How sequestration cuts affect primary care physicians and graduate medical education.

Science.gov (United States)

Chauhan, Bindiya; Coffin, Janis

2013-01-01

On April 1, 2013, sequestration cuts went into effect impacting Medicare physician payments, graduate medical education, and many other healthcare agencies. The cuts range from 2% to 5%, affecting various departments and organizations. There is already a shortage of primary care physicians in general, not including rural or underserved areas, with limited grants for advanced training. The sequestration cuts negatively impact the future of many primary care physicians and hinder the care many Americans will receive over time.

Assessment by Employers of Newly Graduated Civil Engineers from the Islamic University of Gaza

Science.gov (United States)

Enshassi, Adnan; Hassouna, Ahmed

2005-01-01

The evaluation process is very important to identify and recognize the strengths and the weaknesses of graduated students. The purpose of this paper is to evaluate the performance of the newly graduated civil engineers from the Islamic University of Gaza in Palestine. The methodology was based on questionnaires and informal interview. The…

International Medical Graduates in the US Physician Workforce and Graduate Medical Education: Current and Historical Trends.

Science.gov (United States)

Ahmed, Awad A; Hwang, Wei-Ting; Thomas, Charles R; Deville, Curtiland

2018-04-01

Data show that international medical graduates (IMGs), both US and foreign born, are more likely to enter primary care specialties and practice in underserved areas. Comprehensive assessments of representation trends for IMGs in the US physician workforce are limited. We reported current and historical representation trends for IMGs in the graduate medical education (GME) training pool and US practicing physician workforce. We compared representation for the total GME and active practicing physician pools with the 20 largest residency specialties. A 2-sided test was used for comparison, with P  < .001 considered significant. To assess significant increases in IMG GME trainee representation for the total pool and each of the specialties from 1990-2015, the slope was estimated using simple linear regression. IMGs showed significantly greater representation among active practicing physicians in 4 specialties: internal medicine (39%), neurology (31%), psychiatry (30%), and pediatrics (25%). IMGs in GME showed significantly greater representation in 5 specialties: pathology (39%), internal medicine (39%), neurology (36%), family medicine (32%), and psychiatry (31%; all P  < .001). Over the past quarter century, IMG representation in GME has increased by 0.2% per year in the total GME pool, and 1.1% per year for family medicine, 0.5% for obstetrics and gynecology and general surgery, and 0.3% for internal medicine. IMGs make up nearly a quarter of the total GME pool and practicing physician workforce, with a disproportionate share, and larger increases over our study period in certain specialties.

Preceptors' perceptions of the elements of a successful and an unsuccessful orientation period for newly graduated nurses.

Science.gov (United States)

Lindfors, Kirsi; Meretoja, Riitta; Kaunonen, Marja; Paavilainen, Eija

2018-04-01

To identify existing orientation patterns and to find elements that may enhance or impede successful orientation of newly graduated nurses. Preceptors have first-hand information concerning orientation and their opinions should not be forgotten when organisations develop their orientation processes. An open-ended questionnaire was undertaken to collect data from preceptors (n = 172) about the current orientation patterns. Data were analysed by using deductive content analysis and by quantifying the phrases. Communal commitment to the orientation process, strong professional orientation know-how and supportive leadership were the enhancing elements of successful orientation. Complex interpersonal relationship problems during orientation, inadequate orientation resources and the organisation's structural and functional problems were the impeding elements of successful orientation. With the elements of successful orientation we ensure a supportive transition to practice for newly graduate nurses and possibilities to focus on good orientation practices for preceptors. Nurse leaders play an important part in ensuring newly graduated nurses have a safe nursing career starting point and, for preceptors, opportunities to provide orientation that is as good as possible. Supportive leadership, sufficient resources and good interpersonal relationships should be the leading principles during newly graduated nurses' orientation period. © 2017 John Wiley & Sons Ltd.

[Use of information sources by recently graduated physicians of Lima].

Science.gov (United States)

Mejia, Christian R; Caceres, Onice J; Vera, Claudia A; Nizama-Vía, Ayar; Curioso, Walter H; Mayta-Tristán, Percy

2014-01-01

In order to determine the use of information sources by recently graduated physicians of Lima, Peru in 2011, a survey was conducted among graduated physicians at seven universities. They were asked about the use of search engines in the health area during their year of medical internship [last year of medical school]. Regular use was defined as the source being used once a week or daily. For 490 respondents, regularly used information sources were SciELO, accessed by 173 (36.4%); PubMed 165 (34.4%); HINARI 117 (25.5%); UpToDate 98 (22.3%); Cochrane Library 94 (20.6%); LILACS 91 (19.8%); a hospital institutional library 70 (15.0%); LIPECS 39 (8.7%); and Peru BVS 42 (9.3%). Only a minority regularly accessed information sources related to health. It is necessary to improve capacity in the efficient use of various resources of scientific information in a continuous way and that reaches students and health professionals.

Human resources for health in Peru: recent trends (2007-2013) in the labour market for physicians, nurses and midwives.

Science.gov (United States)

Jimenez, M Michelle; Bui, Anthony L; Mantilla, Eduardo; Miranda, J Jaime

2017-09-21

Most analyses of gaps in human resources for health (HRH) do not consider training and the transition of graduates into the labour market. This study aims to explore the labour market for Peru's recent medical, nursing, and midwifery graduates as well as their transition into employment in the Ministry of Health's (MOH) system. Data from four different datasets, covering 2007-2013, was used to characterize the patterns of recently trained physicians, nurses, midwives, and postgraduate-trained physicians that enter employment in the MOH system, and scenario analyses were used to describe how this rate of entry needs to adapt in order to fill current HRH shortages. HRH graduates have been increasing from 2007 to 2011, but the proportions that enter employment in the MOH system 2 years later range from 8 to 45% and less than 10% of newly trained medical specialists. Scenario analyses indicate that the gap for physicians and nurses will be met in 2027 and 2024, respectively, while midwives in 2017. However, if the number of HRH graduates entering the MOH system doubles, these gaps could be filled as early as 2020 for physicians and 2019 for nurses. In this latter scenario, the MOH system would still only utilize 56% of newly qualified physicians, 74% of nurses, and 66% of midwives available in the labour market. At 2013 training rates, Peru has the number of physicians, nurses, and midwives it needs to address HRH shortages and meet estimated HRH gaps in the national MOH system during the next decade. However, a significant number of newly qualified health professionals do not work for the MOH system within 2 years of graduation. These analyses highlight the importance of building adequate incentive structures to improve the entry and retention of HRH into the public sector.

What the IOM Report on Graduate Medical Education Means for Physician Assistants.

Science.gov (United States)

Cawley, James F

2015-06-01

Graduate medical education (GME) is funded by taxpayers through Medicare subsidies that pay for physician residency training, primarily to teaching hospitals. The Institute of Medicine (IOM) recently conducted a study of US GME and issued a series of recommendations for future policy reform. This commentary examines the major elements of proposed reforms for GME and offers analysis of those that may pertain specifically to physician assistant education now and in the future.

The $16,819 pay gap for newly trained physicians: the unexplained trend of men earning more than women.

Science.gov (United States)

Lo Sasso, Anthony T; Richards, Michael R; Chou, Chiu-Fang; Gerber, Susan E

2011-02-01

Prior research has suggested that gender differences in physicians' salaries can be accounted for by the tendency of women to enter primary care fields and work fewer hours. However, in examining starting salaries by gender of physicians leaving residency programs in New York State during 1999-2008, we found a significant gender gap that cannot be explained by specialty choice, practice setting, work hours, or other characteristics. The unexplained trend toward diverging salaries appears to be a recent development that is growing over time. In 2008, male physicians newly trained in New York State made on average $16,819 more than newly trained female physicians, compared to a $3,600 difference in 1999.

Reasons for choosing the profession and profile of newly qualified physicians in Brazil

Directory of Open Access Journals (Sweden)

MÁRIO CÉSAR SCHEFFER

Full Text Available SUMMARY Objective To evaluate the socio-demographic profile, path to medical school admission and factors affecting the choice of becoming a physician in Brazil. Method Application of a structured questionnaire to 4,601 participants among the 16,323 physicians who graduated between 2014 and 2015 that subsequently registered with one of the 27 Regional Boards of Medicine (CRMs. Results The average age of participants is 27 years, 77.2% are white, 57% come from families with a monthly income greater than ten times the minimum wage, 65% have fathers who have completed higher education, 79.1% attended a private high school, and 63.5% selected the “will to make a difference in people’s lives or do good” as their main reason for choosing medicine, with some differences between the sexes and matriculation at a public or private medical school. Conclusion The recent politics for educational diversity and the opening of additional medical schools has not yet had an impact on the socio-demographic profile of graduates, who are mainly white, wealthy individuals.

A comprehensive literature review of guidelines facilitating transition of newly graduated nurses to professional nurses.

Science.gov (United States)

van Rooyen, Dalena R M; Jordan, Portia J; Ten Ham-Baloyi, Wilma; Caka, Ernestina M

2018-05-01

Literature shows that successful transition of newly graduate nurses to professional nurses is imperative but does not always take place, resulting in difficulty in performance, cognizance or behaviour of a role as a nurse, affecting the quality of patient care negatively. No integrative literature review could be found to summarize available guidelines facilitating transition of final year nursing students to professional nurses. An extensive search of the literature by means of an integrative literature review was conducted in 2014 and updated in June 2017, following a five-step process. All relevant studies were subsequently appraised for rigour and quality using the AGREE II tool by two independent reviewers. Eight (n = 8) guidelines on transitions were independently extracted. After thematic analysis was done, three factors to facilitate transition of final year nursing students to professional nurses were found: 1) support for new graduates, 2) the graduate's need for socialization and belonging, and 3) a positive clinical learning environment. The availability and implementation of guidelines on transition of final year nursing students by educational institutions and healthcare facilities could ease the transition from being final year nursing students to becoming professional nurses as well as improve retention of newly qualified professional nurses. Copyright © 2018. Published by Elsevier Ltd.

Patient Care Physician Supply and Requirements: Testing COGME Recommendations. Council on Graduate Medical Education, Eighth Report.

Science.gov (United States)

Council on Graduate Medical Education.

This report reassesses recommendations made by the Council on Graduate Medical Education in earlier reports which had, beginning in 1992, addressed the problems of physician oversupply. In this report physician supply and requirements are examined in the context of a health care system increasingly dominated by managed care. Patterns of physician…

The experience of learning to speak up: a narrative inquiry on newly graduated registered nurses.

Science.gov (United States)

Law, Bernice Yee-Shui; Chan, Engle Angela

2015-07-01

To explore the process of learning to speak up in practice among newly graduated registered nurses. Speaking up is an important aspect of communication to ensure patient safety within a healthcare team. However, nurses have reported being hesitant about speaking up or being unable to be heard, despite adopting various safety tools. A power differential could be a factor in their hesitation to speak up. While a large number of new graduates are employed in the lower rungs of the hospital hierarchy to resolve local and global nursing shortages, the process of their learning to speak up remains under-explored. The narrative concept of experience is addressed through the three-dimensional space of a narrative inquiry. Eighteen new graduates were recruited. Stories of experiences of speaking up emerged naturally during repeated unstructured interviews and ongoing email conversations with three participants. The complex process of learning to speak up is schematically represented. Three interrelated narrative threads were identified: (1) learning to speak up requires more than one-off training and safety tools, (2) mentoring speaking up in the midst of educative and miseducative experiences and (3) making public spaces safe for telling secret stories. Speaking up requires ongoing mentoring to see new possibilities for sustaining professional identities in the midst of miseducative experiences under the potential shaping of the Chinese culture and generational differences. Appreciative inquiry might be a new approach that can be used to promote positive cultural changes to encourage newly graduated registered nurses to learn to speak up to ensure patient safety. Cultivating a safe and open culture of communication and mentoring new graduates to speak up will benefit patient safety now and in the future by helping to retain committed patient advocates who could mentor future generations. © 2015 John Wiley & Sons Ltd.

Generational differences in factors influencing physicians to choose a work location.

Science.gov (United States)

Mathews, M; Seguin, M; Chowdhury, N; Card, R T

2012-01-01

Canadian medical schools have increased enrolment and recruited more rural students in an effort to address general and rural physician shortages. The success of this approach depends on the recruitment of these newly trained physicians to under-serviced areas. Studies from North America suggest that the career expectations and practice patterns of younger, more recently graduated physicians differ from those of their older counterparts. This study explored the factors that influenced the work location choices of physicians of differing generations, who trained at universities in Saskatchewan, and Newfoundland and Labrador, two Canadian provinces with large rural populations and no community larger than 235 000 population. Semi-structured, qualitative interviews were conducted with physicians who graduated from either the Memorial University of Newfoundland or the University of Saskatchewan. Generation definitions were based on the graduation year. Early-career physicians graduated between 1995 and 1999; mid-career physician graduated between 1985 and 1989; late-career physicians graduated between 1975 and 1979; and end-career physicians graduated between 1965 and 1969. Each physician was asked questions about the number and nature of work location changes over the course of their careers and the factors related to their decision to choose each location. Interview transcripts and notes were analyzed using a thematic analysis approach. Although the study focus was on generational differences, similarities and differences between universities, sexes and specialties (family physicians/GPs vs specialists) were also examined. Recruitment to the provinces was focused on as a whole, because the largest communities in the provinces are small compared with most urban communities. Forty-eight physicians were interviewed, five to nine physicians who graduated in each decade and from each university. The desire to be near family and friends was cited as the primary

New graduate nurses' perception of the workplace: have they experienced bullying?

Science.gov (United States)

Vogelpohl, Darla A; Rice, Susan K; Edwards, Mary Ellen; Bork, Christopher E

2013-01-01

This study investigated the bullying experience in the workplace of newly licensed registered nurses (RNs). Preventing newly licensed nurses from leaving the profession is important, especially because there is a nursing shortage. Education of staff and administrators provides recognition of negative behaviors in the workplace. Participants in this research study included 135 newly licensed RN's from 5 nursing schools in Northwestern Ohio licensed in years 2007-2010. Quantitative methods and a descriptive design process included chi-square tests and descriptive statistical methods. Bullying workplace behaviors were identified by participants utilizing the survey tool, the Negative Acts Questionnaire-Revised, and a questionnaire on work relationships and bullies recognized in the workplace. Nursing peers, physicians, or a patient's family were the main sources of bullying, and 29.5% had considered leaving the nursing profession. Education of staff is imperative for providing recognition of negative behaviors in the workplace. Bullying occurs in the workplace and is affecting the new graduates' work performance. Retaining newly graduated nurses is the ultimate goal for maintaining RN's in the workforce. Copyright © 2013 Elsevier Inc. All rights reserved.

Newly graduated doctors' competence in managing cardiopulmonary arrests assessed using a standardized Advanced Life Support (ALS) assessment

DEFF Research Database (Denmark)

Jensen, Morten Lind; Hesselfeldt, Rasmus; Rasmussen, Maria Birkvad

2008-01-01

Aim of the study: Several studies using a variety of assessment approaches have demonstrated that young doctors possess insufficient resuscitation competence. The aims of this study were to assess newly graduated doctors’ resuscitation competence against an internationally recognised standard and...

Newly Graduated Nurses' Job Satisfaction: Comparison with Allied Hospital Professionals, Social Workers, and Elementary School Teachers

Directory of Open Access Journals (Sweden)

Mihyun Park, PhD, RN

2012-09-01

Conclusion: Relatively dissatisfying job characteristics in nursing work environment that were significant predictors for nurses' job satisfaction should be improved. Newly graduated nurses are at risk for job dissatisfaction. This can result in high turnover rates and can exacerbate the nursing shortage. Efforts to improve the work environment are needed.

Factors associated with intended and effective settlement of nursing students and newly graduated nurses in a rural setting after graduation: a mixed-methods review.

Science.gov (United States)

Trépanier, Amélie; Gagnon, Marie-Pierre; Mbemba, Gisèle Irène Claudine; Côté, José; Paré, Guy; Fortin, Jean-Paul; Duplàa, Emmanuel; Courcy, François

2013-03-01

To identify factors that influence the initial plan and final decision to choose a rural area as first employment location in final-year nursing students or newly graduated nurses. We conducted a mixed-methods review of the literature, including both published and gray literature, using established criteria. Two reviewers performed data extraction of relevant information independently. We retrieved empirical studies from the following databases: PubMED, Embase, CINAHL (EBSCO), Web of Science (SCI and SSCI), The Cochrane Library, Business Source Premier (EBSCO), ERIC, Proquest and PsychInfo. We also searched for empirical studies in the technical and gray literature and reviewed journals related to rural health. Additionally, we conducted searches in websites such as the Center for Health Workforce Planning and Analysis, as well as Google and Google Scholar search engines. Of the 523 studies thus screened, 15 were included for data extraction. We identified more than 40 factors associated with initial plans and final decision to settle in a rural area among nursing graduates. Only limited literature is currently available on the factors associated with the intention of nursing students or newly graduated nurses of practicing in rural areas and on the relationship between intention and effective behavior. This review highlights the needs for further research in this field. Copyright © 2012 Elsevier Ltd. All rights reserved.

Impact of the rural pipeline in medical education: practice locations of recently graduated family physicians in Ontario.

Science.gov (United States)

Wenghofer, Elizabeth F; Hogenbirk, John C; Timony, Patrick E

2017-02-20

The "rural pipeline" suggests that students educated in rural, or other underserviced areas, are more likely to establish practices in such locations. It is upon this concept that the Northern Ontario School of Medicine (NOSM) was founded. Our analysis answers the following question: Are physicians who were educated at NOSM more likely to practice in rural and northern Ontario compared with physicians who were educated at other Canadian medical schools? We used data from the College of Physicians and Surgeons of Ontario. We compared practice locations of certified Ontario family physicians who had graduated from NOSM vs. other Canadian medical schools in 2009 or later. We categorized the physicians according to where they completed their undergraduate (UG) and postgraduate (PG) training, either at NOSM or elsewhere. We used logistic regression models to determine if the location of UG and PG training was associated with rural or northern Ontario practice location. Of the 535 physicians examined, 67 had completed UG and/or PG medical education at NOSM. Over two thirds of physicians with any NOSM education were practicing in northern areas and 25.4% were practicing in rural areas of Ontario compared with those having no NOSM education, with 4.3 and 10.3% in northern and rural areas, respectively. Physicians who graduated from NOSM-UG were more likely to have practices located in rural Ontario (OR = 2.57; p = 0.014) whereas NOSM-PG physicians were more likely to have practices in northern Ontario (OR = 57.88; p education was associated with an increased likelihood of practicing in rural (NOSM-UG) and northern (NOSM-PG) Ontario.

International Medical Graduates. Immigration Law and Policy and the U.S. Physician Workforce. Council on Graduate Medical Education Resource Paper. A COGME Panel Discussion (Washington, DC, March 12, 1996).

Science.gov (United States)

Health Resources and Services Administration (DHHS/PHS), Rockville, MD. Bureau of Health Professions.

This report includes presentations and discussions by the Council on Graduate Medical Education (COGME) addressing issues related to the current supply of physicians in the United States and the role of international medical graduates (IMGs). The presentations focused on the following areas: the exchange visitor program and the use of waivers, the…

Newly graduated nurses use of knowledge sources in clinical decison-making - a qualitative study

DEFF Research Database (Denmark)

Voldbjerg, Siri

Evidence-based practice has been introduced internationally as a standard for healthcare delivery to improve the quality of care, thus ensuring safe care and treatment. Evidence-based practice calls for a decision-making that specifically requires nurses to place the patient at the centre...... of clinical decisions, based on transparent, articulate and reflective use of knowledge sources. Furthermore, it is implied that nurses are able to retrieve, asses, implement and evaluate research evidence. To meet these requirements, nursing educations around the world have organised curricula to educate...... and support future nurses, enabling them to work within a framework of evidence-based practice. Recent studies underline that despite curricula interventions, newly graduated nurses’ use of research evidence and components within evidence-based practice is limited. However, it is unclear why the newly...

A profile of solo/two-physician practices.

Science.gov (United States)

Lee, Doohee; Fiack, Kelly James; Knapp, Kenneth Michael

2014-01-01

Understanding practice behaviors of solo/dual physician ownership and associated factors at the national level is important information for policymakers and clinicians in response to the Affordable Care Act (ACA) of 2010, but poorly understood in the literature. We analyzed nationally representative data (n = 4,720). The study results reveal nearly 33% of the sample reported solo/two-physician practices. Male/minority/older physicians, psychiatrists, favor small practices. Greater market competition was perceived and less charity care was given among solo/two-physician practitioners. The South region was favored by small physician practitioners. Physicians in solo or two-person practices provided fewer services to chronic patients and were dissatisfied with their overall career in medicine. Small practices were favored by international medical graduates (IMGs) and primary care physicians (PCPs). Overall our data suggest that the role of solo/dual physician practices is fading away in the delivery of medicine. Our findings shed light on varied characteristics and practice behaviors of solo/two-physician practitioners, but more research may be needed to reevaluate the potential role of small physician practitioners and find a way to foster a private physician practice model in the context of the newly passed ACA of 2010.

Trends in MD/PhD Graduates Entering Psychiatry: Assessing the Physician-Scientist Pipeline.

Science.gov (United States)

Arbuckle, Melissa R; Luo, Sean X; Pincus, Harold Alan; Gordon, Joshua A; Chung, Joyce Y; Chavez, Mark; Oquendo, Maria A

2018-06-01

The goal of this study was to identify trends in MD/PhD graduates entering psychiatry, to compare these trends with other specialties, and to review strategies for enhancing the physician-scientist pipeline. Data on 226,588 medical students graduating from Liaison Committee on Medical Education accredited programs between 1999 and 2012 (6626 MD/PhDs) were used to evaluate the number, percentage, and proportion of MD/PhDs entering psychiatry in comparison with other specialties (neurology, neurosurgery, internal medicine, family medicine, and radiation oncology). Linear regression and multiple linear regression determined whether these values increased over time and varied by sex. Over 14 years, an average of 18 MD/PhDs (range 13-29) enrolled in psychiatry each year. The number of MD/PhDs going into psychiatry significantly increased, although these gains were modest (less than one additional MD/PhD per year). The proportion of students entering psychiatry who were MD/PhDs varied between 2.9 and 5.9 per 100 residents, with no significant change over time. There was also no change in the percentage of MD/PhDs entering psychiatry from among all MD/PhD graduates. The rate of increase in the number of MD/PhDs going into psychiatry did not differ significantly from other specialties except for family medicine, which is decreasing. The rate of MD/PhDs going into psychiatry was higher for women, suggesting closure of the sex gap in 17 years. Despite the increase in the number of MD/PhDs entering psychiatry, these numbers remain low. Expanding the cohort of physician-scientists dedicated to translational research in psychiatry will require a multipronged approach.

Addressing the nation's physician workforce needs: The Society of General Internal Medicine (SGIM) recommendations on graduate medical education reform.

Science.gov (United States)

Jackson, Angela; Baron, Robert B; Jaeger, Jeffrey; Liebow, Mark; Plews-Ogan, Margaret; Schwartz, Mark D

2014-11-01

The Graduate Medical Education (GME) system in the United States (US) has garnered worldwide respect, graduating over 25,000 new physicians from over 8,000 residency and fellowship programs annually. GME is the portal of entry to medical practice and licensure in the US, and the pathway through which resident physicians develop the competence to practice independently and further develop their career plans. The number and specialty distribution of available GME positions shapes the overall composition of our national workforce; however, GME is failing to provide appropriate programs that support the delivery of our society's system of healthcare. This paper, prepared by the Health Policy Education Subcommittee of the Society of General Internal Medicine (SGIM) and unanimously endorsed by SGIM's Council, outlines a set of recommendations on how to reform the GME system to best prepare a physician workforce that can provide high quality, high value, population-based, and patient-centered health care, aligned with the dynamic needs of our nation's healthcare delivery system. These recommendations include: accurate workforce needs assessment, broadened GME funding sources, increased transparency of the use of GME dollars, and implementation of incentives to increase the accountability of GME-funded programs for the preparation and specialty selection of their program graduates.

The impact of gender and parenthood on physicians' careers--professional and personal situation seven years after graduation

OpenAIRE

Buddeberg-Fischer, B; Stamm, M; Buddeberg, C; Bauer, G; Hämmig, O; Knecht, Michaela; Klaghofer, R

2010-01-01

Abstract Background The profile of the medical profession is changing in regard to feminization, attitudes towards the profession, and the lifestyle aspirations of young physicians. The issues addressed in this study are the careers of female and male physicians seven years after graduation and the impact of parenthood on career development. Methods Data reported originates from the fifth assessment (T5) of the prospective SwissMedCareer Study, beginning in 2001 (T1). At T5 in 2009, 579 resid...

The Islamic Revolution of Iran and migration of physicians to the United States.

Science.gov (United States)

Ronaghy, Hossain A; Shajari, Anoshiravan

2013-10-01

Following the Islamic Revolution of 1979 in Iran, the trend of migration of physicians from the country continued. The total number of Iranian physicians migrated to the United States (US) increased from 1625 before revolution in 1974, to 5045 in 2010, thirty years post-revolution. The percentage of medical graduates migrating to the US, in the same period dropped from 15% to 5%. The reasons for this drop were restrictions imposed, along with creation of good postgraduate residency and fellowship programs in Iran. Following the revolution, the number of medical schools increased from 13 to 48. Despite all the restrictions and impediments for post-revolution medical graduates, over 500 medical graduates from newly established medical schools found their ways into the healthcare system of the US.     In spite of all hardships of eight years of imposed war, and 30 years of the US sanctions, Iran has been able to maintain good progress in its healthcare, education, and research in medicine and other branches of science and technology.

COGME 1995 Physician Workforce Funding Recommendations for Department of Health and Human Services' Programs. Council on Graduate Medical Education, 7th Report.

Science.gov (United States)

Council on Graduate Medical Education.

This report presents specific recommendations to the Department of Health and Human Services and Congress from the Council on Graduate Medical Education that address Medicare's direct and indirect graduate medical education (GME) payments and the monies allocated by the Public Health Service that is targeted toward physician education and primary…

Producing physician-scientists: a survey of graduates from the Harvard--MIT Program in Health Sciences and Technology.

Science.gov (United States)

Wilkerson, L; Abelmann, W H

1993-03-01

The Harvard-MIT Program in Health Sciences and Technology (HST) is a flexible, preclinical curriculum, taught by members of the faculties of both Harvard University and the Massachusetts Institute of Technology, that stresses a rigorous, scientific, quantitative approach, small classes (usually fewer than 50 students), and student-faculty interaction. The program is aimed at students with strong backgrounds in quantitative and biological sciences who are interested in careers as physician-scientists. The first 234 students of the program, who graduated between 1975 and 1985, were asked to participate in a 1990 follow-up study by completing a four-page questionnaire and submitting curricula vitae and lists of publications, if available. Data were analyzed quantitatively and qualitatively. Of the 234 graduates, 211 (90%) responded. Sixty-three (30%) had received both MD and PhD degrees. The graduates were twice as likely to describe their primary professional roles as academic than as clinical practice; 94 held full-time faculty positions at 50 medical schools. The 154 (73%) in research spent an average of 51% of their time on this activity. According to the 179 graduates (85%) who stated that they would choose HST again, the most frequently mentioned reasons were the quantitative approach that emphasized integration of basic science and clinical practice (49%) and the small class size (37%). The HST MD curriculum, with its emphasis on basic science and research experience, has been successful in preparing carefully selected students for careers as physician-scientists, without necessarily requiring the completion of a PhD degree.

22 CFR 62.27 - Alien physicians.

Science.gov (United States)

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Alien physicians. 62.27 Section 62.27 Foreign... Provisions § 62.27 Alien physicians. (a) Purpose. Pursuant to the Mutual Educational and Cultural Exchange... Foreign Medical Graduates must sponsor alien physicians who wish to pursue programs of graduate medical...

[Self perception of clinical competences declared by recently graduated physicians of the University of Chile].

Science.gov (United States)

Millán K, Teresa; Ercolano F, Mariely; Pérez A, Marcela; Fuentes F, Cristián

2007-11-01

The new curriculum of the University of Chile School of Medicine includes the evaluation not only of knowledge and skills, but also abilities and attitudes. To measure the self perceived level of basic clinical competences (BCC) declared by recently graduated physicians. A self evaluation survey was designed, based on the proposed objectives of the Faculty Curriculum Committee and on an instrument used in Spanish Universities. It contained 194 questions and the possible answers were: 1.1 know what it is and it has been explained to me; 2.1 have seen it done; 3.1 have done it before under supervision; 4. I would be capable to do it under any circumstance. It was applied confidentially to 50 of a total of 170 recently graduated physicians. Perception of BCC for the diagnosis of most common diseases was felt as satisfactory. History taking and physical examination were also considered as achieved skills. Deficiencies were found in practical aspects of nursing care, obstetric and gynecological abilities and reanimation procedures. Answers may be biased considering that the survey was a self assessment procedure. However, results provide sound orientation to detect strengths and weaknesses of delivered education. Achievement of BCC is proportional to clinical practice opportunities as a student.

Accelerating physician workforce transformation through competitive graduate medical education funding.

Science.gov (United States)

Goodman, David C; Robertson, Russell G

2013-11-01

Graduate medical education (GME) has fallen short in training physicians to meet changes in the US population and health care delivery systems. The shortfall in training has happened despite a consensus on the need for accelerated change. This article discusses the varied causes of GME inertia and proposes a new funding mechanism coupled to a competitive peer-review process. The result would be to reward GME programs that are aligned with publicly set priorities for specialty numbers and training content. New teaching organizations and residency programs would compete on an equal footing with existing ones. Over a decade, all current programs would undergo peer review, with low review scores leading to partial, but meaningful, decreases in funding. This process would incentivize incremental and continual change in GME and would provide a mechanism for funding innovative training through special requests for proposals.

Racial and ethnic differences in personal cervical cancer screening amongst post-graduate physicians: Results from a cross-sectional survey

Directory of Open Access Journals (Sweden)

Ross Joseph S

2008-10-01

Full Text Available Abstract Background Racial and ethnic disparities in cervical cancer screening have been attributed to socioeconomic, insurance, and cultural differences. Our objective was to explore racial and ethnic differences in adherence to cervical cancer screening recommendations among female post-graduate physicians. Methods We conducted a cross-sectional survey at one university hospital among a convenience sample of 204 female post-graduate physicians (52% of all potential participants, examining adherence to United States Preventive Services Task Force cervical cancer screening recommendations, perception of adherence to recommendations, and barriers to obtaining care. Results Overall, 83% of women were adherent to screening recommendations and 84% accurately perceived adherence or non-adherence. Women who self-identified as Asian were significantly less adherent when compared with women who self-identified as white (69% vs. 87%; Relative Risk [RR] = 0.79, 95% Confidence Interval [CI], 0.64–0.97; P Conclusion Among a small group of insured, highly-educated physicians who have access to health care, we found racial and ethnic differences in adherence to cervical cancer screening recommendations, suggesting that culture may play a role in cervical cancer screening.

Psychometric evaluation of the Environmental Reality Shock-Related Issues and Concerns instrument for newly graduated nurses.

Science.gov (United States)

Kim, Eun-Young; Yeo, Jung Hee; Park, Hyunjeong; Sin, Kyung Mi; Jones, Cheryl B

2018-02-01

Reality shock is a critical representation of the gap between nursing education and clinical practice and it is important to explore the level of reality shock among nurses. However, there is no relevant instrument to assess the level of reality shock in South Korea. The purpose of this is to determine the validity and reliability of the Korean version of the Environmental Reality Shock-Related Issues and Concerns instrument. A cross-sectional study design was used in this study. The data collection was conducted in selected 15 hospitals in South Korea. A convenience sample of 216 newly graduated nurses participated in the study. The Korean version of the Environmental Reality Shock-Related Issues and Concerns instrument was developed through the forward-backward translation technique, and revision based on feedback from expert groups. The internal consistency reliability was assessed using Cronbach's alpha, and the construct validity was determined via exploratory and confirmatory factor analysis. The Korean version of the Environmental Reality Shock-Related Issues and Concerns has reliable internal consistency (Cronbach's alpha=0.91). Exploratory factor analysis revealed five factors including job, relationships, expectations, private life, and performance, which explained 61.92% of variance. The factor loadings ranged from 0.451 to 0.832. The five-factor structure was validated by confirmatory factor analysis (RMR0.9). It was concluded that the Korean version of the Environmental Reality Shock-Related Issues and Concerns instrument has satisfactory construct validity and reliability to measure the reality shock of newly graduated nurses in South Korea. Copyright © 2017 Elsevier Ltd. All rights reserved.

Forms of Knowledge Incorporated in Clinical Decision-making among Newly-Graduated Nurses: A Metasynthesis

DEFF Research Database (Denmark)

Voldbjerg, Siri; Elgaard Sørensen, Erik; Grønkjær, Mette

2014-01-01

Clinical-decision-making is of decisive importance to how evidence-based practice is put into practice. Schools of Nursing have a responsibility to teach and train nursing students to make clinical decisions within a frame of evidence-based practice. Clinical decision-making among nurses has been...... explored from numerous angles using a diversity of methodologies. Existing research has mainly focused on promoting and inhibiting factors for implementation of evidence-based practice and incorporation of research evidence in the clinical-decision. Little attention has been given to the nurses' behavior......, including the knowledge that actually informs the newly graduated nurses’ clinical decision. The aim of the study is to combine and synthesize results from qualitative research. Noblit and Hare’s meta-ethnographic approach is used to conduct a metasynthesis of qualitative research that has studied...

Accounting for graduate medical education production of primary care physicians and general surgeons: timing of measurement matters.

Science.gov (United States)

Petterson, Stephen; Burke, Matthew; Phillips, Robert; Teevan, Bridget

2011-05-01

Legislation proposed in 2009 to expand GME set institutional primary care and general surgery production eligibility thresholds at 25% at entry into training. The authors measured institutions' production of primary care physicians and general surgeons on completion of first residency versus two to four years after graduation to inform debate and explore residency expansion and physician workforce implications. Production of primary care physicians and general surgeons was assessed by retrospective analysis of the 2009 American Medical Association Masterfile, which includes physicians' training institution, residency specialty, and year of completion for up to six training experiences. The authors measured production rates for each institution based on physicians completing their first residency during 2005-2007 in family or internal medicine, pediatrics, or general surgery. They then reassessed rates to account for those who completed additional training. They compared these rates with proposed expansion eligibility thresholds and current workforce needs. Of 116,004 physicians completing their first residency, 54,245 (46.8%) were in primary care and general surgery. Of 683 training institutions, 586 met the 25% threshold for expansion eligibility. At two to four years out, only 29,963 physicians (25.8%) remained in primary care or general surgery, and 135 institutions lost eligibility. A 35% threshold eliminated 314 institutions collectively training 93,774 residents (80.8%). Residency expansion thresholds that do not account for production at least two to four years after completion of first residency overestimate eligibility. The overall primary care production rate from GME will not sustain the current physician workforce composition. Copyright © by the Association of American medical Colleges.

Physician-scientist: Attitude of Graduates of Clinical Medicine Graduate Schools

Directory of Open Access Journals (Sweden)

Ken N. Kuo

2008-07-01

Conclusion: The physician-scientist has a unique ability to bridge the gap between bench/laboratory and bedside. In a changing socioeconomic climate as well as cultural evolution in medical practice, external pressures are unavoidable. The support of research from institutions or government is very important, as are financial resources, space and equipment. For those physicians who are going into research, a special training of strict methodology in research will obviously become necessary.

Medical school type and physician income.

Science.gov (United States)

Weeks, William B; Wallace, Tanner A

2008-01-01

We wanted to determine whether the type of medical school attended--private US, public US, or foreign medical school--is associated with practice characteristics or incomes of physicians. Therefore, we used survey responses obtained during the 1990s from 10,436 actively practicing white male physicians who worked in one of 13 medical specialties and who graduated from a public US (5,702), private US (3,797), or international (937) medical school. We used linear regression modeling to determine the association between type of medical school attended and physicians' annual incomes after controlling for specialty, work hours, provider characteristics, and practice characteristics. We found that, for most specialties, international medical school graduates worked longer hours, were less likely to be board certified, had practiced medicine for fewer years, and were less likely to work in rural settings than US medical school graduates. After controlling for key variables, international medical school graduates' annual incomes were 2.6 percent higher (95% CI: 0.1%, 4.4%, p = .043) and public US medical school graduates' were 2.2 percent higher (95% CI: -0.9% -6.1%, p = 0.2) than private US medical school graduates' incomes. Because of their lower tuition expenses, international and public US medical school graduates may experience higher returns on educational investment than their counterparts who graduated from private US medical schools.

University Environment Experience of the First Two Years of University Graduates at a Newly Established Small University Located in Suburban Area in Taiwan

Science.gov (United States)

Lin, Yii-Nii

2011-01-01

The purpose of this study is to describe students' university environment experience from the perspectives of the first two years of university graduates of a newly established small university located in suburban area in Taiwan. A qualitative method of phenomenology with in-depth interviews is adopted. Fourteen male and sixteen female seniors,…

Job and career satisfaction and turnover intentions of newly graduated nurses.

Science.gov (United States)

Laschinger, Heather K Spence

2012-05-01

To describe new graduate nurses' worklife experiences in Ontario hospital settings in the first 2 years of practice and to examine predictors of job and career satisfaction and turnover intentions. With a large cohort of nurses approaching retirement, every effort must be made to ensure that the work environments of new graduate nurses are positive, promoting job satisfaction and commitment to the profession to address the nursing workforce shortage. A cross-sectional analysis of data from a mail survey of new graduate nurses (n=342) in their first and second year of experience was used to address the research objectives. Overall, new graduate nurses were positive about their working conditions and there were few differences between nurses in their first and second years of practice. Structural and personal factors explained significant amounts of variance (31-68%) in both job and career satisfaction and turnover intentions. Empowerment, work engagement and burnout were important significant predictors. Modifiable workplace factors play an important role in influencing new graduates' job and career satisfaction and turnover intentions. Managers can employ strategies to enhance quality work environments that promote retention of new graduates and lessen the nursing workforce shortage. © 2011 Blackwell Publishing Ltd.

The role of MD and MBA training in the professional development of a physician: a survey of 30 years of graduates from the Wharton Health Care Management Program.

Science.gov (United States)

Patel, Mitesh S; Arora, Vishal; Patel, Mamta S; Kinney, June M; Pauly, Mark V; Asch, David A

2014-09-01

The number of medical schools offering MD and MBA training has increased fivefold in the last two decades. The authors evaluated graduates' perceptions of the role of such training on their career and professional development. In 2011, the authors surveyed physician graduates from the Wharton School MBA Program in Heath Care Management at the University of Pennsylvania from 1981 to 2010. Survey responses were analyzed and evaluated using grounded theory. Among 247 eligible graduates, 59.9% (148/247) completed the questionnaire and 89.9% (133/148) of them provided free-text responses. Approximately 85.1% (126/148) of respondents were male and 79.7% (118/148) entered residency training; however, both rates declined slightly over time. Among respondents within their first decade after graduation, 46.2% (24/52) reported clinical practice as their primary work sector compared with 39.5% (15/38) among respondents 11 to 20 years after graduation and 19.2% (5/26) of respondents 21 to 30 years after graduation. Overall, graduates reported mostly positive attitudes and often noted the benefits of career acceleration, professional flexibility, and credibility in multidisciplinary domains. The few negative remarks were focused on the opportunity cost of time and how peers in one discipline may negatively perceive the role of the other discipline's degree. Graduates with an MD and MBA report mostly positive attitudes towards their training, and many are pursuing leadership and primarily nonclinical roles later in their careers. These findings reveal new insights for policies affecting physician workforce. Further study is necessary to evaluate whether similar trends exist more broadly.

