subspecialties and the difficulties faced by young physicians when they decide whether to practice as internist or in a subspecialty. In Chile as in most occidental countries formal training in a subspecialty of internal medicine requires previous certification in internal medicine but the proportion of young physicians who remain in practice as general internists appears to be considerably lower than those who choose a subspecialty. The main reasons for this unbalance can be related to financial advantages (by the practice of specialized technologies) and the patients' tendency to request direct assistance by a professional thought to be better qualified to take care of their specific problems. Training programs in internal medicine should consider a greater emphasis in comprehensive outpatient care instead of the traditional emphasis for training in hospital wards.

Professional Training Of Specialists In International Marketing In Poland

OpenAIRE

Żukowski Wojciech

2015-01-01

Polish experience in training specialists in international marketing in the context of globalization and integration processes has been studied. A range of theoretical resources, namely Market Entry Strategy for Poland; the articles dedicated to international marketing and economy development (W. Grzegorczyk, M. Viachevskyi, M. Urbanetst); program specifications and structures at Polish universities, namely University of Lodz and Collegium Civitas, have been analyzed. It has been defined that...

Specialist training in pediatric anesthesia

DEFF Research Database (Denmark)

Hansen, Tom G

2009-01-01

There has been a great deal of focus on specialist training in pediatric anesthesia in the last decade or so. Internationally, however, there is still no uniform agreement as to how such a training program should be arranged and organized. Since September 2003, the Scandinavian Society of Anaesth......There has been a great deal of focus on specialist training in pediatric anesthesia in the last decade or so. Internationally, however, there is still no uniform agreement as to how such a training program should be arranged and organized. Since September 2003, the Scandinavian Society...... of Anaesthesiology and Intensive Care Medicine has coordinated an advanced Inter-Nordic educational program in pediatric anesthesia and intensive care. The training program is managed by a Steering Committee. This program is intended for physicians who recently have received their specialist degree in anesthesiology...... and intensive care. The training period is 12 months of which 9 months are dedicated to pediatric anesthesia and 3 months to pediatric intensive care. During the 1-year training period, the candidates are designated a Scandinavian host clinic (at a tertiary pediatric center in Scandinavia approved...

The European Register of Specialists in Clinical Chemistry and Laboratory Medicine: guide to the Register, version 3-2010.

LENUS (Irish Health Repository)

McMurray, Janet

2010-07-01

In 1997, the European Communities Confederation of Clinical Chemistry and Laboratory Medicine (EC4) set up a Register for European Specialists in Clinical Chemistry and Laboratory Medicine. The operation of the Register is undertaken by a Register Commission (EC4RC). During the last 12 years, more than 2200 specialists in Clinical Chemistry and Laboratory Medicine have joined the Register. In 2007, EC4 merged with the Forum of European Societies of Clinical Chemistry and Laboratory Medicine (FESCC) to form the European Federation of Clinical Chemistry and Laboratory Medicine (EFCC). Two previous Guides to the Register have been published, one in 1997 and another in 2003. The third version of the Guide is presented in this article and is based on the experience gained and development of the profession since the last revision. Registration is valid for 5 years and the procedure and criteria for re-registration are presented as an Appendix at the end of the article.

Whither the Pulmonary Ward Attending? Preserving Subspecialty Exposure in United States Internal Medicine Residency Training.

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Santhosh, Lekshmi; Babik, Jennifer; Looney, Mark R; Hollander, Harry

2017-04-01

Twenty years ago, the term "hospitalist" was coined at the University of California-San Francisco (San Francisco, CA), heralding a new specialty focused on the care of inpatients. There are now more than 50,000 hospitalists practicing in the United States. At many academic medical centers, hospitalists are largely replacing subspecialists as attendings on the inpatient medicine wards. At University of California-San Francisco, this has been accompanied by declining percentages of residency graduates who enter subspecialty training in internal medicine. The decline in subspecialty medicine interest can be attributed to many factors, including differences in compensation, decreased subspecialist exposure, and a changing research funding landscape. Although there has not been systematic documentation of this trend in pulmonary and critical care medicine, we have noted previously pulmonary and critical care-bound trainees switching to hospital medicine instead. With our broad, multiorgan system perspective, pulmonary and critical care faculty should embrace teaching general medicine. Residency programs have instituted creative solutions to encourage more internal medicine residents to pursue careers in subspecialty medicine. Some solutions include creating rotations that promote more contact with subspecialists and physician-scientists, creating clinician-educator tracks within fellowship programs, and appointing subspecialists to internal medicine residency leadership positions. We need more rigorous research to track the trends and implications of the generalist-specialist balance of inpatient ward teams on resident career choices, and learn what interventions affect those choices.

Shadowing emergency medicine residents by medical education specialists to provide feedback on non-medical knowledge-based ACGME sub-competencies

Directory of Open Access Journals (Sweden)

Waterbrook AL

2018-05-01

Full Text Available Anna L Waterbrook,1 Karen C Spear Ellinwood,2 T Gail Pritchard,3 Karen Bertels,1 Ariel C Johnson,4 Alice Min,1 Lisa R Stoneking1 1Department of Emergency Medicine, The University of Arizona College of Medicine, Tucson, AZ, USA; 2Department of Obstetrics and Gynecology, The University of Arizona College of Medicine, Tucson, AZ, USA; 3Department of Pediatrics, The University of Arizona College of Medicine, Tucson, AZ, USA; 4College of Medicine, The University of Arizona College of Medicine, Tucson, AZ, USA Objective: Non-medical knowledge-based sub-competencies (multitasking, professionalism, accountability, patient-centered communication, and team management are challenging for a supervising emergency medicine (EM physician to evaluate in real-time on shift while also managing a busy emergency department (ED. This study examines residents’ perceptions of having a medical education specialist shadow and evaluate their nonmedical knowledge skills.Methods: Medical education specialists shadowed postgraduate year 1 and postgraduate year 2 EM residents during an ED shift once per academic year. In an attempt to increase meaningful feedback to the residents, these specialists evaluated resident performance in selected non-medical knowledge-based Accreditation Council of Graduate Medical Education (ACGME sub-competencies and provided residents with direct, real-time feedback, followed by a written evaluation sent via email. Evaluations provided specific references to examples of behaviors observed during the shift and connected these back to ACGME competencies and milestones.Results: Twelve residents participated in this shadow experience (six post graduate year 1 and six postgraduate year 2. Two residents emailed the medical education specialists ahead of the scheduled shadow shift requesting specific feedback. When queried, five residents voluntarily requested their feedback to be included in their formal biannual review. Residents received

Definition of Specific Functions and Procedural Skills Required by Cuban Specialists in Intensive Care and Emergency Medicine.

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Véliz, Pedro L; Berra, Esperanza M; Jorna, Ana R

2015-07-01

INTRODUCTION Medical specialties' core curricula should take into account functions to be carried out, positions to be filled and populations to be served. The functions in the professional profile for specialty training of Cuban intensive care and emergency medicine specialists do not include all the activities that they actually perform in professional practice. OBJECTIVE Define the specific functions and procedural skills required of Cuban specialists in intensive care and emergency medicine. METHODS The study was conducted from April 2011 to September 2013. A three-stage methodological strategy was designed using qualitative techniques. By purposive maximum variation sampling, 82 professionals were selected. Documentary analysis and key informant criteria were used in the first stage. Two expert groups were formed in the second stage: one used various group techniques (focus group, oral and written brainstorming) and the second used a three-round Delphi method. In the final stage, a third group of experts was questioned in semistructured in-depth interviews, and a two-round Delphi method was employed to assess priorities. RESULTS Ultimately, 78 specific functions were defined: 47 (60.3%) patient care, 16 (20.5%) managerial, 6 (7.7%) teaching, and 9 (11.5%) research. Thirty-one procedural skills were identified. The specific functions and procedural skills defined relate to the profession's requirements in clinical care of the critically ill, management of patient services, teaching and research at the specialist's different occupational levels. CONCLUSIONS The specific functions and procedural skills required of intensive care and emergency medicine specialists were precisely identified by a scientific method. This product is key to improving the quality of teaching, research, administration and patient care in this specialty in Cuba. The specific functions and procedural skills identified are theoretical, practical, methodological and social contributions to

General medicine vs subspecialty career plans among internal medicine residents.

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West, Colin P; Dupras, Denise M

2012-12-05

Current medical training models in the United States are unlikely to produce sufficient numbers of general internists and primary care physicians. Differences in general internal medicine (GIM) career plans between internal medicine residency program types and across resident demographics are not well understood. To evaluate the general medicine career plans of internal medicine residents and how career plans evolve during training. A study of US internal medicine residents using an annual survey linked to the Internal Medicine In-Training Examination taken in October of 2009-2011 to evaluate career plans by training program, sex, and medical school location. Of 67,207 US eligible categorical and primary care internal medicine residents, 57,087 (84.9%) completed and returned the survey. Demographic data provided by the National Board of Medical Examiners were available for 52,035 (77.4%) of these residents, of whom 51,390 (76.5%) responded to all survey items and an additional 645 (1.0%) responded to at least 1 survey item. Data were analyzed from the 16,781 third-year residents (32.2%) in this sample. Self-reported ultimate career plans of internal medicine residents. A GIM career plan was reported by 3605 graduating residents (21.5%). A total of 562 primary care program (39.6%) and 3043 categorical (19.9%) residents reported GIM as their ultimate career plan (adjusted odds ratio [AOR], 2.76; 99% CI, 2.35-3.23; P international medical graduates (22.0% vs 21.1%, respectively; AOR, 1.76; 99% CI, 1.50-2.06; P international medical graduates (57.3% vs 27.3%, respectively; AOR, 3.48; 99% CI, 2.58-4.70; P internal medicine residents, including those in primary care training programs, and differed according to resident sex, medical school location, and program type.

Postgraduate education in internal medicine in Europe.

Science.gov (United States)

Cranston, Mark; Slee-Valentijn, Monique; Davidson, Christopher; Lindgren, Stefan; Semple, Colin; Palsson, Runolfur

2013-10-01

Limited information exists on the framework and content of postgraduate education in internal medicine in Europe. This report describes the results of a survey of postgraduate training in internal medicine in the European countries. Two online questionnaire-based surveys were carried out by the European Board of Internal Medicine, one on the practice of internists and the other on postgraduate training in internal medicine. The national internal medicine societies of all 30 member countries of the European Federation of Internal Medicine were invited to participate. The responses were reviewed by internal medicine residents from the respective countries and summaries of the data were sent to the national societies for approval. Descriptive analysis of the data on postgraduate training in internal medicine was performed. Twenty-seven countries (90%) completed the questionnaire and approved their datasets. The length of training ranged from four to six years and was commonly five years. The majority of countries offered training in internal medicine and a subspecialty. A common trunk of internal medicine was frequently a component of subspecialty training programmes. Hospital inpatient service was the predominant setting used for training. A final certifying examination was in place in 14 countries. Although some similarities exists, there appear to be significant differences in the organisation, content and governance of postgraduate training in internal medicine between the European countries. Our findings will prove invaluable for harmonisation of training and qualification in internal medicine in Europe. © 2013.

Professional Competencies of Cuban Specialists in Intensive Care and Emergency Medicine.

Science.gov (United States)

Véliz-Martínez, Pedro L; Jorna-Calixto, Ana R; Oramas-González, René

2016-10-01

INTRODUCTION The quality of medical training and practice reflects the competency level of the professionals involved. The intensive care and emergency medicine specialty in Cuba has not defined its competencies. OBJECTIVE Identify the competencies required for specialty practice in intensive care and emergency medicine. METHODS The study was conducted from January 2014 to December 2015, using qualitative techniques; 48 professionals participated. We undertook functional occupational analysis, based on functions defined in a previous study. Three expert groups were utilized: the first used various group techniques; the second, the Delphi method; and the third, the Delphi method and a Likert questionnaire. RESULTS A total of 73 specific competencies were defined, grouped in 11 units: 44 in the patient care function, 16 in management, 7 in teaching and 6 in research. A competency map is provided. CONCLUSIONS The intensive care and emergency medicine specialty competencies identified will help improve professional standards, ensure health workforce quality, improve patient care and academic performance, and enable objective evaluation of specialists' competence and performance. KEYWORDS Clinical competency, competency-based education, professional education, intensive care, emergency medicine, urgent care, continuing medical education, curriculum, medical residency, Cuba.

One hundred years since the birth of academician Dimitar Arsov, founder and nestor of the modern internal medicine in the Republic of Macedonia.

Science.gov (United States)

Polenaković, M

2013-01-01

Dimitar Arsov was born in Kriva Palanka on September 28, 1908 and died on July 2, 1974 in Skopje; he had finished elementary education in Kriva Palanka, high school (1922-1926) in Kumanovo, Macedonia and Col-lege of Medicine (1926-1932), Ph. D. University of Paris, Sorbone, France, 1936. He returned to Macedonia in 1937. In 1947 he was elected and Assistant Professor and in 1950 a Docent at the Faculty of Medicine in Skopje. He was appointed Director of the Clinic of Medicine and Head of the Chair of Internal Medicine, who served at those positions in the period 1952-74. In 1958 he was elected Professor of Internal Medicine. The first habilitation of the Medical Faculty in Skopje was defended by D. Arsov in 1954, titled: "The Effects of the Intravenous Epinephrine on the Hypersplenism of Malaria and Cala-Azar". On August 18, 1967, D. Arsov was elected Full Member and also the first member in the field of medicine of the Macedonian Academy of Sciences and Arts. The excellent experience in the work with the patients, precise observation of the symptoms and syndromes of the diseases in each patient, knowing the most advanced therapy at that time enabled D. Arsov to make conclusion for possibility of new therapy and gave him the material for writing scientific papers. In the first half of the 50s, during his regular work, Arsov discovers a new, internationally recognized therapy for rheumatism. Patients of both Cala-Azar and inflammatory rheumatism were treated with small doses of adrenaline therapy and they felt drastic decrease in rheumatism inflammation within one week. This therapy was used a couple of years in several countries around the world. He participated in the undergraduate and graduate studies. He contributed to the development of 2,240 graduated doctors and under his management over 300 doctors specialized in internal medicine and became specialists internists. Under his management, numerous habilitations and dissertations in internal medicine were

Does an in-house internist at a GP practice result in reduced referrals to hospital-based specialist care?

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Quanjel, Tessa C C; Winkens, Anne; Spreeuwenberg, Marieke D; Struijs, Jeroen N; Winkens, Ron A G; Baan, Caroline A; Ruwaard, Dirk

2018-03-01

Consistent evidence on the effects of specialist services in the primary care setting is lacking. Therefore, this study evaluated the effects of an in-house internist at a GP practice on the number of referrals to specialist care in the hospital setting. Additionally, the involved GPs and internist were asked to share their experiences with the intervention. A retrospective interrupted times series study. Two multidisciplinary general practitioner (GP) practices. An internist provided in-house patient consultations in two GP practices and participated in the multidisciplinary meetings. The referral data extracted from the electronic medical record system of the GP practices, including all referral letters from the GPs to specialist care in the hospital setting. The number of referrals to internal medicine in the hospital setting. This study used an autoregressive integrated moving average model to estimate the effect of the intervention taking account of a time trend and autocorrelation among the observations, comparing the pre-intervention period with the intervention period. It was found that the referrals to internal medicine did not statistically significant decrease during the intervention period. This small explorative study did not find any clues to support that an in-house internist at a primary care setting results in a decrease of referrals to internal medicine in the hospital setting. Key Points An in-house internist at a primary care setting did not result in a significant decrease of referrals to specialist care in the hospital setting. The GPs and internist experience a learning-effect, i.e. an increase of knowledge about internal medicine issues.

Training specialists in international relations: rethinking the new paradigm

Directory of Open Access Journals (Sweden)

Elena V. Voevoda

2014-01-01

Full Text Available The article considers new tasks of universities and faculties training students of international relations. The author analyzes the essence of the concept "paradigm" in education because paradigm serves as the basis of the educational process in universities. The content of professional education depends on the aims of professional education of specialists in international relations. The process of globalization, global changes, challenges and threats bring about the necessity to study specific features of international cooperation in ecology, psychology of conflict, psychology of leadership, etc. In the age of globalization, national economies are converging while national cultures are diverging. Representatives of different nations realize the importance of preserving cultural identity. It is of vital importance to instil tolerance in future specialists in international relations and prepare them for cross-cultural communication. At the same time, it is necessary that they should not only enjoy individual freedom and national cultural identity, but realize their own responsibility to the state. In the modern world, the axiological and educational functions of professional training are growing. At the same time, it is crucial to let the students build a number of professionally relevant competences that will make it possible for them to effectively perform their professional functions. It is the competence-based approach that makes the basis of Federal state education standards, including education standards for faculties of international relations. Another direction that needs developing is training and retraining lecturers for universities specializing in international relations. Foreign language training of lecturers in basic subjects will make it possible for the, to give lectures in foreign languages, particularly in English, which, in its turn, will help to make Russia's universities more competitive.

Philanthropic endowments in general internal medicine.

Science.gov (United States)

Murden, R A; Lamb, J F

1999-04-01

We performed two surveys to uncover the status of philanthropic endowments in general internal medicine divisions. The initial survey of U.S. medical school departments of medicine found that only 14.1% of general internal medicine divisions hold endowments versus 21.9% of all other divisions, and that endowment sources for general medicine are atypical. The second survey of successfully endowed divisions found that sympathetic administrators and active pursuit of endowments were associated with endowment success. Aggressive pursuit of endowments, publicizing successes of general medicine, and consideration of endowment sources noted in this study are recommended to improve philanthropic contributions to general internal medicine.

Essential travel medicine

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Zuckerman, Jane N; Leggat, Peter

2015-01-01

This 1st edition of Essential Travel Medicine provides an excellent concise introduction to the specialty of Travel Medicine. This core text will enable health care practitioners particularly those new to the clinical practice of Travel Medicine, to gain a fundamental understanding of the diverse and complex issues which can potentially affect the health of the many millions of people who undertake international travel. Jane N Zuckerman is joined by Gary W Brunette from CDC and Peter A Leggat from Australia as Editors. Leading international specialists in their fields have contributed authoritative chapters reflecting current knowledge to facilitate best clinical practice in the different aspects of travel medicine. The aim of Essential Travel Medicine is to provide a comprehensive guide to Travel Medicine as well as a fundamental knowledge base to support international undergraduate and postgraduate specialty training programmes in the discipline of Travel Medicine. The 1st edition of Essential Travel ...

Military Internal Medicine Resident Decision to Apply to Fellowship and Extend Military Commitment.

Science.gov (United States)

Barsoumian, Alice E; Hartzell, Joshua D; Bonura, Erin M; Ressner, Roseanne A; Whitman, Timothy J; Yun, Heather C

2018-02-06

Nationally, the number of internal medicine physicians practicing in primary care has decreased amidst increasing interest in hospitalist medicine. Current priorities in the Military Health System include access to primary care and retention of trained personnel. Recently, we have conducted a study of military internal medicine residents' decision to enter infectious disease. As part of our larger effort, we saw an opportunity to characterize factors impacting decision making of internal medicine residents' desire to apply for subspecialty training and to extend active duty service obligations. Questions were developed after discussion with various military graduate medical education and internal medicine leaders, underwent external review, and were added to a larger question set. The survey link was distributed electronically to all U.S. military affiliated residencies' graduating internal medicine residents in December 2016-January 2017. Data were analyzed by decision to apply to fellowship and decision to extend military obligation using Fisher's exact test or Pearon's chi-square test. Sixty-eight residents from 10 of 11 military residency programs responded, for a response rate of 51%. The majority (62%) applied to fellowship to start after residency completion. Reasons cited for applying to fellowship included wanting to become a specialist as soon as possible (74%), wishing to avoid being a general internist (57%), and because they are unable to practice as a hospitalist in the military (52%). Fellowship applicants were more likely to plan to extend their military obligation than non-applicants, as did those with longer duration of military commitments. No other factors, including Uniformed Services University attendance or participation in undergraduate military experiences, were found to impact plan to extend active duty service commitment. The majority of graduating internal medicine residents apply for fellowship and report a desire to avoid being a

Librarian co-authors correlated with higher quality reported search strategies in general internal medicine systematic reviews.

Science.gov (United States)

Rethlefsen, Melissa L; Farrell, Ann M; Osterhaus Trzasko, Leah C; Brigham, Tara J

2015-06-01

To determine whether librarian and information specialist authorship was associated with better reported systematic review (SR) search quality. SRs from high-impact general internal medicine journals were reviewed for search quality characteristics and reporting quality by independent reviewers using three instruments, including a checklist of Institute of Medicine Recommended Standards for the Search Process and a scored modification of the Peer Review of Electronic Search Strategies instrument. The level of librarian and information specialist participation was significantly associated with search reproducibility from reported search strategies (Χ(2) = 23.5; P Librarian co-authored SRs had significantly higher odds of meeting 8 of 13 analyzed search standards than those with no librarian participation and six more than those with mentioned librarian participation. One-way ANOVA showed that differences in total search quality scores between all three groups were statistically significant (F2,267 = 10.1233; P librarian or information specialist co-authors are correlated with significantly higher quality reported search strategies. To minimize bias in SRs, authors and editors could encourage librarian engagement in SRs including authorship as a potential way to help improve documentation of the search strategy. Copyright © 2015 Elsevier Inc. All rights reserved.

[Assessing research productivity in Department of Internal Medicine, University of Zagreb, School of Medicine and University Hospital Centre Zagreb].

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Petrak, Jelka; Sember, Marijan; Granić, Davorka

2012-01-01

Bibliometric analysis may give an objective information about publishing activity, citation rate and collaboration patterns of individuals, groups and institutions. The publication productivity of the present medical staff (79 with specialist degree and 22 residents) in Department of Internal Medicine, University of Zagreb School of Medicine in University Hospital Centre Zagreb was measured by the number of papers indexed by Medline, their impact was measured by the number of times these papers had subsequently been cited in the medical literature, while the collaboration pattern was estimated by the authors' addresses listed in the papers. PubMed database was a source for verifying the bibliographic data, and the citation data were searched via Thomson Web of Scence (WoS) platform. There were a total of 1182 papers, published from 1974 to date. The number of papers per author ranged from 0 to 252. Sixty of papers were published in English, and 39% in Croatian language. The roughly equal share was published in local and foreign journals. The RCT studies and practice guidelines were among the most cited papers and were at the same time published by the highly ranked journals. The collaboration analysis confirmed the extensive involment in the international multicentric clinical trials as well as in the development of international/local practice guidelines.

3rd International Arab Forensic Sciences & Forensic Medicine Conference, ASFSFM 2017: Conference Report

Directory of Open Access Journals (Sweden)

Abdulsallam A. Bakdash

2017-12-01

Full Text Available The Arab Society for Forensic Sciences and Forensic Medicine (ASFSFM at Naif Arab University for Security Sciences seeks to present the latest developments in all fields of forensic sciences through holding specialized scientific events and academic activities. This is also achieved through its periodic scientific peer-reviewed journal, the Arab Journal of Forensic Sciences and Forensic Medicine. It also seeks to promote scientific research in all fields of forensic science and forensic medicine, and seeks actively to contribute in holding scientific meetings in accordance with advanced scientific standards, including the 3rd International Arab Forensic Sciences & Forensic Medicine Conference. This important event was attended by scientists and experts from various fields of criminal and forensic sciences from both Arab and non-Arab countries. This conference was a significant scientific accomplishment that contributed to the advancement of forensic sciences and forensic medicine in the Arab world. The conference aimed, in accordance with the vision of Naif Arab University for Security Sciences, to enhance peace, security and justice in Arab societies.  Naif Arab University for Security Sciences, represented by the Arab Society for Forensic Sciences and Forensic Medicine, held the 3rd International Arab Forensic Sciences & Forensic Medicine Conference on the University's campus during the period from 21st to 23rd November 2017. The event included the participation of more than 720 experts in forensic sciences and forensic medicine from 33 countries all over the world. Experts discussed and presented the latest developments in their fields. The conference provided a creative environment for students from both local and international universities to benefit from experts and specialists, and to access the most recent research.  On behalf of His Excellency the president of Naif Arab University for Security Sciences, and the Arab Society for

Later Leaders in Education: Hazel Flannery Gabbard--Specialist in International Education.

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Blackwood, Paul E.

1993-01-01

This biography of Hazel Flannery Gabbard discusses her organization of nursery school centers in Rochester, New York; her work as an education specialist in the U.S. Office of Education; her cooperation with national organizations; and her international education activities. (SM)

What skills should new internal medicine interns have in july? A national survey of internal medicine residency program directors.

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Angus, Steven; Vu, T Robert; Halvorsen, Andrew J; Aiyer, Meenakshy; McKown, Kevin; Chmielewski, Amy F; McDonald, Furman S

2014-03-01

The transition from medical student to intern may cause stress and burnout in new interns and the delivery of suboptimal patient care. Despite a formal set of subinternship curriculum guidelines, program directors have expressed concern regarding the skill set of new interns and the lack of standardization in that skill set among interns from different medical schools. To address these issues, the Accreditation Council for Graduate Medical Education's Next Accreditation System focuses on the development of a competency-based education continuum spanning undergraduate, graduate, and continuing medical education. In 2010, the Clerkship Directors in Internal Medicine subinternship task force, in collaboration with the Association of Program Directors in Internal Medicine survey committee, surveyed internal medicine residency program directors to determine which competencies or skills they expected from new medical school graduates. The authors summarized the results using categories of interest. In both an item rank list and free-text responses, program directors were nearly uniform in ranking the skills they deemed most important for new interns-organization and time management and prioritization skills; effective communication skills; basic clinical skills; and knowing when to ask for assistance. Stakeholders should use the results of this survey as they develop a milestone-based curriculum for the fourth year of medical school and for the internal medicine subinternship. By doing so, they should develop a standardized set of skills that meet program directors' expectations, reduce the stress of transitions across the educational continuum, and improve the quality of patient care.

Transition to international classification of disease version 10, clinical modification: the impact on internal medicine and internal medicine subspecialties.

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Caskey, Rachel N; Abutahoun, Angelos; Polick, Anne; Barnes, Michelle; Srivastava, Pavan; Boyd, Andrew D

2018-05-04

The US health care system uses diagnostic codes for billing and reimbursement as well as quality assessment and measuring clinical outcomes. The US transitioned to the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) on October, 2015. Little is known about the impact of ICD-10-CM on internal medicine and medicine subspecialists. We used a state-wide data set from Illinois Medicaid specified for Internal Medicine providers and subspecialists. A total of 3191 ICD-9-CM codes were used for 51,078 patient encounters, for a total cost of US $26,022,022 for all internal medicine. We categorized all of the ICD-9-CM codes based on the complexity of mapping to ICD-10-CM as codes with complex mapping could result in billing or administrative errors during the transition. Codes found to have complex mapping and frequently used codes (n = 295) were analyzed for clinical accuracy of mapping to ICD-10-CM. Each subspecialty was analyzed for complexity of codes used and proportion of reimbursement associated with complex codes. Twenty-five percent of internal medicine codes have convoluted mapping to ICD-10-CM, which represent 22% of Illinois Medicaid patients, and 30% of reimbursements. Rheumatology and Endocrinology had the greatest proportion of visits and reimbursement associated with complex codes. We found 14.5% of ICD-9-CM codes used by internists, when mapped to ICD-10-CM, resulted in potential clinical inaccuracies. We identified that 43% of diagnostic codes evaluated and used by internists and that account for 14% of internal medicine reimbursements are associated with codes which could result in administrative errors.

Palliative Care Exposure in Internal Medicine Residency Education: A Survey of ACGME Internal Medicine Program Directors.

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Edwards, Asher; Nam, Samuel

2018-01-01

As the baby boomer generation ages, the need for palliative care services will be paramount and yet training for palliative care physicians is currently inadequate to meet the current palliative care needs. Nonspecialty-trained physicians will need to supplement the gap between supply and demand. Yet, no uniform guidelines exist for the training of internal medicine residents in palliative care. To our knowledge, no systematic study has been performed to evaluate how internal medicine residencies currently integrate palliative care into their training. In this study, we surveyed 338 Accreditation Council for Graduate Medical Education-accredited internal medicine program directors. We queried how palliative care was integrated into their training programs. The vast majority of respondents felt that palliative care training was "very important" (87.5%) and 75.9% of respondents offered some kind of palliative care rotation, often with a multidisciplinary approach. Moving forward, we are hopeful that the data provided from our survey will act as a launching point for more formal investigations into palliative care education for internal medicine residents. Concurrently, policy makers should aid in palliative care instruction by formalizing required palliative care training for internal medicine residents.

Specialty and Associate Specialist doctors: still the dependable backbone of genitourinary medicine.

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Lee, J D; Carlin, E M; Robinson, A

2013-05-01

Workforce planning is an inexact science. Specialty and Associate Specialist (SAS) doctors are rarely included in workforce analyses. Past studies have shown that SAS doctors are significant contributors to the work in genitourinary (GU) medicine clinics. This survey confirms the large amount of clinical work undertaken by SAS doctors. It appears that 51% of SAS doctors in GU plan to retire in the next 15 years and it is uncertain what effect the 2008 SAS contract will have on SAS recruitment. This information should be taken into consideration in future GUM workforce planning.

Frequency of bullying perceived in clinical practices of last year interns of a medicine school: cross sectional study

Directory of Open Access Journals (Sweden)

Nubia Fernanda Sánchez

2016-07-01

Full Text Available Introduction: During the medical internship year, students attend several hospitals and are observed and influenced by postgraduate students, general practitioners and other interns, who provide them with fundamental support regarding professional training. Bullying is defined as an aggressive behavior that occurs between a perpetrator and a victim in different scenarios and authority relationships, such as clinical practices at Medicine programs. Objective: To describe the perceived frequency of bullying among a group of interns of the Faculty of Medicine from Universidad Nacional de Colombia during internship. Materials and methods: A transversal analytical study was performed through a questionnaire applied to 82 medical interns of the School of Medicine from Universidad Nacional de Colombia. Results: The perceived frequency of bullying was 90%. Statistically significant differences were not found in the stratified analysis by sex or place of practice. In most cases, bullying was perpetrated by other interns, while residents and specialists showed a lower frequency. Conclusion: Perceived frequency of bullying was higher than expected according to the existing literature. These results can be used as a basis for new studies.

The European Federation of Clinical Chemistry and Laboratory Medicine syllabus for postgraduate education and training for Specialists in Laboratory Medicine: version 5 - 2018.

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Jassam, Nuthar; Lake, Jennifer; Dabrowska, Milena; Queralto, Jose; Rizos, Demetrios; Lichtinghagen, Ralf; Baum, Hannsjörg; Ceriotti, Ferruccio; O'Mullane, John; Homšak, Evgenija; Charilaou, Charis; Ohlson, Mats; Rako, Ivana; Vitkus, Dalius; Kovac, Gustav; Verschuure, Pauline; Racek, Jaroslav; Chifiriuc, Mariana Carmen; Wieringa, Gilbert

2018-06-05

Although laboratory medicine practise varies across the European Union's (EU) member states, the extent of overlap in scope is such that a common syllabus describing the education and training associated with high-quality, specialist practise can be identified. In turn, such a syllabus can help define the common set of skills, knowledge and competence in a Common Training Framework (CTF) for non-medical Specialists in Laboratory Medicine under EU Directive 2013/55/EU (The recognition of Professional Qualifications). In meeting the requirements of the directive's CTF patient safety is particularly enhanced when specialists seek to capitalise on opportunities for free professional migration across EU borders. In updating the fourth syllabus, the fifth expands on individual discipline requirements, new analytical techniques and use of statistics. An outline structure for a training programme is proposed together with expected responsibilities of trainees and trainers; reference is provided to a trainee's log book. In updating the syllabus, it continues to support national programmes and the aims of EU Directive 2013/55/EU in providing safeguards to professional mobility across European borders at a time when the demand for highly qualified professionals is increasing in the face of a disparity in their distribution across Europe. In support of achieving a CTF, the syllabus represents EFLM's position statement for the education and training that underpins the framework.

The internal medicine clerkship and ambulatory learning experiences: results of the 2010 clerkship directors in internal medicine survey.

Science.gov (United States)

Shaheen, Amy; Papp, Klara K; Torre, Dario

2013-01-01

Education in the ambulatory setting should be an integral part of undergraduate medical education. However, previous studies have shown education in this setting has been lacking in medical school. Ambulatory education occurs on some internal medicine clerkships. The extent of this education is unclear. The purpose of this survey was to assess the structure, curriculum, assessment methods, and barriers to implementation of ambulatory education on the internal medicine clerkship. An annual survey of institutional members of the Clerkship Directors in Internal Medicine (CDIM) was done in April 2010. The data were anonymous and descriptive statistics were used to summarize responses. Free text results were analyzed using qualitative techniques. The response rate was 75%. The majority of respondents had a required ambulatory component to the clerkship. Ambulatory experiences distinct from the inpatient internal medicine experience were common (46%). Integration with either the inpatient experiences or other departmental clerkships also occurred. The majority of ambulatory educational experiences were with generalists (74%) and/or subspecialists (45%). The most common assessment tool was the National Board of Medical Examiners (NBME) ambulatory shelf exam. Thematic analysis of the question about how practice based learning was taught elicited four major themes: Not taught; taught in the context of learning evidence based medicine; taught while learning chronic disease management with quality improvement; taught while learning about health care finance. Barriers to implementation included lack of faculty and financial resources. There have been significant increases in the amount of time dedicated to ambulatory internal medicine. The numbers of medical schools with ambulatory internal medicine education has increased. Integration of the ambulatory experiences with other clerkships such as family medicine occurs. Curriculum was varied but difficulties with dissemination

[A physician profile--specialists in social medicine and health services administration].

Science.gov (United States)

Elterlein, E

1989-04-01

Specialists in social medicine and the organization of health services, in particular those in leading functions, are the most important persons who master the argumentation and justification of optimal relations of proposed innovations from the aspect of improving the health status of the population and from the aspect of national economy, ensuring expedient investment into the system of health services and early return of these investments. These leading workers must have exceptional abilities as regards management and organization and moreover be able to stimulate collaborators to creative work, ensure their effective cooperation, team work and consequential integration at the level of different health and economic facilities entrusted to them.

American Internal Medicine in the 21st Century

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Huddle, Thomas S; Centor, Robert; Heudebert, Gustavo R

2003-01-01

American internal medicine suffers a confusion of identity as we enter the 21st century. The subspecialties prosper, although unevenly, and retain varying degrees of connection to their internal medicine roots. General internal medicine, identified with primary care since the 1970s, retains an affinity for its traditional consultant-generalist ideal even as primary care further displaces that ideal. We discuss the origins and importance of the consultant-generalist ideal of internal medicine as exemplified by Osler, and its continued appeal in spite of the predominant role played by clinical science and accompanying subspecialism in determining the academic leadership of American internal medicine since the 1920s. Organizing departmental clinical work along subspecialty lines diminished the importance of the consultant-generalist ideal in academic departments of medicine after 1950. General internists, when they joined the divisions of general internal medicine that appeared in departments of medicine in the 1970s, could sometimes emulate Osler in practicing a general medicine of complexity, but often found themselves in a more limited role doing primary care. As we enter the 21st century, managed care threatens what remains of the Oslerian ideal, both in departments of medicine and in clinical practice. Twenty-first century American internists will have to adjust their conditions of work should they continue to aspire to practice Oslerian internal medicine. PMID:12950486

Hospitalist career decisions among internal medicine residents.

Science.gov (United States)

Ratelle, John T; Dupras, Denise M; Alguire, Patrick; Masters, Philip; Weissman, Arlene; West, Colin P

2014-07-01

Hospital medicine is a rapidly growing field of internal medicine. However, little is known about internal medicine residents' decisions to pursue careers in hospital medicine (HM). To identify which internal medicine residents choose a career in HM, and describe changes in this career choice over the course of their residency education. Observational cohort using data collected from the annual Internal Medicine In-Training Examination (IM-ITE) survey. 16,781 postgraduate year 3 (PGY-3) North American internal medicine residents who completed the annual IM-ITE survey in 2009-2011, 9,501 of whom completed the survey in all 3 years of residency. Self-reported career plans for individual residents during their postgraduate year 1 (PGY-1), postgraduate year 2 (PGY-2) and PGY-3. Of the 16,781 graduating PGY-3 residents, 1,552 (9.3 %) reported HM as their ultimate career choice. Of the 951 PGY-3 residents planning a HM career among the 9,501 residents responding in all 3 years, 128 (13.5 %) originally made this decision in PGY-1, 192 (20.2 %) in PGY-2, and 631 (66.4 %) in PGY-3. Only 87 (9.1 %) of these 951 residents maintained a career decision of HM during all three years of residency education. Hospital medicine is a reported career choice for an important proportion of graduating internal medicine residents. However, the majority of residents do not finalize this decision until their final year.

[Legal medicine specialists within the framework of acute care : Analysis of legal medicine consultations in relation to the victims' statistics of the state office of criminal investigation in Saxony-Anhalt].

Science.gov (United States)

Pliske, G; Heide, S; Lucas, B; Brandstädter, K; Walcher, F; Kropf, S; Lessig, R; Piatek, S

2018-05-01

In acute medical care, there are patients who have been injured by the influence of others. The aim of this study was to analyze all cases which were presented to the Institute for Legal Medicine of the University Halle (Saale). The cases where analyzed in relation to the victims' statistics of the state office of criminal investigation in Saxony-Anhalt. The consultations of the Institute for Legal Medicine Halle-Wittenberg for 2012-2015 were evaluated with regard to the age and gender distribution, the reasons for the consultation and time until the request for consultations. These cases were statistically compared to the victims' statistics of the state office of criminal investigation in Saxony-Anhalt 2014-2015. A total of 536 cases (55.6% male and 44.4% female patients) were evaluated. In all, 62.1% of patients were under 18 years of age; 43.5% of all consultations were requested by pediatric (surgery) clinics. The most common reasons for consultation were sexual child abuse or violence against children (50.7%). Compared to the victims' statistics, significantly more children were examined by legal medicine specialists than could have been expected (p legal medicine specialists in relation to the victims' statistics. Most of them were children and women. The temporal latency between the act of violence and the consultations was one day and more. The latency and the renunciation of the consultation of the legal medicine specialists can lead to loss of evidence.

Education of radiation safety specialists at Faculty of Medicine of Vilnius University

International Nuclear Information System (INIS)

Urbelis, A.; Surkiene, G.

2004-01-01

Vilnius University is the first institution of higher education in Lithuania that began to teach students on radiation safety. The special course of radiation hygiene was delivered to students in 1962-1992. In 1992 it was introduced residency of radiation hygiene and graduated students qualified for title of radiation hygiene specialist. The residency lasted one year and included six cycles: fundamentals of nuclear physics, statistics and noninfectious epidemiology, radiobiology, radiological research methods, controls of radiation safety and hygienic analysis of radiation safety. From 1994 Vilnius University has been educating and training professionals of public health. The specialists of radiation safety aren't been training as isolated branch. All courses is divided into two parts. The first one is included into bachelor, the second part - into master study. The bachelor study consists of 2 credits (16 hours for lectures and 32 hours for practical studies). The future bachelors study introduction of radiation safety, elements of nuclear physics, dose limit values, fundamentals of radiological protection, natural radiation. The master study consists of 2 credits (8 hours for lectures and 48 hours for practical studies). The future masters study specific problems of radiation safety in medicine and industry, the safety problems of nuclear power - stations, the problems of radioactive wastes, radiation biology, radiation risk. Radiation safety study model in Faculty of medicine of Vilnius University differs from study model in most European countries as it makes great play of radiation safety while usual model includes radiation safety as insignificant part of environmental health. (author)

10th national conference of Society of Nuclear Medicine, Bangladesh and International symposium, Dhaka, Bangladesh, 10-11 February 2005: A report

International Nuclear Information System (INIS)

Alam, F.

2005-01-01

The Society of Nuclear Medicine, Bangladesh organized its 10th Annual Conference at Dhaka on 10-11 February 2005. The theme of this year's convention was 'Interventional Nuclear Medicine'. Besides the faculty from Bangladesh including consultants from various clinical specialties, four international experts also participated in the two day meeting. The pre-congress CME was held in the premises of Bangladesh Atomic Energy Commission on 10 February. Several lectures on the management of Thyroid Disorders using radionuclide techniques were delivered by a distinguished national and international faculty. The lectures were attended by a large audience with a packed auditorium, mostly nuclear medicine specialists, general physicians, surgeons and endocrinologists from Dhaka and other places of Bangladesh. There was good interaction and participants took active part in the discussions. The actual Annual Convention of Society of Nuclear Medicine Bangladesh (SNMB) was held in Dhaka on 11 February 2005. The convention was attended by more than 250 registered participants, including nuclear medicine physicians, clinicians, residents, and technologists, representative of the Atomic Energy Commission and pioneers of nuclear medicine in Bangladesh

The practice of travel medicine in Europe.

Science.gov (United States)

Schlagenhauf, P; Santos-O'Connor, F; Parola, P

2010-03-01

Europe, because of its geographical location, strategic position on trade routes, and colonial past, has a long history of caring for travellers' health. Within Europe, there is great diversity in the practice of travel medicine. Some countries have travel medicine societies and provisions for a periodic distribution of recommendations, but many countries have no national pre-travel guidelines and follow international recommendations such as those provided by the WHO. Providers of travel medicine include tropical medicine specialists, general practice nurses and physicians, specialist 'travel clinics', occupational physicians, and pharmacists. One of the core functions of the European Centre for Disease Prevention and Control-funded network of travel and tropical medicine professionals, EuroTravNet, is to document the status quo of travel medicine in Europe. A three-pronged approach is used, with a real-time online questionnaire, a structured interview with experts in each country, and web searching.

Internal medicine. An illustrated radiological guide

International Nuclear Information System (INIS)

Al-Tubaikh, Jarrah Ali; Sabah Hospital, Kuwait

2010-01-01

This book explains how radiology can be a powerful tool for establishing the diagnosis of many internal medicine diseases that are usually diagnosed on the basis of their laboratory or clinical presentation. It is organized in the classic fashion for internal medicine books, with eleven chapters covering the different internal medicine specialties. Within these chapters, more than 450 diseases are considered, some of which are rarely encountered but are nonetheless significant. For each disease, radiological and clinical features are displayed in images and high-quality digital medical illustrations, and those differential diagnoses are identified that can be ruled out by imaging alone. In addition, the pathophysiology underlying the radiological features is described, enabling the reader to understand why a particular sign is seen on MR images, CT scans, or plain radiographs. The book will serve as an excellent radiological atlas for internal medicine practitioners and family physicians, showing disease presentations that may be hard to find in standard medical textbooks and explaining which imaging modalities are likely to be most informative in particular patients. (orig.)

[Internal Medicine in the curriculum of General Medicine at Universities of Mexico, 2014].

Science.gov (United States)

Maldonado, Jesús Adrián; Peinado, José María

2017-01-01

The aim of this study was to analyze Internal Medicine as a subject and its requirement in each of the Universities curriculum in Mexico that offers a degree in General Medicine. By the end of the first quarter of 2014, the research was closed and 81 campuses were studied. This research was quantitative, using an analytical technique, written discourse, exploratory and purposive sampling not random and homogeneous type. The Likert questionnaire was used in this study to analyse the following variables: the record of Internal Medicine as a subject, the burden of credit, and the location of the program. The procedure consisted of three phases. First obtaining an official list of all the Universities in the Mexican Association of Colleges and Schools of Medicine. Second, obtaining an analysis of each of the Universities' curriculums, and lastly gathering each variable of the study. The results of the Universities were 63% were public and 37% private. Internal Medicine as a subject in the curriculum was 37.1%, and 20% of the universities include it for six months and 9% offer it the whole year. However, the undergraduate internship in Internal Medicine offers it 100%. In conclusion, Internal Medicine as a subject could disappear from the curriculum in General Medicine before coming to the undergraduate internship, even though the latter is declared required in hospital shifts.

A dozen years of American Academy of Sleep Medicine (AASM) International Mini-Fellowship: program evaluation and future directions.

Science.gov (United States)

Ioachimescu, Octavian C; Wickwire, Emerson M; Harrington, John; Kristo, David; Arnedt, J Todd; Ramar, Kannan; Won, Christine; Billings, Martha E; DelRosso, Lourdes; Williams, Scott; Paruthi, Shalini; Morgenthaler, Timothy I

2014-03-15

Sleep medicine remains an underrepresented medical specialty worldwide, with significant geographic disparities with regard to training, number of available sleep specialists, sleep laboratory or clinic infrastructures, and evidence-based clinical practices. The American Academy of Sleep Medicine (AASM) is committed to facilitating the education of sleep medicine professionals to ensure high-quality, evidence-based clinical care and improve access to sleep centers around the world, particularly in developing countries. In 2002, the AASM launched an annual 4-week training program called Mini-Fellowship for International Scholars, designed to support the establishment of sleep medicine in developing countries. The participating fellows were generally chosen from areas that lacked a clinical infrastructure in this specialty and provided with training in AASM Accredited sleep centers. This manuscript presents an overview of the program, summarizes the outcomes, successes, and lessons learned during the first 12 years, and describes a set of programmatic changes for the near-future, as assembled and proposed by the AASM Education Committee and recently approved by the AASM Board of Directors. Ioachimescu OC; Wickwire EM; Harrington J; Kristo D; Arnedt JT; Ramar K; Won C; Billings ME; DelRosso L; Williams S; Paruthi S; Morgenthaler TI. A dozen years of American Academy of Sleep Medicine (AASM) international mini-fellowship: program evaluation and future directions.

Thieme Textbook Internal Medicine - TIM

International Nuclear Information System (INIS)

Flasnoecker, M.

1999-01-01

The textbook and reference work covers the entire field of internal medicine arranged in 15 chapters, each covering a particular branch of internal medicine. This subject arrangement corresponds to the subject clusters of the regime of post-graduate education. Every branch, i. e. every chapter, has its own responsible editor. This selection of editors and authors,- all in all 180 experts in general and clinical practice -, guarantees a maximum of competence and compliance with the frontiers of research and clinical experience. (orig./CB) [de

[What's new in internal medicine?

Science.gov (United States)

Fardet, L

2017-12-01

As it is practiced in France, internal medicine meets the Anglo-Saxon definition of the specialty, ie doctors "equipped to handle the broad and comprehensive spectrum of illnesses that affect adults, and are recognized as experts in diagnosis, in treatment of chronic illness, and in health promotion and disease prevention - they are not limited to one type of medical problem or organ system". This 2017 "What's new in internal medicine" will consist of 2 parts, a first part on significant publications in the field of systemic and autoimmune diseases and a second part on more diverse publications (HIV, cancer, pregnancy, well-being...) important for medicine in general and its different specialties. © 2017 Elsevier Masson SAS. Tous droits réservés.

Educational support for specialist international medical graduates in anaesthesia.

Science.gov (United States)

Higgins, Niall S; Taraporewalla, Kersi; Edirippulige, Sisira; Ware, Robert S; Steyn, Michael; Watson, Marcus O

2013-08-19

To measure specialist international medical graduates' (SIMGs) level of learning through participation in guided tutorials, face-to-face or through videoconferencing (VC), and the effect of tutorial attendance and quality of participation on success in specialist college examinations. Tutorials were conducted at the Royal Brisbane and Women's Hospital between 19 September 2007 and 23 August 2010, and delivered through VC to participants at other locations. Tutorials were recorded and transcribed, and speaker contributions were tagged and ranked using content analysis software. Summary examination results were obtained from the Australian and New Zealand College of Anaesthetists. Tutorial participation and attendance, and college examination pass and fail rates. Transcripts were obtained for 116 tutorials. The median participation percentage for those who subsequently failed the college examinations was 1% (interquartile range [IQR], 0%-1%), while for those who passed the exams it was 5% (IQR, 2%-8%; P technology was found to be a feasible method to assist SIMGs to become aware of the requirements of the exam and to prepare more effectively.

Internal Medicine Point-of-Care Ultrasound Curriculum: Consensus Recommendations from the Canadian Internal Medicine Ultrasound (CIMUS) Group.

Science.gov (United States)

Ma, Irene W Y; Arishenkoff, Shane; Wiseman, Jeffrey; Desy, Janeve; Ailon, Jonathan; Martin, Leslie; Otremba, Mirek; Halman, Samantha; Willemot, Patrick; Blouw, Marcus

2017-09-01

Bedside point-of-care ultrasound (POCUS) is increasingly used to assess medical patients. At present, no consensus exists for what POCUS curriculum is appropriate for internal medicine residency training programs. This document details the consensus-based recommendations by the Canadian Internal Medicine Ultrasound (CIMUS) group, comprising 39 members, representing 14 institutions across Canada. Guiding principles for selecting curricular content were determined a priori. Consensus was defined as agreement by at least 80% of the members on POCUS applications deemed appropriate for teaching and assessment of trainees in the core (internal medicine postgraduate years [PGY] 1-3) and expanded (general internal medicine PGY 4-5) training programs. We recommend four POCUS applications for the core PGY 1-3 curriculum (inferior vena cava, lung B lines, pleural effusion, and abdominal free fluid) and three ultrasound-guided procedures (central venous catheterization, thoracentesis, and paracentesis). For the expanded PGY 4-5 curriculum, we recommend an additional seven applications (internal jugular vein, lung consolidation, pneumothorax, knee effusion, gross left ventricular systolic function, pericardial effusion, and right ventricular strain) and four ultrasound-guided procedures (knee arthrocentesis, arterial line insertion, arterial blood gas sampling, and peripheral venous catheterization). These recommendations will provide a framework for training programs at a national level.

Teaching Prevention in Internal Medicine Clerkships.

Science.gov (United States)

Kinsinger, Linda

2000-01-01

Reviews the rationale for including prevention in the clinical medicine clerkship. Summarizes current guidelines, presents examples of curricula in several medical schools, and proposes a future direction that stresses integrating teaching preventive medicine into internal medicine clerkships and across the entire four-year medical curriculum. (DB)

Perception of drug teratogenicity among general practitioners and specialists in obstetrics/gynecology

DEFF Research Database (Denmark)

Gils, Charlotte; Pottegård, Anton; Ennis, Zandra Nymand

2016-01-01

the perception of the teratogenic risk of 9 commonly and 3 rarely prescribed drugs among general practitioners and specialists in obstetrics/gynecology. METHODS: All 811 general practitioners in the Region of Southern Denmark and all 502 specialist obstetricians/gynecologists in Denmark as a whole were invited...... to participate in the study based on an online questionnaire. Medians and interpercentile ranges of the perceived background risk and perceived risks for each of the drugs were included in the questionnaire. RESULTS: One hundred forty three (18 %) general practitioners and 138 (27 %) obstetricians...... by a dermatologist, and warfarin treatment is only rarely initiated in women of the fertile age without involvement of specialists in internal medicine. Hence, the active knowledge on the teratogenic potential of these drugs is likely to be less accurate among general practitioners and obstetricians...

Nuclear medicine resources manual

International Nuclear Information System (INIS)

2006-02-01

Over the past decade many IAEA programmes have significantly enhanced the capabilities of numerous Member States in the field of nuclear medicine. Functional imaging using nuclear medicine procedures has become an indispensable tool for the diagnosis, treatment planning and management of patients. However, due to the heterogeneous growth and development of nuclear medicine in the IAEA's Member States, the operating standards of practice vary considerably from country to country and region to region. This publication is the result of the work of over 30 international professionals who have assisted the IAEA in the process of standardization and harmonization. This manual sets out the prerequisites for the establishment of a nuclear medicine service, including basic infrastructure, suitable premises, reliable supply of electricity, maintenance of a steady temperature, dust exclusion for gamma cameras and radiopharmacy dispensaries. It offers clear guidance on human resources and training needs for medical doctors, technologists, radiopharmaceutical scientists, physicists and specialist nurses in the practice of nuclear medicine. The manual describes the requirements for safe preparation and quality control of radiopharmaceuticals. In addition, it contains essential requirements for maintenance of facilities and instruments, for radiation hygiene and for optimization of nuclear medicine operational performance with the use of working clinical protocols. The result is a comprehensive guide at an international level that contains practical suggestions based on the experience of professionals around the globe. This publication will be of interest to nuclear medicine physicians, radiologists, medical educationalists, diagnostic centre managers, medical physicists, medical technologists, radiopharmacists, specialist nurses, clinical scientists and those engaged in quality assurance and control systems in public health in both developed and developing countries

Complexity in graduate medical education: a collaborative education agenda for internal medicine and geriatric medicine.