Difficulties facing physician mothers in Japan.

Science.gov (United States)

Yamazaki, Yuka; Kozono, Yuki; Mori, Ryo; Marui, Eiji

2011-11-01

Despite recent increases in the number of female physicians graduating in Japan, their premature resignations after childbirth are contributing to the acute shortage of physicians. Previous Japanese studies have explored supportive measures in the workplace, but have rarely focused on the specific problems or concerns of physician-mothers. Therefore, this study explored the challenges facing Japanese physician-mothers in efforts to identify solutions for their retention. Open-ended questionnaires were mailed to 646 alumnae of Juntendo University School of Medicine. We asked subjects to describe their opinions about 'The challenges related to female physicians' resignations'. Comments gathered from alumnae who graduated between 6 and 30 years ago and have children were analyzed qualitatively. Overall, 249 physicians returned the questionnaire (response rate 38.5%), and 73 alumnae with children who graduated in the stated time period provided comments. The challenges facing physician-mothers mainly consisted of factors associated with Japanese society, family responsibilities, and work environment. Japanese society epitomized by traditional gender roles heightened stress related to family responsibilities and promoted gender discrimination at work environment. Additionally, changing Japanese society positively influenced working atmosphere and husband's support. Moreover, the introduction of educational curriculums that alleviated traditional gender role was proposed for pre- and post- medical students. Traditional gender roles encourage discrimination by male physicians or work-family conflicts. The problems facing female physicians involve more than just family responsibilities: diminishing the notion of gender role is key to helping retain them in the workforce. © 2011 Tohoku University Medical Press

[Assessment of moral competence of physicians].

Science.gov (United States)

Agurto, Mariela; Tello, Daniel; Elgueta, Alfredo; Larrea, Ricardo; Minaeff, Tamara; Miranda, Alejandro; Parodi, Ezio; Salas, Juan M; Vukusich, Antonio; Llanos, Semiramis; Daza, Pamela; López, Sebastián

2017-09-01

Moral competence (MC) in physicians is fundamental, given the increasing complexity of medicine. The "Moral Competence Test" (MCT © Lind) evaluates this feature and its indicator is the C Index (CI). To explore moral competence and its associated factors among physicians working in Chile. The MCT was answered by 236 physicians from two medical centers who voluntarily participated in the study. Besides the test, participants completed an encrypted form giving information about gender, years in practice and post-graduate studies. The average CI value of the participants was 20,9. Post-graduate studies had a significant positive influence on CI. There was a significant decrease in CI, between 16 and 20 years of professional exercise. Gender and the area of post-graduate studies did not have a significant influence. The studied physicians showed a wide range of CI which was positively affected by the postgraduate studies performed. The years of professional practice had a negative influence. Expanding training opportunities during professional practice could have a positive effect on CM as measured by CI.

Newly graduated nurses' job satisfaction: comparison with allied hospital professionals, social workers, and elementary school teachers.

Science.gov (United States)

Park, Mihyun; Lee, Ji Yun; Cho, Sung-Hyun

2012-09-01

The purposes of this study are to examine differences in job satisfaction among professional groups including nurses, allied hospital professionals, social workers, and elementary school teachers, and to identify specific characteristics of job satisfaction of nurses. The study design was a cross-sectional exploratory study using secondary data analysis with the 2009 Graduates Occupational Mobility Survey. The sample was female new graduates. The differences in job satisfaction among professional groups were analyzed using logistic regression (satisfied vs. not satisfied). Overall, 41.5% of nurses, 50.1% of allied hospital professionals, 58.2% of social workers, and 89% of elementary school teachers were satisfied with their job. Nurses were significantly less satisfied than the other professionals in 5 of the 11 job characteristics and had the lowest odds ratio (OR) when compared with elementary school teachers: work content (OR = 0.197, 95% CI [0.128, 0.304]), physical work environment (OR = 0.353, 95% CI [0.236, 0.529]), working hours (OR = 0.054, 95% CI [0.033, 0.088]), personal growth (OR = 0.242, 95% CI [0.160, 0.366]), and autonomy (OR = 0.188, 95% CI [0.123, 0.288]). Work content, physical work environment, interpersonal relationship, advancement system, and autonomy were significantly associated with the overall job satisfaction of nurses. Relatively dissatisfying job characteristics in nursing work environment that were significant predictors for nurses' job satisfaction should be improved. Newly graduated nurses are at risk for job dissatisfaction. This can result in high turnover rates and can exacerbate the nursing shortage. Efforts to improve the work environment are needed. Copyright © 2012. Published by Elsevier B.V.

Physician Requirements-1990. For Cardiology.

Science.gov (United States)

Tracy, Octavious; Birchette-Pierce, Cheryl

Professional requirements for physicians specializing in cardiology were estimated to assist policymakers in developing guidelines for graduate medical education. The determination of physician requirements was based on an adjusted needs rather than a demand or utilization model. For each illness, manpower requirements were modified by the…

The effectiveness and implementation of mentoring program for newly graduated nurses: A systematic review.

Science.gov (United States)

Zhang, Yuanyuan; Qian, Yan; Wu, Juemin; Wen, Fule; Zhang, Yaqing

2016-02-01

Newly graduated nurses suffer from occupational stress during the transition from school to employment as a result of inadequacy, interpersonal relationships, and the overwhelming workload. Mentoring programs have proved effective in facilitating this transition. To evaluate the effectiveness of a mentoring program on the mentor, mentee, and organization. The Cochrane Library, Medline, Ovid, Elsevier, Embase, CINAHL, CBM, CNKI, and WanFang Data databases were searched to identify relevant publications in English or Chinese up to October 2014. This is a systematic review. This review identified nine potentially eligible studies, and the methodological quality levels of the included studies were all ranked as level B. These studies revealed that the turnover rate can be decreased through a mentoring program. Additionally, mentoring can enhance nursing competency and establish a supportive workforce environment, resulting in positive outcomes. This review reveals that a mentoring program has positive effects on the mentors, mentees, and organizations. A successful mentorship program should include rigorous mentor selection and adequate training. Additionally, potential barriers such as time constraints and scheduling limitations should be taken into consideration during implementation. Copyright © 2015 Elsevier Ltd. All rights reserved.

Learning beyond graduation: exploring newly qualified specialists' entrance into daily practice from a learning perspective.

Science.gov (United States)

Cuyvers, Katrien; Donche, Vincent; Van den Bossche, Piet

2016-05-01

The entrance of newly qualified medical specialists into daily practice is considered to be a stressful period in which curriculum support is absent. Although engaging in both personal and professional learning and development activities is recognized fundamental for lifelong professional competence, research on medical professionals' entrance into practice is scarce. This research aims to contribute to the framework of medical professionals' informal learning and outlines the results of an exploratory study on the nature of learning in daily practice beyond postgraduate training. Eleven newly qualified physicians from different specialized backgrounds participated in a phenomenographic study, using a critical incident method and a grounded theory approach. Results demonstrated that learning in the workplace is, to a large extent, informal and associated with a variety of learning experiences. Analysis shows that experiences related to diagnostics and treatments are important sources for learning. Furthermore, incidents related to communication, changing roles, policy and organization offer learning opportunities, and therefore categorized as learning experiences. A broad range of learning activities are identified in dealing with these learning experiences. More specifically, actively engaging in actions and interactions, especially with colleagues of the same specialty, are the most mentioned. Observing others, consulting written sources, and recognizing uncertainties, are also referred to as learning activities. In the study, interaction, solely or combined with other learning activities, are deemed as very important by specialists in the initial entrance into practice. These insights can be used to develop workplace structures to support the entrance into practice following postgraduate training.

The economic impact of rural family physicians practicing obstetrics.

Science.gov (United States)

Avery, Daniel M; Hooper, Dwight E; McDonald, John T; Love, Michael W; Tucker, Melanie T; Parton, Jason M

2014-01-01

The economic impact of a family physician practicing family medicine in rural Alabama is $1,000,000 a year in economic benefit to the community. The economic benefit of those rural family physicians practicing obstetrics has not been studied. This study was designed to determine whether there was any added economic benefit of rural family physicians practicing obstetrics in rural, underserved Alabama. The Alabama Family Practice Rural Health Board has funded the University of Alabama Family Medicine Obstetrics Fellowship since its beginning in 1986. Family medicine obstetrics fellowship graduates who practice obstetrics in rural, underserved areas were sent questionnaires and asked to participate in the study. The questions included the most common types and average annual numbers of obstetrics/gynecological procedures they performed. Ten physicians, or 77% of the graduates asked to participate in the study, returned the questionnaire. Fourteen common obstetrics/gynecological procedures performed by the graduates were identified. A mean of 115 deliveries were performed. The full-time equivalent reduction in family medicine time to practice obstetrics was 20%. A family physician practicing obstetrics in a rural area adds an additional $488,560 in economic benefit to the community in addition to the $1,000,000 from practicing family medicine, producing a total annual benefit of $1,488,560. The investment of $616,385 from the Alabama Family Practice Rural Health Board resulted in a $399 benefit to the community for every dollar invested. The cumulative effect of fellowship graduates practicing both family medicine and obstetrics in rural, underserved areas over the 26 years studied was $246,047,120. © Copyright 2014 by the American Board of Family Medicine.

The Growing Demand for Hospice and Palliative Medicine Physicians: Will the Supply Keep Up?

Science.gov (United States)

Lupu, Dale; Quigley, Leo; Mehfoud, Nicholas; Salsberg, Edward S

2018-04-01

The need for hospice and palliative care is growing rapidly as the population increases and ages and as both hospice and palliative care become more accepted. Hospice and palliative medicine (HPM) is a relatively new physician specialty, currently training 325 new fellows annually. Given the time needed to increase the supply of specialty-trained physicians, it is important to assess future needs to guide planning for future training capacity. We modeled the need for and supply of specialist HPM physicians through the year 2040 to determine whether training capacity should continue growing. To create a benchmark for need, we used a population-based approach to look at the current geographic distribution of the HPM physician supply. To model future supply, we calculated the annual change in current supply by adding newly trained physicians and subtracting physicians leaving the labor force. The current U.S. supply of HPM specialists is 13.35 per 100,000 adults 65 and older. This ratio varies greatly across the country. Using alternate assumptions for future supply and demand, we project that need in 2040 will range from 10,640 to almost 24,000 HPM specialist physicians. Supply will range from 8100 to 19,000. Current training capacity is insufficient to keep up with population growth and demand for services. HPM fellowships would need to grow from the current 325 graduates annually to between 500 and 600 per year by 2030 to assure sufficient physician workforce for hospice and palliative care services given current service provision patterns. Copyright © 2018 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

The impact of gender and parenthood on physicians' careers--professional and personal situation seven years after graduation.

Science.gov (United States)

Buddeberg-Fischer, Barbara; Stamm, Martina; Buddeberg, Claus; Bauer, Georg; Häemmig, Oliver; Knecht, Michaela; Klaghofer, Richard

2010-02-18

The profile of the medical profession is changing in regard to feminization, attitudes towards the profession, and the lifestyle aspirations of young physicians. The issues addressed in this study are the careers of female and male physicians seven years after graduation and the impact of parenthood on career development. Data reported originates from the fifth assessment (T5) of the prospective SwissMedCareer Study, beginning in 2001 (T1). At T5 in 2009, 579 residents (81.4% of the initial sample at T1) participated in the questionnaire survey. They were asked about occupational factors, career-related factors including specialty choice and workplace, work-life balance and life satisfaction. The impact of gender and parenthood on the continuous variables was investigated by means of multivariate and univariate analyses of variance; categorical variables were analyzed using Chi-square tests. Female physicians, especially those with children, have lower rates of employment and show lower values in terms of career success and career support experiences than male physicians. In addition, parenthood has a negative impact on these career factors. In terms of work-life balance aspired to, female doctors are less career-oriented and are more inclined to consider part-time work or to continue their professional career following a break to bring up a family. Parenthood means less career-orientation and more part-time orientation. As regards life satisfaction, females show higher levels of satisfaction overall, especially where friends, leisure activities, and income are concerned. Compared to their male colleagues, female physicians are less advanced in their specialty qualification, are less prone to choosing prestigious surgical fields, have a mentor less often, more often work at small hospitals or in private practice, aspire less often to senior hospital or academic positions and consider part-time work more often. Any negative impact on career path and advancement is

Using Reflections of Recent Resident Graduates and their Pediatric Colleagues to Evaluate a Residency Program

Directory of Open Access Journals (Sweden)

Robert K. Kamei, M.D.

2003-01-01

Full Text Available Background and Purposes: In response to the new Accreditation Council for Graduate Medical Education (ACGME mandate for residency programs to use feedback to improve its educational program, we piloted a novel evaluation strategy of a residency program using structured interviews of resident graduates working in a primary care practice and their physician associates. Methods: A research assistant performed a structured telephone interview. Quantitative data assessing the graduate’s self-assessment and the graduate’s clinical practice by the associate were analyzed. In addition, we performed a qualitative analysis of the interviews. Results: Thirteen resident graduates in primary care practice and seven physician practice associates participated in the study. Graduate self-assessment revealed high satisfaction with their residency training and competency. The associates judged our graduates as highly competent and mentioned independent decision-making and strong interpersonal skills (such as teamwork and communication as important. They specifically cited the graduate’s skills in intensive care medicine and adolescent medicine as well as communication and teamwork skills as important contributions to their practice. Conclusions: The ACGME Outcomes Project, which increases the emphasis on educational outcomes in the accreditation of residency education programs, requires programs to provide evidence of its effectiveness in preparing residents for practice. Direct assessment of the competency of our physician graduates in practice using structured interviews of graduates and their practice associates provide useful feedback information to a residency program as part of a comprehensive evaluation plan of our program’s curriculum and can be used to direct future educational initiatives of our training program

Foreign Medical Graduates in the 1980s: Trends in Specialization.

Science.gov (United States)

Mick, Stephen S.; Worobey, Jacqueline Lowe

1984-01-01

Despite predictions of a physician surplus by 1990, graduates of foreign medical schools (both aliens and U.S. citizens) continue to flow into the United States. Secondary analysis of 1980 data suggests that graduates of foreign schools may secure their presence within the American medical system by selecting specialties where shortages exist. (KH)

Funding of Graduate Medical Education in a Market-Based Healthcare System.

Science.gov (United States)

Schuster, Barbara L

2017-02-01

The graduate medical education (GME) process in the United States is considered the most respected model for high-quality education of graduate physicians in the world. With substantial funding through government and private insurers and through structured educational accreditation standards, the American Board of Medical Specialists-certified physicians are recognized for their expertise in delivering high-quality medical care. However, under fiscal constraints and changing social expectations, questions are continually posed about the process of funding and whether the "physician outcomes" are sufficient to continue with the investment. This article reviews the history of postgraduate physician education, the multiple funding pathways, disruptions to a placid educational system and changing social expectations. The ultimate issues involve the core goals of GME and how much GME should shoulder responsibility for changing the healthcare system. Copyright © 2017 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

Physician recruitment in Ontario Provincial Psychiatric Hospitals.

Science.gov (United States)

Draper, R; Galbraith, D; Frost, B

1989-11-01

Recruitment of Physicians/Psychiatrists to staff the Ontario Provincial Psychiatric Hospitals remains an ongoing problem despite the introduction of measures such as University Affiliation and Incentive Grants. Historically there has been heavy reliance upon Foreign Medical Graduates (GOFM's) who have been denied the possibility of professional mobility and advancement because of restrictive licences. Recent changes in regulations have severely restricted the recruitment of GOFM's. During 1987, details of all physicians employed in the provincial hospitals during the preceeding five years were entered into a computerized data base. This paper presents some initial analyses which indicate that Canadian graduates have provided low levels of service, especially outside major urban centres, quite insufficient to replace the GOFM's. These findings raise urgent social and professional concerns.

Workplace discrimination: experiences of practicing physicians.

Science.gov (United States)

Coombs, Alice A Tolbert; King, Roderick K

2005-04-01

In response to a growing concern regarding physician discrimination in the workplace, this study was developed to: (1) describe the types of discrimination that exist for the practicing physician and (2) determine which groups of physicians are more likely to experience the various forms of discrimination. Surveys were mailed to 1930 practicing physicians in Massachusetts. Participants were asked if they had encountered discrimination, how significant the discrimination was against a specific group, the frequency of personal discrimination, and the type of discrimination. Factor analysis identified four types of discrimination: career advancement, punitive behaviors, practice barriers and hiring barriers. A total of 445 responses were received (a 24% response rate). Sixty-three percent of responding physicians had experienced some form of discrimination. Respondents were women (46%), racial/ethnic minorities (42%) and international medical graduates (IMGs) (40%). In addition, 26% of those classified as white were also IMGs. Over 60% of respondents believed discrimination against IMGs was very or somewhat significant. Almost 27% of males acknowledged that gender bias against females was very or somewhat significant. IMGs were more likely to indicate that discrimination against IMGs was significant in their current organization. Of U.S. medical graduates (USMGs) 44% reported that discrimination against IMGs in their current organization was significant. Nonwhites were more likely to report that discrimination based on race/ethnicity was significant. Nearly 29% of white respondents also believed that such discrimination was very or somewhat significant. Physicians practicing in academic, research, and private practice sectors experience discrimination based on gender, ethnic/racial, and IMG status.

Newly Graduated Nurses' Competence and Individual and Organizational Factors: A Multivariate Analysis.

Science.gov (United States)

Numminen, Olivia; Leino-Kilpi, Helena; Isoaho, Hannu; Meretoja, Riitta

2015-09-01

To study the relationships between newly graduated nurses' (NGNs') perceptions of their professional competence, and individual and organizational work-related factors. A multivariate, quantitative, descriptive, correlation design was applied. Data collection took place in November 2012 with a national convenience sample of 318 NGNs representing all main healthcare settings in Finland. Five instruments measured NGNs' perceptions of their professional competence, occupational commitment, empowerment, practice environment, and its ethical climate, with additional questions on turnover intentions, job satisfaction, and demographics. Descriptive statistics summarized the demographic data, and inferential statistics multivariate path analysis modeling estimated the relationships between the variables. The strongest relationship was found between professional competence and empowerment, competence explaining 20% of the variance of empowerment. The explanatory power of competence regarding practice environment, ethical climate of the work unit, and occupational commitment, and competence's associations with turnover intentions, job satisfaction, and age, were statistically significant but considerably weaker. Higher competence and satisfaction with quality of care were associated with more positive perceptions of practice environment and its ethical climate as well as higher empowerment and occupational commitment. Apart from its association with empowerment, competence seems to be a rather independent factor in relation to the measured work-related factors. Further exploration would deepen the knowledge of this relationship, providing support for planning educational and developmental programs. Research on other individual and organizational factors is warranted to shed light on factors associated with professional competence in providing high-quality and safe care as well as retaining new nurses in the workforce. The study sheds light on the strength and direction of

The impact of gender and parenthood on physicians' careers - professional and personal situation seven years after graduation

Directory of Open Access Journals (Sweden)

Knecht Michaela

2010-02-01

Full Text Available Abstract Background The profile of the medical profession is changing in regard to feminization, attitudes towards the profession, and the lifestyle aspirations of young physicians. The issues addressed in this study are the careers of female and male physicians seven years after graduation and the impact of parenthood on career development. Methods Data reported originates from the fifth assessment (T5 of the prospective SwissMedCareer Study, beginning in 2001 (T1. At T5 in 2009, 579 residents (81.4% of the initial sample at T1 participated in the questionnaire survey. They were asked about occupational factors, career-related factors including specialty choice and workplace, work-life balance and life satisfaction. The impact of gender and parenthood on the continuous variables was investigated by means of multivariate and univariate analyses of variance; categorical variables were analyzed using Chi-square tests. Results Female physicians, especially those with children, have lower rates of employment and show lower values in terms of career success and career support experiences than male physicians. In addition, parenthood has a negative impact on these career factors. In terms of work-life balance aspired to, female doctors are less career-oriented and are more inclined to consider part-time work or to continue their professional career following a break to bring up a family. Parenthood means less career-orientation and more part-time orientation. As regards life satisfaction, females show higher levels of satisfaction overall, especially where friends, leisure activities, and income are concerned. Compared to their male colleagues, female physicians are less advanced in their specialty qualification, are less prone to choosing prestigious surgical fields, have a mentor less often, more often work at small hospitals or in private practice, aspire less often to senior hospital or academic positions and consider part-time work more often

The impact of gender and parenthood on physicians' careers - professional and personal situation seven years after graduation

Science.gov (United States)

2010-01-01

Background The profile of the medical profession is changing in regard to feminization, attitudes towards the profession, and the lifestyle aspirations of young physicians. The issues addressed in this study are the careers of female and male physicians seven years after graduation and the impact of parenthood on career development. Methods Data reported originates from the fifth assessment (T5) of the prospective SwissMedCareer Study, beginning in 2001 (T1). At T5 in 2009, 579 residents (81.4% of the initial sample at T1) participated in the questionnaire survey. They were asked about occupational factors, career-related factors including specialty choice and workplace, work-life balance and life satisfaction. The impact of gender and parenthood on the continuous variables was investigated by means of multivariate and univariate analyses of variance; categorical variables were analyzed using Chi-square tests. Results Female physicians, especially those with children, have lower rates of employment and show lower values in terms of career success and career support experiences than male physicians. In addition, parenthood has a negative impact on these career factors. In terms of work-life balance aspired to, female doctors are less career-oriented and are more inclined to consider part-time work or to continue their professional career following a break to bring up a family. Parenthood means less career-orientation and more part-time orientation. As regards life satisfaction, females show higher levels of satisfaction overall, especially where friends, leisure activities, and income are concerned. Compared to their male colleagues, female physicians are less advanced in their specialty qualification, are less prone to choosing prestigious surgical fields, have a mentor less often, more often work at small hospitals or in private practice, aspire less often to senior hospital or academic positions and consider part-time work more often. Any negative impact on

Primary care careers among recent graduates of research-intensive private and public medical schools.

Science.gov (United States)

Choi, Phillip A; Xu, Shuai; Ayanian, John Z

2013-06-01

Despite a growing need for primary care physicians in the United States, the proportion of medical school graduates pursuing primary care careers has declined over the past decade. To assess the association of medical school research funding with graduates matching in family medicine residencies and practicing primary care. Observational study of United States medical schools. One hundred twenty-one allopathic medical schools. The primary outcomes included the proportion of each school's graduates from 1999 to 2001 who were primary care physicians in 2008, and the proportion of each school's graduates who entered family medicine residencies during 2007 through 2009. The 25 medical schools with the highest levels of research funding from the National Institutes of Health in 2010 were designated as "research-intensive." Among research-intensive medical schools, the 16 private medical schools produced significantly fewer practicing primary care physicians (median 24.1% vs. 33.4%, p schools. In contrast, the nine research-intensive public medical schools produced comparable proportions of graduates pursuing primary care careers (median 36.1% vs. 36.3%, p = 0.87) and matching in family medicine residencies (median 7.4% vs. 10.0%, p = 0.37) relative to the other 66 public medical schools. To meet the health care needs of the US population, research-intensive private medical schools should play a more active role in promoting primary care careers for their students and graduates.

Graduate Medical Education That Meets the Nation's Health Needs

Science.gov (United States)

Eden, Jill, Ed.; Berwick, Donald, Ed.; Wilensky, Gail, Ed.

2014-01-01

Today's physician education system produces trained doctors with strong scientific underpinnings in biological and physical sciences as well as supervised practical experience in delivering care. Significant financial public support underlies the graduate-level training of the nation's physicians. Two federal programs--Medicare and…

Educational strategies for rural new graduate registered nurses.

Science.gov (United States)

Dowdle-Simmons, Sara

2013-03-01

Rural health care facilities are geographically remote, tend to be small, and often possess limited resources. Although newly graduated registered nurses are important to the work force of many rural communities, maintaining a formal preceptorship/mentorship program within a rural hospital may prove difficult as a result of limited resources. Unfortunately, the new graduate may become overwhelmed by the many expectations for clinical practice and the facility can experience high turnover rates of new graduate hires. This article explores the unique traits of the rural hospital and the new graduate nurse as well as the pros and cons of a formal preceptorship program within a rural setting. Constructivist learning theory is used to develop practical teaching strategies that can be used by the preceptor and the new graduate. These strategies are inexpensive, yet effective, and are feasible for even the smallest of facilities. Copyright 2013, SLACK Incorporated.

Learning from Physicians with Disabilities and Their Patients.

Science.gov (United States)

DeLisa, Joel A; Lindenthal, Jacob Jay

2016-10-01

Although progress has been made in diversifying medical school admissions and faculty, this has not extended to physicians with physical disabilities. To improve our understanding of medical students and physicians with physical and sensory disabilities, the authors propose systematically gathering information on the needs and experiences of four groups: physicians who had disabilities before beginning practice, physicians whose disabilities were incurred during their medical careers, physicians drawn from those two groups, and patients of physicians with disabilities. It is hoped these data would be used by counselors, administrators, and admissions committees in advising medical school applicants with disabilities and in revising institutional policies with a view to increasing matriculation and graduation rates of medical students with disabilities. © 2016 American Medical Association. All Rights Reserved.

Physician assistant education in Germany

NARCIS (Netherlands)

M. Dierks; L. Kuilman; C. Matthews

2013-01-01

The first physician assistant (PA) program in Germany began in 2005. As of 2013 there are three PA programs operational, with a fourth to be inaugurated in the fall of 2013. The programs have produced approximately 100 graduates, all with a nursing background. The PA model of shifting tasks from

Family medicine graduate proximity to their site of training: policy options for improving the distribution of primary care access.

Science.gov (United States)

Fagan, Ernest Blake; Gibbons, Claire; Finnegan, Sean C; Petterson, Stephen; Peterson, Lars E; Phillips, Robert L; Bazemore, Andrew W

2015-02-01

The US Graduate Medical Education (GME) system is failing to produce primary care physicians in sufficient quantity or in locations where they are most needed. Decentralization of GME training has been suggested by several federal advisory boards as a means of reversing primary care maldistribution, but supporting evidence is in need of updating. We assessed the geographic relationship between family medicine GME training sites and graduate practice location. Using the 2012 American Medical Association Masterfile and American Academy of Family Physicians membership file, we obtained the percentage of family physicians in direct patient care located within 5, 25, 75, and 100 miles and within the state of their family medicine residency program (FMRP). We also analyzed the effect of time on family physician distance from training site. More than half of family physicians practice within 100 miles of their FMRP (55%) and within the same state (57%). State retention varies from 15% to 75%; the District of Columbia only retains 15% of family physician graduates, while Texas and California retain 75%. A higher percentage of recent graduates stay within 100 miles of their FMRP (63%), but this relationship degrades over time to about 51%. The majority of practicing family physicians remained proximal to their GME training site and within state. This suggests that decentralized training may be a part of the solution to uneven distribution among primary care physicians. State and federal policy-makers should prioritize funding training in or near areas with poor access to primary care services.

Preparedness for clinical practice - Perceptions of graduates and their work supervisors

International Nuclear Information System (INIS)

Mackay, S.J.; Anderson, A.C.; Hogg, P.

2008-01-01

Purpose: The standards of performance of healthcare professionals are now well defined and used to determine health professional curricula. Empirical research evidence exists in medicine and nursing which explores how well these curricula prepare their students for clinical practice but not in the radiography profession. This research aims to determine how well prepared newly qualified radiographers were for clinical practice and to identify strengths and weaknesses in their preparedness to inform curriculum development. Methods: A postal questionnaire and semi-structured interview were used to obtain data from newly qualified diagnostic radiographers and their work-based supervisors. The questionnaire assessed graduate preparedness against a number of items drawn from published documents which define UK radiographic practice. Statistical analysis, using ANOVA and Wilcoxon, examined differences between the groups' perception of preparedness. A sample of graduates and their work supervisors were interviewed to explore preparedness. Results: There were significant differences (p ≤ 0.05) between; the preparedness scores of the graduates and supervisors, with supervisors rating the graduates higher than the graduates themselves; subscales of teamwork (p ≤ 0.05), personal attributes (p ≤ 0.05) and digital skills (p ≤ 0.01). No significant differences were found between graduates employed in their training hospital and those employed elsewhere. Interview data revealed perceived areas of graduate strength, weaknesses and areas for curriculum development. Suggestions for improvement to the methodology were identified for exploring preparedness in other health professional programmes. Conclusion: The graduates were well prepared for their role as a diagnostic radiographer. Some curriculum development is needed in specific areas and advice on methodological improvement is offered

A longitudinal study of the characteristics and performances of medical students and graduates from the Arab countries.

Science.gov (United States)

Tekian, Ara; Boulet, John

2015-11-05

While international physician migration has been studied extensively, more focused and regional explorations are not commonplace. In many Arab countries, medical education is conducted in English and students/graduates seek postgraduate opportunities in other countries such as the United States (US). Eligibility for residency training in the US requires certification by the Educational Commission for Foreign Medical Graduates (ECFMG). This study investigates ECFMG application trends, examination performance, and US physician practice data to quantify the abilities and examine the career pathways of Arab-trained physicians. Medical students and graduates from 15 Arab countries where English is the language of medical school instruction were studied. The performances (1(st) attempt pass rates) of individuals on the United States Medical Licensing Examination Step 1, Step 2CK (clinical knowledge), and and a combination of Step 2CS (clinical skills) and ECFMG CSA (clinical skills assessment) were tallied and contrasted by country. Based on physician practice data, the contribution of Arab-trained physicians to the US healthcare workforce was explored. Descriptive statistics (means, frequencies) were used to summarize the collected data. Between 1998 and 2012, there has been an increase in the number of Arab trained students/graduates seeking ECFMG certification. Examination performance varied considerably across countries, suggesting differences in the quality of medical education programs in the Eastern Mediterranean Region. Based on current US practice data, physicians from some Arab countries who seek postgraduate opportunities in the US are less likely to stay in the US following specialty training. Countries, or regions, with concerns about physician migration, physican performance, or the pedagogical quality of their training programs should conduct longitudinal research studies to help inform medical education policies.

Supply and Distribution of Physicians and Physician Extenders. A Background Paper Prepared for the Graduate Medical Education National Advisory Committee

Science.gov (United States)

Health Resources Administration (DHEW/PHS), Bethesda, MD. Div. of Medicine.

Inequities of access to health care and service provisions are considered to be major problems by health policy-makers today. These inequities result from disparities in physician distribution by specialty and geography that are concealed by aggregate analyses of physician supply. This paper describes what is presently known about physician supply…

Generation of physician-scientists manpower: a follow-up study of the first 294 graduates of the Harvard-MIT Program of Health Sciences and Technology.

Science.gov (United States)

Abelmann, W H; Nave, B D; Wilkerson, L

1997-06-01

The MD program of the Harvard-MIT Division of Health Sciences and Technology was founded in 1970. One of its goals was the application of the academic resources of the two universities to the education of leaders in academic medicine and biomedical sciences. The first MD class was admitted in 1971. Prerequisites for admission are a strong background in quantitative sciences and demonstrated interest in research. Research and a thesis are obligatory. Enrollment in a PhD program is elective. Questionnaires were sent to 293 alumni who graduated from the MD program between 1975 and 1988, followed up by letters and telephone calls. By 1988, 296 students had graduated, 207 with an MD only, 89 with MD-PhD degrees. Follow-up by questionnaires of 293 living graduates (92%), plus indirect data on 11 others, revealed that 212 (75%) held faculty appointments in 64 medical schools. Overall, 73.5% of respondents were engaged in research: 68% of MDs and 86% of MD-PhDs. One hundred and four (38%) respondents spent more than 50% of their time on research: 54 (29%) of MDs and 50 (60%) of MD-PhDs. Seventy-five percent of respondents were active in teaching. Our experience indicates that both an MD-PhD program and a research-oriented MD program are effective in producing physician-scientists and leaders in academic medicine.

Using email reminders to engage physicians in an Internet-based CME intervention

Directory of Open Access Journals (Sweden)

Wall Terry

2004-09-01

Full Text Available Abstract Background Engaging practicing physicians in educational strategies that reinforce guideline adoption and improve the quality of healthcare may be difficult. Push technologies such as email offer new opportunities to engage physicians in online educational reinforcing strategies. The objectives are to investigate 1 the effectiveness of email announcements in engaging recruited community-based primary care physicians in an online guideline reinforcement strategy designed to promote Chlamydia screening, 2 the characteristics of physicians who respond to email announcements, as well as 3 how quickly and when they respond to email announcements. Methods Over a 45-week period, 445 recruited physicians received up to 33 email contacts announcing and reminding them of an online women's health guideline reinforcing CME activity. Participation was defined as physician log-on at least once to the website. Data were analyzed to determine participation, to compare characteristics of participants with recruited physicians who did not participate, and to determine at what point and when participants logged on. Results Of 445 recruited physicians with accurate email addresses, 47.2% logged on and completed at least one module. There were no significant differences by age, race, or specialty between participants and non-participants. Female physicians, US medical graduates and MDs had higher participation rates than male physicians, international medical graduates and DOs. Physicians with higher baseline screening rates were significantly more likely to log on to the course. The first 10 emails were the most effective in engaging community-based physicians to complete the intervention. Physicians were more likely to log on in the afternoon and evening and on Monday or Thursday. Conclusions Email course reminders may enhance recruitment of physicians to interventions designed to reinforce guideline adoption; physicians' response to email reminders may

Costs of a medical education: comparison with graduate education in law and business.

Science.gov (United States)

Kerr, Jason R; Brown, Jeffrey J

2006-02-01

The costs of graduate school education are climbing, particularly within the fields of medicine, law, and business. Data on graduate level tuition, educational debt, and starting salaries for medical school, law school, and business school graduates were collected directly from universities and from a wide range of published reports and surveys. Medical school tuition and educational debt levels have risen faster than the rate of inflation over the past decade. Medical school graduates have longer training periods and lower starting salaries than law school and business school graduates, although physician salaries rise after completion of post-graduate education. Faced with an early debt burden and delayed entry into the work force, careful planning is required for medical school graduates to pay off their loans and save for retirement.

Dilemmas of a Newly Recruited Academic Qualified Professor: A Case

Science.gov (United States)

Agrawal, Anand

2015-01-01

This case describes the situation of a newly recruited academic professor who volunteered to teach a course on Research Methods to first-term MBA students in a practitioner-oriented case method Business School. Research Methods is a unique course due to its relevance not only in business but also across all graduate programs. Instructional and…

The catastrophic collapse of morale among hospital physicians in Japan

Directory of Open Access Journals (Sweden)

Hideo Yasunaga

2008-11-01

Full Text Available Hideo YasunagaDepartment of Health Management and Policy, Graduate School of Medicine, University of Tokyo, Tokyo, JapanAbstract: The past few decades have witnessed bleak pictures of unhappy physicians worldwide. Japanese physicians working in hospitals are particularly distressed. Today, Japan’s healthcare system is near collapse because physicians are utterly demoralized. Their loss of morale is due to budget constraints, excessive demands, physician shortages, poor distribution, long working hours, hostile media, increasing lawsuits, and violence by patients. Severe cost-saving policies, inadequate distribution of healthcare resources, and the failure to communicate risks has damaged physicians’ morale and created conflicts between physicians and society. Physicians should communicate the uncertainty, limitations, and risks of modern medicine to all members of society. No resolution can be achieved unless trust exists between physicians, patients, the public, the media, bureaucrats, politicians and jurists.Keywords: physician’s morale, physician shortages, overwork, health policy

Possible reasons why female physicians publish fewer scientific articles than male physicians - a cross-sectional study.

Science.gov (United States)

Fridner, Ann; Norell, Alexandra; Åkesson, Gertrud; Gustafsson Sendén, Marie; Tevik Løvseth, Lise; Schenck-Gustafsson, Karin

2015-04-02

The proportion of women in medicine is approaching that of men, but female physicians are still in the minority as regards positions of power. Female physicians are struggling to reach the highest positions in academic medicine. One reason for the disparities between the genders in academic medicine is the fact that female physicians, in comparison to their male colleagues, have a lower rate of scientific publishing, which is an important factor affecting promotion in academic medicine. Clinical physicians work in a stressful environment, and the extent to which they can control their work conditions varies. The aim of this paper was to examine potential impeding and supportive work factors affecting the frequency with which clinical physicians publish scientific papers on academic medicine. Cross-sectional multivariate analysis was performed among 198 female and 305 male Swedish MD/PhD graduates. The main outcome variable was the number of published scientific articles. Male physicians published significantly more articles than female physicians p articles, as was collaborating with a former PhD advisor for both female physicians (OR = 2.97; 95% CI 1.22-7.20) and male physicians (OR = 2.10; 95% CI 1.08-4.10). Control at work was significantly associated with a higher number of published articles for male physicians only (OR = 1.50; 95% CI 1.08-2.09). Exhaustion had a significant negative impact on number of published articles among female physicians (OR = 0.29; 95% CI 0.12-0.70) whilst the publishing rate among male physicians was not affected by exhaustion. Women physicians represent an expanding sector of the physician work force; it is essential that they are represented in future fields of research, and in academic publications. This is necessary from a gender perspective, and to ensure that physicians are among the research staff in biomedical research in the future.

Report of survey results for newly licensed registered nurses in Washington state.

Science.gov (United States)

Hirsch, Anne M

2011-10-01

Current projections for the need for nurses in Washington state are based on an increase in the need for health care, the aging of the population, and the inability of the nursing educational institutions to supply adequate numbers of graduates. Yet many new graduates are providing anecdotal evidence that they cannot find a job in nursing. This study gathered information regarding the employment of newly licensed registered nurses in Washington between May 2009 and August 2010. Questionnaires were administered to a randomly selected sample of 2,200 newly licensed nurses; 532 responses were returned. Nearly 81% reported current employment as a registered nurse and 69.5% reported that they were very or somewhat satisfied with their employment situation. The job search strategies, type of job sought, and factors contributing to their success are reported. Factors contributing to the success of their job search and to job dissatisfaction are explored. Copyright 2011, SLACK Incorporated.

The influence of authentic leadership on newly graduated nurses' experiences of workplace bullying, burnout and retention outcomes: a cross-sectional study.

Science.gov (United States)

Spence Laschinger, Heather K; Wong, Carol A; Grau, Ashley L

2012-10-01

Retaining skilled and engaged nurses is critical during a time of shortage, however growing reports of workplace bullying threaten nurses' health and wellbeing, especially the transition of newly graduated nurses entering the profession. High rates of burnout and turnover among new nurses puts additional strain on limited financial resources in healthcare organizations and can compromise the quality of care provided to patients. The purpose of this study is to test a model linking authentic leadership to new graduate nurses' experiences of workplace bullying and burnout, and subsequently, job satisfaction and intentions to leave their jobs. This study employed a cross-sectional survey design with 342 new graduate nurses (defined as less than two years of practice experience) working in acute care hospitals in Ontario, Canada. Participants completed a questionnaire with measures of authentic leadership, workplace bullying, burnout, job satisfaction and turnover intentions. The model was tested using path analysis techniques within structural equation modeling. The model fit indices suggested that the original hypothesized model did not adequately fit the data (χ(2)=33.59, df=5, p=.000, χ(2)/df=6.72, IFI=.937, CFI=.937, RMSEA=.130), thus an additional theoretically justified direct path from authentic leadership to job satisfaction was added, which improved the fit substantially (χ(2)=5.26, df=4, p=.261, χ(2)/df=1.32, IFI=.997, CFI=.997, RMSEA=.030). Authentic leadership had a negative direct effect on workplace bullying, which in turn had a direct positive effect on emotional exhaustion. Authentic leadership also influenced job satisfaction indirectly through bullying and emotional exhaustion. Authentic leadership, workplace bullying and emotional exhaustion all had significant direct effects on job satisfaction, which in turn, was related to lower turnover intentions. The findings from this study demonstrate the fundamental importance of authentic leadership in

Teaching Critical Thinking in Graduate Medical Education: Lessons Learned in Diagnostic Radiology.