Science.gov (United States)

Chang, Anna; Fernandez, Helen; Cayea, Danelle; Chheda, Shobhina; Paniagua, Miguel; Eckstrom, Elizabeth; Day, Hollis

2014-06-01

Internal medicine residents today face significant challenges in caring for an increasingly complex patient population within ever-changing education and health care environments. As a result, medical educators, health care system leaders, payers, and patients are demanding change and accountability in graduate medical education (GME). A 2012 Society of General Internal Medicine (SGIM) retreat identified medical education as an area for collaboration between internal medicine and geriatric medicine. The authors first determined a short-term research agenda for resident education by mapping selected internal medicine reporting milestones to geriatrics competencies, and listing available sample learner assessment tools. Next, the authors proposed a strategy for long-term collaboration in three priority areas in clinical medicine that are challenging for residents today: (1) team-based care, (2) transitions and readmissions, and (3) multi-morbidity. The short-term agenda focuses on learner assessment, while the long-term agenda allows for program evaluation and improvement. This model of collaboration in medical education combines the resources and expertise of internal medicine and geriatric medicine educators with the goal of increasing innovation and improving outcomes in GME targeting the needs of our residents and their patients.

Roles of the International Council for Laboratory Animal Science (ICLAS) and International Association of Colleges of Laboratory Animal Medicine (IACLAM) in the Global Organization and Support of 3Rs Advances in Laboratory Animal Science

Science.gov (United States)

Turner, Patricia V; Pekow, Cynthia; Clark, Judy MacArthur; Vergara, Patri; Bayne, Kathryn; White, William J; Kurosawa, Tsutomu Miki; Seok, Seung-Hyeok; Baneux, Philippe

2015-01-01

Practical implementation of the 3Rs at national and regional levels around the world requires long-term commitment, backing, and coordinated efforts by international associations for laboratory animal medicine and science, including the International Association of Colleges of Laboratory Animal Medicine (IACLAM) and the International Council for Laboratory Animal Science (ICLAS). Together these organizations support the efforts of regional organization and communities of laboratory animal science professionals as well as the development of local associations and professional colleges that promote the training and continuing education of research facility personnel and veterinary specialists. The recent formation of a World Organization for Animal Health (OIE) Collaborating Center for Laboratory Animal Science and Welfare emphasizes the need for research into initiatives promoting laboratory animal welfare, particularly in emerging economies and regions with nascent associations of laboratory animal science. PMID:25836964

Obstetric medicine: Interlinking obstetrics and internal medicine

African Journals Online (AJOL)

1 Mayo Clinic Hospitals, Division of Hospital Internal Medicine, Rochester, Minn, USA ... Obstetric physicians have a specific role in managing pregnant and postpartum women with ... problems may also affect pregnancy outcomes, with increased risk of ... greatly benefited from good control of her diabetes and hypertension.

Empirical treatment of bacterial keratitis: an international survey of corneal specialists.

Science.gov (United States)

Austin, Ariana; Schallhorn, Julie; Geske, Mike; Mannis, Mark; Lietman, Tom; Rose-Nussbaumer, Jennifer

2017-08-01

New antibiotic agents and changing susceptibility patterns may have changed the empirical treatment of bacterial keratitis. Our objective in this study was to survey cornea specialists' practice patterns in the initial treatment of bacterial ulcers. This study consisted of a short online survey emailed to members of the Cornea Society listserv for an international sample of cornea specialists. Data collection began July 2014 and ended October 2014. A total of 1009 surveys were emailed, and we received 140 (14%) responses. The majority of US clinicians surveyed (n=83, 80%) chose fortified antibiotics empirically, with 55% (n=57) selecting fortified vancomycin and 16% (n=17) using fluoroquinolone alone. International respondents were twice as likely to use fluoroquinolone monotherapy (31%, n=11, p=0.07) and less likely to use fortified vancomycin (33%, n=12, p=0.03). Forty-five per cent (n=46) of US respondents reported that their initial antibiotic choice covered methicillin-resistant Staphylococcus aureus , compared with 22% (n=8) of international respondents (p<0.01). Overall, respondents who were concerned about availability of antibiotics and toxicity were 20.86 (p<0.001) and 7.48 (p<0.001) times more likely to choose fluoroquinolone monotherapy, respectively. If respondents' primary considerations were broad spectrum coverage or antibiotic resistance they had 7.10 (p<0.001) and 12.51 (p<0.001) times the odds of using fortified vancomycin, respectively. Practice patterns for the initial treatment of bacterial keratitis vary with clinicians in the USA being more likely to use fortified antibiotics versus fluoroquinolone monotherapy and more concerned with resistant organisms than their international peers.

[Development and status of intensive care medicine in internal medicine at the Karl Marx University in Leipzig].

Science.gov (United States)

Engelmann, L; Schneider, D

1989-01-15

Issuing from the accomplishments of Köhler for the development of the intensive medicine in internal medicine-in 1964 he performed the first long-term respiration at the then Medical Clinic of the Karl Marx University, in 1969 he institutionalized the young subdiscipline at the clinic, in 1978 he founded the department for intensive medicine and is at work by his decisions concerning the development of young scientists, by the handbook "Intensive Medicine. Internal Medicine and Adjacent Subjects" as well as a member of the presidium of the GDR Society for Internal Medicine for the development of the internal intensive medicine-a description of the development of the department, its achievements and problems is given. The promotion of the intensive medicine by Köhler results, as we think, also from the comprehension that it has the duty to perform a function integrating the subdisciplines, which the modern internal medicine oriented to organs and systems threatens to lose, which, however, makes its self-apprehension, which the patient wishes and the teaching is demanding. From this and from the charge for a highly specialized care of patients who life-threateningly fell ill with internal diseases as well as from the duty to create a scientific forerunning results the stringent necessity of the development of the non-operative, in reality internal intensive medicine in the clinics for internal medicine of the county hospitals and university institutions as well as the greater identification of the internist with the subdiscipline in the district hospitals dealing with multidisciplinary intensive medicine.

Course on internal dosimetry in nuclear medicine

International Nuclear Information System (INIS)

2004-01-01

This documentation was distributed to the participants in the Course of Internal Dosimetry in Nuclear Medicine organised by the Nuclear Regulatory Authority (ARN) of Argentina and held in Buenos Aires, Argentina, August 9-13, 2004. The course was intended for people from IAEA Member States in the Latin American and Caribbean region, and for professionals and workers in medicine, related with the radiation protection. Spanish and English were the languages of the course. The following subjects were covered: radioprotection of the patient in nuclear medicine; injuries by ionizing radiations; MIRD methodology; radiation dose assessment in nuclear medicine; small scale and microdosimetry; bone and marrow dose modelling; medical internal dose calculations; SPECT and image reconstruction; principles of the gamma camera; scattering and attenuation correction in SPECT; tomography in nuclear medicine

International assistance and cooperation for access to essential medicines.

Science.gov (United States)

Mok, Emily A

2010-06-15

Access to essential medicines is a critical problem that plagues many developing countries. With a daunting number of domestic constraints - technologically, economically, and otherwise - developing countries are faced with a steep uphill battle to meet the human rights obligation of providing essential medicines immediately. To meet these challenges, the international human rights obligations of international assistance and cooperation can play a key role to help developing countries fulfill the need for access to essential medicines. This article seeks to highlight and expand upon the current understanding of international assistance and cooperation for access to essential medicines through a review of obligations identified in international human rights law and a synthesis of official guidance provided on the matter.

Medicine in the 21st century: recommended essential geriatrics competencies for internal medicine and family medicine residents.

Science.gov (United States)

Williams, Brent C; Warshaw, Gregg; Fabiny, Anne Rebecca; Lundebjerg Mpa, Nancy; Medina-Walpole, Annette; Sauvigne, Karen; Schwartzberg, Joanne G; Leipzig, Rosanne M

2010-09-01

Physician workforce projections by the Institute of Medicine require enhanced training in geriatrics for all primary care and subspecialty physicians. Defining essential geriatrics competencies for internal medicine and family medicine residents would improve training for primary care and subspecialty physicians. The objectives of this study were to (1) define essential geriatrics competencies common to internal medicine and family medicine residents that build on established national geriatrics competencies for medical students, are feasible within current residency programs, are assessable, and address the Accreditation Council for Graduate Medical Education competencies; and (2) involve key stakeholder organizations in their development and implementation. Initial candidate competencies were defined through small group meetings and a survey of more than 100 experts, followed by detailed item review by 26 program directors and residency clinical educators from key professional organizations. Throughout, an 8-member working group made revisions to maintain consistency and compatibility among the competencies. Support and participation by key stakeholder organizations were secured throughout the project. The process identified 26 competencies in 7 domains: Medication Management; Cognitive, Affective, and Behavioral Health; Complex or Chronic Illness(es) in Older Adults; Palliative and End-of-Life Care; Hospital Patient Safety; Transitions of Care; and Ambulatory Care. The competencies map directly onto the medical student geriatric competencies and the 6 Accreditation Council for Graduate Medical Education Competencies. Through a consensus-building process that included leadership and members of key stakeholder organizations, a concise set of essential geriatrics competencies for internal medicine and family medicine residencies has been developed. These competencies are well aligned with concerns for residency training raised in a recent Medicare Payment Advisory

PanVascular medicine. 2. ed.

Energy Technology Data Exchange (ETDEWEB)

Lanzer, Peter (ed.) [Health Care Center Bitterfeld (Germany). Division of Cardiovascular Disease

2015-06-01

Vascular management and care has become a truly multidisciplinary enterprise as the number of specialists involved in the treatment of patients with vascular diseases has steadily increased. While in the past, treatments were delivered by individual specialists, in the twenty-first century a team approach is without doubt the most effective strategy. In order to promote professional excellence in this dynamic and rapidly evolving field, a shared knowledge base and interdisciplinary standards need to be established. Pan Vascular Medicine, 2nd edition has been designed to offer such an interdisciplinary platform, providing vascular specialists with state-of-the art descriptive and procedural knowledge. Basic science, diagnostics, and therapy are all comprehensively covered. In a series of succinct, clearly written chapters, renowned specialists introduce and comment on the current international guidelines and present up-to-date reviews of all aspects of vascular care.

PanVascular medicine. 2. ed.

International Nuclear Information System (INIS)

Lanzer, Peter

2015-01-01

Vascular management and care has become a truly multidisciplinary enterprise as the number of specialists involved in the treatment of patients with vascular diseases has steadily increased. While in the past, treatments were delivered by individual specialists, in the twenty-first century a team approach is without doubt the most effective strategy. In order to promote professional excellence in this dynamic and rapidly evolving field, a shared knowledge base and interdisciplinary standards need to be established. Pan Vascular Medicine, 2nd edition has been designed to offer such an interdisciplinary platform, providing vascular specialists with state-of-the art descriptive and procedural knowledge. Basic science, diagnostics, and therapy are all comprehensively covered. In a series of succinct, clearly written chapters, renowned specialists introduce and comment on the current international guidelines and present up-to-date reviews of all aspects of vascular care.

Curricula and Organization of Primary Care Residencies in Internal Medicine.

Science.gov (United States)

Eisenberg, John M.

1980-01-01

The organization and curricula of internal medicine residencies programs that emphasize primary care are described and compared with traditional residencies in internal medicine. It is noted that primary care residents spend more time in ambulatory care and are allowed more electives in specialties outside of internal medicine. Out-of-hospital…

The Evolution of General Internal Medicine (GIM)in Canada: International Implications.

Science.gov (United States)

Card, Sharon E; Clark, Heather D; Elizov, Michelle; Kassam, Narmin

2017-05-01

General internal medicine (GIM), like other generalist specialties, has struggled to maintain its identity in the face of mounting sub-specialization over the past few decades. In Canada, the path to licensure for general internists has been through the completion of an extra year of training after three core years of internal medicine. Until very recently, the Royal College of Physicians and Surgeons of Canada (RCPSC) did not recognize GIM as a distinct entity. In response to a societal need to train generalist practitioners who could care for complex patients in an increasingly complex health care setting, the majority of universities across Canada voluntarily developed structured GIM training programs independent of RCPSC recognition. However, interest amongst trainees in GIM was declining, and the GIM workforce in Canada, like that in many other countries, was in danger of serious shortfalls. After much deliberation and consultation, in 2010, the RCPSC recognized GIM as a distinct subspecialty of internal medicine. Since this time, despite the challenges in the educational implementation of GIM as a distinct discipline, there has been a resurgence of interest in this field of medicine. This paper outlines the journey of the Canadian GIM to educational implementation as a distinct discipline, the impact on the discipline, and the implications for the international GIM community.

Does clerkship experience influence interest In internal medicine ...

African Journals Online (AJOL)

BACKGROUND:The career intention of undergraduate medical students may be influenced by the clerkship experience in the various specialties. AIM:This study was undertaken to assess the medical student's perception of the internal medicine clerkship and determine its influence in the choice of internal medicine as a ...

International Journal of Medicine and Health Development

African Journals Online (AJOL)

International Journal of Medicine and Health Development ... This is the official publication of College of Medicine, University of Nigeria under the ... Health related quality of life and sociodemographic characteristics among Iranian students ...

Predictors of yoga use among internal medicine patients.

Science.gov (United States)

Cramer, Holger; Lauche, Romy; Langhorst, Jost; Paul, Anna; Michalsen, Andreas; Dobos, Gustav

2013-07-13

Yoga seems to be an effective means to cope with a variety of internal medicine conditions. While characteristics of yoga users have been investigated in the general population, little is known about predictors of yoga use and barriers to yoga use in internal medicine patients. The aim of this cross-sectional analysis was to identify sociodemographic, clinical, and psychological predictors of yoga use among internal medicine patients. A cross-sectional analysis was conducted among all patients being referred to a Department of Internal and Integrative Medicine during a 3-year period. It was assessed whether patients had ever used yoga for their primary medical complaint, the perceived benefit, and the perceived harm of yoga practice. Potential predictors of yoga use including sociodemographic characteristics, health behavior, internal medicine diagnosis, general health status, mental health, satisfaction with health, and health locus of control were assessed; and associations with yoga use were tested using multiple logistic regression analysis. Odds ratios (OR) with 95% confidence intervals (CI) were calculated for significant predictors. Of 2486 participants, 303 (12.19%) reported having used yoga for their primary medical complaint. Of those, 184 (60.73%) reported benefits and 12 (3.96%) reported harms due to yoga practice. Compared to yoga non-users, yoga users were more likely to be 50-64 years old (OR = 1.45; 95%CI = 1.05-2.01; P = 0.025); female (OR = 2.45; 95%CI = 1.45-4.02; P internal health locus of control (OR = 1.92; 95%CI = 1.38-2.67; P internal integrative medicine patient population and was commonly perceived as beneficial. Yoga use was not associated with the patients' specific diagnosis but with sociodemographic factors, mental health, and health locus of control. To improve adherence to yoga practice, it should be considered that male, younger, and anxious patients and those with low internal health locus of control might be less intrinsically

Experience inheritance from famous specialists based on real-world clinical research paradigm of traditional Chinese medicine.

Science.gov (United States)

Song, Guanli; Wang, Yinghui; Zhang, Runshun; Liu, Baoyan; Zhou, Xuezhong; Zhou, Xiaji; Zhang, Hong; Guo, Yufeng; Xue, Yanxing; Xu, Lili

2014-09-01

The current modes of experience inheritance from famous specialists in traditional Chinese medicine (TCM) include master and disciple, literature review, clinical-epidemiology-based clinical research observation, and analysis and data mining via computer and database technologies. Each mode has its advantages and disadvantages. However, a scientific and instructive experience inheritance mode has not been developed. The advent of the big data era as well as the formation and practice accumulation of the TCM clinical research paradigm in the real world have provided new perspectives, techniques, and methods for inheriting experience from famous TCM specialists. Through continuous exploration and practice, the research group proposes the innovation research mode based on the real-world TCM clinical research paradigm, which involves the inheritance and innovation of the existing modes. This mode is formulated in line with its own development regularity of TCM and is expected to become the main mode of experience inheritance in the clinical field.

Elder Specialists: Psychosocial Aspects of Medical Education in Geriatric Care

Science.gov (United States)

McCann-Stone, Nancy; Robinson, Sherry B.; Rull, Gary; Rosher, Richard B.

2009-01-01

This paper describes an Elder Specialist Program developed by one school of medicine to sensitize medical students to geriatric psychosocial issues. Elder Specialists participate in panel discussions as part of each geriatric session. As an alternative to traditional senior mentoring programs, the Elder Specialist Program provides all students a…

Proceedings of international conference of leading specialists, young scientists and students 'Ecological problems of XXI century'; Materialy mezhdunarodnoj konferentsii vedushchikh spetsialistov, molodykh uchenykh i studentov 'Sakharovskie chteniya 2002 goda: Ehkologicheskie problemy XXI veka'

Energy Technology Data Exchange (ETDEWEB)

Milyutin, A A [International A. Sakharov Environmental Univ., Minsk (Belarus)

2002-05-01

The present publication represents the collection of materials of a scientific conference of the leading specialists, young scientists and students, which was organized by Ministry for Education of the Republic of Belarus on the basis of International A. Sakharov Environmental University (Minsk, Republic of Belarus). The ecological problems were viewed on the following directions: ecology, radioecology, ecological monitoring, ecological information systems, eco priority power engineering, eco biology, medical ecology, molecular medicine, social ecology.

Topics of internal medicine for undergraduate dental education: a qualitative study.

Science.gov (United States)

Kunde, A; Harendza, S

2015-08-01

Due to the ageing population, internal medicine has become increasingly important for dental education. Although several studies have reported dentists' dissatisfaction with their internal medicine training, no guidelines exist for internal medicine learning objectives in dental education. The aim of this study was to identify topics of internal medicine considered to be relevant for dental education by dentists and internists. Eight dentists from private dental practices in Hamburg and eight experienced internal medicine consultants from Hamburg University Hospital were recruited for semi-structured interviews about internal medicine topics relevant for dentists. Internal diseases were clustered into representative subspecialties. Dentists and internists were also asked to rate medical diseases or emergencies compiled from the literature by their relevance to dental education. Coagulopathy and endocarditis were rated highest by dentists, whilst anaphylaxis was rated highest by internists. Dentists rated hepatitis, HIV, organ transplantation and head/neck neoplasm significantly higher than internists. The largest number of different internal diseases mentioned by dentists or internists could be clustered under cardiovascular diseases. The number of specific diseases dentists considered to be relevant for dental education was higher in the subspecialties cardiovascular diseases, haematology/oncology and infectiology. We identified the internal medicine topics most relevant for dental education by surveying practising dentists and internists. The relevance of these topics should be confirmed by larger quantitative studies to develop guidelines how to design specific learning objectives for internal medicine in the dental curriculum. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The practice of internal medicine in Europe: organisation, clinical conditions and procedures.

Science.gov (United States)

Cranston, Mark; Semple, Colin; Duckitt, Roger; Vardi, Moshe; Lindgren, Stefan; Davidson, Christopher; Palsson, Runolfur

2013-10-01

Current information on the role of internists in the European countries is scarce. This report describes the results of a survey of the practice of internists in Europe. Two online questionnaire-based surveys were carried out by the European Board of Internal Medicine, one on the practice of internists and the other on postgraduate training in internal medicine. The national internal medicine societies of all 30 member countries of the European Federation of Internal Medicine were invited to participate. The responses were reviewed by internal medicine trainees from the respective countries and summaries of the data were sent to the national societies for approval. Descriptive analysis of the data on the practice of internists was carried out. Twenty-seven countries (90%) completed the questionnaire and approved their datasets. In 8 European countries, most internists practised internal medicine alone and in 7 countries at least half of physicians practised internal medicine together with a subspecialty. Internal medicine was considered a hospital-based specialty in most countries. The majority of selected presenting problems and diagnoses were rated as commonly encountered in all countries. More variability between countries was observed in the performance of diagnostic and therapeutic procedures. Many similarities exist in the practice of internal medicine between the European countries, while some differences are present that likely reflect the variable impact of subspecialisation. The results of the survey should prove valuable for the definition of specific competencies and development of a common curriculum for internal medicine at the European level. © 2013.

Performance of International Medical Students In psychosocial medicine.

Science.gov (United States)

Huhn, D; Lauter, J; Roesch Ely, D; Koch, E; Möltner, A; Herzog, W; Resch, F; Herpertz, S C; Nikendei, C

2017-07-10

Particularly at the beginning of their studies, international medical students face a number of language-related, social and intercultural challenges. Thus, they perform poorer than their local counterparts in written and oral examinations as well as in Objective Structured Clinical Examinations (OSCEs) in the fields of internal medicine and surgery. It is still unknown how international students perform in an OSCE in the field of psychosocial medicine compared to their local fellow students. All students (N = 1033) taking the OSCE in the field of psychosocial medicine and an accompanying written examination in their eighth or ninth semester between 2012 and 2015 were included in the analysis. The OSCE consisted of four different stations, in which students had to perform and manage a patient encounter with simulated patients suffering from 1) post-traumatic stress disorder, 2) schizophrenia, 3) borderline personality disorder and 4) either suicidal tendency or dementia. Students were evaluated by trained lecturers using global checklists assessing specific professional domains, namely building a relationship with the patient, conversational skills, anamnesis, as well as psychopathological findings and decision-making. International medical students scored significantly poorer than their local peers (p International students showed poorer results in clinical-practical exams in the field of psychosocial medicine, with conversational skills yielding the poorest scores. However, regarding factual and practical knowledge examined via a multiple-choice test, no differences emerged between international and local students. These findings have decisive implications for relationship building in the doctor-patient relationship.

Part-time and full-time medical specialists, are there differences in allocation of time?

Directory of Open Access Journals (Sweden)

Groenewegen Peter P

2006-03-01

Full Text Available Abstract Background An increasing number of medical specialists prefer to work part-time. This development can be found worldwide. Problems to be faced in the realization of part-time work in medicine include the division of night and weekend shifts, as well as communication between physicians and continuity of care. People tend to think that physicians working part-time are less devoted to their work, implying that full-time physicians complete a greater number of tasks. The central question in this article is whether part-time medical specialists allocate their time differently to their tasks than full-time medical specialists. Methods A questionnaire was sent by mail to all internists (N = 817, surgeons (N = 693 and radiologists (N = 621 working in general hospitals in the Netherlands. Questions were asked about the actual situation, such as hours worked and night and weekend shifts. The response was 53% (n = 411 for internists, 52% (n = 359 for surgeons, and 36% (n = 213 for radiologists. Due to non-response on specific questions there were 367 internists, 316 surgeons, and 71 radiologists included in the analyses. Multilevel analyses were used to analyze the data. Results Part-time medical specialists do not spend proportionally more time on direct patient care. With respect to night and weekend shifts, part-time medical specialists account for proportionally more or an equal share of these shifts. The number of hours worked per FTE is higher for part-time than for full-time medical specialists, although this difference is only significant for surgeons. Conclusion In general, part-time medical specialists do their share of the job. However, we focussed on input only. Besides input, output like the numbers of services provided deserves attention as well. The trend in medicine towards more part-time work has an important consequence: more medical specialists are needed to get the work done. Therefore, a greater number of medical specialists

Update in outpatient general internal medicine: practice-changing evidence published in 2014.

Science.gov (United States)

Sundsted, Karna K; Wieland, Mark L; Szostek, Jason H; Post, Jason A; Mauck, Karen F

2015-10-01

The practice of outpatient general internal medicine requires a diverse and evolving knowledge base. General internists must identify practice-changing shifts in the literature and reflect on their impact. Accordingly, we conducted a review of practice-changing articles published in outpatient general internal medicine in 2014. To identify high-quality, clinically relevant publications, we reviewed all titles and abstracts published in the following primary data sources in 2014: New England Journal of Medicine, Journal of the American Medical Association (JAMA), Annals of Internal Medicine, JAMA Internal Medicine, and the Cochrane Database of Systematic Reviews. All 2014 primary data summaries from Journal Watch-General Internal Medicine and ACP JournalWise also were reviewed. The authors used a modified Delphi method to reach consensus on inclusion of 8 articles using the following criteria: clinical relevance to outpatient internal medicine, potential for practice change, and strength of evidence. Clusters of important articles around one clinical question were considered as a single-candidate series. The article merits were debated until consensus was reached on the final 8, spanning a variety of topics commonly encountered in outpatient general internal medicine. Copyright © 2015 Elsevier Inc. All rights reserved.

[Prevalence and factors associated with clinical counselling on drug use among internal specialists residents of Andalusia (Spain)].

Science.gov (United States)

Juárez-Jiménez, María de la Villa; Pérez-Milena, Alejandro; Valverde-Bolívar, Francisco Javier; Rosa-Garrido, Carmen

2015-12-01

To determine the frequency of offering clinical counseling against the consumption of alcohol, tobacco and illegal drugs by internal specialist residents (EIR) of Andalusia, and the factors related to such advice. Multicenter cross-sectional study by self-administered questionnaire sent by mail. EIR of Andalusia. The questionnaire collected the frequency of counseling against the use of alcohol, tobacco and illegal drugs (dependent variable). age/gender, specialty, drug consumption and Fagerström test. Out of a total of 4245 participants, 66% responded, 29% did not respond, and 5% poorly completed questionnaires. The mean age was 29.1(±SD 5.1) years, 69% female, 89% Spanish nationality, 84% in medical training (73% hospital, 27% family medicine). The frequency of counseling against tobacco (85%) and alcohol (82%) is higher than illegal drugs (56%, pformative elements of their own specialty such as personal consumption of alcohol and tobacco, which should be considered for improvement of this preventive activity. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

[Diagnosis and treatment in general internal medicine. Curriculum selection].

Science.gov (United States)

Casal, E R; Vázquez, E N; Husni, C

1994-01-01

In our country general internists are the providers of adult medical care in urban areas. In the past twenty years, with the increasing subspecialization within internal medicine and the development of advances in technology, the role of the general internist seems to be endangered. Recently much attention has been focused on this area and Divisions and Programs of General Internal Medicine have been established in most medical schools in the USA. The University of Buenos Aires instituted a Program of General Internal Medicine in its major teaching hospital in 1987. One of its purposes was to offer an educational experience to residents in the field of internal medicine primary care. This paper summarizes how this program was carried out and the subjects proposed in the area of Diagnosis and Treatment. The Program of General Internal Medicine is performed in the Outpatient Division and it is staffed by 3 faculty members and 4 fellows. Residents in Internal Medicine have a three month, full-time block rotation in the Program. A young, city dwelling, lower middle class population participates in the Program, with almost 10000 visits a year. The Program offers an experience that includes supervised patient care, an average of 100 office visits a month, and seminars and/or workshops covering topics of "Diagnosis and Treatment", "Case Presentations", "Clinical Epidemiology", "Prevention", and "Doctor-Patient Interview". In the area of Diagnosis and Treatment, the criteria used were: 1-frequency of diagnosis as determined by previous investigations, 2-relevant clinical conditions absent from the frequency list as determined by a consensus process by faculty members.(ABSTRACT TRUNCATED AT 250 WORDS)

Shadowing emergency medicine residents by medical education specialists to provide feedback on non-medical knowledge-based ACGME sub-competencies.

Science.gov (United States)

Waterbrook, Anna L; Spear Ellinwood, Karen C; Pritchard, T Gail; Bertels, Karen; Johnson, Ariel C; Min, Alice; Stoneking, Lisa R

2018-01-01

Non-medical knowledge-based sub-competencies (multitasking, professionalism, accountability, patient-centered communication, and team management) are challenging for a supervising emergency medicine (EM) physician to evaluate in real-time on shift while also managing a busy emergency department (ED). This study examines residents' perceptions of having a medical education specialist shadow and evaluate their nonmedical knowledge skills. Medical education specialists shadowed postgraduate year 1 and postgraduate year 2 EM residents during an ED shift once per academic year. In an attempt to increase meaningful feedback to the residents, these specialists evaluated resident performance in selected non-medical knowledge-based Accreditation Council of Graduate Medical Education (ACGME) sub-competencies and provided residents with direct, real-time feedback, followed by a written evaluation sent via email. Evaluations provided specific references to examples of behaviors observed during the shift and connected these back to ACGME competencies and milestones. Twelve residents participated in this shadow experience (six post graduate year 1 and six postgraduate year 2). Two residents emailed the medical education specialists ahead of the scheduled shadow shift requesting specific feedback. When queried, five residents voluntarily requested their feedback to be included in their formal biannual review. Residents received milestone scores and narrative feedback on the non-medical knowledge-based ACGME sub-competencies and indicated the shadow experience and subsequent feedback were valuable. Medical education specialists who observe residents over the course of an entire shift and evaluate non-medical knowledge-based skills are perceived by EM residents to provide meaningful feedback and add valuable information for the biannual review process.

Exploring the Educational Value of Clinical Vignettes from the Society of General Internal Medicine National Meeting in the Internal Medicine Clerkship

Science.gov (United States)

Wofford, James L; Singh, Sonal

2006-01-01

INTRODUCTION Whether the clinical vignettes presented at the Society of General Internal Medicine (SGIM) annual meeting could be of educational value to third year students in the Internal Medicine clerkship has not been studied. OBJECTIVE To explore the relevance and learning value of clinical vignettes from the SGIM national meeting in the Internal Medicine clerkship. SETTING Third year Ambulatory Internal Medicine clerkship at one academic medical center (academic year 2005 to 2006). METHODS Students were introduced to the clinical vignette and oriented to the database of clinical vignettes available through the SGIM annual meeting website. Students then reviewed 5 to 10 clinical vignettes using a worksheet, and rated the learning value of each vignette using a 5-point Likert scale (1 = least, 5 = greatest). A single investigator evaluated congruence of the vignette with the Clerkship Directors of Internal Medicine (CDIM)-SGIM curriculum to assess relevance. MAIN RESULTS A total of 42 students evaluated 371 clinical vignettes from the 2004 and 2005 meetings. The clinical vignettes were curriculum-congruent in 42.6% (n = 175), and clearly incongruent in 40.4% (n = 164). The mean rating for learning value was 3.8 (±1.0) (5 signifying greatest learning value). Curriculum-congruent vignettes had a higher mean learning value compared with curriculum-incongruent vignettes (4.0 vs 3.6, Student's t-test, P =.017). CONCLUSION The clinical vignettes presented at the national SGIM meeting offer clinical content that is relevant and of some educational value for third year clerkship students. Based on this pilot study, the educational value and strategies for their use in the clinical clerkships deserve further study. PMID:17026730

Factors influencing career decisions in internal medicine.

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Macdonald, C; Cawood, T

2012-08-01

Numerous factors influence career decisions for internal medicine trainees and Fellows. There is a perception that a greater emphasis is placed on work-family balance by younger physicians. To determine the characteristics of the modern internal medicine workforce and ascertain whether job flexibility is important to career decision-making. We hypothesised that factors which reflect flexibility would be highly influential in decision-making, especially for women and those with young children. A questionnaire was mailed to 250 New Zealand internal medicine trainees and Fellows. It focused on factors, including job flexibility, interest and collegial support, and included demographic details which were primarily aimed at ascertaining family responsibilities. Response rate was 54%. The majority of female physicians are the main person responsible for their children (62%), and the majority of their partners work full-time (80%). This contrasts with male physicians, of whom only 4% are the main person responsible for their children. Flexibility was found to be more influential in women, those with young children, trainees and those working in outpatient-based subspecialties. However, contrary to our original hypothesis, flexibility was not reported to be highly influential in any group, with career choice being most influenced by interest and enjoyment, intellectual challenge and variety within the job. It is hoped that results will inform employers and those involved with training to enable them to better cater for the needs of the workforce and also encourage trainees to consider future family commitments when making career decisions. © 2012 The Authors. Internal Medicine Journal © 2012 Royal Australasian College of Physicians.

Diagnostic accuracy of general physician versus emergency medicine specialist in interpretation of chest X-ray suspected for iatrogenic pneumothorax: a brief report

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Ghane Mohammad-reza

2012-03-01

Conclusion: These findings indicate that the diagnostic accuracy of emergency medicine specialists is significantly higher than those of general physicians. The diagnostic accuracy of both physician groups was higher than the values in similar studies that signifies the role of relevant training given in the emergency departments of the Hospital.

Concurrent Validity Between a Shared Curriculum, the Internal Medicine In-Training Examination, and the American Board of Internal Medicine Certifying Examination.

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Sisson, Stephen D; Bertram, Amanda; Yeh, Hsin-Chieh

2015-03-01

A core objective of residency education is to facilitate learning, and programs need more curricula and assessment tools with demonstrated validity evidence. We sought to demonstrate concurrent validity between performance on a widely shared, ambulatory curriculum (the Johns Hopkins Internal Medicine Curriculum), the Internal Medicine In-Training Examination (IM-ITE), and the American Board of Internal Medicine Certifying Examination (ABIM-CE). A cohort study of 443 postgraduate year (PGY)-3 residents at 22 academic and community hospital internal medicine residency programs using the curriculum through the Johns Hopkins Internet Learning Center (ILC). Total and percentile rank scores on ILC didactic modules were compared with total and percentile rank scores on the IM-ITE and total scores on the ABIM-CE. The average score on didactic modules was 80.1%; the percentile rank was 53.8. The average IM-ITE score was 64.1% with a percentile rank of 54.8. The average score on the ABIM-CE was 464. Scores on the didactic modules, IM-ITE, and ABIM-CE correlated with each other (P ITE total and percentile rank scores (P ITE percentile rank. Performance on a widely shared ambulatory curriculum is associated with performance on the IM-ITE and the ABIM-CE.

Academic general internal medicine: a mission for the future.

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Armstrong, Katrina; Keating, Nancy L; Landry, Michael; Crotty, Bradley H; Phillips, Russell S; Selker, Harry P

2013-06-01

After five decades of growth that has included advances in medical education and health care delivery, value cohesion, and integration of diversity, we propose an overarching mission for academic general internal medicine to lead excellence, change, and innovation in clinical care, education, and research. General internal medicine aims to achieve health care delivery that is comprehensive, technologically advanced and individualized; instills trust within a culture of respect; is efficient in the use of time, people, and resources; is organized and financed to achieve optimal health outcomes; maximizes equity; and continually learns and adapts. This mission of health care transformation has implications for the clinical, educational, and research activities of divisions of general internal medicine over the next several decades.

Polish Code of Ethics of a Medical Laboratory Specialist.

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Elżbieta, Puacz; Waldemar, Glusiec; Barbara, Madej-Czerwonka

2014-09-01

Along with the development of medicine, increasingly significant role has been played by the laboratory diagnostics. For over ten years the profession of the medical laboratory specialist has been regarded in Poland as the autonomous medical profession and has enjoyed a status of one of public trust. The process of education of medical laboratory specialists consists of a five-year degree in laboratory medicine, offered at Medical Universities, and of a five-year Vocational Specialization in one of the fields of laboratory medicine such as clinical biochemistry, medical microbiology, medical laboratory toxicology, medical laboratory cytomorphology and medical laboratory transfusiology. An important component of medical laboratory specialists' identity is awareness of inherited ethos obtained from bygone generations of workers in this particular profession and the need to continue its further development. An expression of this awareness is among others Polish Code of Ethics of a Medical Laboratory Specialist (CEMLS) containing a set of values and a moral standpoint characteristic of this type of professional environment. Presenting the ethos of the medical laboratory specialist is a purpose of this article. Authors focus on the role CEMLS plays in areas of professional ethics and law. Next, they reconstruct the Polish model of ethos of medical diagnostic laboratory personnel. An overall picture consists of a presentation of the general moral principles concerning execution of this profession and rules of conduct in relations with the patient, own professional environment and the rest of the society. Polish model of ethical conduct, which is rooted in Hippocratic medical tradition, harmonizes with the ethos of medical laboratory specialists of other European countries and the world.

Hospitalist workload influences faculty evaluations by internal medicine clerkship students

OpenAIRE

Robinson, Robert

2015-01-01

Robert L Robinson Department of Internal Medicine, Southern Illinois University School of Medicine, Springfield, Illinois, USA Background: The last decade has brought significant changes to internal medicine clerkships through resident work-hour restrictions and the widespread adoption of hospitalists as medical educators. These key medical educators face competing demands for quality teaching and clinical service intensity. Objective: The study reported here was conducted to explore the rel...

A Learning-Curve Approach to the Self-Assessment of Internal Medicine Training.

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Day, Susan C.; And Others

1984-01-01

In response to the perceived need for primary care physicians, two major changes in internal medicine training have occurred: (1) a third year of general training was required for internal medicine board certification and (2) many hospitals developed primary care internal medicine residencies with an increased emphasis on ambulatory training.…

International Telemedicine/Disaster Medicine Conference: Papers and Presentations

Science.gov (United States)

1991-01-01

The first International Telemedicine/Disaster Medicine Conference was held in Dec. 1991. The overall purpose was to convene an international, multidisciplinary gathering of experts to discuss the emerging field of telemedicine and assess its future directions; principally the application of space technology to disaster response and management, but also to clinical medicine, remote health care, public health, and other needs. This collection is intended to acquaint the reader with recent landmark efforts in telemedicine as applied to disaster management and remote health care, the technical requirements of telemedicine systems, the application of telemedicine and telehealth in the U.S. space program, and the social and humanitarian dimensions of this area of medicine.

Recent trends in internal medicine education: a brief update.

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Flannery, Michael T

2014-03-01

This perspective attempts to bring graduate medical offices, residency programs and medical students interested in categorical internal medicine (CIM) a brief update on the American Board of Internal Medicine (ABIM), Accreditation Council for Graduate Medical Education (ACGME) and the National Registry for Medical Programs (NRMP) changes for the past 3-5 years in the United States (US). The US model for certification and recertification may serve as a homogenous example for other countries. This model will be described so that there is an understanding of the importance of such changes in the American system and its effect on resident education. This is critical knowledge for both teachers and learners in internal medicine in preparation for a lifetime career and requirements for certification/credentialing for both programs and their residents/fellows. Data from the review indicate a small increase in the number of applicants but a concordant decrease in ABIM initial certification exams. Programs should well be aware of the new focus on outcomes via the Next Accreditation System (NAS) being put forth by the ACGME. Copyright © 2014 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Hospitalist workload influences faculty evaluations by internal medicine clerkship students

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Robinson RL

2015-02-01

Full Text Available Robert L Robinson Department of Internal Medicine, Southern Illinois University School of Medicine, Springfield, Illinois, USA Background: The last decade has brought significant changes to internal medicine clerkships through resident work-hour restrictions and the widespread adoption of hospitalists as medical educators. These key medical educators face competing demands for quality teaching and clinical service intensity. Objective: The study reported here was conducted to explore the relationship between clinical service intensity and teaching evaluations of hospitalists by internal medicine clerkship students. Design: A retrospective correlation analysis of clinical service intensity and teaching evaluations of hospitalists by internal medicine clerkship students during the 2009 to 2013 academic years at Southern Illinois University School of Medicine was conducted. Participants: Internal medicine hospitalists who supervise the third-year inpatient experience for medical students during the 2009 to 2013 academic years participated in the study. Measures: Clinical service intensity data in terms of work relative value units (RVUs, patient encounters, and days of inpatient duty were collected for all members of the hospitalist service. Medical students rated hospitalists in the areas of patient rapport, enthusiasm about the profession, clinical skills, sharing knowledge and skills, encouraging the students, probing student knowledge, stimulating independent learning, providing timely feedback, providing constructive criticism, and observing patient encounters with students. Results: Significant negative correlations between higher work RVU production, total patient encounters, duty days, and learner evaluation scores for enthusiasm about the profession, clinical skills, probing the student for knowledge and judgment, and observing a patient encounter with the student were identified. Higher duty days had a significant negative correlation

Evaluation of a Substance Use Disorder Curriculum for Internal Medicine Residents

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Stein, Melissa R.; Arnsten, Julia H.; Parish, Sharon J.; Kunins, Hillary V.

2011-01-01

Teaching about diagnosis, treatment, and sequelae of substance use disorders (SUDs) is insufficient in most Internal Medicine residency programs. To address this, the authors developed, implemented, and evaluated a novel and comprehensive SUD curriculum for first year residents (interns) in Internal Medicine, which anchors the ensuing 3-year…

Update in Outpatient General Internal Medicine: Practice-Changing Evidence Published in 2017.

Science.gov (United States)

Wieland, Mark L; Szostek, Jason H; Wingo, Majken T; Post, Jason A; Mauck, Karen F

2018-02-26

Clinicians are challenged to identify new practice-changing articles in the medical literature. To identify the practice-changing articles published in 2017 most relevant to outpatient general internal medicine, 5 internists reviewed the following sources: 1) titles and abstracts from internal medicine journals with the 7 highest impact factors, including New England Journal of Medicine, Lancet, Journal of the American Medical Association, British Medical Journal, Public Library of Science Medicine, Annals of Internal Medicine, and JAMA Internal Medicine; 2) synopses and syntheses of individual studies, including collections in the American College of Physicians Journal Club, Journal Watch, and Evidence-Based Medicine; 3) databases of synthesis, including Evidence Updates and the Cochrane Library. Inclusion criteria were perceived clinical relevance to outpatient general medicine, potential for practice change, and strength of evidence. This process yielded 140 articles. Clusters of important articles around one topic were considered as a single-candidate series. A modified Delphi method was utilized by the 5 authors to reach consensus on 7 topics to highlight and appraise from the 2017 literature. Copyright © 2018 Elsevier Inc. All rights reserved.

Six decades of the chair of Internal Medicine at the Medical Faculty in Skopje.

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Chakalaroski, K

2013-01-01

The chair of internal medicine in Republic of Macedonia was created in 1947. The Department of Internal Medicine (CIM) is the most numerous at Skopje's medical faculty (currently 56 members). According to the archive material from the first session of the Scientific Teaching Council of the Faculty of Medicine (17.03.1947), Mr Mario Krmpotic (Professor of Internal Medicine) was proposed as the first Director of the Internal Clinic (1947). For reasons unknown, Mr Krmpotic never came to Skopje to accept the post. As a consequence of this fact, the real founder of the CIM was the Russian Professor Alexandar Ignjatovski (1875-1955). Mr Ignjatovski was elected as the first Director of the Clinic for Internal Medicine in 1948 for a period of 4 years (1948-1952). At the same time, he was the first Chief of the CIM in Skopje (Macedonia). Dr D. Arsov was elected as the first Assistant Professor of Medicine in 1947, and second (and last) Director of the Clinic for Internal Medicine (1952-1974). For the same period (22 years) he was Head of the CIM. Dr D. Arsov sequentially and successively became first associated and then ordinary professor of medicine in the years 1951 and 1958. The regular activities of the CIM are as follows: 1) Undergraduate education for students (Clinical Investigation, Internal Medicine, Clinical Pharmacy) in general medicine, dentistry, geriatrics, urgent and family medicine (ECKTS); Undergraduate educationfor nurses, speech therapists, physiotherapists, radiologists (high /three year/ nurses School, ECKTS); 2) Postgraduate education (candidates for specialisation in internal medicine, infectology, anaesthesiology, neurology and surgery; 3) Continual medical education (a traditional morning scientific meeting on Thursdays, 08 h; weekly meetings of all internal medicine subspecialists); Scientific meetings, symposiums, congresses of former internal medicine associations (cardiology, pulmoallergology, gastroenterology, nephrology, haematology

Factors influencing selection of internal medicine residency--a prospective study.

Science.gov (United States)

Pereg, David; Gronich, Naomi; Lishner, Michael

2006-08-01

Recently, the popularity of internal medicine residency has been decreasing. We studied the effect of an improved working environment and a decrease in residents' workload on the selection of internal medicine residency. An organizational diagnosis team joined our department and identified several causes for residents' heavy workload. These findings were subsequently discussed in a workshop and led to a modification of the daily routine and a parallel decrease in workload and rise in residents' satisfaction. Following these changes, the demand for residency in our department rose. We conclude that an improvement in the working environment and workload during residency increases the residents' satisfaction and the demand for residency in internal medicine.

Incidence of refeeding syndrome in internal medicine patients.

Science.gov (United States)

Kraaijenbrink, B V C; Lambers, W M; Mathus-Vliegen, E M H; Siegert, C E H

2016-03-01

Refeeding syndrome is a potentially fatal shift of fluids and electrolytes that may occur after reintroducing nutrition in a malnourished patient. Its incidence in internal medicine patients is not known. We aimed at determining the incidence in a heterogeneous group of patients acutely admitted to a department of internal medicine. All patients acutely admitted to the department of internal medicine of a teaching community hospital in Amsterdam, the Netherlands, between 22 February 2011 and 29 April 2011, were included. We applied the National Institute for Health and Care Excellence (NICE) criteria for determining people at risk of refeeding syndrome and took hypophosphataemia as the main indicator for the presence of this syndrome. Of 178 patients included in the study, 97 (54%) were considered to be at risk of developing refeeding syndrome and 14 patients actually developed the syndrome (14% of patients at risk and 8% of study population). Patients with a malignancy or previous malignancy were at increased risk of developing refeeding syndrome (p refeeding syndrome. The Short Nutritional Assessment Questionnaire score had a positive and negative predictive value of 13% and 95% respectively. The incidence of refeeding syndrome was relatively high in patients acutely admitted to the department of internal medicine. Oncology patients are at increased risk of developing refeeding syndrome. When taking the occurrence of hypophosphataemia as a hallmark, no other single clinical or composite parameter could be identified that accurately predicts the development of refeeding syndrome.

Rural specialists: The nature of their work and professional satisfaction by geographical location of work.

Science.gov (United States)

O'Sullivan, Belinda; McGrail, Matthew; Russell, Deborah

2017-12-01

Systematically describe the characteristics of rural specialists, their work and job satisfaction by geographical location of work. Cross-sectional. Three thousand, four hundred and seventy-nine medical specialists participating in the 2014 Medicine in Australia: Balancing Employment and Life (MABEL) survey of doctors. Location of practice, whether metropolitan, large (>50 000 population) or small regional centres (Rural specialists had more on-call requirements and poorer professional development opportunities. However, satisfaction with work hours, remuneration, variety of work, level of responsibility, opportunities to use abilities and overall satisfaction did not differ. Specialists in general medicine and general surgery were significantly more likely to work rurally compared with anaesthetists, particularly in small regional centres, whereas a range of other relevant specialists had lower than the average rural distribution and paediatricians and endocrinologists were significantly less likely to work in large regional centres. Rural specialists are just as satisfied as metropolitan counterparts reporting equivalent variety and responsibility at work. Better support for on-call demands and access to professional development could attract more specialists to rural practice. Increased rural training opportunities and regional workforce planning is needed to develop and recruit relevant specialties. Specifically, targeted support is warranted for training and development of specialists in general medicine and general surgery and overseas-trained specialists, who provide essential services in smaller regional centres. © 2017 National Rural Health Alliance Inc.

A Delphi developed syllabus for the medical specialty of sport and exercise medicine.

Science.gov (United States)

Humphries, David; Jaques, Rod; Dijkstra, Hendrik Paulus

2018-04-01

Training in the medical specialty of sport and exercise medicine is now available in many, but not all countries. Lack of resources may be a barrier to the development of this important specialty field and the International Syllabus in Sport and Exercise Medicine Group was convened to reduce one potential barrier, the need to develop a syllabus. The group is composed of 17 sport and exercise medicine specialists residing in 12 countries (Australia, Canada, India, Ireland, Malaysia, the Netherlands, Qatar, South Africa, Sweden, Switzerland, the UK and USA). This paper presents the first phase of this project covering the domains and general learning areas of a specialist training syllabus in sport and exercise medicine. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Principles to Consider in Defining New Directions in Internal Medicine Training and Certification

Science.gov (United States)

Turner, Barbara J; Centor, Robert M; Rosenthal, Gary E

2006-01-01

SGIM endoreses seven principles related to current thinking about internal medicine training: 1) internal medicine requires a full three years of residency training before subspecialization; 2) internal medicine residency programs must dramatically increase support for training in the ambulatory setting and offer equivalent opportunities for training in both inpatient and outpatient medicine; 3) in settings where adequate support and time are devoted to ambulatory training, the third year of residency could offer an opportunity to develop further expertise or mastery in a specific type or setting of care; 4) further certification in specific specialties within internal medicine requires the completion of an approved fellowship program; 5) areas of mastery in internal medicine can be demonstrated through modified board certification and recertification examinations; 6) certification processes throughout internal medicine should focus increasingly on demonstration of clinical competence through adherence to validated standards of care within and across practice settings; and 7) regardless of the setting in which General Internists practice, we should unite to promote the critical role that this specialty serves in patient care. PMID:16637826

Current models of care for disorders of sex development – results from an International survey of specialist centres

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Andreas Kyriakou

2016-11-01

Full Text Available Abstract Background To explore the current models of practice in centres delivering specialist care for children with disorders of sex development (DSD, an international survey of 124 clinicians, identified through DSDnet and the I-DSD Registry, was performed in the last quarter of 2014. Results A total of 78 (63 % clinicians, in 75 centres, from 38 countries responded to the survey. A formal national network for managing DSD was reported to exist in 12 (32 % countries. The paediatric specialists routinely involved in the initial evaluation of a newborn included: endocrinologist (99 %, surgeon/urologist (95 %, radiologist (93 %, neonatologist (91 %, clinical geneticist (81 % and clinical psychologist (69 %. A team consisting of paediatric specialists in endocrinology, surgery/urology, clinical psychology, and nursing was only possible in 31 (41 % centres. Of the 75 centres, 26 (35 % kept only a local DSD registry and 40 (53 % shared their data in a multicentre DSD registry. Attendance in local, national and international DSD-related educational programs was reported by 69, 78 and 84 % clinicians, respectively. Participation in audits/quality improvement exercises in DSD care was reported by 14 (19 % centres. In addition to complex biochemistry and molecular genetic investigations, 40 clinicians (51 % also had access to next generation sequencing. A genetic test was reported to be more preferable than biochemical tests for diagnosing 5-alpha reductase deficiency and 17-beta hydroxysteroid dehydrogenase 3 deficiency by 50 and 55 % clinicians, respectively. Conclusion DSD centres report a high level of interaction at an international level, have access to specialist staff and are increasingly relying on molecular genetics for routine diagnostics. The quality of care provided by these centres locally requires further exploration.

IT Security Specialist | IDRC - International Development Research ...

International Development Research Centre (IDRC) Digital Library (Canada)

The IT Security Specialist takes a strategic role in the delivery of Infrastructure ... on IT Security to project managers, business clients and senior management. ... as a team member or a team leader by undertaking research, investigations, ...

Internal Contamination by 131I in nuclear medicine department

International Nuclear Information System (INIS)

Chahed, N.; Mtimet, S.; Hammami, H.; Mhiri, A.

1998-01-01

Therapeutic applications in nuclear medicine use high activities of 131 I in sodium iodine liquid from which is volatile at ambient temperature. Besides external exposure there is, for the nuclear medicine personnel, an internal exposure risk induced by 131 iodine inhalation. So we tried to assess this risk among the personnel in a nuclear medicine department. We used direct method for measuring 131 radioactivity in vivo by external counting. Gamma ray detector with a Nal ( TI ) probe positioned near the thyroid gland allows investigation of 131 radioactivity. We realised 34 measurements among the personnel, two times at an interval of one month. The results indicate that an 131 iodine internal contamination is found. Estimated thyroid activities were ranging from 35 to 132 Bq. The highest activities has been found in the thyroid of the technicians involved in the administration of 131 iodine therapy. Therefore this values are lower than norms. This study must lead to the implementation control of the 131 iodine internal contamination in order to optimise the personnel protection in nuclear medicine departments (author)

MEĐUNARODNA AKTIVNOST ASOCIJACIJE SPORTSKE MEDICINE SRBIJE I CRNE GORE I 10. KONGRES EVROPSKOG KOLEDŽA SPORTSKIH NAUKA

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Dikić N.