Science.gov (United States)

Morrissey, Benjamin; Heilbrun, Marta E

2017-01-01

The 2014 Institute of Medicine report, Graduate Medical Education that Meets the Nation's Health Needs , challenged the current graduate medical training process and encouraged new opportunities to redefine the fundamental skills and abilities of the physician workforce. This workforce should be skilled in critically evaluating the current systems to improve care delivery and health. To meet these goals, current challenges, motivations, and educational models at the medical school and graduate medical education levels related to formal training in nonclinical aspects of medicine, especially critical thinking, are reviewed. Our diagnostic radiology training program is presented as a "case study" to frame the review.

Disciplinary action against physicians: who is likely to get disciplined?

Science.gov (United States)

Khaliq, Amir A; Dimassi, Hani; Huang, Chiung-Yu; Narine, Lutchmie; Smego, Raymond A

2005-07-01

We sought to determine the characteristics of disciplined physicians at-large and the risk of disciplinary action over time and to report the type and frequency of complaints and the nature of disciplinary actions against allopathic physicians in Oklahoma. Descriptive statistics, Kaplan-Meier analysis, and Cox proportional hazards modeling of publicly available data on physicians licensed by the Oklahoma Board of Medical Licensure and Supervision. Among 14,314 currently or previously licensed physicians, 396 (2.8%) had been disciplined. Using univariate proportional hazards analysis, men (P disciplinary action compared to US medical graduates (P disciplinary action, medical schools and residency training programs must continue to emphasize both patient care and medical professionalism as critical core competencies.

Delayed Workforce Entry and High Emigration Rates for Recent Canadian Radiation Oncology Graduates.

Science.gov (United States)

Loewen, Shaun K; Halperin, Ross; Lefresne, Shilo; Trotter, Theresa; Stuckless, Teri; Brundage, Michael

2015-10-01

To determine the employment status and location of recent Canadian radiation oncology (RO) graduates and to identify current workforce entry trends. A fill-in-the-blank spreadsheet was distributed to all RO program directors in December 2013 and June 2014, requesting the employment status and location of their graduates over the last 3 years. Visa trainee graduates were excluded. Response rate from program directors was 100% for both survey administrations. Of 101 graduates identified, 99 (98%) had known employment status and location. In the December survey, 5 2013 graduates (16%), 17 2012 graduates (59%), and 18 2011 graduates (75%) had permanent staff employment. Six months later, 5 2014 graduates (29%), 15 2013 graduates (48%), 24 2012 graduates (83%), and 21 2011 graduates (88%) had secured staff positions. Fellowships and temporary locums were common for those without staff employment. The proportion of graduates with staff positions abroad increased from 22% to 26% 6 months later. Workforce entry for most RO graduates was delayed but showed steady improvement with longer time after graduation. High emigration rates for jobs abroad signify domestic employment challenges for newly certified, Canadian-trained radiation oncologists. Coordination on a national level is required to address and regulate radiation oncologist supply and demand disequilibrium in Canada. Copyright © 2015 Elsevier Inc. All rights reserved.

Employer Expectations for Newly Trained Pathologists: Report of a Survey From the Graduate Medical Education Committee of the College of American Pathologists.

Science.gov (United States)

Post, Miriam D; Johnson, Kristen; Brissette, Mark D; Conran, Richard Michael; Domen, Ronald E; Hoffman, Robert D; McCloskey, Cindy B; Raciti, Patricia M; Roberts, Cory Anthony; Rojiani, Amyn M; Tucker, J Allan; Powell, Suzanne Z

2017-02-01

-Multiple sources have identified challenges that training programs face in preparing graduates for the "real world" practice of pathology, and many training programs have sought to decrease the gap between skills acquired during training and those required in practice. However, there exists the possibility that some of the difficulty experienced by newly trained pathologists and employers might arise from differences between employer expectations of new hires and what applicants expect from their first job. -To define the constellation of skills and attributes employers prioritize when hiring newly trained pathologists. -A survey of fellows of the College of American Pathologists in practice for 5 or more years in the United States was administered and the results were analyzed. -A total of 630 pathologists who were responsible for hiring a new-in-practice pathologist completed the survey. Regardless of practice setting, certain skills and attributes were rated critically important in new hires, including ethics/integrity, work ethic, and professionalism. Seventy-one percent reported having some difficulty hiring entry-level pathologists and cited inadequate training/experience during residency, and applicants having unrealistic expectations regarding work load/hours as the most common reasons. -Prospective employers not only expect well-developed diagnostic skills in their job applicants, but also require evidence of a strong work ethic and outstanding professionalism. Successful applicants must display willingness to assume responsibilities and flexibility regarding existing and new responsibilities. A secondary but important finding of this survey was that most jobs are garnered through word-of-mouth recommendations; therefore, it is crucial for pathologists-in-training to hone their networking skills.

Fertility and Childbearing Among American Female Physicians.

Science.gov (United States)

Stentz, Natalie Clark; Griffith, Kent A; Perkins, Elena; Jones, Rochelle DeCastro; Jagsi, Reshma

2016-10-01

Female physicians may experience unique challenges regarding fertility and family planning. We sought to determine childbearing patterns and decision-making among American female physicians. In 2012-2013, we surveyed a random sample of 600 female physicians who graduated medical school between 1995 and 2000. Primary outcome measures included fertility and childbearing history, reflections regarding decision-making, perceptions of workplace support, and estimations of childbearing potential. Response rate was 54.5% (327/600). A majority (82.0%) of the sample were parents, 77.4% had biological children with an average of 2.3 children. Average age at medical school graduation was 27.5 years, at completion of training (completion of medical school, residency, and/or fellowship) was 31.6 years, and at first pregnancy was 30.4 years. Nearly one quarter (24.1%) of respondents who had attempted conception were diagnosed with infertility, with an average age at diagnosis of 33.7 years. Among those with infertility, 29.3% reported diminished ovarian reserve. When asked what they would do differently in retrospect, most respondents (56.8%) would do nothing differently regarding fertility/conception/childbearing, 28.6% would have attempted conception earlier, 17.1% would have gone into a different specialty, and 7.0% would have used cryopreservation to extend fertility. Fewer of those whose first pregnancy was in medical school perceived substantial workplace support (68.2%) than those whose first pregnancies followed training (88.6%). A substantial proportion of female physicians have faced infertility or have regrets about family planning decisions and career decision-making. Combining a medical career with motherhood continues to pose challenges, meriting further investigation and targeted support.

Qualified nurses' perceptions of nursing graduates' abilities vary according to specific demographic and clinical characteristics. A descriptive quantitative study.

Science.gov (United States)

Missen, Karen; McKenna, Lisa; Beauchamp, Alison; Larkins, Jo-Ann

2016-10-01

Evidence from the literature and anecdotally from clinical settings suggests that newly graduated nurses are not fully prepared to be independent practitioners in healthcare settings. The aim of this study was to explore perceptions of qualified nurses in relation to the practice readiness of newly registered nursing graduates and determine whether these views differ according to specific demographic characteristics, clinical settings, and geographical locations. A descriptive quantitative design was used. An online survey tool was used to assess how qualified nurses (n=201) in Victoria, Australia, rated newly graduated nurses' abilities on 51 individual clinical skills/competencies in eight key skill areas. A composite score was calculated for each skill area and a comparative analysis was undertaken on the various cohorts of participants according to their demographic and clinical characteristics using one-way ANOVA and post hoc tests. Newly graduated nurses were found to be lacking competence in two key skill areas and were rated as performing adequately in the remaining six skill areas assessed. Significant differences (p≤0.05) in performance were found according to the age of the nurse, number of years registered, the educational setting in which they undertook their nurse education, their role, and the clinical area in which they worked. There were no significant differences according to whether the nurse worked in the private or public healthcare sector. Few differences were found between nurses working in a metropolitan vs. regional/rural healthcare setting. This is the first study to quantify the scale of this problem. Our findings serve as a reference for both nurse education providers and healthcare settings in better preparing nursing graduates to be competent, safe practitioners in all clinical areas. Copyright © 2016 Elsevier Ltd. All rights reserved.

Hospital restructuring and physician job satisfaction: an empirical study.

Science.gov (United States)

Mascia, Daniele; Morandi, Federica; Cicchetti, Americo

2014-02-01

The adoption of clinical directorates through the internal reconfiguration of hospital organizations has been one of the most widespread restructuring interventions in many Western European countries. Despite its extensive adoption, a lack of knowledge remains on the analysis of how this reorganization affects professionals' job satisfaction. This paper contributes to the debate on clinical directorates by exploring how the structural characteristics of newly adopted organizational models influence physician's job satisfaction. More than 300 physicians in 18 clinical directorates in the Italian National Health Service were surveyed regarding their overall job satisfaction following the introduction of departmental arrangements. Survey results were then linked to another survey that classified newly adopted models according to the criteria used to merge hospital wards into directorates, by recognizing "Process-integration", "Specialty-integration" and "Mixed-integration" types of directorates. Our findings show that structural aspects of change significantly influenced overall job satisfaction, and that a physician's openness to experience moderated the adoption and implementation of new clinical directorates. Specifically, results demonstrate that physicians with high openness to experience scores were more receptive to the positive impacts of change on overall job satisfaction. Implications for how these findings may facilitate organizational shifts within hospital settings are discussed. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Endocrine surgery fellowship graduates past, present, and future: 8 years of early job market experiences and what program directors and trainees can expect.

Science.gov (United States)

Krishnamurthy, Vikram D; Gutnick, Jesse; Slotcavage, Rachel; Jin, Judy; Berber, Eren; Siperstein, Allan; Shin, Joyce J

2017-01-01

Given the increasing number of endocrine surgery fellowship graduates, we investigated if expectations and job opportunities changed over time. American Association of Endocrine Surgeons (AAES) fellowship graduates, surgery department chairs, and physician recruiters were surveyed. Univariate analysis was performed with JMP Pro 12 software. We identified 141 graduates from 2008-2015; survey response rate was 72% (n = 101). Compared to earlier graduates, fewer academic opportunities were available for the recent graduates who intended to join them (P = .001). Unlike earlier graduates, recent graduates expected to also perform elective general surgery, which ultimately represented a greater percentage of their practices (both P job offers decreased. Overall, 84% of graduates matched their intended practice type and 98% reported being satisfied. Reponses from graduates, department chairs, and physician recruiters highlighted opportunities to improve mentor involvement, job search strategies, and online job board utilization. The endocrine surgery job market has diversified resulting in more graduates entering nonacademic practices and performing general surgery. This rapid evolution supports future analyses of the job market and opportunities for job creation. Almost every graduate reported job satisfaction, which encourages graduates to consider joining both academic and nonacademic practices equally. Copyright © 2016 Elsevier Inc. All rights reserved.

Physician and nurse supply in Serbia using time-series data.

Science.gov (United States)

Santric-Milicevic, Milena; Vasic, Vladimir; Marinkovic, Jelena

2013-06-17

Unemployment among health professionals in Serbia has risen in the recent past and continues to increase. This highlights the need to understand how to change policies to meet real and projected needs. This study identified variables that were significantly related to physician and nurse employment rates in the public healthcare sector in Serbia from 1961 to 2008 and used these to develop parameters to model physician and nurse supply in the public healthcare sector through to 2015. The relationships among six variables used for planning physician and nurse employment in public healthcare sector in Serbia were identified for two periods: 1961 to 1982 and 1983 to 2008. Those variables included: the annual total national population; gross domestic product adjusted to 1994 prices; inpatient care discharges; outpatient care visits; students enrolled in the first year of medical studies at public universities; and the annual number of graduated physicians. Based on historic trends, physician supply and nurse supply in the public healthcare sector by 2015 (with corresponding 95% confidence level) have been modeled using Autoregressive Integrated Moving Average (ARIMA) / Transfer function (TF) models. The ARIMA/TF modeling yielded stable and significant forecasts of physician supply (stationary R2 squared = 0.71) and nurse supply (stationary R2 squared = 0.92) in the public healthcare sector in Serbia through to 2015. The most significant predictors for physician employment were the population and GDP. The supply of nursing staff was, in turn, related to the number of physicians. Physician and nurse rates per 100,000 population increased by 13%. The model predicts a seven-year mismatch between the supply of graduates and vacancies in the public healthcare sector is forecasted at 8,698 physicians - a net surplus. The ARIMA model can be used to project trends, especially those that identify significant mismatches between forecasted supply of physicians and vacancies and can

[Family and career planning in young physicians].

Science.gov (United States)

Buddeberg-Fischer, Barbara; Stamm, Martina; Klaghofer, Richard

2008-01-01

The study investigates in what way physicians integrate their desire to have children into their career planning. Within the framework of a prospective cohort study of Swiss medical school graduates on career development of young physicians, beginning in 2001, 534 participants (285 women, 249 men) were assessed in January 2007, in terms of having children, planning to have children, the career aspired to and the work-family balance used or planned. Among the study participants, 19% (54) of the women and 24% (59) of the men have children. Of the others 88% plan to start a family in the future. Female physicians with children are less advanced in their careers than women without children; for male physicians no such difference can be observed. Of the female physicians with children or the desire for children 42% aspire to work in a practice, 28% to a clinical and only 4% to an academic career. Of the male physicians with children or the desire for children one third aspire to work in a practice, one third to a clinical and 14% to an academic career. The preferred model of work repartition of female physicians with children is father full time/mother part time or both parents part time; the preferred model of male physicians is father full time/mother part time or not working. Children are an important factor in the career and life planning of physicians, female physicians paying more attention to an even work-family balance than male physicians. Copyright 2008 S. Karger AG, Basel.

Dealing with suicidal patients – a challenging task: a qualitative study of young physicians' experiences

Directory of Open Access Journals (Sweden)

Talseth Anne-Grethe

2006-08-01

Full Text Available Abstract Background Suicide is a major public health problem and treating suicidal patients represents one of the most challenging and complex clinical situations for young physicians. Education of physicians is considered an important strategy in suicide prevention. Young physicians often meet suicidal patients early in their career. Limited information is available about how newly educated physicians experience treating suicidal patients. The aim of the study was to shed light on the meaning of newly educated physicians' lived experiences in treating patients at risk of committing suicide. Methods Thirteen newly educated physicians narrated their experiences with suicidal patients. The interview text was transcribed and interpreted using a phenomenological-hermeneutical method inspired by Ricoeur's philosophy. Results Three main themes and ten themes were noted: Striving for relatedness: relating with the patient; not being able to relate with the patient; Intervening competently: having adequate professional knowledge; performing professionally; having professional values; evaluating one's own competence; and Being emotionally involved: accepting one's own vulnerability; feeling morally indignant; feeling powerless and accepting one's own fallibility. The recently educated physicians clearly described the variety of emotional and ethical dilemmas that arose in meeting suicidal patients and the professional challenge facing this clinical situation. The findings were interpreted in the perspective of communication, clinical decision-making and attention to the professional's emotional reactions. Conclusion An examination of the experiences of young physicians treating suicidal patients reveals three main themes that were a professional challenge for them: Striving for relatedness, Intervening competently and Being emotionally involved. Support for young practitioners that are treating these patients is likely important both to facilitate

Is the Role of Physicians Really Evolving Due to Non-physician Clinicians Predominance in Staff Makeup in Sub-Saharan African Health Systems? Comment on "Non-physician Clinicians in Sub-Saharan Africa and the Evolving Role of Physicians".

Science.gov (United States)

Sidat, Mohsin M

2016-07-02

Health workforce shortages in Sub-Saharan Africa are widely recognized, particularly of physicians, leading the training and deployment of Non-physician clinicians (NPCs). The paper by Eyal et al provides interesting and legitimate viewpoints on evolving role of physicians in context of decisive increase of NPCss in Sub-Saharan Africa. Certainly, in short or mid-term, NPCs will continue to be a proxy solution and a valuable alternative to overcome physicians' shortages in sub-Saharan Africa. Indeed, NPCs have an important role at primary healthcare (PHC) level. Physicians at PHC level can certainly have all different roles that were suggested by Eyal et al, including those not directly related to healthcare provision. However, at secondary and higher levels of healthcare, physicians would assume other roles that are mainly related to patient clinical care. Thus, attempting to generalize the role of physicians without taking into account the context where they will work would be not entirely appropriate. It is true that often physicians start the professional carriers at PHC level and progress to other levels of healthcare particularly after clinical post-graduation training. Nevertheless, the training programs offered by medical institutions in sub-Saharan Africa need to be periodically reviewed and take into account professional and occupational roles physicians would take in context of evolving health systems in sub-Saharan Africa. © 2016 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

The experiences of newly graduated nurses during their first year of practice in the Sultanate of Oman - A case study.

Science.gov (United States)

Al Awaisi, Huda; Cooke, Hannah; Pryjmachuk, Steven

2015-11-01

Studies have demonstrated that the transition experience of new graduate nurses is complex and frequently negative, leading to dissatisfaction with nursing and increased attrition. Existing studies of new graduate nurses' transition experiences tend to be concerned with the experiences of new graduate nurses in the West. To date, no study has been conducted examining the transition experience in any Middle Eastern country where the cultural context surrounding nursing education and practice is different. To explore the experiences of new graduate nurses during their transition period in the Sultanate of Oman. A qualitative case study utilising an embedded single case design was conducted to investigate the transition experience of new nursing graduates from one university in the Sultanate of Oman. Data were collected from the perspective of new graduate nurses and also from the perspective of other key informants who are key organisational actors such as clinical instructors, managers and preceptors. As is characteristic of case study design, this study employed triangulated methods including individual and focus group interviews, observation and documentary analysis. Data collected were thematically analysed using Microsoft Access. This study showed that nursing is not an attractive choice for Omani students to study and pursue as a future career. During the transition period, new graduate nurses experienced reality shock resulting mainly from a theory-practice gap. They found themselves with limited practical experience but a high level of theoretical knowledge that was difficult to utilise in practice. They experienced many competing priorities in their working environment which resulted in task-orientation and compromised patient care. Many new graduate nurses resented their involvement in basic nursing care, which they believed should not be part of their role as degree nurses. Omani new graduate nurses' transition experiences are complex and highly affected

[Availability of physicians in Chile at the year 2004].

Science.gov (United States)

Román, Oscar; Acuña, Miguel; Señoret, Miriam

2006-08-01

The number of physicians available in a given country, their efficiency, quality and specialization is of utmost epidemiological importance. To evaluate the availability of physicians in Chile. The information about the number of physicians in Chile up to the year 2004, was obtained from the Ministry of Health, national universities and the register of immigrant physicians since 1950. The total number of physicians licensed to practice was 25,542, of whom 2,700 are immigrants. The physician/inhabitant ratio increased from 1/921 in 1998 to 1/612 in 2004. The greater impact in the increment of available physicians was given by the immigration of professionals and by the increase in the number of physicians graduated from national universities, mainly from the new private universities. Forty two percent of physicians work at public services and 61% of these are certified specialists. The regional distribution of general practitioners and basic specialists is adequate. Along the country, the mean physician/beneficiary ratio is 8.45/10,000, the specialist/beneficiary ratio is 4.9/10,000 and the general practitioner/beneficiary ratio is 2.3/10,000. The national information of available physicians, especially in the private sector, should be improved. Immigration of physicians should be regulated, maintaining validation examinations and a National Medical Test to assess medical proficiency should be instituted.

An emigration versus a globalization perspective of the Lebanese physician workforce: a qualitative study

Science.gov (United States)

2012-01-01

Background Lebanon is witnessing an increased emigration of physicians. The objective of this study was to understand the perceptions of Lebanese policymakers of this emigration, and elicit their proposals for future policies and strategies to deal with this emigration. Methods We conducted semi-structured individual interviews with the deans of Lebanon’s seven medical schools, the presidents of the two physicians professional associations, and governmental officials. We analyzed the results qualitatively. Results Participants differed in the assessment of the extent and gravity of emigration. Lebanon has a surplus of physicians, driven largely by the over-production of graduates by a growing number of medical schools. Participants cited advantages and disadvantages of the emigration on the personal, financial, medical education system, healthcare system, and national levels. Proposed strategies included limiting the number of students entering medical schools, creating job opportunities for graduating students, and implementing quality standards. Most participants acknowledged the globalization of the Lebanese physician workforce, including exchanges with the Gulf region, exchanges with developed countries, and the involvement of North American medical education institutions in the region. Conclusion Many Lebanese policy makers, particularly deans of medical schools, perceive the emigration of the physician workforce as an opportunity in the context of the globalization of the profession. PMID:22646478

An emigration versus a globalization perspective of the Lebanese physician workforce: a qualitative study.

Science.gov (United States)

Akl, Elie A; Maroun, Nancy; Rahbany, Aline; Hagopian, Amy

2012-05-30

Lebanon is witnessing an increased emigration of physicians. The objective of this study was to understand the perceptions of Lebanese policymakers of this emigration, and elicit their proposals for future policies and strategies to deal with this emigration. We conducted semi-structured individual interviews with the deans of Lebanon's seven medical schools, the presidents of the two physicians professional associations, and governmental officials. We analyzed the results qualitatively. Participants differed in the assessment of the extent and gravity of emigration. Lebanon has a surplus of physicians, driven largely by the over-production of graduates by a growing number of medical schools. Participants cited advantages and disadvantages of the emigration on the personal, financial, medical education system, healthcare system, and national levels. Proposed strategies included limiting the number of students entering medical schools, creating job opportunities for graduating students, and implementing quality standards. Most participants acknowledged the globalization of the Lebanese physician workforce, including exchanges with the Gulf region, exchanges with developed countries, and the involvement of North American medical education institutions in the region. Many Lebanese policy makers, particularly deans of medical schools, perceive the emigration of the physician workforce as an opportunity in the context of the globalization of the profession.

Health care professionals' and students' attitude toward collaboration between pharmacists and physicians in Croatia.

Science.gov (United States)

Seselja-Perisin, Ana; Mestrovic, Arijana; Klinar, Ivana; Modun, Darko

2016-02-01

As traditional roles of pharmacists and physicians seem nowadays insufficient to ensure patient safety and therapy effectiveness, interprofessional collaboration has been suggested to improve health outcomes. To assess and compare the attitudes of physicians and pharmacists, as well as medical and pharmacy students in Croatia, toward interprofessional collaboration in primary health care. The study included 513 pharmacists and physicians, and 365 students of pharmacy and medicine from Croatia. The validated questionnaire, Scale of Attitudes Toward Physician–Pharmacist Collaboration, was translated in Croatian and completed, anonymously and voluntarily, by all participants. Results Pharmacists showed a more positive attitude toward collaboration than physicians (53.8 ± 4.8 vs. 50.7 ± 5.0). Pharmacy students expressed the most positive attitude (56.2 ± 4.9), while medical students showed the remarkably lowest attitude toward collaboration (44.6 ± 6.2). Pharmacists and physicians in Croatia expressed a relatively positive attitude toward their collaboration, comparable with their colleges in the USA. On the other hand, medical students expressed a 21 % less positive attitude than pharmacy students which could have an effect on interprofessional collaboration in the future when those students start working as health care professionals. Future studies, focusing on the promotion of this collaboration, on both under-graduated and post-graduated level, are warranted.

An emigration versus a globalization perspective of the Lebanese physician workforce: a qualitative study

Directory of Open Access Journals (Sweden)

Akl Elie A

2012-05-01

Full Text Available Abstract Background Lebanon is witnessing an increased emigration of physicians. The objective of this study was to understand the perceptions of Lebanese policymakers of this emigration, and elicit their proposals for future policies and strategies to deal with this emigration. Methods We conducted semi-structured individual interviews with the deans of Lebanon’s seven medical schools, the presidents of the two physicians professional associations, and governmental officials. We analyzed the results qualitatively. Results Participants differed in the assessment of the extent and gravity of emigration. Lebanon has a surplus of physicians, driven largely by the over-production of graduates by a growing number of medical schools. Participants cited advantages and disadvantages of the emigration on the personal, financial, medical education system, healthcare system, and national levels. Proposed strategies included limiting the number of students entering medical schools, creating job opportunities for graduating students, and implementing quality standards. Most participants acknowledged the globalization of the Lebanese physician workforce, including exchanges with the Gulf region, exchanges with developed countries, and the involvement of North American medical education institutions in the region. Conclusion Many Lebanese policy makers, particularly deans of medical schools, perceive the emigration of the physician workforce as an opportunity in the context of the globalization of the profession.

Knowledge, Perceptions, and Communication about Colorectal Cancer Screening among Chinese American Primary Care Physicians

Directory of Open Access Journals (Sweden)

Wenchi Liang D.D.S., Ph.D.

2008-01-01

Full Text Available Objective To assess Chinese American primary care physicians’ knowledge, attitude, and barriers to recommending colorectal cancer (CRC screening to their Chinese American patients. Methods Chinese American primary care physicians serving Chinese American patients in two metropolitan areas were invited to complete a mailed survey on CRC screening knowledge, attitudes toward shared decision making and CRC screening, and CRC screening recommendation patterns. Results About half of the 56 respondents did not know CRC incidence and mortality figures for Chinese Americans. Those aged 50 and younger, graduating from U.S. medical schools, or working in non-private settings had higher knowledge scores ( p < 0.01. Physicians graduating from U.S. medical schools had more favorable attitudes toward shared decision making ( p < 0.01. Lack of health insurance, inconsistent guidelines, and insufficient time were the most frequently cited barriers to recommending CRC screening. Conclusions Most Chinese American physicians had knowledge, attitude, and communication barriers to making optimal CRC screening recommendations.

Medical Decision-Making Incapacity among Newly Diagnosed Older Patients with Hematological Malignancy Receiving First Line Chemotherapy: A Cross-Sectional Study of Patients and Physicians.

Directory of Open Access Journals (Sweden)

Koji Sugano

Full Text Available Decision-making capacity to provide informed consent regarding treatment is essential among cancer patients. The purpose of this study was to identify the frequency of decision-making incapacity among newly diagnosed older patients with hematological malignancy receiving first-line chemotherapy, to examine factors associated with incapacity and assess physicians' perceptions of patients' decision-making incapacity.Consecutive patients aged 65 years or over with a primary diagnosis of malignant lymphoma or multiple myeloma were recruited. Decision-making capacity was assessed using the Structured Interview for Competency and Incompetency Assessment Testing and Ranking Inventory-Revised (SICIATRI-R. Cognitive impairment, depressive condition and other possible associated factors were also evaluated.Among 139 eligible patients registered for this study, 114 completed the survey. Of these, 28 (25%, 95% confidence interval [CI]: 17%-32% were judged as having some extent of decision-making incompetency according to SICIATRI-R. Higher levels of cognitive impairment and increasing age were significantly associated with decision-making incapacity. Physicians experienced difficulty performing competency assessment (Cohen's kappa -0.54.Decision-making incapacity was found to be a common and under-recognized problem in older patients with cancer. Age and assessment of cognitive impairment may provide the opportunity to find patients that are at a high risk of showing decision-making incapacity.

Delayed Workforce Entry and High Emigration Rates for Recent Canadian Radiation Oncology Graduates

Energy Technology Data Exchange (ETDEWEB)

Loewen, Shaun K., E-mail: shaun.loewen@cancercare.mb.ca [CancerCare Manitoba, Winnipeg, MB (Canada); Halperin, Ross; Lefresne, Shilo [BC Cancer Agency, Vancouver, BC (Canada); Trotter, Theresa [Tom Baker Cancer Centre, Calgary, AB (Canada); Stuckless, Teri [Dr H. Bliss Murphy Cancer Centre, St. John' s, NL (Canada); Brundage, Michael [Cancer Centre of Southeastern Ontario, Kingston, ON (Canada)

2015-10-01

Purpose: To determine the employment status and location of recent Canadian radiation oncology (RO) graduates and to identify current workforce entry trends. Methods and Materials: A fill-in-the-blank spreadsheet was distributed to all RO program directors in December 2013 and June 2014, requesting the employment status and location of their graduates over the last 3 years. Visa trainee graduates were excluded. Results: Response rate from program directors was 100% for both survey administrations. Of 101 graduates identified, 99 (98%) had known employment status and location. In the December survey, 5 2013 graduates (16%), 17 2012 graduates (59%), and 18 2011 graduates (75%) had permanent staff employment. Six months later, 5 2014 graduates (29%), 15 2013 graduates (48%), 24 2012 graduates (83%), and 21 2011 graduates (88%) had secured staff positions. Fellowships and temporary locums were common for those without staff employment. The proportion of graduates with staff positions abroad increased from 22% to 26% 6 months later. Conclusions: Workforce entry for most RO graduates was delayed but showed steady improvement with longer time after graduation. High emigration rates for jobs abroad signify domestic employment challenges for newly certified, Canadian-trained radiation oncologists. Coordination on a national level is required to address and regulate radiation oncologist supply and demand disequilibrium in Canada.

Delayed Workforce Entry and High Emigration Rates for Recent Canadian Radiation Oncology Graduates

International Nuclear Information System (INIS)

Loewen, Shaun K.; Halperin, Ross; Lefresne, Shilo; Trotter, Theresa; Stuckless, Teri; Brundage, Michael

2015-01-01

Purpose: To determine the employment status and location of recent Canadian radiation oncology (RO) graduates and to identify current workforce entry trends. Methods and Materials: A fill-in-the-blank spreadsheet was distributed to all RO program directors in December 2013 and June 2014, requesting the employment status and location of their graduates over the last 3 years. Visa trainee graduates were excluded. Results: Response rate from program directors was 100% for both survey administrations. Of 101 graduates identified, 99 (98%) had known employment status and location. In the December survey, 5 2013 graduates (16%), 17 2012 graduates (59%), and 18 2011 graduates (75%) had permanent staff employment. Six months later, 5 2014 graduates (29%), 15 2013 graduates (48%), 24 2012 graduates (83%), and 21 2011 graduates (88%) had secured staff positions. Fellowships and temporary locums were common for those without staff employment. The proportion of graduates with staff positions abroad increased from 22% to 26% 6 months later. Conclusions: Workforce entry for most RO graduates was delayed but showed steady improvement with longer time after graduation. High emigration rates for jobs abroad signify domestic employment challenges for newly certified, Canadian-trained radiation oncologists. Coordination on a national level is required to address and regulate radiation oncologist supply and demand disequilibrium in Canada

Developing an Organizational Leadership Graduate Program: A "CHAT" about Leadership Education

Science.gov (United States)

Hughes, Patrick J.; Panzo, Donna

2015-01-01

Much of recent research on leadership education focuses on the application of a particular assignment or project to develop an individual's leadership. Other research has examined leadership development from different educational levels such as graduate, undergraduate, and even K-12. The following paper is an idea brief surrounding a newly created…

Internship for physicians in Slovenia

Directory of Open Access Journals (Sweden)

Gaber Plavc

2016-05-01

Full Text Available Background: Well-educated and highly-trained physicians are an essential part of high-quality health care. Therefore, quality assurance in medical education must be one of the priorities of health systems. We researched and analysed responses from physicians after completion of internship (IS and their mentors to questions regarding preparedness to IS and IS itself.Methods: In this cross-sectional study electronic surveys were sent to 298 physicians, having completed the IS between February 2014 and February 2015, and to their 200 mentors. Ordinal reponses of two independent groups were compared by Mann-Whitney-U test, while Kruskal-Wallis test was used for comparing more than two groups. Frequency distributions of practical procedures that were completed by interns in required quantities were compared between institutions by χ²-test. The same test was used for comparing frequency distributions of binary responses between clinical departments.Results: Statistically significant differences were found in the following: in reported preparedness for IS between graduates of the two Slovenian medical faculties; in realisation of practical procedures in quantities as prescribed in the IS program between different health institutions; in agreement with statements about satisfaction between different clinical departments and different institutions; and in reported active participation in patient care between different clinical departments.Conclusions: In this study we identified differences in phisicians' preparedness for IS between the graduates of the two Slovenian medical faculties, as well as differences in realization of IS program between health institutions and clinical departments. Alongside presented descriptive statistics these data allow evaluation of the current quality of IS in Slovenia. Furthermore, the results of this study will permit assessment of quality improvement after realisation of planned IS program renovation.

Professional and spatial mobility of osteopathic physicians.

Science.gov (United States)

Hassinger, E W; Gill, L S; Hobbs, D J; Hageman, R L

1979-12-01

The study examines changes in location of osteopathic and medical doctors in a 20-county area of rural Missouri over a 14-year period. Losses of osteopathic physicians were greater than medical doctors. However, there was a convergence over the 14-year period in background characteristics of the two types of physicians. The finding of greater spatial mobility of DOs is placed in the context of professional mobility of osteopathy. It is also argued that as practice opportunities for DOs increase, background factors associated with early socialization become more influential in choice of practice sites. The relationship of practice opportunities to choice of practice sites can be extended to foreign medical school graduates and "new health practitioners."

Effect of attitudes towards patients on sexual history taking: a survey of Iranian-American physicians in California, USA.

Science.gov (United States)

Rashidian, Mitra; Minichiello, Victor; Knutsen, Synnove F; Ghamsary, Mark

2017-11-01

Although obtaining sexual history from patients is essential, the attitudes of physicians can become a barrier to sexual health care. Iranian-American physicians may face particular challenges because talking about sexuality is considered a taboo within their culture. Our study examined these physicians' attitudes when taking a sexual history from their patients. In 2013, a self-administrated questionnaire was sent to 1550 Iranian-American physicians in California, USA. Using factor analysis, the principal components approach with a Varimax rotation was used on a set of 12-item questions (five-point Likert scales) to detect latent factors that explain attitudes affecting sexual history taking. Scores are generated to determine physicians' attitudes towards sexual history taking. In total, 354 questionnaires were returned (23% response rate). Three factors were identified as internally consistent (Cronbach's α=0.84 - 0.94): (1) attitude towards various patients; (2) female sexuality; and (3) age and marriage. Significant association were found between these three factors and some variables such as physicians' gender, country of medical graduation, religion, birthplace and age. Results revealed that cultural attitudes are important factors affecting physicians' involvement in sexual history taking. Additional studies from this population and other subpopulations of US physicians are needed. New strategies that reflect on physicians' attitude on sexual healthcare delivery is needed. If confirmed in other studies, our findings could have implications for the training of medical graduates globally.

Training the next generation of physician-executives: an innovative residency pathway in management and leadership.

Science.gov (United States)

Ackerly, D Clay; Sangvai, Devdutta G; Udayakumar, Krishna; Shah, Bimal R; Kalman, Noah S; Cho, Alex H; Schulman, Kevin A; Fulkerson, William J; Dzau, Victor J

2011-05-01

The rapidly changing field of medicine demands that future physician-leaders excel not only in clinical medicine but also in the management of complex health care enterprises. However, many physicians have become leaders "by accident," and the active cultivation of future leaders is required. Addressing this need will require multiple approaches, targeting trainees at various stages of their careers, such as degree-granting programs, residency and fellowship training, and career and leadership development programs. Here, the authors describe a first-of-its-kind graduate medical education pathway at Duke Medicine, the Management and Leadership Pathway for Residents (MLPR). This program was developed for residents with both a medical degree and management training. Created in 2009, with its first cohort enrolled in the summer of 2010, the MLPR is intended to help catalyze the emergence of a new generation of physician-leaders. The program will provide physicians-in-training with rigorous clinical exposure along with mentorship and rotational opportunities in management to accelerate the development of critical leadership and management skills in all facets of medicine, including care delivery, research, and education. To achieve this, the MLPR includes 15 to 18 months of project-based rotations under the guidance of senior leaders in many disciplines including finance, patient safety, health system operations, strategy, and others. Developing both clinical and management skill sets during graduate medical education holds the promise of engaging future leaders of health care at an early career stage, keeping more MD-MBA graduates within health care, and creating a bench of talented future physician-executives. Copyright © by the Association of American medical Colleges.

Formal public health education and career outcomes of medical school graduates.

Directory of Open Access Journals (Sweden)

Marie Krousel-Wood

Full Text Available BACKGROUND: Few data are available evaluating the associations of formal public health education with long-term career choice and professional outcomes among medical school graduates. The objective of this study was to determine if formal public health education via completion of a masters of public health (MPH degree among US medical school graduates was associated with early and long-term career choice, professional satisfaction, or research productivity. METHODS: We conducted a retrospective cohort study in 1108 physicians (17.1% completed a MPH degree who had 10-20 years of follow-up post medical school graduation. Multivariable logistic regression analyses were conducted. RESULTS: Compared to their counterparts with no MPH, medical school graduates with a MPH were more likely to have completed a generalist primary care residency only [relative risk (RR 1.79, 95% confidence interval (CI 1.35-2.29], obtain employment in an academic institution (RR 1.81; 95% CI 1.33-2.37 or government agency (RR 3.26; 95% CI 1.89-5.38, and practice public health (RR 39.84; 95% CI 12.13-107.38 or primary care (RR 1.59; 95% CI 1.18-2.05. Furthermore, medical school graduates with a MPH were more likely to conduct public health research (RR 8.79; 95% CI: 5.20-13.82, receive NIH or other federal funding (RR 3.11, 95% CI 1.74-5.33, have four or more peer-reviewed publications (RR 2.07; 95% CI 1.56-2.60, and have five or more scientific presentations (RR 2.31, 95% CI 1.70-2.98. CONCLUSION: Formal public health education via a MPH was associated with career choice and professional outcomes among physicians.

Examining the Relationships between Labour Market Mismatches, Earnings and Job Satisfaction among Immigrant Graduates in Europe

OpenAIRE

McGuinness, Seamus; Byrne, Delma

2014-01-01

This paper uses graduate survey data and econometric methods to estimate the incidence and wage/job satisfaction effects of over-education and overskilling among immigrants graduating from EU 15 based universities in 2005. Female immigrants with shorter durations of domicile were found to have a higher likelihood of overskilling. Newly arrived immigrants incurred wage penalties' which were exacerbated by additional penalties resulting from overskilling in the male labour market and overeducat...

Electronic health record in the internal medicine clinic of a Brazilian university hospital: Expectations and satisfaction of physicians and patients.

Science.gov (United States)

Duarte, Jurandir Godoy; Azevedo, Raymundo Soares

2017-06-01

To evaluate the satisfaction and expectations of patients and physicians before and after the implementation of an electronic health record (EHR) in the outpatient clinic of a university hospital. We conducted 389 interviews with patients and 151 with physicians before and after the implementation of a commercial EHR at the internal medicine clinic of Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo (HC-FMUSP), Brazil. The physicians were identified by their connection to the outpatient clinic and categorized by their years since graduation: residents and preceptors (with 10 years or less of graduation) or assistants (with more than 10 years of graduation). The answers to the questionnaire given by the physicians were classified as favorable or against the use of EHR, before and after the implementation of this system in this clinic, receiving 1 or 0 points, respectively. The sum of these points generated a multiple regression score to determine which factors contribute to the acceptance of EHR by physicians. We also did a third survey, after the EHR was routinely established in the outpatient clinic. The degree of patient satisfaction was the same before and after implementation, with more than 90% positive evaluations. They noted the use of the computer during the consultation and valued such use. Resident (younger) physicians had more positive expectations than assistants (older physicians) before EHR implementation. This optimism was reduced after implementation. In the third evaluation the use of EHR was higher among resident physicians. Resident physicians perceived and valued the EHR more and used it more. In 28 of the 57 questions on performance of clinical tasks, resident physicians found it easier to use EHR than assistant physicians with significant differences (pclinical setting should be preceded by careful planning to improve physician's adherence to the use of EHR. Patients do not seem to notice much difference to the

Intervention improves physician counseling on teen driving safety.