2005-05-01

Full Text Available One of the first medicine associations in history of medicine, Association International Medico-Sportive, has founded by 50 sports medicine doctors from 11 countries during Winter Olympic Games in Sent Moritz at February 1928, which changed the name to FIMS (Fedration Internationale de Medicine du sport. Today FIMS has more then 100.000 sports physicians in more then 130 national member associations. In the same time sports medicine is bumming in Europe, 16 European countries have specialization of sports medicine and 11 of them have subspecialization. Many European countries have hundreds of sports medicine specialists, like Italy who has 2000. There is more then 120 specialist of sports medicine in our country, which is respectable number in world statistics. After many years SMASM is again member of FIMS, EFSMA and ECSS. Representatives of SMASM are licensed for Team Physician Instructors, Doping Control Officers, Providers of BLS, ALS and AED. Due to SMASM activity copyright for Team Physician Manual is awarded. Crown of International activity is hosting of 10th ECSS Congress. The previous nine congresses has organized in Nice 1996 (450 participants, Copenhagen (700, Manchester (744, Rome (1000, Jyvaskyla – Finland (950, Cologne (1500, Athens (1200, Salzburg (1600 and Clermont Ferrand (1600. It is expected between 1500-2000 participants from 70 countries in Belgrade. International activity of SMASM has return Serbia and Montenegro on sports map of the world just in three years.

[Attitudes of Polish occupational medicine physicians towards a proposal of requirements for occupational medicine training in Europe].

Science.gov (United States)

Indulski, J A; Boczkowski, A; Mikulski, M

1998-01-01

In order to determine key competences required of occupational medicine specialists, common throughout Europe, a questionnaire has been developed and distributed among several European countries. The questionnaire contained 115 subjects related to 8 fields of activities carried out by occupational medicine physicians (occupational hazards to health, assessment of disability and fitness for work, communications, research methods, management, environmental medicine, occupational health law and ethics, and health promotion). In each of these fields, competences were classified into three following categories: knowledge, experience and skills. Respondents were asked to allocate a score from 0 to 5 for each subject, where 0 = not necessary; 1 = of minimum importance, and 5 = most important or essential. In Poland the questionnaire was distributed among two groups of specialists: group I--experienced specialists in occupational medicine (leading representatives of occupational health care management), and group II--relatively younger and less experienced occupational medicine physicians, participating in the specialist training, organised by The Nofer Institute of Occupational Medicine. A comprehensive analysis of the completed questionnaires was carried out in two dimensions: substantive (the importance of individual competences as perceived by Polish specialists in occupational medicine), and comparative (evaluation and interpretation of similarities and differences between two groups of respondents). A hierarchy of requirements, occupational medicine training in Poland is to satisfy, was reconstructed with two sets of competences, one recognised by respondents as needless and the other recognised as useful with different grades of importance. Some characteristic differences in opinions between two groups studies were highlighted.

Necessity of Internal Monitoring for Nuclear Medicine Staff in a Large Specialized Chinese Hospital.

Science.gov (United States)

Wang, Hong-Bo; Zhang, Qing-Zhao; Zhang, Zhen; Hou, Chang-Song; Li, Wen-Liang; Yang, Hui; Sun, Quan-Fu

2016-04-12

This work intends to quantify the risk of internal contaminations in the nuclear medicine staff of one hospital in Henan province, China. For this purpose, the criteria proposed by the International Atomic Energy Agency (IAEA) to determine whether it is necessary to conduct internal individual monitoring was applied to all of the 18 nuclear medicine staff members who handled radionuclides. The activity of different radionuclides used during a whole calendar year and the protection measures adopted were collected for each staff member, and the decision as to whether nuclear medicine staff in the hospital should be subjected to internal monitoring was made on the basis of the criteria proposed by IAEA. It is concluded that for all 18 members of the nuclear medicine staff in the hospital, internal monitoring is required. Internal exposure received by nuclear medicine staff should not be ignored, and it is necessary to implement internal monitoring for nuclear medicine staff routinely.

Politics and Graduate Medical Education in Internal Medicine: A Dynamic Landscape.

Science.gov (United States)

Wardrop, Richard M; Berkowitz, Lee R

2017-02-01

The promotion of change and growth within medical education is oftentimes the result of a complex mix of societal, cultural and economic forces. Graduate medical education in internal medicine is not immune to these forces. Several entities and organizations can be identified as having a major influence on internal medicine training and graduate medical education as a whole. We have reviewed how this is effectively accomplished through these entities and organizations. The result is a constantly changing and dynamic landscape for internal medicine training. Copyright © 2017 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

International Journal of Medicine and Biomedical Research

African Journals Online (AJOL)

The International Journal of Medicine and Biomedical Research (IJMBR) is a peer-reviewed ... useful to researchers in all aspects of Clinical and Basic Medical Sciences including Anatomical Sciences, Biochemistry, Dentistry, Genetics, ...

Determining and prioritizing competencies in the undergraduate internal medicine curriculum in Saudi Arabia.

Science.gov (United States)

Almoallim, H

2011-08-01

To determine knowledge and skills competencies in internal medicine for the undergraduate curriculum in Saudi Arabia, competencies were identified based on group work utilizing common textbooks. The Delphi Technique was used as a consensus method to determine and prioritize competencies in internal medicine. A group of 20 clinicians rated the identified competencies from 0-3 (0: no need to know, 1: interesting to know, 2: should know and 3: must know). After formulating the results, a second Delphi round was conducted with 5 experts in internal medicine. A total of 1513 knowledge competencies and 189 skills competencies were determined and prioritized. The competencies corresponded to the 12 systems in internal medicine. All competencies rated 2.2-3.0 were produced separately and considered core competencies for the undergraduate internal medicine curriculum. Determining and prioritizing competencies should influence the curriculum reform process.

Update in Outpatient General Internal Medicine: Practice-Changing Evidence Published in 2015.

Science.gov (United States)

Szostek, Jason H; Wieland, Mark L; Post, Jason A; Sundsted, Karna K; Mauck, Karen F

2016-08-01

Identifying new practice-changing articles is challenging. To determine the 2015 practice-changing articles most relevant to outpatient general internal medicine, 3 internists independently reviewed the titles and abstracts of original articles, synopses of single studies and syntheses, and databases of syntheses. For original articles, internal medicine journals with the 7 highest impact factors were reviewed: New England Journal of Medicine, Lancet, Journal of the American Medical Association (JAMA), British Medical Journal, Public Library of Science Medicine, Annals of Internal Medicine, and JAMA Internal Medicine. For synopses of single studies and syntheses, collections in American College of Physicians Journal Club, Journal Watch, and Evidence-Based Medicine were reviewed. For databases of synthesis, Evidence Updates and the Cochrane Library were reviewed. More than 100 articles were identified. Criteria for inclusion were as follows: clinical relevance, potential for practice change, and strength of evidence. Clusters of important articles around one topic were considered as a single-candidate series. The 5 authors used a modified Delphi method to reach consensus on inclusion of 7 topics for in-depth appraisal. Copyright © 2016 Elsevier Inc. All rights reserved.

Study of nuclear medicine practices in Portugal from an internal dosimetry perspective

International Nuclear Information System (INIS)

Bento, J.; Teles, P.; Neves, M.; Santos, A. I.; Cardoso, G.; Barreto, A.; Alves, F.; Guerreiro, C.; Rodrigues, A.; Santos, J. A. M.; Capelo, C.; Parafita, R.; Martins, B.

2012-01-01

Nuclear medicine practices involve the handling of a wide range of pharmaceuticals labelled with different radionuclides, for diagnostic and therapeutic purposes. This work intends to evaluate the potential risks of internal contamination of nuclear medicine staff in several Portuguese nuclear medicine services and to conclude about the requirement of a routine internal monitoring. A methodology proposed by the International Atomic Energy Agency (IAEA), providing a set of criteria to determine the need, or not, for an internal monitoring programme, was applied. The evaluation of the risk of internal contaminations in a given set of working conditions is based on the type and amount of radionuclides being handled, as well as the safety conditions with which they are manipulated. The application of the IAEA criteria showed that 73.1 % of all the workers included in this study should be integrated in a routine monitoring programme for internal contaminations; more specifically, 100 % of workers performing radioimmunoassay techniques should be monitored. This study suggests that a routine monitoring programme for internal exposures should be implemented in Portugal for most nuclear medicine workers. (authors)

Associations between subspecialty fellowship interest and knowledge of internal medicine: A hypothesis-generating study of internal medicine residents

Science.gov (United States)

2011-01-01

Background Little is known about whether and how medical knowledge relates to interest in subspecialty fellowship training. The purpose of this study was to examine the relationships between residents' interest in subspecialty fellowship training and their knowledge of internal medicine (IM). Methods A questionnaire was emailed to 48 categorical postgraduate-year (PGY) two and three residents at a New York university-affiliated IM residency program in 2007 using the Survey Monkey online survey instrument. Overall and content area-specific percentile scores from the IM in-training examination (IM-ITE) for the same year was used to determine objective knowledge. Results Forty-five of 48 residents (response rate was 93.8%) completed the survey. Twenty-two (49%) were PG2 residents and 23(51%) were PGY3 residents. Sixty percent of respondents were male. Six (13%) residents were graduates of U.S. medical schools. Eight (18%) reported formal clinical training prior to starting internal medicine residency in the U.S. Of this latter group, 6 (75%) had training in IM and 6 (75) % reported a training length of 3 years or less. Thirty-seven of 45 (82%) residents had a subspecialty fellowship interest. Residents with a fellowship interest had a greater mean overall objective knowledge percentile score (56.44 vs. 31.67; p = 0.04) as well as greater mean percentile scores in all content areas of IM. The adjusted mean difference was statistically significant (p internal medicine residents. PMID:21281500

Correlations Between Ratings on the Resident Annual Evaluation Summary and the Internal Medicine Milestones and Association With ABIM Certification Examination Scores Among US Internal Medicine Residents, 2013-2014.

Science.gov (United States)

Hauer, Karen E; Vandergrift, Jonathan; Hess, Brian; Lipner, Rebecca S; Holmboe, Eric S; Hood, Sarah; Iobst, William; Hamstra, Stanley J; McDonald, Furman S

2016-12-06

US internal medicine residency programs are now required to rate residents using milestones. Evidence of validity of milestone ratings is needed. To compare ratings of internal medicine residents using the pre-2015 resident annual evaluation summary (RAES), a nondevelopmental rating scale, with developmental milestone ratings. Cross-sectional study of US internal medicine residency programs in the 2013-2014 academic year, including 21 284 internal medicine residents (7048 postgraduate-year 1 [PGY-1], 7233 PGY-2, and 7003 PGY-3). Program director ratings on the RAES and milestone ratings. Correlations of RAES and milestone ratings by training year; correlations of medical knowledge ratings with American Board of Internal Medicine (ABIM) certification examination scores; rating of unprofessional behavior using the 2 systems. Corresponding RAES ratings and milestone ratings showed progressively higher correlations across training years, ranging among competencies from 0.31 (95% CI, 0.29 to 0.33) to 0.35 (95% CI, 0.33 to 0.37) for PGY-1 residents to 0.43 (95% CI, 0.41 to 0.45) to 0.52 (95% CI, 0.50 to 0.54) for PGY-3 residents (all P values internal medicine residents in the 2013-2014 academic year, milestone-based ratings correlated with RAES ratings but with a greater difference across training years. Both rating systems for medical knowledge correlated with ABIM certification examination scores. Milestone ratings may better detect problems with professionalism. These preliminary findings may inform establishment of the validity of milestone-based assessment.

[A history of internal medicine: medical specialization: as old as antiquity].

Science.gov (United States)

Echenberg, Donald

2007-11-28

This article presents a short review of the history of medical specialization and the evolution of internal medicine within the last two centuries. Medical specialization, far from being a recent phenomenon, existed in the Hellenistic world and in Rome. The development of specialization during the latter part of the 19th century and early 20th century is credited to the rapid expansion of medical knowledge which made it impossible for a single doctor to encompass all the different spheres of the profession. The term innere medizin or internal medicine was adopted from German terminology in the 1880's. The Canadian society of internal medicine was formed in 1983 and its main goal is to promote a broad perspective of medical care and to master the complexity in medicine through a generalist approach.

Hospitalist workload influences faculty evaluations by internal medicine clerkship students.

Science.gov (United States)

Robinson, Robert L

2015-01-01

The last decade has brought significant changes to internal medicine clerkships through resident work-hour restrictions and the widespread adoption of hospitalists as medical educators. These key medical educators face competing demands for quality teaching and clinical service intensity. The study reported here was conducted to explore the relationship between clinical service intensity and teaching evaluations of hospitalists by internal medicine clerkship students. A retrospective correlation analysis of clinical service intensity and teaching evaluations of hospitalists by internal medicine clerkship students during the 2009 to 2013 academic years at Southern Illinois University School of Medicine was conducted. Internal medicine hospitalists who supervise the third-year inpatient experience for medical students during the 2009 to 2013 academic years participated in the study. Clinical service intensity data in terms of work relative value units (RVUs), patient encounters, and days of inpatient duty were collected for all members of the hospitalist service. Medical students rated hospitalists in the areas of patient rapport, enthusiasm about the profession, clinical skills, sharing knowledge and skills, encouraging the students, probing student knowledge, stimulating independent learning, providing timely feedback, providing constructive criticism, and observing patient encounters with students. Significant negative correlations between higher work RVU production, total patient encounters, duty days, and learner evaluation scores for enthusiasm about the profession, clinical skills, probing the student for knowledge and judgment, and observing a patient encounter with the student were identified. Higher duty days had a significant negative correlation with sharing knowledge/skills and encouraging student initiative. Higher work RVUs and total patient encounters were negatively correlated with timely feedback and constructive criticism. The results suggest that

VIIIth international symposium on nuclear medicine

International Nuclear Information System (INIS)

1986-01-01

The conference proceedings contain 92 abstracts of submitted papers dealing with various applications of radioisotopes in diagnosis and therapy. The papers were devoted to scintiscanning, radioimmunoassay, tomography, the applications of nuclear magnetic resonance and electron microscopy in different branches - oncology, cardiology, neurology, histology, gynecology, internal medicine, etc. (M.D.)

The International Classification of Functioning, Disability and Health: a unifying model for the conceptual description of physical and rehabilitation medicine.

Science.gov (United States)

Stucki, Gerold; Melvin, John

2007-05-01

There is a need to develop a contemporary and internationally accepted conceptual description of physical and rehabilitation medicine (PRM). The process of evolving such a definition can now rely on the unifying conceptual model and taxonomy of the International Classification of Functioning, Disability and Health (ICF) and an ICF-based conceptual description of rehabilitation understood as a health strategy. The PRM section of the European Union of Medical Specialists (UEMS) has endorsed the application of the ICF as a unifying conceptual model for PRM and supports the process of moving towards an "ICF-based conceptual description and according definitions of PRM". With this goal in mind, the authors have developed a first tentative conceptual description in co-operation with the professional practice committee of the UEMS-PRM-section. A respective brief definition describes PRM as the medical specialty that, based on the assessment of functioning and including the diagnosis and treatment of health conditions, performs, applies and co-ordinates biomedical and engineering and a wide range of other interventions with the goal of optimizing functioning of people experiencing or likely to experience disability. Readers of the Journal of Rehabilitation Medicine are invited to contribute to the process of achieving an internationally accepted ICF-based conceptual description of PRM by submitting commentaries to the Editor of this journal.

Correlation of United States Medical Licensing Examination and Internal Medicine In-Training Examination Performance

Science.gov (United States)

Perez, Jose A., Jr.; Greer, Sharon

2009-01-01

The Internal Medicine In-Training Examination (ITE) is administered during residency training in the United States as a self-assessment and program assessment tool. Performance on this exam correlates with outcome on the American Board of Internal Medicine Certifying examination. Internal Medicine Program Directors use the United States Medical…

The historical development of academic journals in occupational medicine, 1901-2009.

Science.gov (United States)

Smith, Derek R

2009-01-01

Academic journals in a specialist field provide an interesting historical record of its development and progression over time. This article describes the evolution of some major international journals of occupational medicine, including some historical background on their editorial board. As North America, the United Kingdom, and Northern Europe are known to have the highest contribution to scientific production, it was considered appropriate to investigate the main occupational medicine periodicals in these regions. Given the remarkable improvements in Japanese occupational health following the Second World War, it was also considered worthwhile to investigate the two English-language journals of occupational medicine from this country.

International congress on aromatic and medicinal plants

International Nuclear Information System (INIS)

2009-01-01

Full Text : In Morocco, medicinal and aromatic plants occupy an important place in the traditional care system of a large number of local people. They are also economically strong potential, but unfortunately they are not valued enough. Indeed, Morocco by its privileged geographical position in the Mediterranean basin and its floristic diversity (with a total of over 4,200 species and subspecies of which over 500 are recognized as medicinal and aromatic plants), is a leading provider of traditional global market. In this context and given the back label of the natural global, group research and studies on Aromatic and Medicinal Plants (GREPAM), the Faculty of Semlalia and University Cadi Ayyad, organize: the International Congress on Medicinal and Aromatic Plants CIPAM 2009. The organization of this conference is part of scientific research developed by the GREPAM. [fr

Optimizing the use of intravenous therapy in internal medicine.

Science.gov (United States)

Champion, Karine; Mouly, Stéphane; Lloret-Linares, Celia; Lopes, Amanda; Vicaut, Eric; Bergmann, Jean-François

2013-10-01

We aimed to evaluate the impact of physicians' educational programs in the reduction of inappropriate intravenous lines in internal medicine. Fifty-six French internal medicine units were enrolled in a nationwide, prospective, blinded, randomized controlled trial. Forms describing the patients with an intravenous line and internal medicine department characteristics were filled out on 2 separate days in January and April 2007. Following the first visit, all units were randomly assigned to either a specific education program on the appropriate indications of an intravenous line, during February and March 2007, or no training (control group). The Investigators' Committee then blindly evaluated the clinical relevance of the intravenous line according to pre-established criteria. The primary outcome was the percentage of inappropriate intravenous lines. During January 2007, intravenous lines were used in 475 (24.9%) of the 1910 hospitalized patients. Of these, 80 (16.8%) were considered inappropriate. In April 2007, 416 (22.8%) of the 1823 hospitalized patients received an intravenous line, which was considered in 10.2% (21/205) of patients managed by trained physicians, versus 16.6% (35/211) of patients in the control group (relative difference 39%; 95% confidence interval, -0.6-13.3; P = .05). Reduced intravenous administration of fluids, antibiotics, and analgesics accounted for the observed decrease. The use of a simple education program reduced the rate of inappropriate intravenous lines by almost 40% in an internal medicine setting (NCT01633307). Copyright © 2013 Elsevier Inc. All rights reserved.

Meeting the demand of the future: a curriculum to stimulate interest in careers in primary care internal medicine.

Science.gov (United States)

Hawthorne, Mary R; Dinh, An

2017-01-01

There is a growing need for primary care physicians, but only a small percentage of graduating medical students enter careers in primary care. To assess whether a Primary Care Intraclerkship within the Medicine clerkship can significantly improve students' attitudes by analyzing scores on pre- and post-tests. Students on the Medicine clerkship at the University of Massachusetts Medical School participated in full-day 'intraclerkships',to demonstrate the importance of primary care and the management of chronic illness in various primary care settings. Pre-and post-tests containing students' self-reported, five-point Likert agreement scale evaluations to 26 items (measuring perceptions about the roles of primary care physicians in patient care and treatment) were collected before and after each session. Eleven intraclerkships with 383 students were held between June 2010 and June 2013. Responses were analyzed using the GLM Model Estimate. Results from the survey analysis showed significantly more positive attitudes toward primary care in the post-tests compared to the pre-tests. Students who were satisfied with their primary care physicians were significantly more likely to show an improvement in post-test attitudes toward primary care in the areas of physicians improving the quality of patient care, making a difference in overall patient health, finding primary care as an intellectually challenging field, and in needing to collaborate with specialists. Older students were more likely than younger students to show more favorable answers on questions concerning the relative value of primary care vs. specialty care. A curriculum in Primary Care Internal Medicine can provide a framework to positively influence students' attitudes toward the importance of primary care, and potentially to influence career decisions to enter careers in Primary Care Internal Medicine. Ensuring that medical students receive excellent primary care for themselves can also positively influence

Diagnosis and treatment for ocular tuberculosis among uveitis specialists: the international perspective.

Science.gov (United States)

Lou, Susan M; Montgomery, Paul A; Larkin, Kelly L; Winthrop, Kevin; Zierhut, Manfred; Rosenbaum, James T

2015-02-01

To assess the approach of international specialists, who primarily practice in tuberculosis-endemic areas, to ocular tuberculosis (TB). International experts from India, Brazil, Taiwan, and more than 10 other countries were surveyed using two clinical cases and general questions. A total of 244 experts were sent a survey about the treatment and diagnosis of ocular tuberculosis; 65 responded (27%), of whom 34 were affiliated with practices in India, while 31 primarily practice at international sites outside of India and North America. The data from this survey were compared with the results of a similar survey sent to members of the American Uveitis Society. The survey provided normative data on how physicians evaluate patients with uveitis as well as opinions about ocular TB. Responses varied widely on topics such as tests to include in the workup of undifferentiated uveitis, initial therapy, and duration of treatment. Physicians from developing countries relied more on chest CT scans and tuberculin skin testing (TST) than their counterparts in developed countries. The approach to diagnosis and management of TB is heterogeneous worldwide. However, there are substantial differences in the clinical approach to uveitis depending on the clinician's location of practice.

Relationship between internal medicine program board examination pass rates, accreditation standards, and program size.

Science.gov (United States)

Falcone, John L; Gonzalo, Jed D

2014-01-19

To determine Internal Medicine residency program compliance with the Accreditation Council for Graduate Medical Education 80% pass-rate standard and the correlation between residency program size and performance on the American Board of Internal Medicine Certifying Examination. Using a cross-sectional study design from 2010-2012 American Board of Internal Medicine Certifying Examination data of all Internal Medicine residency pro-grams, comparisons were made between program pass rates to the Accreditation Council for Graduate Medical Education pass-rate standard. To assess the correlation between program size and performance, a Spearman's rho was calculated. To evaluate program size and its relationship to the pass-rate standard, receiver operative characteristic curves were calculated. Of 372 Internal Medicine residency programs, 276 programs (74%) achieved a pass rate of =80%, surpassing the Accreditation Council for Graduate Medical Education minimum standard. A weak correlation was found between residency program size and pass rate for the three-year period (p=0.19, pInternal Medicine residency programs complied with Accreditation Council for Graduate Medical Education pass-rate standards, a quarter of the programs failed to meet this requirement. Program size is positively but weakly associated with American Board of Internal Medicine Certifying Examination performance, suggesting other unidentified variables significantly contribute to program performance.

Internal radiation dosimetry using nuclear medicine imaging in radionuclide therapy

International Nuclear Information System (INIS)

Kim, Kyeong Min; Byun, Byun Hyun; Cheon, Gi Jeong; Lim, Sang Moo

2007-01-01

Radionuclide therapy has been an important field in nuclear medicine. In radionuclide therapy, relevant evaluation of internally absorbed dose is essential for the achievement of efficient and sufficient treatment of incurable disease, and can be accomplished by means of accurate measurement of radioactivity in body and its changes with time. Recently, the advances of nuclear medicine imaging and multi modality imaging processing techniques can provide chance of more accurate and easier measurement of the measures commented above, in cooperation of conventional imaging based approaches. In this review, basic concept for internal dosimetry using nuclear medicine imaging is summarized with several check points which should be considered in real practice

Trend and impact of international collaboration in clinical medicine papers published in Malaysia.

Science.gov (United States)

Low, Wah Yun; Ng, Kwan Hoong; Kabir, M A; Koh, Ai Peng; Sinnasamy, Janaki

2014-01-01

Research collaboration is the way forward in order to improve quality and impact of its research findings. International research collaboration has resulted in international co-authorship in scientific communications and publications. This study highlights the collaborating research and authorship trend in clinical medicine in Malaysia from 2001 to 2010. Malaysian-based author affiliation in the Web of Science (Science Citation Index Expanded) and clinical medicine journals ( n  = 999) and articles ( n  = 3951) as of 30th Oct 2011 were downloaded. Types of document analyzed were articles and reviews, and impact factors (IF) in the 2010 Journal Citation Report Science Edition were taken to access the quality of the articles. The number of publications in clinical medicine increased from 4.5 % ( n  = 178) in 2001 to 23.9 % ( n  = 944) in 2010. The top three contributors in the subject categories are Pharmacology and Pharmacy (13.9 %), General and Internal Medicine (13.6 %) and Tropical Medicine (7.3 %). By journal tier system: Tier 1 (18.7 %, n  = 738), Tier 2 (22.5 %, n  = 888), Tier 3 (29.6 %, n  = 1170), Tier 4 (27.2 %, n  = 1074), and journals without IF (2.1 %, n  = 81). University of Malaya was the most productive. Local collaborators accounted for 60.3 % and international collaborations 39.7 %. Articles with international collaborations appeared in journals with higher journal IFs than those without international collaboration. They were also cited more significantly than articles without international collaborations. Citations, impact factor and journal tiers were significantly associated with international collaboration in Malaysia's clinical medicine publications. Malaysia has achieved a significant number of ISI publications in clinical medicine participation in international collaboration.

Competency-based education and training in internal medicine.

Science.gov (United States)

Weinberger, Steven E; Pereira, Anne G; Iobst, William F; Mechaber, Alex J; Bronze, Michael S

2010-12-07

Recent efforts to improve medical education include adopting a new framework based on 6 broad competencies defined by the Accreditation Council for Graduate Medical Education. In this article, the Alliance for Academic Internal Medicine Education Redesign Task Force II examines the advantages and challenges of a competency-based educational framework for medical residents. Efforts to refine specific competencies by developing detailed milestones are described, and examples of training program initiatives using a competency-based approach are presented. Meeting the challenges of a competency-based framework and supporting these educational innovations require a robust faculty development program. Challenges to competency-based education include teaching and evaluating the competencies related to practice-based learning and improvement and systems-based practice, as well as implementing a flexible time frame to achieve competencies. However, the Alliance for Academic Internal Medicine Education Redesign Task Force II does not favor reducing internal medicine training to less than 36 months as part of competency-based education. Rather, the 36-month time frame should allow for remediation to address deficiencies in achieving competencies and for diverse enrichment experiences in such areas as quality of care and practice improvement for residents who have demonstrated skills in all required competencies.

[Monitoring medication errors in an internal medicine service].

Science.gov (United States)

Smith, Ann-Loren M; Ruiz, Inés A; Jirón, Marcela A

2014-01-01

Patients admitted to internal medicine services receive multiple drugs and thus are at risk of medication errors. To determine the frequency of medication errors (ME) among patients admitted to an internal medicine service of a high complexity hospital. A prospective observational study conducted in 225 patients admitted to an internal medicine service. Each stage of drug utilization system (prescription, transcription, dispensing, preparation and administration) was directly observed by trained pharmacists not related to hospital staff during three months. ME were described and categorized according to the National Coordinating Council for Medication Error Reporting and Prevention. In each stage of medication use, the frequency of ME and their characteristics were determined. A total of 454 drugs were prescribed to the studied patients. In 138 (30,4%) indications, at least one ME occurred, involving 67 (29,8%) patients. Twenty four percent of detected ME occurred during administration, mainly due to wrong time schedules. Anticoagulants were the therapeutic group with the highest occurrence of ME. At least one ME occurred in approximately one third of patients studied, especially during the administration stage. These errors could affect the medication safety and avoid achieving therapeutic goals. Strategies to improve the quality and safe use of medications can be implemented using this information.

Radiation physics in medicine and veterinary medicine studies

International Nuclear Information System (INIS)

Popovic, D.; Djuric, G.

2000-01-01

Medical and veterinary medicine staff and specialists represent an important decision making group in national administration and institutions dealing with radiation protection and environmental protection matters in general. Still, their education in physics, especially in radiation physics is fragmentary and loose, both from technical and theoretical point of view. Within medicine and veterinary medicine studies as well as within other biomedical sciences (biology, pharmacology, biotechnology) radiation physics is usually incorporated in the first year curricula as a part of general physics or biophysics course. Some segments of radiation physics mainly as a technical base for different instrumentation methods and techniques could be also found within different graduate and post-graduate courses of radiology, physical therapy, radiation hygiene, environmental protection, etc. But the traditional approach in presenting the matter and inflexibility of the educational system strongly confront the growing public concern for the environmental problems dealing with radiation and demands for better informing and technical education for those involved in informing and administration. This paper considers some of these problems presenting a new approach in education in radiation physics for medical and veterinary medicine students based on education through student projects and work in the field, as well as on the strong collaboration among administration, universities and professional societies on the national and international level. (author)

THE ROLE OF PUBLIC INSTITUTIONS IN TRAINING OF INTERNATIONAL RELATIONS SPECIALISTS IN CANADA

Directory of Open Access Journals (Sweden)

Kateryna Istomina

2016-09-01

Full Text Available The article deals with theoretical and pedagogical research of the development and integration of students’ public work on the example of the system of professional training of future specialists on international relations in universities of Canada. The features of the organization have been analized and the implementation of students’ public work into curricula of education programs has been done. This research provides general overview of factors that have direct impact on the successful integration of students’ public work in the learning process and which depend on the success of this teaching method implementation. The difficulties of implementing students’ public work in the learning process, as well as positive changes which is the result of this practice in higher education have been shown. The integration of public work in the system of professional training of specialists has been determined as the prospect of the development of higher education which promotes the individual formation with the necessary set of significant social, leadership and personal qualities. The prospects for further research in this area and the practical application of the results have been outlined.

Comparison of Patient Health History Questionnaires Used in General Internal and Family Medicine, Integrative Medicine, and Complementary and Alternative Medicine Clinics.

Science.gov (United States)

Laube, Justin G R; Shapiro, Martin F

2017-05-01

Health history questionnaires (HHQs) are a set of self-administered questions completed by patients prior to a clinical encounter. Despite widespread use, minimal research has evaluated the content of HHQs used in general internal medicine and family medicine (GIM/FM), integrative medicine, and complementary and alternative medicine (CAM; chiropractic, naturopathic, and Traditional Chinese Medicine [TCM]) clinics. Integrative medicine and CAM claim greater emphasis on well-being than does GIM/FM. This study investigated whether integrative medicine and CAM clinics' HHQs include more well-being content and otherwise differ from GIM/FM HHQs. HHQs were obtained from GIM/FM (n = 9), integrative medicine (n = 11), naturopathic medicine (n = 5), chiropractic (n = 4), and TCM (n = 7) clinics in California. HHQs were coded for presence of medical history (chief complaint, past medical history, social history, family history, surgeries, hospitalizations, medications, allergies, review of systems), health maintenance procedures (immunization, screenings), and well-being components (nutrition, exercise, stress, sleep, spirituality). In HHQs of GIM/FM clinics, the average number of well-being components was 1.4 (standard deviation [SD], 1.4) compared with 4.0 (SD, 1.1) for integrative medicine (p medicine (p = 0.04), 2.0 (SD, 1.4) for chiropractic (p = 0.54), and 2.0 (SD, 1.5) for TCM (p = 0.47). In HHQs of GIM/FM clinics, the average number of medical history components was 6.4 (SD, 1.9) compared with 8.3 (SD, 1.2) for integrative medicine (p = 0.01), 9.0 (SD, 0) for naturopathic medicine (p = 0.01), 7.1 (SD, 2.8) for chiropractic (p = 0.58), and 7.1 (SD, 1.7) for TCM (p = 0.41). Integrative and naturopathic medicine HHQs included significantly more well-being and medical history components than did GIM/FM HHQs. Further investigation is warranted to determine the optimal HHQ content to support the clinical and preventive

Theses of XX International Seminar on charged particle accelerators

International Nuclear Information System (INIS)

Papkovich, V.G.; Rakivnenko, L.M.

2007-01-01

Published abstracts of reports of the XX International Seminar on charged particle accelerators have interest for specialists in the fields of linear accelerator physics and technology, VHF uses systems of beam diagnostics and autometed control, new acceleration methods and for theses who use electrophysical devices in industry, medicine and research

The Current Status and Future Perspectives of Nuclear Medicine in Korea

International Nuclear Information System (INIS)

Lee, Myung Chul; Oh, So Won; Chung, June Key; Lee, Dong Soo

2010-01-01

Since the introduction of nuclear medicine in 1959, Korea accomplished a brilliant development in terms of both clinical practice and research activities, which was mainly due to the dedication of nuclear medicine specialists, consisting of physicians, technicians, and scientists, and strong support from the Korean Government. Now, Korea has 150 medical institutes, performing approximately 561,000 nuclear imaging procedures and 11.6 million in vitro studies in 2008, and ranked fourth in the number of presentations at the Annual Meeting of the Society of Nuclear Medicine (SNM) in 2008. The successful progress in this field has allowed Korea to focus on the international promotion of nuclear medicine, especially in the developing and underdeveloped countries. In consequence, the Asian Regional Cooperative Council for Nuclear Medicine (ARCCNM) was established in 2001, and Seoul hosted the 9th Congress of the World Federation of Nuclear Medicine and Biology (WFNMB) in 2006. In the future, Korea will strive to sustain its rate of advancement in the field and make every effort to share its progress and promote the exchange of scientific information at the international level.

Ultrasound for internal medicine physicians: the future of the physical examination.

Science.gov (United States)

Dulohery, Megan M; Stoven, Samantha; Kurklinsky, Andrew K; Kurklinksy, Andrew; Halvorsen, Andrew; McDonald, Furman S; Bhagra, Anjali

2014-06-01

With the advent of compact ultrasound (US) devices, it is easier for physicians to enhance their physical examinations through the use of US. However, although this new tool is widely available, few internal medicine physicians have US training. This study sought to understand physicians' baseline knowledge and skill, provide education in US principles, and demonstrate that proper use of compact US devices is a skill that can be quickly learned. Training was performed at the Mayo Clinic in June 2010 and June 2011. The participants consisted of internal medicine residents. The workshop included didactics and hands-on US experiences with human and cadaver models in a simulation center. Pretests and posttests of residents' knowledge, attitudes, and skills with US were completed. We reassessed the 2010 group in the spring of 2012 with a long-term retention survey for knowledge and confidence in viewing images. A total of 136 interns completed the workshop. Thirty-nine residents completed the long-term retention survey. Posttest assessments showed a statistically significant improvement in the knowledge of US imaging, confidence in identifying structures, image identification, and image acquisition (P internal medicine training and practice. © 2014 by the American Institute of Ultrasound in Medicine.

Part-time careers in academic internal medicine: A report from the association of specialty professors part-time careers task force on behalf of the alliance for academic internal medicine

OpenAIRE

Linzer, M; Warde, C; Alexander, RW; DeMarco, DM; Haupt, A; Hicks, L; Kutner, J; Mangione, CM; Mechaber, H; Rentz, M; Riley, J; Schuster, B; Solomon, GD; Volberding, P; Ibrahim, T

2009-01-01

To establish guidelines for more effectively incorporating part-time faculty into departments of internal medicine, a task force was convened in early 2007 by the Association of Specialty Professors. The task force used informal surveys, current literature, and consensus building among members of the Alliance for Academic Internal Medicine to produce a consensus statement and a series of recommendations. The task force agreed that part-time faculty could enrich a department of medicine, enhan...

A Survey of Clinical Skills Evaluation Practices in Internal Medicine Residency Programs.

Science.gov (United States)

Blank, Linda L.; And Others

1984-01-01

The evaluation processes of 75 internal medicine residencies visited by the American Board of Internal Medicine (ABIM) in 1978-82 are reviewed. The methods of evaluation used by the residencies are described and compared with the findings from an earlier cycle of visits in 1972-75. (Author/MLW)

Mindfulness, burnout, and effects on performance evaluations in internal medicine residents

Directory of Open Access Journals (Sweden)

Braun SE

2017-08-01

Full Text Available Sarah E Braun,1 Stephen M Auerbach,1 Bruce Rybarczyk,1 Bennett Lee,2 Stephanie Call2 1Department of Psychology, School of Humanities and Sciences, Virginia Commonwealth University, Richmond, VA, USA; 2Department of Internal Medicine, Division of General Medicine, Virginia Commonwealth University, Richmond, VA, USA Purpose: Burnout has been documented at high levels in medical residents with negative effects on performance. Some dispositional qualities, like mindfulness, may protect against burnout. The purpose of the present study was to assess burnout prevalence among internal medicine residents at a single institution, examine the relationship between mindfulness and burnout, and provide preliminary findings on the relation between burnout and performance evaluations in internal medicine residents.Methods: Residents (n = 38 completed validated measures of burnout at three time points separated by 2 months and a validated measure of dispositional mindfulness at baseline. Program director end-of-year performance evaluations were also obtained on 22 milestones used to evaluate internal medicine resident performance; notably, these milestones have not yet been validated for research purposes; therefore, the investigation here is exploratory.Results: Overall, 71.1% (n = 27 of the residents met criteria for burnout during the study. Lower scores on the “acting with awareness” facet of dispositional mindfulness significantly predicted meeting burnout criteria χ2(5 = 11.88, p = 0.04. Lastly, meeting burnout criteria significantly predicted performance on three of the performance milestones, with positive effects on milestones from the “system-based practices” and “professionalism” domains and negative effects on a milestone from the “patient care” domain.Conclusion: Burnout rates were high in this sample of internal medicine residents and rates were consistent with other reports of burnout during medical residency. Dispositional

[Highlights of hospital-based internal medicine in 2010: chief residents' perspective].

Science.gov (United States)

Uhlmann, Marc; Burnard, Jérôme; Cosma Rochat, Monica; Gabus, Vincent; Micheloud, Valérie Geiser; Gobin, Niels; Laurent, Jean-Christophe; Marino, Laura; Méan, Marie; Merz, Laurent; Regamey, Julien; Stadelmann, Raphaël

2011-02-02

Applying knowledge acquired from recent medical studies to patient care poses a daily challenge to physicians. Chief residents from the Department of Internal Medicine at the University Hospital of Lausanne carried out a review of some of the issues they considered important. The conclusions of these various publications may have a significant impact on the daily practice of hospital-based internal medicine. Modern medicine based on scientific studies is a reminder that in spite of the essential importance of clinical experience, it is crucial to confront it with the results of relevant publications from the medical literature.

Theses of XIX International Seminar on charged particle accelerators

International Nuclear Information System (INIS)

Anon

2005-01-01

Published abstracts of reports of the XIX International Seminar on charged particle accelerators have interest for specialists in the fields of linear accelerator physics and technology, VHF uses, systems of beam diagnostics and automated control, new acceleration methods, as well as for theses who use electrophysical devices in industry, medicine and research

Burnout, coping, and spirituality among internal medicine resident physicians.

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Doolittle, Benjamin R; Windish, Donna M; Seelig, Charles B

2013-06-01

Burnout in physicians is common, and studies show a prevalence of 30% to 78%. Identifying constructive coping strategies and personal characteristics that protect residents against burnout may be helpful for reducing errors and improving physician satisfaction. We explored the complex relationships between burnout, behaviors, emotional coping, and spirituality among internal medicine and internal medicine-pediatrics residents. We anonymously surveyed 173 internal medicine and medicine-pediatrics residents to explore burnout, coping, and spiritual attitudes. We used 3 validated survey instruments: the Maslach Burnout Inventory, the Carver Coping Orientation to Problems Experienced (COPE) Inventory, and the Hatch Spiritual Involvement and Beliefs Scale (SIBS). A total of 108 (63%) residents participated, with 31 (28%) reporting burnout. Residents who employed strategies of acceptance, active coping, and positive reframing had lower emotional exhaustion and depersonalization (all, P < .03). Residents who reported denial or disengagement had higher emotional exhaustion and depersonalization scores. Personal accomplishment was positively correlated with the SIBS total score (r  =  +.28, P  =  .003), as well as the internal/fluid domain (r  =  +.32, P  =  .001), existential axes (r  =  +.32, P  =  .001), and humility/personal application domain (r  =  +.23, P  =  .02). The humility/personal application domain also was negatively correlated with emotional exhaustion (r  =  -.20, P  =  .04) and depersonalization (r  =  -.25, P  =  .009). No activity or demographic factor affected any burnout domain. Burnout is a heterogeneous syndrome that affects many residents. We identified a range of emotional and spiritual coping strategies that may have protective benefit.

[Day hospital in internal medicine: A chance for ambulatory care].

Science.gov (United States)

Grasland, A; Mortier, E

2018-04-16

Internal medicine is an in-hospital speciality. Along with its expertise in rare diseases, it shares with general medicine the global care of patients but its place in the ambulatory shift has yet to be defined. The objective of our work was to evaluate the benefits of an internal medicine day-hospital devoted to general medicine. Named "Centre Vi'TAL" to underline the link between the city and the hospital, this novel activity was implemented in order to respond quickly to general practitioners having difficulties to synthesize their complex patients or facing diagnostic or therapeutic problems. Using preferentially email for communication, the general practitioners can contact an internist who is committed to respond on the same day and take over the patient within 7 days if day-hospital is appropriate for his condition. The other patients are directed either to the emergency department, consultation or full hospitalization. In 14 months, the center has received 213 (144 women, 69 men) patients, mean age 53.6, addressed by 88 general practitioners for 282 day-hospital sessions. Requests included problem diagnoses (n=105), synthesis reviews for complex patients (n=65), and treatment (n=43). In the ambulatory shift advocated by the authorities, this experience shows that internal medicine should engage in the recognition of day-hospital as a place for diagnosis and synthesis reviews connected with the city while leaving the general practitioners coordinator of their patient care. This activity of synthesis in day-hospital is useful for the patients and efficient for our healthcare system. Copyright © 2018 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Variation in Emergency Department vs Internal Medicine Excess Charges in the United States.

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Xu, Tim; Park, Angela; Bai, Ge; Joo, Sarah; Hutfless, Susan M; Mehta, Ambar; Anderson, Gerard F; Makary, Martin A

2017-08-01

Uninsured and insured but out-of-network emergency department (ED) patients are often billed hospital chargemaster prices, which exceed amounts typically paid by insurers. To examine the variation in excess charges for services provided by emergency medicine and internal medicine physicians. Retrospective analysis was conducted of professional fee payment claims made by the Centers for Medicare & Medicaid Services for all services provided to Medicare Part B fee-for-service beneficiaries in calendar year 2013. Data analysis was conducted from January 1 to July 31, 2016. Markup ratios for ED and internal medicine professional services, defined as the charges submitted by the hospital divided by the Medicare allowable amount. Our analysis included 12 337 emergency medicine physicians from 2707 hospitals and 57 607 internal medicine physicians from 3669 hospitals in all 50 states. Services provided by emergency medicine physicians had an overall markup ratio of 4.4 (340% excess charges), which was greater than the markup ratio of 2.1 (110% excess charges) for all services performed by internal medicine physicians. Markup ratios for all ED services ranged by hospital from 1.0 to 12.6 (median, 4.2; interquartile range [IQR], 3.3-5.8); markup ratios for all internal medicine services ranged by hospital from 1.0 to 14.1 (median, 2.0; IQR, 1.7-2.5). The median markup ratio by hospital for ED evaluation and management procedure codes varied between 4.0 and 5.0. Among the most common ED services, laceration repair had the highest median markup ratio (7.0); emergency medicine physician review of a head computed tomographic scan had the greatest interhospital variation (range, 1.6-27.7). Across hospitals, markups in the ED were often substantially higher than those in the internal medicine department for the same services. Higher ED markup ratios were associated with hospital for-profit ownership (median, 5.7; IQR, 4.0-7.1), a greater percentage of uninsured patients seen

Documentation of quality improvement exposure by internal medicine residency applicants.

Science.gov (United States)

Kolade, Victor O; Sethi, Anuradha

2016-01-01

Quality improvement (QI) has become an essential component of medical care in the United States. In residency programs, QI is a focus area of the Clinical Learning Environment Review visits conducted by the Accreditation Council for Graduate Medical Education. The readiness of applicants to internal medicine residency to engage in QI on day one is unknown. To document the reporting of QI training or experience in residency applications. Electronic Residency Application Service applications to a single internal medicine program were reviewed individually looking for reported QI involvement or actual projects in the curriculum vitae (CVs), personal statements (PSs), and letters of recommendation (LORs). CVs were also reviewed for evidence of education in QI such as completion of Institute for Healthcare Improvement (IHI) modules. Of 204 candidates shortlisted for interview, seven had QI items on their CVs, including one basic IHI certificate. Three discussed their QI work in their PSs, and four had recommendation letters describing their involvement in QI. One applicant had both CV and LOR evidence, so that 13 (6%) documented QI engagement. Practice of or instruction in QI is rarely mentioned in application documents of prospective internal medicine interns.

Internal medicine point-of-care ultrasound assessment of left ventricular function correlates with formal echocardiography.

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Johnson, Benjamin K; Tierney, David M; Rosborough, Terry K; Harris, Kevin M; Newell, Marc C

2016-02-01

Although focused cardiac ultrasonographic (FoCUS) examination has been evaluated in emergency departments and intensive care units with good correlation to formal echocardiography, accuracy for the assessment of left ventricular systolic function (LVSF) when performed by internal medicine physicians still needs independent evaluation. This prospective observational study in a 640-bed, academic, quaternary care center, included 178 inpatients examined by 10 internal medicine physicians who had completed our internal medicine bedside ultrasound training program. The ability to estimate LVSF with FoCUS as "normal," "mild to moderately decreased," or "severely decreased" was compared with left ventricular ejection fraction (>50%, 31-49%, and internal medicine physician-performed FoCUS and formal echocardiography for any LVSF impairment was "good/substantial" with κ = 0.77 (p Internal medicine physicians using FoCUS identify normal versus decreased LVSF with high sensitivity, specificity, and "good/substantial" interrater agreement when compared with formal echocardiography. These results support the role of cardiac FoCUS by properly trained internal medicine physicians for discriminating normal from reduced LVSF. © 2015 Wiley Periodicals, Inc.

[Internal medicine and the holistic approach to the patient between globalization and advanced technologies].

Science.gov (United States)

Dammacco, Franco

2012-06-01

Although Internal Medicine (IM) has played for many years a crucial role in the medical education and in the diagnostic framing of the most common diseases, starting from the beginning of the 70's the knowledge explosion, the recognition of the multidisciplinary nature of IM and the consequent impossibility for the Internist to master an ever growing array of notions have resulted in the development of specialized disciplines restricted to pathologies of single organs or apparatus. The parcelling out of medical knowledge has thus induced the onset of a number of specializations stemmed from IM and, as a direct consequence, an identity crisis of the same IM. Social transformations and variations in the epidemiology of several diseases have contributed to such crisis, including aging, frailty and disability, polypathology and chronicity. In the last few years, however, IM has regained a central role in medicine, in that the Internist is an expert of "medicine of complexity" and the only specialist able to envisage an holistic approach to the patient. The development of biotechnologies, characterized on one side by nanotechnologies and on the other by the instruments of diagnostic imaging, has provided an important contribution to make clinical medicine more and more precise and reliable. The genomic analysis of novel pharmacological targets has opened new therapeutic horizons, especially in the oncology field. A striking aspect of modern medicine, again based on unreasonable expectations of improvement and recovery, is the progressive increment of malpractice claims leading to an indemnity payment. Defensive medicine has been the answer to face this growing problem: physicians are in fact induced to prescribe a much higher number of often unnecessary examinations and laboratory tests, that result in a wasting rise of health costs. In view of the rapidly changing reality, it seems fair to ask the question as to whether in our country the medical education is abreast

Doing HOF work in NPP - an internal specialist point of view

International Nuclear Information System (INIS)

Koistinen, Petri

2011-01-01

Organisational learning has been identified as one success factor both in general business literature and also in nuclear industry. One part of organisational learning is routines that support organisational learning. In nuclear industry learning from events is an important process of organisational learning. The other building blocks of learning organisation are climate that supports learning and leadership that encourages learning. These have also been identified in nuclear industry as being important issues. Learning from events relies on the validity of the investigation process. Investigation process and report has simply three parts: what happened (facts), why it happened (analysis) and how to prevent reoccurrence (corrective actions, CA). In RCA analysis part is highlighted, however it cannot be done correctly unless the facts have not been collected well. In a good learning process there must also be a follow up and feedback system for CA's. The following are the key points from this presentation: - Koistinen has been an internal HOF specialist since 2004; still the only HOF specialist at TVO. - Main duties are event investigations (including RCA), operating experience, safety culture improvement, human performance and organisational development issues. - Human error is typically the end point of an investigation - Koistinen's job is to find out what has led a good professional to make an error (organisational factors). - A blame-free or just culture is required to identify the organisational issues in an event. - RCA is used for the most serious events - about 5 RCA like investigations are conducted at the two TVO units per year. - Finland does not have RCA training available and so staff must go elsewhere. Those working in event investigations are usually new in the nuclear business and therefore lack experience. - The author presents a number of guidelines from STUK, the Finnish regulatory body. There are requirements for competence of investigators

[International reference prices and cost minimization analysis for the regulation of medicine prices in Colombia].

Science.gov (United States)

Vacca, Caludia; Acosta, Angela; Rodriguez, Ivan

2011-01-01

To suggest a scheme of decision making on pricing for medicines that are part of Free Regulated Regime, a regulation way of the pharmaceutical pricing policy in Colombia. It includes two regulation tools: international reference prices and a cost minimization analysis methodology. Following the current pricing policy, international reference prices were built with data from five countries for selected medicines, which are under Free Regulated Regime. The cost minimization analysis methodology includes selection of those medicines under Free Regulated Regime with possible comparable medicines, selection of comparable medicines, and treatment costs evaluation. As a result of the estimate of International Reference Prices, four medicines showed in the domestic pharmaceutical market a bigger price than the Reference Price. A scheme of decision-making was design containing two possible regulation tools for medicines that are part of Free Regulated Regime: estimate of international reference prices and cost minimization analysis methodology. This diagram would be useful to assist the pricing regulation of Free Regulated Regime in Colombia. As present results shows, international reference prices make clear when domestic prices are higher than those of reference countries. In the current regulation of pharmaceutical prices in Colombia, the international reference price has been applied for four medicines. Would be suitable to extend this methodology to other medicines of high impact on the pharmaceutical expenditure, in particular those covered by public funding. The availability of primary sources about treatment costs in Colombia needs to be improved as a requirement to develop pharmaco-economic evidence. SISMED is an official database that represents an important primary source of medicines prices in Colombia. Nevertheless, having into account that SISMED represents an important advantage of transparency in medicines prices, it needs to be improved in quality and data

Support for and aspects of use of educational games in family medicine and internal medicine residency programs in the US: a survey

OpenAIRE

Wilson Mark C; Mustafa Reem; Gunukula Sameer; Akl Elie A; Symons Andrew; Moheet Amir; Schünemann Holger J

2010-01-01

Abstract Background The evidence supporting the effectiveness of educational games in graduate medical education is limited. Anecdotal reports suggest their popularity in that setting. The objective of this study was to explore the support for and the different aspects of use of educational games in family medicine and internal medicine residency programs in the United States. Methods We conducted a survey of family medicine and internal medicine residency program directors in the United Stat...

Associations between subspecialty fellowship interest and knowledge of internal medicine: A hypothesis-generating study of internal medicine residents

Directory of Open Access Journals (Sweden)

Haidet Paul

2011-01-01

Full Text Available Abstract Background Little is known about whether and how medical knowledge relates to interest in subspecialty fellowship training. The purpose of this study was to examine the relationships between residents' interest in subspecialty fellowship training and their knowledge of internal medicine (IM. Methods A questionnaire was emailed to 48 categorical postgraduate-year (PGY two and three residents at a New York university-affiliated IM residency program in 2007 using the Survey Monkey online survey instrument. Overall and content area-specific percentile scores from the IM in-training examination (IM-ITE for the same year was used to determine objective knowledge. Results Forty-five of 48 residents (response rate was 93.8% completed the survey. Twenty-two (49% were PG2 residents and 23(51% were PGY3 residents. Sixty percent of respondents were male. Six (13% residents were graduates of U.S. medical schools. Eight (18% reported formal clinical training prior to starting internal medicine residency in the U.S. Of this latter group, 6 (75% had training in IM and 6 (75 % reported a training length of 3 years or less. Thirty-seven of 45 (82% residents had a subspecialty fellowship interest. Residents with a fellowship interest had a greater mean overall objective knowledge percentile score (56.44 vs. 31.67; p = 0.04 as well as greater mean percentile scores in all content areas of IM. The adjusted mean difference was statistically significant (p Conclusions More than half of surveyed residents indicated interest in pursuing a subspecialty fellowship. Fellowship interest appears positively associated with general medical knowledge in this study population. Further work is needed to explore motivation and study patterns among internal medicine residents.

Patient characteristics, resource use and outcomes associated with general internal medicine hospital care: the General Medicine Inpatient Initiative (GEMINI) retrospective cohort study.

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Verma, Amol A; Guo, Yishan; Kwan, Janice L; Lapointe-Shaw, Lauren; Rawal, Shail; Tang, Terence; Weinerman, Adina; Cram, Peter; Dhalla, Irfan A; Hwang, Stephen W; Laupacis, Andreas; Mamdani, Muhammad M; Shadowitz, Steven; Upshur, Ross; Reid, Robert J; Razak, Fahad

2017-12-11

The precise scope of hospital care delivered under general internal medicine services remains poorly quantified. The purpose of this study was to describe the demographic characteristics, medical conditions, health outcomes and resource use of patients admitted to general internal medicine at 7 hospital sites in the Greater Toronto Area. This was a retrospective cohort study involving all patients who were admitted to or discharged from general internal medicine at the study sites between Apr. 1, 2010, and Mar. 31, 2015. Clinical data from hospital electronic information systems were linked to administrative data from each hospital. We examined trends in resource use and patient characteristics over the study period. There were 136 208 admissions to general internal medicine involving 88 121 unique patients over the study period. General internal medicine admissions accounted for 38.8% of all admissions from the emergency department and 23.7% of all hospital bed-days. Over the study period, the number of admissions to general internal medicine increased by 32.4%; there was no meaningful change in the median length of stay or cost per hospital stay. The median patient age was 73 (interquartile range [IQR] 57-84) years, and the median number of coexisting conditions was 6 (IQR 3-9). The median acute length of stay was 4.6 (IQR 2.5-8.6) days, and the median total cost per hospital stay was $5850 (IQR $3915-$10 061). Patients received at least 1 computed tomography scan in 52.2% of admissions. The most common primary discharge diagnoses were pneumonia (5.0% of admissions), heart failure (4.7%), chronic obstructive pulmonary disease (4.1%), urinary tract infection (4.0%) and stroke (3.6%). Patients admitted to general internal medicine services represent a large, heterogeneous, resource-intensive and growing population. Understanding and improving general internal medicine care is essential to promote a high-quality, sustainable health care system. Copyright 2017

[History of training and certification programs of medical specialists in Peru].

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Burstein Alva, Zuño

2014-01-01

In this paper, historical reference is made about legal provisions for recognition of the training and certification of medical specialists in Peru through university programs provided since 1928 and culminating in 1973 with the legal authorization by the relevant state authority to implement the Second Specialization Program in Human Medicine and to grant the Certification of Specialist in the Name of the Nation upon completion of a university residency program and specialized training by the “regular modality”, and the recognition by the university with the “non-regular modality”. In Peru it has been established to the present that the Professional Certifications of Specialists in Human Medicine “in the Name of the Nation”, both in “regular modality” as well as in “non-regular modality”, can only be granted by public or private universities authorized for this mission and, besides, no other public or private institution can claim this role that corresponds exclusively for the Peruvian University.

Imperial Medicine in a Changing World: The Fourth International Congresses on Tropical Medicine and Malaria, 1948.

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Wells, Julia

2016-01-01

The close connections between colonialism and tropical medicine have been widely discussed by historians over the last fifty years. However, few authors consider the relationship between tropical medicine and European and North American imperialism in the immediate post-World War II period. This article examines the Fourth International Congresses on Tropical Medicine and Malaria, held jointly in Washington in 1948. Using the research presented during the conference, it questions to what degree the specialisation had changed in the postwar period. It argues that although some changes are discernable, imperial traditions and relationships remained firmly embedded within the tropical medicine of the congress.

National Target for South Asia Specialists. A Report.

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National Council on Foreign Language and International Studies, New York, NY.

The South Asia Panel of the National Council on Foreign Languages and International Studies reports on the need for specialists in the languages and cultures of Afghanistan, Bangladesh, India, Nepal, Pakistan, Sri Lanka, Bhutan, and the Maldives. Two categories of specialists are discussed: (1) individuals in government, mission, etc., in…

[Pharmacovigilance center --internal medicine interactions: A useful diagnostic tool].

Science.gov (United States)

Rochoy, M; Gautier, S; Bordet, R; Caron, J; Launay, D; Hachulla, E; Hatron, P-Y; Lambert, M

2015-08-01

Patients hospitalized in internal medicine often have unexplained clinical symptoms for which a drug origin can be considered. The prevalence of patients hospitalized for iatrogenic is estimated between 4-22%. We wanted to evaluate the diagnostic value of the regional center of pharmacovigilance to identify or confirm an iatrogenic disease in the department of internal medicine of Lille and characterize factors associated with drug-related side effect. This is a single-center prospective diagnostic study. We included all subsequent requests from the department of internal medicine with the Nord-Pas-de-Calais regional pharmacovigilance center between 2010 and 2012. The opinion of the regional pharmacovigilance centre was held on the record of the adverse drug reaction in the national pharmacovigilance database and analyzed according to the conclusion of iatrogenic used by clinicians in internal medicine (reference diagnosis) with a follow-up to June 2013. The variables relating to the patient, medication and adverse events were analyzed by binary logistic regression. We analyzed 160 contacts: 118 concordant cases, 38 false-positives (drug-related side effect retained by the regional pharmacovigilance center only), 4 false negatives. Registration in the national pharmacovigilance database had a sensitivity of 96% (95% CI [0.92 to 0.99]), a specificity of 46% (95% CI [0.38 to 0.53]), a value positive predictive of 69% (95% CI [0.62 to 0.76]), a negative predictive value of 89% (95% CI [0.84 to 0.94]) and a negative likelihood ratio of 0.1. False-positive had chronological and semiological accountabilities questionable (adjusted RR=2.1, 95% CI [1.2 to 2.8]). In our study, the regional pharmacovigilance center confirms the clinician's suspicion of drug-related side effects and helps to exclude drug-induced with a high negative predictive value. Copyright © 2015 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Naturopathic physicians: holistic primary care and integrative medicine specialists.

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Litchy, Andrew P

2011-12-01

The use of Complimentary and Alternative Medicine (CAM) is increasing in the United States; there is a need for physician level practitioners who possess extensive training in both CAM and conventional medicine. Naturopathic physicians possess training that allows integration of modern scientific knowledge and the age-old wisdom of natural healing techniques. Naturopathic philosophy provides a framework to implement CAM in concert with conventional therapies. The naturopathic physician's expertise in both conventional medicine and CAM allows a practice style that provides excellent care through employing conventional and CAM modalities while utilizing modern research and evidence-based medicine.

Proceedings of the international specialist meeting on BWR-pressure suppression containment technology. Vol. 1

International Nuclear Information System (INIS)

Schultheiss, G.F.

1981-01-01

In the frame of R + D-work for BWR-pressure suppression systems the GKSS-Forschungszentrum Geesthacht GmbH organized an international specialist meeting. All important safety relevant aspects of pressure suppression system technology have been included. About 60 experts from USA, Japan, Sweden, Italy, Netherlands and the Federal Republic of Germany participated. They came from licensing authorities, vendors, research centers and universities. In 24 papers they have shown the world-wide present status of theoretical and experimental know-how on pressure suppression system behaviour. In discussions and working groups recommendations for future work have been compiled. (orig.) [de

Proceedings of the international specialist meeting on BWR-pressure suppression containment technology. Vol. 2

International Nuclear Information System (INIS)

Schultheiss, G.F.

1981-01-01

In the frame of R + D-work for BWR-pressure suppression systems the GKSS-Forschungszentrum Geesthacht GmbH organized an international specialist meeting. All important safety relevant aspects of pressure suppression system technology have been included. About 60 experts from USA, Japan, Sweden, Italy, Netherland and the Federal Republic of Germany participated. They came from licensing authorities, vendors, research centers and universities. In 24 papers they have shown the world-wide present status of theoretical and experimental know-how on pressure suppression system behaviour. In discussions and working groups recommendations for future work have been compiled. (orig.) [de

Implementing standardized, inter-unit communication in an international setting: handoff of patients from emergency medicine to internal medicine.

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Balhara, Kamna S; Peterson, Susan M; Elabd, Mohamed Moheb; Regan, Linda; Anton, Xavier; Al-Natour, Basil Ali; Hsieh, Yu-Hsiang; Scheulen, James; Stewart de Ramirez, Sarah A

2018-04-01

Standardized handoffs may reduce communication errors, but research on handoff in community and international settings is lacking. Our study at a community hospital in the United Arab Emirates characterizes existing handoff practices for admitted patients from emergency medicine (EM) to internal medicine (IM), develops a standardized handoff tool, and assesses its impact on communication and physician perceptions. EM physicians completed a survey regarding handoff practices and expectations. Trained observers utilized a checklist based on the Systems Engineering Initiative for Patient Safety model to observe 40 handoffs. EM and IM physicians collaboratively developed a written tool encouraging bedside handoff of admitted patients. After the intervention, surveys of EM physicians and 40 observations were subsequently repeated. 77.5% of initial observed handoffs occurred face-to-face, with 42.5% at bedside, and in four different languages. Most survey respondents considered face-to-face handoff ideal. Respondents noted 9-13 patients suffering harm due to handoff in the prior month. After handoff tool implementation, 97.5% of observed handoffs occurred face-to-face (versus 77.5%, p = 0.014), with 82.5% at bedside (versus 42.5%, p face-to-face and bedside handoff, positively impacted workflow, and increased perceptions of safety by EM physicians in an international, non-academic setting. Our three-step approach can be applied towards developing standardized, context-specific inter-specialty handoff in a variety of settings.

Education in sexual medicine: proceedings from the international consultation in sexual medicine, 2009.

Science.gov (United States)

Parish, Sharon J; Rubio-Aurioles, Eusebio

2010-10-01

Sexual problems in men and women are common; and physicians endorse many barriers to addressing these issues, including lack of knowledge about the diagnosis and management of sexual problems and inadequate training in sexual health communication and counseling. To update the recommendations published in 2004, from the International Consultation on Sexual Medicine (ICSM) relevant to the educational aspects of sexual health in undergraduate, graduate, and postgraducate medical education. A third international consultation in collaboration with the major sexual health organizations assembled over 186 multidisciplinary experts from 33 countries into 25 committees. Three experts from three countries contributed to this committee's review of Education in Sexual Medicine. Expert opinion was based on a comprehensive review of the medical literature, committee discussion, public presentation, and debate. A comprehensive review about the current state of undergraduate, graduate, and postgraduate sexual health education worldwide is provided. Recommendations about ideal sexual health curricula across training levels are provided. Best methods for achieving optimal training approaches to sexual health communication and interviewing, clinical skills and management, and counseling are described. Current sexual health education for undergraduate and practicing physicians is inadequate to meet the advancing science and technology and increasing patient demand for high-quality sexual health care. There is a need for enhanced training in medical institutions responsible for physician sexual health training worldwide. Future training programs at all levels of medical education should incorporate standardized measures of sexual health clinical skills acquisition and assessments of the impact on patient outcomes into the design of educational initiatives. © 2010 International Society for Sexual Medicine.

The State of Evaluation in Internal Medicine Residency

Science.gov (United States)

Holmboe, Eric; Beasley, Brent W.

2008-01-01

Background There are no nationwide data on the methods residency programs are using to assess trainee competence. The Accreditation Council for Graduate Medical Education (ACGME) has recommended tools that programs can use to evaluate their trainees. It is unknown if programs are adhering to these recommendations. Objective To describe evaluation methods used by our nation’s internal medicine residency programs and assess adherence to ACGME methodological recommendations for evaluation. Design Nationwide survey. Participants All internal medicine programs registered with the Association of Program Directors of Internal Medicine (APDIM). Measurements Descriptive statistics of programs and tools used to evaluate competence; compliance with ACGME recommended evaluative methods. Results The response rate was 70%. Programs were using an average of 4.2–6.0 tools to evaluate their trainees with heavy reliance on rating forms. Direct observation and practice and data-based tools were used much less frequently. Most programs were using at least 1 of the Accreditation Council for Graduate Medical Education (ACGME)’s “most desirable” methods of evaluation for all 6 measures of trainee competence. These programs had higher support staff to resident ratios than programs using less desirable evaluative methods. Conclusions Residency programs are using a large number and variety of tools for evaluating the competence of their trainees. Most are complying with ACGME recommended methods of evaluation especially if the support staff to resident ratio is high. PMID:18612734

Barriers to Medical Compassion as a Function of Experience and Specialization: Psychiatry, Pediatrics, Internal Medicine, Surgery, and General Practice.

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Fernando, Antonio T; Consedine, Nathan S

2017-06-01

Compassion is an expectation of patients, regulatory bodies, and physicians themselves. Most research has, however, studied compassion fatigue rather than compassion itself and has concentrated on the role of the physician. The Transactional Model of Physician Compassion suggests that physician, patient, external environment, and clinical factors are all relevant. Because these factors vary both across different specialities and among physicians with differing degrees of experience, barriers to compassion are also likely to vary. We describe barriers to physician compassion as a function of specialization (psychiatry, general practice, surgery, internal medicine, and pediatrics) and physician experience. We used a cross-sectional study using demographic data, specialization, practice parameters, and the Barriers to Physician Compassion Questionnaire. Nonrandom convenience sampling was used to recruit 580 doctors, of whom 444 belonged to the targeted speciality groups. The sample was characterized before conducting a factorial Multivariate Analysis of Covariance and further post hoc analyses. A 5 (speciality grouping) × 2 (more vs. less physician experience) Multivariate Analysis of Covariance showed that the barriers varied as a function of both speciality and experience. In general, psychiatrists reported lower barriers, whereas general practitioners and internal medicine specialists generally reported greater barriers. Barriers were generally greater among less experienced doctors. Documenting and investigating barriers to compassion in different speciality groups have the potential to broaden current foci beyond the physician and inform interventions aimed at enhancing medical compassion. In addition, certain aspects of the training or practice of psychiatry that enhance compassion may mitigate barriers to compassion in other specialities. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Nailfold videocapillaroscopy in internal medicine

Directory of Open Access Journals (Sweden)

Paola Faggioli

2015-09-01

Full Text Available Capillaroscopy is an actual inexpensive imaging technique, used to examine, non-invasively and safely, the morphology of nailfold dermal papillary capillaries. Many studies agree in the statement that the capillaroscopy is one of the gold standard methods for non-invasive examination of the microcirculation and it plays an important role in screening in Raynaud’s phenomenon and in monitoring of systemic sclerosis and other rheumatologic diseases. There are also many reports on the possible use of nailfold capillaroscopy in the diagnosis and monitoring of many other diseases in internal medicine.

US Medical Student Performance on the NBME Subject Examination in Internal Medicine: Do Clerkship Sequence and Clerkship Length Matter?

Science.gov (United States)

Ouyang, Wenli; Cuddy, Monica M; Swanson, David B

2015-09-01

Prior to graduation, US medical students are required to complete clinical clerkship rotations, most commonly in the specialty areas of family medicine, internal medicine, obstetrics and gynecology (ob/gyn), pediatrics, psychiatry, and surgery. Within a school, the sequence in which students complete these clerkships varies. In addition, the length of these rotations varies, both within a school for different clerkships and between schools for the same clerkship. The present study investigated the effects of clerkship sequence and length on performance on the National Board of Medical Examiner's subject examination in internal medicine. The study sample included 16,091 students from 67 US Liaison Committee on Medical Education (LCME)-accredited medical schools who graduated in 2012 or 2013. Student-level measures included first-attempt internal medicine subject examination scores, first-attempt USMLE Step 1 scores, and five dichotomous variables capturing whether or not students completed rotations in family medicine, ob/gyn, pediatrics, psychiatry, and surgery prior to taking the internal medicine rotation. School-level measures included clerkship length and average Step 1 score. Multilevel models with students nested in schools were estimated with internal medicine subject examination scores as the dependent measure. Step 1 scores and the five dichotomous variables were treated as student-level predictors. Internal medicine clerkship length and average Step 1 score were used to predict school-to-school variation in average internal medicine subject examination scores. Completion of rotations in surgery, pediatrics and family medicine prior to taking the internal medicine examination significantly improved scores, with the largest benefit observed for surgery (coefficient = 1.58 points; p value internal medicine subject examination performance. At the school level, longer internal medicine clerkships were associated with higher scores on the internal medicine

Self-reported hypertension, dyslipidemia and hyperuricemia management by Italian Internal Medicine Units: a national survey of the FADOI Study Group in Cardiovascular Medicine

Directory of Open Access Journals (Sweden)

Alberto Mazza

2017-11-01

Full Text Available The aim of this study was to evaluate the management practices of internal medicine clinicians for patients with cardiovascular risk factors, with particular respect to treatment thresholds, medication choices and target goals. A sample of internists - representatives of Internal Medicine Units (IMUs from all the regions in Italy - were identified by the cardiovascular medicine study group of the Italian Internal Medicine FADOI (Federazione delle Associazioni dei Dirigenti Ospedalieri Internisti Society and invited to fill out a questionnaire about hypertension, dyslipidemia and hyperuricemia. From the 101 questionnaires collected, it was found that despite large heterogeneity between IMUs in terms of patient management and adherence to guidelines, internists were experts in the management of patients with multiple cardiovascular risk factors and associated comorbidities. We hope that these data prompt the internal medicine community to consider the value of producing shared, real-world guidelines on the management of cardiovascular disease.

[Inventory of training of internal medicine in France: Results of a national survey].

Science.gov (United States)

Samson, M; Terrier, B; Mangin, O; Mouthon, L

2017-05-01

To make an inventory of training of Internal Medicine in France. This study was conducted between May and September 2015 with coordinators (interviews of 45minutes) of local Internal Medicine training and fellows (online questionnaire). All coordinators (n=28) responded to the interviews. Local training of Internal Medicine exists in 86% of regions (3.1±3.1hours/month) and an interregional training in all interregions (34.7±13.9hours/year). When excluding Île-de-France, no correlation between the number of teachers and the amount of lessons was noted (P=0.61). Of the 550 fellows in Internal Medicine in 2014-2015, 223 (41%) responded to the online questionnaire. Mean level was 5.5±2.7 semesters. The rate of satisfaction (1=very dissatisfied and 5=very satisfied) was 3.0±1.0 and 3.8±0.8 for regional and interregional teaching, respectively (P<0.0001). Regional teaching satisfaction was correlated with the perceived expanse of diseases covered into the program (P<0.0001). In addition, 89% of fellows wish to evaluate themselves online, 66% wish to have a practical evaluation at the bedside and 70% in simulation centers. Finally, 91% of fellows support the establishment of a national program for the training of Internal Medicine. This survey states for the first time an inventory of training of Internal Medicine dedicated to fellows in France. This report highlights that fellows wish to have a national program, be further evaluated and have access to more interactive approach of teaching. Copyright © 2016 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Associations between quality indicators of internal medicine residency training programs

Science.gov (United States)

2011-01-01

Background Several residency program characteristics have been suggested as measures of program quality, but associations between these measures are unknown. We set out to determine associations between these potential measures of program quality. Methods Survey of internal medicine residency programs that shared an online ambulatory curriculum on hospital type, faculty size, number of trainees, proportion of international medical graduate (IMG) trainees, Internal Medicine In-Training Examination (IM-ITE) scores, three-year American Board of Internal Medicine Certifying Examination (ABIM-CE) first-try pass rates, Residency Review Committee-Internal Medicine (RRC-IM) certification length, program director clinical duties, and use of pharmaceutical funding to support education. Associations assessed using Chi-square, Spearman rank correlation, univariate and multivariable linear regression. Results Fifty one of 67 programs responded (response rate 76.1%), including 29 (56.9%) community teaching and 17 (33.3%) university hospitals, with a mean of 68 trainees and 101 faculty. Forty four percent of trainees were IMGs. The average post-graduate year (PGY)-2 IM-ITE raw score was 63.1, which was 66.8 for PGY3s. Average 3-year ABIM-CE pass rate was 95.8%; average RRC-IM certification was 4.3 years. ABIM-CE results, IM-ITE results, and length of RRC-IM certification were strongly associated with each other (p ITE scores were higher in programs with more IMGs and in programs that accepted pharmaceutical support (p < 0.05). RRC-IM certification was shorter in programs with higher numbers of IMGs. In multivariable analysis, a higher proportion of IMGs was associated with 1.17 years shorter RRC accreditation. Conclusions Associations between quality indicators are complex, but suggest that the presence of IMGs is associated with better performance on standardized tests but decreased duration of RRC-IM certification. PMID:21651768

Monitoring stress among internal medicine residents: an experience-driven, practical and short measure.

Science.gov (United States)

Myszkowski, Nils; Villoing, Barbara; Zenasni, Franck; Jaury, Philippe; Boujut, Emilie

2017-07-01

Residents experience severely high levels of stress, depression and burnout, leading to perceived medical errors, as well as to symptoms of impairment, such as chronic anger, cognitive impairment, suicidal behavior and substance abuse. Because research has not yet provided a psychometrically robust population-specific tool to measure the level of stress of medicine residents, we aimed at building and validating such a measure. Using an inductive scale development approach, a short, pragmatic measure was built, based on the interviews of 17 medicine residents. The Internal Medicine Residency Stress Scale (IMRSS) was then administered in a sample of 259 internal medicine residents (199 females, 60 males, M Age  = 25.6) along with the Hospital Anxiety and Depression Scale, Maslach Burnout Inventory, Satisfaction With Life Scale and Ways of Coping Checklist. The IMRSS showed satisfactory internal reliability (Cronbach's α = .86), adequate structural validity - studied through Confirmatory Factor Analysis (χ 2 /df = 2.51, CFI = .94; SRMR = .037, RMSEA = .076) - and good criterion validity - the IMRSS was notably strongly correlated with emotional exhaustion (r = .64; p is recommended to quickly and frequently assess and monitor stress among internal medicine residents.

Point-of-care ultrasonography as a training milestone for internal medicine residents: the time is now.

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Sabath, Bruce F; Singh, Gurkeerat

2016-01-01

Point-of-care (POC) ultrasonography is considered fundamental in emergency medicine training and recently has become a milestone in critical care fellowship programs as well. Currently, there is no such standard requirement for internal medicine residency programs in the United States. We present a new case and briefly review another case at our institution - a community hospital - in which internal medicine house staff trained in ultrasonography were able to uncover unexpected and critical diagnoses that significantly changed patient care and outcomes. We also review the growing evidence of the application of ultrasound in the diagnosis of a myriad of conditions encountered in general internal medicine as well as the mounting data on the ability of internal medicine residents to apply this technology accurately at the bedside. We advocate that the literature has sufficiently established the role of POC ultrasonography in general internal medicine that there should no longer be any delay in giving this an official place in the development of internal medicine trainees. This may be particularly useful in the community hospital setting where 24-h echocardiography or other sonography may not be readily available.

Charting the Road to Competence: Developmental Milestones for Internal Medicine Residency Training

Science.gov (United States)

Green, Michael L.; Aagaard, Eva M.; Caverzagie, Kelly J.; Chick, Davoren A.; Holmboe, Eric; Kane, Gregory; Smith, Cynthia D.; Iobst, William

2009-01-01

Background The Accreditation Council for Graduate Medical Education (ACGME) Outcome Project requires that residency program directors objectively document that their residents achieve competence in 6 general dimensions of practice. Intervention In November 2007, the American Board of Internal Medicine (ABIM) and the ACGME initiated the development of milestones for internal medicine residency training. ABIM and ACGME convened a 33-member milestones task force made up of program directors, experts in evaluation and quality, and representatives of internal medicine stakeholder organizations. This article reports on the development process and the resulting list of proposed milestones for each ACGME competency. Outcomes The task force adopted the Dreyfus model of skill acquisition as a framework the internal medicine milestones, and calibrated the milestones with the expectation that residents achieve, at a minimum, the “competency” level in the 5-step progression by the completion of residency. The task force also developed general recommendations for strategies to evaluate the milestones. Discussion The milestones resulting from this effort will promote competency-based resident education in internal medicine, and will allow program directors to track the progress of residents and inform decisions regarding promotion and readiness for independent practice. In addition, the milestones may guide curriculum development, suggest specific assessment strategies, provide benchmarks for resident self-directed assessment-seeking, and assist remediation by facilitating identification of specific deficits. Finally, by making explicit the profession's expectations for graduates and providing a degree of national standardization in evaluation, the milestones may improve public accountability for residency training. PMID:21975701

The universal, collaborative and dynamic model of specialist and advanced nursing and midwifery practice: A way forward?

Science.gov (United States)

O'Connor, Laserina; Casey, Mary; Smith, Rita; Fealy, Gerard M; Brien, Denise O'; O'Leary, Denise; Stokes, Diarmuid; McNamara, Martin S; Glasgow, Mary Ellen; Cashin, Andrew

2018-03-01

To inform and guide the development of a future model of specialist and advanced nursing and midwifery practice. There is a sizable body of empirical literature supporting the unique contributions of specialist and advanced practice roles to health care. However, there is very little international evidence to inform the integration of a future model for advanced or specialist practice in the Irish healthcare system. A qualitative study was conducted to initiate this important area of inquiry. Purposive sampling was used to generate a sample of informants (n = 15) for the interviews. Nurses and midwives working in specialist and advanced practice and participants from other areas such as legislative, regulatory, policy, medicine and education were included in the sampling frame. Arguments for a new model of specialist and advanced practice were voiced. A number of participants proposed that flexibility within specialist and advanced practitioner career pathways was essential. Otherwise, there existed the possibility of being directed into specialised "silos," precluding movement to another area of integrated practice. Future specialist and advanced practice education programmes need to include topics such as the development of emotional and political intelligence. The contribution of specialist and advanced practice roles to the health service includes providing rapid access to care, seamless patient flow across services, early discharge and lead coordinator of the patient's care trajectory. There was a recommendation of moving towards a universal model to cultivate specialist and advanced nurse and midwife practitioners. The model design has Universal application in a range of contexts "U." It is Collaborative in its inclusivity of all key stakeholders "C." The model is Dynamic pertinent to accommodating movement of nurses and midwives across health continua rather than plateauing in very specialised "silos" "D." © 2017 John Wiley & Sons Ltd.

[Challenges of Digital Medicine].

Science.gov (United States)

Blaser, Jürg

2018-06-01

Challenges of Digital Medicine Abstract. Digitization is increasingly covering more and more sectors, including medicine. To ensure medical operation 365 × 24 hours, progressively more human and financial resources are necessary. The transformation of patient histories from paper into electronic patient records focused initially on documentation. Today, hospital information systems are increasingly used as a platform for the communication of all professionals involved in the patient process - in Switzerland, however, so far without providing patients direct access to their data. Digititizing processes intend to increase efficiency, but also to enhance clinical and administrative decision support and quality assurance. The introduction of the electronic patient record in Switzerland in 2020 is expected to provide cross-company, more complete documentation of patient care. Multimorbid patients, often treated in different institutions and by different specialists, should benefit from this in particular. Advances in artificial intelligence offer new opportunities in medicine. Challenges include ensuring reliable data protection, and better interoperability of the systems involved. Semantically structured, machine-readable data exchange is a necessity for both networked services and internationally competitive research.

Attitudes and preferences toward the provision of medication abortion in an urban academic internal medicine practice.

Science.gov (United States)

Page, Cameron; Stumbar, Sarah; Gold, Marji

2012-06-01

Mifepristone offers internal medicine doctors the opportunity to greatly expand access to abortion for their patients. Almost 70% of pregnancy terminations, however, still occur in specialized clinics. No studies have examined the preferences of Internal Medicine patients specifically. Determine whether patient preference is a reason for the limited uptake of medication abortion among internal medicine physicians. Women aged 18-45 recruited from the waiting room in an urban academic internal medicine clinic. A semi-structured questionnaire was used to determine risk of unintended pregnancy and attitudes toward abortion. Support for provision of medication abortion in the internal medicine clinic was assessed with a yes/no question, followed by the open-ended question, "Why do you think this clinic should or should not offer medication abortion?" Subjects were asked whether it was very important, somewhat important, or not important for the internal medicine clinic to provide medication abortion. Of 102 women who met inclusion criteria, 90 completed the survey, yielding a response rate of 88%. Twenty-two percent were at risk of unintended pregnancy. 46.7% had had at least one lifetime abortion. Among those who would consider having an abortion, 67.7% responded yes to the question, "Do you think this clinic should offer medication abortions?" and 83.9% stated that it was "very important" or "somewhat important" to offer this service. Of women open to having an abortion, 87.1% stated that they would be interested in receiving a medication abortion from their primary care doctor. A clinically significant proportion of women in this urban internal medicine clinic were at risk of unintended pregnancy. Among those open to having an abortion, a wide majority would consider receiving it from their internal medicine doctor. The provision of medication abortion by internal medicine physicians has the potential to greatly expand abortion access for women.

Predictors of Final Specialty Choice by Internal Medicine Residents

Science.gov (United States)

Diehl, Andrew K; Kumar, Vineeta; Gateley, Ann; Appleby, Jane L; O'Keefe, Mary E

2006-01-01

BACKGROUND Sociodemographic factors and personality attributes predict career decisions in medical students. Determinants of internal medicine residents' specialty choices have received little attention. OBJECTIVE To identify factors that predict the clinical practice of residents following their training. DESIGN Prospective cohort study. PARTICIPANTS Two hundred and four categorical residents from 2 university-based residency programs. MEASUREMENTS Sociodemographic and personality inventories performed during residency, and actual careers 4 to 9 years later. RESULTS International medical school graduates (IMGs) were less likely to practice general medicine than U.S. graduates (33.3% vs 70.6%, Pinternal medicine was observed among those who perceived General Internists to have lower potential incomes (69.0% vs 53.3%, P = .08). There was a trend for generalists to have lower scores on scales measuring authoritarianism, negative orientation to psychological problems, and Machiavellianism (0.05medicine, with trends apparent for higher debt (P = .05) and greater comfort caring for patients with psychological problems (P = .07). CONCLUSION Recruitment of IMGs may not increase the supply of General Internists. Prospects of lower income, even in the face of large debt, may not discourage residents from becoming generalists. If increasing generalist manpower is a goal, residencies should consider weighing applicants' personal attributes during the selection process. PMID:16836624

Are peer specialists happy on the job?

Science.gov (United States)

Jenkins, Sarah; Chenneville, Tiffany; Salnaitis, Christina

2018-03-01

This study was designed to examine the impact of role clarity and job training on job satisfaction among peer specialists. A 3-part survey assessing job training, job satisfaction, and role clarity was administered online to 195 peer specialists who are members of the International Association of Peer Specialists. Data was analyzed using descriptive statistics, correlational analyses to include multiple linear regressions and analysis of variance. Self-study and online training methods were negatively correlated with job satisfaction while job shadowing was positively correlated with job satisfaction. Role clarity was positively correlated with job satisfaction and job training satisfaction as well as job shadowing and one-on-one training. The use of self-study and online training for peer specialists is contraindicated by current findings, which suggest the need to utilize job shadowing or training methods that allow for personal interaction between peer specialists and their colleagues. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

The impact of the improvement in internal medicine consultation process on ED length of stay.

Science.gov (United States)

Shin, Sangheon; Lee, Soo Hoon; Kim, Dong Hoon; Kim, Seong Chun; Kim, Tae Yun; Kang, Changwoo; Jeong, Jin Hee; Lim, Daesung; Park, Yong Joo; Lee, Sang Bong

2018-04-01

Although consultations are essential for delivering safe, high-quality care to patients in emergency departments, they contribute to emergency department patient flow problems and overcrowding which is associated with several adverse outcomes, such as increases in patient mortality and poor quality care. This study aimed to investigate how time flow metrics including emergency department length of stay is influenced by changes to the internal medicine consultation policy. This study is a pre- and post-controlled interventional study. We attempted to improve the internal medicine consultation process to be more concise. After the intervention, only attending emergency physicians consult internal medicine chief residents, clinical fellows, or junior staff of each internal medicine subspecialty who were on duty when patients required special care or an admission to internal medicine. Emergency department length of stay of patients admitted to the department of internal medicine prior to and after the intervention decreased from 996.94min to 706.62min. The times from consultation order to admission order and admission order to emergency department departure prior to and after the intervention were decreased from 359.59min to 180.38min and from 481.89min to 362.37min, respectively. The inpatient mortality rates and Inpatient bed occupancy rates prior to and after the intervention were similar. The improvements in the internal medicine consultation process affected the flow time metrics. Therefore, more comprehensive and cooperative strategies need to be developed to reduce the time cycle metrics and overcrowding of all patients in the emergency department. Copyright © 2017 Elsevier Inc. All rights reserved.

The clinical nurse specialist: leadership in quality improvement.

Science.gov (United States)

Finkelman, Anita

2013-01-01

Healthcare delivery is in a crisis, requiring improvement. How to improve and who should assume more leadership are not clear. At the same time, the nursing profession struggles with a weak education system, graduating students who require major support for an extended time. There is also confusion related to nursing roles, particularly with nurses who have a graduate degree. The Institute of Medicine has published a series of reports about the healthcare system and need for improvement and describes a structure for improvement. The clinical nurse specialist is particularly suited to assume a major role in nursing leadership to guide staff and the healthcare system to better ensure improved care. There is great need to communicate that the clinical nurse specialist can and should assume this role. This will require a review and development of more quality improvement content and experiences in clinical nurse specialist educational programs, but much of the content is already in programs. The clinical nurse specialist works in systems, impacts systems, works with staff, and can thus reach more patients with improvement approaches.

Conflict Management Strategies in the ICU Differ Between Palliative Care Specialists and Intensivists.

Science.gov (United States)

Chiarchiaro, Jared; White, Douglas B; Ernecoff, Natalie C; Buddadhumaruk, Praewpannarai; Schuster, Rachel A; Arnold, Robert M

2016-05-01

Conflict is common between physicians and surrogate decision makers around end-of-life care in ICU. Involving experts in conflict management improve outcomes, but little is known about what differences in conflict management styles may explain the benefit. We used simulation to examine potential differences in how palliative care specialists manage conflict with surrogates about end-of-life treatment decisions in ICUs compared with intensivists. Subjects participated in a high-fidelity simulation of conflict with a surrogate in an ICU. In this simulation, a medical actor portrayed a surrogate decision maker during an ICU family meeting who refuses to follow an advance directive that clearly declines advanced life-sustaining therapies. We audiorecorded the simulation encounters and applied a coding framework to quantify conflict management behaviors, which was organized into two categories: task-focused communication and relationship building. We used negative binomial modeling to determine whether there were differences between palliative care specialists' and intensivists' use of task-focused communication and relationship building. Single academic medical center ICU. Palliative care specialists and intensivists. None. We enrolled 11 palliative care specialists and 25 intensivists. The palliative care specialists were all attending physicians. The intensivist group consisted of 11 attending physicians, 9 pulmonary and critical care fellows, and 5 internal medicine residents rotating in the ICU. We excluded five residents from the primary analysis in order to reduce confounding due to training level. Physicians' mean age was 37 years with a mean of 8 years in practice. Palliative care specialists used 55% fewer task-focused communication statements (incidence rate ratio, 0.55; 95% CI, 0.36-0.83; p = 0.005) and 48% more relationship-building statements (incidence rate ratio, 1.48; 95% CI, 0.89-2.46; p = 0.13) compared with intensivists. We found that palliative care

Incidence of refeeding syndrome in internal medicine patients

NARCIS (Netherlands)

Kraaijenbrink, B. V. C.; Lambers, W. M.; Mathus-Vliegen, E. M. H.; Siegert, C. E. H.

2016-01-01

Refeeding syndrome is a potentially fatal shift of fluids and electrolytes that may occur after reintroducing nutrition in a malnourished patient. Its incidence in internal medicine patients is not known. We aimed at determining the incidence in a heterogeneous group of patients acutely admitted to

Burnout and Physical Activity in Minnesota Internal Medicine Resident Physicians

Science.gov (United States)

Olson, Shawn M.; Odo, Nnaemeka U.; Duran, Alisa M.; Pereira, Anne G.; Mandel, Jeffrey H.

2014-01-01

Background Regular physical activity plays an important role in the amelioration of several mental health disorders; however, its relationship with burnout has not yet been clarified. Objective To determine the association between achievement of national physical activity guidelines and burnout in internal medicine resident physicians. Methods A Web-based survey of internal medicine resident physicians at the University of Minnesota and Hennepin County Medical Center was conducted from September to October 2012. Survey measures included the Maslach Burnout Inventory-Human Services Survey and the International Physical Activity Questionnaire. Results Of 149 eligible residents, 76 (51.0%) completed surveys, which were used in the analysis. Burnout prevalence, determined by the Maslach Burnout Inventory, was 53.9% (41 of 76). Prevalence of failure to achieve US Department of Health and Human Services physical activity guidelines was 40.8% (31 of 76), and 78.9% (60 of 76) of residents reported that their level of physical activity has decreased since they began medical training. Residents who were able to meet physical activity guidelines were less likely to be burned out than their fellow residents (OR, 0.38, 95% CI 0.147–0.99). Conclusions Among internal medicine resident physicians, achievement of national physical activity guidelines appears to be inversely associated with burnout. Given the high national prevalence of burnout and inactivity, additional investigation of this relationship appears warranted. PMID:26140116

World Workshop on Oral Medicine VI: an international validation study of clinical competencies for advanced training in oral medicine.

Science.gov (United States)

Steele, John C; Clark, Hadleigh J; Hong, Catherine H L; Jurge, Sabine; Muthukrishnan, Arvind; Kerr, A Ross; Wray, David; Prescott-Clements, Linda; Felix, David H; Sollecito, Thomas P

2015-08-01

To explore international consensus for the validation of clinical competencies for advanced training in Oral Medicine. An electronic survey of clinical competencies was designed. The survey was sent to and completed by identified international stakeholders during a 10-week period. To be validated, an individual competency had to achieve 90% or greater consensus to keep it in its current format. Stakeholders from 31 countries responded. High consensus agreement was achieved with 93 of 101 (92%) competencies exceeding the benchmark for agreement. Only 8 warranted further attention and were reviewed by a focus group. No additional competencies were suggested. This is the first international validated study of clinical competencies for advanced training in Oral Medicine. These validated clinical competencies could provide a model for countries developing an advanced training curriculum for Oral Medicine and also inform review of existing curricula. Copyright © 2015 Elsevier Inc. All rights reserved.

What Is a Pediatric Sports Medicine Specialist?

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... Ribbon Commands Skip to main content Turn off Animations Turn on Animations Our Sponsors Log in | Register Menu Log in | ... in mind. They may have toys, videos, and reading materials for young people available. Pediatric sports medicine ...

Evaluating M.D.-Level Competence in Internal Medicine.

Science.gov (United States)

Anderson, Alexander S.; Botticelli, Max G.

1981-01-01

The implementation of a clinical clerkship in internal medicine that was flexible in time required that a new evaluation program be developed to assess the progress of students. The progress of the classes of 1979 and 1980 toward achievement of predetermined levels of mastery is presented. (Author/MLW)

Pediatric Specialists

Science.gov (United States)

... Healthy Children > Family Life > Medical Home > Pediatric Specialists Pediatric Specialists Article Body ​Your pediatrician may refer your child to a pediatric specialist for further evaluation and treatment. Pediatric specialists ...

European undergraduate curriculum in geriatric medicine developed using an international modified Delphi technique

DEFF Research Database (Denmark)

Masud, T.; Blundell, A.; Gordon, A. L.

2014-01-01

Introduction: the rise in the number of older, frail adults necessitates that future doctors are adequately trained in the skills of geriatric medicine. Few countries have dedicated curricula in geriatric medicine at the undergraduate level. The aim of this project was to develop a consensus among...... geriatricians on a curriculum with the minimal requirements that a medical student should achieve by the end of medical school. Methods: a modified Delphi process was used. First, educational experts and geriatricians proposed a set of learning objectives based on a literature review. Second, three Delphi...... rounds involving a panel with 49 experts representing 29 countries affiliated to the European Union of Medical Specialists (UEMS) was used to gain consensus for a final curriculum. Results: the number of disagreements following Delphi Rounds 1 and 2 were 81 and 53, respectively. Complete agreement...

Book of abstracts of the Fifth International School for young scientists and specialists Interaction of hydrogen isotopes with structural materials. IHISM-09 JUNIOR

International Nuclear Information System (INIS)

2009-01-01

The book includes abstracts of presentations at the Fifth International School for young scientists and specialists Interaction of hydrogen isotopes with structural materials (IHISM-09 JUNIOR). Abstracts of lecture faculty and reports of young scientists and specialists covering the use of hydrogen isotopes in energetics, national economy and fundamental researches are given. Papers presented on the following topics: mechanical properties and structural transformations; kinetics and thermodynamics of interaction between hydrogen isotopes and solids including effects of radiogenic helium accumulation, hydrides and hydride transformations; equipment and research techniques

A Qualitative Study of Work-Life Choices in Academic Internal Medicine

Science.gov (United States)

Isaac, Carol; Byars-Winston, Angela; McSorley, Rebecca; Schultz, Alexandra; Kaatz, Anna; Carnes, Mary L.

2014-01-01

The high attrition rate of female physicians pursuing an academic medicine research career has not been examined in the context of career development theory. We explored how internal medicine residents and faculty experience their work within the context of their broader life domain in order to identify strategies for facilitating career…

Practical occupational medicine in "practice"

DEFF Research Database (Denmark)

Ingemann Larsen, Anders; Schmidt, Jan; Jepsen, Jørgen Riis

2016-01-01

with few occupational health resources. This Editorial argues that family physicians are indeed in a position where they can make a major positive difference for their working patients and for the enterprises where they work. Without specialist knowledge in occupational medicine, the family physician......’s empiric knowledge in combination with a narrative approach to the patient permits the contribution from family medicine not only with regard to diagnosis and treatment, but also relating to actions targeted to optimize the patient’s future accommodation at work as well as to protect other similarly......In Denmark, the practice of occupational medicine tends to be carried out by specialists in occupational medicine and less so by family physicians. The provision of health service to workers is therefore limited. This constraint may also apply in other developed countries and even more in countries...

Do we need a universal 'code of ethics' in nuclear medicine?

Science.gov (United States)

Ramesh, Chandakacharla N; Vinjamuri, Sobhan

2010-06-01

Recent years have seen huge advances in medicine and the science of medicine. Nuclear medicine has been no exception and there has been rapid acceptance of new concepts, new technologies and newer ways of working. Ethical principles have been traditionally considered as generic skills applicable to wide groups of scientists and doctors, with only token refinement at specialty level. Specialist bodies across the world representing wide groups of practitioners frequently have subgroups dealing exclusively with ethical issues. It could easily be argued that the basic principles of ethical practice adopted by specialist bodies closest to nuclear medicine practice, such as radiology and oncology, will also be applicable to nuclear medicine and that time and effort need not be spent on specifying a separate code for nuclear medicine. It could also be argued that nuclear medicine is an independent specialty and some (if not most) practitioners will not be aware of the guidelines adopted by other specialist societies, and that there is a need for re-iteration of ethical principles at the specialty level and on a worldwide scale.In this article we would like to present a brief history of medical ethics, discuss some of the advances in nuclear medicine and their associated ethical aspects, as well as list a framework of principles for consideration, should a specialist body deem it suitable to establish a 'code of ethics' for nuclear medicine.

Gender differences in salary of internal medicine residency directors: a national survey.

Science.gov (United States)

Willett, Lisa L; Halvorsen, Andrew J; McDonald, Furman S; Chaudhry, Saima I; Arora, Vineet M

2015-06-01

Whether salary disparities exist between men and women in medical education leadership roles is not known. The study objective was to determine whether salary disparities exist between male and female Internal Medicine residency program directors, and if so, to identify factors associated with the disparities and explore historical trends. The annual Association of Program Directors in Internal Medicine (APDIM) survey in August 2012 included items to assess the salary and demographic characteristics of program directors, which were merged with publically available program data. To assess historical trends, we used similarly obtained survey data from 2008 to 2011. The study included program directors of 370 APDIM member programs, representing 95.6% of the 387 accredited Internal Medicine training programs in the United States and Puerto Rico. Of the 370 APDIM member programs, 241 (65.1%) completed the survey, of whom 169 (70.1%) were men and 72 (29.9%) were women. Program directors' total annual salary, measured in $25,000 increments, ranged from $75,000 or less to more than $400,000. Historical trends of mode salary by gender from 2008 to 2012 were assessed. The mode salary was $200,000 to 225,000 for men and $175,000 to $200,000 for women (P = .0005). After controlling for academic rank, career in general internal medicine, and program director age, the distribution of salary remained different by gender (P = .004). Historical trends show that the difference in mode salary has persisted since 2008. Leaders in academic medical centers, residency and fellowship directors, and all faculty in medical education need to be aware that salary disparities cited decades ago persist in this sample of medical educators. Closing the gender gap will require continued advocacy for measuring and reporting salary gaps, and changing the culture of academic medical centers. Copyright © 2015 Alliance for Academic Internal Medicine. Published by Elsevier Inc. All rights reserved.

General medical training in gastroenterology: views from specialist trainees on the challenges of dual accreditation.

Science.gov (United States)

Neale, James R; Basford, Peter J

2015-02-01

Higher specialist training in general internal medicine (GIM) and the medical specialties has been subject to many changes and increasing subspecialisation in recent years. The 'Shape of Training' review proposes 'broad-based specialty training', shortening of training by one year, and subspecialisation to be undertaken after the certificate of specialty training is obtained. All higher level gastroenterology trainees based in the UK were invited to complete an online survey between July and September 2012 to assess their experience of gastroenterology and GIM training. Overall, 72.7% of trainees expressed satisfaction with their training in gastroenterology but significantly fewer (43.5%) expressed satisfaction with their training in GIM. Satisfaction with gastroenterology training thus is good, but satisfaction with GIM training is lower and levels of dissatisfaction have increased significantly since 2008. Up to 50% of trainees are not achieving the minimum recommended number of colonoscopy procedures for their stage of training. Experience in GIM is seen as service orientated, with a lack of training opportunities. There is a worrying difficulty in gaining the minimum required experience in endoscopy. If the length of specialist training is shortened and generalised, training in key core specialist skills such as endoscopy may be compromised further. © 2015 Royal College of Physicians.

Problematic communications during 2016 fellowship recruitment in internal medicine.

Science.gov (United States)

Cornett, Patricia A; Williams, Chris; Alweis, Richard L; McConville, John; Frank, Michael; Dalal, Bhavin; Kopelman, Richard I; Luther, Vera P; O'connor, Alec B; Muchmore, Elaine A

2017-01-01

Some internal medicine residency program directors have expressed concerns that their third-year residents may have been subjected to inappropriate communication during the 2016 fellowship recruitment season. The authors sought to study applicants' interpersonal communication experiences with fellowship programs. Many respondents indicated that they had been asked questions that would constitute violations of the National Residency Matching Program (NRMP) Communications Code of Conduct agreement, including how they plan to rank specific programs. Moreover, female respondents were more likely to have been asked questions during interview experiences about other programs to which they applied, and about their family plans. Post-interview communication policies were not made clear to most applicants. These results suggest ongoing challenges for the internal medicine community to improve communication with applicants and uniform compliance with the NRMP communications code of conduct during the fellowship recruitment process.

International Atomic Energy Agency specialists meeting on experience in ageing, maintenance, and modernization of instrumentation and control systems for improving nuclear power plant availability

Energy Technology Data Exchange (ETDEWEB)

1993-10-01

This report presents the proceedings of the Specialist`s Meeting on Experience in Aging, Maintenance and Modernization of Instrumentation and Control Systems for Improving Nuclear Power Plant Availability that was held at the Ramada Inn in Rockville, Maryland on May 5--7, 1993. The Meeting was presented in cooperation with the Electric Power Research Institute, Oak Ridge National Laboratory and the International Atomic Energy Agency. There were approximately 65 participants from 13 countries at the Meeting. Individual reports have been cataloged separately.

Full text publication rates of studies presented at an international emergency medicine scientific meeting.

Science.gov (United States)

Chan, Jannet W M; Graham, Colin A

2011-09-01

The publication rate of full text papers following an abstract presentation at a medical conference is variable, and few studies have examined the situation with respect to international emergency medicine conferences. This retrospective study aimed to identify the publication rate of abstracts presented at the 2006 International Conference on Emergency Medicine (ICEM) held in Halifax, Canada. The full text publication rate was 33.2%, similar to previous emergency medicine meetings. English language barriers may play a role in the low publication rate seen.

Methodological bases of innovative training of specialists in nanotechnology field

Directory of Open Access Journals (Sweden)

FIGOVSKY Oleg Lvovich

2016-10-01

Full Text Available The performance of innovative training system aimed at highly intellectual specialists in the area of nanotechnologies for Kazakhstan’s economy demands establishment and development of nanotechnological market in the country, teaching of innovative engineering combined with consistent research, integration of trained specialists with latest technologies and sciences at the international level. Methodological aspects of training competitive specialists for nanotechnological field are specific. The paper presents methodological principles of innovative training of specialists for science-intensive industry that were realized according to grant given by the Ministry of Education and Science of the Republic of Kazakhstan.

Support for and aspects of use of educational games in family medicine and internal medicine residency programs in the US: a survey.

Science.gov (United States)

Akl, Elie A; Gunukula, Sameer; Mustafa, Reem; Wilson, Mark C; Symons, Andrew; Moheet, Amir; Schünemann, Holger J

2010-03-25

The evidence supporting the effectiveness of educational games in graduate medical education is limited. Anecdotal reports suggest their popularity in that setting. The objective of this study was to explore the support for and the different aspects of use of educational games in family medicine and internal medicine residency programs in the United States. We conducted a survey of family medicine and internal medicine residency program directors in the United States. The questionnaire asked the program directors whether they supported the use of educational games, their actual use of games, and the type of games being used and the purpose of that use. Of 434 responding program directors (52% response rate), 92% were in support of the use of games as an educational strategy, and 80% reported already using them in their programs. Jeopardy like games were the most frequently used games (78%). The use of games was equally popular in family medicine and internal medicine residency programs and popularity was inversely associated with more than 75% of residents in the program being International Medical Graduates. The percentage of program directors who reported using educational games as teaching tools, review tools, and evaluation tools were 62%, 47%, and 4% respectively. Given a widespread use of educational games in the training of medical residents, in spite of limited evidence for efficacy, further evaluation of the best approaches to education games should be explored.

Support for and aspects of use of educational games in family medicine and internal medicine residency programs in the US: a survey

Directory of Open Access Journals (Sweden)

Wilson Mark C

2010-03-01

Full Text Available Abstract Background The evidence supporting the effectiveness of educational games in graduate medical education is limited. Anecdotal reports suggest their popularity in that setting. The objective of this study was to explore the support for and the different aspects of use of educational games in family medicine and internal medicine residency programs in the United States. Methods We conducted a survey of family medicine and internal medicine residency program directors in the United States. The questionnaire asked the program directors whether they supported the use of educational games, their actual use of games, and the type of games being used and the purpose of that use. Results Of 434 responding program directors (52% response rate, 92% were in support of the use of games as an educational strategy, and 80% reported already using them in their programs. Jeopardy like games were the most frequently used games (78%. The use of games was equally popular in family medicine and internal medicine residency programs and popularity was inversely associated with more than 75% of residents in the program being International Medical Graduates. The percentage of program directors who reported using educational games as teaching tools, review tools, and evaluation tools were 62%, 47%, and 4% respectively. Conclusions Given a widespread use of educational games in the training of medical residents, in spite of limited evidence for efficacy, further evaluation of the best approaches to education games should be explored.

Role of laboratory medicine in collaborative healthcare.