Science.gov (United States)

Campbell, Brendan T; Borrup, Kevin; Saleheen, Hassan; Banco, Leonard; Lapidus, Garry

2009-07-01

As part of a statewide campaign, we surveyed physician attitudes and practice regarding teen driving safety before and after a brief intervention designed to facilitate in office counseling. A 31-item self-administered survey was mailed to Connecticut physicians, and this was followed by a mailing of teen driving safety materials to physician practices in the state. A postintervention survey was mailed 8 months after the presurvey. A total of 102 physicians completed both the pre and postsurveys. Thirty-nine percent (39%) reported having had a teen in their practice die in a motor vehicle crash in the presurvey, compared with 49% in the postsurvey. Physician counseling increased significantly for a number of issues: driving while impaired from 86% to 94%; restrictions on teen driving from 53% to 64%; teen driving laws from 53% to 63%; safe vehicle from 32% to 42%; parents model safe driving from 29% to 44%; and teen-parent written contract from 15% to 37%. At baseline, the majority of physicians who provide care to teenagers in Connecticut report discussing and counseling teens on first wave teen driver safety issues (seat belts, alcohol use), but most do not discuss graduate driver licensing laws or related issues. After a brief intervention, there was a significant increase in physician counseling of teens on teen driving laws and on the use of teen-parent contracts. Additional interventions targeting physician practices can improve physician counseling to teens and their parents on issues of teen driving safety.

Psychomotor Skills for the General Professional Education of the Physician.

Science.gov (United States)

Irby, David M.; And Others

1991-01-01

A University of Washington medical faculty survey identified 43 psychomotor skills deemed essential for physicians by over 60 percent of respondents. A committee of clerkship directors refined the list to 28 skills that should be required for graduation. The data are used to specify educational objectives and design tests. (Author/MSE)

A new graduate education program in radiation therapy

International Nuclear Information System (INIS)

Beldham-Collins, Rachael; Milinkovic, Danielle

2009-01-01

Purpose: The evaluation of the Radiation Oncology Network's (RON) in house professional development year (PDY) support program was implemented to determine the appropriate teaching, learning and transfer of learning strategies that assist the newly practicing radiation therapists' transition into the busy working environment. As the AIR program saw little clinical support offered to participating new graduates and thus a need for further educational support was felt. The RON support program was initially introduced as the clinical education support component of the NSW PDY program that was introduced in 1995 by the Australian Institute of Radiography. Method: Following the facilitation of the RON PDY program over a twelve month period, qualitative feedback was obtained using a focus group consisting of new graduates from the program. Two moderators facilitated the focus group: one moderator facilitated the discussion while the second moderator transcribed it. The graduate practitioners were asked a number of questions related to the teaching and learning strategies employed by the program as well as the structure of the program. Results/discussion: The responses were analysed into the following themes: teaching and learning strategies, transfer of learning, facilitation and future learning needs. Overall the graduate practitioners found the program nurtured their skill, knowledge and attitudes appropriately at such a critical stage in their career

Standing out and moving up: performance appraisal of cultural minority physicians

NARCIS (Netherlands)

Leyerzapf, H.; Abma, T.A.; Steenwijk, R.R.; Croiset, G.; Verdonk, P.

2015-01-01

Despite a growing diversity within society and health care, there seems to be a discrepancy between the number of cultural minority physicians graduating and those in training for specialization (residents) or working as a specialist in Dutch academic hospitals. The purpose of this article is to

Exodus of male physicians from primary care drives shift to specialty practice.

Science.gov (United States)

Tu, Ha T; O'Malley, Ann S

2007-06-01

An exodus of male physicians from primary care is driving a marked shift in the U.S. physician workforce toward medical-specialty practice, according to a national study by the Center for Studying Health System Change (HSC). Two factors have helped mask the severity of the shift--a growing proportion of female physicians, who disproportionately choose primary care, and continued reliance on international medical graduates (IMGs), who now account for nearly a quarter of all U.S. primary care physicians. Since 1996-97, a 40 percent increase in the female primary care physician supply has helped to offset a 16 percent decline in the male primary care physician supply relative to the U.S. population. At the same time, primary care physicians' incomes have lost ground to both inflation and medical and surgical specialists' incomes. And women in primary care face a 22 percent income gap relative to men, even after accounting for differing characteristics. If real incomes for primary care physicians continue to decline, there is a risk that the migration of male physicians will intensify and that female physicians may begin avoiding primary care--trends that could aggravate a predicted shortage of primary care physicians.

Feeling Safe and Taking on Responsibilities: Newly Graduated Nurses' Perceptions and Evaluations of Their Transition Into a Forensic Mental Health Inpatient Setting.

Science.gov (United States)

Sørensen, Tanja; Tingleff, Ellen B; Gildberg, Frederik A

2018-03-30

Forensic mental health care is faced with serious problems in the recruitment and retention of newly graduated nurses (NGNs). Research into NGNs' experiences of their transition to and evaluations of transition programs in forensic care is sparse, and more studies are called for. This study aimed to investigate the characteristics of NGNs' experiences and perceptions of their transition into a forensic setting and their evaluations of the introduction period. Three focus group interviews were carried out, involving 13 NGNs, lasting 79.68 minutes on average. They were analyzed using thematic analysis. Results show two main themes: "feeling safe" and "taking on responsibilities." If NGNs felt overburdened with clinical responsibilities during their transition, their feeling of safety reduced. The converse also applied; theThe safer they felt, the greater clinical responsibility they felt capable of handling. The more difficult the NGNs perceived the informal transition, the more unsafe they felt, and the more negatively they perceived the responsibilities placed upon them. Tailored programs designed to support both the informal and formal transitions are recommended, along with preceptorship, theoretical training, and role-based support, such as a shift manager, along with early introduction to conflict management and security measures.

Shifting tides in the emigration patterns of Canadian physicians to the United States: a cross-sectional secondary data analysis.

Science.gov (United States)

Freeman, Thomas R; Petterson, Stephen; Finnegan, Sean; Bazemore, Andrew

2016-12-01

The relative ease of movement of physicians across the Canada/US border has led to what is sometimes referred to as a 'brain drain' and previous analysis estimated that the equivalent of two graduating classes from Canadian medical schools were leaving to practice in the US each year. Both countries fill gaps in physician supply with international medical graduates (IMGs) so the movement of Canadian trained physicians to the US has international ramifications. Medical school enrolments have been increased on both sides of the border, yet there continues to be concerns about adequacy of physician human resources. This analysis was undertaken to re-examine the issue of Canadian physician migration to the US. We conducted a cross-sectional analysis of the 2015 American Medical Association (AMA) Masterfile to identify and locate any graduates of Canadian schools of medicine (CMGs) working in the United States in direct patient care. We reviewed annual reports of the Canadian Resident Matching Service (CaRMS); the Canadian Post-MD Education Registry (CAPER); and the Canadian Collaborative Centre for Physician Resources (C3PR). Beginning in the early 1990s the number of CMGs locating in the U.S. reached an all-time high and then abruptly dropped off in 1995. CMGs are going to the US for post-graduate training in smaller numbers and, are less likely to remain than at any time since the 1970's. This four decade retrospective found considerable variation in the migration pattern of CMGs to the US. CMGs' decision to emigrate to the U.S. may be influenced by both 'push' and 'pull' factors. The relative strength of these factors changed and by 2004, more CMGs were returning from abroad than were leaving and the current outflow is negligible. This study supports the need for medical human resource planning to assume a long-term view taking into account national and international trends to avoid the rapid changes that were observed. These results are of importance to medical

The distribution and transitions of physicians in Japan: a 1974–2004 retrospective cohort study

Directory of Open Access Journals (Sweden)

Kodama Tomoko

2009-08-01

Full Text Available Abstract Background In Japan, physicians freely choose their specialty and workplace, because to date there is no management system to ensure a balanced distribution of physicians. Physicians in Japan start their careers in hospitals, then become specialists, and then gradually leave hospitals to work in private clinics and take on primary care roles in their specialty fields. The present study aimed to analyse national trends in the distribution and career transitions of physicians among types of facilities and specialties over a 30-year period. Methods We obtained an electronic file containing physician registration data from the Survey of Physicians, Dentists and Pharmacists. Descriptive statistics and data on movement between facilities (hospitals and clinics for all physicians from 1974, 1984, 1994 and 2004 were analysed. Descriptive statistics for the groups of physicians who graduated in 1970, 1980 and 1990 were also analysed, and we examined these groups over time to evaluate their changes of occupation and specialty. Results The number of physicians per 100 000 population was 113 in 1974, and rose to 212 by 2004. The number of physicians working in hospitals increased more than threefold. In Japan, while almost all physicians choose hospital-based positions at the beginning of their career, around 20% of physicians withdrew from hospitals within 10 years, and this trend of leaving hospitals was similar among generations. Physicians who graduated in 1980 and registered in general surgery, cardiovascular surgery or paediatric surgery were 10 times more likely to change their specialty, compared with those who registered in internal medicine. More than half of the physicians who registered in 1970 had changed their specialties within a period of 30 years. Conclusion The government should focus primarily on changing the physician fee schedule, with careful consideration of the balance between office-based physicians and hospital

Projecting Thailand physician supplies between 2012 and 2030: application of cohort approaches

Directory of Open Access Journals (Sweden)

Suphanchaimat Rapeepong

2013-02-01

Full Text Available Abstract Background This study forecasts physician supply between 2012 and 2030 using cohort analysis, based on future production capacity and losses from the profession, and assesses if, and by when, the projected numbers of physicians would meet the targets of one doctor per 1,500 population, as proposed by the 7th National Conference on Medical Education in 2001, and one per 1,800, proposed by the Ministry of Public Health (MoPH in 2004. Methods We estimated the annual loss rate that best reflected the dynamics of existing practising doctors, then applied this rate to the existing physicians, plus the newly licensed physicians flowing into the pool over the next two decades (from 2012 to 2030. Finally, the remaining practising physicians, after adjustment for losses, were verified against demand projections in order to identify supply gaps. Results Thailand has been experiencing an expansion in the total number of physicians, with an annual loss rate of 1%. Considering future plans for admission of medical students, the number of licensed physicians flowing into the pool should reach 2,592 per annum, and 2,661 per annum, by 2019 and 2030 respectively. By applying the 1% loss rate to the existing, and future newly licensed, physicians, there are forecast to be around 40,000 physicians in active clinical service by 2016, and in excess of 60,000 by 2028. Conclusion This supply forecast, given various assumptions, would meet the targets outlined above, of one doctor per 1,800 population, and one per 1,500 population, by 2016 and 2020 respectively. However, rapid changes in the contextual environment, e.g. economic demand, physician demographics, and disease burden, may mean that the annual loss rate of 1% used in this projection is not accurate in the future. To ensure population health needs are met, parallel policies on physician production encompassing both qualitative and quantitative aspects should be in place. Improved, up

Newly qualified doctors' views on the significance and accessibility of career advice during medical training in Saudi Arabia.

Science.gov (United States)

Mehmood, Syed Imran; Norcini, John J; Borleffs, Jan C C

2013-01-01

Career advice is an important instrument to help students with the proper specialty selection. The study aims (1) to explore the views of newly graduated doctors in Saudi Arabia about their experience with the current status of career support system during medical training and (2) to identify cross-cultural similarities and differences. A cross-sectional design study was conducted using a questionnaire to elicit the responses of participants from newly qualified doctors concerning the availability and significance of career advice. SPSS (version 11.0; Chicago, IL) was used to analyze the data and statistical tests, such as chi-square and unpaired t tests, were used to analyze the observations. A response rate of 94.7% was obtained. Among this group, 102 were males and 78 were females. Only 53% did receive career advice. The majority of men felt that career advice during medical studies was inadequate, while women were less negative (69% versus 32%; p = 0.0001). Furthermore, men were more disappointed about the possibilities for career advice after graduating than women (34% versus 13%, p = 0.0001). The results show that only half of newly graduated doctors had received any career advice during medical training. As the health care system cannot afford the potential waste of time and resources for doctors, career guidance should begin in undergraduate training so that the process of thinking about their future career starts longtime before they make their career choice.

Factors associated with patients' choice of physician in the Korean population: Database analyses of a tertiary hospital.

Directory of Open Access Journals (Sweden)

Kidong Kim

Full Text Available This study aimed to determine the factors influencing patients' choice of physician at the first visit through database analysis of a tertiary hospital in South Korea. We collected data on the first treatments performed by physicians who had treated patients for at least 3 consecutive years over 10 years (from 2003 to 2012 from the database of Seoul National University's affiliated tertiary hospital. Ultimately, we obtained data on 524,012 first treatments of 319,004 patients performed by 115 physicians. Variables including physicians' age and medical school and patients' age were evaluated as influencing factors for the number of first treatments performed by each physician in each year using a Poisson regression through generalized estimating equations with a log link. The number of first treatments decreased over the study period. Notably, the relative risk for first treatments was lower among older physicians than among younger physicians (relative risk 0.96; 95% confidence interval 0.95 to 0.98. Physicians graduating from Seoul National University (SNU also had a higher risk for performing first treatments than did those not from SNU (relative risk 1.58; 95% confidence interval 1.18 to 2.10. Finally, relative risk was also higher among older patients than among younger patients (relative risk 1.03; 95% confidence interval 1.01 to 1.04. This study systematically demonstrated that physicians' age, whether the physician graduated from the highest-quality university, and patients' age all related to patients' choice of physician at the first visit in a tertiary university hospital. These findings might be due to Korean cultural factors.

Core Competencies in Integrative Pain Care for Entry-Level Primary Care Physicians.

Science.gov (United States)

Tick, Heather; Chauvin, Sheila W; Brown, Michael; Haramati, Aviad

2015-11-01

The objective was to develop a set of core competencies for graduating primary care physicians in integrative pain care (IPC), using the Accreditation Council for Graduate Medical Education (ACGME) domains. These competencies build on previous work in competencies for integrative medicine, interprofessional education, and pain medicine and are proposed for inclusion in residency training. A task force was formed to include representation from various professionals who are involved in education, research, and the practice of IPC and who represent broad areas of expertise. The task force convened during a 1.5-day face-to-face meeting, followed by a series of surveys and other vetting processes involving diverse interprofessional groups, which led to the consensus of a final set of competencies. The proposed competencies focus on interprofessional knowledge, skills, and attitudes (KSAs) and are in line with recommendations by the Institute of Medicine, military medicine, and professional pain societies advocating the need for coordination and integration of services for effective pain care with reduced risk and cost and improved outcomes. These ACGME domain compatible competencies for physicians reflect the contributions of several disciplines that will need to be included in evolving interprofessional settings and underscore the need for collaborative care. These core competencies can guide the incorporation of KSAs within curricula. The learning experiences should enable medical educators and graduating primary care physicians to focus more on integrative approaches, interprofessional team-based, patient-centered care that use evidence-based, traditional and complementary disciplines and therapeutics to provide safe and effective treatments for people in pain. Wiley Periodicals, Inc.

Physician Emigration from Sub-Saharan Africa to the United States: Analysis of the 2011 AMA Physician Masterfile

Science.gov (United States)

Tankwanchi, Akhenaten Benjamin Siankam; Özden, Çağlar; Vermund, Sten H.

2013-01-01

Background The large-scale emigration of physicians from sub-Saharan Africa (SSA) to high-income nations is a serious development concern. Our objective was to determine current emigration trends of SSA physicians found in the physician workforce of the United States. Methods and Findings We analyzed physician data from the World Health Organization (WHO) Global Health Workforce Statistics along with graduation and residency data from the 2011 American Medical Association Physician Masterfile (AMA-PM) on physicians trained or born in SSA countries who currently practice in the US. We estimated emigration proportions, year of US entry, years of practice before emigration, and length of time in the US. According to the 2011 AMA-PM, 10,819 physicians were born or trained in 28 SSA countries. Sixty-eight percent (n = 7,370) were SSA-trained, 20% (n = 2,126) were US-trained, and 12% (n = 1,323) were trained outside both SSA and the US. We estimated active physicians (age ≤70 years) to represent 96% (n = 10,377) of the total. Migration trends among SSA-trained physicians increased from 2002 to 2011 for all but one principal source country; the exception was South Africa whose physician migration to the US decreased by 8% (−156). The increase in last-decade migration was >50% in Nigeria (+1,113) and Ghana (+243), >100% in Ethiopia (+274), and >200% (+244) in Sudan. Liberia was the most affected by migration to the US with 77% (n = 175) of its estimated physicians in the 2011 AMA-PM. On average, SSA-trained physicians have been in the US for 18 years. They practiced for 6.5 years before US entry, and nearly half emigrated during the implementation years (1984–1999) of the structural adjustment programs. Conclusion Physician emigration from SSA to the US is increasing for most SSA source countries. Unless far-reaching policies are implemented by the US and SSA countries, the current emigration trends will persist, and the US will remain a leading

Entry of US Medical School Graduates Into Family Medicine Residencies: 2015-2016.

Science.gov (United States)

Kozakowski, Stanley M; Travis, Alexandra; Bentley, Ashley; Fetter, Gerald

2016-10-01

This is the 35th national study conducted by the American Academy of Family Physicians (AAFP) that reports retrospectively the percentage of graduates from MD-granting and DO-granting medical schools who entered Accreditation Council for Graduate Medical Education (ACGME)-accredited family medicine residency programs as first-year residents. Approximately 8.7% of the 18,929 students graduating from US MD-granting medical schools and 15.5% of the 5,314 students graduating from DO-granting medical schools between July 2014 and June 2015 entered an ACGME family medicine residency in 2015. Together, 10.2% of graduates of MD- and DO-granting schools entered family medicine. Of the 1,640 graduates of the MD-granting medical schools who entered a family medicine residency in 2015, 80% graduated from 70 of the 134 schools (52%). In 2015, DO-granting medical schools graduated 823 into ACGME-accredited family medicine residencies, 80% graduating from 19 of the 32 schools (59%). In aggregate, medical schools west of the Mississippi River represent less than a third of all MD-granting schools but have a rate of students selecting family medicine that is 40% higher than schools located east of the Mississippi. Fifty-one percent (24/47) of states and territories containing medical schools produce 80% of the graduates entering ACGME-accredited family medicine residency programs. A rank order list of MD-granting medical schools was created based on the last 3 years' average percentage of graduates who became family medicine residents, using the 2015 and prior AAFP census data.

New paths in post-graduate medical training in general practice - 8 years of experience with the pilot project Verbundweiterbildungplus Baden-Württemberg.

Science.gov (United States)

Schwill, Simon; Magez, Julia; Joos, Stefanie; Steinhäuser, Jost; Ledig, Thomas; Rubik, Aline; Niebling, Wilhelm; Szecsenyi, Joachim; Flum, Elisabeth

2017-01-01

Background: In face of the looming shortage of general practitioners, primary healthcare providers and post-graduate training in general practice are increasingly becoming part of the political agenda in Germany. In 2009 the program "Verbundweiterbildung plus Baden-Württemberg" (VWB plus BW) was developed by the Competence Center for General Practice in Baden-Wuerttemberg to ensure primary healthcare in the future by enhancing the attractiveness of general medicine. This paper describes the experiences that have been gathered in developing a post-graduate training-program for physicians undergoing specialist training in general practice. Project description: The Competence Center for General Practice in Baden-Wuerttemberg supports the organization of regional networks dedicated to post-graduate medical education. First core element of the VWB plus BW program is a special seminar series for physicians pursuing post-graduate training. This seminar program is aligned with the German competency-based curriculum in general medicine and is meant to promote medical expertise and other related competencies, such as business and medical practice management and communication skills. Mentoring and advising the physicians regarding professional and personal planning form the second core element. The third core element is seen in the train-the-trainer seminars that address the competencies of the trainers. In order to focus the program's content closely on the needs of the target groups, scientifically based evaluations and research are carried out. Results: Since starting in 2009, 685 physicians have entered the program and 141 have passed the examination to become medical specialists (as of December 2016). In total, 31 networks, 60 hospitals and 211 general practices have participated. The seminar sessions have been rated on average with 1.43 on a six-point Likert scale by the physician trainees (1=extremely satisfied, 6=extremely dissatisfied). Alongside the medical

Competency of Graduate Nurses as Perceived by Nurse Preceptors and Nurse Managers

Science.gov (United States)

Wise, Vanessa

2013-01-01

As newly graduated associate degree nurses (ADN) and baccalaureate degree nurses (BSN) enter into the workforce, they must be equipped to care for a complex patient population; therefore, the purpose of this study was to address the practice expectations and clinical competency of new nurses as perceived by nurse preceptors and nurse managers.…

Factors associated with the intention to leave among newly graduated nurses in advanced-treatment hospitals in Japan.

Science.gov (United States)

Tominaga, Maki T; Miki, Akiko

2011-06-01

The early resignation of newly graduated nurses (NGNs) will become a concern in Japan as the need for nurses increases. The aim of this study was to conduct an investigation using the Effort-Reward Imbalance (ERI) questionnaire to examine the effect of stressful experiences in the work environment and over-commitment on NGNs' intention to leave and to identify the factors that were associated with their intention to leave, clarifying the appropriate times at which to conduct interventions to prevent NGNs from leaving advanced-treatment hospitals. Anonymous self-administered questionnaires were distributed to all the NGNs (n = 1364) in 14 advanced-treatment university hospitals. Questionnaires with no missing data were returned by 737 NGNs (54%). For the development of the questionnaire, we designed a framework that consisted of the factors that occur during three stages of the NGNs' transition into the workplace. The questions addressed items for individual attributes, employment and organizational characteristics, the Role Model Scale, the ERI questionnaire, two scale items for health status, and the intention to leave. In order to determine the factors that related to the dependent variables, hierarchical multiple linear regression analyses were carried out. We revealed that effort, subjective health status, role models, and effort were important factors that related to the NGNs' intention to leave, as well as their age and city size. Over-commitment and reward were not significant factors. We also found that three subscales of the Job Readiness Scale independently related to the NGNs' intention to leave. These findings can help employers, supervisors, and senior staff of advanced-treatment university hospitals in Japan to improve their work environment in order to benefit NGNs and aid in their retention. © 2010 The Authors. Japan Journal of Nursing Science © 2010 Japan Academy of Nursing Science.

Skills of primary healthcare physicians in paediatric cardiac auscultation.

Science.gov (United States)

Germanakis, Ioannis; Petridou, Eleni T H; Varlamis, George; Matsoukis, Ioannis L; Papadopoulou-Legbelou, Kiriaki; Kalmanti, Maria

2013-02-01

To evaluate the performance of primary healthcare physicians in paediatric cardiac auscultation and the impact of a multimedia-based teaching intervention. A total of 106 primary healthcare physicians (77 paediatricians, 14 general practitioners and 15 medical graduates) attended four paediatric cardiac auscultation teaching courses based on virtual patients' presentation (digital phonocardiography). Their auscultatory performance was documented at the beginning of each course and at the end of two of the courses. Participants initially detected 73% of abnormal murmurs and 17% of additional sounds, while 22% of innocent murmurs were interpreted as abnormal. Overall cardiac auscultation performance, assessed by a combined auscultation score, was low and independent of training level (graduates: 39.5/trainees: 42.8/board certified: 42.6, p = 0.89) or specialty (paediatricians: 42.7/general practitioners: 43.1, p = 0.89). Multimedia-based teaching was associated with a significant improvement in abnormal murmur (92.5%) and additional sound (40%) detection (p auscultation, independent of training level or specialty, still leave potential for improvement. Multimedia-based teaching interventions represent an effective means of improving paediatric cardiac auscultatory skills. ©2012 The Author(s)/Acta Paediatrica ©2012 Foundation Acta Paediatrica.

A new graduate education program in radiation therapy

Energy Technology Data Exchange (ETDEWEB)

Beldham-Collins, Rachael [Radiation Oncology Network, Department of Radiation Oncology, Westmead Hospital, PO Box 533, Wentworthville NSW 2145 (Australia); School of Medical Radiation Sciences, Faculty of Health Sciences, University of Sydney, PO Box 170, Lidcombe, NSW 1825 (Australia); Milinkovic, Danielle [School of Medical Radiation Sciences, Faculty of Health Sciences, University of Sydney, PO Box 170, Lidcombe, NSW 1825 (Australia)], E-mail: d.milinkovic@fhs.usyd.edu.au

2009-02-15

Purpose: The evaluation of the Radiation Oncology Network's (RON) in house professional development year (PDY) support program was implemented to determine the appropriate teaching, learning and transfer of learning strategies that assist the newly practicing radiation therapists' transition into the busy working environment. As the AIR program saw little clinical support offered to participating new graduates and thus a need for further educational support was felt. The RON support program was initially introduced as the clinical education support component of the NSW PDY program that was introduced in 1995 by the Australian Institute of Radiography. Method: Following the facilitation of the RON PDY program over a twelve month period, qualitative feedback was obtained using a focus group consisting of new graduates from the program. Two moderators facilitated the focus group: one moderator facilitated the discussion while the second moderator transcribed it. The graduate practitioners were asked a number of questions related to the teaching and learning strategies employed by the program as well as the structure of the program. Results/discussion: The responses were analysed into the following themes: teaching and learning strategies, transfer of learning, facilitation and future learning needs. Overall the graduate practitioners found the program nurtured their skill, knowledge and attitudes appropriately at such a critical stage in their career.

Is the Role of Physicians Really Evolving Due to Non-physician Clinicians Predominance in Staff Makeup in Sub-Saharan African Health Systems?; Comment on “Non-physician Clinicians in Sub-Saharan Africa and the Evolving Role of Physicians”

Directory of Open Access Journals (Sweden)

Mohsin M. Sidat

2016-12-01

Full Text Available Health workforce shortages in Sub-Saharan Africa are widely recognized, particularly of physicians, leading the training and deployment of Non-physician clinicians (NPCs. The paper by Eyal et al provides interesting and legitimate viewpoints on evolving role of physicians in context of decisive increase of NPCss in Sub-Saharan Africa. Certainly, in short or mid-term, NPCs will continue to be a proxy solution and a valuable alternative to overcome physicians’ shortages in sub-Saharan Africa. Indeed, NPCs have an important role at primary healthcare (PHC level. Physicians at PHC level can certainly have all different roles that were suggested by Eyal et al, including those not directly related to healthcare provision. However, at secondary and higher levels of healthcare, physicians would assume other roles that are mainly related to patient clinical care. Thus, attempting to generalize the role of physicians without taking into account the context where they will work would be not entirely appropriate. It is true that often physicians start the professional carriers at PHC level and progress to other levels of healthcare particularly after clinical post-graduation training. Nevertheless, the training programs offered by medical institutions in sub-Saharan Africa need to be periodically reviewed and take into account professional and occupational roles physicians would take in context of evolving health systems in sub-Saharan Africa.

Transforming Medical Education is the Key to Meeting North Carolina's Physician Workforce Needs.

Science.gov (United States)

Cunningham, Paul R G; Baxley, Elizabeth G; Garrison, Herbert G

2016-01-01

To meet the needs of the population of North Carolina, an epic transformation is under way in health care. This transformation requires that we find new ways to educate and train physicians and other health care professionals. In this commentary, we propose that the success of the Brody School of Medicine in preparing a primary care physician workforce can serve as a model for meeting the state's future physician workforce needs. Other considerations include increasing graduate medical education positions through state funding and providing incentives for medical students who stay in North Carolina. ©2016 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.

New paths in post-graduate medical training in general practice – 8 years of experience with the pilot project Verbundweiterbildung Baden-Württemberg

Directory of Open Access Journals (Sweden)

Schwill, Simon

2017-11-01

Full Text Available Background: In face of the looming shortage of general practitioners, primary healthcare providers and post-graduate training in general practice are increasingly becoming part of the political agenda in Germany. In 2009 the program “Verbundweiterbildung Baden-Württemberg” (VWB BW was developed by the Competence Center for General Practice in Baden-Wuerttemberg to ensure primary healthcare in the future by enhancing the attractiveness of general medicine. This paper describes the experiences that have been gathered in developing a post-graduate training-program for physicians undergoing specialist training in general practice.Project description: The Competence Center for General Practice in Baden-Wuerttemberg supports the organization of regional networks dedicated to post-graduate medical education. First core element of the VWB BW program is a special seminar series for physicians pursuing post-graduate training. This seminar program is aligned with the German competency-based curriculum in general medicine and is meant to promote medical expertise and other related competencies, such as business and medical practice management and communication skills. Mentoring and advising the physicians regarding professional and personal planning form the second core element. The third core element is seen in the train-the-trainer seminars that address the competencies of the trainers. In order to focus the program’s content closely on the needs of the target groups, scientifically based evaluations and research are carried out.Results: Since starting in 2009, 685 physicians have entered the program and 141 have passed the examination to become medical specialists (as of December 2016. In total, 31 networks, 60 hospitals and 211 general practices have participated. The seminar sessions have been rated on average with 1.43 on a six-point Likert scale by the physician trainees (1=extremely satisfied, 6=extremely dissatisfied. Alongside the medical

Standing Out and Moving Up: Performance Appraisal of Cultural Minority Physicians

Science.gov (United States)

Leyerzapf, Hannah; Abma, Tineke A.; Steenwijk, Reina R.; Croiset, Gerda; Verdonk, Petra

2015-01-01

Despite a growing diversity within society and health care, there seems to be a discrepancy between the number of cultural minority physicians graduating and those in training for specialization (residents) or working as a specialist in Dutch academic hospitals. The purpose of this article is to explore how performance appraisal in daily medical…

Equipping family physician trainees as teachers: a qualitative evaluation of a twelve-week module on teaching and learning.

Science.gov (United States)

de Villiers, Marietjie R; Cilliers, Francois J; Coetzee, Francois; Herman, Nicoline; van Heusden, Martie; von Pressentin, Klaus B

2014-10-22

There is a dire need to expand the capacity of institutions in Africa to educate health care professionals. Family physicians, as skilled all-rounders at district level, are potentially well placed to contribute to an extended training platform in this context. To play this role, they need to both have an understanding of their specialist role that incorporates teaching and be equipped for their role as trainers of current and future health workers and specialists. A teaching and learning capacity-building module was introduced into a new master's programme in family medicine at Stellenbosch University, South Africa. We report on the influence of this module on graduates after the first six years. A qualitative study was undertaken, interviewing thirteen graduates of the programme. Thematic analysis of data was done by a team comprising tutors and graduates of the programme and an independent researcher. Ethical clearance was obtained. The module influenced knowledge, skills and attitudes of respondents. Perceptions and evidence of changes in behaviour, changes in practice beyond the individual respondent and benefits to students and patients were apparent. Factors underlying these changes included the role of context and the role of personal factors. Contextual factors included clinical workload and opportunity pressure i.e., the pressure and responsibility to undertake teaching. Personal factors comprised self-confidence, modified attitudes and perceptions towards the roles of a family physician and towards learning and teaching, in addition to the acquisition of knowledge and skills in teaching and learning. The interaction between opportunity pressure and self-confidence influenced the application of what was learned about teaching. A module on teaching and learning influenced graduates' perceptions of, and self-reported behaviour relating to, teaching as practicing family physicians. This has important implications for educating family physicians in and for

Pre-graduate and post-graduate education in personalized medicine in the Czech Republic: statistics, analysis and recommendations.

Science.gov (United States)

Polivka, Jiri; Polivka, Jiri; Karlikova, Marie; Topolcan, Ondrej

2014-01-01

The main goal of personalized medicine is the individualized approach to the patient's treatment. It could be achieved only by the integration of the complexity of novel findings in diverse "omics" disciplines, new methods of medical imaging, as well as implementation of reliable biomarkers into the medical care. The implementation of personalized medicine into clinical practice is dependent on the adaptation of pre-graduate and post-graduate medical education to these principles. The situation in the education of personalized medicine in the Czech Republic is analyzed together with novel educational tools that are currently established in our country. The EPMA representatives in the Czech Republic in cooperation with the working group of professionals at the Faculty of Medicine in Pilsen, Charles University in Prague have implemented the survey of personalized medicine awareness among students of Faculty of Medicine in Pilsen-the "Personalized Medicine Questionnaire". The results showed lacking knowledge of personalized medicine principles and students' will of education in this domain. Therefore, several educational activities addressed particularly to medical students and young physicians were realized at our facility with very positive evaluation. These educational activities (conferences, workshops, seminars, e-learning and special courses in personalized medicine (PM)) will be a part of pre-graduate and post-graduate medical education, will be extended to other medical faculties in our country. The "Summer School of Personalized Medicine in Plzen 2015" will be organized at the Faculty of Medicine and Faculty Hospital in Pilsen as the first event on this topic in the Czech Republic.

[Availability of physicians in Chile and its middle-term projection].

Science.gov (United States)

Goić, A

1994-02-01

The availability of active physicians in Chile and its 5 and 10 years projections were studied. The number of inhabitants was estimated using the 1992 National Population Census and the number of physicians, using the 1980 records of the Chilean College of Physicians (year in which enrollment was mandatory for all physicians). A 1.6% annual population growth rate and a 5% physician mortality rate was applied (slightly lower that the general population mortality rate). The annual retirement from professional practice was estimated in 0.5% and physicians over 70 years old were considered retired. According to these figures, in 1993 the population is 13,816,990 and there are 14,400 active physicians, a physician/inhabitant relationship of 1:960 (in 1980 it was 1:1,407). The estimated number agrees with that of the 1992 National Population Census and the 1993 income tax declarations. According to projections, in 1998 Chile will have 14,958,292 inhabitants, 16,770 physicians and an inhabitant/physician relationship of 1:921. The figures for year 2003 will be 16,193,867; 18,597 and 1:871 respectively. On the other hand, the study reveals a reduction in the number of admissions to medical schools and of graduated physicians and a reduction in the annual physician population growth rate from 5 to 2% (slightly higher than the general population growth rate). Depending on the economic growth estimations and the needs for medical attention for the next decade, the admission shares for medical schools should be revisited.

Migration analysis of physicians practicing in Hawai'i from 2009-2011.

Science.gov (United States)

Stephens, Laura D; Withy, Kelley M; Racsa, C Philip

2012-04-01

Hawai'i suffers a 20% shortage of physicians. Examining physician migration patterns into and out of Hawai'i may better inform physician recruitment and retention techniques. 2009-2011 practice location data on all non-military, practicing physicians in Hawai'i were compiled in a database maintained by the University of Hawai'i John A Burns School of Medicine, Area Health Education Center (AHEC). Medical school attended was extracted from an AMA Masterfile list. Physicians were contacted or searched online to ascertain practice location as of September 2011. Currently 3,187 physicians actively practice in Hawai'i; 2,707 (84.9%) trained at a total of 136 US medical schools. Nearly half of all US-trained physicians attended medical school in Hawai'i, California, New York, Illinois, or Pennsylvania. International medical graduates represented 191 medical schools from 67 distinct countries, primarily in the Philippines (23.1%). From 2009-2011, 238 physicians retired from clinical activity, and 329 physicians left Hawai'i to practice in other locations. California received the largest portion of Hawai'i's former physicians (26.4%). Only 15.5% of physicians returned to the state where they attended medical school. Medical schools with some of the most alumni practicing in Hawai'i (eg, Creighton, UCLA, Georgetown) all have active Hawai'i student clubs, suggesting a target for recruitment efforts. Physician emigration cannot be fully explained by geography of a physician's medical school alma mater. Analysis of physician residency locations and exit surveys of physicians leaving Hawai'i are recommended for future study.

Medical women of the West.

Science.gov (United States)

Scully, A L

1988-01-01

The presence in the West of women physicians with degrees from regular medical schools spans a period of approximately 130 years. Women's Medical College of Pennsylvania graduated many of these early women physicians. The first woman medical graduate of a western school was Lucy M. Field Wanzer, who finished in 1876 at the Department of Medicine, University of California in San Francisco. Soon thereafter, schools that would become Stanford University and the Oregon Health Sciences University schools of medicine, as well as the newly founded University of Southern California, were contributing to the pool of women physicians. The University of Michigan Medical School, the first coeducational state medical school, also educated some of the western women physicians, who by 1910 numbered about 155. This regional account of the progress of women physicians as they strove to become an integral part of the profession emphasizes the familiar themes of altruism, ingenuity, and perseverance that characterized their efforts. Images PMID:3074578

[Forecast of physician workforce in the 22 French regions (1998-2013)].

Science.gov (United States)

Coste, Emmanuel; Doan, Bui Dang Ha

2003-01-01

The first chapter provides detailed information on the methodology and data used. As were the other projections carried out in the past by the Centre de sociologie et de démographie médicales, the present work is basically a demographic projection. Whereas a projection of national workforce uses the total number of annual new graduates as inflow, a regional projection has to collect other types of data, as new graduates move freely from one region to another. This fundamental difference implies the use of more complex models for predicting the flows of newcomers at regional level. As concerns the outflow, a single table covering retirement and death is used for all regions. The medical profession is a homogeneous group and such a decision is not irrelevant. The second chapter presents briefly the results of the work as concerns one region. In the high variant, the regional number of physicians will continue to increase from 1998 to 2007 or 2008, then it will decrease. In the low variant, the growth will end in 2004 or 2005, followed by a stronger decreasing process. The decrease is caused by the "graduate boom" cohorts (doctors graduated during the 70's and 80's) reaching retirement age. Given the duration of medical training, the decrease will take place even if the numerous clausus (at the start of medical training) rises steadily right now. The decrease in the number of physicians will be accompanied by an aging process: the proportion of senior active doctors will raise and that of junior doctors will diminish. The third chapter evidences the diversity of the various regional trends.

'Practising under your own Pin'- a description of the transition experiences of newly qualified midwives.

Science.gov (United States)

Avis, Mark; Mallik, Maggie; Fraser, Diane M

2013-11-01

Transition experiences of newly qualified midwives were examined in depth during the third phase of a UK evaluation study of midwifery education. The fitness to practise and the retention of newly qualified nursing and midwifery graduates are pressing concerns for health care managers. The advantages of preceptorship are reported in the literature but the content and timing of schemes remain unclear. A semi-structured diary was kept for up to 6 months by 35 newly qualified midwives in 18 work sites covering all countries in the UK. The preceptor and supervisor of midwives for each newly qualified midwife completed short questionnaires about their preceptee's performance, and a further sub-sample of newly qualified midwives and preceptors participated in a semi-structured interview. Data were analysed to elicit aspects of newly qualified midwives transition experiences. Findings confirm that structured preceptorship schemes are not widely available. Newly qualified midwives primarily obtained transition support from members of the midwifery team. Although perceived as competent, there is no demarcation point in becoming confident to practise as a registered practitioner. Implications for managers include the importance of a supportive culture within clinical teams for successful transition and the introduction of structured preceptorship schemes facilitated by appropriate rotation patterns. © 2012 John Wiley & Sons Ltd.