Science.gov (United States)

Watson, Ian D; Wilkie, Patricia; Hannan, Amir; Beastall, Graham H

2018-04-09

Healthcare delivery and responsibility is changing. Patient-centered care is gaining international acceptance with the patient taking greater responsibility for his/her health and sharing decision making for the diagnosis and management of illness. Laboratory medicine must embrace this change and work in a tripartite collaboration with patients and with the clinicians who use clinical laboratory services. Improved communication is the key to participation, including the provision of educational information and support. Knowledge management should be targeted to each stakeholder group. As part of collaborative healthcare clinical laboratory service provision needs to be more flexible and available, with implications for managers who oversee the structure and governance of the service. Increased use of managed point of care testing will be essential. The curriculum content of laboratory medicine training programs will require trainees to undertake practice-based learning that facilitates interaction with patients, clinicians and managers. Continuing professional development for specialists in laboratory medicine should also embrace new sources of information and opportunities for collaborative healthcare.

European Council of Legal Medicine (ECLM) accreditation of forensic pathology services in Europe

DEFF Research Database (Denmark)

Mangin, P; Bonbled, F; Väli, M

2015-01-01

in order to provide forensic reports of high quality. In this respect, there is a need for any private or public national or international authority including non-governmental organizations seeking experts qualified in forensic medicine to have at disposal a list of specialists working in accordance...... process, determining in a scientific way the cause(s) and manner of unexpected and/or unnatural death or bringing clinical evidence in case of physical, psychological, or sexual abuse in living people. From a legal perspective, these types of investigation must meet international standards, i...

Grading Practices and Distributions Across Internal Medicine Clerkships.

Science.gov (United States)

Fazio, Sara B; Torre, Dario M; DeFer, Thomas M

2016-01-01

Clerkship evaluation and grading practices vary widely between U.S. medical schools. Grade inflation continues to exist, and grade distribution is likely to be different among U.S. medical schools. Increasing the number of available grades curtails "grade inflation." A national survey of all Clerkship Directors in Internal Medicine members was administered in 2011. The authors assessed key aspects of grading. Response rate was 76%. Among clerkship directors (CDs), 61% of respondents agreed that grade inflation existed in the internal medicine clerkship at their school, and 43% believed that it helped students obtain better residency positions. With respect to grading practices, 79% of CDs define specific behaviors needed to achieve each grade, and 36% specify an ideal grade distribution. In addition, 44% have a trained core faculty responsible for evaluating students, 35% describe formal grading meetings, and 39% use the Reporter-Interpreter-Manager-Educator (RIME) scheme. Grading scales were described as follows: 4% utilize a pass/fail system, 13% a 3-tier (e.g., Honors/Pass/Fail), 45% 4-tier, 35% 5-tier, and 4% 6+-tier system. There was a trend to higher grades with more tiers available. Grade inflation continues in the internal medicine clerkship. Almost half of CDs feel that this practice assists students to obtain better residency positions. A minority of programs have a trained core faculty who are responsible for evaluation. About one third have formal grading meetings and use the RIME system; both have been associated with more robust and balanced grading practices. In particular, there is a wide variation between schools in the percentage of students who are awarded the highest grade, which has implications for residency applications. Downstream users of clinical clerkship grades must be fully aware of these variations in grading in order to appropriately judge medical student performance.

[Social Security Needs Social Medicine: Self-image of Physicians Practicing Social Medicine in Statutory Health Insurances and Social Security Systems].

Science.gov (United States)

Nüchtern, E; Bahemann, A; Egdmann, W; van Essen, J; Gostomzyk, J; Hemmrich, K; Manegold, B; Müller, B; Robra, B P; Röder, M; Schmidt, L; Zobel, A; von Mittelstaedt, G

2015-09-01

In January, 2014, the division "Social Medicine in Practice and Rehabilitation" of the German Society for Social Medicine and Prevention established a working group on the self-image of the physicians active in the field of social medicine (medical expertise and counseling). The result of this work is the contribution presented here after consensus was achieved by specialists of social medicine from different fields and institutions (social security etc.) and in good cooperation with Prof. Dr. Gostomzyk and Prof. Dr. Robra. Based on the importance of an up to date social medicine for claimants and recipients of benefits on the one hand and the social security system on the other, and also on a description of the subjects, objectives and methods the following aspects are presented: · The perspective of social medicine. · Qualification in social medicine, concerning specialist training and continuing medical education. · The fields of duty of experts in social medicine. · The proceedings in social medicine. The working group identified challenges for the specialists in social medicine by a narrowed perception of social medicine by physicians in hospitals and practice, accompanied by an enlarged importance of expertise in social medicine, by the demand for more "patient orientation" and gain of transparency, and concerning the scientific foundation of social medicine. The working group postulates: · The perspective of social medicine should be spread more widely.. · Confidence in experts of social medicine and their independency should be strengthened.. · The not case-related consulting of the staff and executives should be expanded.. · Social medicine in practice needs support by politics and society, and especially by research and teaching.. · Good cooperation and transfer of experiences of the different branches of social security are essential for the impact of social medicine.. © Georg Thieme Verlag KG Stuttgart · New York.

Burnout syndrome during residency in internal medicine and pediatrics in a country without working time directive.

Science.gov (United States)

Aksoy, Duygu Yazgan; Durusu Tanriover, Mine; Unal, Sule; Dizdar, Omer; Kalyoncu, Umut; Karakaya, Jale; Unal, Serhat; Kale, Gulsev

2014-01-01

The purpose of this paper is to demonstrate burnout syndrome among internal medicine and pediatrics residents in a country that does not have the working time directive (WTD) and also to determine the risk factors and consequent impact on efficient functioning in clinical areas. A 57-item questionnaire was given to internal medicine and pediatrics residents. Responses from 22 pediatrics and 33 internal medicine residents were evaluated. Demographic findings, burnout scores, having hobbies, social activities and reading books unrelated to medicine were similar between the two groups. Six pediatrics residents (27.3 per cent) and 11 (33.3 per cent) internal medicine residents met the criteria for clinically significant burnout. Personal accomplishment scores and reading books unrelated to medicine were found to be related to burnout. Burnout is a syndrome characterized by depersonalization, emotional exhaustion and a low sense of personal accomplishment. It is important to document burnout in countries where WTDs are not implemented. Further studies might demonstrate burnout's effect on patient safety, service quality and physician's performance.

Development of an international nuclear decay data and cross-section database. Summary report of an IAEA specialists` meeting, Vienna, 24-28 October 1994

Energy Technology Data Exchange (ETDEWEB)

Lemmel, H D [ed.

1994-12-01

An IAEA Specialists` Meeting proposes procedures describing how an internationally accepted database of high-priority nuclear decay data and thermal neutron cross-sections can be developed through a network of experts coordinated by the IAEA Nuclear Data Section. (author).

Development of an international nuclear decay data and cross-section database. Summary report of an IAEA specialists' meeting, Vienna, 24-28 October 1994

International Nuclear Information System (INIS)

Lemmel, H.D.

1994-12-01

An IAEA Specialists' Meeting proposes procedures describing how an internationally accepted database of high-priority nuclear decay data and thermal neutron cross-sections can be developed through a network of experts coordinated by the IAEA Nuclear Data Section. (author)

Basic Geriatrics Knowledge Among Internal Medicine Trainees in a Teaching Hospital in Saudi Arabia.

Science.gov (United States)

Al-Aama, Tareef

2016-06-01

To assess the basic knowledge of medical trainees, in the absence of a structured geriatrics curriculum, around a variety of geriatric medicine components that are considered essential for the care of the rapidly increasing elderly population. Eighty-three trainees at different levels of training in internal medicine were asked about a variety of common geriatric conditions. Those included: delirium, falls, geriatric syndromes, pain, cognitive impairment, and medications. The trainees' knowledge about common geriatric condition was overall poor. The most pronounced deficits included: the lack of familiarity in diagnosing geriatric syndromes (63 %) or managing them (67 %), the underestimation of the prevalence of delirium (49 %), and the tendency to undertreat pain (64 %). Poor familiarity with polypharmacy and its impact, as well as inappropriate prescription practices in the elderly were also observed. In the absence of a structured geriatric medicine curriculum, internal medicine trainees' knowledge about important geriatric conditions is poor, even if their internal medicine knowledge is overall adequate. This would translate into suboptimal care for this vulnerable and rapidly expanding segment of the population.

Mindfulness, burnout, and effects on performance evaluations in internal medicine residents.

Science.gov (United States)

Braun, Sarah E; Auerbach, Stephen M; Rybarczyk, Bruce; Lee, Bennett; Call, Stephanie

2017-01-01

Burnout has been documented at high levels in medical residents with negative effects on performance. Some dispositional qualities, like mindfulness, may protect against burnout. The purpose of the present study was to assess burnout prevalence among internal medicine residents at a single institution, examine the relationship between mindfulness and burnout, and provide preliminary findings on the relation between burnout and performance evaluations in internal medicine residents. Residents (n = 38) completed validated measures of burnout at three time points separated by 2 months and a validated measure of dispositional mindfulness at baseline. Program director end-of-year performance evaluations were also obtained on 22 milestones used to evaluate internal medicine resident performance; notably, these milestones have not yet been validated for research purposes; therefore, the investigation here is exploratory. Overall, 71.1% (n = 27) of the residents met criteria for burnout during the study. Lower scores on the "acting with awareness" facet of dispositional mindfulness significantly predicted meeting burnout criteria χ 2 (5) = 11.88, p = 0.04. Lastly, meeting burnout criteria significantly predicted performance on three of the performance milestones, with positive effects on milestones from the "system-based practices" and "professionalism" domains and negative effects on a milestone from the "patient care" domain. Burnout rates were high in this sample of internal medicine residents and rates were consistent with other reports of burnout during medical residency. Dispositional mindfulness was supported as a protective factor against burnout. Importantly, results from the exploratory investigation of the relationship between burnout and resident evaluations suggested that burnout may improve performance on some domains of resident evaluations while compromising performance on other domains. Implications and directions for future research are discussed.

Can we predict final outcome of internal medicine residents with in-training evaluation.

Science.gov (United States)

Chierakul, Nitipatana; Pongprasobchai, Supot; Boonyapisit, Kanokwan; Chinthammitr, Yingyong; Pithukpakorn, Manop; Maneesai, Adisak; Srivijitkamol, Apiradee; Koomanachai, Pornpan; Koolvisoot, Ajchara; Tanwandee, Tawesak; Shayakul, Chairat; Kachintorn, Udom

2011-02-01

To assess the predictive value of in-training evaluation for determining future success in the internal medicine board certifying examination. Ninety-seven internal medicine residents from Faculty of Medicine Siriraj Hospital who undertake the Thai Board examination during the academic year 2006-2008 were enrolled. Correlation between the scores during internal medicine rotation and final scores in board examination were then examined. Significant positive linear correlation was found between scores from both written and clinical parts of board certifying examination and scores from the first-year summative written and clinical examinations and also the second-year formative written examination (r = 0.43-0.68, p evaluation by attending staffs was less well correlated (r = 0.29-0.36) and the evaluation by nurses or medical students demonstrated inverse relationship (r = -0.2, p = 0.27 and r = -0.13, p = 0.48). Some methods of in-training evaluation can predict successful outcome of board certifying examination. Multisource assessments cannot well extrapolate some aspects of professional competences and qualities.

Correlation of United States Medical Licensing Examination and Internal Medicine In-Training Examination performance.

Science.gov (United States)

Perez, Jose A; Greer, Sharon

2009-12-01

The Internal Medicine In-Training Examination (ITE) is administered during residency training in the United States as a self-assessment and program assessment tool. Performance on this exam correlates with outcome on the American Board of Internal Medicine Certifying examination. Internal Medicine Program Directors use the United States Medical Licensing Examination (USMLE) to make decisions in recruitment of potential applicants. This study was done to determine a correlation of USMLE Steps 1, 2 and 3 results with ITE scores in each level of Internal Medicine training. A retrospective review of all residents graduating from an Internal Medicine program from 1999 to 2006 was done. Subjects included had data for all USMLE Steps and ITE during all years of training. Thirty-one subjects were included in the study. Correlations of USMLE Steps 1, 2 and 3 were done with ITE scores (percent correct) in each year of training. Pearson's correlation coefficient (r) was determined for each pairing and a t test to determine statistical significance of the correlation was done. Statistical significance was defined as P value ITE percent correct in PGY I, II and III were 0.46, 0.55 and 0.51 respectively. Corresponding r values for USMLE Step 2 and ITE percent correct were 0.79, 0.70 and 0.72; for USMLE Step 3 these values were 0.51, 0.37 and 0.51 respectively for each training year. USMLE scores are correlated with ITE scores. This correlation was strongest for USMLE Step 2.

Year-End Clinic Handoffs: A National Survey of Academic Internal Medicine Programs.

Science.gov (United States)

Phillips, Erica; Harris, Christina; Lee, Wei Wei; Pincavage, Amber T; Ouchida, Karin; Miller, Rachel K; Chaudhry, Saima; Arora, Vineet M

2017-06-01

While there has been increasing emphasis and innovation nationwide in training residents in inpatient handoffs, very little is known about the practice and preparation for year-end clinic handoffs of residency outpatient continuity practices. Thus, the latter remains an identified, yet nationally unaddressed, patient safety concern. The 2014 annual Association of Program Directors in Internal Medicine (APDIM) survey included seven items for assessing the current year-end clinic handoff practices of internal medicine residency programs throughout the country. Nationwide survey. All internal medicine program directors registered with APDIM. Descriptive statistics of programs and tools used to formulate a year-end handoff in the ambulatory setting, methods for evaluating the process, patient safety and quality measures incorporated within the process, and barriers to conducting year-end handoffs. Of the 361 APDIM member programs, 214 (59%) completed the Transitions of Care Year-End Clinic Handoffs section of the survey. Only 34% of respondent programs reported having a year-end ambulatory handoff system, and 4% reported assessing residents for competency in this area. The top three barriers to developing a year-end handoff system were insufficient overlap between graduating and incoming residents, inability to schedule patients with new residents in advance, and time constraints for residents, attendings, and support staff. Most internal medicine programs do not have a year-end clinic handoff system in place. Greater attention to clinic handoffs and resident assessment of this care transition is needed.

Metabolic syndrome in Internal Medicine patients: the pilot NIMEC study (National Internal Medicine Equivalent/Complex C-V-@Risk

Directory of Open Access Journals (Sweden)

R. Nardi

2013-05-01

Full Text Available BACKGROUND Metabolic Syndrome (MetS, currently defined as slight differences in the criteria of diagnosis – depending on which authority is quoted [i.e.: NCEP-ATP III (National Cholesterol Education Program/Adult Treatment Panel III; WHO (World Health Organization; IDF (International Diabetes Federation; AACE (American Association of Clinical Endocrinologists], designates a cluster of metabolic risk factors that come together in a single individual, leading to cardiovascular disease. MetS is quite common, approximately 20-30% of the population in industrialized countries being affected. However, most of epidemiological data regarding MetS are derived from populations consisting mostly of middle-aged and younger subjects. AIM OF THE STUDY To assess the prevalence of the MetS in Internal Medicine wards and to determine its related comorbidities, including other clinical forms of atherosclerotic disease such as CHD risk equivalents. METHODS Our study was performed in patients admitted in Internal Medicine wards and selected as a randomization list in 12 Emilia Romagna-Marche FADOI centers. 1.316 patients were registered. According to explicit inclusion/exclusion criteria, we studied overall 902 participants (50.6% men, mean of age: 71-73 years. RESULTS According to NCEP-ATP III and IDF criteria the prevalence of MetS was 45.3% (IC 95%: 41.6-49.1 and 38.6% (IC 95%: 34.9-42.3, respectively. Patients with MetS presented a higher significant rate of ALT increase, syncope, atrial fibrillation, COPD, unstable angina, chronic kidney disease, cancer, valvular heart disease, peripheral arterial disease and carotid plaques. A strong association between IDF-MetS and congestive heart failure was observed, suggesting a role of central obesity as an independent risk factor in the elderly. DISCUSSION World-wide populations are becoming older. Aging and MetS are two conditions that represent an important part of health-care spending. Trunkal fatness increases in

Promoting Success: A Professional Development Coaching Program for Interns in Medicine.

Science.gov (United States)

Palamara, Kerri; Kauffman, Carol; Stone, Valerie E; Bazari, Hasan; Donelan, Karen

2015-12-01

Residency is an intense period. Challenges, including burnout, arise as new physicians develop their professional identities. Residency programs provide remediation, but emotional support for interns is often limited. Professional development coaching of interns, regardless of their performance, has not been reported. Design, implement, and evaluate a program to support intern professional development through positive psychology coaching. We implemented a professional development coaching program in a large residency program. The program included curriculum development, coach-intern interactions, and evaluative metrics. A total of 72 internal medicine interns and 26 internal medicine faculty participated in the first year. Interns and coaches were expected to meet quarterly; expected time commitments per year were 9 hours (per individual coached) for coaches, 5 1/2 hours for each individual coachee, and 70 hours for the director of the coaching program. Coaches and interns were asked to complete 2 surveys in the first year and to participate in qualitative interviews. Eighty-two percent of interns met with their coaches 3 or more times. Coaches and their interns assessed the program in multiple dimensions (participation, program and professional activities, burnout, coping, and coach-intern communication). Most of the interns (94%) rated the coaching program as good or excellent, and 96% would recommend this program to other residency programs. The experience of burnout was lower in this cohort compared with a prior cohort. There is early evidence that a coaching program of interactions with faculty trained in positive psychology may advance intern development and partially address burnout.

Course on internal dosimetry in nuclear medicine; Curso de dosimetria interna en medicina nuclear

Energy Technology Data Exchange (ETDEWEB)

NONE

2004-07-01

This documentation was distributed to the participants in the Course of Internal Dosimetry in Nuclear Medicine organised by the Nuclear Regulatory Authority (ARN) of Argentina and held in Buenos Aires, Argentina, August 9-13, 2004. The course was intended for people from IAEA Member States in the Latin American and Caribbean region, and for professionals and workers in medicine, related with the radiation protection. Spanish and English were the languages of the course. The following subjects were covered: radioprotection of the patient in nuclear medicine; injuries by ionizing radiations; MIRD methodology; radiation dose assessment in nuclear medicine; small scale and microdosimetry; bone and marrow dose modelling; medical internal dose calculations; SPECT and image reconstruction; principles of the gamma camera; scattering and attenuation correction in SPECT; tomography in nuclear medicine.

Towards a conceptual description of Physical and Rehabilitation Medicine.

Science.gov (United States)

Gutenbrunner, Christoph; Meyer, Thorsten; Melvin, John; Stucki, Gerold

2011-09-01

Physical and Rehabilitation Medicine (PRM) is an independent medical specialty focusing on the improvement of functioning. A shared understanding of concepts is of vital importance for integrated action in this field. The aim of the present paper is to provide a conceptual model of PRM, to give background on its development and adoptions, and to explain the choice of terms, phrases, and concepts. It is based on the terms and concepts of the International Classification of Functioning, Disability and Health (ICF) that provides a widely accepted conceptual model and taxonomy of human functioning. Based on the White Book on Physical and Rehabilitation Medicine in Europe of 2006 a first proposal for a conceptual description of rehabilitation has been published in 2007. This proposal has been subjected to comments for modifications and amendments. E.g. it was underlined that PRM can apply both a health condition perspective including curative approaches and measures aiming at body functions and structures and a multi-dimensional and multi-professional team approach aiming to optimize functioning from a comprehensive functioning and disability perspective. The interaction between the PRM specialist and the person should be characterized as a partnership. PRM specialists work across all areas of health services and across all age groups. In summary, the specialty of PRM is characterized as the medicine of functioning.

Application impact of internal monitoring criteria in radiological protection programs of nuclear medicine services

International Nuclear Information System (INIS)

Dantas, Bernardo M.; Dantas, Ana Leticia A.; Juliao, Ligia Q.C.; Lourenco, Maria Cristina; Melo, Dunstana R.

2005-01-01

This work presents the simulation of the internal monitoring criteria application for the most used radionuclides by the area of nuclear medicine, taking into consideration the usual conditions of usual source handling and the activity bands authorized by the CNEN. It is concluded that the handling of Iodine 131 for therapeutical purposes is the practice which presents the most risk of internal exposure for the works, requiring the adoption of a program for internal monitoring by the nuclear medicine services

Estimation of Internal Radiation Dose to Nuclear Medicine Workers at Siriraj Hospital

International Nuclear Information System (INIS)

Asawarattanapakdee, J.; Sritongkul, N.; Chaudakshetrin, P.; Kanchanaphiboon, P.; Tuntawiroon, M.

2012-01-01

Every type of work performed in a nuclear medicine department will make a contribution to both external and internal exposure of the worker. The purpose of this study is to evaluate the potential risks of internal contamination to staff members during nuclear medicine practices and to conclude about the requirement of a routine internal monitoring. Following the method describes in the ICRP Publication 78 and the IAEA Safety Standard Series No. RS- G-1.2, in vivo thyroid bioassays using NaI(Tl) thyroid probe were performed to determine the intake estimates on 7 groups of nuclear medicine personnel working with I-131 and Tc-99m, based on working conditions and amount of radionuclides being handled. Frequency of measurements was between 7 and 14 days. These include (1) physicians and physicists, (2) radiochemists (3) technologists, (4) nurses and assistant nurses, (5) imaging room assistants, (6) hot lab workers and (7) hospital ward housekeepers/cleaners. Among all workers, the intake estimates of I-131 in the thyroid ranged from 0 to 76.7 kBq and of the technetium-99m from 0 to 35.4 MBq. The mean committed effective dose equivalent (CEDE) from both I-131 and Tc-99m were 0.63, 1.44 0.53, 0.57, 0.73, 0.98, and 1.36, mSv, for group 1 through group 7 respectively. However, the highest mean CEDE of 1.44 (max. 1.75) and 1.36 (max. 2.11) mSv observed in groups of radiochemists and hospital ward housekeepers were within the permissible level. Our results showed that CEDE for internal exposure in this study were less than investigate level of 5 mSv according to the ICRP Publication 78 and the IAEA Basic Safety Standards. However, the mean CEDE for radiochemists and hospital ward housekeepers were considered in exceed of the limits of recording level (1 mSv).The increasing use of I-131 and Tc-99m in nuclear medicine poses significant risks of internal exposure to the staff. This study suggests that a routine monitoring program for internal exposures should be implemented for

Developing a higher specialist training programme in renal medicine in the era of competence-based training.

Science.gov (United States)

Kamesh, Lavanya; Clapham, Mike; Foggensteiner, Lukas

2012-08-01

Renal specialty medical training in the UK was reformed in August 2007, with an emphasis placed on competency-based training and the publication of a new curriculum and assessment blueprint. This model of training places additional time demands on both trainees and trainers, with implications for job planning and service delivery. We evaluated the resource requirements and impact on service delivery of implementing a high-quality training programme in renal medicine. Each trainee maintained a portfolio containing details of workplace-based assessments. The change in educational environment led to improved trainee satisfaction. The mean total consultant time involved in implementing the training programme was 0.7 programmed activities (PAs) per trainee per week in the first year, which decreased to 0.5 PAs per trainee per week in the second year. This pilot study indicates that it is possible to integrate successful and high-quality specialty training in a busy clinical environment. The model outlined could form a template for postgraduate specialist training delivery in a variety of medical specialties.

Optimizing the Internal Medicine Clinic at Evans Army Community Hospital

National Research Council Canada - National Science Library

Bonilla, Jose

2003-01-01

...) 2002, the Internal Medicine (IM) clinic at Evans Army Community Hospital, Fort Carson, Colorado, failed to meet access to care standards for routine appointments, and was only marginally successful in meeting standards for urgent appointments...

Venous thromboembolism: the prevailing approach to diagnosis, prevention and treatment among Internal Medicine practitioners.

Science.gov (United States)

Markel, Arie; Gavish, Israel; Kfir, Hila; Rimbrot, Sofia

2017-02-01

Venous thromboembolism (VTE) is the third most common cause of death and the leading cause of sudden death in hospitalized medical patients. Despite the existence of guidelines for prevention and treatment of this disorder, their implementation in everyday life is not always accomplished. We performed a survey among directors of Internal Medicine departments in our country in order to evaluate their attitude and approach to this issue. A questionnaire with pertinent questions regarding prevention and treatment of VTE, including deep vein thrombosis (DVT) and pulmonary embolism (PE) was sent to each one of the directors of Internal Medicine Departments around the country. Sixty-nine out of 97 (71%) of the Internal Medicine departments directors responded the questionnaire. We found that several of the current guidelines were followed in a reasonable way. On the other hand, heterogeneity of responses was also present and the performance of current guidelines was imperfectly followed, and showed to be deficient in several aspects. An effort should be done in order to reemphasize and put in effect current guidelines for the prevention and treatment of VTE among hospitalists and Internal Medicine practitioners.

Divergent Fates of the Medical Humanities in Psychiatry and Internal Medicine: Should Psychiatry Be Rehumanized?

Science.gov (United States)

Rutherford, Bret R.; Hellerstein, David J.

2008-01-01

Objective: To determine the degree to which the medical humanities have been integrated into the fields of internal medicine and psychiatry, the authors assessed the presence of medical humanities articles in selected psychiatry and internal medicine journals from 1950 to 2000. Methods: The journals searched were the three highest-ranking…

Dentistry and internal medicine: from the focal infection theory to the periodontal medicine concept.

Science.gov (United States)

Pizzo, Giuseppe; Guiglia, Rosario; Lo Russo, Lucio; Campisi, Giuseppina

2010-12-01

During past decades the relationship between dentistry and internal medicine and especially the concept of the so-called focal infection theory have long been a matter of debate. The pathogenesis of focal diseases has been classically attributed to dental pulp pathologies and periapical infections. Nonetheless, in recent years, their role is being dismissed while increasing interest is being devoted to the possible associations between periodontal infection and systemic diseases. In fact, periodontal pathogens and their products, as well as inflammatory mediators produced in periodontal tissues, might enter the bloodstream, causing systemic effects and/or contributing to systemic diseases. On the basis of this mechanism, chronic periodontitis has been suggested as a risk factor for cardiovascular diseases associated with atherosclerosis, bacterial endocarditis, diabetes mellitus, respiratory disease, preterm delivery, rheumatoid arthritis, and, recently, osteoporosis, pancreatic cancer, metabolic syndrome, renal diseases and neurodegenerative diseases such as Alzheimer's disease. Various hypotheses, including common susceptibility, systemic inflammation, direct bacterial infection and cross-reactivity, or molecular mimicry, between bacterial antigens and self-antigens, have been postulated to explain these relationships. In this scenario, the association of periodontal disease with systemic diseases has set the stage for introducing the concept of periodontal medicine. This narrative review summarizes the evolution of focal infection theory up to the current pathophysiology of periodontal disease, and presents an update on the relationships between chronic periodontitis and systemic diseases. Copyright © 2010 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Update in Internal Medicine

Science.gov (United States)

López-Jiménez, Francisco; Brito, Máximo; Aude, Y. Wady; Scheinberg, Phillip; Kaplan, Mariana; Dixon, Denise A.; Schneiderman, Neil; Trejo, Jorge F.; López-Salazar, Luis Humberto; Ramírez-Barba, Ector Jaime; Kalil, Roberto; Ortiz, Carmen; Goyos, José; Buenaño, Alvaro; Kottiech, Samer; Lamas, Gervasio A.

2009-01-01

More than 500,000 new medical articles are published every year and available time to keep updated is scarcer every day. Nowadays, the task of selecting useful, consistent, and relevant information for clinicians is a priority in many major medical journals. This review has the aim of gathering the results of the most important findings in clinical medicine in the last few years. It is focused on results from randomized clinical trials and well-designed observational research. Findings were included preferentially if they showed solid results, and we avoided as much as possible including only preliminary data, or results that included only non-clinical outcomes. Some of the most relevant findings reported here include the significant benefit of statins in patients with coronary artery disease even with mean cholesterol level. It also provides a substantial review of the most significant trials assessing the effectiveness of IIb/IIIa receptor blockers. In gastroenterology many advances have been made in the H. pylori eradication, and the finding that the cure of H. pylori infection may be followed by gastroesophageal reflux disease. Some new antivirals have shown encouraging results in patients with chronic hepatitis. In the infectious disease arena, the late breaking trials in anti-retroviral disease are discussed, as well as the new trends regarding antibiotic resistance. This review approaches also the role of leukotriene modifiers in the treatment of asthma and discusses the benefit of using methylprednisolone in patients with adult respiratory distress syndrome, among many other advances in internal medicine. PMID:11068074

A new model for accreditation of residency programs in internal medicine.

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Goroll, Allan H; Sirio, Carl; Duffy, F Daniel; LeBlond, Richard F; Alguire, Patrick; Blackwell, Thomas A; Rodak, William E; Nasca, Thomas

2004-06-01

A renewed emphasis on clinical competence and its assessment has grown out of public concerns about the safety, efficacy, and accountability of health care in the United States. Medical schools and residency training programs are paying increased attention to teaching and evaluating basic clinical skills, stimulated in part by these concerns and the responding initiatives of accrediting, certifying, and licensing bodies. This paper, from the Residency Review Committee for Internal Medicine of the Accreditation Council for Graduate Medical Education, proposes a new outcomes-based accreditation strategy for residency training programs in internal medicine. It shifts residency program accreditation from external audit of educational process to continuous assessment and improvement of trainee clinical competence.

The International Certification of Addiction Medicine: Validating Clinical Knowledge across Borders

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el-Guebaly, Nady; Violato, Claudio

2011-01-01

The experience of the International Society of Addiction Medicine in setting up the first international certification of clinical knowledge is reported. The steps followed and the results of a psychometric analysis of the tests from the first 65 candidates are reported. Lessons learned in the first 5 years and challenges for the future are…

The association of students requiring remediation in the internal medicine clerkship with poor performance during internship.

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Hemann, Brian A; Durning, Steven J; Kelly, William F; Dong, Ting; Pangaro, Louis N; Hemmer, Paul A

2015-04-01

To determine whether the Uniformed Services University (USU) system of workplace performance assessment for students in the internal medicine clerkship at the USU continues to be a sensitive predictor of subsequent poor performance during internship, when compared with assessments in other USU third year clerkships. Utilizing Program Director survey results from 2007 through 2011 and U.S. Medical Licensing Examination (USMLE) Step 3 examination results as the outcomes of interest, we compared performance during internship for students who had less than passing performance in the internal medicine clerkship and required remediation, against students whose performance in the internal medicine clerkship was successful. We further analyzed internship ratings for students who received less than passing grades during the same time period on other third year clerkships such as general surgery, pediatrics, obstetrics and gynecology, family medicine, and psychiatry to evaluate whether poor performance on other individual clerkships were associated with future poor performance at the internship level. Results for this recent cohort of graduates were compared with previously published findings. The overall survey response rate for this 5 year cohort was 81% (689/853). Students who received a less than passing grade in the internal medicine clerkship and required further remediation were 4.5 times more likely to be given poor ratings in the domain of medical expertise and 18.7 times more likely to demonstrate poor professionalism during internship. Further, students requiring internal medicine remediation were 8.5 times more likely to fail USMLE Step 3. No other individual clerkship showed any statistically significant associations with performance at the intern level. On the other hand, 40% of students who successfully remediated and did graduate were not identified during internship as having poor performance. Unsuccessful clinical performance which requires remediation in

Clinical preventive services in Guatemala: a cross-sectional survey of internal medicine physicians.

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Juan E Corral

Full Text Available Guatemala is currently undergoing an epidemiologic transition. Preventive services are key to reducing the burden of non-communicable diseases, and smoking counseling and cessation are among the most cost-effective and wide-reaching strategies. Internal medicine physicians are fundamental to providing such services, and their knowledge is a cornerstone of non-communicable disease control.A national cross-sectional survey was conducted in 2011 to evaluate knowledge of clinical preventive services for non-communicable diseases. Interns, residents, and attending physicians of the internal medicine departments of all teaching hospitals in Guatemala completed a self-administered questionnaire. Participants' responses were contrasted with the Guatemalan Ministry of Health (MoH prevention guidelines and the US Preventive Services Task Force (USPSTF recommendations. Analysis compared knowledge of recommendations within and between hospitals.In response to simulated patient scenarios, all services were recommended by more than half of physicians regardless of MoH or USPSTF recommendations. Prioritization was adequate according to the MoH guidelines but not including other potentially effective services (e.g. colorectal cancer and lipid disorder screenings. With the exception of colorectal and prostate cancer screening, less frequently recommended by interns, there was no difference in recommendation rates by level.Guatemalan internal medicine physicians' knowledge on preventive services recommendations for non-communicable diseases is limited, and prioritization did not reflect cost-effectiveness. Based on these data we recommend that preventive medicine training be strengthened and development of evidence-based guidelines for low-middle income countries be a priority.

Combined residency training in emergency medicine and internal medicine: an update on career outcomes and job satisfaction.

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Kessler, Chad S; Stallings, Leonard A; Gonzalez, Andrew A; Templeman, Todd A

2009-09-01

This study was designed to provide an update on the career outcomes and experiences of graduates of combined emergency medicine-internal medicine (EM-IM) residency programs. The graduates of the American Board of Emergency Medicine (ABEM) and American Board of Internal Medicine (ABIM)-accredited EM-IM residencies from 1998 to 2008 were contacted and asked to complete a survey concerning demographics, board certification, fellowships completed, practice setting, academic affiliation, and perceptions about EM-IM training and careers. There were 127 respondents of a possible 163 total graduates for a response rate of 78%. Seventy graduates (55%) practice EM only, 47 graduates (37%) practice both EM and IM, and nine graduates (7%) practice IM or an IM subspecialty only. Thirty-one graduates (24%) pursued formal fellowship training in either EM or IM. Graduates spend the majority of their time practicing clinical EM in an urban (72%) and academic (60%) environment. Eighty-seven graduates (69%) spend at least 10% of their time in an academic setting. Most graduates (64%) believe it practical to practice both EM and IM. A total of 112 graduates (88%) would complete EM-IM training again. Dual training in EM-IM affords a great deal of career opportunities, particularly in academics and clinical practice, in a number of environments. Graduates hold their training in high esteem and would do it again if given the opportunity.

Current presentation and management of 7148 patients with atrial fibrillation in cardiology and internal medicine hospital centers: the ATA AF study.

Science.gov (United States)

Di Pasquale, Giuseppe; Mathieu, Giovanni; Maggioni, Aldo Pietro; Fabbri, Gianna; Lucci, Donata; Vescovo, Giorgio; Pirelli, Salvatore; Chiarella, Francesco; Scherillo, Marino; Gulizia, Michele Massimo; Gussoni, Gualberto; Colombo, Fabrizio; Panuccio, Domenico; Nozzoli, Carlo; Berisso, Massimo Zoni

2013-09-10

Atrial fibrillation (AF) is associated with a high risk of stroke and mortality. To describe the difference in AF management of patients (pts) referred to Cardiology (CARD) or Internal Medicine (MED) units in Italy. From May to July 2010, 360 centers enrolled 7148 pts (54% in CARD and 46% in MED). Median age was 77 years (IQR 70-83). Hypertension was the most prevalent associated condition, followed by hypercholesterolemia (28.9%), heart failure (27.7%) and diabetes (24.3%). MED pts were older, more frequently females and more often with comorbidities than CARD pts. In the 4845 pts with nonvalvular AF, a CHADS2 score ≥ 2 was present in 53.0% of CARD vs 75.3% of MED pts (pmanaged in MED had a significantly lower probability to be treated with OAC. Rate control strategy was pursued in 51.4% of the pts (60.5% in MED and 43.6% in CARD) while rhythm control was the choice in 39.8% of CARD vs 12.9% of MED pts (pmanage pts with large epidemiological differences. Both CARD and MED specialists currently fail to prescribe OAC in accordance with stroke risk. Patients managed by MED specialists have a lower probability to receive an OAC treatment, irrespective of the severity of clinical conditions. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

New developments in education and training in sexual medicine.

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Reisman, Yacov; Eardley, Ian; Porst, Hartmut

2013-04-01

INTRODUCTION.: The past 12 months have been historic ones for the field of Sexual Medicine in that we have seen the creation of the European Board examination in Sexual Medicine with the title of "Fellow of the European Committee on Sexual Medicine" (FECSM) offered to successful candidates. AIM.: The study aims to promote a high standard of care in Sexual Medicine. METHODS.: An important way of promoting high standards of care is by the development of training, regulation, and assessment framework. The background to these developments and the recent educational activities of the European Society for Sexual Medicine (ESSM) are described in this article. RESULTS.: The creation of the Multidisciplinary Joint Committee on Sexual Medicine (MJCSM) under the auspices of the European Union of Medical Specialists, with the primary purpose to develop the highest possible standards of training in Sexual Medicine in Europe, made it possible to create a process for qualification in Sexual Medicine. The ESSM educational activities created opportunities to support trainees in Sexual Medicine and the first MJCSM exam was held in Amsterdam with a high overall success rate. CONCLUSION.: These activities are intended to improve quality. The FECSM examination is the first of its type and provides a real opportunity for Sexual Medicine physicians to demonstrate and document their knowledge. © 2013 International Society for Sexual Medicine.

Quality of life, burnout, educational debt, and medical knowledge among internal medicine residents.

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West, Colin P; Shanafelt, Tait D; Kolars, Joseph C

2011-09-07

Physician distress is common and has been associated with negative effects on patient care. However, factors associated with resident distress and well-being have not been well described at a national level. To measure well-being in a national sample of internal medicine residents and to evaluate relationships with demographics, educational debt, and medical knowledge. Study of internal medicine residents using data collected on 2008 and 2009 Internal Medicine In-Training Examination (IM-ITE) scores and the 2008 IM-ITE survey. Participants were 16,394 residents, representing 74.1% of all eligible US internal medicine residents in the 2008-2009 academic year. This total included 7743 US medical graduates and 8571 international medical graduates. Quality of life (QOL) and symptoms of burnout were assessed, as were year of training, sex, medical school location, educational debt, and IM-ITE score reported as percentage of correct responses. Quality of life was rated "as bad as it can be" or "somewhat bad" by 2402 of 16,187 responding residents (14.8%). Overall burnout and high levels of emotional exhaustion and depersonalization were reported by 8343 of 16,192 (51.5%), 7394 of 16,154 (45.8%), and 4541 of 15,737 (28.9%) responding residents, respectively. In multivariable models, burnout was less common among international medical graduates than among US medical graduates (45.1% vs 58.7%; odds ratio, 0.70 [99% CI, 0.63-0.77]; P $200,000 relative to no debt). Residents reporting QOL "as bad as it can be" and emotional exhaustion symptoms daily had mean IM-ITE scores 2.7 points (99% CI, 1.2-4.3; P ITE scores 5.0 points (99% CI, 4.4-5.6; P ITE scores.

[Employment opportunities and education needs of physicians with specialty training in Hygiene and Preventive Medicine.].

Science.gov (United States)

Fara, Gaetano M; Nardi, Giuseppe; Signorelli, Carlo; Fanti, Mila

2005-01-01

This survey was carried out under the sponsorship of the Italian Society of Hygiene (SItI), to evaluate the current professional position of physicians who completed their post-graduate professional training in Hygiene and Preventive Medicine in the years 2000 through 2003. An ad-hoc questionnaire was administered to 689 such specialists across Italy with a response rate of 40%. The results show that specialists in Hygiene and Preventive Medicine are generally satisfied with their professional choice though most specialists were found to have only temporary employment. Post-specialty training courses of major interest to specialists in Hygiene and Preventive medicine are those regarding occupational health, statistical analysis and epidemiology, and quality of health care.

Proceedings of the 2. International symposium on the radioactive accident in Goiania. Program

International Nuclear Information System (INIS)

1993-01-01

This 2. International symposium on the radioactive accident with cesium-137 brings together in Goiania renowned international and Brazilian specialists. These are recognized professionals of Medicine, Physics, Biology and Psychology who, gathered around a strictly scientific event, will discuss the complex problems originated by a serious accident, exchanging experiences and searching for definite solutions for the issues. The main topics are: the environmental and social impacts; technical and medical procedures; victims contamination and biological radiation effects in the body of the victims

Dynamics of Professional and Communicative Tolerance in Educating International Relations Specialists

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Alexander L. Temnitskiy

2014-01-01

Full Text Available Under the conditions of the accelerated development of Russian economics, commercial sector and due to a great number of international private companies we can see the intensified problem of tolerance of future diplomats, international specialists, regarding to the system, its the main components such as political, economic, military. It is supposed, that in the modern student environment of future diplomats we can notice the exaltation of values of individual pragmatism and increasing the lack of sociality by deciding of questions about their present and future professional activity. Sociological researches carried out among the students of faculty of international affairs in 2002, 2007 and 2012 review different factors of professional and communicative tolerance. The author of this article markes and diagnoses the materially - pragmatic and art-substantial values of the chosen profession and it's given an interpretation of value orientations content on the categories of employment after the university graduation. Students' estimations define the personal competents of government employee, which are necessary for the successful carrier in the system of MFA of Russia. The interpretation and the real content of communicative tolerance levels are reviewed in the article. The ethnic component of communicative tolerance is studied separately. In conclusion of the article we can define the role of material differentiation of students in the context of communicative tolerance. According to the analyse it is confuted the initial supposition about the glorification of individual pragmatic values and shortage of social responsibility in the student environment. It was found out, that in the communicative tolerance the level of empathy in the personal contact is keeping to be prevalent and stable according to different years of survey. However, it is deduced, the occurred for 10 years the growth of students material welfare didn't contribute to the growth

Impact of personal goals on the internal medicine R4 subspecialty match: a Q methodology study.

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Daniels, Vijay J; Kassam, Narmin

2013-12-21

There has been a decline in interest in general internal medicine that has resulted in a discrepancy between internal medicine residents' choice in the R4 subspecialty match and societal need. Few studies have focused on the relative importance of personal goals and their impact on residents' choice. The purpose of this study was to assess if internal medicine residents can be grouped based on their personal goals and how each group prioritizes these goals compared to each other. A secondary objective was to explore whether we could predict a resident's desired subspecialty choice based on their constellation of personal goals. We used Q methodology to examine how postgraduate year 1-3 internal medicine residents could be grouped based on their rankings of 36 statements (derived from our previous qualitative study). Using each groups' defining and distinguishing statements, we predicted their subspecialties of interest. We also collected the residents' first choice in the subspecialty match and used a kappa test to compare our predicted subspecialty group to the residents' self-reported first choice. Fifty-nine internal medicine residents at the University of Alberta participated between 2009 and 2010 with 46 Q sorts suitable for analysis. The residents loaded onto four factors (groups) based on how they ranked statements. Our prediction of each groups' desired subspecialties with their defining and/or distinguishing statements are as follows: group 1 - general internal medicine (variety in practice); group 2 - gastroenterology, nephrology, and respirology (higher income); group 3 - cardiology and critical care (procedural, willing to entertain longer training); group 4 - rest of subspecialties (non-procedural, focused practice, and valuing more time for personal life). There was moderate agreement (kappa = 0.57) between our predicted desired subspecialty group and residents' self-reported first choice (p internal medicine subspecialty. The key goals that define

Factors associated with the subspecialty choices of internal medicine residents in Canada.

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Horn, Leora; Tzanetos, Katina; Thorpe, Kevin; Straus, Sharon E

2008-06-26

Currently, there are more residents enrolled in cardiology training programs in Canada than in immunology, pharmacology, rheumatology, infectious diseases, geriatrics and endocrinology combined. There is no published data regarding the proportion of Canadian internal medicine residents applying to the various subspecialties, or the factors that residents consider important when deciding which subspecialty to pursue. To address the concern about physician imbalances in internal medicine subspecialties, we need to examine the factors that motivate residents when making career decisions. In this two-phase study, Canadian internal medicine residents participating in the post graduate year 4 (PGY4) subspecialty match were invited to participate in a web-based survey and focus group discussions. The focus group discussions were based on issues identified from the survey results. Analysis of focus group transcripts grew on grounded theory. 110 PGY3 residents participating in the PGY4 subspecialty match from 10 participating Canadian universities participated in the web-based survey (54% response rate). 22 residents from 3 different training programs participated in 4 focus groups held across Canada. Our study found that residents are choosing careers that provide intellectual stimulation, are consistent with their personality, and that provide a challenge in diagnosis. From our focus group discussions it appears that lifestyle, role models, mentorship and the experience of the resident with the specialty appear to be equally important in career decisions. Males are more likely to choose procedure based specialties and are more concerned with the reputation of the specialty as well as the anticipated salary. In contrast, residents choosing non-procedure based specialties are more concerned with issues related to lifestyle, including work-related stress, work hours and time for leisure as well as the patient populations they are treating. This study suggests that internal

Factors associated with the subspecialty choices of internal medicine residents in Canada

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Thorpe Kevin

2008-06-01

Full Text Available Abstract Background Currently, there are more residents enrolled in cardiology training programs in Canada than in immunology, pharmacology, rheumatology, infectious diseases, geriatrics and endocrinology combined. There is no published data regarding the proportion of Canadian internal medicine residents applying to the various subspecialties, or the factors that residents consider important when deciding which subspecialty to pursue. To address the concern about physician imbalances in internal medicine subspecialties, we need to examine the factors that motivate residents when making career decisions. Methods In this two-phase study, Canadian internal medicine residents participating in the post graduate year 4 (PGY4 subspecialty match were invited to participate in a web-based survey and focus group discussions. The focus group discussions were based on issues identified from the survey results. Analysis of focus group transcripts grew on grounded theory. Results 110 PGY3 residents participating in the PGY4 subspecialty match from 10 participating Canadian universities participated in the web-based survey (54% response rate. 22 residents from 3 different training programs participated in 4 focus groups held across Canada. Our study found that residents are choosing careers that provide intellectual stimulation, are consistent with their personality, and that provide a challenge in diagnosis. From our focus group discussions it appears that lifestyle, role models, mentorship and the experience of the resident with the specialty appear to be equally important in career decisions. Males are more likely to choose procedure based specialties and are more concerned with the reputation of the specialty as well as the anticipated salary. In contrast, residents choosing non-procedure based specialties are more concerned with issues related to lifestyle, including work-related stress, work hours and time for leisure as well as the patient populations

ROLE OF THE INTERNATIONAL ORGANIZATIONS IN PREVENTING THE COUNTERFEIT MEDICINES ENTRY INTO THE WORLD MARKETS.

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Stukina, Valeryia; Dohnal, Jiri; Saloun, Jan

2016-09-01

30 years have passed since Conference of Experts on the Rational Use of Drugs was held in Nairobi, Kenya, from 25 to 29 November 1985, where the problem of counterfeit medicines was mentioned as the international for the first time. The problem of counterfeit medicines is not only a major threat to public health and national and private economy, but also it is of great interest for key decision-making actors at the international level. The authors analyzed what has been done since that time by international organizations. Combating the counterfeiting of medicines cannot be successfully achieved by the health sector alone - World Health Organization (WHO), - so the efforts of the other United Nations (UN) organizations relevant to counterfeiting were in need and were studied in the article: World Intellectual Property Organization (WIPO), World Trade Organization (WTO), World Customs Organization (WCO), United Nations Office on Drugs and Crime (UNODC), etc. Today WHO is unable to coordinate all their activities, so the few existing proposals for establishing a new mechanism of international cooperation have been examined. Will the MEDICRIME Convention that will enter into force on January 1, 2016 be the start of the new era in the combating with the counterfeit medicines? - the authors offered their vision on the international developments.

[Part-time medical specialist training; experiences with job-sharing for trainee internists].

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Bevers, K; Nauta, S; Stuyt, P M

2004-02-14

Due to various factors such as social changes, an increasing number of couples with two incomes, and a growing proportion of female doctors, there has been a growing demand for part-time work in recent years. This is also true for resident physicians. Objections such as a discontinuity in care and the decline in the quality of education frequently prevent resident physicians from working part-time. Over the past two years, the University Medical Centre Nijmegen, the Netherlands, has experimented with job-sharing on clinical wards for resident physicians in internal medicine. This approach works well in practice, as long as a number of conditions, including the proper transfer of medical information and good communication, are satisfied. Job-sharing is one means of satisfying the growing demand for part-time work among resident physicians and specialists.

Reasons why specialist doctors undertake rural outreach services: an Australian cross-sectional study.

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O'Sullivan, Belinda G; McGrail, Matthew R; Stoelwinder, Johannes U

2017-01-07

The purpose of the study is to explore the reasons why specialist doctors travel to provide regular rural outreach services, and whether reasons relate to (1) salaried or private fee-for-service practice and (2) providing rural outreach services in more remote locations. A national cross-sectional study of specialist doctors from the Medicine in Australia: Balancing Employment and Life (MABEL) survey in 2014 was implemented. Specialists providing rural outreach services self-reported on a 5-point scale their level of agreement with five reasons for participating. Chi-squared analysis tested association between agreement and variables of interest. Of 567 specialists undertaking rural outreach services, reasons for participating include to grow the practice (54%), maintain a regional connection (26%), provide complex healthcare (18%), healthcare for disadvantaged people (12%) and support rural staff (6%). Salaried specialists more commonly participated to grow the practice compared with specialists in fee-for-service practice (68 vs 49%). This reason was also related to travelling further and providing outreach services in outer regional/remote locations. Private fee-for-service specialists more commonly undertook outreach services to provide complex healthcare (22 vs 14%). Specialist doctors undertake rural outreach services for a range of reasons, mainly to complement the growth and diversity of their main practice or maintain a regional connection. Structuring rural outreach around the specialist's main practice is likely to support participation and improve service distribution.

Citation analysis of The Korean Journal of Internal Medicine from KoMCI, Web of Science, and Scopus.

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Huh, Sun

2011-03-01

The Korean Journal of Internal Medicine (KJIM) is the international journal published in English by the Korean Association of Internal Medicine. To understand the position of the journal in three different databases, the citation indicators were elucidated. From databases such as Korean Medical Citation Index (KoMCI), Web of Science, and Scopus, citation indicators such as the impact factor, SCImago journal rank (SJR), or Hirsch Index were calculated according to the year and the results were drawn. The KJIM 2010 impact factor increased to 0.623 in Web of Science. That of year 2009 in KoMCI was a 0.149. The 2009 SJR in Scopus was 0.073, with a ranking of 27/72 (37.5%) in the category of internal medicine and 414/1,618 (25.6%) in the category of medicine, miscellaneous. The Hirsch Index from KoMCI, Web of Science and Scopus were 5, 14, and 16, respectively. The KJIM is now cited more by international researchers than Korean researchers, indicating that the content of the journal is now valued at the international level.

The Assessment of I-131 Internal Doses of Nuclear Medicine Workers in Korea Using Thyroid uptake system

International Nuclear Information System (INIS)

Bahn, Young Kag; Oh, Gi Back; Lee, Chang Ho; Lee, Jong Doo; Yeom, Yu Sun; Hwang, Young Muk

2012-01-01

There are possibilities the radiation workers could intake the radiation when workers deal with radiation-materials. Therefore, internal radiation doses of radiation workers need to be assessed. Although an application of the nuclear medicine is continuously increased in Korea, there is not a proper tool and form to monitor the internal doses of nuclear medicine workers. However, it is possible to attain the internal doses of I-131 to evaluate using thyroid uptake and well count system. In this study, we measured and evaluated the I-131 internal doses of nuclear medicine workers in Korea using thyroid uptake and well count system and performed an air sampling

Postgraduate internal medicine residents' roles at patient discharge - do their perceived roles and perceptions by other health care providers correlate?

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Card, Sharon Elizabeth; Ward, Heather A; Chipperfield, Dylan; Sheppard, M Suzanne

2014-01-01

Knowing one's own role is a key collaboration competency for postgraduate trainees in the Canadian competency framework (CanMEDS®). To explore methods to teach collaborative competency to internal medicine postgraduate trainees, baseline role knowledge of the trainees was explored. The perceptions of roles (self and others) at patient discharge from an acute care internal medicine teaching unit amongst 69 participants, 34 physicians (25 internal medicine postgraduate trainees and 9 faculty physicians) and 35 health care professionals from different professions were assessed using an adapted previously validated survey (Jenkins et al., 2001). Internal medicine postgraduate trainees agreed on 8/13 (62%) discharge roles, but for 5/13 (38%), there was a substantial disagreement. Other professions had similar lack of clarity about the postgraduate internal medicine residents' roles at discharge. The lack of interprofessional and intraprofessional clarity about roles needs to be explored to develop methods to enhance collaborative competence in internal medicine postgraduate trainees.

International Conference on New Technologies in the Humanities and Fourth International Conference on Optics Within Life Sciences

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Bally, Gert

1997-01-01

New high-tech developments in the field of optics show increasing applicability not only in classical technological fields but also in the humanities. This book contains selected contributions to an international, interdisciplinary joint conference on "New Technologies in the Humanities" and "Optics Within Life Sciences". Its objective is to forward interdisciplinary information and communication between specialists in optics as well as in medicine, biology, environmental sciences, and cultural heritage. It is unique as a presentation of new optical technologies for cultural heritage protection. The contributions cover international research activities in the areas of archaeological research and new technologies, holography and interferometry, material analysis, laser cleaning, pattern recognition, unconventional microscopy, spectroscopial techniques, and profilometry.

Study of business ethics in occupational medicine.

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Philipp, R; Goodman, G; Harling, K; Beattie, B

1997-01-01

OBJECTIVE: To investigate the views of specialists in occupational medicine about business ethics in occupational medicine. METHOD: A qualitative study with face to face focus groups and successive reviews of the draft consensus was undertaken of all accredited specialists in occupational medicine who were members of the south Wales and west of England group of the Society of Occupational Medicine, and of all regional specialty advisers and deputies from the Faculty of Occupational Medicine. RESULTS: There was widespread agreement for the need of a code of business ethics. In all, during the four draft stages of preparing a consensus, 72% (28/39) of members of the south Wales and west of England group of the Society of Occupational Medicine, and 31% (20/64) of regional specialty advisers and deputies provided detailed comment for inclusion in it. CONCLUSIONS: Consensus of their views was reached among study participants for issues of business ethics involving advertising, competence, qualifications, fees, commitment, changes in provider contracts, regulation, and supervision of trainees. It provides a basis for further debate. PMID:9196458

Study of business ethics in occupational medicine.

Science.gov (United States)

Philipp, R; Goodman, G; Harling, K; Beattie, B

1997-05-01

To investigate the views of specialists in occupational medicine about business ethics in occupational medicine. A qualitative study with face to face focus groups and successive reviews of the draft consensus was undertaken of all accredited specialists in occupational medicine who were members of the south Wales and west of England group of the Society of Occupational Medicine, and of all regional specialty advisers and deputies from the Faculty of Occupational Medicine. There was widespread agreement for the need of a code of business ethics. In all, during the four draft stages of preparing a consensus, 72% (28/39) of members of the south Wales and west of England group of the Society of Occupational Medicine, and 31% (20/64) of regional specialty advisers and deputies provided detailed comment for inclusion in it. Consensus of their views was reached among study participants for issues of business ethics involving advertising, competence, qualifications, fees, commitment, changes in provider contracts, regulation, and supervision of trainees. It provides a basis for further debate.

Effect of Experience of Internal Medicine Residents during Infectious Disease Elective on Future Infectious Disease Fellowship Application

Science.gov (United States)

2017-10-04

Experience of !ntcrnal Medicine Residents during Infectious Disease Elective on Future lntCctious Di~casc Fcllo\\vship Application Sb. GRANT N_UMBER...undefined. Since 2008 at our institution. internal medicine (!!vi) residents have been required to do a four-\\\\’eek inpatient !D rotation as an intern... Medicine Residents during Infectious Disease Elective on Fut ure Infectious Disease Fellowship Application ~ Poeter# 1440 .,...._,: OVfil"S~ ti

Factors Associated with Medical Knowledge Acquisition During Internal Medicine Residency

Science.gov (United States)

Zeger, Scott L.; Kolars, Joseph C.

2007-01-01

BACKGROUND Knowledge acquisition is a goal of residency and is measurable by in-training exams. Little is known about factors associated with medical knowledge acquisition. OBJECTIVE To examine associations of learning habits on medical knowledge acquisition. DESIGN, PARTICIPANTS Cohort study of all 195 residents who took the Internal Medicine In-Training Examination (IM-ITE) 421 times over 4 years while enrolled in the Internal Medicine Residency, Mayo Clinic, Rochester, MN. MEASUREMENTS Score (percent questions correct) on the IM-ITE adjusted for variables known or hypothesized to be associated with score using a random effects model. RESULTS When adjusting for demographic, training, and prior achievement variables, yearly advancement within residency was associated with an IM-ITE score increase of 5.1% per year (95%CI 4.1%, 6.2%; p international medical school graduation, −3.4% (95%CI −6.5%, −0.36%; p = .03). CONCLUSIONS Conference attendance and self-directed reading of an electronic knowledge resource had statistically and educationally significant independent associations with knowledge acquisition that were comparable to the benefit of a year in residency training. PMID:17468889

Professional training of future specialists with the use of information technologies

Directory of Open Access Journals (Sweden)

Виктор Семенович Корнилов

2013-12-01

Full Text Available This paper deals with implementation of information technologies within different levels of professional training of the future specialists at A. Yassawi International Kazakh-Turkish University. Information technologies enable the future specialists to engage in online exchanges and it gives great good opportunity in learning the subject efficiently; thereby expanding their study and learning community during the classroom activity. The results obtained by the use of the information technologies show improvements in professional training of the future specialists in teaching foreign language. The use of information technology in teaching is increasing, which should lead to a significant improvement of the training quality of future specialists. Improvements also are observed in the experimental groups of higher levels, which indicates the efficiency of the use of information technologies in the professional training of future specialists.

Overspecialized and undertrained? Patient diversity encountered by medical students during their internal medicine clerkship at a university hospital.

Science.gov (United States)

Melderis, Simon; Gutowski, Jan-Philipp; Harendza, Sigrid

2015-03-31

During the four-month internal medicine clerkship in their final year, undergraduate medical students are closely involved in patient care. Little is known about what constitutes their typical learning experiences with respect to patient diversity within the different subspecialties of internal medicine and during on call hours. 25 final year medical students (16 female, 9 male) on their internal medicine clerkship participated in this observational single-center study. To detail the patient diversity encountered by medical students at a university hospital during their 16-week internal medicine clerkship, all participants self-reported their patient contacts in the different subspecialties and during on call hours on patient encounter cards. Patients' chief complaint, suspected main diagnosis, planned diagnostic investigations, and therapy in seven different internal medicine subspecialties and the on call medicine service were documented. 496 PECs were analysed in total. The greatest diversity of chief complaints (CC) and suspected main diagnoses (SMD) was observed in patients encountered on call, with the combined frequencies of the three most common CCs or SMDs accounting for only 23% and 25%, respectively. Combined, the three most commonly encountered CC/SMD accounted for high percentages (82%/63%), i.e. less diversity, in oncology and low percentages (37%/32%), i.e. high diversity, in nephrology. The percentage of all diagnostic investigations and therapies that were classified as "basic" differed between the subspecialties from 82%/94% (on call) to 37%/50% (pulmonology/oncology). The only subspecialty with no significant difference compared with on call was nephrology for diagnostic investigations. With respect to therapy, nephrology and infectious diseases showed no significant differences compared with on call. Internal medicine clerkships at a university hospital provide students with a very limited patient diversity in most internal medicine

TRAINING SYSTEM OF FUTURE SPECIALISTS: QUALITY CONTROL

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Vladimir A. Romanov

2015-01-01

Full Text Available The aim of the investigation is development of innovative strategy of quality control training of engineers and skilled workers (hereinafter – future specialists in educational professional organizations on the principles of social partnership.Methods. Theoretic: theoretic and methodological analysis, polytheoretic synthesis, modeling. Empirical: research and generalization of the system, process and competence – based approaches experience, experiment, observation, surveys, expert evaluation, SWOT-analysis as a method of strategic planning which is to identify the internal and external factors (socio-cultural of the organization surrounding.Results. The strategy of the development of the process of quality control training in educational professional organizations and a predictive model of the system of quality control training for future engineers and workers have been created on the analysis and synthesis of a quantitative specification of the quality, the obtained experience and success in control training of future specialists in educational professional organizations in recent economic and educational conditions.Scientific novelty. There has been built a predicative model of quality control training of future specialists to meet modern standards and the principles of social partnership; the control algorithm of the learning process, developed in accordance with the standards (international of quality ISO in the implementation of the quality control systems of the process approach (matrix-based responsibility, competence and remit of those responsible for the education process in the educational organization, the «problem» terms and diagnostic tools for assessing the quality of professional training of future specialists. The perspective directions of innovation in the control of the quality of future professionals training have been determined; the parameters of a comprehensive analysis of the state of the system to ensure the

[Supply and demand of medical specialists in the health facilities of the Ministry of Health: national, regional and by type of specialty gaps].

Science.gov (United States)

Zevallos, Leslie; Pastor, Reyna; Moscoso, Betsy

2011-06-01

To characterize the supply, demand and the gap of medical specialists in facilities of the Ministry of Health of Peru (MINSA) at the national, regional and specialty type levels. Observational, descriptive study through which we calculated the supply of medical specialists using secondary sources of MINSA. The analysis of the demand for medical specialists was based on two methodologies: the need for specialists according to the guidelines of classification of the health facilities and according to the epidemiological and demographic profile. The arithmetic difference between the estimated demand and the supply was the procedure used to calculate the gap of medical specialists. The Ministry of Health has a total supply at the national level of 6,074 medical specialists of which 61.5% belong to the clinical specialties, 33.2% to the surgical specialties, 4.9% specialities related to aid to diagnosis and treatment and 0.4% to public health specialties. According to the categorization guideline there is a total demand of 11,176 medical specialists and according to the epidemiological and demographic profile of 11,738. The national estimated gaps found are similar in both methods, although they differ widely across regions and by type of specialty. At the regional level, the gaps are greater in Loreto, Piura, Puno and Madre de Dios when estimating the defficit in relation to the supply. Regarding the speciality, the gap is greater in the four basic specialties: gynecology and obstetrics, pediatrics, internal medicine and general surgery. There is a waid gap between supply and demand of medical specialists at the national and regional levels, as a whole representing approximately 45% of the current offer, regardless of the estimation method.

Role of international organizations in promoting nuclear medicine in the developing countries

Energy Technology Data Exchange (ETDEWEB)

Nofal, M

1993-12-31

Today, because of the diversity of its applications - radiation and radionuclides for medical and biological purposes are used in more countries and in more laboratories than any other application of atomic energy. International organizations, mainly the IAEA and the WHO, have played a significant role in the spread of this nuclear technology in developing countries. There are altogether 112 member states of the Agency, about 71 of them can be classified as developing countries. Out of them, nearly 56 have some kind of nuclear medicine. By that I mean there is some medical use of radioisotopes, be it imaging, radioimmunoassay or the old thyroid uptake. In most of these countries, the personnel working in nuclear medicine has been trained abroad. Training can be as short as few weeks abroad in the form of attendance at one of the four or six week training courses offered by an international organization. Occasionally it is through a fellowship offered by the same organizations. In terms of technology and training, Nuclear Medicine, in its present form, can thus be considered a high technology imported medicine in many of these countries

Role of international organizations in promoting nuclear medicine in the developing countries

International Nuclear Information System (INIS)

Nofal, M.

1992-01-01

Today, because of the diversity of its applications - radiation and radionuclides for medical and biological purposes are used in more countries and in more laboratories than any other application of atomic energy. International organizations, mainly the IAEA and the WHO, have played a significant role in the spread of this nuclear technology in developing countries. There are altogether 112 member states of the Agency, about 71 of them can be classified as developing countries. Out of them, nearly 56 have some kind of nuclear medicine. By that I mean there is some medical use of radioisotopes, be it imaging, radioimmunoassay or the old thyroid uptake. In most of these countries, the personnel working in nuclear medicine has been trained abroad. Training can be as short as few weeks abroad in the form of attendance at one of the four or six week training courses offered by an international organization. Occasionally it is through a fellowship offered by the same organizations. In terms of technology and training, Nuclear Medicine, in its present form, can thus be considered a high technology imported medicine in many of these countries

Russian family physicians try to develop an identity in specialist-oriented country.

OpenAIRE

Stewart, J

1995-01-01

Russia is in the process of reforming its medical system to place more emphasis on family medicine. Currently, most of the emphasis is on specialization and family doctors are considered little more than referral agents to specialists. Last fall, three Russian doctors with an interest in family medicine attended a conference in Winnipeg. Although they hope to learn from Canadian colleagues, they also think that Canada might be able to learn from Russian experience in the health-promotion field.

Precision medicine needs pioneering clinical bioinformaticians.

Science.gov (United States)

Gómez-López, Gonzalo; Dopazo, Joaquín; Cigudosa, Juan C; Valencia, Alfonso; Al-Shahrour, Fátima

2017-10-25

Success in precision medicine depends on accessing high-quality genetic and molecular data from large, well-annotated patient cohorts that couple biological samples to comprehensive clinical data, which in conjunction can lead to effective therapies. From such a scenario emerges the need for a new professional profile, an expert bioinformatician with training in clinical areas who can make sense of multi-omics data to improve therapeutic interventions in patients, and the design of optimized basket trials. In this review, we first describe the main policies and international initiatives that focus on precision medicine. Secondly, we review the currently ongoing clinical trials in precision medicine, introducing the concept of 'precision bioinformatics', and we describe current pioneering bioinformatics efforts aimed at implementing tools and computational infrastructures for precision medicine in health institutions around the world. Thirdly, we discuss the challenges related to the clinical training of bioinformaticians, and the urgent need for computational specialists capable of assimilating medical terminologies and protocols to address real clinical questions. We also propose some skills required to carry out common tasks in clinical bioinformatics and some tips for emergent groups. Finally, we explore the future perspectives and the challenges faced by precision medicine bioinformatics. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Internal Medicine Residents Reject ?Longer and Gentler? Training

OpenAIRE

Gopal, R. K.; Carreira, F.; Baker, W. A.; Glasheen, J. J.; Crane, L. A.; Miyoshi, T. J.; Prochazka, A. V.

2007-01-01

Background Increasing complexity of medical care, coupled with limits on resident work hours, has prompted consideration of extending Internal Medicine training. It is unclear whether further hour reductions and extension of training beyond the current duration of 3?years would be accepted by trainees. Objective We aimed to determine if further work-hour reductions and extension of training would be accepted by trainees and whether resident burnout affects their opinions. Design A postal surv...

Requirements for occupational medicine training in Europe postulated by Polish professionals.

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Indulski, J A; Boczkowski, A; Mikulski, M

1998-01-01

In order to determine common key competences required for occupational medicine specialists across Europe, a questionnaire has been developed and disseminated in several European countries. The questionnaire contained 115 subjects relating to eight fields of activity of an occupational medicine physician (occupational hazards to health, assessment of disability and fitness for work, communications, research methods, management, environmental medicine, occupational health law and ethics, and health promotion). Items in each part were classified into three categories: knowledge, experience and skills. For each of the subjects respondents were asked to allocate a score from 0 to 5, where 0 = not necessary, 1 = of minimal importance and 5 = most important or essential. In Poland the questionnaire was distributed between two groups of specialists: group I--chief administrators of occupational health services, and group II--relatively younger occupational medicine physicians participating in a specialist training. A comprehensive analysis of the completed questionnaires had three dimensions: (a) substantive (classification of the importance of particular key competences, as perceived by Polish specialists in occupational medicine), (b) personal (differences in opinions among occupational medicine physicians and an attempt to explain these differences in sociological terms), (c) comparative (evaluation and interpretation of similarities and differences between two groups). A hierarchy of requirements for occupational medicine training in Poland was constructed, with one set of competences recognized by the respondents as needless and others as useful with different grade of importance. Surprisingly, a wide diversity of opinions among respondents has given rise to the explanation hypotheses, some of them being verified using the material gathered.

Tomography in nuclear medicine. Proceedings of an international symposium

International Nuclear Information System (INIS)

1996-01-01

Single photon emission computed tomography (SPECT) is currently being used universally in clinical practice, while positron emission tomography (PET), originally developed as a technique for research, has also gradually moved from the research laboratory to the clinical environment. However, there are significant differences in nuclear medicine capabilities, especially in tomography, between developed and developing countries. The present status and future prospects of nuclear medicine tomography were the main topics of discussion at this latest international symposium, organized by the IAEA in co-operation with the World Health Organization and held in Vienna from 21 to 25 August 1995. The purpose of the meeting was to share experience and information on new developments and clinical applications of two promising tomographic techniques: SPECT and PET. Eight invited papers and 34 regular papers from 23 countries were presented. In addition, there was a panel discussion on the future and direction of tomography in nuclear medicine for developing countries. Refs, figs, tabs

Differential characteristics in polypathological inpatients in internal medicine departments and acute geriatric units: the PLUPAR study.

Science.gov (United States)

Díez-Manglano, Jesús; de Escalante Yangüela, Begoña; García-Arilla Calvo, Ernesto; Ubis Díez, Elena; Munilla López, Eulalia; Clerencia Sierra, Mercedes; Revillo Pinilla, Paz; Omiste Sanvicente, Teresa

2013-12-01

To determine whether there are any differences between polypathological patients attended in Internal Medicine departments and acute Geriatric units. A cross-sectional multicenter study was performed. Polypathological patients admitted to an internal medicine or geriatrics department and attended by investigators consecutively between March 1 and June 30, 2011 were included. Data of age, sex, living in a nursing residence or at home, diagnostic category, use of chronic medication, Charlson, Barthel and Lawton-Brody indexes, Pfeiffer questionnaire, delirium during last admission, need of a caregiver, and having a caregiver were gathered. The need of a caregiver was defined when the Barthel index wasinternal medicine and 144 from geriatrics units were included. Geriatrics inpatients were older and more frequently female. Cardiac (62.1% vs 49.6%; p=.01), digestive (8.3% vs 3.0%; p=.04) and oncohematological diseases (30.2% vs 18.8%; p=.01) were more frequent in patients of internal medicine units and neurological (66.2% vs 40.2%; pinternal medicine inpatients [4.0(2.1) vs 3.5(2.1); p=.04). Patients attended in geriatrics scored higher in Pfeiffer questionnaire [5.5(3.7) vs 3.8(3.3); pinternal medicine and geriatrics departments. © 2013.

Overnight Hospital Experiences for Medical Students: Results of the 2014 Clerkship Directors in Internal Medicine National Survey.

Science.gov (United States)

Goren, Eric N; Leizman, Debra S; La Rochelle, Jeffrey; Kogan, Jennifer R

2015-09-01

Since the 2011 Accreditation Council of Graduate Medical Education (ACGME) work hour rules for residents were implemented, 24-30 h call for interns has been replaced by shift work, including night-float. The impact of these changes on undergraduate medical education experiences in internal medicine has not been described. We aimed to determine the current status of medical students' overnight experiences in Internal Medicine clerkships and sub-internships, and to assess internal medicine educators' perceptions of the importance of overnight work during internal medicine rotations. In May 2014, the Clerkship Directors in Internal Medicine (CDIM) conducted its annual survey. Twenty-eight questions about student participation in overnight work and perceptions of the importance of overnight work (rated on 1-5 Likert scale, 1 = very unimportant and 5 =  ery important) were included. Descriptive statistics were used to summarize responses. Free text results were analyzed qualitatively. The response rate was 78 %. A minority of respondents reported students having any overnight experience during the clerkship (38.7 %) or the sub-internship (40.7 %). Only 5 % of respondents reported having students assigned to night-float rotations outside of clerkships or sub-internships. Respondents agreed that overnight experiences were more important during the sub-internship than the clerkship, 4.0 ± 1.1 vs. 3.2 ± 1.2, p intern in particular was an important chance to practice providing emergency cross coverage and other intern roles. In the era of ACGME duty hours, there is a need to further examine whether there is a role for increased overnight hospital experiences for medical students.

Core addiction medicine competencies for doctors: An international consultation on training.

Science.gov (United States)

Ayu, Astri Parawita; El-Guebaly, Nady; Schellekens, Arnt; De Jong, Cor; Welle-Strand, Gabrielle; Small, William; Wood, Evan; Cullen, Walter; Klimas, Jan

2017-01-01

Despite the high prevalence of substance use disorders, associated comorbidities, and the evidence base upon which to base clinical practice, most health systems have not invested in standardized training of health care providers in addiction medicine. As a result, people with substance use disorders often receive inadequate care, at the cost of quality of life and enormous direct health care costs and indirect societal costs. Therefore, this study was undertaken to assess the views of international scholars, representing different countries, on the core set of addiction medicine competencies that need to be covered in medical education. A total of 13 members of the International Society of 20 Addiction Medicine (ISAM), from 12 different countries (37% response rate), were interviewed over Skype, e-mail survey, or in person at the annual conference. Content analysis was used to analyze interview transcripts, using constant comparison methodology. We identified recommendations related to the core set of the addiction medicine competencies at 3 educational levels: (i) undergraduate, (ii) postgraduate, and (iii) continued medical education (CME). The participants described broad ideas, such as knowledge/skills/attitudes towards addiction to be obtained at undergraduate level, or knowledge of addiction treatment to be acquired at graduate level, as well as specific recommendations, including the need to tailor curriculum to national settings and different specialties. Although it is unclear whether a global curriculum is needed, a consensus on a core set of principles for progression of knowledge, attitudes, and skills in addiction medicine to be developed at each educational level amongst medical graduates would likely have substantial value.

STS-95 Mission Specialist Duque suits up during TCDT

Science.gov (United States)

1998-01-01

STS-95 Mission Specialist Pedro Duque of Spain, representing the European Space Agency, suits up in the Operations and Checkout Building prior to his trip to Launch Pad 39-B. Duque and the rest of the STS-95 crew are at KSC to participate in the Terminal Countdown Demonstration Test (TCDT) which includes mission familiarization activities, emergency egress training, and a simulated main engine cutoff. The other crew members are Payload Specialist Chiaki Mukai (M.D., Ph.D.), representing the National Space Development Agency of Japan (NASDA), Pilot Steven W. Lindsey, Mission Specialist Scott E. Parazynski, Mission Specialist Stephen K. Robinson, Payload Specialist John H. Glenn Jr., senator from Ohio, and Mission Commander Curtis L. Brown. The STS-95 mission, targeted for liftoff on Oct. 29, includes research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process. Following the TCDT, the crew will be returning to Houston for final flight preparations.

A nomogram to predict the probability of passing the American Board of Internal Medicine examination

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Andrei Brateanu

2012-10-01

Full Text Available Background : Although the American Board of Internal Medicine (ABIM certification is valued as a reflection of physicians’ experience, education, and expertise, limited methods exist to predict performance in the examination. Purpose : The objective of this study was to develop and validate a predictive tool based on variables common to all residency programs, regarding the probability of an internal medicine graduate passing the ABIM certification examination. Methods : The development cohort was obtained from the files of the Cleveland Clinic internal medicine residents who began training between 2004 and 2008. A multivariable logistic regression model was built to predict the ABIM passing rate. The model was represented as a nomogram, which was internally validated with bootstrap resamples. The external validation was done retrospectively on a cohort of residents who graduated from two other independent internal medicine residency programs between 2007 and 2011. Results : Of the 194 Cleveland Clinic graduates used for the nomogram development, 175 (90.2% successfully passed the ABIM certification examination. The final nomogram included four predictors: In-Training Examination (ITE scores in postgraduate year (PGY 1, 2, and 3, and the number of months of overnight calls in the last 6 months of residency. The nomogram achieved a concordance index (CI of 0.98 after correcting for over-fitting bias and allowed for the determination of an estimated probability of passing the ABIM exam. Of the 126 graduates from two other residency programs used for external validation, 116 (92.1% passed the ABIM examination. The nomogram CI in the external validation cohort was 0.94, suggesting outstanding discrimination. Conclusions : A simple user-friendly predictive tool, based on readily available data, was developed to predict the probability of passing the ABIM exam for internal medicine residents. This may guide program directors’ decision

Report on the second Congress of the Russian nuclear medicine society and on International conference Current problems of nuclear medicine and radiopharmaceuticals

International Nuclear Information System (INIS)

Lishmanov, Yu.B.; Chernov, V.I.

2001-01-01

Information on the work of Second Congress of Russian Nuclear Medicine Society and International Conference - Current problems of nuclear medicine and radiopharmaceuticals, - held in Obninsk in October, 2000, is adduced. Reports presented in the conference are dedicated to various aspects of application of radionuclide methods to cardiology, angiology, oncology, surgery, hematology, endocrinology, pediatrics and neurology. Problems in the development of radiopharmaceutical, training and skill advancement of experts, dosimetry and radiation safety in nuclear medicine were discussed. Congress considered the organizational problems in Russian nuclear medicine [ru

[French training program for medical students in transfusion medicine. Transfusion Medicine Teachers' College].

Science.gov (United States)

Wautier, J-L; Cabaud, J-J; Cazenave, J-P; Fialon, P; Fruchart, M-F; Joussemet, M; Leblond, V; Muller, J-Y; Rouger, P; Vignon, D; Waller, C; Lefrère, J-J; Worms, B; Vileyn, F

2005-02-01

In France, transfusion medicine training program has been updated. A national committee of professors in transfusion medicine propose a series of 13 items which represent the minimum knowledge that general practitioners should possess. This overview of transfusion medicine is far below the level that specialists should reach and they will need an additional specialized training. Several French universities have set up their own training program which is quite similar to the work of the committee of professors. The following recommendations are not strict guidelines but is a common basis which will be improved in 2005 according to new evidence based transfusion medicine.

Knowledge, attitudes, and practices evaluation about travel medicine in international travelers and medical students in Chile.

Science.gov (United States)

Guerrero-Lillo, Lisette; Medrano-Díaz, Jorge; Pérez, Carmen; Chacón, Rodrigo; Silva-Urra, Juan; Rodriguez-Morales, Alfonso J

2009-01-01

Because information about travel medicine in Chile is lacking, a knowledge, attitudes, and practices evaluation in international travelers and medical students was done. The travelers and medical students did not know the travel medicine and sanitary conditions of their destinations, although they perceived travel-associated health risks, but <10% had any vaccination and 5% got sick during international trips.

4th International Workshop on Adaptive Optics for Industry and Medicine

CERN Document Server

Wittrock, Ulrich

2005-01-01

This book treats the development and application of adaptive optics for industry and medicine. The contributions describe recently developed components for adaptive-optics systems such as deformable mirrors, wavefront sensors, and mirror drivers as well as complete adaptive optical systems and their applications in industry and medicine. Applications range from laser-beam forming and adaptive aberration correction for high-power lasers to retinal imaging in ophthalmology. The contributions are based on presentations made at the 4th International Workshop on Adaptive Optics in Industry and Medicine which took place in Münster, Germany, in October 2003. This highly successful series of workshops on adaptive optics started in 1997 and continues with the 5th workshop in Beijing in 2005.

Internal Medicine Residents Do Not Accurately Assess Their Medical Knowledge

Science.gov (United States)

Jones, Roger; Panda, Mukta; Desbiens, Norman

2008-01-01

Background: Medical knowledge is essential for appropriate patient care; however, the accuracy of internal medicine (IM) residents' assessment of their medical knowledge is unknown. Methods: IM residents predicted their overall percentile performance 1 week (on average) before and after taking the in-training exam (ITE), an objective and well…

Views of new internal medicine faculty of their preparedness and competence in physician-patient communication

Directory of Open Access Journals (Sweden)

Duncan Alan K

2006-05-01

Full Text Available Abstract Background We sought to assess self-rated importance of the medical interview to clinical practice and competence in physician-patient communication among new internal medicine faculty at an academic medical center. Methods Since 2001, new internal medicine faculty at the Mayo Clinic College of Medicine (Rochester, Minnesota have completed a survey on physician-patient communication. The survey asks the new faculty to rate their overall competence in medical interviewing, the importance of the medical interview to their practice, their confidence and adequacy of previous training in handling eight frequently encountered challenging communication scenarios, and whether they would benefit from additional communication training. Results Between 2001 and 2004, 75 general internists and internal medicine subspecialists were appointed to the faculty, and of these, 58 (77% completed the survey. The faculty rated (on a 10-point scale the importance of the medical interview higher than their competence in interviewing; this difference was significant (average ± SD, 9.4 ± 1.0 vs 7.7 ± 1.2, P Conclusion Although new internal medicine faculty rate high the importance of the medical interview, they rate their competence and adequacy of previous training in medical interviewing relatively low, and many indicate that they would benefit from additional communication training. These results should encourage academic medical centers to make curricula in physician-patient communication available to their faculty members because many of them not only care for patients, but also teach clinical skills, including communication skills, to trainees.

Short Sleep Times Predict Obesity in Internal Medicine Clinic Patients

Science.gov (United States)

Buscemi, Dolores; Kumar, Ashwani; Nugent, Rebecca; Nugent, Kenneth

2007-01-01

Study Objectives: Epidemiological studies have demonstrated an association between short sleep times and obesity as defined by body mass index (BMI). We wanted to determine whether this association occurs in patients with chronic medical diagnoses since the number of confounding factors is likely higher in patients than the general population. Methods: Two hundred patients attending internal medicine clinics completed a survey regarding sleep habits, lifestyle characteristics, and medical diagnoses. An independent surveyor collected the information on the questionnaires and reviewed the medical records. Height and weight were measured by clinic personnel. Data were analyzed with multivariate logistic regression. Results: Subjects with short sleep times (< 7 hours) had an increased likelihood of obesity as defined by a BMI ≥ 30 kg/m2 when compared to the reference group of (8, 9] hours (odds ratio 2.93; 95% confidence interval, 1.06–8.09). There was a U-shaped relationship between obesity and sleep time in women but not in men. Young age (18 to 49 years), not smoking, drinking alcohol, hypertension, diabetes, and sleep apnea were also associated with obesity in the overall model. Conclusions: This study demonstrates an association between short sleep times and obesity in undifferentiated patients attending an internal medicine clinic using models adjusting for age, lifestyle characteristics, and some medical diagnoses. The U-shaped relationship in women suggests that sleep patterns may have gender specific associations. These observations provide the background for therapeutic trials in weight loss in patients with established medical problems. Citation: Buscemi D; Kumar A; Nugent R; Nugent K. Short sleep times predict obesity in internal medicine clinic patients. J Clin Sleep Med 2007;3(7):681–688. PMID:18198800

The Third International Genomic Medicine Conference (3rd IGMC, 2015: overall activities and outcome highlights

Directory of Open Access Journals (Sweden)

Muhammad Abu-Elmagd

2016-10-01

Full Text Available Abstract The Third International Genomic Medicine Conference (3rd IGMC was organised by the Centre of Excellence in Genomic Medicine Research (CEGMR at the King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia (KSA. This conference is a continuation of a series of meetings, which began with the first International Genomic Medicine Conference (1st IGMC, 2011 followed by the second International Genomic Medicine Conference (2nd IGMC, 2013. The 3rd IGMC meeting presented as a timely opportunity to bring scientists from across the world to gather, discuss, and exchange recent advances in the field of genomics and genetics in general as well as practical information on using these new technologies in different basic and clinical applications. The meeting undoubtedly inspired young male and female Saudi researchers, who attended the conference in large numbers, as evidenced by the oversubscribed oral and poster presentations. The conference also witnessed the launch of the first content for npj Genomic Medicine, a high quality new journal was established in partnership by CEGMR with Springer Nature and published as part of the Nature Partner Journal series. Here, we present a brief summary report of the 2-day meeting including highlights from the oral presentations, poster presentations, workshops, poster prize-winners and comments from the distinguished scientists.

Nuclear medicine training and practice in Poland

International Nuclear Information System (INIS)

Teresinska, Anna; Birkenfeld, Bozena; Krolicki, Leszek; Dziuk, Miroslaw

2014-01-01

In Poland, nuclear medicine (NM) has been an independent specialty since 1988. At the end of 2013, the syllabus for postgraduate specialization in NM has been modified to be in close accordance with the syllabus approved by the European Union of Medical Specialists and is expected to be enforced before the end of 2014. The National Consultant in Nuclear Medicine is responsible for the specialization program in NM. The Medical Center of Postgraduate Training is the administrative body which accepts the specialization programs, supervises the training, organizes the examinations, and awards the specialist title. Specialization in NM for physicians lasts for five years. It consists of 36 months of training in a native nuclear medicine department, 12 months of internship in radiology, 3 months in cardiology, 3 months in endocrinology, 3 months in oncology, and 3 months in two other departments of NM. If a NM trainee is a specialist of a clinical discipline and/or is after a long residency in NM departments, the specialization in NM can be shortened to three years. During the training, there are obligatory courses to be attended which include the elements of anatomy imaging in USG, CT, and MR. Currently, there are about 170 active NM specialists working for 38.5 million inhabitants in Poland. For other professionals working in NM departments, it is possible to get the title of a medical physics specialist after completing 3.5 years of training (for those with a master's in physics, technical physics or biomedical engineering) or the title of a radiopharmacy specialist after completing 3 years of training (for those with a master's in chemistry or biology). At present, the specialization program in NM for nurses is being developed by the Medical Centre of Postgraduate Education. Continuing education and professional development are obligatory for all physicians and governed by the Polish Medical Chamber. The Polish Society of Nuclear Medicine (PTMN) organizes regular

Nuclear medicine training and practice in Poland

Energy Technology Data Exchange (ETDEWEB)

Teresinska, Anna [Institute of Cardiology, Department of Nuclear Medicine, Warsaw (Poland); Birkenfeld, Bozena [Pomeranian Medical University, Department of Nuclear Medicine, Szczecin (Poland); Krolicki, Leszek [Warsaw Medical University, Department of Nuclear Medicine, Warsaw (Poland); Dziuk, Miroslaw [Military Institute of Medicine, Department of Nuclear Medicine, Warsaw (Poland)

2014-10-15

In Poland, nuclear medicine (NM) has been an independent specialty since 1988. At the end of 2013, the syllabus for postgraduate specialization in NM has been modified to be in close accordance with the syllabus approved by the European Union of Medical Specialists and is expected to be enforced before the end of 2014. The National Consultant in Nuclear Medicine is responsible for the specialization program in NM. The Medical Center of Postgraduate Training is the administrative body which accepts the specialization programs, supervises the training, organizes the examinations, and awards the specialist title. Specialization in NM for physicians lasts for five years. It consists of 36 months of training in a native nuclear medicine department, 12 months of internship in radiology, 3 months in cardiology, 3 months in endocrinology, 3 months in oncology, and 3 months in two other departments of NM. If a NM trainee is a specialist of a clinical discipline and/or is after a long residency in NM departments, the specialization in NM can be shortened to three years. During the training, there are obligatory courses to be attended which include the elements of anatomy imaging in USG, CT, and MR. Currently, there are about 170 active NM specialists working for 38.5 million inhabitants in Poland. For other professionals working in NM departments, it is possible to get the title of a medical physics specialist after completing 3.5 years of training (for those with a master's in physics, technical physics or biomedical engineering) or the title of a radiopharmacy specialist after completing 3 years of training (for those with a master's in chemistry or biology). At present, the specialization program in NM for nurses is being developed by the Medical Centre of Postgraduate Education. Continuing education and professional development are obligatory for all physicians and governed by the Polish Medical Chamber. The Polish Society of Nuclear Medicine (PTMN) organizes

Sepsis in Internal Medicine wards: current knowledge, uncertainties and new approaches for management optimization.

Science.gov (United States)

Zaccone, Vincenzo; Tosoni, Alberto; Passaro, Giovanna; Vallone, Carla Vincenza; Impagnatiello, Michele; Li Puma, Domenica Donatella; De Cosmo, Salvatore; Landolfi, Raffaele; Mirijello, Antonio

2017-11-01

Sepsis represents a global health problem in terms of morbidity, mortality, social and economic costs. Although usually managed in Intensive Care Units, sepsis showed an increased prevalence among Internal Medicine wards in the last decade. This is substantially due to the ageing of population and to multi-morbidity. These characteristics represent both a risk factor for sepsis and a relative contra-indication for the admission to Intensive Care Units. Although there is a lack of literature on the management of sepsis in Internal Medicine, the outcome of these patients seems to be gradually improving. This is due to Internists' increased adherence to guidelines and "bundles". The routine use of SOFA score helps physicians in the definition of septic patients, even if the optimal score has still to come. Point-of-care ultrasonography, lactates, procalcitonin and beta-d-glucan are of help for treatment optimization. The purpose of this narrative review is to focus on the management of sepsis in Internal Medicine departments, particularly on crucial concepts regarding diagnosis, risk assessment and treatment. Key Messages Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. The prevalence of sepsis is constantly increasing, affecting more hospital patients than any other disease. At least half of patients affected by sepsis are admitted to Internal Medicine wards. Adherence to guidelines, routine use of clinical and lab scores and point-of-care ultrasonography are of help for early recognition of septic patients and treatment optimization.

[History of the 4th Department of Internal Medicine of the First Faculty of Medicine at Charles University and the General University Hospital in Prague].

Science.gov (United States)

Bartůněk, Petr

In 2015, the doctors and nurses of the 4th Department of Internal Medicine of the First Faculty of Medicine, Charles University and the General University Hospital in Prague celebrated the 70th anniversary of its founding. The article summarizes the clinics contribution to the field of internal medicine, and particularly to angiology, hepatogastroenterology and lipidology. It comments the clinics current activities and the possibilities of its further development. Attention is also paid to the tradition of high ethical and professional standards of medical care in accordance with the norms established by the clinic's founder, prof. MUDr. Bohumil Prusík.

Evaluation of radiation protection in nuclear medicine diagnostic procedures

International Nuclear Information System (INIS)

Mohammed, Ezzeldien Mohammed Nour

2013-05-01

This study conducted to evaluate the radiation protection in nuclear medicine diagnostic procedures in four nuclear medicine departments in Sudan. The evaluated procedures followed in these departments were in accordance with the standards, International Recommendations and code of practice for radiation protection in nuclear medicine. The evolution included the optimum design for diagnostic nuclear medicine departments, dealing with radioactive sources, quality assurance and quality control, training and responsibilities for radiation worker taking into account economic factors in Sudan. Evaluation of radiation protection procedures in diagnostic investigations was carried out by taken direct measurements of dose rate and the contamination level in some areas where radiation sources, radiation workers and public are involved. Designated questionnaires covered thirteen areas of radiation protection based on inspection check list for nuclear medicine prepared by the International Atomic Energy Agency (IAEA) and American Association of Physicist in Medicine (AAPM) were used in the evaluation. This questionnaire has been Filled by Radiation Protection Officer (RPO), nuclear medicine technologist, nuclear medicine specialist in the nuclear medicine departments. Four hospitals, two governmental hospital and two private hospitals, have been assisted, the assessment shows that although the diagnostic nuclear medicine department in Sudan are not applying a fully safety and radiation protection procedures, but the level of radiation dose and the contamination level were found within acceptable limits. The private hospital D scored the higher level of protection (85.25%) while the governmental hospital C scored the lower level of protection (59.02%). Finally, this study stated some recommendations that if implemented could improve the level of radiation protection in nuclear medicine department. One of the most important recommendations is that a proper radiation protection

PM Mumo Holistic Healing, An Analytical Review of Medicine-men ...

African Journals Online (AJOL)

PM Mumo

Key words. Holistic healing, African traditional medicine, medicine-men, religious specialists ... The article has the following specific objectives: ..... Others have embraced modern marketing strategies and are advertising their herbs through.

Problematic communications during 2016 fellowship recruitment in internal medicine.

OpenAIRE

Cornett, PA; Williams, C; Alweis, RL; McConville, J; Frank, M; Dalal, B; Kopelman, RI; Luther, VP; O'connor, AB; Muchmore, EA

2017-01-01

ABSTRACT Some internal medicine residency program directors have expressed concerns that their third-year residents may have been subjected to inappropriate communication during the 2016 fellowship recruitment season. The authors sought to study applicants’ interpersonal communication experiences with fellowship programs. Many respondents indicated that they had been asked questions that would constitute violations of the National Residency Matching Program (NRMP) Communications Code of Condu...

Learning Mathematics for Teaching Mathematics: Non-Specialist Teachers' Mathematics Teacher Identity

Science.gov (United States)

Crisan, Cosette; Rodd, Melissa

2017-01-01

A non-specialist teacher of mathematics is a school teacher who qualified to teach in a subject other than mathematics yet teaches mathematics to students in secondary school. There is an emerging interest internationally in this population, a brief report of which is given in the paper. Because of concerns about the quality of non-specialists'…

Etiologies and Management of Aseptic Meningitis in Patients Admitted to an Internal Medicine Department.

Science.gov (United States)

Jarrin, Irène; Sellier, Pierre; Lopes, Amanda; Morgand, Marjolaine; Makovec, Tamara; Delcey, Veronique; Champion, Karine; Simoneau, Guy; Green, Andrew; Mouly, Stéphane; Bergmann, Jean-François; Lloret-Linares, Célia

2016-01-01

Several studies have focused on the clinical and biological characteristics of meningitis in order to distinguish between bacterial and viral meningitis in the emergency setting. However, little is known about the etiologies and outcomes of aseptic meningitis in patients admitted to Internal Medicine.The aim of the study is to describe the etiologies, characteristics, and outcomes of aseptic meningitis with or without encephalitis in adults admitted to an Internal Medicine Department.A retrospective cohort study was conducted in the Internal Medicine Department of the Lariboisière Hospital in Paris, France, from January 2009 to December 2011. Clinical and biological characteristics of aseptic meningitis were recorded. These included cerebrospinal fluid analysis, results of polymerase chain reaction testing, final diagnoses, and therapeutic management.The cohort included 180 patients fulfilling the criteria for aseptic meningitis with (n = 56) or without (n = 124) encephalitis. A definitive etiological diagnosis was established in 83 of the 180 cases. Of the cases with a definitive diagnosis, 73 were due to infectious agents, mainly enteroviruses, Herpes Simplex Virus 2, and Varicella Zoster Virus (43.4%, 16.8%, and 14.5% respectively). Inflammatory diseases were diagnosed in 7 cases. Among the 97 cases without definitive diagnoses, 26 (26.8%) remained free of treatment throughout their management whereas antiviral or antibiotic therapy was initiated in the emergency department for the remaining 71 patients. The treatment was discontinued in only 10 patients deemed to have viral meningitis upon admission to Internal Medicine.The prevalence of inflammatory diseases among patients admitted to internal medicine for aseptic meningitis is not rare (4% of overall aseptic meningitis). The PCR upon admission to the emergency department is obviously of major importance for the prompt optimization of therapy and management. However, meningitis due to viral agents or

Evidence-based medicine and prejudice-based medicine: the case of homeopathy

Directory of Open Access Journals (Sweden)

Nelson Filice de Barros

2014-11-01

Full Text Available In recent decades an important social movement related to Complementary and Alternative Medicine has been identified worldwide. In Brazil, although homeopathy was recognized as a specialist medical area in 1980, few medical schools offer courses related to it. In a previous study, 176 resident doctors at the University of Campinas Medical School were interviewed and 86 (49% rejected homeopathy as a subject in the core medical curriculum. Thus, this qualitative study was conducted to understand their reasons for refusing. 20 residents from 15 different specialist areas were interviewed. Very few of them admitted to a lack of knowledge for making a judgment about homeopathy; none of them made a conscientious objection to it; and the majority demonstrated prejudice, affirming that there is not enough scientific evidence to support homeopathy, defending their position based on personal opinion, limited clinical practice and on information circulated in the mass media. Finally, resident doctors’ prejudices against homeopathy can be extended to practices other than allopathic medicine.

Core Addiction Medicine Competencies for Doctors, An International Consultation on Training.

LENUS (Irish Health Repository)

Ayu, Astri Parawita

2017-07-18

Despite the high prevalence of substance use disorders, associated comorbidities and the evidence-base upon which to base clinical practice, most health systems have not invested in standardised training of healthcare providers in addiction medicine. As a result, people with substance use disorders often receive inadequate care, at the cost of quality of life and enormous direct health care costs and indirect societal costs. Therefore, we undertook this study to assess the views of international scholars, representing different countries, on the core set of addiction medicine competencies that need to be covered in medical education.

Emergency medicine and internal medicine trainees’ smartphone use in clinical settings in the United States

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Sonja E. Raaum

2015-10-01

Full Text Available Purpose: Smartphone technology offers a multitude of applications (apps that provide a wide range of functions for healthcare professionals. Medical trainees are early adopters of this technology, but how they use smartphones in clinical care remains unclear. Our objective was to further characterize smartphone use by medical trainees at two United States academic institutions, as well as their prior training in the clinical use of smartphones. Methods: In 2014, we surveyed 347 internal medicine and emergency medicine resident physicians at the University of Utah and Brigham and Women’s Hospital about their smartphone use and prior training experiences. Scores (0%–100% were calculated to assess the frequency of their use of general features (email, text and patient-specific apps, and the results were compared according to resident level and program using the Mann-Whitney U-test. Results: A total of 184 residents responded (response rate, 53.0%. The average score for using general features, 14.4/20 (72.2% was significantly higher than the average score for using patient-specific features and apps, 14.1/44 (33.0%, P<0.001. The average scores for the use of general features, were significantly higher for year 3–4 residents, 15.0/20 (75.1% than year 1–2 residents, 14.1/20 (70.5%, P=0.035, and for internal medicine residents, 14.9/20 (74.6% in comparison to emergency medicine residents, 12.9/20 (64.3%, P= 0.001. The average score reflecting the use of patient-specific apps was significantly higher for year 3–4 residents, 16.1/44 (36.5% than for year 1–2 residents, 13.7/44 (31.1%; P=0.044. Only 21.7% of respondents had received prior training in clinical smartphone use. Conclusion: Residents used smartphones for general features more frequently than for patient-specific features, but patient-specific use increased with training. Few residents have received prior training in the clinical use of smartphones.

The costs, resource use and cost-effectiveness of Clinical Nurse Specialist-led interventions for patients with palliative care needs: A systematic review of international evidence.

Science.gov (United States)

Salamanca-Balen, Natalia; Seymour, Jane; Caswell, Glenys; Whynes, David; Tod, Angela

2018-02-01

Patients with palliative care needs do not access specialist palliative care services according to their needs. Clinical Nurse Specialists working across a variety of fields are playing an increasingly important role in the care of such patients, but there is limited knowledge of the extent to which their interventions are cost-effective. To present results from a systematic review of the international evidence on the costs, resource use and cost-effectiveness of Clinical Nurse Specialist-led interventions for patients with palliative care needs, defined as seriously ill patients and those with advanced disease or frailty who are unlikely to be cured, recover or stabilize. Systematic review following PRISMA methodology. Medline, Embase, CINAHL and Cochrane Library up to 2015. Studies focusing on the outcomes of Clinical Nurse Specialist interventions for patients with palliative care needs, and including at least one economic outcome, were considered. The quality of studies was assessed using tools from the Joanna Briggs Institute. A total of 79 papers were included: 37 randomized controlled trials, 22 quasi-experimental studies, 7 service evaluations and other studies, and 13 economic analyses. The studies included a wide variety of interventions including clinical, support and education, as well as care coordination activities. The quality of the studies varied greatly. Clinical Nurse Specialist interventions may be effective in reducing specific resource use such as hospitalizations/re-hospitalizations/admissions, length of stay and health care costs. There is mixed evidence regarding their cost-effectiveness. Future studies should ensure that Clinical Nurse Specialists' roles and activities are clearly described and evaluated.

[Databases for surgical specialists in Cancún, Quintana Roo].

Science.gov (United States)

Contla-Hosking, Jorge Eduardo; Ceballos-Martínez, Zoila Inés; Peralta-Bahena, Mónica Esther

2004-01-01

Our aim was to identify the level of knowledge of surgical health-area specialists in Cancún, Quintana Roo, Mexico, from the personal productivity database. We carried out an investigation of 37 surgical specialists: 24 belonged to the Mexican Social Security Institute (IMSS), while 13 belonged to the Mexican Health Secretariat (SSA). In our research, we found that 61% of surgical health-area specialist physicians were familiar with some aspects of the institutional surgical registry, including the following: 54% knew of the existence of a personal registry of surgeries carried out, and 43% keep a record of their personal activities. From the latter percentage, 69% of surgical health-area specialist physicians mentioned keeping their records manually, while 44% used the computer. Results of the research suggest that these physicians would like to have some kind of record of the surgeries carried out by each. An important percentage of these specialists do not keep a personal record on a database; due to this lack of knowledge, we obtain incorrect information in institutional records of the reality of what is actually done. We consider it important to inform surgical specialists concerning the existence of personal institutional records in database form or even of record done manually, as well as correct terminology for the International Codification (CIE-9 & 10). We inform here of the need to encourage a culture in records and databases in the formative stage of surgeon specialists.

Clinical Holistic Medicine: Chronic Pain in Internal Organs

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Søren Ventegodt

2005-01-01

Full Text Available Holistic medicine seems to be efficient in the treatment of chronic pain in internal organs, especially when the pain has no known cause. It is quite surprising that while chronic pain can be one of the toughest challenges in the biomedical clinic, it is often one of the simplest things to alleviate in the holistic clinic. These pains are regarded as being caused by repressed emotions and are explained as psychosomatic reactions. Using holistic medicine, the patients can often be cured of their suffering when they assume responsibility for the repressed feelings. The holistic process theory of healing states that the return to the natural (pain free state of being is possible whenever the person obtains the resources needed for existential healing. This shift is explained by the related quality of life and life mission theories. The resources needed are “holding” or genuine care in the dimensions of awareness, respect, care, acknowledgment, and acceptance with support and processing in the dimensions of feeling, understanding, and letting go of negative attitudes and beliefs. The preconditions for the holistic healing to take place are “love” and trust. Obtaining the full trust of the patient, therefore, seems to be the biggest challenge of holistic medicine, especially when dealing with a patient in pain.

Complex decision making in patients with dementia in an internal medicine department.

Science.gov (United States)

Kabelka, Ladislav

2017-10-01

With the increase of polymorbidity, extending life expectancy and improving treatment options for chronic diseases, the care for dementia is moving into other areas of medicine. The length and quality of life with advanced dementia is directly dependent on the quality of medical and nursing care, early detection and treatment of complications, nutritional support and palliative care plan. Significant is also the support for family carers. The key coordinators of care for patients with dementia are general practitioners (GPs), geriatricians, psychiatrists, and an increasingly important role play internists. Case reports of patients admitted to an internal medicine department. Description of clinical experiences with caring on patients with dementia. In the internal departments of regional hospitals, there is a room for adjustment of the care plan, for comprehensive assessment of the patient and for making crucial decisions regarding nutrition, treatment of chronic diseases, consideration of previously expressed wishes in the context of the patient condition, and potential prognostic indicators. This assessment must result in a comprehensive documentation and communication with patients, and in the case of advanced dementia with their family members. The general internal medicine is very often the first place where the patient has a chance to hear about indication for palliative care. Without the availability of a multidisciplinary assessment, good communication and documentation, it is unrealistic to expect that the hospital would provide comprehensive care for patients with dementia.

Effect of Weekend Admissions on the Treatment Process and Outcomes of Internal Medicine Patients

Science.gov (United States)

Huang, Chun-Che; Huang, Yu-Tung; Hsu, Nin-Chieh; Chen, Jin-Shing; Yu, Chong-Jen

2016-01-01

Abstract Many studies address the effect of weekend admission on patient outcomes. This population-based study aimed to evaluate the relationship between weekend admission and the treatment process and outcomes of general internal medicine patients in Taiwan. A total of 82,340 patients (16,657 weekend and 65,683 weekday admissions) aged ≥20 years and admitted to the internal medicine departments of 17 medical centers between 2007 and 2009 were identified from the Taiwan National Health Insurance Research Database. A generalized estimating equation (GEE) analysis was used to compare patients admitted on weekends and those admitted on weekdays. Patients who were admitted on weekends were more likely to undergo intubation (odds ratio [OR]: 1.27; 95% confidence interval [CI]: 1.16–1.39; P internal medicine patients who were admitted on weekends experienced more intensive care procedures and higher ICU admission, in-hospital mortality, and treatment cost. Intensive care utilization may serve as early indicator of poorer outcomes and a potential entry point to offer preventive intervention before proceeding to intensive treatment. PMID:26871788

Complementary and alternative medicine use by visitors to rural Japanese family medicine clinics: results from the international complementary and alternative medicine survey.