An Implementation Strategy to Improve the Guideline Adherence of Insurance Physicians: A Process Evaluation Alongside an Experiment in a Controlled Setting

Science.gov (United States)

Zwerver, Feico; Bonefaas-Groenewoud, Karin; Schellart, Antonius J. M.; Anema, Johannes R.; van der Beek, Allard J.

2013-01-01

Background: We developed an implementation strategy for the insurance medicine guidelines for depression, which we implemented via a post-graduate course for insurance physicians (IPs). In this study we evaluate the physicians' experiences of the implementation strategy by measuring the following aspects: recruitment and reach, dose delivered and…

Scientific activity and working hours of physicians in university hospitals: results from the Innsbruck and Salzburg physician lifestyle assessment (TISPLA).

Science.gov (United States)

Steger, Bernhard; Colvin, Hans Peter; Rieder, Josef

2009-01-01

Controllable lifestyle has become an important factor influencing career decision-making among physicians. In academic medicine, doctors are required to combine both patient care and research in their daily routine. Insufficient release of clinicians for research during contracted work hours may lead to increased weekly working hours in academic medical centers and deter medical graduates from academia. We tested for an association between numbers of scientific publications and an increased hourly workload among physicians. This was a cross-sectional online survey among all salaried physicians working in the university hospitals of Innsbruck and Salzburg, Austria. The main outcome measures were the self-reported total number of scientific papers published in peer-reviewed medical journals over the past two years and self-reported working hours. Of 590 returned surveys, 393 were fully completed and included in the study. The sample was stratified into three groups according to scientific output in the past two years: Group A, >/= 6 publications; Group B, 1-5 publications; Group C, no publications. Men were more likely than women to have a scientific publication: in Group A there was a male predominance of 75%, whereas in Group C only 48% were men (P = 0.0034). A total of 59% (n = 232) of all participants had not published a scientific article in the past two years (Group C) and worked a mean of 58.3 +/- 12 h/week. Physicians in Group B (n = 113) had published 2.4 +/- 1.4 papers and worked 62.8 +/- 12.9 h/week; those in Group A (n = 48) had published 11.5 +/- 6.6 papers and worked 73 +/- 13.1 h/week (P work time but for 60% of overtime hours, reflecting the fact that research was mainly performed during overtime. Research activity among clinicians in academic medical centers is associated with significantly increased overtime hours. Measures need to be taken to allow medical graduates an academic career at reasonable impairment of personal lifestyle.

Diversity Based on Race, Ethnicity, and Sex, of the US Radiation Oncology Physician Workforce

International Nuclear Information System (INIS)

Chapman, Christina H.; Hwang, Wei-Ting; Deville, Curtiland

2013-01-01

Purpose: To assess the current diversity of the US radiation oncology (RO) physician workforce by race, ethnicity, and sex. Methods and Materials: Publicly available American Medical Association, American Association of Medical Colleges, and US census registries were used to assess differences by race, ethnicity, and sex for 2010 among RO practicing physicians, academic faculty, residents, and residency applicants. RO resident diversity was compared to medical school graduates and medical oncology (MO) fellows. Significant differences in diversity of RO residents by race, ethnicity, and sex were evaluated between 2003 and 2010 academic years. Results: Females and traditionally underrepresented minorities in medicine (URM), blacks, Hispanics, American Indians, Alaska Natives, Native Hawaiian, and Pacific Islanders are underrepresented as RO residents (33.3% and 6.9%, respectively), faculty (23.8%, 8.1%), and practicing physicians (25.5%, 7.2%) levels compared with the US population (50.8%, 30.0%; P<.01). Although females and URMs remain underrepresented at the resident trainee level compared with their proportions as medical school graduates (48.3%, 15.6%) and MO fellows (45.0%, 10.8%; P<.01), females are significantly increased in proportion as RO residents compared with RO practicing physicians (P<.01), whereas representation of individual URM groups as RO residents is no different than current practicing physicians. There is no trend toward increased diversification for female or URM trainees over 8 years, suggesting underrepresentation is not diminishing. Conclusions: Females and URM are underrepresented in the RO physician workforce. Given existing cancer disparities, further research and efforts are needed to ensure that the field is equipped to meet the needs of an increasingly diverse society

Diversity Based on Race, Ethnicity, and Sex, of the US Radiation Oncology Physician Workforce

Energy Technology Data Exchange (ETDEWEB)

Chapman, Christina H. [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Hwang, Wei-Ting [Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Deville, Curtiland, E-mail: deville@uphs.upenn.edu [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States)

2013-03-15

Purpose: To assess the current diversity of the US radiation oncology (RO) physician workforce by race, ethnicity, and sex. Methods and Materials: Publicly available American Medical Association, American Association of Medical Colleges, and US census registries were used to assess differences by race, ethnicity, and sex for 2010 among RO practicing physicians, academic faculty, residents, and residency applicants. RO resident diversity was compared to medical school graduates and medical oncology (MO) fellows. Significant differences in diversity of RO residents by race, ethnicity, and sex were evaluated between 2003 and 2010 academic years. Results: Females and traditionally underrepresented minorities in medicine (URM), blacks, Hispanics, American Indians, Alaska Natives, Native Hawaiian, and Pacific Islanders are underrepresented as RO residents (33.3% and 6.9%, respectively), faculty (23.8%, 8.1%), and practicing physicians (25.5%, 7.2%) levels compared with the US population (50.8%, 30.0%; P<.01). Although females and URMs remain underrepresented at the resident trainee level compared with their proportions as medical school graduates (48.3%, 15.6%) and MO fellows (45.0%, 10.8%; P<.01), females are significantly increased in proportion as RO residents compared with RO practicing physicians (P<.01), whereas representation of individual URM groups as RO residents is no different than current practicing physicians. There is no trend toward increased diversification for female or URM trainees over 8 years, suggesting underrepresentation is not diminishing. Conclusions: Females and URM are underrepresented in the RO physician workforce. Given existing cancer disparities, further research and efforts are needed to ensure that the field is equipped to meet the needs of an increasingly diverse society.

Implications of early workplace experiences on continuing interprofessional education for physicians and nurses.

Science.gov (United States)

Veerapen, Kiran; Purkis, Mary Ellen

2014-05-01

Formative experiences, identities and collaborative strategies of nurses and physicians need to be appreciated to develop transformative interprofessional education for them. This article develops the collaborative profiles of recently graduated physicians and nurses based on a phenomenological study conducted at tertiary training hospitals in Canada and the United Kingdom. Recent nursing and medical graduates were interviewed to study the impact of undergraduate professional education on their ability to practice collaboratively in the workplace. The impact of undergraduate professional education on teamwork was found to be diluted by internal contradictions and overshadowed by the demands and contingencies of the workplace reported here. Initiation into the workplace was frequently precipitous and for residents the workplace environment was fluid and repeatedly new, as they rotated through various disciplines in the hospital. In busy wards, interdependent but competing priorities led to the development of adversarial uniprofessional identities and derogatory stereotyping of the other. Both groups were overwhelmed by high workload, unpreparedness and responsibility. Cross generational and gender based interactions also provoked resentment. Over time collaborative attitudes became blunted and interprofessional identities were renegotiated. Continuing interprofessional education, for recent graduates that prioritises problem areas, alongside appropriate structural changes could potentially transform the prevalent culture and impact teamwork downstream.

The effects of problem-based learning during medical school on physician competency: a systematic review.

Science.gov (United States)

Koh, Gerald Choon-Huat; Khoo, Hoon Eng; Wong, Mee Lian; Koh, David

2008-01-01

Systematic reviews on the effects of problem-based learning have been limited to knowledge competency either during medical school or postgraduate training. We conducted a systematic review of evidence of the effects that problem-based learning during medical school had on physician competencies after graduation. We searched MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane Databases, and the tables of contents of 5 major medical education journals from earliest available date through Oct. 31, 2006. We included studies in our review if they met the following criteria: problem-based learning was a teaching method in medical school, physician competencies were assessed after graduation and a control group of graduates of traditional curricula was used. We developed a scoring system to assess the quality of the studies, categorized competencies into 8 thematic dimensions and used a second system to determine the level of evidence for each competency assessed. Our search yielded 102 articles, of which 15 met inclusion criteria after full text review. Only 13 studies entered final systematic analysis because 2 studies reported their findings in 2 articles. According to self-assessments, 8 of 37 competencies had strong evidence in support of problem-based learning. Observed assessments had 7 competencies with strong evidence. In both groups, most of these competencies were in the social and cognitive dimensions. Only 4 competencies had moderate to strong levels of evidence in support of problem-based learning for both self-and observed assessments: coping with uncertainty (strong), appreciation of legal and ethical aspects of health care (strong), communication skills (moderate and strong respectively) and self-directed continuing learning (moderate). Problem-based learning during medical school has positive effects on physician competency after graduation, mainly in social and cognitive dimensions.

Newly qualified doctors' views on the significance and accessibility of career advice during medical training in Saudi Arabia

NARCIS (Netherlands)

Mehmood, Syed Imran; Norcini, John J.; Borleffs, Jan C. C.

2013-01-01

Background: Career advice is an important instrument to help students with the proper specialty selection. The study aims (1) to explore the views of newly graduated doctors in Saudi Arabia about their experience with the current status of career support system during medical training and (2) to

A pre-admission program for underrepresented minority and disadvantaged students: application, acceptance, graduation rates and timeliness of graduating from medical school.

Science.gov (United States)

Strayhorn, G

2000-04-01

To determine whether students' performances in a pre-admission program predicted whether participants would (1) apply to medical school, (2) get accepted, and (3) graduate. Using prospectively collected data from participants in the University of North Carolina at Chapel Hill's Medical Education Development Program (MEDP) and data from the Association of American Colleges Student and Applicant Information Management System, the author identified 371 underrepresented minority (URM) students who were full-time participants and completed the program between 1984 and 1989, prior to their acceptance into medical school. Logistic regression analysis was used to determine whether MEDP performance significantly predicted (after statistically controlling for traditional predictors of these outcomes) the proportions of URM participants who applied to medical school and were accepted, the timeliness of graduating, and the proportion graduating. Odds ratios with 95% confidence intervals were calculated to determine the associations between the independent and outcome variables. In separate logistic regression models, MEDP performance predicted the study's outcomes after statistically controlling for traditional predictors with 95% confidence intervals. Pre-admission programs with similar outcomes can improve the diversity of the physician workforce and the access to health care for underrepresented minority and economically disadvantaged populations.

Rural retention of new medical graduates from the Collaborative Project to Increase Production of Rural Doctors (CPIRD): a 12-year retrospective study.

Science.gov (United States)

Techakehakij, Win; Arora, Rajin

2017-07-01

Physician scarcity in rural areas is a major obstacle to healthcare access, leading to health inequity worldwide. In Thailand, a special recruitment program of medical education [Collaborative Project to Increase Production of Rural Doctors (CPIRD)] was initiated with four different medical training tracks. No previous research has examined the rural retention of new medical graduates across the CPIRD tracks, compared with those receiving conventional medical education (Normal track). This study examines the public retention of rural physicians from different tracks of entry. A retrospective study was conducted in new medical graduates who entered Ministry of Public Health (MoPH) hospitals from January 2003 to October 2014, and followed up until June 2015, using administrative data from the Personnel Administration Division, MoPH. The CPIRD registry database was used to identify physicians' tracks of entry. Survival analyses and multiple logistic regression analyses were applied to compare the annual retention and the probability of 3-year retention of rural physicians. Results clearly demonstrated a high rural retention of CPIRD medical graduates, compared with their Normal track peers, regarding both lower annual resignation (HR 0.456, P rural retention were revealed across the different CPIRD tracks. Evidence from this study can be used as part of the information to reshape the physician production policy to reduce health inequity in rural areas. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Comparing selection criteria of residency directors and physicians' employers.

Science.gov (United States)

Villanueva, A M; Kaye, D; Abdelhak, S S; Morahan, P S

1995-04-01

In 1993, the Medical College of Pennsylvania (MCP), mindful of the rapidly changing environments of health care delivery, created three surveys to gather information from outside the school that would help the faculty plan how the curriculum and advising system could better prepare students and residents for the demands of twenty-first-century medicine. The first survey focused on the MCP seniors graduating that year and asked about their perceptions of their medical education and their specialty and residency choices. The second survey, directed to 40 medical residency program directors in family medicine, internal medicine, pediatrics, and surgery, sought to identify the characteristics of applicants that these directors valued when selecting entrants to their programs. The third survey, of 30 employers of physicians representing four practice environments (private practice, hospitals/other health systems, academic medical centers, and health maintenance organizations), sought information on hiring and recruitment practices and the skills, competencies, and attitudes these employers valued most when hiring recently graduated physicians. The responses showed several differences and/or misperceptions among the views held by the three groups surveyed and suggest that medical educators have not adapted as rapidly as have employers to changes in the health care environment. Academic health centers must broaden their missions and make changes in their own institutional cultures, both to maintain their own viability and to train physicians who have the balance between scientific and technical competency and essential personal characteristics (such as empathy) that the next century's practice will probably demand.

Importance and benefits of the doctoral thesis for medical graduates

Science.gov (United States)

Giesler, Marianne; Boeker, Martin; Fabry, Götz; Biller, Silke

2016-01-01

Introduction: The majority of medical graduates in Germany complete a doctorate, even though a doctoral degree is not necessary for the practice of medicine. So far, little is known about doctoral candidates’ view on the individual benefit a doctoral thesis has for them. Consequently, this is the subject of the present investigation. Method: Data from surveys with graduates of the five medical faculties of Baden-Württemberg from the graduation years 2007/2008 (N=514) and 2010/2011 (N=598) were analysed. Results: One and a half years after graduating 53% of those interviewed had completed their doctorate. When asked about their motivation for writing a doctoral thesis, participants answered most frequently “a doctorate is usual” (85%) and “improvement of job opportunities” (75%), 36% said that an academic career has been their primary motive. Less than 10% responded that they used their doctoral thesis as a means to apply for a job. The proportion of graduates working in health care is equally large among those who have completed a thesis and those who have not. Graduates who pursued a thesis due to scientific interest are also currently more interested in an academic career and recognise more opportunities for research. An implicit benefit of a medical thesis emerged with regard to the self-assessment of scientific competences as those who completed a doctorate rated their scientific competencies higher than those who have not. Discussion: Although for the majority of physicians research interest is not the primary motivation for completing a doctorate, they might nevertheless achieve some academic competencies. For graduates pursuing an academic career the benefit of completing a medical thesis is more obvious. PMID:26958656

Importance and benefits of the doctoral thesis for medical graduates.

Science.gov (United States)

Giesler, Marianne; Boeker, Martin; Fabry, Götz; Biller, Silke

2016-01-01

The majority of medical graduates in Germany complete a doctorate, even though a doctoral degree is not necessary for the practice of medicine. So far, little is known about doctoral candidates' view on the individual benefit a doctoral thesis has for them. Consequently, this is the subject of the present investigation. Data from surveys with graduates of the five medical faculties of Baden-Württemberg from the graduation years 2007/2008 (N=514) and 2010/2011 (N=598) were analysed. One and a half years after graduating 53% of those interviewed had completed their doctorate. When asked about their motivation for writing a doctoral thesis, participants answered most frequently "a doctorate is usual" (85%) and "improvement of job opportunities" (75%), 36% said that an academic career has been their primary motive. Less than 10% responded that they used their doctoral thesis as a means to apply for a job. The proportion of graduates working in health care is equally large among those who have completed a thesis and those who have not. Graduates who pursued a thesis due to scientific interest are also currently more interested in an academic career and recognise more opportunities for research. An implicit benefit of a medical thesis emerged with regard to the self-assessment of scientific competences as those who completed a doctorate rated their scientific competencies higher than those who have not. Although for the majority of physicians research interest is not the primary motivation for completing a doctorate, they might nevertheless achieve some academic competencies. For graduates pursuing an academic career the benefit of completing a medical thesis is more obvious.

Importance and benefits of the doctoral thesis for medical graduates

Directory of Open Access Journals (Sweden)

Giesler, Marianne

2016-02-01

Full Text Available Introduction: The majority of medical graduates in Germany complete a doctorate, even though a doctoral degree is not necessary for the practice of medicine. So far, little is known about doctoral candidates’ view on the individual benefit a doctoral thesis has for them. Consequently, this is the subject of the present investigation.Method: Data from surveys with graduates of the five medical faculties of Baden-Württemberg from the graduation years 2007/2008 (N=514 and 2010/2011 (N=598 were analysed.Results: One and a half years after graduating 53% of those interviewed had completed their doctorate. When asked about their motivation for writing a doctoral thesis, participants answered most frequently “a doctorate is usual” (85% and “improvement of job opportunities” (75%, 36% said that an academic career has been their primary motive. Less than 10% responded that they used their doctoral thesis as a means to apply for a job. The proportion of graduates working in health care is equally large among those who have completed a thesis and those who have not. Graduates who pursued a thesis due to scientific interest are also currently more interested in an academic career and recognise more opportunities for research. An implicit benefit of a medical thesis emerged with regard to the self-assessment of scientific competences as those who completed a doctorate rated their scientific competencies higher than those who have not.Discussion: Although for the majority of physicians research interest is not the primary motivation for completing a doctorate, they might nevertheless achieve some academic competencies. For graduates pursuing an academic career the benefit of completing a medical thesis is more obvious.

Ethics curriculum for emergency medicine graduate medical education.

Science.gov (United States)

Marco, Catherine A; Lu, Dave W; Stettner, Edward; Sokolove, Peter E; Ufberg, Jacob W; Noeller, Thomas P

2011-05-01

Ethics education is an essential component of graduate medical education in emergency medicine. A sound understanding of principles of bioethics and a rational approach to ethical decision-making are imperative. This article addresses ethics curriculum content, educational approaches, educational resources, and resident feedback and evaluation. Ethics curriculum content should include elements suggested by the Liaison Committee on Medical Education, Accreditation Council for Graduate Medical Education, and the Model of the Clinical Practice of Emergency Medicine. Essential ethics content includes ethical principles, the physician-patient relationship, patient autonomy, clinical issues, end-of-life decisions, justice, education in emergency medicine, research ethics, and professionalism. The appropriate curriculum in ethics education in emergency medicine should include some of the content and educational approaches outlined in this article, although the optimal methods for meeting these educational goals may vary by institution. Copyright © 2011 Elsevier Inc. All rights reserved.

Good to great: using 360-degree feedback to improve physician emotional intelligence.

Science.gov (United States)

Hammerly, Milton E; Harmon, Larry; Schwaitzberg, Steven D

2014-01-01

The past decade has seen intense interest and dramatic change in how hospitals and physician organizations review physician behaviors. The characteristics of successful physicians extend past their technical and cognitive skills. Two of the six core clinical competencies (professionalism and interpersonal/communication skills) endorsed by the Accreditation Council for Graduate Medical Education, the American Board of Medical Specialties, and The Joint Commission require physicians to succeed in measures associated with emotional intelligence (EI). Using 360-degree anonymous feedback surveys to screen for improvement opportunities in these two core competencies enables organizations to selectively offer education to further develop physician EI. Incorporating routine use of these tools and interventions into ongoing professional practice evaluation and focused professional practice evaluation processes may be a cost-effective strategy for preventing disruptive behaviors and increasing the likelihood of success when transitioning to an employed practice model. On the basis of a literature review, we determined that physician EI plays a key role in leadership; teamwork; and clinical, financial, and organizational outcomes. This finding has significant implications for healthcare executives seeking to enhance physician alignment and transition to a team-based delivery model.

Intelligent type sodium level gauge and its graduation calibration facility

International Nuclear Information System (INIS)

Chen Daolong; Wang Xuan; Li Xinying; Sun Huiqing; Zhu Jie

1998-04-01

The component construction and their performances of the intelligent type sodium level gauge newly-developed and its graduation calibration facility are presented. They can be operated in the temperature limit 100∼550 degree C. Its graduation characteristic calibration test is described. The temperature effect is analyzed. The graduation characteristic equation using the medium temperature as the parameter is given. The calibration errors are analyzed. The measurement system using this sodium level gauge is presented. The tests show that the intelligent type sodium level gauge possesses good linearity. The accurate sodium level measurement data can be obtained by means of its on-line compensation function of the temperature effect. Moreover, it possesses the self-inspection, the electric shutoff protection, the setting of full-scale, the thermocouple breaking alarm, the two upper limits and two lower limits alarms, the standard analog output signal and the digital output signal. Therefore, it is applicable particularly to the instrument, control and protection systems of LMFBR. The basic error of this intelligent type sodium level gauge is +-1.9% of measuring range

New graduate RN work satisfaction after completing an interactive nurse residency.

Science.gov (United States)

Anderson, Teresa; Linden, Lois; Allen, Marsha; Gibbs, Elizabeth

2009-04-01

The aims of this study were to measure job satisfaction and engagement perceptions of new nurses after completing interactive residency modules and to test the reliability and validity of the Halfer-Graf Job/Work Environment Nursing Satisfaction Survey. US nursing shortages are estimated to increase to 36% by 2020, requiring emphasis on hiring new graduate nurses. Improved retention of new graduates through innovative orientations such as interactive nurse residencies is one option. This mixed qualitative and quantitative study compared perceived job satisfaction and employee engagement of 90 new graduate nurses completing an interactive nurse residency. Reliability and validity of the Halfer-Graf tool were supported. Qualitative analysis yielded trends related to satisfiers (patients, patient outcomes, and teamwork) and dissatisfiers (staffing/scheduling, lack of teamwork, and physician disrespect). Simulation scenarios, debriefing, and e-mail communication with peers ranked high as beneficial teaching strategies. Study findings support previous research. An interactive learning environment was perceived as beneficial. First and second year nurse retention was consistent with previous residency programming.

Establishing a framework for a physician assistant/bioethics dual degree program.

Science.gov (United States)

Carr, Mark F; Bergman, Brett A

2014-01-01

: Numerous medical schools currently offer a master of arts (MA) in bioethics dual degree for physicians. A degree in bioethics enhances the care physicians provide to patients and prepares physicians to serve on ethics committees and consult services. Additionally, they may work on institutional and public policy issues related to ethics. Several physician assistant (PA) programs currently offer a master of public health (MPH) dual degree for PAs. A degree in public health prepares PAs for leadership roles in meeting community health needs. With the success of PA/MPH dual degree programs, we argue here that a PA/bioethics dual degree would be another opportunity to advance the PA profession and consider how such a program might be implemented. The article includes the individual perspectives of the authors, one of whom completed a graduate-level certificate in bioethics concurrently with his 2-year PA program, while the other served as a bioethics program director.

Professional development for graduate students in the atmospheric sciences

Science.gov (United States)

Haacker, R.; Sloan, V.

2015-12-01

The field of atmospheric sciences is rapidly changing, and with it, the employment outlook for recent graduate students. Weather and climate applications for society and the private industry are in demand and have increased significantly over the last few years, creating new employment opportunities for atmospheric scientists. It is therefore more important than ever that our graduates are well prepared for the newly emerging careers. The Bureau's Occupational Outlook predicts that opportunities for atmospheric scientists will increase more rapidly in the private industry than in other sectors (Bureau of Labor Statistics, 2014). Employers in the private sector indicate that, while job applicants often bring the required scientific training, there is a gap between the technical and professional skills needed in those positions and those possessed by graduates. Job candidates were found to be most lacking in written and oral communication skills, adaptability, and project management (Chronicle for Higher Education, 2012). The geoscience community needs to come together to better prepare our graduate students. While some of this work can be done within academic institutions, partnerships with mentoring programs and the private industry are essential. In this paper we will present one approach taken by the Significant Opportunities in Atmospheric Research and Science (SOARS) program to improve its students' skills in project management, collaborating, communication, problem solving, and essential leadership skills.

Entry of US Medical School Graduates Into Family Medicine Residencies: 2014-2015.

Science.gov (United States)

Kozakowski, Stanley M; Fetter, Gerald; Bentley, Ashley

2015-10-01

This is the 34th national study conducted by the American Academy of Family Physicians (AAFP) that reports retrospectively the percentage of graduates from US MD-granting and DO-granting medical schools who entered Accreditation Council for Graduate Medical Education (ACGME)-accredited family medicine residency programs as first-year residents in 2014. Approximately 8.5% of the 18,241 students graduating from US MD-granting medical schools between July 2013 and June 2014 entered a family medicine residency. Of the 1,458 graduates of the US MD-granting medical schools who entered a family medicine residency in 2014, 80% graduated from 69 of the 131 schools. Eleven schools lacking departments or divisions of family medicine produced only a total of 26 students entering family medicine. In aggregate, medical schools west of the Mississippi River represent less than a third of all US MD-granting schools but have an aggregate rate of students selecting family medicine that is two-thirds higher than schools to the east of the Mississippi. A rank order list of US MD-granting medical schools was created based on the last 3 years' average percentage of graduates who became family medicine residents, using the 2014 and prior AAFP census data. US MD schools continue to fail to produce a primary care workforce, a key measure of social responsibility as measured by their production of graduates entering into family medicine. DO-granting and international medical school graduates filled the majority of ACGME-accredited family medicine first-year resident positions in 2014.

Adequacy of Physicians Knowledge Level of Cardiopulmonary Resuscitation to Current Guidelines

Directory of Open Access Journals (Sweden)

Ümmu Kocalar

2016-01-01

Full Text Available Aim: The purpose of this study is to test the level of information on CPR and suitability to current application of the phsicians practicing in hospital ANEAH. Material and Method: The form of a test of 20 questions fort his purpose has been prepared in accordance with the 2010 AHA-ERC CPR guidelines. This form distributed to volunteer physicians to fill in. A total of 173 physicians agreed to participate in he study. The results were analyzed statistically and tried to determine the factors affecting the level of information. Results:According to the results of the study physicians gender, age and the total duration of physicians and medical asistance doesn%u2019t affect the level of information. The number of CPR within 1 month positively affect the level of knowledge. The number of theoretical and practical training in medical school, have taken the positive impact the level of knowledge of physicians. The training period after graduation, significantly increased the level of physicians information. The order of these training sessions with the asistant courses, congress, seminars and lessions on the sempozims are effective. Discussion: CPR trainig programs for physicians should be standardized, updated and expanded. Recurent in-service trainig should be provided to increase phsicians knowledge on skills.

The Time Is Now: Using Graduates' Practice Data to Drive Medical Education Reform.

Science.gov (United States)

Triola, Marc M; Hawkins, Richard E; Skochelak, Susan E

2018-02-13

Medical educators are not yet taking full advantage of the publicly available clinical practice data published by federal, state, and local governments, which can be attributed to individual physicians and evaluated in the context of where they attended medical school and residency training. Understanding how graduates fare in actual practice, both in terms of the quality of the care they provide and the clinical challenges they face, can aid educators in taking an evidence-based approach to medical education. Although in their infancy, efforts to link clinical outcomes data to educational process data hold the potential to accelerate medical education research and innovation. This approach will enable unprecedented insight into the long-term impact of each stage of medical education on graduates' future practice. More work is needed to determine best practices, but the barrier to using these public data is low and the potential for early results is immediate. Using practice data to evaluate medical education programs can transform how the future physician workforce is trained and better align continuously learning medical education and health care systems.

Graduate School and You: A Guide for Prospective Graduate Students.

Science.gov (United States)

Kidwell, Clara Sue; LaPidus, Jules B.

This pamphlet guides the college graduate in determining whether graduate school is an appropriate choice in career planning. Chapter titles include: "Why Graduate School?,""What is Graduate Education?,""Preparation for Graduate School,""Career Options with a Graduate Degree,""Making the Decision,""Financing a Graduate Education,""Choosing a…

Will generalist physician supply meet demands of an increasing and aging population?

Science.gov (United States)

Colwill, Jack M; Cultice, James M; Kruse, Robin L

2008-01-01

We predict that population growth and aging will increase family physicians' and general internists' workloads by 29 percent between 2005 and 2025. We expect a 13 percent increased workload for care of children by pediatricians and family physicians. However, the supply of generalists for adult care, adjusted for age and sex, will increase 7 percent, or only 2 percent if the number of graduates continues to decline through 2008. We expect deficits of 35,000-44,000 adult care generalists, although the supply for care of children should be adequate. These forces threaten the nation's foundation of primary care for adults.

Creating physicians of the 21st century: assessment of the clinical years

Directory of Open Access Journals (Sweden)

Vanderbilt AA

2017-06-01

Full Text Available Allison A Vanderbilt,1 Sara Q Perkins,2 Moriah K Muscaro,2 Thomas J Papadimos,3 Reginald F Baugh4 1Department of Family Medicine, 2College of Medicine and Life Sciences, University of Toledo, 3Department of Anesthesiology, 4Department of Surgery, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA Abstract: Medical education has been under a constant state of revision for the past several years. The overarching theme of the curriculum revisions for medical schools across the USA has been creating better physicians for the 21st century, with the same end result: graduating medical students at the optimal performance level when entering residency. We propose a robust, thorough assessment process that will address the needs of clerkships, residents, students, and, most importantly, medical schools to best measure and improve clinical reasoning skills that are required for the learning outcomes of our future physicians. The Accreditation Council for Graduate Medical Education (ACGME evaluates and accredits medical school graduates based on competency-based outcomes and the assessment of specialty-specific milestones; however, there is some evidence that medical school graduates do not consistently meet the Level 1 milestones prior to entering/beginning residency, thus starting their internship year underprepared and overwhelmed. Medical schools should take on the responsibility to provide competency-based assessments for their students during the clinical years. These assessments should be geared toward preparing them with the cognitive competencies and skills needed to successfully transition to residency. Then, medical schools can produce students who will ultimately be prepared for transition to their residency programs to provide quality care. Keywords: ACGME Core Competencies, milestones, clerkships, medical education, evaluation 

Reflections on the newly qualified social worker's journey : From university training to qualified practice

OpenAIRE

Walker, Clare

2014-01-01

This qualitative research study explores the experience of graduating social workers making the transition from university training into work as qualified social work practitioners. Most studies in this area look at the practice readiness of the newly qualified professional. This study looks at the participants’ experience in the work place. How do participants experience this journey of transition? What skills, particularly reflective practice and supervision, learned in training, are import...

Motivations influencing the specialty choices of medical school graduates

Directory of Open Access Journals (Sweden)

zarghami M

2003-04-01

Full Text Available Background: Growing national concern about distortions in the size, specially composition, and availability of the physician workforce -especially after "cultural revolution n- has evoked challenges in Iran. Purpose: To determine various factors that influence medical graduates choices for residency program. Methods: All applicants for residency program in Mazandaran university of Medical Sciences and Health Services completed the Medical School Graduation Questionnaire, and rated each factor using 0 to 4 Likert-type scale. Factors' ratings were also compared across applicants of different residency program, and demographic variables. Results: The top two factors rated as having strong influences were ones related to interest in helping peop1e (rated 3.07, and intellectual content of the specially (rated 3. Malpractice insurance cost has the least influence (rated 0.98. Most of men preferred independence, whereas most of women preferred predictable working hours. Opportunity to make differences in people's l(fe influenced the specially choices of usual participants. whereas those who used war veterans quota paid more attention to independence and exercise of social responsibility. Patient contact factors were less important to graduates who chose diagnostic speciafties. Also, there was a significant association between the participants' age and four factors. Conclusion: These graduates based their specially preference heavily on the opportunity that the specially affords to help people, and intellectual content of the specially. Knowing the hierarchy of influences on graduates' motivations should help education strategists determine what experiences and perceptions must change if a different mix of specially decision is to result. Keywords: SPECIAL TY, MEDICAL SCHOOL, SARI, MAZANDARAN

A longitudinal study of factors associated with intentions to leave among newly graduated nurses in eight advanced treatment hospitals in Japan.

Science.gov (United States)

Tei-Tominaga, Maki; Miki, Akiko

2010-01-01

This study aimed to examine the factors associated with intentions to leave among newly graduated nurses (NGNs), using a longitudinal design. We distributed self-administered questionnaires (to be returned anonymously) to all the NGNs (n=567) in nine advanced treatment hospitals in Japan on two separate occasions (Time 1 and Time 2, which were approximately 6 months apart). The questionnaire items addressed individual attributes, employment and organizational characteristics, and subjective health, and also included the 22-item Job Content Questionnaire, a scale of intentions to leave, and a novel 21-item job readiness scale. The data from 301 NGNs who had participated in both questionnaire instances was used, and a hierarchical multiple regression analysis was conducted to investigate the factors associated with intentions to leave. The results showed that while psychological distress was a more important predictor of intentions to leave than was cumulative fatigue at Time 1, cumulative fatigue was a more important predictor at Time 2. Among the job stressors, a lack of coworker support consistently led to increased intentions to leave, while a lack of supervisor support had a greater impact on intentions to leave at Time 1. "Being personally suited for nursing work", which was one of the job-readiness subscales, was found to independently and consistently influence intentions to leave. Our study findings revealed the predictors of intentions to leave among NGNs early in their careers in Japan.

Treating a physician patient with psychosis.

Science.gov (United States)

Freedman, Jacob L; Crow, Fredrick F; Gutheil, Thomas G; Sanchez, Luis T; Suzuki, Joji

2012-06-01

The authors present a case of a psychotic female patient who is a former graduate of a locally prestigious medical school and has subsequently been diagnosed with schizophrenia. The patient entered treatment in an outpatient clinic following discharge from her 11th hospitalization. This hospitalization was initiated after the patient's physician friend had called the police and notified them that the patient was significantly disorganized to warrant further evaluation. Treatment was characterized by significant transference and counter-transference reactions amongst her clinicians - both treatment-promoting and treatment-interfering - based on her status as a physician. The problem of insight was a significant hurdle in the treatment of the patient as her medical knowledge of mental illness was substantially greater than her insight into her own mental illness. Throughout treatment, a number of medical-legal and ethical issues arose. Initially, the question was raised as to the legality of the actions by the patient's friend-having made a clinical assessment without having a clinical role in the patient's care. As the patient's clinical status improved and she sought to re-enter the medical field as a resident, new medical legal issues surfaced. What were the roles of the patient's treaters in maintaining confidentiality and simultaneously ensuring the safety of patients that the psychotic physician might care for? This case highlights the universality of psychiatric vulnerability. Insight in psychosis as well as the transference and counter-transference issues involved in caring for a psychotic physician are discussed. Additionally, a thorough medical-legal discussion addresses the various complexities of caring for a psychotic physician. Copyright © 2012 Elsevier B.V. All rights reserved.

Is there a 'pig cycle' in the labour supply of doctors? How training and immigration policies respond to physician shortages.

Science.gov (United States)

Chojnicki, Xavier; Moullan, Yasser

2018-03-01

Many OECD countries are faced with the considerable challenge of a physician shortage. This paper investigates the strategies that OECD governments adopt and determines whether these policies effectively address these medical shortages. Due to the amount of time medical training requires, it takes longer for an expansion in medical school capacity to have an effect than the recruitment of foreign-trained physicians. Using data obtained from the OECD (2014) and Bhargava et al. (2011), we constructed a unique country-level panel dataset that includes annual data for 17 OECD countries on physician shortages, the number of medical school graduates and immigration and emigration rates from 1991 to 2004. By calculating panel fixed-effect estimates, we find that after a period of medical shortages, OECD governments produce more medical graduates in the long run but in the short term, they primarily recruit from abroad; however, at the same time, certain practising physicians choose to emigrate. Simulation results show the limits of recruiting only abroad in the long term but also highlight its appropriateness for the short term when there is a recurrent cycle of shortages/surpluses in the labour supply of physicians (pig cycle theory). Copyright © 2018 Elsevier Ltd. All rights reserved.

'Any style but gothic': Building a home for the Royal College of Physicians of Ireland.

Science.gov (United States)

Wheelock, H

2016-06-01

On 15 July 1864 the Royal College of Physicians of Ireland held its first business meeting in its newly built home at 6 Kildare Street, Dublin. Although the Royal College of Physicians of Ireland had been in existence for over 200 years this was the first occasion that a College meeting had been held in a building owned by the College. This paper looks at the history behind the construction of a home for the Royal College of Physicians of Ireland. It will examine why it took over 200 years for the Physicians to find a permanent home, how they ended up with the building they did, and what they borrowed from the Royal College of Physicians in Edinburgh in the process.

Newly qualified teachers' visions of science learning and teaching

Science.gov (United States)

Roberts, Deborah L.

2011-12-01

This study investigated newly qualified teachers' visions of science learning and teaching. The study also documented their preparation in an elementary science methods course. The research questions were: What educational and professional experiences influenced the instructor's visions of science learning and teaching? What visions of science learning and teaching were promoted in the participants' science methods course? What visions of science learning and teaching did these newly qualified teachers bring with them as they graduated from their teacher preparation program? How did these visions compare with those advocated by reform documents? Data sources included participants' assignments, weekly reflections, and multi-media portfolio finals. Semi-structured interviews provided the emic voice of participants, after graduation but before they had begun to teach. These data were interpreted via a combination of qualitative methodologies. Vignettes described class activities. Assertions supported by excerpts from participants' writings emerged from repeated review of their assignments. A case study of a typical participant characterized weekly reflections and final multi-media portfolio. Four strands of science proficiency articulated in a national reform document provided a framework for interpreting activities, assignments, and interview responses. Prior experiences that influenced design of the methods course included an inquiry-based undergraduate physics course, participation in a reform-based teacher preparation program, undergraduate and graduate inquiry-based science teaching methods courses, participation in a teacher research group, continued connection to the university as a beginning teacher, teaching in diverse Title 1 schools, service as the county and state elementary science specialist, participation in the Carnegie Academy for the Scholarship of Teaching and Learning, service on a National Research Council committee, and experience teaching a

Collaborating internationally on physician leadership education: first steps.

Science.gov (United States)

Matlow, Anne; Chan, Ming-Ka; Bohnen, Jordan David; Blumenthal, Daniel Mark; Sánchez-Mendiola, Melchor; de Camps Meschino, Diane; Samson, Lindy Michelle; Busari, Jamiu

2016-07-04

Purpose Physicians are often ill-equipped for the leadership activities their work demands. In part, this is due to a gap in traditional medical education. An emergent international network is developing a globally relevant leadership curriculum for postgraduate medical education. The purpose of this article is to share key learnings from this process to date. Design/methodology/approach The Toronto International Summit on Leadership Education for Physicians (TISLEP) was hosted by the Royal College of Physicians and Surgeons of Canada, and the University of Toronto's Faculty of Medicine and Institute of Health Policy, Management and Evaluation. Of 64 attendees from eight countries, 34 joined working groups to develop leadership competencies. The CanMEDS Competency Framework, stage of learner development and venue of learning formed the scaffold for the work. Emotional intelligence was selected as the topic to test the feasibility of fruitful international collaboration; results were presented at TISLEP 2015. Findings Dedicated international stakeholders engaged actively and constructively through defined working groups to develop a globally relevant, competency-based curriculum for physician leadership education. Eleven principles are recommended for consideration in physician leadership curriculum development. Defining common language and taxonomy is essential for a harmonized product. The importance of establishing an international network to support implementation, evaluation, sustainability and dissemination of the work was underscored. Originality/value International stakeholders are collaborating successfully on a graduated, competency-based leadership curriculum for postgraduate medical learners. The final product will be available for adaptation to local needs. An international physician leadership education network is being developed to support and expand the work underway.

Physician job satisfaction and working conditions in Japan.