Science.gov (United States)

Shumer, Gregory; Warber, Sara; Motohara, Satoko; Yajima, Ayaka; Plegue, Melissa; Bialko, Matthew; Iida, Tomoko; Sano, Kiyoshi; Amenomori, Masaki; Tsuda, Tsukasa; Fetters, Michael D

2014-09-25

There is growing interest in the use of complementary and alternative medicine (CAM) throughout the world, however previous research done in Japan has focused primarily on CAM use in major cities. The purpose of this study was to develop and distribute a Japanese version of the International Complementary and Alternative Medicine Questionnaire (I-CAM-Q) to assess the use of CAM among people who visit rural Japanese family medicine clinics. Using a Japanese version of the International Complementary and Alternative Medicine Questionnaire (I-CAM-Q), a cross-sectional survey was conducted in three rural family medicine clinics. All patients and those accompanying patients who met inclusion criteria were eligible to participate. Data were entered into SPSS Statistics and analyzed for use by age, gender, and location. Of the 519 respondents who participated in the project, 415 participants reported CAM use in the past 12 months (80.0%). When prayer is excluded, the prevalence of CAM use drops to 77.3% in the past year, or 403 respondents. The most common forms of CAM used by respondents were pain relief pads (n = 170, 32.8%), herbal medicines/supplements (n = 167, 32.2%), and massage by self or family (n = 166, 32.0%). Female respondents, individuals with higher levels of education, and those with poorer overall health status were more likely to use CAM than respondents without these characteristics. Only 22.8% of CAM therapies used were reported to physicians by survey participants. These data indicate that CAM use in rural Japan is common. The results are consistent with previous studies that show that Japanese individuals are more interested in forms of CAM such as pain relief pads and massage, than in mind-body forms of CAM like relaxation and meditation. Due to the high utilization of certain CAM practices, and given that most CAM users do not disclose their CAM use to their doctors, we conclude that physicians in rural Japan would benefit by asking about CAM use

Do specialists exit the firm outsourcing its R&D?

DEFF Research Database (Denmark)

Wang, Wenjing

Do specialists exit the firm increasingly outsourcing its research and development (R&D) work? Although this question is critical in understanding how R&D outsourcing links to innovation performance, the answer is not yet clear. This paper proposes that the optimal level of firm's internal...... employment of R&D specialists decreases with the deepening of R&D outsourcing but increases with the broadening of R&D outsourcing. These relations can be inferred from previous empirical studies as well as our theoretical analysis, and are supported by the empirical evidence from estimations of correlated...

Proceedings of the German Society of Internal Medicine

International Nuclear Information System (INIS)

Miehlke, K.

1988-01-01

The proceedings of the German Society of Internal Medicine from its 94th congress held at Wiesbaden (April 10-14, 1988) provide coverage of the following issues: Gastrointestinal tumours - diagnosis and therapy at an early stage; diagnostic methods used in the pancreas; endoscopy during surgery; medical imaging in gastroenterology; therapy of chronic inflammatory changes of the intestine; proctology on an out-patient basis and geriatric patients showing cerebrovasucular insufficiency. Three papers have been separately for the database. (GDG) With 290 figs., 248 tabs [de

[Corticosteroid therapy and therapeutic education: experience of an internal medicine department

NARCIS (Netherlands)

Simon, A.; Ane, A.M.; Afroun, A.

2013-01-01

In 2003, we sought to determine what were the needs of patients prescribed with long-term glucocorticoid therapy in our internal medicine department. Following this inventory, we decided to homogenize the medical practices regarding glucocorticoid prescriptions in our institution. We also set up a

Identification and Hierarchy of Main Electronic Health Record Components in Occupational Medicine

Directory of Open Access Journals (Sweden)

Dorin TRIFF

2010-12-01

Full Text Available Starting from the legal requirements relating to structuring of medical records in occupational medicine and international requirements regarding the certification of electronic health records we have focused on structuring and then evaluating an EHR model in occupational medicine that integrates the main functions and certification criteria required by the European and US certification bodies. The application we designed, called Medmun, structured for use in occupational medicine practices based on the model of medical file provided by the Romanian legislation, integrates both necessary components of occupational medicine practice for administration of characteristic information related to socio-economic unit, work place, health surveillance as well as components of specific EHR functionality. The application has been submitted for free evaluation by specialist physicians of five counties over a period of nine months and subsequently assessed using a questionnaire on the usefulness of specific functional components in the EHR occupational medicine practice. The model was positively evaluated after experimental employment by occupational health practitioners. They consider that absence of legislative support for EHR implementation in medical practice is the main obstacle to the use of such applications in occupational medicine practice.

Student performance of the general physical examination in internal medicine: an observational study

Science.gov (United States)

2014-01-01

Background Many practicing physicians lack skills in physical examination. It is not known whether physical examination skills already show deficiencies after an early phase of clinical training. At the end of the internal medicine clerkship students are expected to be able to perform a general physical examination in every new patient encounter. In a previous study, the basic physical examination items that should standardly be performed were set by consensus. The aim of the current observational study was to assess whether medical students were able to correctly perform a general physical examination regarding completeness as well as technique at the end of the clerkship internal medicine. Methods One hundred students who had just finished their clerkship internal medicine were asked to perform a general physical examination on a standardized patient as they had learned during the clerkship. They were recorded on camera. Frequency of performance of each component of the physical examination was counted. Adequacy of performance was determined as either correct or incorrect or not assessable using a checklist of short descriptions of each physical examination component. A reliability analysis was performed by calculation of the intra class correlation coefficient for total scores of five physical examinations rated by three trained physicians and for their agreement on performance of all items. Results Approximately 40% of the agreed standard physical examination items were not performed by the students. Students put the most emphasis on examination of general parameters, heart, lungs and abdomen. Many components of the physical examination were not performed as was taught during precourses. Intra-class correlation was high for total scores of the physical examinations 0.91 (p internal medicine clerkship. Possible causes and suggestions for improvement are discussed. PMID:24712683

Examining the Reading Level of Internet Medical Information for Common Internal Medicine Diagnoses.

Science.gov (United States)

Hutchinson, Nora; Baird, Grayson L; Garg, Megha

2016-06-01

The National Institutes of Health (NIH) recommend that health materials be written at a grade 6-7 reading level, which has generally not been achieved in online reading materials. Up to the present time, there have not been any assessments focused on the reading level of online educational materials across the most popular consumer Web sites for common internal medicine diagnoses. In this study, we examined the readability of open-access online health information for 9 common internal medicine diagnoses. Nine of the most frequently encountered inpatient and ambulatory internal medicine diagnoses were selected for analysis. In November and December 2014, these diagnoses were used as search terms in Google, and the top 5 Web sites across all diagnoses and a diagnosis-specific site were analyzed across 5 validated reading indices. On average, the lowest reading grade-level content was provided by the NIH (10.7), followed by WebMD (10.9), Mayo Clinic (11.3), and diagnosis-specific Web sites (11.5). Conversely, Wikipedia provided content that required the highest grade-level readability (14.6). The diagnoses with the lowest reading grade levels were chronic obstructive pulmonary disease (10.8), followed by diabetes (10.9), congestive heart failure (11.7), osteoporosis (11.7) and hypertension (11.7). Depression had the highest grade-level readability (13.8). Despite recommendations for patient health information to be written at a grade 6-7 reading level, our examination of online educational materials pertaining to 9 common internal medicine diagnoses revealed reading levels significantly above the NIH recommendation. This was seen across both diagnosis-specific and general Web sites. There is a need to improve the readability of online educational materials made available to patients. These improvements have the potential to greatly enhance patient awareness, engagement, and physician-patient communication. Published by Elsevier Inc.

Prevalence of delirium in hospitalized internal medicine and surgical adult patients in Shohadaye ashayer hospital of Khoram abad

Directory of Open Access Journals (Sweden)

raheleh Asaee

2008-10-01

Full Text Available Asaee R1, Nasari H2,Hoseini S3 1. Assistant professor, Department of Physiology, Faculty of Medicine, Lorestanl University of Medical Sciences, Khorramabad, Iran 1. Assistant professor, Department of Psychiatry, Faculty of Medicine, Lorestanl University of Medical Sciences, Khorramabad, Iran 2. G.P, Khorramabad, Iran Abstract Background: Delirium is common in elderly persons and in hospitalized patients especially after surgical procedures. But many of them are undetected and don’t receive treatment so they involve with increased mortality and morbidity, adverse outcomes, length of hospital stay and mental disability sequels. Unfortunetly , despite the importance of this syndrom , physicians and staff are able to diagnose only one thirth of the patients. Material and methods: In this cross sectional study, 240 inpatiants (120 from surgery ward and 120 from miernal medicine ward from Shohadaye Ashayer hospital of Khorramabad were selected randomly. The diagnostic criteria for delirium were Mini-Mental state examination (MMSE questionnaire, and patients daily examination for 4 days by MMSE. Results: Delirium was observed in 37 (30.8% of the patients of internal medicine ward and 25 (20.8% of the patients of surgery ward. 27 (22.5% of the patients of internal medicine ward and 37 (30.8% of the patients of surgery ward were suspicious for delirium. In age group of 58-77 years in surgery ward and patients over 77 years in internal medicine ward had the most frequency of delirium. There was significant relationship (p=0.01 between two sex in surgery ward. But there was not significant difference (p=0.92 between two sex in internal medicine ward for delirium. Conclusion: Reading the results of this study and frequency of delirum in surgery and internal medicine wards, presence of a psychiatrist in mentioned wards is necessary of early diagnosis and control of delirium.

Impact of the application of criteria of internal monitoring in radiological protection programmes in nuclear medicine services

International Nuclear Information System (INIS)

Dantas, B.M.; Dantas, A.L.A.; Juliao, L.Q.C.; Lourenco, M.C.; Melo, D.R.

2005-01-01

The manipulation of open sources in Nuclear Medicine services involves risks of external exposure and internal contamination. The radiological protection plan of facilities licensed by CNEN - Brazilian Nuclear Energy Commission - must include the evaluation of such risks and propose a programme of individual monitoring to control exposure and ensure the maintenance of conditions of radiation safety. The IAEA - International Atomic Energy Agency - recommendations presented in the Safety Guide RS-G-1.2 suggest that an internal worker monitoring program be implemented where there is a possibility of internal contamination lead to effective dose committed annual values equal to or greater than 1 mSv. This paper presents the application of such criteria to the radionuclides most frequently used in the field of Nuclear Medicine, taking into account the normal conditions of handling and the ranges of activity authorized by CNEN. It is concluded that iodine 131 manipulation for therapeutic purposes is the practice that presented the greatest risk of internal exposure of workers, requiring the adoption of a programme of internal monitoring of Nuclear Medicine services

A comparison of risk and protective factors related to suicide ideation among residents and specialists in academic medicine.

Science.gov (United States)

Eneroth, Mari; Gustafsson Sendén, Marie; Løvseth, Lise T; Schenck-Gustafsson, Karin; Fridner, Ann

2014-03-22

Physicians have an elevated risk of experiencing suicidal thoughts, which might be due to work-related factors. However, the hierarchical work positions as well as work-related health differ among resident and specialist physicians. As such, the correlates of suicide ideation may also vary between these two groups. In the present study, work- and health-related factors and their association with suicidal thoughts among residents (n=234) and specialists (n=813) working at a university hospital were examined using cross-sectional data. Logistic regression analysis showed that having supportive meetings was associated with a lower level of suicide ideation among specialists (OR=0.68, 95% CI: 0.50-0.94), while an empowering leadership was related to a lower level of suicide ideation among residents (OR=0.55, 95% CI: 0.32-0.94). Having been harassed at work was associated with suicidal ideation among specialists (OR=2.26, 95% CI: 1.31-3.91). In addition, sickness presenteeism and work disengagement were associated with suicide ideation in both groups of physicians. These findings suggest that different workplace interventions are needed to prevent suicide ideation in residents and specialists.

Developing educators, investigators, and leaders during internal medicine residency: the area of distinction program.

Science.gov (United States)

Kohlwes, R Jeffrey; Cornett, Patricia; Dandu, Madhavi; Julian, Katherine; Vidyarthi, Arpana; Minichiello, Tracy; Shunk, Rebecca; Jain, Sharad; Harleman, Elizabeth; Ranji, Sumant; Sharpe, Brad; O'Sullivan, Patricia; Hollander, Harry

2011-12-01

Professional organizations have called for individualized training approaches, as well as for opportunities for resident scholarship, to ensure that internal medicine residents have sufficient knowledge and experience to make informed career choices. To address these training issues within the University of California, San Francisco, internal medicine program, we created the Areas of Distinction (AoD) program to supplement regular clinical duties with specialized curricula designed to engage residents in clinical research, global health, health equities, medical education, molecular medicine, or physician leadership. We describe our AoD program and present this initiative's evaluation data. METHODS AND PROGRAM EVALUATION: We evaluated features of our AoD program, including program enrollment, resident satisfaction, recruitment surveys, quantity of scholarly products, and the results of our resident's certifying examination scores. Finally, we described the costs of implementing and maintaining the AoDs. AoD enrollment increased from 81% to 98% during the past 5 years. Both quantitative and qualitative data demonstrated a positive effect on recruitment and improved resident satisfaction with the program, and the number and breadth of scholarly presentations have increased without an adverse effect on our board certification pass rate. The AoD system led to favorable outcomes in the domains of resident recruitment, satisfaction, scholarship, and board performance. Our intervention showed that residents can successfully obtain clinical training while engaging in specialized education beyond the bounds of core medicine training. Nurturing these interests 5 empower residents to better shape their careers by providing earlier insight into internist roles that transcend classic internal medicine training.

Italian intersociety consensus on DOAC use in internal medicine.

Science.gov (United States)

Prisco, Domenico; Ageno, Walter; Becattini, Cecilia; D'Angelo, Armando; Davì, Giovanni; De Cristofaro, Raimondo; Dentali, Francesco; Di Minno, Giovanni; Falanga, Anna; Gussoni, Gualberto; Masotti, Luca; Palareti, Gualtiero; Pignatelli, Pasquale; Santi, Roberto M; Santilli, Francesca; Silingardi, Mauro; Tufano, Antonella; Violi, Francesco

2017-04-01

The direct oral anticoagulants (DOACs) are drugs used in clinical practice since 2009 for the prevention of stroke or systemic embolism in non-valvular atrial fibrillation, and for the treatment and secondary prevention of venous thromboembolism. The four DOACs, including the three factor Xa inhibitors (rivaroxaban, apixaban and edoxaban) and one direct thrombin inhibitor (dabigatran) provide oral anticoagulation therapy alternatives to Vitamin K antagonists (VKAs). Despite their clear advantages, the DOACs require on the part of the internist a thorough knowledge of their pharmacokinetic and pharmacodynamic characteristics to ensure their correct use, laboratory monitoring and the appropriate management of adverse events. This document represents a consensus paper on the use of DOACs by representatives of three Italian scientific societies: the Italian Society of Internal Medicine (SIMI), the Federation of the Associations of Hospital Managers (FADOI), and the Society for the Study of Haemostasis and Thrombosis (SISET). This document formulates expert opinion guidance for pragmatic managing, monitoring and reversing the anticoagulant effect of DOACs in both chronic and emergency settings. This practical guidance may help the internist to create adequate protocols for patients hospitalized ion internal medicine wards, where patients are often elderly subjects affected by poly-morbidities and renal insufficiency, and, thus, require particular attention to drug-drug interactions and peri-procedural protocols.

Characteristics of Homeopathy Users among Internal Medicine Patients in Germany.

Science.gov (United States)

Steel, Amie; Cramer, Holger; Leung, Brenda; Lauche, Romy; Adams, Jon; Langhorst, Jost; Dobos, Gustav

2016-01-01

Homeopathy use continues to grow in many European countries, and some studies have examined the characteristics of patients using homeopathy within the general population. The aim of this study was to identify predictors for homeopathy use among internal medicine patients. A cross-sectional analysis was conducted among all patients being referred to the Department of Internal and Integrative Medicine at Essen, Germany, over a 3-year period. The analysis examined whether patients had used homeopathy for their primary medical complaint before, the perceived benefit, and the perceived harm of homeopathy use. Odds ratios with 95% confidence intervals were calculated using multiple logistic regression analysis. Of 2,045 respondents, 715 (35.0%) reported having used homeopathy for their primary medical complaint (diagnosis according to the International Statistical Classification of Diseases and Related Health Problems), with 359 (50.2%) reporting perceived benefits and 15 (2.1%) reporting harm. Homeopathy use was positively associated with female gender, high school level education, suffering from fibromyalgia or subthreshold depression, and being fast food abstinent, while patients with osteoarthritis, spinal or other pain, smokers, and patients with a high external-social health locus of control were less likely to use homeopathy. Personal characteristics and health status may impact on the use and the perceived helpfulness of homeopathy. © 2016 S. Karger GmbH, Freiburg.

The research rotation: competency-based structured and novel approach to research training of internal medicine residents

Directory of Open Access Journals (Sweden)

Dimitrov Vihren

2006-10-01

Full Text Available Abstract Background In the United States, the Accreditation Council of graduate medical education (ACGME requires all accredited Internal medicine residency training programs to facilitate resident scholarly activities. However, clinical experience and medical education still remain the main focus of graduate medical education in many Internal Medicine (IM residency-training programs. Left to design the structure, process and outcome evaluation of the ACGME research requirement, residency-training programs are faced with numerous barriers. Many residency programs report having been cited by the ACGME residency review committee in IM for lack of scholarly activity by residents. Methods We would like to share our experience at Lincoln Hospital, an affiliate of Weill Medical College Cornell University New York, in designing and implementing a successful structured research curriculum based on ACGME competencies taught during a dedicated "research rotation". Results Since the inception of the research rotation in 2004, participation of our residents among scholarly activities has substantially increased. Our residents increasingly believe and appreciate that research is an integral component of residency training and essential for practice of medicine. Conclusion Internal medicine residents' outlook in research can be significantly improved using a research curriculum offered through a structured and dedicated research rotation. This is exemplified by the improvement noted in resident satisfaction, their participation in scholarly activities and resident research outcomes since the inception of the research rotation in our internal medicine training program.

Real time curriculum map for internal medicine residency

Directory of Open Access Journals (Sweden)

Roberts J Mark

2007-11-01

Full Text Available Abstract Background To manage the voluminous formal curriculum content in a limited amount of structured teaching time, we describe the development and evaluation of a curriculum map for academic half days (AHD in a core internal medicine residency program. Methods We created a 3-year cyclical curriculum map (an educational tool combining the content, methodology and timetabling of structured teaching, comprising a matrix of topics under various specialties/themes and corresponding AHD hours. All topics were cross-matched against the ACP-ASIM in-training examination, and all hours were colour coded based on the categories of core competencies. Residents regularly updated the map on a real time basis. Results There were 208 topics covered in 283 AHD hours. All topics represented core competencies with minimal duplication (78% covered once in 3 years. Only 42 hours (15% involved non-didactic teaching, which increased after implementation of the map (18–19 hours/year versus baseline 5 hours/year. Most AHD hours (78% focused on medical expert competencies. Resident satisfaction (90% response was high throughout (range 3.64 ± 0.21, 3.84 ± 0.14 out of 4, which improved after 1 year but returned to baseline after 2 years. Conclusion We developed and implemented an internal medicine curriculum map based on real time resident input, with minimal topic duplication and high resident satisfaction. The map provided an opportunity to balance didactic versus non-didactic teaching, and teaching on medical versus non medical expert topics.

Item Analysis to Improve Reliability for an Internal Medicine Undergraduate OSCE

Science.gov (United States)

Auewarakul, Chirayu; Downing, Steven M.; Praditsuwan, Rungnirand; Jaturatamrong, Uapong

2005-01-01

Utilization of objective structured clinical examinations (OSCEs) for final assessment of medical students in Internal Medicine requires a representative sample of OSCE stations. The reliability and generalizability of OSCE scores provides validity evidence for OSCE scores and supports its contribution to the final clinical grade of medical…

Care for post-stroke patients at Malaysian public health centres: self-reported practices of family medicine specialists.

Science.gov (United States)

Abdul Aziz, Aznida F; Mohd Nordin, Nor Azlin; Abd Aziz, Noor; Abdullah, Suhazeli; Sulong, Saperi; Aljunid, Syed M

2014-03-02

Provision of post stroke care in developing countries is hampered by discoordination of services and limited access to specialised care. Albeit shortcomings, primary care continues to provide post-stroke services in less than favourable circumstances. This paper aimed to review provision of post-stroke care and related problems among Family Medicine Specialists managing public primary health care services. A semi-structured questionnaire was distributed to 121 Family Physicians servicing public funded health centres in a pilot survey focused on improving post stroke care provision at community level. The questionnaire assessed respondents background and practice details i.e. estimated stroke care burden, current service provision and opinion on service improvement. Means and frequencies described quantitative data. For qualitative data, constant comparison method was used until saturation of themes was reached. Response rate of 48.8% was obtained. For every 100 patients seen at public healthcentres each month, 2 patients have stroke. Median number of stroke patients seen per month is 5 (IQR 2-10). 57.6% of respondents estimated total stroke patients treated per year at each centre was less than 40 patients. 72.4% lacked a standard care plan although 96.6% agreed one was needed. Patients seen were: discharged from tertiary care (88.1%), shared care plan with specialists (67.8%) and patients who developed stroke during follow up at primary care (64.4%). Follow-ups were done at 8-12 weekly intervals (60.3%) with 3.4% on 'as needed' basis. Referrals ranked in order of frequency were to physiotherapy services, dietitian and speech and language pathologists in public facilities. The FMS' perceived 4 important 'needs' in managing stroke patients at primary care level; access to rehabilitation services, coordinated care between tertiary centres and primary care using multidisciplinary care approach, a standardized guideline and family and caregiver support. Post discharge

Infectious Disease Specialist: What Is an Infectious Disease Specialist?

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... medical professionals? When do I need an ID specialist? Many common infections can be treated by your ... diseases. Back to Top How was my ID specialist trained? Your ID Physician has 9-10 years ...

A modified Elixhauser score for predicting in-hospital mortality in internal medicine admissions.

Science.gov (United States)

Fabbian, Fabio; De Giorgi, Alfredo; Maietti, Elisa; Gallerani, Massimo; Pala, Marco; Cappadona, Rosaria; Manfredini, Roberto; Fedeli, Ugo

2017-05-01

In-hospital mortality (IHM) is an indicator of the quality of care provided. The two most widely used scores for predicting IHM by International Classification of Diseases (ICD) codes are the Elixhauser (EI) and the Charlson Comorbidity indexes. Our aim was to obtain new measures based on internal medicine ICD codes for the original EI, to detect risk for IHM. This single-center retrospective study included hospital admissions for any cause in the department of internal medicine between January 1, 2000, and December 31, 2013, recorded in the hospital database. The EI was calculated for evaluation of comorbidity, then we added age, gender and diagnosis of ischemic heart disease. IHM was our outcome. Only predictors positively associated with IHM were taken into consideration and the Sullivan's method was applied in order to modify the parameter estimates of the regression model into an index. We analyzed 75,586 admissions (53.4% females) and mean age was 72.7±16.3years. IHM was 7.9% and mean score was 12.1±7.6. The points assigned to each condition ranged from 0 to 16, and the possible range of the score varied between 0 and 89. In our population the score ranged from 0 to 54, and it was higher in the deceased group. Receiver operating characteristic curve of the new score was 0.721 (95% CI 0.714-0.727, pInternal Medicine. Published by Elsevier B.V. All rights reserved.

Perceived inequity: Does it explain burnout among medical specialists?

NARCIS (Netherlands)

Smets, E. M. A.; Visser, M. R. M.; Oort, F. J.; Schaufeli, W. B.; de Haes, H. J. C. J. M.

2004-01-01

This study investigated, among medical specialists (N = 2,400), the association between perceived inequity in relationships at work (patients, colleagues, organization) and burn-out, and the moderating role of communal orientation. Intrapersonal inequity, involving an internal standard of reference,

Creating Entrustable Professional Activities to Assess Internal Medicine Residents in Training: A Mixed-Methods Approach.

Science.gov (United States)

Taylor, David R; Park, Yoon Soo; Smith, Christopher A; Karpinski, Jolanta; Coke, William; Tekian, Ara

2018-05-15

Competency-based medical education has not advanced residency training as much as many observers expected. Some medical educators now advocate reorienting competency-based approaches to focus on a resident's ability to do authentic clinical work. To develop descriptions of clinical work for which internal medicine residents must gain proficiency to deliver meaningful patient care (for example, "Admit and manage a medical inpatient with a new acute problem"). A modified Delphi process involving clinical experts followed by a conference of educational experts. The Royal College of Physicians and Surgeons of Canada. In phase 1 of the project, members of the Specialty Committee for Internal Medicine participated in a modified Delphi process to identify activities in internal medicine that represent the scope of the specialty. In phase 2 of the project, 5 experts who were scholars and leaders in competency-based medical education reviewed the results. Phase 1 identified important activities, revised descriptions to improve accuracy and avoid overlap, and assigned activities to stages of training. Phase 2 compared proposed activity descriptions with published guidelines for their development and application in medical education. The project identified 29 activities that qualify as entrustable professional activities. The project also produced a detailed description of each activity and guidelines for using them to assess residents. These activities reflect the practice patterns of the developers and may not fully represent internal medicine practice in Canada. Identification of these activities is expected to facilitate modification of training and assessment programs for medical residents so that programs focus less on isolated skills and more on integrated tasks. Southeastern Ontario Academic Medical Organization Endowed Scholarship and Education Fund and Queen's University Department of Medicine Innovation Fund.

Part-time careers in academic internal medicine: a report from the association of specialty professors part-time careers task force on behalf of the alliance for academic internal medicine.

Science.gov (United States)

Linzer, Mark; Warde, Carole; Alexander, R Wayne; Demarco, Deborah M; Haupt, Allison; Hicks, Leroi; Kutner, Jean; Mangione, Carol M; Mechaber, Hilit; Rentz, Meridith; Riley, Joanne; Schuster, Barbara; Solomon, Glen D; Volberding, Paul; Ibrahim, Tod

2009-10-01

To establish guidelines for more effectively incorporating part-time faculty into departments of internal medicine, a task force was convened in early 2007 by the Association of Specialty Professors. The task force used informal surveys, current literature, and consensus building among members of the Alliance for Academic Internal Medicine to produce a consensus statement and a series of recommendations. The task force agreed that part-time faculty could enrich a department of medicine, enhance workforce flexibility, and provide high-quality research, patient care, and education in a cost-effective manner. The task force provided a series of detailed steps for operationalizing part-time practice; to do so, key issues were addressed, such as fixed costs, malpractice insurance, space, cross-coverage, mentoring, career development, productivity targets, and flexible scheduling. Recommendations included (1) increasing respect for work-family balance, (2) allowing flexible time as well as part-time employment, (3) directly addressing negative perceptions about part-time faculty, (4) developing policies to allow flexibility in academic advancement, (5) considering part-time faculty as candidates for leadership positions, (6) encouraging granting agencies, including the National Institutes of Health and Veterans Administration, to consider part-time faculty as eligible for research career development awards, and (7) supporting future research in "best practices" for incorporating part-time faculty into academic departments of medicine.

Third International Electronic Conference on Medicinal Chemistry (ECMC-3

Directory of Open Access Journals (Sweden)

Annie Mayence

2018-02-01

Full Text Available The third International Electronic Conference on Medicinal Chemistry, organized and sponsored by MDPI AG, publisher, and the journal Pharmaceuticals, took place in November 2017 on the SciForum website (www.sciforum.net/conference/ecmc-3. Around 300 authors from 34 different countries participated at the event, which hosted more than 70 presentations, keynotes, videos, and posters. A short description of some works presented during that scientific meeting is disclosed in this report.

International Working Group on Fast Reactors. Meeting of Specialists on the Value of Plutonium Alpha, Winfrich, UK, 30 June - 1 July 1969. Summary Report

Energy Technology Data Exchange (ETDEWEB)

NONE

1969-07-15

The meeting of specialists on the value of plutonium alpha was held at Winfrith in accordance to the recommendation of the International Working Group on Fast Reactors, and in agreement with the UK authorities. Participants from six countries and two international organizations took part in the meeting. A short review on available data for plutonium alpha received by the IAEA Nuclear Data Unit was presented. Three experiments recently known where the measurements of the alpha-value have been made in the energy range of interest were referred to.

[Potential improvements in medical education as retrospectively evaluated by candidates for specialist examinations].

Science.gov (United States)

Hofer, M; Jansen, M; Soboll, S

2006-02-24

As part of the new regulations for licensing doctors there have been numerous attempts at reform by many medical faculties to consider interdisciplinary linkage of the curriculum with emphasis on teaching of small groups of students. This study was undertaken to help answer the question of how much weight should be given to the various subjects and what resources are needed for any reformed curriculum and what key areas of competence need to be given greater importance. 1029 candidates of specialist examinations of the Medical Council of North-Rhine in 2002 and 2003 filled in questionnaires to evaluate retrospectively the actual relevance of individual preclinical and clinical subjects, courses and areas of practical competence to their further medical education and related potentials for improvement in their studies. The participants were from 5 medical faculties in the North-Rhine area of Germany. They were also asked about methods of examination that were effective in aiding their learning behaviour. Those answering the questionnaire considered especially chemistry and physics as well as environmental, occupational and forensic medicine, bio-mathematics, radiotherapy and nuclear medicine among the less relevant subjects. On the other hand, anatomy, physiology, internal medicine, pharmacology and surgery were considered especially relevant. The greatest deficiencies in most of the medical curricula as taught in the North-Rhine medical courses are in the areas of competence in communication and practical clinical skills. Members of this group also pleaded for an increased use of standardized objective structured clinical examinations (OSCE).

[Giving medico-legal opinions in cases with suspicion of medical mistake.part 1. between medicine and justice.

Science.gov (United States)

Chowaniec, Czesław; Chowaniec, Małgorzata; Wilk, Mateusz

2017-01-01

Creating medico-legal opinion is a sophisticated investigative, analytical, decision-making and creative process. Forensic medicine specialist in cooperation with clinical medicine consultants, on the basis of evidence analysis, which was gathered during procedures and contained in the acts has to create an objective and essential opinion. This opinion is a vital, very important and irreplaceable proof in every case. Judicial body consults with forensic medicine specialist or specialists if there are circumstances for settlement of which there is a need of classified informations - art. 193 of Penalty Code. Forensic medicine specialists face many difficulties which may have effect on quality, positiveness of opinion, compliance with the deadline, increasing expectancy of judicial body or sides. It is very difficult to find clinical specialists which except their clinical knowledge have basic knowledge about law, the role and duties of an court expert. In this article we discuss creating-opinion problems, role and position of court expert in confrontation with expectations of judicial body and the Justice with particular emphasis on medical mistakes and assessment of medical proceedings. We show the complexity of creating of medical opinions, especially these institutional.

Use of Team-Based Learning Pedagogy for Internal Medicine Ambulatory Resident Teaching.

Science.gov (United States)

Balwan, Sandy; Fornari, Alice; DiMarzio, Paola; Verbsky, Jennifer; Pekmezaris, Renee; Stein, Joanna; Chaudhry, Saima

2015-12-01

Team-based learning (TBL) is used in undergraduate medical education to facilitate higher-order content learning, promote learner engagement and collaboration, and foster positive learner attitudes. There is a paucity of data on the use of TBL in graduate medical education. Our aim was to assess resident engagement, learning, and faculty/resident satisfaction with TBL in internal medicine residency ambulatory education. Survey and nominal group technique methodologies were used to assess learner engagement and faculty/resident satisfaction. We assessed medical learning using individual (IRAT) and group (GRAT) readiness assurance tests. Residents (N = 111) involved in TBL sessions reported contributing to group discussions and actively discussing the subject material with other residents. Faculty echoed similar responses, and residents and faculty reported a preference for future teaching sessions to be offered using the TBL pedagogy. The average GRAT score was significantly higher than the average IRAT score by 22%. Feedback from our nominal group technique rank ordered the following TBL strengths by both residents and faculty: (1) interactive format, (2) content of sessions, and (3) competitive nature of sessions. We successfully implemented TBL pedagogy in the internal medicine ambulatory residency curriculum, with learning focused on the care of patients in the ambulatory setting. TBL resulted in active resident engagement, facilitated group learning, and increased satisfaction by residents and faculty. To our knowledge this is the first study that implemented a TBL program in an internal medicine residency curriculum.

Hybrid imaging, PET-CT and SPECT-CT: What impact on nuclear medicine education and practice in France?

International Nuclear Information System (INIS)

Mundler, O.

2009-01-01

To define the policy of our specialty with a consensus opinion, a questionnaire entitled 'hybrid imaging' was sent to practicing nuclear medicine specialist physicians in France to obtain their opinion on the impact of this recent method in training and in the practice of nuclear medicine and on the relations between nuclear medicine specialists and other medical imaging specialists. This questionnaire, written by the office of the French Society of Nuclear Medicine (F.S.N.M.) and molecular imaging, was divided into four parts: Profile and experience in hybrid imaging, Relations with radiologists, Practice of CT scans with hybrid equipment, and the Future of the specialty and of training in nuclear medicine. The response rate was 60%, i.e. 374 completed questionnaires. Overall, the responses were uniform, whatever the respondent's experience, type and place of practice. Regular participation in hybrid imaging practice was the reply provided by the majority of respondents. In terms of relations with radiologists, such contacts existed in over 85% of cases and are considered as being of high quality in over 90% of cases. The vast majority of practitioners believe that hybrid imaging will become the standard. Opinions on the diagnostic use of CT scans are divided, as well as their interpretation by a radiologist, a nuclear medicine specialist or by both. In the opinion of the vast majority, hybrid equipment systems should be managed by nuclear medicine specialists. With regard to the future, nuclear medicine should remain an independent specialty with enhanced training in morphological imaging and a residency training program whose length should be increased to 5 years. (author)

The Computer Book of the Internal Medicine Resident: competence acquisition and achievement of learning objectives.

Science.gov (United States)

Oristrell, J; Oliva, J C; Casanovas, A; Comet, R; Jordana, R; Navarro, M

2014-01-01

The Computer Book of the Internal Medicine resident (CBIMR) is a computer program that was validated to analyze the acquisition of competences in teams of Internal Medicine residents. To analyze the characteristics of the rotations during the Internal Medicine residency and to identify the variables associated with the acquisition of clinical and communication skills, the achievement of learning objectives and resident satisfaction. All residents of our service (n=20) participated in the study during a period of 40 months. The CBIMR consisted of 22 self-assessment questionnaires specific for each rotation, with items on services (clinical workload, disease protocolization, resident responsibilities, learning environment, service organization and teamwork) and items on educational outcomes (acquisition of clinical and communication skills, achievement of learning objectives, overall satisfaction). Associations between services features and learning outcomes were analyzed using bivariate and multivariate analysis. An intense clinical workload, high resident responsibilities and disease protocolization were associated with the acquisition of clinical skills. High clinical competence and teamwork were both associated with better communication skills. Finally, an adequate learning environment was associated with increased clinical competence, the achievement of educational goals and resident satisfaction. Potentially modifiable variables related with the operation of clinical services had a significant impact on the acquisition of clinical and communication skills, the achievement of educational goals, and resident satisfaction during the specialized training in Internal Medicine. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Preparing for the primary care clinic: an ambulatory boot camp for internal medicine interns

Science.gov (United States)

Esch, Lindsay M.; Bird, Amber-Nicole; Oyler, Julie L.; Lee, Wei Wei; Shah, Sachin D.; Pincavage, Amber T.

2015-01-01

Introduction Internal medicine (IM) interns start continuity clinic with variable ambulatory training. Multiple other specialties have utilized a boot camp style curriculum to improve surgical and procedural skills, but boot camps have not been used to improve interns’ ambulatory knowledge and confidence. The authors implemented and assessed the impact of an intern ambulatory boot camp pilot on primary care knowledge, confidence, and curricular satisfaction. Methods During July 2014, IM interns attended ambulatory boot camp. It included clinically focused case-based didactic sessions on common ambulatory topics as well as orientation to the clinic and electronic medical records. Interns anonymously completed a 15-question pre-test on topics covered in the boot camp as well as an identical post-test after the boot camp. The interns were surveyed regarding their confidence and satisfaction. Results Thirty-eight interns participated in the boot camp. Prior to the boot camp, few interns reported confidence managing common outpatient conditions. The average pre-test knowledge score was 46.3%. The average post-test knowledge score significantly improved to 76.1% (pinterns reported that the boot camp was good preparation for clinics and 97% felt that the boot camp boosted their confidence. Conclusions The ambulatory boot camp pilot improved primary care knowledge, and interns thought it was good preparation for clinic. The ambulatory boot camp was well received and may be an effective way to improve the preparation of interns for primary care clinic. Further assessment of clinical performance and expansion to other programs and specialties should be considered. PMID:26609962

The Quality of Written Feedback by Attendings of Internal Medicine Residents.

Science.gov (United States)

Jackson, Jeffrey L; Kay, Cynthia; Jackson, Wilkins C; Frank, Michael

2015-07-01

Attending evaluations are commonly used to evaluate residents. Evaluate the quality of written feedback of internal medicine residents. Retrospective. Internal medicine residents and faculty at the Medical College of Wisconsin from 2004 to 2012. From monthly evaluations of residents by attendings, a randomly selected sample of 500 written comments by attendings were qualitatively coded and rated as high-, moderate-, or low-quality feedback by two independent coders with good inter-rater reliability (kappa: 0.94). Small group exercises with residents and attendings also coded the utterances as high, moderate, or low quality and developed criteria for this categorization. In-service examination scores were correlated with written feedback. There were 228 internal medicine residents who had 6,603 evaluations by 334 attendings. Among 500 randomly selected written comments, there were 2,056 unique utterances: 29% were coded as nonspecific statements, 20% were comments about resident personality, 16% about patient care, 14% interpersonal communication, 7% medical knowledge, 6% professionalism, and 4% each on practice-based learning and systems-based practice. Based on criteria developed by group exercises, the majority of written comments were rated as moderate quality (65%); 22% were rated as high quality and 13% as low quality. Attendings who provided high-quality feedback rated residents significantly lower in all six of the Accreditation Council for Graduate Medical Education (ACGME) competencies (p service examination scores. Most attending written evaluation was of moderate or low quality. Attendings who provided high-quality feedback appeared to be more discriminating, providing significantly lower ratings of residents in all six ACGME core competencies, and across a greater range. Attendings' negative written comments on medical knowledge correlated with lower in-service training scores.

Public health interventions to protect against falsified medicines: a systematic review of international, national and local policies.

Science.gov (United States)

Hamilton, William L; Doyle, Cormac; Halliwell-Ewen, Mycroft; Lambert, Gabriel

2016-12-01

Falsified medicines are deliberately fraudulent drugs that pose a direct risk to patient health and undermine healthcare systems, causing global morbidity and mortality. To produce an overview of anti-falsifying public health interventions deployed at international, national and local scales in low and middle income countries (LMIC). We conducted a systematic search of the PubMed, Web of Science, Embase and Cochrane Central Register of Controlled Trials databases for healthcare or pharmaceutical policies relevant to reducing the burden of falsified medicines in LMIC. Our initial search identified 660 unique studies, of which 203 met title/abstract inclusion criteria and were categorised according to their primary focus: international; national; local pharmacy; internet pharmacy; drug analysis tools. Eighty-four were included in the qualitative synthesis, along with 108 articles and website links retrieved through secondary searches. On the international stage, we discuss the need for accessible pharmacovigilance (PV) global reporting systems, international leadership and funding incorporating multiple stakeholders (healthcare, pharmaceutical, law enforcement) and multilateral trade agreements that emphasise public health. On the national level, we explore the importance of establishing adequate medicine regulatory authorities and PV capacity, with drug screening along the supply chain. This requires interdepartmental coordination, drug certification and criminal justice legislation and enforcement that recognise the severity of medicine falsification. Local healthcare professionals can receive training on medicine quality assessments, drug registration and pharmacological testing equipment. Finally, we discuss novel technologies for drug analysis which allow rapid identification of fake medicines in low-resource settings. Innovative point-of-purchase systems like mobile phone verification allow consumers to check the authenticity of their medicines. Combining anti

Aspects of Sino-Japan Complementary and Alternative Medicine and Development on the Traditional Uighur Medicine

Science.gov (United States)

Yusup, Abdiryim

2009-01-01

Two consecutive conferences on ‘Sino-Japan Complementary and Alternative Medicine and Development on the Traditional Uighur Medicine’ were held in Xinjiang Medical University on July 3 and Kanazawa Medical University on October 6, 2007. The Vice president Halmurat Upur presided over the meeting and gave congratulatory address on holding of the conference. In order to understand mutually and discuss the possibility of the Uighur Medicine as CAM and the situation of medicine in the global sense, specialist scholars of Traditional Uighur Medicine and postgraduates attended this conference. In the meeting of the CAM, the achievements on the research of Traditional Uighur Medicine were exchanged and warmly discussed. Presentations were made in the consecutive conference. PMID:19470524

Struggling doctors in specialist training: a case control study

DEFF Research Database (Denmark)

O'Neill, Lotte; Norberg, Karen; Thomsen, Maria

), or transferred (i.e. had unplanned changes in place of training/ward due to failure to thrive or due to inadequate development of competences), or dropped out (i.e. were dismissed from, had resigned from, or changed their speciality). Controls were a random sample of doctors in the source population, who were......Abstract summary The aim of this cummulative incidence case-control study was to examine: if struggling trainees in medical specialist training (cases) tended to struggle already in medical school or not compared to non-struggling controls, and which performance indicators during medical school...... seemed to predict struggling in postgraduate education if any. The study design is rooted in epidemiological methodology. Struggling doctors in specialist training: a case-control study. It has been reported in the international literature, that around 3-10% of doctors in post-garduate specialist...

Current situation of International Organization for Standardization/Technical Committee 249 international standards of traditional Chinese medicine.

Science.gov (United States)

Liu, Yu-Qi; Wang, Yue-Xi; Shi, Nan-Nan; Han, Xue-Jie; Lu, Ai-Ping

2017-05-01

To review the current situation and progress of traditional Chinese medicine (TCM) international standards, standard projects and proposals in International Organization for Standardization (ISO)/ technical committee (TC) 249. ISO/TC 249 standards and standard projects on the ISO website were searched and new standard proposals information were collected from ISO/TC 249 National Mirror Committee in China. Then all the available data were summarized in 5 closely related items, including proposed time, proposed country, assigned working group (WG), current stage and classifification. In ISO/TC 249, there were 2 international standards, 18 standard projects and 24 new standard proposals proposed in 2014. These 44 standard subjects increased year by year since 2011. Twenty-nine of them were proposed by China, 15 were assigned to WG 4, 36 were in preliminary and preparatory stage and 8 were categorized into 4 fifields, 7 groups and sub-groups based on International Classifification Standards. A rapid and steady development of international standardization in TCM can be observed in ISO/TC 249.

Abstracts of the sixth international conference on modern problems of nuclear physics

International Nuclear Information System (INIS)

Yuldashev, B.; Fazylov, M.; Ibragimova, E.; Salikhbaev, U.

2006-09-01

The Sixth International Conference on modern problems of nuclear physics was held on 19-22 September, 2006 in Tashkent, Uzbekistan. The specialists discussed various aspects of modern problems of both fundamental and applied nuclear physics. About 275 talks were presented in the meetingof on the following subjects: particle physics, relativistic nuclear physics and physics of atomic nuclei; radiation physics of condenced matter; nuclear applications in industry, medicine, biology and agriculture; nuclear and radiation safety, non prolifaration issues. (K.M.)

Abstracts of the sixth international conference on modern problems of nuclear physics

Energy Technology Data Exchange (ETDEWEB)

Yuldashev, B; Fazylov, M; Ibragimova, E; Salikhbaev, U [eds.

2006-09-15

The Sixth International Conference on modern problems of nuclear physics was held on 19-22 September, 2006 in Tashkent, Uzbekistan. The specialists discussed various aspects of modern problems of both fundamental and applied nuclear physics. About 275 talks were presented in the meetingof on the following subjects: particle physics, relativistic nuclear physics and physics of atomic nuclei; radiation physics of condenced matter; nuclear applications in industry, medicine, biology and agriculture; nuclear and radiation safety, non prolifaration issues. (K.M.)

Sleep medicine in Saudi Arabia: Current problems and future challenges

Science.gov (United States)

BaHammam, Ahmed S.

2011-01-01

Sleep medicine is a relatively new specialty in the medical community. The practice of sleep medicine in Saudi Arabia (KSA) began in the mid to late nineties. Since its inception, the specialty has grown, and the number of specialists has increased. Nevertheless, sleep medicine is still underdeveloped in the KSA, particularly in the areas of clinical service, education, training and research. Based on available data, it appears that sleep disorders are prevalent among Saudis, and the demand for sleep medicine service is expected to rise significantly in the near future. A number of obstacles have been defined that hinder the progress of the specialty, including a lack of trained technicians, specialists and funding. Awareness about sleep disorders and their serious consequences is low among health care workers, health care authorities, insurance companies and the general public. A major challenge for the future is penetrating the educational system at all levels to demonstrate the high prevalence and serious consequences of sleep disorders. To attain adequate numbers of staff and facilities, the education and training of health care professionals at the level of sleep medicine specialists and sleep technologists is another important challenge that faces the specialty. This review discusses the current position of sleep medicine as a specialty in the KSA and the expected challenges of the future. In addition, it will guide clinicians interested in setting up new sleep medicine services in the KSA or other developing countries through the potential obstacles that may face them in this endeavor. PMID:21264164

Sleep medicine in Saudi Arabia: Current problems and future challenges

Directory of Open Access Journals (Sweden)

BaHammam Ahmed

2011-01-01

Full Text Available Sleep medicine is a relatively new specialty in the medical community. The practice of sleep medicine in Saudi Arabia (KSA began in the mid to late nineties. Since its inception, the specialty has grown, and the number of specialists has increased. Nevertheless, sleep medicine is still underdeveloped in the KSA, particularly in the areas of clinical service, education, training and research. Based on available data, it appears that sleep disorders are prevalent among Saudis, and the demand for sleep medicine service is expected to rise significantly in the near future. A number of obstacles have been defined that hinder the progress of the specialty, including a lack of trained technicians, specialists and funding. Awareness about sleep disorders and their serious consequences is low among health care workers, health care authorities, insurance companies and the general public. A major challenge for the future is penetrating the educational system at all levels to demonstrate the high prevalence and serious consequences of sleep disorders. To attain adequate numbers of staff and facilities, the education and training of health care professionals at the level of sleep medicine specialists and sleep technologists is another important challenge that faces the specialty. This review discusses the current position of sleep medicine as a specialty in the KSA and the expected challenges of the future. In addition, it will guide clinicians interested in setting up new sleep medicine services in the KSA or other developing countries through the potential obstacles that may face them in this endeavor.

Career interest and perceptions of nephrology: A repeated cross-sectional survey of internal medicine residents.

Science.gov (United States)

Daniels, Michael N; Maynard, Sharon; Porter, Ivan; Kincaid, Hope; Jain, Deepika; Aslam, Nabeel

2017-01-01

Interest in nephrology careers among internal medicine residents in the United States is declining. Our objective was to assess the impact of the presence of a nephrology fellowship training program on perceptions and career interest in nephrology among internal medicine residents. A secondary objective was to identify commonly endorsed negative perceptions of nephrology among internal medicine residents. This was a repeated cross-sectional survey of internal medicine residents before (Group 1) and 3 years after (Group 2) the establishment of nephrology fellowship programs at two institutions. The primary outcome was the percentage of residents indicating nephrology as a career interest in Group 1 vs. Group 2. Secondary outcomes included the frequency that residents agreed with negative statements about nephrology. 131 (80.9%) of 162 residents completed the survey. 19 (14.8%) residents indicated interest in a nephrology career, with 8 (6.3%) indicating nephrology as their first choice. There was no difference in career interest in nephrology between residents who were exposed to nephrology fellows during residency training (Group 2) and residents who were not (Group 1). The most commonly endorsed negative perceptions of nephrology were: nephrology fellows have long hours/burdensome call (36 [28.1%] of residents agreed or strongly agreed), practicing nephrologists must take frequent/difficult call (35 [27.6%] agreed or strongly agreed), and nephrology has few opportunities for procedures (35 [27.3%] agreed or strongly agreed). More residents in Group 2 agreed that nephrology is poorly paid (8.9% in Group 1 vs. 20.8% in Group 2, P = 0.04), whereas more residents in Group 1 agreed that nephrologists must take frequent/difficult call (40.0% in Group 1 vs. 18.1% in Group 2, P = 0.02). The initiation of a nephrology fellowship program was not associated with an increase in internal medicine residents' interest in nephrology careers. Residents endorsed several negative

Career interest and perceptions of nephrology: A repeated cross-sectional survey of internal medicine residents.

Directory of Open Access Journals (Sweden)

Michael N Daniels

Full Text Available Interest in nephrology careers among internal medicine residents in the United States is declining. Our objective was to assess the impact of the presence of a nephrology fellowship training program on perceptions and career interest in nephrology among internal medicine residents. A secondary objective was to identify commonly endorsed negative perceptions of nephrology among internal medicine residents.This was a repeated cross-sectional survey of internal medicine residents before (Group 1 and 3 years after (Group 2 the establishment of nephrology fellowship programs at two institutions. The primary outcome was the percentage of residents indicating nephrology as a career interest in Group 1 vs. Group 2. Secondary outcomes included the frequency that residents agreed with negative statements about nephrology.131 (80.9% of 162 residents completed the survey. 19 (14.8% residents indicated interest in a nephrology career, with 8 (6.3% indicating nephrology as their first choice. There was no difference in career interest in nephrology between residents who were exposed to nephrology fellows during residency training (Group 2 and residents who were not (Group 1. The most commonly endorsed negative perceptions of nephrology were: nephrology fellows have long hours/burdensome call (36 [28.1%] of residents agreed or strongly agreed, practicing nephrologists must take frequent/difficult call (35 [27.6%] agreed or strongly agreed, and nephrology has few opportunities for procedures (35 [27.3%] agreed or strongly agreed. More residents in Group 2 agreed that nephrology is poorly paid (8.9% in Group 1 vs. 20.8% in Group 2, P = 0.04, whereas more residents in Group 1 agreed that nephrologists must take frequent/difficult call (40.0% in Group 1 vs. 18.1% in Group 2, P = 0.02.The initiation of a nephrology fellowship program was not associated with an increase in internal medicine residents' interest in nephrology careers. Residents endorsed several

Export Management Specialist. A Training Program. Instructor's Edition.

Science.gov (United States)

Oklahoma State Dept. of Vocational and Technical Education, Stillwater. Curriculum and Instructional Materials Center.

This publication provides instructors with materials for an export management specialist (EMS) training program. The objective of the training program is to assist companies in reaching their export goals by educating current and potential managers about the basics of exporting. It provides a foundation for considering international trade and for…

Improvements for international medicine donations: a review of the World Health Organization Guidelines for Medicine Donations, 3rd edition.

Science.gov (United States)

Cañigueral-Vila, Nuria; Chen, Jennifer C; Frenkel-Rorden, Lindsey; Laing, Richard

2015-01-01

Some humanitarian and development organizations respond to major natural disasters and emergencies by donating medicines. Many provide medicines on a routine basis to support health systems, particularly those run by Faith-Based Organizations. Although such donations can provide essential medicines to populations in great need, inappropriate donations also take place, with burdensome consequences. The World Health Organization (WHO) has developed the interagency Guidelines for Medicine Donations for use by donors and recipients in the context of emergency aid and international development assistance. Although comprehensive in nature and transferable to various emergency situations, adjustments to both content and formatting would improve this resource. Recommendations for the next version of these guidelines include: specific wording and consistent formatting; definition of who is a recipient, clear distinction between acute and long-term emergencies, and proper donation procedures pertaining to each; inclusion of visual aides such as flowcharts, checklists, and photos; and improving the citations system.