Science.gov (United States)

Wada, Koji; Arimatsu, Mayuri; Higashi, Toshiaki; Yoshikawa, Toru; Oda, Susumu; Taniguchi, Hatsumi; Kawashima, Masatoshi; Aizawa, Yoshiharu

2009-01-01

The aim of this study was to determine factors of working conditions associated with job satisfaction among physicians in Japan. We sent a questionnaire to all the physicians who graduated from a medical school in Japan. Physicians who were satisfied with their job were determined as those who selected "very satisfied" and "satisfied" in response to the question: "Overall, are you satisfied with your job?" Working conditions were determined from 10 different aspects: income fairness, hospital resources, career satisfaction, difficulty in patient care, lack of personal time, administrative work, workload, and relationships with physician colleagues, staff and patients. Logistic regression analysis was used to explore the association between working conditions and job satisfaction. Among the respondents, 209 (55.4%) men and 62 (61.4%) women were determined to be satisfied with their job. Job satisfaction was associated with income fairness for both men (corrected odds ratio 1.31, 95% confidence interval 1.09 to 1.47) and women (1.35, 1.05 to 1.53). For men, job satisfaction was associated with good hospital resources (1.45, 1.29 to 1.57), high career satisfaction (1.41, 1.23 to 1.57), good relationships with physician colleagues (1.33, 1.12 to 1.49), and good relationships with hospital staff (1.28, 1.07 to 1.45). For women, job satisfaction was associated with good relationships with patients (1.41, 1.07 to 1.56). Certain working conditions were important factors for job satisfaction among physicians. These factors should be discussed for improving working conditions.

Addressing the primary care physician shortage in an evolving medical workforce

Directory of Open Access Journals (Sweden)

Lakhan Shaheen E

2009-05-01

Full Text Available Abstract Background Primary care physicians have been shown to play an important role in the general health of the communities in which they serve. In spite of their importance, however, there has been a decrease in the number of physicians interested in pursuing primary care fields, while the proportion of specialists continues to increase. The prediction of an overall physician shortage only augments this issue in the US, where this uneven distribution is particularly evident. As such, serious effort to increase the number of practicing primary care physicians is both necessary and beneficial for meeting this country's health care needs. Discussion There are several factors at play which contribute to the decrease in the number of practicing physicians in primary specialties. Lifestyle concerns, such as schedule and income, as well as the lack of prestige associated with this field seem to be among the most prevalent reasons cited for the diminishing interest. Multifaceted concerns such as these, however, are difficult to adequately invalidate; doing so would not only require a great deal research, but also a good deal of time – a resource which is in short supply given the current physician shortage being faced. Thus, a more immediate solution may lie in the increased recruitment and continued support of those individuals who are already associated with primary care service. This is particularly relevant given the Association of American Medical College's goal of increasing medical school enrollment by 15% over the next 10 years. Several groups have been shown to be large contributors to primary care in the US. Here, we focus on three such groups: minority students, International Medical Graduates (IMGs and Osteopathic Physicians (DOs. Although these groups are highly diverse individually, they all share the distinction of being underutilized in regard to the current primary care shortages faced. Thus, through more fully accentuating these

Principal forensic physicians as educational supervisors.

Science.gov (United States)

Stark, Margaret M

2009-10-01

This research project was performed to assist the Faculty of Forensic and Legal Medicine (FFLM) with the development of a training programme for Principal Forensic Physicians (PFPs) (Since this research was performed the Metropolitan Police Service have dispensed with the services of the Principal Forensic Physicians so currently (as of January 2009) there is no supervision of newly appointed FMEs or the development training of doctors working in London nor any audit or appraisal reviews.) to fulfil their role as educational supervisors. PFPs working in London were surveyed by questionnaire to identify the extent of their knowledge with regard to their role in the development training of all forensic physicians (FPs) in their group, the induction of assistant FPs and their perceptions of their own training needs with regard to their educational role. A focus group was held at the FFLM annual conference to discuss areas of interest that arose from the preliminary results of the questionnaire. There is a clear need for the FFLM to set up a training programme for educational supervisors in clinical forensic medicine, especially with regard to appraisal. 2009 Elsevier Ltd and Faculty of Forensic and Legal Medicine.

Gender and academic medicine: a good pipeline of women graduates is not advancing.

Science.gov (United States)

Puljak, Livia; Kojundzic, Sanja Lovric; Sapunar, Damir

2008-01-01

Women are underrepresented in the higher levels of appointment in academic medicine, despite the so-called feminization of medicine. A 27-year (1979-2006) retrospective study was conducted regarding the success and advancement of women and men at the University of Split School of Medicine in Croatia. Data were collected from the school's archive, including number of women and men among applicants, enrollees, graduates, teachers, department chairs and the school management: high school grade averages and admission tests scores by applicant gender and gender-based graduation grade averages. The number and gender patterns of all employed and unemployed physicians in the Split-Dalmatia county were also collected. Men represent the minority among applicants, enrollees, and graduates, whereas women were in the minority among faculty, department chairs, and the school management across all 27 years. Graduation grades from high school and medical school showed that women were statistically better students, although the difference was slight. In the same geographic area, women are more often unemployed and less likely to specialize. More women are applying, enrolling and graduating from the University of Split School of Medicine. Women also perform statistically better on entrance exam and have better graduation grades, yet they remain a minority in faculty and leadership positions. A review of county-wise employment statistics revealed that women were more frequently unemployed and less likely to specialize in this study.

A Reflection and Comparison of Physician Training in the United States of America and United Kingdom

Directory of Open Access Journals (Sweden)

Rohit S. Aiyer

2013-11-01

Full Text Available As a final year medical student at the University of Birmingham in England, I am very familiar with the training structure of physicians in the National Health Service (NHS. Recently, I had the opportunity to do 4 months of clinical electives at the University of Massachusetts in Worcester, Massachusetts and Mount Sinai Medical Center in New York City, New York. This experience allowed me to gain insight on the American training system for medical student graduates that provided a new perspective on physician training. The following reflection will be based on my experiences in the two countries and focus on the working guidelines for junior doctors in the United States that is based on the Accredited Council of Graduate Medical Education (ACGME Duty Hours protocol, and will be compared to the European Work Time Directive (EWTD guidelines for British junior doctors.

Physician's self-perceived abilities at primary care settings in Indonesia.

Science.gov (United States)

Istiono, Wahyudi; Claramita, Mora; Ekawati, Fitriana Murriya; Gayatri, Aghnaa; Sutomo, Adi Heru; Kusnanto, Hari; Graber, Mark Alan

2015-01-01

Southeast Asian countries with better-skilled primary care physicians have been shown to have better health outcomes. However, in Indonesia, there has been a large number of inappropriate referrals, leading to suboptimal health outcomes. This study aimed to examine the reasons underlying the unnecessary referrals as related to Indonesian physicians' standard of abilities. This was a multiple-case study that explored physicians' self-evaluation of their abilities. Self-evaluation questionnaires were constructed from the Indonesian Standards of Physicians Competences of 2006-2012 (ISPC), which is a list of 155 diseases. This study was undertaken in three cities, three towns, and one "border-less developed" area during 2011-2014. The study involved 184 physicians in those seven districts. Data were collected using one-on-one, in-depth interviews, focus group discussions (FGDs), and clinical observations. This study found that primary care physicians in Indonesia felt that they were competent to handle less than one-third of "typical" primary care cases. The reasons were limited understanding of person-centered care principles and limited patient care services to diagnosis and treatment of common biomedical problems. Additionally, physical facilities in primary care settings are lacking. Strengthening primary health care in Indonesia requires upscaling doctors' abilities in managing health problems through more structured graduate education in family medicine, which emphasizes the bio-psycho-socio-cultural background of persons; secondly, standardizing primary care facilities to support physicians' performance is critical. Finally, a strong national health policy that recognizes the essential role of primary care physicians in health outcomes is an urgent need.

Saudi regulations for the accreditation of sleep medicine physicians and technologists

Directory of Open Access Journals (Sweden)

Ahmed S BaHammam

2013-01-01

Full Text Available The professional content of sleep medicine has grown significantly over the past few decades, warranting the recognition of sleep medicine as an independent specialty. Because the practice of sleep medicine has expanded in Saudi Arabia over the past few years, a national regulation system to license and ascertain the competence of sleep medicine physicians and technologists has become essential. Recently, the Saudi Commission for Health Specialties formed the National Committee for the Accreditation of Sleep Medicine Practice and developed national accreditation criteria. This paper presents the newly approved Saudi accreditation criteria for sleep medicine physicians and technologists.

Continuity of care with physicians and risk of subsequent hospitalization and end-stage renal disease in newly diagnosed type 2 diabetes mellitus patients.

Science.gov (United States)

Chang, Po-Ya; Chien, Li-Nien; Bai, Chyi-Huey; Lin, Yuh-Feng; Chiou, Hung-Yi

2018-01-01

Effective management for type 2 diabetes mellitus (DM) can slow the progression of kidney outcomes and reduce hospital admissions. Better continuity of care (COC) was found to improve patients' adherence and self-management. This study examined the associations between COC, hospitalization, and end-stage renal disease (ESRD) in DM patients. In the cohort study, data from 1996 to 2012 were retrieved from the Longitudinal Health Insurance Database, using inverse probability weighted analysis. A total of 26,063 patients with newly diagnosed type 2 DM who had been treated with antihyperglycemic agents were included. COC is to assess the extent to which a DM patient visited the same physician during the study period. This study categorized COC into 3 groups - low, intermediate, and high, - according to the distribution of scores in our sample. The number of ESRD patients in the high, intermediate, and low COC groups were 92 (22.33%), 130 (31.55%), and 190 (46.12%), respectively, and the mean follow-up periods for the 3 groups were 7.13, 7.12, and 7.27 years, respectively. After using inverse probability weighting, the intermediate and low COC groups were significantly associated with an increased risk of ESRD compared with the high COC group (adjusted hazard ratio (aHR) 1.36 [95% CI, 1.03-1.80] and aHR 1.76 [95% CI, 1.35-2.30], respectively). The intermediate and low COC groups were also significantly associated with the subsequent hospitalization compared with the high COC group (aHR 1.15 [95% CI, 0.99-1.33] and aHR 1.72 [95% CI, 1.50-1.97], respectively). COC is related to ESRD onset and subsequent hospitalization among patients with DM. This study suggested that when DM patients keep visiting the same physician for managing their diseases, the progression of renal disease can be prevented.

Brain Drain: Post Graduation Migration Intentions and the influencing factors among Medical Graduates from Lahore, Pakistan.

Science.gov (United States)

Imran, Nazish; Azeem, Zahra; Haider, Imran I; Amjad, Naeem; Bhatti, Muhammad R

2011-10-17

The increasing migration of health professionals to affluent countries is not a recent phenomenon and has been addressed in literature. However the various facets of physician migration from Pakistan, the third leading source of International medical graduates has not been rigorously evaluated. The objective of the current study was to survey final year students and recent medical graduates in Lahore, Pakistan about their intentions to train abroad, their post training plans as well as to identify the factors responsible for their motivation for international migration. A self administered structured questionnaire was developed to collect respondents' demographic and educational characteristics, intention to train abroad, their preferred destination & post training intentions of returning to Pakistan. Various influencing factors which impact on medical graduate's motivation to train abroad or stay in Pakistan were explored using a 10 point scale. SPSS software was used for data entry and analysis. Of the 400 eligible respondents, 275 responded (response rate 68.7%). One hundred and sixty six respondents (60.4%) intended to train abroad either for a specialty (54.9%) or a subspecialty (5.5%) The United States and United Kingdom were the most preferred destination. While 14.2% intended to return to Pakistan immediately after training, a significant percentage (10%) never intended to return to Pakistan or wished to stay abroad temporarily (37%). Professional excellence and establishing quickly in the competitive market were the most important goal to be achieved by the respondents for intention for postgraduate training abroad. The most common reasons cited for training abroad were the impact of residency training on future career (mean score 8.20 ± 2.3), financial conditions of doctors (mean score 7.97 ± 2.37) and job opportunities (mean score7.90 ± 2.34). An alarming percentage of medical graduates from Lahore, Pakistan intend to migrate for post graduate

Brain Drain: Post Graduation Migration Intentions and the influencing factors among Medical Graduates from Lahore, Pakistan

Directory of Open Access Journals (Sweden)

Imran Nazish

2011-10-01

Full Text Available Abstract Background The increasing migration of health professionals to affluent countries is not a recent phenomenon and has been addressed in literature. However the various facets of physician migration from Pakistan, the third leading source of International medical graduates has not been rigorously evaluated. The objective of the current study was to survey final year students and recent medical graduates in Lahore, Pakistan about their intentions to train abroad, their post training plans as well as to identify the factors responsible for their motivation for international migration. Method A self administered structured questionnaire was developed to collect respondents' demographic and educational characteristics, intention to train abroad, their preferred destination & post training intentions of returning to Pakistan. Various influencing factors which impact on medical graduate's motivation to train abroad or stay in Pakistan were explored using a 10 point scale. SPSS software was used for data entry and analysis. Results Of the 400 eligible respondents, 275 responded (response rate 68.7%. One hundred and sixty six respondents (60.4% intended to train abroad either for a specialty (54.9% or a subspecialty (5.5% The United States and United Kingdom were the most preferred destination. While 14.2% intended to return to Pakistan immediately after training, a significant percentage (10% never intended to return to Pakistan or wished to stay abroad temporarily (37%. Professional excellence and establishing quickly in the competitive market were the most important goal to be achieved by the respondents for intention for postgraduate training abroad. The most common reasons cited for training abroad were the impact of residency training on future career (mean score 8.20 ± 2.3, financial conditions of doctors (mean score 7.97 ± 2.37 and job opportunities (mean score7.90 ± 2.34. Conclusion An alarming percentage of medical graduates from

Newly approved antibiotics and antibiotics reserved for resistant infections: Implications for emergency medicine.

Science.gov (United States)

Mazer-Amirshahi, Maryann; Pourmand, Ali; May, Larissa

2017-01-01

Millions of patients are evaluated every year in the emergency department (ED) for bacterial infections. Emergency physicians often diagnose and prescribe initial antibiotic therapy for a variety of bacterial infections, ranging from simple urinary tract infections to severe sepsis. In life-threatening infections, inappropriate choice of initial antibiotic has been shown to increase morbidity and mortality. As such, initiation of appropriate antibiotic therapy on the part of the emergency physician is critical. Increasing rates of antibiotic resistance, drug allergies, and antibiotic shortages further complicates the choice of antibiotics. Patients may have a history of prior resistant infections or culture data indicating that common first-line antibiotics used in the ED may be ineffective. In recent years, there have been several new antibiotic approvals as well as renewed interest in second and third line antibiotics because of the aforementioned concerns. In addition, several newly approved antibiotics have the advantage of being administered once weekly or even as a single infusion, which has the potential to decrease hospitalizations and healthcare costs. This article reviews newly approved antibiotics and antibiotics used to treat resistant infections with a focus on implications for emergency medicine. Copyright © 2016 Elsevier Inc. All rights reserved.

Preparing Master of Public Health Graduates to Work in Local Health Departments.

Science.gov (United States)

Hemans-Henry, Calaine; Blake, Janice; Parton, Hilary; Koppaka, Ram; Greene, Carolyn M

2016-01-01

To identify key competencies and skills that all master of public health (MPH) graduates should have to be prepared to work in a local health department. In 2011-2012, the New York City Department of Health and Mental Hygiene administered electronic surveys to 2 categories of staff: current staff with an MPH as their highest degree, and current hiring managers. In all, 312 (77%) staff members with an MPH as their highest degree and 170 (57%) hiring managers responded to the survey. Of the respondents with an MPH as their highest degree, 85% stated that their MPH program prepared them for work at the New York City Health Department. Skills for which MPH graduates most often stated they were underprepared included facility in using SAS® statistical software, quantitative data analysis/statistics, personnel management/leadership, and data collection/database management/data cleaning. Among the skills hiring managers identified as required of MPH graduates, the following were most often cited as those for which newly hired MPH graduates were inadequately prepared: quantitative data analysis, researching/conducting literature reviews, scientific writing and publication, management skills, and working with contracts/requests for proposals. These findings suggest that MPH graduates could be better prepared to work in a local health department upon graduation. To be successful, new MPH graduate hires should possess fundamental skills and knowledge related to analysis, communication, management, and leadership. Local health departments and schools of public health must each contribute to the development of the current and future public health workforce through both formal learning opportunities and supplementary employment-based training to reinforce prior coursework and facilitate practical skill development.

The assessment of pathologists/laboratory medicine physicians through a multisource feedback tool.

Science.gov (United States)

Lockyer, Jocelyn M; Violato, Claudio; Fidler, Herta; Alakija, Pauline

2009-08-01

There is increasing interest in ensuring that physicians demonstrate the full range of Accreditation Council for Graduate Medical Education competencies. To determine whether it is possible to develop a feasible and reliable multisource feedback instrument for pathologists and laboratory medicine physicians. Surveys with 39, 30, and 22 items were developed to assess individual physicians by 8 peers, 8 referring physicians, and 8 coworkers (eg, technologists, secretaries), respectively, using 5-point scales and an unable-to-assess category. Physicians completed a self-assessment survey. Items addressed key competencies related to clinical competence, collaboration, professionalism, and communication. Data from 101 pathologists and laboratory medicine physicians were analyzed. The mean number of respondents per physician was 7.6, 7.4, and 7.6 for peers, referring physicians, and coworkers, respectively. The reliability of the internal consistency, measured by Cronbach alpha, was > or = .95 for the full scale of all instruments. Analysis indicated that the medical peer, referring physician, and coworker instruments achieved a generalizability coefficient of .78, .81, and .81, respectively. Factor analysis showed 4 factors on the peer questionnaire accounted for 68.8% of the total variance: reports and clinical competency, collaboration, educational leadership, and professional behavior. For the referring physician survey, 3 factors accounted for 66.9% of the variance: professionalism, reports, and clinical competency. Two factors on the coworker questionnaire accounted for 59.9% of the total variance: communication and professionalism. It is feasible to assess this group of physicians using multisource feedback with instruments that are reliable.

A new wave of urologists? Graduating urology residents' practices of and attitudes toward social media.

Science.gov (United States)

Jain, Kunal; Fervaha, Gagan; Fuoco, Michael B; Leveridge, Michael J

2018-03-19

Social media (SoMe) have revolutionized healthcare, but physicians remain hesitant to adopt SoMe in their practices. We sought to assess graduating urology residents' practices of and attitudes toward SoMe. A close-ended questionnaire, employing five-point Likert scales, was distributed to all final-year residents (n=100) in Canadian urology training programs in 2012, 2014, and 2016 to assess SoMe usage and perceived usefulness. All (100%) questionnaires were completed. Respondents frequently used online services for personal (100%) and professional (96%) purposes. Most (92%) used SoMe. Many (73%) frequently used SoMe for personal purposes, but few (12%) frequently used SoMe for professional purposes. While a majority (59%) opposed direct patient interaction online, most supported using SoMe to provide patients with static information (76%) and collaborate with colleagues (65%). Many (70-73%) were optimistic that novel solutions to privacy issues in online communications will arise, making SoMe and email contact with patients conceivable. Few (2-8%) were aware and had read guidelines and legislations regarding physician online practices; however, awareness of medical associations' and institutional SoMe policies significantly increased over time (pprofessional settings and were wary of using it in patient care. Nevertheless, they were optimistic toward its integration in urology and supported its use in physician-physician communication. Considering SoMe's increased influence on urology and graduating residents' limited awareness of guidelines and legislations, postgraduate medical educators should encourage residents to become more familiar with current online communication recommendations.

Physician Self-directed Learning and Education

Directory of Open Access Journals (Sweden)

Masami Tagawa

2008-07-01

Full Text Available Physicians are expected to be life-long learners because updated and effective patient care should be provided while medical and clinical knowledge and skills and social requirements for patient care are rapidly changing. Also, qualified clinical competence needs long periods of training and each physician has to continually learn as long as he/she works as a professional. Self-directed learning is an important factor in adult learning. Medical students' readiness for self-directed learning is not high, and should be improved by medical school and postgraduate training curricula. Garrison proposed a comprehensive model of self-directed learning, and it has dimensions of motivation (entering and task, self-monitoring (responsibility, and self-management (responsibility. To teach individual self-directed learning competencies, the following are important: (1 situate learners to experience “real” problems; (2 encourage learners to reflect on their own performance; (3 create an educational atmosphere in clinical training situations. In 2005, a 2-year mandatory residency program was implemented in Japan, and fewer medical school graduates took residency programs in medical school hospitals and advanced specialty programs provided by medical school departments. Medical school departments provide traditional, but life-long clinical training opportunities. Under the new residency program, an additional postgraduate and continuing medical training system has to be built up to maintain and confirm a physician's competencies. If physicians do clinical work using a scholarly way of thinking with critical analysis of their own competencies and improvement by reflection, they will become an excellent life-long learner.

Singapore's proposed graduate medical school--an expensive medical tutorial college or an opportunity for transforming Singapore medicine?

Science.gov (United States)

Soo, K C

2005-07-01

The proposed Graduate Medical School at the Outram Campus will open in 2007. The main value of this medical school is the transformation of the medical institutions in the campus and SingHealth into Academic Medical Centres. Such centres will train and host quality physicians and physician-scientists. It will help push the development of translational research, complementing the country's investment in Biopolis. It will also underpin Singapore's push into regional medical tourism and its development as an educational hub in the biomedical sciences.

Career Choices and Career Progression of Junior Doctors in Dermatology: Surveys of UK Medical Graduates.

Science.gov (United States)

Barat, Atena; Goldacre, Michael J; Lambert, Trevor W

2018-01-01

To report UK-trained doctors' career choices for dermatology, career destinations, and factors influencing career pathways. Multicohort multipurpose longitudinal surveys of UK-trained doctors who graduated between 1974 and 2015. In all, 40,412 doctors (58% of graduates) responded in year 1, 31,466 (64%) in year 3, and 24,970 (67%) in year 5. One year after graduation, 1.7% of women and 0.6% of men made dermatology their first choice but by five years after graduation the respective figures were 1.0% and 0.7%. Compared to their predecessors, its popularity fell more substantially from years 1 to 5 among recent graduates (2005-15), particularly for women (from 2.1% in year 1 to 0.8% in year 5) compared with a fall from 0.8% to 0.5% among men. The most important factor influencing dermatology choice was "hours/working conditions": in year one, 69% regarded this as important compared with 31% of those choosing other hospital physician specialties. Only 18% of respondents who chose dermatology at year 1 eventually worked in it; however, almost all practising dermatologists (94%), 10 years after qualifying, had made their future career decision by year 5. Dermatology is popular among female UK graduates. Most dermatologists made their career decision late but decisively.

[Bioethical analysis of the use of newly dead patients in medical learning].

Science.gov (United States)

Gomes, Andréia Patrícia; Rego, Sergio; Palácios, Marisa; Siqueira-Batista, Rodrigo

2010-01-01

The purpose of this article is to carry out, a discussion on the subject of bioethics and cadavers based upon a critic review of literature. A review of literature, was made with a survey of articles between 1977 and 2007 in the sites 'Biblioteca Virtual de Saúde', PubMed and SciElo, utilizing the keywords: newly deceased patients, newly dead patients, simulators,. This was complemented by a critical evaluation of books published in the area of ethics and bioethics. The possibility to develop learning without orientation by a supervisor is doubtful.. The utilization of newly dead for learning invasive procedures is very frequent and seldom admitted. These procedures, are usually, carried out secretly, without the knowledge and consent of the family. The ethical aspects of these practices are not discussed in the practical medical education. It essential that the ethics of use of recent deceased become a necessary content of graduate education. Performance of these procedures by students should always be authorized by family members. The simulators meet the requirements of training. Discussions about the ethical and bioethical aspects cannot be separated from practical considerations during the students learning time.

Essential professional duties for the sub-Saharan medical/dental graduate: An Association of Medical Schools of Africa initiative.

Science.gov (United States)

Olapade-Olaopa, E O; Sewankambo, N; Iputo, J E; Rugarabamu, P; Amlak, A H; Mipando, M; Monekosso G L

2016-09-01

BACKGROUND - Globally, human resources for health are being optimized to address the increasing health burden and concomitant increased demands on health professionals. These demands are even more exacting in Sub-SaharanAfrica considering the shortage of health care workers, especially physicians. The noteworthy efforts at deploying task-shifting to address this situation not-withstanding, the situation also signals the need to re-define the objectives of medical instruction to ensure effective and contemporary medical practice in a mostly physician-led health workforce across the sub-continent. In this regard, medical and dental graduates must be educated to perform certain minimum essential professional duties competently. Essential Professional Duties are locally relevant professional activities of international standard that represent identifiable outcomes against which the effectiveness of physicians in a specific community can be measured to ensure social accountability. PROCEDURE AND PRODUCT - The Association of Medical Schools of Africa has developed the 'Essential Professional Duties for sub-Saharan medical and dental graduates' to ensure these physicians provide safe and effective contemporary medical/dental practice on the sub-continent. The duties have been grouped into those required for basic patient care, basic administrative skills, basic emergency care, communication, inter-professional relationships, self-directed learning and social responsibilities. Their relevance and suitability have been evaluated prior to their adoption by the Association. CONCLUSION; These Essential Physician Duties have been developed to serve as targets for health professionals training instruments and thus give direction to health system strategies. It is hoped that they will be adopted by medical and dental schools across sub-,. Saharan Africa.

Underrepresentation of Women and Minorities in the United States IR Academic Physician Workforce.

Science.gov (United States)

Higgins, Mikhail C S S; Hwang, Wei-Ting; Richard, Chase; Chapman, Christina H; Laporte, Angelique; Both, Stefan; Thomas, Charles R; Deville, Curtiland

2016-12-01

To assess the United States interventional radiology (IR) academic physician workforce diversity and comparative specialties. Public registries were used to assess demographic differences among 2012 IR faculty and fellows, diagnostic radiology (DR) faculty and residents, DR subspecialty fellows (pediatric, abdominal, neuroradiology, and musculoskeletal), vascular surgery and interventional cardiology trainees, and 2010 US medical school graduates and US Census using binomial tests with .001 significance level (Bonferroni adjustment for multiple comparisons). Significant trends in IR physician representation were evaluated from 1992 to 2012. Women (15.4%), blacks (2.0%), and Hispanics (6.2%) were significantly underrepresented as IR fellows compared with the US population. Women were underrepresented as IR (7.3%) versus DR (27.8%) faculty and IR fellows (15.4%) versus medical school graduates (48.3%), DR residents (27.8%), pediatric radiology fellows (49.4%), and vascular surgery trainees (27.7%) (all P < .001). IR ranked last in female representation among radiologic subspecialty fellows. Blacks (1.8%, 2.1%, respectively, for IR faculty and fellows); Hispanics (1.8%, 6.2%); and combined American Indians, Alaska Natives, Native Hawaiians, and Pacific Islanders (1.8%, 0) showed no significant differences in representation as IR fellows compared with IR faculty, DR residents, other DR fellows, or interventional cardiology or vascular surgery trainees. Over 20 years, there was no significant increase in female or black representation as IR fellows or faculty. Women, blacks, and Hispanics are underrepresented in the IR academic physician workforce relative to the US population. Given prevalent health care disparities and an increasingly diverse society, research and training efforts should address IR physician workforce diversity. Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.

Job requirements compared to medical school education: differences between graduates from problem-based learning and conventional curricula

Directory of Open Access Journals (Sweden)

Federkeil Gero

2010-01-01

Full Text Available Abstract Background Problem-based Learning (PBL has been suggested as a key educational method of knowledge acquisition to improve medical education. We sought to evaluate the differences in medical school education between graduates from PBL-based and conventional curricula and to what extent these curricula fit job requirements. Methods Graduates from all German medical schools who graduated between 1996 and 2002 were eligible for this study. Graduates self-assessed nine competencies as required at their day-to-day work and as taught in medical school on a 6-point Likert scale. Results were compared between graduates from a PBL-based curriculum (University Witten/Herdecke and conventional curricula. Results Three schools were excluded because of low response rates. Baseline demographics between graduates of the PBL-based curriculum (n = 101, 49% female and the conventional curricula (n = 4720, 49% female were similar. No major differences were observed regarding job requirements with priorities for "Independent learning/working" and "Practical medical skills". All competencies were rated to be better taught in PBL-based curriculum compared to the conventional curricula (all p Conclusion Among medical graduates in Germany, PBL demonstrated benefits with regard to competencies which were highly required in the job of physicians. Research and business competence deserve closer attention in future curricular development.

Entrustable professional activities in post-licensure training in primary care pediatrics: Necessity, development and implementation of a competency-based post-graduate curriculum

Directory of Open Access Journals (Sweden)

Fehr, Folkert

2017-11-01

Full Text Available There is an absence of broad-based and binding curricular requirements for structured competency-based post-graduate medical training in Germany, and thus no basis for comparing the competencies of physicians undergoing training in a medical specialty (. In response, the German Society of Primary Care Pediatrics’ working group on post-graduate education (DGAAP has identified realistic entrustable professional activities (EPAs in primary care, defined their number, scope and content, selected competency domains, specified required knowledge and skills, and described appropriate assessment methods. These guidelines are referred to as and can be accessed electronically by educators in pediatric medicine; the use and effectiveness of these guidelines are monitored by the German Association for Medical Education’s committee on post-graduate education (GMA. Teaching and training in pediatric medicine should take EPAs into consideration. To accomplish this, phases dedicated to primary care should be integrated into formal medical specialty training. Primary care pediatrics must enhance the sites where such training takes place into learning environments that prepare physicians trainees and turn the practicing specialists into mentoring educators.

The Effectiveness of the Community Medicine Undergraduate Program in Medical Schools on Enabling Medical Graduates to Work in the Health Systems

Directory of Open Access Journals (Sweden)

Hossein Jabbari Bayrami

2013-05-01

Full Text Available Introduction: The main mission of medical schools is to train competent medical trainees for providing primary health care services, management of health care team and improving the health status of the population. The aim of this study was to determine the effectiveness of the undergraduate program of community medicine department among the graduates as general (family physicians in health system of East Azerbaijan, North-West of` Iran. Methods: In this cross- sectional study all family physicians of East Azerbaijan province were included. A questionnaire on the views of graduates about the effectiveness of community medicine undergraduate program was used for gathering data. Data were analyzed by T-test, ANOVA, and Pearson correlation. Results: Performance of community medicine department in creating competency for providing effective health services among physicians was 2.13 and management competency was 1.96 out of 4. To teach the necessary skills to meet the professional needs in Primary Health Care (PHC, Tabriz Community Medicine Department was better compared to Azad and other medical schools (p<0.001. Conclusions: The results of the study showed that the community medicine program in undergraduate medical education was effective for future career of physicians in the health system. There is a need to revise the health management courses in community medicine program.

The role that graduate medical education must play in ensuring health equity and eliminating health care disparities.

Science.gov (United States)

Maldonado, Maria E; Fried, Ethan D; DuBose, Thomas D; Nelson, Consuelo; Breida, Margaret

2014-05-01

Despite the 2002 Institute of Medicine report that described the moral and financial impact of health care disparities and the need to address them, it is evident that health care disparities persist. Recommendations for addressing disparities include collecting and reporting data on patient race and ethnicity, supporting language interpretation services, increasing awareness of health care disparities through education, requiring cultural competency training for all health care professionals, and increasing diversity among those delivering health care. The Accreditation Council on Graduate Medical Education places strong emphasis on graduate medical education's role in eliminating health care disparities by asking medical educators to objectively evaluate and report on their trainees' ability to practice patient-centered, culturally competent care. Moreover, one of the objectives of the Accreditation Council on Graduate Medical Education Clinical Learning Environment Review visits as part of the Next Accreditation System is to identify how sponsoring institutions engage residents and fellows in the use of data to improve systems of care, reduce health care disparities, and improve patient outcomes. Residency and fellowship programs should ensure the delivery of meaningful curricula on cultural competency and health care disparities, for which there are numerous resources, and ensure resident assessment of culturally competent care. Moreover, training programs and institutional leadership need to collaborate on ensuring data collection on patient satisfaction, outcomes, and quality measures that are broken down by patient race, cultural identification, and language. A diverse physician workforce is another strategy for mitigating health care disparities, and using strategies to enhance faculty diversity should also be a priority of graduate medical education. Transparent data about institutional diversity efforts should be provided to interested medical students

Exercise recommendations in patients with newly diagnosed fibromyalgia.

Science.gov (United States)

Wilson, Brad; Spencer, Horace; Kortebein, Patrick

2012-04-01

To evaluate exercise recommendations in patients newly diagnosed with fibromyalgia. A retrospective chart review. A public university rheumatology clinic. Patients newly diagnosed with fibromyalgia (N = 122). Frequency and type of exercise recommendations. The mean (standard deviation) age of these patients with fibromyalgia was 45 ± 12 years; 91% were women. Exercise was recommended as part of the documented treatment plan in 47% of these patients (57/122); only 3 patients had a documented contraindication for exercise. Aquatic exercise was most frequently recommended (56% [32/57]), followed by combined aquatic-aerobic exercise (26% [15/57]), and, infrequently, aerobic exercise only (5% [3/57]); only 7% of these patients (4/57) were referred for physical therapy. The primary method of communication was verbal discussion (94% [54/57]). Although there is well-documented evidence that exercise is beneficial for patients with fibromyalgia, we found that less than half of patients with newly diagnosed fibromyalgia in our study were provided recommendations to initiate an exercise program as part of their treatment plan. Further investigation of these findings are warranted, including evaluation of other university and community rheumatology practices as well as that of other physicians caring for patients with fibromyalgia. However, our findings indicate that there appears to be an opportunity to provide more specific and practical education regarding the implementation of an exercise regimen for patients with newly diagnosed fibromyalgia. Physiatrists may be particularly well suited to manage the exercise component of patients with fibromyalgia because of their specialized training in exercise prescription. Copyright © 2012 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Investigation on legal problems encountered by emergency medicine physicians in Turkey.

Science.gov (United States)

Kayipmaz, Afsin Emre; Kavalci, Cemil; Gulalp, Betul; Kocalar, Ummu Gulsum; Giray, Tufan Akin; Yesilagac, Hasan; Ozel, Betul Akbuga; Celikel, Elif; Karagun, Ozlem

2015-01-01

Medicine is a profession that carries certain risks. One risky area of practice is the emergency department. Emergency physicians diagnose and treat a high volume of patients, and are also responsible for preparing reports for forensic cases. In this study, we aim to investigate emergency physicians' legal-administrative problems and reveal their level of understanding on forensic cases. An electronic questionnaire form was prepared after the approval of an ethical committee. This form was sent to the residents, specialists and academicians of emergency medicine by e-mail. The physicians were asked to fill out the form online. All the gathered data was analyzed. Descriptive statistics were presented as frequency percentages with mean and standard deviation. Chi-square tests were used to compare the groups. Correlation between number of complaint cases and age, sex, career, institution, and duration of service in emergency department were investigated. pmedicine and age. There was a significant difference between number of complaint reports and career (p<0.05). The physicians' level of awareness on forensic cases was found to be insufficient. Lack of legislation knowledge may be an important cause of complaint reports concerning emergency physicians, who have a high load of patients. Thus, we think that increasing the frequency of post-graduate education sessions and periodical reviews might be beneficial.

The gendered realities and talent management imperatives of women physicians.

Science.gov (United States)

Hoff, Timothy; Scott, Sarah

2016-01-01

U.S. medicine is increasingly a gender-balanced profession with half of all medical school graduates now female. Despite this reality and the potentially transformative nature of a large female physician cohort in U.S. health care, there is less examination of their workplace realities and the key talent management strategies for health care organizations employing women physicians. First, we identify current knowledge about U.S. women physician satisfaction, role challenges, and work tradeoffs. Gender theory is used to help interpret these workplace realities. Second, we use this information to identify talent management strategies health care organizations might consider to mitigate the realities and provide greater support for women physicians. To facilitate our analysis, we conducted a narrative review of published research that includes analysis focused on U.S. women physicians for the time period 2006-2014. Applying ideas from gender theory, we extrapolated key findings from that research related to three issues: satisfaction, role challenges, and tradeoffs. Then we synthesized the findings to identify general talent management strategies that could address these dynamics proactively while enhancing recruitment and retention with respect to women physicians. U.S. women physicians express strong levels of satisfaction, particularly with their careers, at the same time they continue to experience gender-based inequities, role challenges, and lack of work-life balance in their chosen specialty fields. Lack of suitable role models and appropriate mentoring for women physicians, in addition to barriers to career advancement, are also prevalent across different medical specialties. Similar to other occupations and industries, gender-based inequities and role strains are very real issues for women physicians. Health care organizations must acknowledge these issues and employ effective talent management strategies aimed at women doctors if they are to be viewed as an

The subject of pedagogy from theory to practice--the view of newly registered nurses.

Science.gov (United States)

Ivarsson, Bodil; Nilsson, Gunilla

2009-07-01

The aim was to describe, from the newly registered nurses' perspective, specific events when using their pedagogical knowledge in their everyday clinical practice. The design was qualitative and the critical incident technique was used. Data was collected via interviews with ten newly registered nurses who graduated from the same University program 10 months earlier and are now employed at a university hospital. Two categories emerged in the analyses. The first category was "Pedagogical methods in theory" with the sub-categories Theory and the application of the course in practice, Knowledge of pedagogy and Information as a professional competence. The second category was "Pedagogical methods in everyday clinical practice" with sub-categories Factual knowledge versus pedagogical knowledge, Information and relatives, Difficulties when giving information, Understanding information received, Pedagogical tools, Collaboration in teams in pedagogical situations, and Time and giving information. By identifying specific events regarding pedagogical methods the findings can be useful for everyone from teachers and health-care managers to nurse students and newly registered nurses, to improve teaching methods in nurse education.

Factors enhancing career satisfaction among female emergency physicians.

Science.gov (United States)

Clem, Kathleen J; Promes, Susan B; Glickman, Seth W; Shah, Anand; Finkel, Michelle A; Pietrobon, Ricardo; Cairns, Charles B

2008-06-01

Attrition rates in emergency medicine have been reported as high as 25% in 10 years. The number of women entering emergency medicine has been increasing, as has the number of female medical school graduates. No studies have identified factors that increase female emergency physician career satisfaction. We assess career satisfaction in women emergency physicians in the American College of Emergency Physicians (ACEP) and identify factors associated with career satisfaction. The survey questionnaire was developed by querying 3 groups: (1) ACEP women in the American Association of Women Emergency Physicians, the (2) Society for Academic Emergency Medicine Mentoring Women Interest Group, and (3) nonaffiliated female emergency physicians. Their responses were categorized into 6 main areas: schedule, relationships with colleagues, administrative support and mentoring, patient/work-related issues, career advancement opportunities, and financial. The study cohort for the survey included all female members of ACEP with a known e-mail address. All contact with survey recipients was exclusively through the e-mail that contained a uniform resource locator link to the survey itself. Two thousand five hundred two ACEP female members were sent the uniform resource locator link. The Web survey was accessed a total of 1,851 times, with a total of 1,380 surveys completed, an overall response rate of 56%. Most women were satisfied with their career as an emergency physician, 492 (35.5%) very satisfied, 610 (44.0%) satisfied, 154 (11.1%) neutral, 99 (7.1%) not satisfied, and 31 (2.3%) very unsatisfied. Significant factors for career satisfaction included amount of recognition at work, career advancement, schedule flexibility, and the fairness of financial compensation. Workplace factors associated with high satisfaction included academic practice setting and sex-equal opportunity for advancement and sex-equal financial compensation. Most of the ACEP female physicians surveyed were

History and Outcomes of 50 Years of Physician-Scientist Training in Medical Scientist Training Programs.

Science.gov (United States)

Harding, Clifford V; Akabas, Myles H; Andersen, Olaf S

2017-10-01

Physician-scientists are needed to continue the great pace of recent biomedical research and translate scientific findings to clinical applications. MD-PhD programs represent one approach to train physician-scientists. MD-PhD training started in the 1950s and expanded greatly with the Medical Scientist Training Program (MSTP), launched in 1964 by the National Institute of General Medical Sciences (NIGMS) at the National Institutes of Health. MD-PhD training has been influenced by substantial changes in medical education, science, and clinical fields since its inception. In 2014, NIGMS held a 50th Anniversary MSTP Symposium highlighting the program and assessing its outcomes. In 2016, there were over 90 active MD-PhD programs in the United States, of which 45 were MSTP supported, with a total of 988 trainee slots. Over 10,000 students have received MSTP support since 1964. The authors present data for the demographic characteristics and outcomes for 9,683 MSTP trainees from 1975-2014. The integration of MD and PhD training has allowed trainees to develop a rigorous foundation in research in concert with clinical training. MSTP graduates have had relative success in obtaining research grants and have become prominent leaders in many biomedical research fields. Many challenges remain, however, including the need to maintain rigorous scientific components in evolving medical curricula, to enhance research-oriented residency and fellowship opportunities in a widening scope of fields targeted by MSTP graduates, to achieve greater racial diversity and gender balance in the physician-scientist workforce, and to sustain subsequent research activities of physician-scientists.

Accreditation status of U.S. military graduate medical education programs.

Science.gov (United States)

De Lorenzo, Robert A

2008-07-01

Military graduate medical education (GME) comprises a substantial fraction of U.S. physician training capacity. The wars in Iraq and Afghanistan have placed substantial stress on military medicine, and lay and professional press accounts have raised awareness of the effects on military GME. To date, however, objective data on military GME quality remains sparse. Determine the accreditation status of U.S. military GME programs. Additionally, military GME program data will be compared to national (U.S.) accreditation lengths. Retrospective review of Accreditation Council for Graduate Medical Education (ACGME) data. All military-sponsored core programs in specialties with at least three residencies were included. Military-affiliated but civilian-sponsored programs were excluded. The current and past cycle data were used for the study. For each specialty, the current mean accreditation length and the net change in cycle was calculated. National mean accreditation lengths by specialty for 2005 to 2006 were obtained from the ACGME. Comparison between the overall mean national and military accreditation lengths was performed with a z test. All other comparisons employed descriptive statistics. Ninety-nine military programs in 15 specialties were included in the analysis. During the study period, 1 program was newly accredited, and 6 programs had accreditation withdrawn or were closed. The mean accreditation length of the military programs was 4.0 years. The overall national mean for the same specialties is 3.5 years (p < 0.01). In previous cycles, 68% of programs had accreditation of 4 years or longer, compared to 70% in the current cycle, while 13% had accreditation of 2 years or less in the previous cycle compared to 14% in the current cycle. Ten (68%) of the military specialties had mean accreditation lengths greater than the national average, while 5 (33%) were below it. Ten (68%) specialties had stable or improving cycle lengths when compared to previous cycles

Investigation on legal problems encountered by emergency medicine physicians in Turkey.

Directory of Open Access Journals (Sweden)

Afsin Emre Kayipmaz

Full Text Available Medicine is a profession that carries certain risks. One risky area of practice is the emergency department. Emergency physicians diagnose and treat a high volume of patients, and are also responsible for preparing reports for forensic cases. In this study, we aim to investigate emergency physicians' legal-administrative problems and reveal their level of understanding on forensic cases.An electronic questionnaire form was prepared after the approval of an ethical committee. This form was sent to the residents, specialists and academicians of emergency medicine by e-mail. The physicians were asked to fill out the form online. All the gathered data was analyzed. Descriptive statistics were presented as frequency percentages with mean and standard deviation. Chi-square tests were used to compare the groups. Correlation between number of complaint cases and age, sex, career, institution, and duration of service in emergency department were investigated. p<0.05 was considered statistically significant.294 physicians participated in the questionnaire. According to the questionnaire, 170 of the physicians were reported to the patient communication units due to medical malpractice. Mean number of compliant reports was 3.20±3.5. 29 of the physicians received administrative penalties. 42 of the physicians were judged in the court for medical malpractice. 1 physician was fined 5000 Turkish Liras as a result of these judgments.We found that the number of complaint reports is negatively correlated with duration of service in emergency medicine and age. There was a significant difference between number of complaint reports and career (p<0.05. The physicians' level of awareness on forensic cases was found to be insufficient. Lack of legislation knowledge may be an important cause of complaint reports concerning emergency physicians, who have a high load of patients. Thus, we think that increasing the frequency of post-graduate education sessions and

Career Choices and Career Progression of Junior Doctors in Dermatology: Surveys of UK Medical Graduates

Directory of Open Access Journals (Sweden)

Atena Barat

2018-01-01

Full Text Available Objective. To report UK-trained doctors’ career choices for dermatology, career destinations, and factors influencing career pathways. Methods. Multicohort multipurpose longitudinal surveys of UK-trained doctors who graduated between 1974 and 2015. Results. In all, 40,412 doctors (58% of graduates responded in year 1, 31,466 (64% in year 3, and 24,970 (67% in year 5. One year after graduation, 1.7% of women and 0.6% of men made dermatology their first choice but by five years after graduation the respective figures were 1.0% and 0.7%. Compared to their predecessors, its popularity fell more substantially from years 1 to 5 among recent graduates (2005–15, particularly for women (from 2.1% in year 1 to 0.8% in year 5 compared with a fall from 0.8% to 0.5% among men. The most important factor influencing dermatology choice was “hours/working conditions”: in year one, 69% regarded this as important compared with 31% of those choosing other hospital physician specialties. Only 18% of respondents who chose dermatology at year 1 eventually worked in it; however, almost all practising dermatologists (94%, 10 years after qualifying, had made their future career decision by year 5. Conclusion. Dermatology is popular among female UK graduates. Most dermatologists made their career decision late but decisively.

Accreditation of undergraduate and graduate medical education

DEFF Research Database (Denmark)

Davis, Deborah J; Ringsted, Charlotte

2006-01-01

Accreditation organizations such as the Liaison Committee for Medical Education (LCME), the Royal College of Physicians and Surgeons of Canada (RCPSC), and the Accreditation Council for Graduate Medical Education (ACGME) are charged with the difficult task of evaluating the educational quality...... of medical education programs in North America. Traditionally accreditation includes a more quantitative rather than qualitative judgment of the educational facilities, resources and teaching provided by the programs. The focus is on the educational process but the contributions of these to the outcomes...... are not at all clear. As medical education moves toward outcome-based education related to a broad and context-based concept of competence, the accreditation paradigm should change accordingly. Udgivelsesdato: 2006-Aug...

An MBA: the utility and effect on physicians' careers.

Science.gov (United States)

Parekh, Selene G; Singh, Bikramjit

2007-02-01

Higher economic, legislative, legal, and administrative constraints in health-care services in the United States have led to an increase in physician dissatisfaction and a decrease in physician morale. In this study, we attempted to understand the motivation for a physician to enroll in a business school, and to discover the utility of the Master of Business Administration degree and how it changed the career path for the practicing clinician. We conducted a retrospective study in which a twenty-seven-question survey was distributed by the United States Postal Service and by e-mail to 161 physician graduates of three East Coast business schools. The results were evaluated, and a statistical analysis was performed. Eighty-seven physicians (54%) responded. Eight surveys were discarded because of incomplete data or stray marks, leaving seventy-nine surveys. The average age of the respondents was 41.4 years. The major motivations for going back to school included learning the business aspects of the health-care system (fifty-three respondents; 67%) and obtaining a more interesting job (forty-one respondents; 52%). The time that the respondents allocated for health-care-related activities before and after obtaining the degree was 58.3% and 31.8%, respectively, for patient care (p administrative responsibilities (p principles (thirty-three; 42%), working within a team (twenty-seven; 34%), and negotiating effectively (twenty-five; 32%). Sixty-four physicians (81%) believed that their business degree had been very useful or essential in the advancement of their careers. Many physicians decide to acquire a Master of Business Administration degree to understand the business of medicine. After they complete the degree program, their practice patterns substantially change, which is reflected particularly by an increase in time spent on administrative responsibilities. In order for physicians to overcome the multifaceted challenges of the evolving health-care system, it is

[Impact of Increased Supply of Newly Licensed Nurses on Hospital Nurse Staffing and Policy Implications].

Science.gov (United States)

Kim, Yunmi; You, Sunju; Kim, Jinhyun

2017-12-01

This study aimed to analyze the impact of increasing the supply of newly licensed nurses on improving the hospital nurse staffing grades for the period of 2009~2014. Using public administrative data, we analyzed the effect of newly licensed nurses on staffing in 1,594 hospitals using Generalized Estimating Equation (GEE) ordered logistic regression, and of supply variation on improving staffing grades in 1,042 hospitals using GEE logistic regression. An increase of one newly licensed nurse per 100 beds in general units had significantly lower odds of improving staffing grades (grades 6~0 vs. 7) (odds ratio=0.95, p=.005). The supply of newly licensed nurses increased by 32% from 2009 to 2014, and proportion of hospitals whose staffing grade had improved, not changed, and worsened was 19.1%, 70.1%, and 10.8% respectively. Compared to 2009, the supply variation of newly licensed nurses in 2014 was not significantly related to the increased odds of improving staffing grades in the region (OR=1.02, p=.870). To achieve a balance in the regional supply and demand for hospital nurses, compliance with nurse staffing legislation and revisions in the nursing fee differentiation policy are needed. Rather than relying on increasing nurse supply, retention policies for new graduate nurses are required to build and sustain competent nurse workforce in the future. © 2017 Korean Society of Nursing Science

Physician deficit in USA - where is the bottleneck? [Ärztemangel in den USA - wo wird es eng?

Directory of Open Access Journals (Sweden)

Walid, M. Sami

2009-05-01

Full Text Available [english] The population of physician professionals in the US has been carefully controlled over the last century to ensure profitable work for people in the profession and provide physician workforce for the nation. However, the emergence of managed care in the US has spurred speculations that the US will experience a substantial excess of physicians by the beginning of the 21st century. In light of these forecasts, the number of residency positions funded by Medicare has been restricted. Additionally, enrollment at allopathic medical schools has been decreasing over the last two decades of the Twentieth Century. It is now evident that those predictions were erroneous and that the current supply of physicians does not exceed the demand for their services. That is why the Association of American Medical Colleges now aims to increase the number of US medical school graduates by 3,000 yearly by the year 2015. However, even if this difficult mission can be accomplished, the US can still have a deficit of 200,000 physicians by the year 2020. The reason is the bottleneck that controls the flow of medical graduates aiming to enter residency programs and get clinical training in order to obtain the license required to practice medicine. With the restriction on the number of Medicare-funded residency positions in the US an increase in US medical school graduates will only displace an equal number of international medical graduates applying for residency positions and consequently reduce the number of international medical graduates who join the physician workforce. This will probably not increase the number of practicing physicians. Shortage of physicians will remain an issue and undeniably make access to medical care problematic for all citizens. [german] Im 20. Jahrhundert wurde die Zahl der Ärzte in den Vereinigten Staaten sorgfältig reguliert, um lohnende Arbeitsbedingungen im ärztlichen Beruf und die Versorgung mit Ärzten für die Bev

Barriers to success for female physicians in academic medicine

Directory of Open Access Journals (Sweden)

Ashley C. Wietsma

2014-07-01

Full Text Available Despite the fact that women now comprise half of the medical student and resident populations, women remain underrepresented in prominent leadership positions in academia. Women are challenging themselves to live up to the expectations of their professional peers, society, and their patients in order to ‘have it all.’ These pressures are leading to professional and personal dissatisfaction. Is this a problem that will resolve itself as the younger generations of female physicians graduate into faculty positions, or does it require more attention from both male and female medical professionals?

Barriers to success for female physicians in academic medicine.

Science.gov (United States)

Wietsma, Ashley C

2014-01-01

Despite the fact that women now comprise half of the medical student and resident populations, women remain underrepresented in prominent leadership positions in academia. Women are challenging themselves to live up to the expectations of their professional peers, society, and their patients in order to 'have it all.' These pressures are leading to professional and personal dissatisfaction. Is this a problem that will resolve itself as the younger generations of female physicians graduate into faculty positions, or does it require more attention from both male and female medical professionals?

Physician tracking in sub-Saharan Africa: current initiatives and opportunities.

Science.gov (United States)

Chen, Candice; Baird, Sarah; Ssentongo, Katumba; Mehtsun, Sinit; Olapade-Olaopa, Emiola Oluwabunmi; Scott, Jim; Sewankambo, Nelson; Talib, Zohray; Ward-Peterson, Melissa; Mariam, Damen Haile; Rugarabamu, Paschalis

2014-04-23

Physician tracking systems are critical for health workforce planning as well as for activities to ensure quality health care - such as physician regulation, education, and emergency response. However, information on current systems for physician tracking in sub-Saharan Africa is limited. The objective of this study is to provide information on the current state of physician tracking systems in the region, highlighting emerging themes and innovative practices. This study included a review of the literature, an online search for physician licensing systems, and a document review of publicly available physician registration forms for sub-Saharan African countries. Primary data on physician tracking activities was collected as part of the Medical Education Partnership Initiative (MEPI) - through two rounds over two years of annual surveys to 13 medical schools in 12 sub-Saharan countries. Two innovations were identified during two MEPI school site visits in Uganda and Ghana. Out of twelve countries, nine had existing frameworks for physician tracking through licensing requirements. Most countries collected basic demographic information: name, address, date of birth, nationality/citizenship, and training institution. Practice information was less frequently collected. The most frequently collected practice fields were specialty/degree and current title/position. Location of employment and name and sector of current employer were less frequently collected. Many medical schools are taking steps to implement graduate tracking systems. We also highlight two innovative practices: mobile technology access to physician registries in Uganda and MDNet, a public-private partnership providing free mobile-to-mobile voice and text messages to all doctors registered with the Ghana Medical Association. While physician tracking systems vary widely between countries and a number of challenges remain, there appears to be increasing interest in developing these systems and many

Physicians' job satisfaction and motivation in a public academic hospital.

Science.gov (United States)

de Oliveira Vasconcelos Filho, Paulo; de Souza, Miriam Regina; Elias, Paulo Eduardo Mangeon; D'Ávila Viana, Ana Luiza

2016-12-07

Physician shortage is a global issue that concerns Brazil's authorities. The organizational structure and the environment of a medical institution can hide a low-quality life of a physician. This study examines the relationship between the hospital work environment and physicians' job satisfaction and motivation when working in a large public academic hospital. The study was restricted to one large, multispecialty Brazil's hospital. Six hundred hospital physicians were invited to participate by e-mail. A short version of the Physician Worklife Survey (PWS) was used to measure working satisfaction. Physicians were also asked for socio-demographic information, medical specialty, and the intention to continue working in the hospital. Data from 141 questionnaires were included in the analyses. Forty-five physicians graduated from the hospital's university, and they did not intend to leave the hospital under any circumstance (affective bond). The motivating factor for beginning the career at the hospital and to continue working there were the connection to the medical school and the hospital status as a "prestigious academic hospital"; the physicians were more satisfied with the career than the specialty. Only 30% completely agreed with the statement "If I had to start my career over again, I would choose my current specialty," while 45% completely agreed with the statement "I am not well compensated given my training and experience." The greater point of satisfaction was the relationship with physician colleagues. They are annoyed about the amount of calls they are requested to take and about how work encroaches on their personal time. No significant differences between medical specialties were found in the analysis. The participants were satisfied with their profession. The fact that they remained at the hospital was related to the academic environment, the relationship with colleagues, and the high prestige in which society holds the institution. The points of

Nurses graduating in Fiji between 2001 and 2010: sufficient supply for Fiji's health service demands?

Science.gov (United States)

Aiyub, S; Linh, N N; Tayler-Smith, K; Khogali, M; Bissell, K

2013-03-21

Fiji's schools of nursing and government health services, 2001-2010. To report on 1) the number and characteristics of nurses who graduated in Fiji, 2) the proportion of vacant nursing positions in the government health services and 3) attrition among nurses. Descriptive study involving a retrospective record review of Ministry of Health annual reports and nursing registers. Over the period 2001-2010, a total of 1500 nurses graduated, with the overall trend being a gradual increase in newly qualified nurses year on year. Available data from 2007 onwards showed relatively low vacancy rates (range 0.4-2%), with a sharp rise to 15% in 2009. Complete data on nurse attrition were available only from 2007 onwards, with rates of attrition ranging from 4% to 10%; the most common reason for attrition was resignation. While it was unable to directly assess whether Fiji's supply of nursing graduates has been meeting the country's health service demands, this study provides a series of baseline data on Fiji's nurse graduate and nursing workforce. In addition, it identifies some of the challenges and gaps that need to be considered to better assess and address nursing staff shortages.

Transition to life--a sendoff to the real world for graduating medical students.

Science.gov (United States)

Coates, Wendy C; Spector, Tahlia S; Uijtdehaage, Sebastian

2012-01-01

Graduating medical students will enter the workforce, often for the first time. Many have spent the past 20 years as students, receiving financial support from parents, and have not managed real-life issues such as financial planning, real estate, balancing well-being with employment, and integrating into a new community with stressful working conditions. To address a perceived need, we designed an intervention to introduce graduating medical students to financial planning, real estate choices, physician wellness during relocation/internship, and traits of efficient interns. The objectives of this study are to (a) assess baseline experience, knowledge, and comfort of seniors about "real-life" experiences, and (b) assess the efficacy of a 4-hr educational intervention on perceptions of understanding financial planning, real estate choices, intern preparedness, and physician wellness. Acute Care College seniors (classes of 2009 and 2010) attended the intervention after match day and completed a survey to gather demographic data and assess preexisting knowledge and a postintervention survey (1-7 Likert scale). Forty-nine students (45% male; M age = 25.5 years) participated. Prior experiences: 43% no break in education, 51% no full-time job, 38% never signed a rental lease and 94% had not purchased real estate, 90% did not have (or were not aware of having) disability insurance, and 82% had educational debt exceeding $50,000. Following the workshop, students felt more confident in their understanding of life skills topics (real estate, 83%; financial planning, 94%; well-being, 86%). Our workshop assisted in preparing for life after medical school for 98% of the participants. Graduating medical students can gain knowledge about real-life responsibilities and confidence during an educational session prior to starting residency.

How do physicians and their partners coordinate their careers and private lives?

Science.gov (United States)

Stamm, Martina; Buddeberg-Fischer, Barbara

2011-03-25

Over the past few years, there has been increasing interest in the question of how couples coordinate their careers and private lives. The aim of this study was to investigate the career arrangements of physicians and their partners according to gender and parenthood status, and to compare dual-physician couples with other types of couples. Data pertaining to 414 physicians (214 females, 51.7%; 200 males, 48.3%) from a cohort of medical school graduates participating in the SwissMedCareer Study was analysed according to socio-demographic variables, employment status and career prioritisation of the physicians and their partners. Differences in terms of gender, parenthood status and type of couple were investigated with Chi-square tests. The most prevalent career arrangement for a male physician with young children was that of full-time employment for the physician himself with a partner not in employment or working less than 50%-time. By contrast, the most common arrangement for a female physician with young children was that of 50-69% part-time employment with a partner working full-time. For couples without children, the most common arrangement was full-time employment for both partners. Dual-physician couples differed significantly from other types of couples in terms of how they rated career priority, with male physicians with physician partners more likely than male physicians with partners holding another academic degree or with non-academic partners to regard both careers as equally important (p ≤0.001). Female physicians with physician partners were more likely to consider their partners' careers as of prime importance than those with academic or non-academic partners (p ≤0.001). The priority given by couples to the man's career reflects traditional gender-role attitudes in male and female physicians. Starting a family slows down the career progress of female physicians but not of male physicians. Providing more childcare facilities in hospitals and

Case Reports, Case Series - From Clinical Practice to Evidence-Based Medicine in Graduate Medical Education.

Science.gov (United States)

Sayre, Jerry W; Toklu, Hale Z; Ye, Fan; Mazza, Joseph; Yale, Steven

2017-08-07

Case reports and case series or case study research are descriptive studies that are prepared for illustrating novel, unusual, or atypical features identified in patients in medical practice, and they potentially generate new research questions. They are empirical inquiries or investigations of a patient or a group of patients in a natural, real-world clinical setting. Case study research is a method that focuses on the contextual analysis of a number of events or conditions and their relationships. There is disagreement among physicians on the value of case studies in the medical literature, particularly for educators focused on teaching evidence-based medicine (EBM) for student learners in graduate medical education. Despite their limitations, case study research is a beneficial tool and learning experience in graduate medical education and among novice researchers. The preparation and presentation of case studies can help students and graduate medical education programs evaluate and apply the six American College of Graduate Medical Education (ACGME) competencies in the areas of medical knowledge, patient care, practice-based learning, professionalism, systems-based practice, and communication. A goal in graduate medical education should be to assist residents to expand their critical thinking, problem-solving, and decision-making skills. These attributes are required in the teaching and practice of EBM. In this aspect, case studies provide a platform for developing clinical skills and problem-based learning methods. Hence, graduate medical education programs should encourage, assist, and support residents in the publication of clinical case studies; and clinical teachers should encourage graduate students to publish case reports during their graduate medical education.

Perspective: physician leaders and their bases of power: common and disparate elements.

Science.gov (United States)

Gabel, Stewart

2012-02-01

Physicians hold numerous types of leadership positions in academic, executive, and/or clinical environments. To be successful, physician leaders must exert power, or social influence, as power is conceptualized in social psychology. The power of leaders accrues through their positions, expertise, or other factors, such as communication abilities or their ability to influence others to identify with the vision they espouse. This article discusses the types of leadership roles that physicians play and the power types they must apply in these roles. Crossing all leadership roles are a series of necessary personal characteristics and interpersonal competencies that result in what has been called "referent power," a more subtle form of social influence that is crucial for success regardless of position. Leadership training that includes practice in cultivating these personal characteristics and interpersonal competencies should be an essential component of medical and graduate medical education. Studying the types and nature of power also would be a valuable contribution to courses on professionalism in medical practice. Examples are provided of the types and uses of power that may be applied in the various leadership roles that physicians hold.

Exit competencies in pathology and laboratory medicine for graduating medical students: the Canadian approach.

Science.gov (United States)

Ford, Jason; Pambrun, Chantale

2015-05-01

Physicians in every medical and surgical field must be able to use pathology concepts and skills in their practice: for example, they must order and interpret the correct laboratory tests, they must use their understanding of pathogenesis to diagnose and treat, and they must work with the laboratory to care for their patients. These important concepts and skills may be ignored by medical schools and even national/international organizations setting graduation expectations for medical students. There is an evolving international consensus about the importance of exit competencies for medical school graduates, which define the measurable or observable behaviors each graduate must be able to demonstrate. The Canadian Association of Pathologists (CAP) Education Group set out to establish the basic competencies in pathology and laboratory medicine which should be expected of every medical graduate: not competencies for pathologists, but for medical graduates who intend to enter any residency program. We defined 4 targets for pathology and laboratory medicine exit competencies: that they represent only measurable behaviors, that they be clinically focused, that they be generalizable to every medical graduate, and that the final competency document be user-friendly. A set of competencies was developed iteratively and underwent final revision at the 2012 CAP annual meeting. These competencies were subsequently endorsed by the CAP executive and the Canadian Leadership Council on Laboratory Medicine. This clinically focused consensus document provides the first comprehensive list of exit competencies in pathology and laboratory medicine for undergraduate medical education. Copyright © 2015 Elsevier Inc. All rights reserved.

Treatment practices in pulmonary tuberculosis by private sector physicians of Meerut, Uttar Pradesh.

Science.gov (United States)

Yadav, A; Garg, S K; Chopra, H; Bajpai, S K; Bano, T; Jain, S; Kumar, A

2012-01-01

Majority of the qualified medical practitioners in the country are in the private sector and more than half of patients with tuberculosis (TB) seek treatment from them. The present study was conducted with the objective of assessing the treatment modalities in pulmonary tuberculosis by the private physicians in Meerut City, Uttar Pradesh, India. A cross-sectional study was carried out covering all the private physicians (graduates and postgraduates in Medicine and Chest Diseases) registered under the Indian Medical Association, Meerut Branch (n = 154). The physicians were interviewed by a pre-designed and pre-tested questionnaire about the treatment modalities practiced by them. Only 43.5% private physicians had attended any Revised National Tuberculosis Control Programme (RNTCP) training in the past five years. Only 33.1% of them were aware of the International Standards of Tuberculosis Care (ISTC). Fifty-three different regimens were used to treat the patients. Majority of physicians (76%) prescribed daily regimens while 24% administered both daily and intermittent treatment. None of the private physicians prescribed exclusive intermittent regimen. Eighty-seven different treatment regimens were used for the treatment of multidrug-resistant TB (MDR-TB) with none of them prescribing standard treatment under RNTCP. As majority of private practitioners do not follow RNTCP guidelines for treating TB, there is an urgent need for their continued education in this area.

Smoking-Related Attitudes and Knowledge Among Medical Students and Recent Graduates in Argentina: A Cross-Sectional Study.

Science.gov (United States)

Salgado, M Victoria; Mejía, Raúl M; Kaplan, Celia P; Pérez-Stable, Eliseo J

2017-05-01

Physicians in Argentina smoke at rates similar to the general population, and do not have a clear role in tobacco control strategies. To describe the attitudes and knowledge of medical students and recent graduates towards smoking behavior in Argentina. Cross-sectional self-administered online survey conducted in 2011. Medical students and recent medical graduates from the University of Buenos Aires. Attitudes and knowledge were evaluated by responses to 16 statements regarding the effects of smoking cigarettes and the role of physicians in tobacco control. Rates of agreement with a full ban on indoor smoking in different public settings were assessed. The sample included 1659 participants (response rate: 35.1 %), 453 of whom (27.3 %) were current smokers. Only 52 % of participants agreed that doctors should set an example for their patients by not smoking, 30.9 % thought that medical advice had little effect on patients' cessation behavior, and 19.4 % believed that physicians could decline to care for smoking patients who failed to quit. In adjusted logistic regression models, current smokers had less supportive attitudes about tobacco control and were less likely than non-smokers to agree with a full indoor smoking ban in hospitals (OR: 0.30; 95 % CI 0.16-0.58), universities (OR: 0.55; 95 % CI 0.41-0.73), workplaces (OR: 0.67; 95 % CI 0.50-0.88), restaurants (OR: 0.42; 95 % CI 0.33-0.53), cafes (OR: 0.41; 95 % CI 0.33-0.51), nightclubs (OR: 0.32; 95 % CI 0.25-0.40), and bars (0.35; 95 % CI 0.28-0.45). Recent medical graduates had more accurate knowledge about cessation and were more likely to agree with a full smoking ban in recreational venues. Although most participants reported a strong anti-tobacco attitude, a proportion still failed to recognize the importance of their role as physicians in tobacco control strategies. Current smokers and current students were less likely to support indoor smoking bans. Specific educational curricula could address

Job requirements compared to medical school education: differences between graduates from problem-based learning and conventional curricula.

Science.gov (United States)

Schlett, Christopher L; Doll, Hinnerk; Dahmen, Janosch; Polacsek, Ole; Federkeil, Gero; Fischer, Martin R; Bamberg, Fabian; Butzlaff, Martin

2010-01-14

Problem-based Learning (PBL) has been suggested as a key educational method of knowledge acquisition to improve medical education. We sought to evaluate the differences in medical school education between graduates from PBL-based and conventional curricula and to what extent these curricula fit job requirements. Graduates from all German medical schools who graduated between 1996 and 2002 were eligible for this study. Graduates self-assessed nine competencies as required at their day-to-day work and as taught in medical school on a 6-point Likert scale. Results were compared between graduates from a PBL-based curriculum (University Witten/Herdecke) and conventional curricula. Three schools were excluded because of low response rates. Baseline demographics between graduates of the PBL-based curriculum (n = 101, 49% female) and the conventional curricula (n = 4720, 49% female) were similar. No major differences were observed regarding job requirements with priorities for "Independent learning/working" and "Practical medical skills". All competencies were rated to be better taught in PBL-based curriculum compared to the conventional curricula (all p learning/working" (Delta + 0.57), "Psycho-social competence" (Delta + 0.56), "Teamwork" (Delta + 0.39) and "Problem-solving skills" (Delta + 0.36), whereas "Research competence" (Delta--1.23) and "Business competence" (Delta--1.44) in the PBL-based curriculum needed improvement. Among medical graduates in Germany, PBL demonstrated benefits with regard to competencies which were highly required in the job of physicians. Research and business competence deserve closer attention in future curricular development.

A gender gap in the next generation of physician-scientists: medical student interest and participation in research.

Science.gov (United States)

Guelich, Jill M; Singer, Burton H; Castro, Marcia C; Rosenberg, Leon E

2002-11-01

For 2 decades, the number of physician-scientists has not kept pace with the overall growth of the medical research community. Concomitantly, the number of women entering medical schools has increased markedly. We have explored the effect of the changing gender composition of medical schools on the present and future pipeline of young physician-scientists. We analyzed data obtained from the Association of American Medical Colleges, the National Institutes of Health, and the Howard Hughes Medical Institute pertaining to the expressed research intentions or research participation of male and female medical students in the United States. A statistically significant decline in the percentage of matriculating and graduating medical students--both men and women-who expressed strong research career intentions occurred during the decade between 1987 and 1997. Moreover, matriculating and graduating women were significantly less likely than men to indicate strong research career intentions. Each of these trends has been observed for medical schools overall and for research-intensive ones. Cohort data obtained by tracking individuals from matriculation to graduation revealed that women who expressed strong research career intentions upon matriculation were more likely than men to decrease their research career intentions during medical school. Medical student participation in research supported the gender gap identified by assessing research intentions. Female medical student participation in the Medical Scientist Training Program and the Howard Hughes Medical Institute/National Institutes of Health-sponsored Cloisters Program has increased but lags far behind the growth in the female population in medical schools. Three worrisome trends in the research career intentions and participation of the nation's medical students (a decade-long decline for both men and women, a large and persistent gender gap, and a negative effect of the medical school experience for women) presage a

Admission factors associated with international medical graduate certification success: a collaborative retrospective review of postgraduate medical education programs in Ontario.

Science.gov (United States)

Grierson, Lawrence E M; Mercuri, Mathew; Brailovsky, Carlos; Cole, Gary; Abrahams, Caroline; Archibald, Douglas; Bandiera, Glen; Phillips, Susan P; Stirrett, Glenna; Walton, J Mark; Wong, Eric; Schabort, Inge

2017-11-24

The failure rate on certification examinations of The College of Family Physicians of Canada (CFPC) and the Royal College of Physicians and Surgeons of Canada (RCPSC) is significantly higher for international medical graduates than for Canadian medical school graduates. The purpose of the current study was to generate evidence that supports or refutes the validity of hypotheses proposed to explain the lower success rates. We conducted retrospective analyses of admissions and certification data to determine the factors associated with success of international medical graduate residents on the certification examinations. International medical graduates who entered an Ontario residency program between 2005 and 2012 and had written a certification examination by the time of the analysis (2015) were included in the study. Data available at the time of admission for each resident, including demographic characteristics, previous experiences and previous professional experiences, were collected from each of the 6 Ontario medical schools and matched with certification examination results provided by The CFPC and the RCPSC. We developed logistic regression models to determine the association of each factor with success on the examinations. Data for 900 residents were analyzed. The models revealed resident age to be strongly associated with performance across all examinations. Fluency in English, female sex and the Human Development Index value associated with the country of medical school training had differential associations across the examinations. The findings should contribute to an improved understanding of certification success by international medical graduates, help residency programs identify at-risk residents and underpin the development of specific educational and remedial interventions. In considering the results, it should be kept in mind that some variables are not amenable to changes in selection criteria. Copyright 2017, Joule Inc. or its licensors.

The Single Graduate Medical Education (GME) Accreditation System Will Change the Future of the Family Medicine Workforce.

Science.gov (United States)

Peabody, Michael R; O'Neill, Thomas R; Eden, Aimee R; Puffer, James C

2017-01-01

Due to the Accreditation Council for Graduate Medical Education (ACGME)/American Osteopathic Association (AOA) single-accreditation model, the specialty of family medicine may see as many as 150 programs and 500 trainees in AOA-accredited programs seek ACGME accreditation. This analysis serves to better understand the composition of physicians completing family medicine residency training and their subsequent certification by the American Board of Family Medicine. We identified residents who completed an ACGME-accredited or dual-accredited family medicine residency program between 2006 and 2016 and cross-tabulated the data by graduation year and by educational background (US Medical Graduate-MD [USMG-MD], USMG-DO, or International Medical Graduate-MD [IMG-MD]) to examine the cohort composition trend over time. The number and proportion of osteopaths completing family medicine residency training continues to rise concurrent with a decline in the number and proportion of IMGs. Take Rates for USMG-MDs and USMG-IMGs seem stable; however, the Take Rate for the USMG-DOs has generally been rising since 2011. There is a clear change in the composition of graduating trainees entering the family medicine workforce. As the transition to a single accreditation system for graduate medical education progresses, further shifts in the composition of this workforce should be expected. © Copyright 2017 by the American Board of Family Medicine.

Implementing the 2009 Institute of Medicine recommendations on resident physician work hours, supervision, and safety.

Science.gov (United States)

Blum, Alexander B; Shea, Sandra; Czeisler, Charles A; Landrigan, Christopher P; Leape, Lucian

2011-01-01

Long working hours and sleep deprivation have been a facet of physician training in the US since the advent of the modern residency system. However, the scientific evidence linking fatigue with deficits in human performance, accidents and errors in industries from aeronautics to medicine, nuclear power, and transportation has mounted over the last 40 years. This evidence has also spawned regulations to help ensure public safety across safety-sensitive industries, with the notable exception of medicine. In late 2007, at the behest of the US Congress, the Institute of Medicine embarked on a year-long examination of the scientific evidence linking resident physician sleep deprivation with clinical performance deficits and medical errors. The Institute of Medicine's report, entitled "Resident duty hours: Enhancing sleep, supervision and safety", published in January 2009, recommended new limits on resident physician work hours and workload, increased supervision, a heightened focus on resident physician safety, training in structured handovers and quality improvement, more rigorous external oversight of work hours and other aspects of residency training, and the identification of expanded funding sources necessary to implement the recommended reforms successfully and protect the public and resident physicians themselves from preventable harm. Given that resident physicians comprise almost a quarter of all physicians who work in hospitals, and that taxpayers, through Medicare and Medicaid, fund graduate medical education, the public has a deep investment in physician training. Patients expect to receive safe, high-quality care in the nation's teaching hospitals. Because it is their safety that is at issue, their voices should be central in policy decisions affecting patient safety. It is likewise important to integrate the perspectives of resident physicians, policy makers, and other constituencies in designing new policies. However, since its release, discussion of the

Credentialing and retention of visa trainees in post-graduate medical education programs in Canada.

Science.gov (United States)

Mathews, Maria; Kandar, Rima; Slade, Steve; Yi, Yanqing; Beardall, Sue; Bourgeault, Ivy; Buske, Lynda

2017-06-12

Visa trainees are international medical graduates (IMG) who come to Canada to train in a post-graduate medical education (PGME) program under a student or employment visa and are expected to return to their country of origin after training. We examined the credentialing and retention of visa trainees who entered PGME programs between 2005 and 2011. Using the Canadian Post-MD Education Registry's National IMG Database linked to Scott's Medical Database, we examined four outcomes: (1) passing the Medical Council of Canada Qualifying Examination Part 2 (MCCQE2), (2) obtaining a specialty designation (CCFP, FRCPC/SC), and (3) working in Canada after training and (4) in 2015. The National IMG Database is the most comprehensive source of information on IMG in Canada; data were provided by physician training and credentialing organizations. Scott's Medical Database provides data on physician locations in Canada. There were 233 visa trainees in the study; 39.5% passed the MCCQE2, 45.9% obtained a specialty designation, 24.0% worked in Canada after their training, and 53.6% worked in Canada in 2015. Family medicine trainees (OR = 8.33; 95% CI = 1.69-33.33) and residents (OR = 3.45; 95% CI = 1.96-6.25) were more likely than other specialist and fellow trainees, respectively, to pass the MCCQE2. Residents (OR = 7.69; 95% CI = 4.35-14.29) were more likely to obtain a specialty credential than fellows. Visa trainees eligible for a full license were more likely than those not eligible for a full license to work in Canada following training (OR = 3.41; 95% CI = 1.80-6.43) and in 2015 (OR = 3.34; 95% CI = 1.78-6.27). Visa training programs represent another route for IMG to qualify for and enter the physician workforce in Canada. The growth in the number of visa trainees and the high retention of these physicians warrant further consideration of the oversight and coordination of visa trainee programs in provincial and in pan

Perceptions of desirable graduate competencies for science and technology new graduates

Science.gov (United States)

Coll, Richard K.; Zegwaard, Karsten E.

2006-05-01

Work-integrated learning (WIL) programmes that combine on-campus classroom-based study with off-campus authentic work experience are a growing area of interest internationally. Despite widespread practice of WIL, there are few reports that shed light on appropriate pedagogies for the work experience in particular. As with any form of education, providers hold certain views as to desirable outcomes in terms of graduate profiles and of desirable graduate competencies. A complication for multi-party WIL programmes is that educational stakeholders (e.g., staff working in tertiary education provider institutions and employers) may hold different views as to desirable graduate competencies. Here we argue that an understanding of stakeholder views of desirable graduate competencies is an essential prerequisite of pedagogical design. The research reported here is an intrinsic case study and comprised an investigation of perceptions of 24 desirable graduate competencies for new science and technology graduates entering the workforce both today, and in ten years’ time. Stakeholders for four sector stakeholder groups (n = 458): undergraduate students (n = 71), recent graduates (n = 143), employers of graduates (n = 172), and faculty (n = 72), were surveyed using a previously reported and validated instrument. The research findings suggest that science and technology stakeholders see all 24 competencies as desirable, and see the importance of all skills and some skills in particular as likely to increase in ten years’ time. Despite emphasis on cognitive and technical skills (often termed ‘hard’ skills), the single most desirable skill is ability and willingness to learn, a behavioural skill (often termed ‘soft’ skills). It is proposed that classroom-based instruction is unlikely to produce graduates with the desired skills, and that work-integrated learning may have a role to play in the development of graduate competencies.

Moving beyond the language barrier: the communication strategies used by international medical graduates in intercultural medical encounters.

Science.gov (United States)

Jain, Parul; Krieger, Janice L

2011-07-01

To understand the communication strategies international medical graduates use in medical interactions to overcome language and cultural barriers. In-depth interviews were conducted with 12 international physicians completing their residency training in internal medicine in a large hospital in Midwestern Ohio. The interview explored (a) barriers participants encountered while communicating with their patients regarding language, affect, and culture, and (b) communication convergence strategies used to make the interaction meaningful. International physicians use multiple convergence strategies when interacting with their patients to account for the intercultural and intergroup differences, including repeating information, changing speaking styles, and using non-verbal communication. Understanding barriers to communication faced by international physicians and recognizing accommodation strategies they employ in the interaction could help in training of future international doctors who come to the U.S. to practice medicine. Early intervention could reduce the time international physicians spend navigating through the system and trying to learn by experimenting with different strategies which will allow these physicians to devote more time to patient care. We recommend developing a training manual that is instructive of the socio-cultural practices of the region where international physician will start practicing medicine. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Maintaining Professional Commitment as a Newly Credentialed Athletic Trainer in the Secondary School Setting.