The Impact of Supervision on Internal Medicine Residents' Attitudes and Management of Depression in Primary Care: A Pilot Study

Science.gov (United States)

Milone, Jennifer M.; Gottumukkala, Aruna; Ward, Christopher P.; York, Kaki M.

2013-01-01

Objective: The authors examined the effect of supervision on internal medicine residents' attitudes toward and management of depression. Method: Internal medicine residents completed a survey during preclinical conferences. The survey included a published, validated questionnaire, the Depression Attitude Questionnaire, and items developed by the…

Guideline-based survey of outpatient COPD management by pulmonary specialists in Germany

Directory of Open Access Journals (Sweden)

Buhl R

2012-02-01

Full Text Available Thomas Glaab1,2, Claus Vogelmeier3, Andreas Hellmann4, Roland Buhl11Department of Respiratory Diseases III, Medical Center of the Johannes Gutenberg-University, Mainz, 2Medical Affairs Germany, Respiratory Medicine, Boehringer Ingelheim Pharma GmbH and Co, KG, Ingelheim, 3Department of Respiratory Diseases, University Hospitals of Giessen and Marburg, Marburg, 4Federal Association of Pneumologists, Augsburg, GermanyBackground: Little is known about the role of guidelines for the practical management of chronic obstructive pulmonary disease (COPD by office-based pulmonary specialists. The aim of this study was to assess their outpatient management in relation to current guideline recommendations for COPD.Methods: A nationwide prospective cross-sectional COPD questionnaire survey in the form of a multiple-choice questionnaire was sent to 1000 office-based respiratory specialists in Germany. The product-neutral questions focused on routine COPD management and were based on current national and international COPD guideline recommendations being consistent in severity classification and treatment recommendations.Results: A total of 590 pulmonary specialists (59% participated in the survey. Body plethysmography was considered the standard for diagnosis (65.9%, followed by spirometry (32%. Most respondents were able to cite the correct spirometric criteria for classifying moderate (87% to very severe COPD (77%. A quarter of the respondents equated the World Health Organization (WHO definition of chronic bronchitis with COPD. Notably, most participants preferred the updated national COPD guidelines (51.4% to the Global Initiative for Chronic Obstructive Lung Disease (GOLD guidelines (40.2%. Improvement of functional exercise capacity and quality of life were considered the two most relevant treatment goals; whereas impact on mortality was secondary. Treatment of COPD largely complied with the guidelines. However, a significant percentage of the

Estimation of internal exposure to 99Mo in nuclear medicine patients

International Nuclear Information System (INIS)

Dantas, B.M.; Silva, C.O.A. da; Dantas, A.L.A.; Lucena, E.A.; Souza, W.O.

2008-01-01

99m Tc is the most widely used radionuclide in nuclear medicine. It is obtained by elution of 99 Mo- 99m Tc generators. Depending on the quality of the generator and its integrity, 99 Mo might be extracted from the column during the elution process, becoming a radionuclidic impurity in the 99m Tc eluate. This fact would impart an undesired dose to the patients submitted to diagnostic procedures using 99m Tc. The aims of this work are: to evaluate the incorporation of 99 Mo as a radionuclidic impurity using in vivo and in vitro techniques; to estimate the internal effective doses in nuclear medicine patients and; to provide additional information about the metabolic behavior of molybdenum in humans. A methodology based on in vivo measurements and urine sampling was developed to determine retention and excretion patterns of molybdenum in the human body. In vivo measurements were performed in IRD whole body counter using a NaI(Tl) 8”x4” scintillation detector. The detector is located inside a shielded room with internal dimensions of 2.5 x 2.5 x 2.65 meters. In vitro analysis was based on the collection of urine samples from the patients and was performed in IRD bioassay laboratory using a High Purity Germanium (HPGe) detection system. Four patients have been monitored by in vivo and in vitro measurements showing detectable activities of 99 Mo in whole body and urine samples. Bioassay results were interpreted by using AIDE software version 6. Estimated values of 99 Mo incorporation were compared to predicted values based on the standard metabolic model of molybdenum established by the International Commission of Radiological Protection (ICRP). Internal effective doses were estimated in the order of micro sieverts per examination. Based on the data obtained in this work it is suggested to implement a routine quality control program of radionuclidic impurity of 99 Mo in 99m Tc eluates to be conducted by radiopharmacy laboratories of nuclear medicine centers. (author)

NICE-Accredited Commissioning Guidance for Weight Assessment and Management Clinics: a Model for a Specialist Multidisciplinary Team Approach for People with Severe Obesity.

Science.gov (United States)

Welbourn, Richard; Dixon, John; Barth, Julian H; Finer, Nicholas; Hughes, Carly A; le Roux, Carel W; Wass, John

2016-03-01

Despite increasing prevalence of obesity, no country has successfully implemented comprehensive pathways to provide advice to all the severely obese patients that seek treatment. We aimed to formulate pathways for referral into and out of weight assessment and management clinics (WAMCs) that include internal medicine/primary care physicians as part of a multidisciplinary team that could provide specialist advice and interventions, including referral for bariatric surgery. Using a National Institute of Health and Care Excellence (NICE)-accredited process, a Guidance Development Group conducted a literature search identifying existing WAMCs. As very few examples of effective structures and clinical pathways existed, the current evidence base for optimal assessment and management of bariatric surgery patients was used to reach a consensus. The model we describe could be adopted internationally by health services to manage severely obese patients.

Determinants of internal medicine residents' choice in the canadian R4 Fellowship Match: A qualitative study

Directory of Open Access Journals (Sweden)

Kassam Narmin

2011-06-01

Full Text Available Abstract Background There is currently a discrepancy between Internal Medicine residents' decisions in the Canadian subspecialty fellowship match (known as the R4 match and societal need. Some studies have been published examining factors that influence career choices. However, these were either demographic factors or factors pre-determined by the authors' opinion as possibly being important to incorporate into a survey. Methods A qualitative study was undertaken to identify factors that determine the residents choice in the subspecialty (R4 fellowship match using focus group discussions involving third and fourth year internal medicine residents Results Based on content analysis of the discussion data, we identified five themes: 1 Practice environment including acuity of practice, ability to do procedures, lifestyle, job prospects and income 2 Exposure in rotations and to role models 3 Interest in subspecialty's patient population and common diseases 4 Prestige and respect of subspecialty 5 Fellowship training environment including fellowship program resources and length of training Conclusions There are a variety of factors that contribute to Internal Medicine residents' fellowship choice in Canada, many of which have been identified in previous survey studies. However, we found additional factors such as the resources available in a fellowship program, the prestige and respect of a subspecialty/career, and the recent trend towards a two-year General Internal Medicine fellowship in our country.

Part-time and full-time medical specialists, are there differences in allocation of time?

NARCIS (Netherlands)

Jong, J.D. de; Heiligers, P.; Groenewegen, P.P.; Hingstman, L.

2006-01-01

BACKGROUND: An increasing number of medical specialists prefer to work part-time. This development can be found worldwide. Problems to be faced in the realization of part-time work in medicine include the division of night and weekend shifts, as well as communication between physicians and

Part-time and full-time medical specialists, are there differences in allocation of time?

NARCIS (Netherlands)

Jong, Judith D. de; Heiligers, Phil; Groenewegen, Peter P.; Hingstman, Lammert

2006-01-01

Background: An increasing number of medical specialists prefer to work part-time. This development can be found worldwide. Problems to be faced in the realization of part-time work in medicine include the division of night and weekend shifts, as well as communication between physicians and

Internationalization of traditional Chinese medicine: current international market, internationalization challenges and prospective suggestions.

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Lin, Annie Xianghong; Chan, Ging; Hu, Yuanjia; Ouyang, Defang; Ung, Carolina Oi Lam; Shi, Luwen; Hu, Hao

2018-01-01

Through reviewing the current international market for traditional Chinese medicine (TCM), this paper identified the internationalization challenges for TCM, including unclear therapeutic material basis and mechanism, difficulty of quality control, low preparation level, registration/policy barriers, and shortage of intellectual property. To deal with these challenges, suggestions were given including: (1) product innovation of TCM (study the TCM by using the methods and means of western medicine; innovate the basic theory of TCM; develop TCM health product); (2) standard innovation of TCM; (3) building big data platform of Chinese medicine (big data platform of TCM preparation; big data platform on the quality of TCM).

Specialist Bibliographic Databases

OpenAIRE

Gasparyan, Armen Yuri; Yessirkepov, Marlen; Voronov, Alexander A.; Trukhachev, Vladimir I.; Kostyukova, Elena I.; Gerasimov, Alexey N.; Kitas, George D.

2016-01-01

Specialist bibliographic databases offer essential online tools for researchers and authors who work on specific subjects and perform comprehensive and systematic syntheses of evidence. This article presents examples of the established specialist databases, which may be of interest to those engaged in multidisciplinary science communication. Access to most specialist databases is through subscription schemes and membership in professional associations. Several aggregators of information and d...

The 52nd International Conference on Medicinal Chemistry (RICT 2016) of the French Medicinal Chemistry Society (SCT) Held in Caen (Normandy).

Science.gov (United States)

Sapi, Janos; Van Hijfte, Luc; Dallemagne, Patrick

2017-06-21

Outstanding Medchem in France: Guest editors Janos Sapi, Luc Van Hjfte, and Patrick Dallemagne look back at the 52 nd International Conference on Medicinal Chemistry (RICT 2016) held in Caen, France. They discuss the history of the French Medicinal Chemistry Society (Société de Chimie Thérapeutique, SCT) and provide highlights of last year's events, including some key presentations now collected in this Special Issue. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Internal medicine residency training for unhealthy alcohol and other drug use: recommendations for curriculum design

Science.gov (United States)

2010-01-01

Background Unhealthy substance use is the spectrum from use that risks harm, to use associated with problems, to the diagnosable conditions of substance abuse and dependence, often referred to as substance abuse disorders. Despite the prevalence and impact of unhealthy substance use, medical education in this area remains lacking, not providing physicians with the necessary expertise to effectively address one of the most common and costly health conditions. Medical educators have begun to address the need for physician training in unhealthy substance use, and formal curricula have been developed and evaluated, though broad integration into busy residency curricula remains a challenge. Discussion We review the development of unhealthy substance use related competencies, and describe a curriculum in unhealthy substance use that integrates these competencies into internal medicine resident physician training. We outline strategies to facilitate adoption of such curricula by the residency programs. This paper provides an outline for the actual implementation of the curriculum within the structure of a training program, with examples using common teaching venues. We describe and link the content to the core competencies mandated by the Accreditation Council for Graduate Medical Education, the formal accrediting body for residency training programs in the United States. Specific topics are recommended, with suggestions on how to integrate such teaching into existing internal medicine residency training program curricula. Summary Given the burden of disease and effective interventions available that can be delivered by internal medicine physicians, teaching about unhealthy substance use must be incorporated into internal medicine residency training, and can be done within existing teaching venues. PMID:20230607

Feasibility of an innovative third-year chief resident system: an internal medicine residency leadership study

Directory of Open Access Journals (Sweden)

Victor O. Kolade

2014-07-01

Full Text Available Introduction: The role of the internal medicine chief resident includes various administrative, academic, social, and educational responsibilities, fulfillment of which prepares residents for further leadership tasks. However, the chief resident position has historically only been held by a few residents. As fourth-year chief residents are becoming less common, we considered a new model for rotating third-year residents as the chief resident. Methods: Online surveys were given to all 29 internal medicine residents in a single university-based program after implementation of a leadership curriculum and specific job description for the third-year chief resident. Chief residents evaluated themselves on various aspects of leadership. Participation was voluntary. Descriptive statistics were generated using SPSS version 21. Results: Thirteen junior (first- or second-year resident responses reported that the chief residents elicited input from others (mean rating 6.8, were committed to the team (6.8, resolved conflict (6.7, ensured efficiency, organization and productivity of the team (6.7, participated actively (7.0, and managed resources (6.6. Responses from senior residents averaged 1 point higher for each item; this pattern repeated itself in teaching evaluations. Chief resident self-evaluators were more comfortable running a morning report (8.4 than with being chief resident (5.8. Conclusion: The feasibility of preparing internal medicine residents for leadership roles through a rotating PGY-3 (postgraduate year chief residency curriculum was explored at a small internal medicine residency, and we suggest extending the study to include other programs.

Internal Medicine Residents' Perceived Responsibility for Patients at Hospital Discharge: A National Survey.

Science.gov (United States)

Young, Eric; Stickrath, Chad; McNulty, Monica C; Calderon, Aaron J; Chapman, Elizabeth; Gonzalo, Jed D; Kuperman, Ethan F; Lopez, Max; Smith, Christopher J; Sweigart, Joseph R; Theobald, Cecelia N; Burke, Robert E

2016-12-01

Medical residents are routinely entrusted with transitions of care, yet little is known about the duration or content of their perceived responsibility for patients they discharge from the hospital. To examine the duration and content of internal medicine residents' perceived responsibility for patients they discharge from the hospital. The secondary objective was to determine whether specific individual experiences and characteristics correlate with perceived responsibility. Multi-site, cross-sectional 24-question survey delivered via email or paper-based form. Internal medicine residents (post-graduate years 1-3) at nine university and community-based internal medicine training programs in the United States. Perceived responsibility for patients after discharge as measured by a previously developed single-item tool for duration of responsibility and novel domain-specific questions assessing attitudes towards specific transition of care behaviors. Of 817 residents surveyed, 469 responded (57.4 %). One quarter of residents (26.1 %) indicated that their responsibility for patients ended at discharge, while 19.3 % reported perceived responsibility extending beyond 2 weeks. Perceived duration of responsibility did not correlate with level of training (P = 0.57), program type (P = 0.28), career path (P = 0.12), or presence of burnout (P = 0.59). The majority of residents indicated they were responsible for six of eight transitional care tasks (85.1-99.3 % strongly agree or agree). Approximately half of residents (57 %) indicated that it was their responsibility to directly contact patients' primary care providers at discharge. and 21.6 % indicated that it was their responsibility to ensure that patients attended their follow-up appointments. Internal medicine residents demonstrate variability in perceived duration of responsibility for recently discharged patients. Neither the duration nor the content of residents' perceived responsibility was

Impact of a competency based curriculum on quality improvement among internal medicine residents.

Science.gov (United States)

Fok, Mark C; Wong, Roger Y

2014-11-28

Teaching quality improvement (QI) principles during residency is an important component of promoting patient safety and improving quality of care. The literature on QI curricula for internal medicine residents is limited. We sought to evaluate the impact of a competency based curriculum on QI among internal medicine residents. This was a prospective, cohort study over four years (2007-2011) using pre-post curriculum comparison design in an internal medicine residency program in Canada. Overall 175 post-graduate year one internal medicine residents participated. A two-phase, competency based curriculum on QI was developed with didactic workshops and longitudinal, team-based QI projects. The main outcome measures included self-assessment, objective assessment using the Quality Improvement Knowledge Assessment Tool (QIKAT) scores to assess QI knowledge, and performance-based assessment via presentation of longitudinal QI projects. Overall 175 residents participated, with a response rate of 160/175 (91%) post-curriculum and 114/175 (65%) after conducting their longitudinal QI project. Residents' self-reported confidence in making changes to improve health increased and was sustained at twelve months post-curriculum. Self-assessment scores of QI skills improved significantly from pre-curriculum (53.4 to 69.2 percent post-curriculum [p-value 0.002]) and scores were sustained at twelve months after conducting their longitudinal QI projects (53.4 to 72.2 percent [p-value 0.005]). Objective scores using the QIKAT increased post-curriculum from 8.3 to 10.1 out of 15 (p-value for difference value for difference from pre-curriculum based assessment occurred via presentation of all projects at the annual QI Project Podium Presentation Day. The competency based curriculum on QI improved residents' QI knowledge and skills during residency training. Importantly, residents perceived that their QI knowledge improved after the curriculum and this also correlated to improved QIKAT

Effect of a Community-Based Service Learning Experience in Geriatrics on Internal Medicine Residents and Community Participants.

Science.gov (United States)

Miller, Rachel K; Michener, Jennifer; Yang, Phyllis; Goldstein, Karen; Groce-Martin, Jennine; True, Gala; Johnson, Jerry

2017-09-01

Community-based service learning (CBSL) provides an opportunity to teach internal medicine residents the social context of aging and clinical concepts. The objectives of the current study were to demonstrate the feasibility of a CBSL program targeting internal medicine residents and to assess its effect on medical residents and community participants. internal medicine residents participated in a CBSL experience for half a day during ambulatory blocks from 2011 to 2014. Residents attended a senior housing unit or center, delivered a presentation about a geriatric health topic, toured the facility, and received information about local older adult resources. Residents evaluated the experience. Postgraduate Year 3 internal medicine residents (n = 71) delivered 64 sessions. Residents felt that the experience increased their ability to communicate effectively with older adults (mean 3.91 ± 0.73 on a Likert scale with 5 = strongly agree), increased their knowledge of resources (4.09 ± 1.01), expanded their knowledge of a health topic pertinent to aging (3.48 ± 1.09), and contributed to their capacity to evaluate and care for older adults (3.84 ± 0.67). Free-text responses demonstrated that residents thought that this program would change their practice. Of 815 older adults surveyed from 36 discrete teaching sessions, 461 (56%) thought that the medical residents delivered health information clearly (4.55 ± 0.88) and that the health topics were relevant (4.26 ± 0.92). Free-text responses showed that the program helped them understand their health concerns. This CBSL program is a feasible and effective tool for teaching internal medicine residents and older adults. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Scandinavian Nurse Specialist Group/Cystic Fibrosis (SNSG/CF)

DEFF Research Database (Denmark)

Bregnballe, Vibeke; Erwander, Inger

2006-01-01

/CF comprises one CF nurse from each of the centers. The board meets twice a year to plan workshops and courses. SNSG/CF is part of the International Nurse Specialist Group/Cystic Fibrosis (INSG/CF). Results: Within the framework of SNSG/CF a 2-day workshop is held every second year for approximately 40...

Comprehensive Auditing in Nuclear Medicine Through the International Atomic Energy Agency Quality Management Audits in Nuclear Medicine (QUANUM) Program. Part 1: the QUANUM Program and Methodology.

Science.gov (United States)

Dondi, Maurizio; Torres, Leonel; Marengo, Mario; Massardo, Teresa; Mishani, Eyal; Van Zyl Ellmann, Annare; Solanki, Kishor; Bischof Delaloye, Angelika; Lobato, Enrique Estrada; Miller, Rodolfo Nunez; Paez, Diana; Pascual, Thomas

2017-11-01

An effective management system that integrates quality management is essential for a modern nuclear medicine practice. The Nuclear Medicine and Diagnostic Imaging Section of the International Atomic Energy Agency (IAEA) has the mission of supporting nuclear medicine practice in low- and middle-income countries and of helping them introduce it in their health-care system, when not yet present. The experience gathered over several years has shown diversified levels of development and varying degrees of quality of practice, among others because of limited professional networking and limited or no opportunities for exchange of experiences. Those findings triggered the development of a program named Quality Management Audits in Nuclear Medicine (QUANUM), aimed at improving the standards of NM practice in low- and middle-income countries to internationally accepted standards through the introduction of a culture of quality management and systematic auditing programs. QUANUM takes into account the diversity of nuclear medicine services around the world and multidisciplinary contributions to the practice. Those contributions include clinical, technical, radiopharmaceutical, and medical physics procedures. Aspects of radiation safety and patient protection are also integral to the process. Such an approach ensures consistency in providing safe services of superior quality to patients. The level of conformance is assessed using standards based on publications of the IAEA and the International Commission on Radiological Protection, and guidelines from scientific societies such as Society of Nuclear Medicine and Molecular Imaging (SNMMI) and European Association of Nuclear Medicine (EANM). Following QUANUM guidelines and by means of a specific assessment tool developed by the IAEA, auditors, both internal and external, will be able to evaluate the level of conformance. Nonconformances will then be prioritized and recommendations will be provided during an exit briefing. The

International development of traditional medicine / complementary and alternative medicine research--what can Europe learn?

Science.gov (United States)

Hök, Johanna; Lewith, George; Weidenhammer, Wolfgang; Santos-Rey, Koldo; Fønnebø, Vinjar; Wiesener, Solveig; Falkenberg, Torkel

2012-01-01

The aim of this study was to analyse global research and development (R&D) strategies for traditional medicine (TM) and complementary and alternative medicine (CAM) across the world to learn from previous and on-going activities. 52 representatives within CAMbrella nominated 43 key international stakeholders (individuals and organisations) and 15 of these were prioritised. Information from policy documents including mission statements, R&D strategies and R&D activities were collected in combination with personal interviews. Data were analysed using the principles of content analysis. Key stakeholders vary greatly in terms of capacity, mission and funding source (private/public). They ranged from only providing research funding to having a comprehensive R&D and communication agenda. A common shift in R&D strategy was noted; whereas 10 years ago research focused mainly on exploring efficacy and mechanisms, today the majority of stakeholders emphasise the importance of a broad spectrum of research, including methodologies exploring context, safety and comparative effectiveness. The scarce public investment in this field in Europe stands in stark contrast to the large investments found in Australia, Asia and North America. There is an emerging global trend supporting a broad research repertoire, including qualitative and comparative effectiveness research. This trend should be considered by the EU given the experience and the substantial research funding committed by the included stakeholders. To facilitate international collaborative efforts and minimise the risk of investment failure, we recommend the formation of a centralised EU CAM research centre fostering a broad CAM R&D agenda with the responsibility for implementing the relevant findings of CAMbrella.

Career preferences and the work-family balance in medicine: gender differences among medical specialists.

NARCIS (Netherlands)

Heiligers, P.J.M.; Hingstman, L.

2000-01-01

In this article career preferences of medical specialists in the Netherlands are analysed, based on a survey among the members of medical associations of five specialities. Four different career preferences were offered, each of which implied a possible variation in working hours. A questionnaire

Level of training and experience in physicians performing interhospital transfers of adult patients in the internal medicine department

DEFF Research Database (Denmark)

Hallas, P; Folkestad, L; Brabrand, M

2009-01-01

AIM: To establish the level of training doctors who participate in interhospital transfers in Denmark. METHODS: A questionnaire was sent to every hospital department in Denmark with acute internal medicine admissions. RESULTS: Eighty-nine internal medicine departments were contacted and 84...... responded (response rate 94.4%). Of the 84 hospitals, 75 (89.3%) indicated that they perform interhospital transfers. Most transfers were performed by interns (61.3%) or senior house officers (10.7%) with only a few months' experience in their current speciality. Training in interhospital transfer...

Some aspects of the development of nuclear medicine in the USSR

International Nuclear Information System (INIS)

Kasatkin, Yu.N.

1989-01-01

Principle directions of the development of nuclear medicine in the USSR are presented.Some problems, which solution affects the state of nuclear medicine in the country are discussed. Problems of technical equipment of nuclear-diagnostic investigations are considered. Measures, directed to improvement of proffesional traing of specialists dealing with nuclear medicine are planned

The coexistence of traditional medicine and biomedicine: A study with local health experts in two Brazilian regions.

Science.gov (United States)

Zank, Sofia; Hanazaki, Natalia

2017-01-01

This study investigated the combined use of traditional medicine and biomedicine by local experts in Chapada do Araripe communities (Ceará State) and maroon communities (Santa Catarina State), Brazil. The objective was to understand the perception of local health specialists regarding the number of healers, demand for healers and use of medicinal plants, and the dependence of different environments to obtain such plants. We also aimed to understand the role of medicinal plants to treat different categories of diseases and if there is a complementary use of medicinal plants and allopathic biomedicine, according to the context of each group. The research was conducted with local health specialists that answered structured interviews, created free lists and participated in guided tours to collect cited plants. Sixty-six local health specialists were identified in the Araripe communities and 22 specialists in the maroon communities. In the maroon communities, a greater number of specialists thought there was a decrease in the number and demand for healers, as well as the use of medicinal plants, due to changes in traditional livelihoods, since they are located in a region where the effects of the modernization were more intense. In the Chapada do Araripe communities the specialists knew more plants extracted from native vegetation, whereas in the maroon communities cultivated plants were better known, which may reflect the environmental conditions and the history of each region. Medicinal plants are preferred to treat simpler health problems that do not require medical care, such as gastrointestinal problems, general pain, flues and colds. The biomedicine is used principally for problems with blood pressure, general pains and endocrine and nutritional diseases. Even with the particularities of each region, in general the use of medicinal plants and biomedicines occurred in a complementary form in both regions; however, this coexistence may result from these different

The coexistence of traditional medicine and biomedicine: A study with local health experts in two Brazilian regions

Science.gov (United States)

Zank, Sofia; Hanazaki, Natalia

2017-01-01

This study investigated the combined use of traditional medicine and biomedicine by local experts in Chapada do Araripe communities (Ceará State) and maroon communities (Santa Catarina State), Brazil. The objective was to understand the perception of local health specialists regarding the number of healers, demand for healers and use of medicinal plants, and the dependence of different environments to obtain such plants. We also aimed to understand the role of medicinal plants to treat different categories of diseases and if there is a complementary use of medicinal plants and allopathic biomedicine, according to the context of each group. The research was conducted with local health specialists that answered structured interviews, created free lists and participated in guided tours to collect cited plants. Sixty-six local health specialists were identified in the Araripe communities and 22 specialists in the maroon communities. In the maroon communities, a greater number of specialists thought there was a decrease in the number and demand for healers, as well as the use of medicinal plants, due to changes in traditional livelihoods, since they are located in a region where the effects of the modernization were more intense. In the Chapada do Araripe communities the specialists knew more plants extracted from native vegetation, whereas in the maroon communities cultivated plants were better known, which may reflect the environmental conditions and the history of each region. Medicinal plants are preferred to treat simpler health problems that do not require medical care, such as gastrointestinal problems, general pain, flues and colds. The biomedicine is used principally for problems with blood pressure, general pains and endocrine and nutritional diseases. Even with the particularities of each region, in general the use of medicinal plants and biomedicines occurred in a complementary form in both regions; however, this coexistence may result from these different

International guidance on the establishment of quality assurance programmes for radioactivity measurement in nuclear medicine

Energy Technology Data Exchange (ETDEWEB)

Zimmerman, B.E. [Dosimetry and Medical Radiation Physics Section, Division of Human Health, International Atomic Energy Agency, Wagramer Strasse 5, P.O. Box 200, A-1400 Vienna (Austria)]. E-mail: b.zimmerman@iaea.org; Herbst, C. [Department of Medical Physics, University of the Free State, Geneeskundige Fisika G 68, Bloemfontein 9300 (South Africa); Norenberg, J.P. [College of Pharmacy, 2502 Marble, NE MSC09 5360, University of New Mexico, Albuquerque 87131 (United States); Woods, M.J. [Ionizing Radiation Consultants, Ltd., 152 Broom Road, Teddington, Middlesex TW11 9PQ (United Kingdom)

2006-10-15

A new guidance document for the implementation of quality assurance (QA) programmes for nuclear medicine radioactivity measurement, produced by the International Atomic Energy Agency, is described. The proposed programme is based on the principles of ISO 17025 and will enable laboratories, particularly in developing countries, to provide consistent, safe and effective radioactivity measurement services to the nuclear medicine community.

International guidance on the establishment of quality assurance programmes for radioactivity measurement in nuclear medicine

International Nuclear Information System (INIS)

Zimmerman, B.E.; Herbst, C.; Norenberg, J.P.; Woods, M.J.

2006-01-01

A new guidance document for the implementation of quality assurance (QA) programmes for nuclear medicine radioactivity measurement, produced by the International Atomic Energy Agency, is described. The proposed programme is based on the principles of ISO 17025 and will enable laboratories, particularly in developing countries, to provide consistent, safe and effective radioactivity measurement services to the nuclear medicine community

[Regular discussion of serious complications during admission to an internal medicine department].

NARCIS (Netherlands)

Janssen, M.C.H.; Koopmans †, P.P.; Gurp, P.J.M. van

2010-01-01

Three patients, two women aged 54 and 84 years, and a man aged 76 years, had serious complications during a stay in an internal medicine ward. The complications were discussed at monthly multidisciplinary complication meetings, which we organise from 2007 and which are aimed at improving care

Measuring Value in Internal Medicine Residency Training Hospitals Using Publicly Reported Measures.

Science.gov (United States)

Schickedanz, Adam; Gupta, Reshma; Arora, Vineet M; Braddock, Clarence H

2018-03-01

Graduate medical education (GME) lacks measures of resident preparation for high-quality, cost-conscious practice. The authors used publicly reported teaching hospital value measures to compare internal medicine residency programs on high-value care training and to validate these measures against program director perceptions of value. Program-level value training scores were constructed using Centers for Medicare & Medicaid Services Value-Based Purchasing (VBP) Program hospital quality and cost-efficiency data. Correlations with Association of Program Directors in Internal Medicine Annual Survey high-value care training measures were examined using logistic regression. For every point increase in program-level VBP score, residency directors were more likely to agree that GME programs have a responsibility to contain health care costs (adjusted odds ratio [aOR] 1.18, P = .04), their faculty model high-value care (aOR 1.07, P = .03), and residents are prepared to make high-value medical decisions (aOR 1.07, P = .09). Publicly reported clinical data offer valid measures of GME value training.

Families' perceptions of the contribution of intellectual disability clinical nurse specialists in Ireland.

Science.gov (United States)

Doody, Owen; Slevin, Eamonn; Taggart, Laurence

2018-01-01

To explore families' perceptions of the contribution of clinical nurse specialists in intellectual disability nursing in Ireland. Clinical nurse specialists roles have developed over the years and are seen as complex and multifaceted, causing confusion, frustration and controversy. 2001 saw the formal introduction of clinical nurse specialists roles in Ireland across nursing including intellectual disability. A exploratory qualitative approach using semistructured one-to-one interviews with 10 family members regarding their perceptions of the clinical nurse specialists in intellectual disability. Data were audio-recorded, transcribed and analysed using Burnard's framework. Ethical approval was gained and access granted by service providers. The study highlights that intellectual disability clinical nurse specialists contribute and support care deliver across a range of areas, including personal caring, supporting and empowering families, liaison, education and leadership. Clinical nurse specialists have an important role and contribution in supporting families and clients, and Ireland is in a unique position to develop knowledge regarding specialist care for people with intellectual disability that can be shared nationally and internationally. Ireland is in a unique position to develop knowledge regarding specialist care for people with intellectual disability that can be shared and adapted by other healthcare professionals in other countries that do not have a specialised intellectual disability nurses. © 2017 John Wiley & Sons Ltd.

Caring for cancer patients on non-specialist wards.

LENUS (Irish Health Repository)

Gill, Finola

2012-02-01

As cancer is the leading cause of death worldwide, every nurse will be required to care for patients with the condition at some point in his\\/her career. However, non-specialized oncology nurses are often ill-prepared to nurse patients suffering from cancer. This literature review aims to provide an overview of current trends and developments in cancer care nursing in an attempt to identify the range of previous research pertaining to caring for patients with cancer on non-specialist wards. The review finds that non-specialized cancer nurses report a lack of education and training with regard to cancer care and cancer treatments, which acts as a barrier to providing quality nursing care. Emotional and communication issues with patients and their families can also cause non-specialist nurses significant distress. International research has shown that specialist oncology nurses make a considerable difference to physical and psychosocial patient care. It is therefore paramount that non-speciality nurses\\' educational needs are met to develop clinical competence and to provide supportive holistic care for both patients and their families.

Specialist Bibliographic Databases.

Science.gov (United States)

Gasparyan, Armen Yuri; Yessirkepov, Marlen; Voronov, Alexander A; Trukhachev, Vladimir I; Kostyukova, Elena I; Gerasimov, Alexey N; Kitas, George D

2016-05-01

Specialist bibliographic databases offer essential online tools for researchers and authors who work on specific subjects and perform comprehensive and systematic syntheses of evidence. This article presents examples of the established specialist databases, which may be of interest to those engaged in multidisciplinary science communication. Access to most specialist databases is through subscription schemes and membership in professional associations. Several aggregators of information and database vendors, such as EBSCOhost and ProQuest, facilitate advanced searches supported by specialist keyword thesauri. Searches of items through specialist databases are complementary to those through multidisciplinary research platforms, such as PubMed, Web of Science, and Google Scholar. Familiarizing with the functional characteristics of biomedical and nonbiomedical bibliographic search tools is mandatory for researchers, authors, editors, and publishers. The database users are offered updates of the indexed journal lists, abstracts, author profiles, and links to other metadata. Editors and publishers may find particularly useful source selection criteria and apply for coverage of their peer-reviewed journals and grey literature sources. These criteria are aimed at accepting relevant sources with established editorial policies and quality controls.

Specialist Bibliographic Databases

Science.gov (United States)

2016-01-01

Specialist bibliographic databases offer essential online tools for researchers and authors who work on specific subjects and perform comprehensive and systematic syntheses of evidence. This article presents examples of the established specialist databases, which may be of interest to those engaged in multidisciplinary science communication. Access to most specialist databases is through subscription schemes and membership in professional associations. Several aggregators of information and database vendors, such as EBSCOhost and ProQuest, facilitate advanced searches supported by specialist keyword thesauri. Searches of items through specialist databases are complementary to those through multidisciplinary research platforms, such as PubMed, Web of Science, and Google Scholar. Familiarizing with the functional characteristics of biomedical and nonbiomedical bibliographic search tools is mandatory for researchers, authors, editors, and publishers. The database users are offered updates of the indexed journal lists, abstracts, author profiles, and links to other metadata. Editors and publishers may find particularly useful source selection criteria and apply for coverage of their peer-reviewed journals and grey literature sources. These criteria are aimed at accepting relevant sources with established editorial policies and quality controls. PMID:27134485

Inpatient glycemic management in internal medicine: an observational multicenter study in Nanjing, China.

Science.gov (United States)

Hao, Shujie; Zhang, Ning; Fish, Anne Folta; Yuan, Xiaodan; Liu, Lin; Li, Fan; Fang, Zhaohui; Lou, Qingqing

2017-08-01

To evaluate the prevalence of hyperglycemia among inpatients in internal medicine, and specifically, to assess the glycemic management of inpatients in non-endocrinology departments in three large urban hospitals in China. A multicenter observational study was conducted using electronic health records, and a survey of 1939 patients who were admitted to internal medicine units and followed until discharge. Those with previously diagnosed diabetes, newly diagnosed diabetes, or impaired fasting glucose were included. Aspects of glycemic management examined were (a) hyperglycemia, (b) endocrinology consultation for hyperglycemia and (c) hypoglycemia. The prevalence of hyperglycemia in internal medicine was 45.7% (886 out of 1939). A total of 741 (83.6%) patients were treated by non-endocrinology departments; of those, 230 (31.1%) were in poor glycemic control and needed an endocrinology consultation. Yet only 57 (24.8%) received one. In 4 cases, the physician did not follow the consultants' advice. Among the remaining 53 consulted patients, 35 (66.1%) were still in poor glycemic control, yet only about half received a second consultation. Finally, among patients treated in non-endocrinology departments, 58 (7.8%) had hypoglycemia; less than half retested their blood glucose after treatment. The majority of patients with hyperglycemia were in non-endocrinology departments. Their glycemic management was poor; the endocrinology consultation rate was low and the result was suboptimal. Also, the management of hypoglycemia was not ideal. Therefore, improving glycemic management is urgently needed in Chinese hospitals.

Psychosocial Training in U.S. Internal Medicine and Family Practice Residency Programs.

Science.gov (United States)

Gaufberg, Elizabeth H.; Joseph, Robert C.; Pels, Richard J.; Wyshak, Grace; Wieman, Dow; Nadelson, Carol C.

2001-01-01

Surveyed directors of internal medicine (IM) and family practice (FP) residency programs regarding the format, content, and quantity of psychosocial training in their programs, their opinions on topics related to such training, and program demographics. Found considerable variation in content and time devoted to psychosocial training within and…

Virtual international experiences in veterinary medicine: an evaluation of students' attitudes toward computer-based learning.

Science.gov (United States)

French, Brigitte C; Hird, David W; Romano, Patrick S; Hayes, Rick H; Nijhof, Ard M; Jongejan, Frans; Mellor, Dominic J; Singer, Randall S; Fine, Amanda E; Gay, John M; Davis, Radford G; Conrad, Patricia A

2007-01-01

While many studies have evaluated whether or not factual information can be effectively communicated using computer-aided tools, none has focused on establishing and changing students' attitudes toward international animal-health issues. The study reported here was designed to assess whether educational modules on an interactive computer CD elicited a change in veterinary students' interest in and attitudes toward international animal-health issues. Volunteer veterinary students at seven universities (first-year students at three universities, second-year at one, third-year at one, and fourth-year at two) were given by random assignment either an International Animal Health (IAH) CD or a control CD, ParasitoLog (PL). Participants completed a pre-CD survey to establish baseline information on interest and attitudes toward both computers and international animal-health issues. Four weeks later, a post-CD questionnaire was distributed. On the initial survey, most students expressed an interest in working in the field of veterinary medicine in another country. Responses to the three pre-CD questions relating to attitudes toward the globalization of veterinary medicine, interest in foreign animal disease, and inclusion of a core course on international health issues in the veterinary curriculum were all positive, with average values above 3 (on a five-point scale where 5 represented strong agreement or interest). Almost all students considered it beneficial to learn about animal-health issues in other countries. After students reviewed the IAH CD, we found a decrease at four universities, an increase at one university, and no change at the remaining two universities in students' interest in working in some area of international veterinary medicine. However, none of the differences was statistically significant.

Usage of Complementary and Alternative Medicine (CAM) among osteoarthritis patients attending an urban multi-specialist hospital in Lagos, Nigeria.

Science.gov (United States)

Obalum, D C; Ogo, C N

2011-03-01

Osteoarthritis (OA), a chronic degenerative disease of synovial joints is characterised by pain and stiffness. Aim of treatment is pain relief. Complementary and alternative medicine (CAM) refers to practices which are not an integral part of orthodox medicine. To determine the pattern of usage of CAM among OA patients in Nigeria. Consecutive patients with OA attending orthopaedic clinic of Havana Specialist Hospital, Lagos, Nigeria were interviewed over a 6- month period st st of 1 May to 31 October 2007 on usage of CAM. Structured and open-ended questions were used. Demographic data, duration of OA and treatment as well as compliance to orthodox medications were documented. One hundred and sixty four patients were studied.120 (73.25%) were females and 44(26.89%) were males. Respondents age range between 35-74 years. 66(40.2%) patients used CAM. 35(53.0%) had done so before presenting to the hospital. The most commonly used CAM were herbal products used by 50(75.8%) of CAM users. Among herbal product users, 74.0% used non- specific local products, 30.0% used ginger, 36.0% used garlic and 28.0% used Aloe Vera. Among CAM users, 35(53.0%) used local embrocation and massage, 10(15.2%) used spiritual methods. There was no significant difference in demographics, clinical characteristics and pain control among CAM users and non-users. Many OA patients receiving orthodox therapy also use CAM. Medical doctors need to keep a wary eye on CAM usage among patients and enquire about this health-seeking behaviour in order to educate them on possible drug interactions, adverse effects and long term complications.

Saudi Internal Medicine Residents׳ Perceptions of the Objective Structured Clinical Examination as a Formative Assessment Tool

Directory of Open Access Journals (Sweden)

Salwa Alaidarous

2016-12-01

Full Text Available The Saudi Commission for Health Specialties first implemented the Objective Structured Clinical Examinations (OSCE as part of the final year Internal Medicine clerkship exam during the 2007–2008 academic year. This study evaluated Internal Medicine residents׳ overall perceptions of the OSCE as a formative assessment tool. It focused on residents׳ perceptions of the OSCE stations׳ attributes, determined the acceptability of the process, and provided feedback to enhance further development of the assessment tool. The main objective was to assess Internal Medicine resident test-takers׳ perceptions and acceptance of the OSCE, and to identify its strengths and weaknesses through their feedback. Sixty six residents were involved in the studied administered on November 8th 2012 at King Abdulaziz University Hospital in Jeddah, Kingdom of Saudi Arabia. Overall, resident׳s evaluation of the OSCE was favorable and encouraging. To this end, we recommend that formative assessment opportunities using the OSCE for providing feedback to students should be included in the curriculum, and continuing refinement and localized adaptation of OSCEs in use should be pursued by course directors and assessment personnel.

Impact of the Pharmacy Practice Model Initiative on Clinical Pharmacy Specialist Practice.

Science.gov (United States)

Jacobi, Judith; Ray, Shaunta'; Danelich, Ilya; Dodds Ashley, Elizabeth; Eckel, Stephen; Guharoy, Roy; Militello, Michael; O'Donnell, Paul; Sam, Teena; Crist, Stephanie M; Smidt, Danielle

2016-05-01

This paper describes the goals of the American Society of Health-System Pharmacists' Pharmacy Practice Model Initiative (PPMI) and its recommendations for health-system pharmacy practice transformation to meet future patient care needs and elevate the role of pharmacists as patient care providers. PPMI envisions a future in which pharmacists have greater responsibility for medication-related outcomes and technicians assume greater responsibility for product-related activities. Although the PPMI recommendations have elevated the level of practice in many settings, they also potentially affect existing clinical pharmacists, in general, and clinical pharmacy specialists, in particular. Moreover, although more consistent patient care can be achieved with an expanded team of pharmacist providers, the role of clinical pharmacy specialists must not be diminished, especially in the care of complex patients and populations. Specialist practitioners with advanced training and credentials must be available to model and train pharmacists in generalist positions, residents, and students. Indeed, specialist practitioners are often the innovators and practice leaders. Negotiation between hospitals and pharmacy schools is needed to ensure a continuing role for academic clinical pharmacists and their contributions as educators and researchers. Lessons can be applied from disciplines such as nursing and medicine, which have developed new models of care involving effective collaboration between generalists and specialists. Several different pharmacy practice models have been described to meet the PPMI goals, based on available personnel and local goals. Studies measuring the impact of these new practice models are needed. © 2016 Pharmacotherapy Publications, Inc.

Internal Medicine Hospitalists' Perceived Barriers and Recommendations for Optimizing Secondary Prevention of Osteoporotic Hip Fractures.

Science.gov (United States)

Tan, Eng Keong; Loh, Kah Poh; Goff, Sarah L

2017-12-01

Osteoporosis is a major public health concern affecting an estimated 10 million people in the United States. To the best of our knowledge, no qualitative study has explored barriers perceived by medicine hospitalists to secondary prevention of osteoporotic hip fractures. We aimed to describe these perceived barriers and recommendations regarding how to optimize secondary prevention of osteoporotic hip fracture. In-depth, semistructured interviews were performed with 15 internal medicine hospitalists in a tertiary-care referral medical center. The interviews were analyzed with directed content analysis. Internal medicine hospitalists consider secondary osteoporotic hip fracture prevention as the responsibility of outpatient physicians. Identified barriers were stratified based on themes including physicians' perception, patients' characteristics, risks and benefits of osteoporosis treatment, healthcare delivery system, and patient care transition from the inpatient to the outpatient setting. Some of the recommendations include building an integrated system that involves a multidisciplinary team such as the fracture liaison service, initiating a change to the hospital policy to facilitate inpatient care and management of osteoporosis, and creating a smooth patient care transition to the outpatient setting. Our study highlighted how internal medicine hospitalists perceive their role in the secondary prevention of osteoporotic hip fractures and what they perceive as barriers to initiating preventive measures in the hospital. Inconsistency in patient care transition and the fragmented nature of the existing healthcare system were identified as major barriers. A fracture liaison service could remove some of these barriers.

Analysing recurrent events in exercise science and sports medicine

African Journals Online (AJOL)

Episodic or recurrent events are a class of data that is frequently described in sports medicine literature. However, the correct statis- tical techniques to deal with data containing recurrent events are not widely known within sports medicine and the exercise sciences. This is evidenced by the few papers in these specialist ...

Senior Program Specialist | IDRC - International Development ...

International Development Research Centre (IDRC) Digital Library (Canada)

Initiative Development Identifies opportunities that will contribute to meeting the ... internal and governance committees, in-house and external research, global ... of strengthening CRVS systems, including gaps in existing CRVS infrastructure ...

Teamwork assessment in internal medicine: a systematic review of validity evidence and outcomes.

Science.gov (United States)

Havyer, Rachel D A; Wingo, Majken T; Comfere, Nneka I; Nelson, Darlene R; Halvorsen, Andrew J; McDonald, Furman S; Reed, Darcy A

2014-06-01

Valid teamwork assessment is imperative to determine physician competency and optimize patient outcomes. We systematically reviewed published instruments assessing teamwork in undergraduate, graduate, and continuing medical education in general internal medicine and all medical subspecialties. We searched MEDLINE, MEDLINE In-process, CINAHL and PsycINFO from January 1979 through October 2012, references of included articles, and abstracts from four professional meetings. Two content experts were queried for additional studies. Included studies described quantitative tools measuring teamwork among medical students, residents, fellows, and practicing physicians on single or multi-professional (interprofessional) teams. Instrument validity and study quality were extracted using established frameworks with existing validity evidence. Two authors independently abstracted 30 % of articles and agreement was calculated. Of 12,922 citations, 178 articles describing 73 unique teamwork assessment tools met inclusion criteria. Interrater agreement was intraclass correlation coefficient 0.73 (95 % CI 0.63-0.81). Studies involved practicing physicians (142, 80 %), residents/fellows (70, 39 %), and medical students (11, 6 %). The majority (152, 85 %) assessed interprofessional teams. Studies were conducted in inpatient (77, 43 %), outpatient (42, 24 %), simulation (37, 21 %), and classroom (13, 7 %) settings. Validity evidence for the 73 tools included content (54, 74 %), internal structure (51, 70 %), relationships to other variables (25, 34 %), and response process (12, 16 %). Attitudes and opinions were the most frequently assessed outcomes. Relationships between teamwork scores and patient outcomes were directly examined for 13 (18 %) of tools. Scores from the Safety Attitudes Questionnaire and Team Climate Inventory have substantial validity evidence and have been associated with improved patient outcomes. Review is limited to quantitative assessments of teamwork in internal

A Comparison of Selected Supervisory Skills of Content Specialist and Non-Content Specialist University Supervisors

Science.gov (United States)

Hunt, Kevin; Mitchell, Murray; Maina, Michael; Griffin, Lisa

2015-01-01

The purpose of this study was to describe and contrast selected approaches to the supervision of student teachers between Content Specialist and Non-Content Specialist university supervisors. Content Specialist supervisors were identified as trained university supervisors with a background in physical education. Non-Content Specialist supervisors…

Nurses' Experiences in a Turkish Internal Medicine Clinic With Syrian Refugees.

Science.gov (United States)

Sevinç, Sibel

2018-05-01

The increasing flow of Syrian refugees to Turkey, coupled with their extended stay, highlights the need for culturally competent health care, which includes nursing interventions. The purpose of this study was to describe the experiences of nurses who provide care for Syrian refugees in internal medicine clinics in a hospital located in Turkey. This descriptive study was based on qualitative content analysis using an inductive approach and involved discovery and description of the data. The study sample consisted of 10 nurses who work at the internal medicine clinic of a State Hospital in Turkey. Data were collected using semistructured interviews. Three themes with related subthemes were derived from the data. Nurses who participated in the study experienced: (a) Nurses found communicating with Syrian refugees and their families difficult in the clinic. (b) Nurses observed and experienced differences and similarities in caring for Turkish and Syrian patients. (c) Nurses expressed and displayed compassion toward Syrian refugees during the caring process. In order for nurses to provide the best care for Syrian refugee patients, it is important to identify cultural caring behaviors observed by nurses in the promotion of culturally congruent nursing and health care.

[Analises of the mortality in aged in an Internal Medicine Department].

Science.gov (United States)

Cinza Sanjurjo, S; Cabarcos Ortiz de Barrón, A; Nieto Pol, E; Torre Carballada, J A

2007-02-01

To establish the characteristics of the deceased and the death causes. Transversal study descriptive, with intake patients elder than 65 years old in an Internal Medicine Department. The variables analized were: age, sex, intake date, discharge date, days of hospital stay, chronic disease previous, admission cause, deceased, diagnoses. The statistical analysis was performed with measures of central tendency and of standard deviation, Chi-cuadrado, Mann-Whitney-Wilcoxon and Kruskal-Wallis. During the revised year, there are 770 patients intaked in Internal Medicine Department and 128 exitus (16.6%). The global average death age was 78.3 +/- 1.3 years: 53.1% (0.44-0.62; p = 0.48) were men and 46.9% were women. The average death intake days was 13.3 +/- 1.7 days (p < 0.001), 3.9% died in less than forty-eight hours after hospitalization. The most frequent admission cause was: dyspnea (46.1%). The most frequent chronic diseases were: ischemic and hypertensive heart disease (18.8%) and chronic obstructive pulmonary disease. The most frequent death cause was respiratory tract infection (43.8%). The prevalence cardiac and pulmonary disease prevalence is high, these diseases are the of the most frequent causes hospital mortality.

Certification of the instructional competence of nuclear training specialists

International Nuclear Information System (INIS)

Wollert, T.N.

1990-01-01

This study was designed to identify the qualification requirements and the means to assess the unique knowledge and skills necessary to perform the instructional activities needed by nuclear training specialist at Fort Saint Vrain Nuclear Generating Station. A survey questionnaire with 233 task statements categorized into eleven duty areas was distributed to twenty-three nuclear training specialists at Fort Saint Vrain Nuclear Generating Station. On the basis of the data accumulated for this study, the researcher identified the following findings. A list of 158 task statements were identified as being relevant; this list was considered a core knowledge, skills, and abilities needed as a nuclear training specialist. The list consisted of ten duty areas which were relevant to the effective performance of a nuclear training specialist. Thirty-three task statements were identified as being relevant for the duty area Conductive Training. These were considered the core of knowledge, skills, and abilities needed in the development of the initial test instrument and the instructor classroom skills observation checklist. The significant correlation between the results of these two instruments, using a rank-order correlation coefficient, was interpreted by the researcher as indicating that the initial test instrument possessed concurrent validity. The researcher interpreted the reliability value as a positive indicator that the initial test instrument demonstrated internal consistency. It was concluded that it could be determined whether personnel possessed the level of competence needed to perform the instructional duties of a nuclear training specialist by using a written test. Data from this research supported the use of the initial test developed for this study as a valid means to certify nuclear training specialists for the duty area Conducting Training

History and Guideline of Emergency Medicine Residency Discipline in Shahid Beheshti University of Medical Sciences, Iran; Review of 2014

Directory of Open Access Journals (Sweden)

Majid Shojaee

2014-09-01

Full Text Available Introduction: Since many years ago several problems have been felt in emergency departments (ED of hospitals. In fact, none of physicians in the hospital have accepted the direct responsibility of patients’ management in the EDs and emergency wards of University centers have been managed by residents of various disciplines. Thus, the first line of therapy does not have guardian and several consultants with various specialists have been performed regarding patient’s management. The necessity of physician training was noticed for the first time in 1950 and after 24 years in 1974, the academic emergency medicine was established in United States of America (USA in response to people expectations for overnight accessibility to specialized and quality medical cares. It was performed with foundation of the first period of resident’s training in emergency medicine discipline at University of Cincinnati, Ohio. At beginning, specialists of different fields such as internal medicine, surgery, anesthesia, orthopedics, and neurosurgery initiated the training of emergency medicine residents together which could be responsible to most of referees. Finally, with formal accepting the specialty board in 1978, this field has been officially identified as the 23th discipline in USA. Today the EDs of most hospitals in European and American countries has been managing by emergency medicine specialists which leads to improve the quality of education and treatment, significantly. Also in Iran the request of establishing this major has been presented in the secretariat of the council for graduate medical education for the first time in 1996. This request was approved and principles of its initiating recognized officially by the ministry of health. But, considering to lack of an appropriate infrastructure, it postponed until 2000 that again this discipline was missioned for initiating to the council for graduate medical education by the minister and its outcome was

Important Skills for Internship and the Fourth-Year Medical School Courses to Acquire Them: A National Survey of Internal Medicine Residents.