Science.gov (United States)

Mazerolle, Stephanie M; Myers, Sarah L; Walker, Stacy E; Kirby, Jessica

2018-03-01

  Professional commitment, or one's affinity and loyalty to a career, has become a topic of interest in athletic training. The expanding research on the topic, however, has omitted newly credentialed athletic trainers (ATs). For an impressionable group of practitioners, transitioning to clinical practice can be stressful.   To explore the professional commitment of newly credentialed ATs in the secondary school setting.   Secondary school.   Qualitative study.   A total of 31 newly credentialed ATs (6 men, 25 women; mean age = 24 ± 3 years) participated. Of these, 17 ATs (4 men, 13 women; mean age = 25 ± 4 years) were employed full time in the secondary school setting, and 14 ATs (2 men, 12 women; mean age = 23.0 ± 2.0 years) were graduate assistant students in the secondary school setting.   All participants completed semistructured interviews, which focused on their experiences in the secondary school setting and transitioning into the role and setting. Transcripts were analyzed using the phenomenologic approach. Creditability was established by peer review, member checks, and researcher triangulation.   Four main findings related to the professional commitment of newly credentialed ATs in the secondary school setting were identified. Work-life balance, professional relationships formed with the student-athletes, enjoyment gained from working in the secondary school setting, and professional responsibility emerged as factors facilitating commitment.   Affective commitment is a primary facilitator of professional commitment. Newly credentialed ATs who enjoy their jobs and have time to engage in nonwork roles are able to maintain a positive professional commitment. Our findings align with the previous literature and help strengthen our understanding that rejuvenation and passion are important to professional commitment.

Career-success scale – a new instrument to assess young physicians' academic career steps

OpenAIRE

Buddeberg-Fischer, B; Stamm, M; Buddeberg, C; Klaghofer, R

2008-01-01

Abstract Background Within the framework of a prospective cohort study of Swiss medical school graduates, a Career-Success Scale (CSS) was constructed in a sample of young physicians choosing different career paths in medicine. Furthermore the influence of personality factors, the participants' personal situation, and career related factors on their career success was investigated. Methods 406 residents were assessed in terms of career aspired to, and their career progress. The Career-Success...

Disrespect, harassment, and abuse: all in a day's work for family physicians.

Science.gov (United States)

Miedema, Baukje; Easley, Julie; Fortin, Pierrette; Hamilton, Ryan; Tatemichi, Sue

2009-03-01

To examine harassment and abusive encounters between family physicians and their patients or colleagues in the workplace. Qualitative case study using semistructured interviews. Province of New Brunswick. Forty-eight family physicians from across the province. A collective case-study approach was developed, with 24 cases of 2 individuals per case. Cases were selected based on sex, location (urban or rural), language (French or English), and number of years since medical school graduation ( 20 years). Physicians were interviewed in either French or English. Participants were recruited using the College of Physicians and Surgeons of New Brunswick's physician directory. Based on the rates of response and participation, some cases were overrepresented, while others were not completed. All interviews were audiotaped, transcribed verbatim, and analyzed thematically using a categorical aggregation approach. A coding scheme for the thematic analysis was developed by the research team before the interviews were transcribed. Although the original intent of this study was to examine the work environment of family physicians in light of the increasing number of women entering the profession, harassment and abusive encounters in the workplace emerged as a main theme. These encounters ranged from minor to severe. Minor abusive encounters included disrespectful behaviour and verbal threats by patients, their families, and occasionally colleagues. More severe forms of harassment involved physical threats, physical encounters, and stalking. Demanding patients, such as heavy drug users, were often seen as threatening. Location of practice, years in practice, and sex of the physician seemed to affect abusive encounters--young, female, rural physicians appeared to experience such encounters most often. Abusive encounters in the workplace are concerning. It is essential to address these issues of workplace harassment and abuse in order to protect physician safety and avoid workplace

Earnings Expectation and Graduate Employment: Evidence from Recent Chinese College Graduates

Science.gov (United States)

Po, Yang

2011-01-01

Chinese college graduates have faced increasing labor market competition since the expansion of tertiary education. Given rigid market demand, graduates with realistic earnings expectations may experience a more efficient job search. Using the 2008 MYCOS College Graduate Employment Survey, this study finds that a 1000 yuan reduction in a…

Choosing wisely: adherence by physicians to recommended use of spirometry in the diagnosis and management of adult asthma.

Science.gov (United States)

Sokol, Kristin C; Sharma, Gulshan; Lin, Yu-Li; Goldblum, Randall M

2015-05-01

The National Asthma Education and Prevention Program (NAEPP) and the American Thoracic Society provide guidelines stating that physicians should use spirometry in the diagnosis and management of asthma. The aim of this study was to evaluate the trends, over a 10-year period, in the utilization of spirometry in patients newly diagnosed with asthma. We hypothesized that spirometry use would increase in physicians who care for asthma patients, especially since 2007, when the revised NAEPP guidelines were published. This retrospective cohort analysis of spirometry use in subjects newly diagnosed with asthma used a privately insured adult population for the years 2002-2011. Our primary outcome of interest was spirometry performed within a year (± 365 days) of the initial date of asthma diagnosis. We also examined the type of asthma medications prescribed. In all, 134,208 patients were found to have a diagnosis of asthma. Only 47.6% had spirometry performed within 1 year of diagnosis. Younger patients, males, and those residing in the Northeast were more likely to receive spirometry. Spirometry use began to decline in 2007. Patients cared for by specialists were more likely to receive spirometry than those cared for by primary care physicians; 80.1% vs 23.3%, respectively. Lastly, even without spirometry, a significant portion of patients (78.3%) was prescribed asthma drugs. Our study suggests that spirometry is underutilized in newly diagnosed asthma patients. Moreover, the use of controller medications in those diagnosed with asthma without spirometry remains high. Copyright © 2015 Elsevier Inc. All rights reserved.

New graduate registered nurses' knowledge of patient safety and practice: A literature review.

Science.gov (United States)

Murray, Melanie; Sundin, Deborah; Cope, Vicki

2018-01-01

To critically appraise available literature and summarise evidence pertaining to the patient safety knowledge and practices of new graduate registered nurses. Responsibility for patient safety should not be limited to the practice of the bedside nurses, rather the responsibility of all in the healthcare system. Previous research identified lapses in safety across the health care, more specifically with new practitioners. Understanding these gaps and what may be employed to counteract them is vital to ensuring patient safety. A focused review of research literature. The review used key terms and Boolean operators across a 5-year time frame in CINAHL, Medline, psycINFO and Google Scholar for research articles pertaining to the area of enquiry. Eighty-four articles met the inclusion criteria, 39 discarded due to irrelevant material and 45 articles were included in the literature review. This review acknowledges that nursing has different stages of knowledge and practice capabilities. A theory-practice gap for new graduate registered nurses exists, and transition to practice is a key learning period setting new nurses on the path to becoming expert practitioners. Within the literature, there was little to no acknowledgement of patient safety knowledge of the newly registered nurse. Issues raised in the 1970s remain a concern for today's new graduate registered nurses. Research has recognised several factors affecting transition from nursing student to new graduate registered nurse. These factors are leaving new practitioners open to potential errors and risking patient safety. Understanding the knowledge of a new graduate registered nurse upon entering clinical practice may assist in organisations providing appropriate clinical and theoretical support to these nurses during their transition. © 2017 John Wiley & Sons Ltd.

An assessment of psychological stress and symptomatology for didactic phase physician assistant students.

Science.gov (United States)

Childers, William A; May, Ryan K; Ball, Natalie

2012-01-01

The purpose of this study was to assess the amount of psychological stress experienced by didactic phase, physician assistant (PA) students. The Symptom Checklist-90-R (SCL-90-R) survey was administered to 81 students in 2011 during the first two didactic phase semesters at two PA programs. Using ANOVA and t-tests, several variables were analyzed for significance. The SCL-90-R results portray that a significant proportion of the students from both programs reported elevated levels of stress during the first and second semester of the didactic year. Although several significant levels were noted throughout this study, it is not known how these scores from PA students would compare to other medical and/or nonmedical graduate students. Additional studies of stress from both medical and nonmedical graduate students would be beneficial for comparison to PA students.

Acculturation Needs of Pediatric International Medical Graduates: A Qualitative Study.

Science.gov (United States)

Osta, Amanda D; Barnes, Michelle M; Pessagno, Regina; Schwartz, Alan; Hirshfield, Laura E

2017-01-01

Phenomenon: International medical graduates (IMGs) play a key role in host countries' health systems but face unique challenges, which makes effective, tailored support for IMGs essential. Prior literature describing the acculturation needs of IMGs focused primarily on communication content and style. We conducted a qualitative study to explore acculturation that might be specific to IMG residents who care for children. In a study conducted from November 2011 to April 2012, we performed four 90-minute semistructured focus groups with 26 pediatric IMG residents from 12 countries. The focus group transcripts were analyzed using open and focused coding methodology. The focus groups and subsequent analysis demonstrated that pediatric IMG residents' socialization to their home culture impacts their transition to practice in the United States; they must adjust not only to a U.S. culture, different from their own, but also to the culture of medicine in the United States. We identified the following new acculturation themes: understanding the education system and family structure, social determinants of health, communication with African American parents, contraception, physician handoffs, physicians' role in prevention, adolescent health, and physicians' role in child advocacy. We further highlight the acculturation challenges faced by pediatric IMG residents and offer brief recommendations for the creation of a deliberate acculturation curriculum for pediatric IMG residents. Insight: Residency training is a unique period in physicians' personal and professional development and can be particularly challenging for IMGs. There is a significant gap in the identified acculturation needs and the current curricula available to IMG residents who care for children.

Workplace Violence and Job Outcomes of Newly Licensed Nurses.

Science.gov (United States)

Chang, Hyoung Eun; Cho, Sung-Hyun

2016-12-01

The purpose of this study was to examine the prevalence of workplace violence toward newly licensed nurses and the relationship between workplace violence and job outcomes. An online survey was conducted of newly licensed registered nurses who had obtained their license in 2012 or 2013 in South Korea and had been working for 5-12 months after first being employed. The sample consisted of 312 nurses working in hospitals or clinics. The Copenhagen Psychosocial Questionnaire II was used to measure violence and nurse job outcomes. Multiple linear and logistic regression analyses were conducted to examine the relationship between violence and job outcomes. Verbal abuse was most prevalent (59.6%), followed by threats of violence (36.9%), physical violence (27.6%), bullying (25.6%), and sexual harassment (22.4%). Approximately three quarters of the nurses had experienced at least one type of violence. The main perpetrators were patients and nurse colleagues, although the distribution of perpetrators varied depending on the type of violence. Bullying had a significant relationship with all four job outcomes (job satisfaction, burnout, commitment to the workplace, and intent to leave), while verbal abuse was associated with all job outcomes except for intent to leave. Violence perpetrated by nurse colleagues had a significant relationship with all four job outcomes, while violence by physicians had a significant inverse relationship with job satisfaction. Workplace violence is experienced by a high percentage of newly licensed nurses, and is associated with their job outcomes. Copyright © 2016. Published by Elsevier B.V.

Development of physician leadership competencies: perceptions of physician leaders, physician educators and medical students.

Science.gov (United States)

McKenna, Mindi K; Gartland, Myles P; Pugno, Perry A

2004-01-01

Research regarding the development of healthcare leadership competencies is widely available. However, minimal research has been published regarding the development of physician leadership competencies, despite growing recognition in recent years of the important need for effective physician leadership. Usingdata from an electronically distributed, self-administered survey, the authors examined the perceptions held by 110 physician leaders, physician educators, and medical students regarding the extent to which nine competencies are important for effective physician leadership, ten activities are indicative of physician leadership, and seven methods are effective for the development of physician leadership competencies. Results indicated that "interpersonal and communication skills" and "professional ethics and social responsibility" are perceived as the most important competencies for effective physician leadership. Furthermore, respondents believe "influencing peers to adopt new approaches in medicine" and "administrative responsibility in a healthcare organization" are the activities most indicative of effective physician leadership. Finally, respondents perceive"coaching or mentoring from an experienced leader" and "on-job experience (e.g., a management position)" as the most effective methods for developing physician leadership competencies. The implications of these findings for the education and development of physician leaders are discussed.

The development of a model of training in child psychiatry for non-physician clinicians in Ethiopia

Science.gov (United States)

2014-01-01

Background The lack of trained mental health professionals has been an important barrier to establishing mental health services in low income countries. The purpose of this paper is to describe the development and implementation of child psychiatry training within a graduate program in mental health for non-physician clinicians in Ethiopia. Methods The existing needs for competent practitioners in child psychiatry were identified through discussions with psychiatrists working in Ethiopia as well as with relevant departments within the Federal Ministry of Health Ethiopia (FMOHE). As part of a curriculum for a two year Master of Science (MSC) in Mental Health program for non-physician clinicians, child psychiatry training was designed and implemented by Jimma University with the involvement of experts from Addis Ababa University (AAU), Ethiopia, and Ludwig-Maximillian’s University, (LMU), Germany. Graduates gave feedback after completing the course. The World Health Organization’s (WHO) Mental Health Gap Action Program (mhGAP) intervention guide (IG) adapted for Ethiopian context was used as the main training material. Results A two-week child psychiatry course and a four week child psychiatry clinical internship were successfully implemented during the first and the second years of the MSC program respectively. During the two week psychiatry course, trainees learned to observe the behavior and to assess the mental status of children at different ages who had a variety of mental health conditions. Assessment of the trainees’ clinical skills was done by the instructors at the end of the child psychiatry course as well as during the subsequent four week clinical internship. The trainees generally rated the course to be ‘very good’ to ‘excellent’. Many of the graduates have become faculty at the various universities in Ethiopia. Conclusion Child psychiatry training for non-physician mental health specialist trainees was developed and successfully

Graduates' Employability: What Do Graduates and Employers Think?

Science.gov (United States)

Matsouka, Kyriaki; Mihail, Dimitrios M.

2016-01-01

The purpose of this article is to investigate the views of university graduates and human resource managers (HRMs) on graduates' employability in terms of the soft skills required by the labour market. Soft skills (personal attributes that enhance an individual's interactions, job performance and career prospects) are necessary in the labour…

New graduate registered nurse transition into primary health care roles: an integrative literature review.

Science.gov (United States)

Murray-Parahi, Pauline; DiGiacomo, Michelle; Jackson, Debra; Davidson, Patricia M

2016-11-01

To summarise the literature describing new graduate nurse transition to professional practice within the primary health care (PHC) setting. There is a plethora of research literature spanning several decades about new graduate nurse transition in the acute care setting. Yet, the experiences of new graduate nurse in the PHC setting is unremarkable particularly considering the increasing demand for skilled health care workers and focus of health reform to provide care where people work and live. Electronic data bases, Academic Search Complete, EBSCO, Medline, PsycINFO, CINHAL, and ERIC were searched using a combination of terms and synonyms arising from three key concepts which identify the phenomenon; 'transition', 'new graduate registered nurse' and 'primary health care. An inclusive search strategy placed no limits on language or publication date. Of the 50 articles located and examined for relevance; 40 were sourced through databases and 10 from Google Scholar/Alerts and hand-searching references. None of the 19 articles retained for analysis addressed all key concepts. Some challenges of researching the professional transition of graduate nurses in PHC settings included, an absence of definitive transition models, a dearth of literature and deference to acute care research. Nursing in PHC settings, particularly the client's home is notably different to hospital settings because of higher levels of isolation and autonomy. Societal changes, health reform and subsequent demand for skilled workers in PHC settings has caused health care providers to question the logic that such roles are only for experienced nurses. Implications arise for education and health service providers who desire to close the theory practice gap and mitigate risk for all stakeholders when next generation nurses have limited opportunities to experience PHC roles as undergraduates and newly graduated registered nurses are already transitioning in this setting. © 2016 John Wiley & Sons Ltd.

Burnout and Scope of Practice in New Family Physicians.

Science.gov (United States)

Weidner, Amanda K H; Phillips, Robert L; Fang, Bo; Peterson, Lars E

2018-05-01

Family physicians report some of the highest levels of burnout, but no published work has considered whether burnout is correlated with the broad scope of care that family physicians may provide. We examined the associations between family physician scope of practice and self-reported burnout. Secondary analysis of the 2016 National Family Medicine Graduate Survey respondents who provided outpatient continuity care (N = 1,617). We used bivariate analyses and logistic regression to compare self-report of burnout and measures of scope of practice including: inpatient medicine, obstetrics, pediatric ambulatory care, number of procedures and/or clinical content areas, and providing care outside the principal practice site. Forty-two percent of respondents reported feeling burned out from their work once a week or more. In bivariate analysis, elements of scope of practice associated with higher burnout rates included providing more procedures/clinical content areas (mean procedures/clinical areas: 7.49 vs 7.02; P = .02) and working in more settings than the principal practice site (1+ additional settings: 57.6% vs 48.4%: P = .001); specifically in the hospital (31.4% vs 24.2%; P = .002) and patient homes (3.3% vs 1.5%; P = .02). In adjusted analysis, practice characteristics significantly associated with lower odds of burnout were practicing inpatient medicine (OR = 0.70; 95% CI, 0.56-0.87; P = .0017) and obstetrics (OR = 0.64; 95% CI, 0.47-0.88; P = .0058). Early career family physicians who provide a broader scope of practice, specifically, inpatient medicine, obstetrics, or home visits, reported significantly lower rates of burnout. Our findings suggest that comprehensiveness is associated with less burnout, which is critical in the context of improving access to good quality, affordable care while maintaining physician wellness. © 2018 Annals of Family Medicine, Inc.

Evaluation of Documentation Patterns of Trainees and Supervising Physicians Using Data Mining.

Science.gov (United States)

Madhavan, Ramesh; Tang, Chi; Bhattacharya, Pratik; Delly, Fadi; Basha, Maysaa M

2014-09-01

The electronic health record (EHR) includes a rich data set that may offer opportunities for data mining and natural language processing to answer questions about quality of care, key aspects of resident education, or attributes of the residents' learning environment. We used data obtained from the EHR to report on inpatient documentation practices of residents and attending physicians at a large academic medical center. We conducted a retrospective observational study of deidentified patient notes entered over 7 consecutive months by a multispecialty university physician group at an urban hospital. A novel automated data mining technology was used to extract patient note-related variables. A sample of 26 802 consecutive patient notes was analyzed using the data mining and modeling tool Healthcare Smartgrid. Residents entered most of the notes (33%, 8178 of 24 787) between noon and 4 pm and 31% (7718 of 24 787) of notes between 8 am and noon. Attending physicians placed notes about teaching attestations within 24 hours in only 73% (17 843 of 24 443) of the records. Surgical residents were more likely to place notes before noon (P Data related to patient note entry was successfully used to objectively measure current work flow of resident physicians and their supervising faculty, and the findings have implications for physician oversight of residents' clinical work. We were able to demonstrate the utility of a data mining model as an assessment tool in graduate medical education.

Emergency ultrasound usage among recent emergency medicine residency graduates of a convenience sample of 14 residencies.

Science.gov (United States)

Dean, Anthony J; Breyer, Michael J; Ku, Bon S; Mills, Angela M; Pines, Jesse M

2010-02-01

Emergency Medicine (EM) residency graduates are trained to perform Emergency Medicine bedside ultrasound (EMBU). However, the degree to which they use this skill in their practice after graduation is unknown. We sought to test the amount and type of usage of EMBU among recent residency graduates, and how usage and barriers vary among various types of EM practice settings. Graduates from 14 EM residency programs in 2003-2005 were surveyed on their current practice setting and use of EMBU. There were 252 (73%) graduates who completed the survey. Of the 73% of respondents reporting access to EMBU, 98% had used it within the past 3 months. Access to EMBU was higher in academic (97%) vs. community teaching (79%) vs. community non-teaching settings (62%) (p < 0.001), and in Emergency Departments (EDs) where yearly census exceeded 60,000 visits (87% vs. 65%, p < 0.001). Physicians in academic settings reported "high use" of EMBU more frequently than those in community settings for most modalities. FAST (focused assessment by sonography in trauma) was the most common high-use application and the most useful in practice. The greatest impediment to EMBU use was "not enough time" (61%). Ultrasound usage among recent EM residency graduates is significantly higher in teaching than in community settings and in high-volume EDs. Its use is more widespread than in previous reports in all types of practice. There is a wide range of utilization of ultrasound in the various applications in emergency practice, with the evaluation of trauma being the most common. Copyright (c) 2010 Elsevier Inc. All rights reserved.

Career choices on graduation--a study of recent graduates from University College Cork.

LENUS (Irish Health Repository)

McKenna, Gerald

2010-04-23

INTRODUCTION: Irish dental graduates are eligible to enter general dental practice immediately after qualification. Unlike their United Kingdom counterparts, there is no requirement to undertake vocational training (VT) or any pre-registration training. VT is a mandatory 12-month period for all UK dental graduates who wish to work within the National Health Service. It provides structured, supervised experience in training practices and through organised study days. AIMS: This study aimed to profile the career choices made by recent dental graduates from UCC. It aimed to record the uptake of VT and associate posts, and where the graduates gained employment. METHODOLOGY: A self-completion questionnaire was developed and circulated electronically to recent graduates from UCC. An existing database of email addresses was used and responses were returned by post or by email. A copy of the questionnaire used is included as Appendix 1. RESULTS: Questionnaires were distributed over an eight-week period and 142 were returned, giving a response rate of 68.90%. Responses were gathered from those who graduated between 2001 and 2007; however, the majority came from more recent classes. Overall, the majority of graduates took up associate positions after qualification (71.8%) with smaller numbers undertaking VT (28.2%). Increasing numbers have entered VT in recent years, including 54.3% from the class of 2007. Overall, the majority of graduates initially took up positions in England (43%); however, in recent times more have been employed in Scotland. Subsequent work profiles of the graduates illustrate that the majority are now working as associates in general practice (51.4%) and in Ireland (54.2%). CONCLUSIONS: There has been an increase in the proportion of UCC graduates undertaking VT. Graduates tended to move away from Ireland initially to gain employment. There has been a shift away from employment in England towards Scotland where the majority of new UCC graduates are now

Physician-industry relations. Part 1: individual physicians.

Science.gov (United States)

Coyle, Susan L

2002-03-05

This is part 1 of a 2-part paper on ethics and physician-industry relationships. Part 1 offers advice to individual physicians; part 2 gives recommendations to medical education providers and medical professional societies. Physicians and industry have a shared interest in advancing medical knowledge. Nonetheless, the primary ethic of the physician is to promote the patient's best interests, while the primary ethic of industry is to promote profitability. Although partnerships between physicians and industry can result in impressive medical advances, they also create opportunities for bias and can result in unfavorable public perceptions. Many physicians and physicians-in-training think they are impervious to commercial influence. However, recent studies show that accepting industry hospitality and gifts, even drug samples, can compromise judgment about medical information and subsequent decisions about patient care. It is up to the physician to judge whether a gift is acceptable. A very general guideline is that it is ethical to accept modest gifts that advance medical practice. It is clearly unethical to accept gifts or services that obligate the physician to reciprocate. Conflicts of interest can arise from other financial ties between physicians and industry, whether to outside companies or self-owned businesses. Such ties include honorariums for speaking or writing about a company's product, payment for participating in clinic-based research, and referrals to medical resources. All of these relationships have the potential to influence a physician's attitudes and practices. This paper explores the ethical quandaries involved and offers guidelines for ethical business relationships.

Interdisciplinary innovations in biomedical and health informatics graduate education.

Science.gov (United States)

Demiris, G

2007-01-01

Biomedical and health informatics (BHI) is a rapidly growing domain that relies on the active collaboration with diverse disciplines and professions. Educational initiatives in BHI need to prepare students with skills and competencies that will allow them to function within and even facilitate interdisciplinary teams (IDT). This paper describes an interdisciplinary educational approach introduced into a BHI graduate curriculum that aims to prepare informatics researchers to lead IDT research. A case study of the "gerontechnology" research track is presented which highlights how the curriculum fosters collaboration with and understanding of the disciplines of Nursing, Engineering, Computer Science, and Health Administration. Gerontechnology is a new interdisciplinary field that focuses on the use of technology to support aging. Its aim is to explore innovative ways to use information technology and develop systems that support independency and increase quality of life for senior citizens. As a result of a large research group that explores "smart home" technologies and the use of information technology, we integrated this new domain into the curriculum providing a platform for computer scientists, engineers, nurses and physicians to explore challenges and opportunities with our informatics students and faculty. The interdisciplinary educational model provides an opportunity for health informatics students to acquire the skills for communication and collaboration with other disciplines. Numerous graduate and postgraduate students have already participated in this initiative. The evaluation model of this approach is presented. Interdisciplinary educational models are required for health informatics graduate education. Such models need to be innovative and reflect the needs and trends in the domains of health care and information technology.

High-performance teams and the physician leader: an overview.

Science.gov (United States)

Majmudar, Aalap; Jain, Anshu K; Chaudry, Joseph; Schwartz, Richard W

2010-01-01

The complexity of health care delivery within the United States continues to escalate in an exponential fashion driven by an explosion of medical technology, an ever-expanding research enterprise, and a growing emphasis on evidence-based practices. The delivery of care occurs on a continuum that spans across multiple disciplines, now requiring complex coordination of care through the use of novel clinical teams. The use of teams permeates the health care industry and has done so for many years, but confusion about the structure and role of teams in many organizations contributes to limited effectiveness and suboptimal outcomes. Teams are an essential component of graduate medical education training programs. The health care industry's relative lack of focus regarding the fundamentals of teamwork theory has contributed to ineffective team leadership at the physician level. As a follow-up to our earlier manuscripts on teamwork, this article clarifies a model of teamwork and discusses its application to high-performance teams in health care organizations. Emphasized in this discussion is the role played by the physician leader in ensuring team effectiveness. By educating health care professionals on the fundamentals of high-performance teamwork, we hope to stimulate the development of future physician leaders who use proven teamwork principles to achieve the goals of trainee education and excellent patient care. Copyright 2010 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

The relationship of high school graduation exams to graduation rates and SAT scores.

Directory of Open Access Journals (Sweden)

Gregory J. Marchant

2005-01-01

Full Text Available The current study examined the effect of high school graduation exams on states' graduation rates, states' aggregated SAT scores, and individual students' SAT scores. Three data sources were used: One source identified states requiring a standardized test for graduation; the NCES provided state aggregated data on graduation rates for the class of 2002; and the College Board provided its 2001 SAT database for all test-takers. After controlling for students' demographic characteristics (e.g., race, family education and income, GPA and class rank, regression analyses revealed that states requiring graduation exams had lower graduation rates and lower SAT scores. Individually, students from states requiring a graduation exam performed more poorly on the SAT than did students from states not requiring an exam. The impact of high stakes tests' on students' motivation to stay in school and on the teaching of critical thinking skills (tested by the SAT are discussed.

Educating Physicians for Rural America: Validating Successes and Identifying Remaining Challenges With the Rural Medical Scholars Program.

Science.gov (United States)

Wheat, John R; Leeper, James D; Murphy, Shannon; Brandon, John E; Jackson, James R

2018-02-01

To evaluate the Rural Medical Scholars (RMS) Program's effectiveness to produce rural physicians for Alabama. A nonrandomized intervention study compared RMS (1997-2002) with control groups in usual medical education (1991-2002) at the University of Alabama School of Medicine's main and regional campuses. Participants were RMS and others admitted to regular medical education, and the intervention was the RMS Program. Measures assessed the percentage of graduates practicing in rural areas. Odds ratios compared effectiveness of producing rural Alabama physicians. The RMS Program (N = 54), regional campuses (N = 182), and main campus (N = 649) produced 48.1% (odds ratio 6.4, P rural physicians, respectively. The RMS Program, contrasted to other local programs of medical education, was effective in producing rural physicians. These results were comparable to benchmark programs in the Northeast and Midwest USA on which the RMS Program was modeled, justifying the assumption that model programs can be replicated in different regions. However, this positive effect was not shared by a disparate rural minority population, suggesting that models for rural medical education must be adjusted to meet the challenge of such communities for physicians. © 2017 National Rural Health Association.

Continuing to Confront COPD International Physician Survey: physician knowledge and application of COPD management guidelines in 12 countries

Directory of Open Access Journals (Sweden)

Davis KJ

2014-12-01

Full Text Available Kourtney J Davis,1 Sarah H Landis,2 Yeon-Mok Oh,3 David M Mannino,4 MeiLan K Han,5 Thys van der Molen,6 Zaurbek Aisanov,7 Ana M Menezes,8 Masakazu Ichinose,9 Hana Muellerova11Worldwide Epidemiology, GlaxoSmithKline, Wavre, Belgium; 2Worldwide Epidemiology, GlaxoSmithKline, Uxbridge, UK; 3University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea; 4University of Kentucky College of Public Health, Lexington, KY, USA; 5Division of Pulmonary and Critical Care, University of Michigan, Ann Arbor, MI, USA; 6University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; 7Pulmonology Research Institute, Moscow, Russia; 8Federal University of Pelotas, Pelotas, Brazil; 9Tohoku University Graduate School of Medicine, Sendai, JapanAim: Utilizing data from the Continuing to Confront COPD (chronic obstructive pulmonary disease International Physician Survey, this study aimed to describe physicians’ knowledge and application of the GOLD (Global initiative for chronic Obstructive Lung Disease Global Strategy for the Diagnosis, Management and Prevention of COPD diagnosis and treatment recommendations and compare performance between primary care physicians (PCPs and respiratory specialists.Materials and methods: Physicians from 12 countries were sampled from in-country professional databases; 1,307 physicians (PCP to respiratory specialist ratio three to one who regularly consult with COPD, emphysema, or chronic bronchitis patients were interviewed online, by telephone or face to face. Physicians were questioned about COPD risk factors, prognosis, diagnosis, and treatment, including knowledge and application of the GOLD global strategy using patient scenarios.Results: Physicians reported using spirometry routinely (PCPs 82%, respiratory specialists 100%; P<0.001 to diagnose COPD and frequently included validated patient-reported outcome measures (PCPs 67%, respiratory specialists 81%; P<0.001. Respiratory

Gender differences in the salaries of physician researchers.

Science.gov (United States)

Jagsi, Reshma; Griffith, Kent A; Stewart, Abigail; Sambuco, Dana; DeCastro, Rochelle; Ubel, Peter A

2012-06-13

It is unclear whether male and female physician researchers who perform similar work are currently paid equally. To determine whether salaries differ by gender in a relatively homogeneous cohort of physician researchers and, if so, to determine if these differences are explained by differences in specialization, productivity, or other factors. A US nationwide postal survey was sent in 2009-2010 to assess the salary and other characteristics of a relatively homogeneous population of physicians. From all 1853 recipients of National Institutes of Health (NIH) K08 and K23 awards in 2000-2003, we contacted the 1729 who were alive and for whom we could identify a mailing address. The survey achieved a 71% response rate. Eligibility for the present analysis was limited to the 800 physicians who continued to practice at US academic institutions and reported their current annual salary. A linear regression model of self-reported current annual salary was constructed considering the following characteristics: gender, age, race, marital status, parental status, additional graduate degree, academic rank, leadership position, specialty, institution type, region, institution NIH funding rank, change of institution since K award, K award type, K award funding institute, years since K award, grant funding, publications, work hours, and time spent in research. The mean salary within our cohort was $167,669 (95% CI, $158,417-$176,922) for women and $200,433 (95% CI, $194,249-$206,617) for men. Male gender was associated with higher salary (+$13,399; P = .001) even after adjustment in the final model for specialty, academic rank, leadership positions, publications, and research time. Peters-Belson analysis (use of coefficients derived from regression model for men applied to women) indicated that the expected mean salary for women, if they retained their other measured characteristics but their gender was male, would be $12,194 higher than observed. Gender differences in salary exist

Qualified nurses' rate new nursing graduates as lacking skills in key clinical areas.

Science.gov (United States)

Missen, Karen; McKenna, Lisa; Beauchamp, Alison; Larkins, Jo-Ann

2016-08-01

The aim of this study was to explore perceptions of qualified nurses on the abilities of newly registered nursing graduates to perform a variety of clinical skills. Evidence from the literature suggests that undergraduate nursing programmes do not adequately prepare nursing students to be practice-ready on completion of their nursing courses. A descriptive quantitative design was used. Participants were recruited through the Australian Nursing and Midwifery Federation, Victorian branch. A brief explanation of the study and a link to the survey were promoted in their monthly e-newsletter. A total of 245 qualified nurses in the state of Victoria, Australia participated in this study. A survey tool of 51 clinical skills and open-ended questions was used, whereby participants were asked to rate new nursing graduates' abilities using a 5-point Likert scale. Overall participants rated new nursing graduates' abilities for undertaking clinical skills as good or very good in 35·3% of skills, 33·3% were rated as adequate and 31·4% rated as being performed poorly or very poorly. Of concern, essential clinical skills, such as critical thinking and problem solving, working independently and assessment procedures, were found to be poorly executed and affecting new registered nurses graduates' competence. The findings from this study can further serve as a reference for nursing education providers to enhance nursing curricula and work collaboratively with healthcare settings in preparing nurses to be competent, safe practitioners on completion of their studies. Identifying key areas in which new nursing graduates are not yet competent means that educational providers and educators from healthcare settings can focus on these skills in better preparing our nurses to be work ready. © 2016 John Wiley & Sons Ltd.

[Determination and analysis of cost and production measures in physicians' practices and hospitals for the objective evaluation of medical measures].

Science.gov (United States)

Gessner, U; Horisberger, B

1981-05-01

The complete data on 7200 practising physicians in Switzerland were analyzed in the first phase of the project. The 2600 GP's and the 4600 specialists (in 18 medical specialties) were categorized as to year of graduation and geographic regions (population centres). The distributions of the practising physician of the different specialties over the population centres (defined by 30-min. catchment area) areas were evaluated. Trends towards specialization in larger settlement areas were analyzed. The results are being used as a basis for formation of samples for further studies. The inventories of medical technical equipment and medical procedures are in the process of systematization.

Perception of physicians about medical education received during their Nephrology residency training in Peru.

Science.gov (United States)

Herrera-Añazco, Percy; Bonilla-Vargas, Luis; Hernandez, Adrian V; Silveira-Chau, Manuela

2015-01-01

In Peru there are different hospitals and university programs for training of specialists in nephrology. To assess the perception of physicians who attend such programs. We carried out a descriptive cross-sectional national-level study in physicians who were in the last two years of nephrology training during February 2012 and who had graduated from it in 2010 and 2011. A self-applied questionnaire was developed along with the Peruvian Society of Nephrology based on international standards. The questionnaire evaluated: mentoring, clinical training, procedures, external rotations, research and global perception. Forty doctors were surveyed nationwide. 82.5% had tutors, 22.5% of them said their support was poor. A 27.5% described their theoretical formation as deficient. The practical training was perceived as acceptable globally; however, improvements in training on peritoneal dialysis and reading kidney transplant biopsies are necessary. A 90% have national external rotations and 65% reported to have an international rotation. In the assessment of research, 77.5% thought this is deficient. In addition, 82.5% believed that residency should last four years. However, 60% reported that their residency training was good. There is a decrease in the positive perception of the aspects studied among residents regarding graduates. The overall perception of nephrology residency training was considered good; however, areas of tutoring, and academic and research activities on average were deficient.

Percepções do fonoaudiólogo recém-formado quanto a sua formação, intenção profissional e atualização de conhecimentos Perceptions of newly graduated Speech and Language Pathologists regarding their academic formation, professional goals and knowledge update

Directory of Open Access Journals (Sweden)

Denise Guapyassú Meirelles da Silva

2010-01-01

Full Text Available OBJETIVO: Investigar as percepções do fonoaudiólogo recém-formado do estado do Rio de Janeiro quanto a sua formação, intenção profissional e busca por atualização de conhecimento. MÉTODOS: Participaram fonoaudiólogos graduados em cursos de formação no estado do Rio de Janeiro, nos anos 2005 e 2006. Foi aplicado um questionário constituído por dez perguntas fechadas, elaboradas para esta pesquisa e previamente verificadas por projeto piloto. Os dados foram submetidos a análise estatística com cruzamento de variáveis. RESULTADOS: Observou-se que a maioria dos fonoaudiólogos considerou-se atendida em suas expectativas e segura dos conhecimentos adquiridos (pPURPOSE: To investigate the perceptions of newly graduated Speech and Language Pathologists (SLP from the state of Rio de Janeiro regarding their academic formation, professional goals and search for knowledge updates. METHODS: SLPs graduated from universities located at the state of Rio de Janeiro during the years of 2005 and 2006 participated in the study. A questionnaire with ten closed questions, developed for the present study and validated through a pilot study, was applied. Data were statistically analyzed comparing different variables. RESULTS: It was observed that the majority of the SLPs interviewed considered that their expectations were met and felt safe about the knowledge acquired (p<0.001. These professionals wish to act mostly in clinics (89%, and intend to continue their studies through lato sensu programs (70%. Language was considered the area in which they received the best support during their training (68%, while Public Health was the area in which they considered to have received less support (72%, and this difference was statistically significant. Industry was considered the most difficult workplace to be accessed by SLPs (p<0,05. CONCLUSION: Newly graduated SLPs from the state of Rio de Janeiro considered to have met their expectations regarding their

National High School Graduation Rate: Are Recent Birth Cohorts Taking More Time to Graduate?

Science.gov (United States)

Joo, Myungkook; Kim, Jeounghee

2016-01-01

Debates about the national high school graduation rate have heated up as various national high school graduation estimates based on the Common Core of Data (CCD) and the Current Population Survey (CPS) do not coincide with one another partially due to different assumptions about graduation age. This study found that (a) while graduation rate by…

The relationship of high school graduation exams to graduation rates and SAT scores.

OpenAIRE

Gregory J. Marchant; Sharon E. Paulson

2005-01-01

The current study examined the effect of high school graduation exams on states' graduation rates, states' aggregated SAT scores, and individual students' SAT scores. Three data sources were used: One source identified states requiring a standardized test for graduation; the NCES provided state aggregated data on graduation rates for the class of 2002; and the College Board provided its 2001 SAT database for all test-takers. After controlling for students' demographic characteristics (e.g., r...

Diversity based on race, ethnicity, and sex, of the US radiation oncology physician workforce.

Science.gov (United States)

Chapman, Christina H; Hwang, Wei-Ting; Deville, Curtiland

2013-03-15

To assess the current diversity of the US radiation oncology (RO) physician workforce by race, ethnicity, and sex. Publicly available American Medical Association, American Association of Medical Colleges, and US census registries were used to assess differences by race, ethnicity, and sex for 2010 among RO practicing physicians, academic faculty, residents, and residency applicants. RO resident diversity was compared to medical school graduates and medical oncology (MO) fellows. Significant differences in diversity of RO residents by race, ethnicity, and sex were evaluated between 2003 and 2010 academic years. Females and traditionally underrepresented minorities in medicine (URM), blacks, Hispanics, American Indians, Alaska Natives, Native Hawaiian, and Pacific Islanders are underrepresented as RO residents (33.3% and 6.9%, respectively), faculty (23.8%, 8.1%), and practicing physicians (25.5%, 7.2%) levels compared with the US population (50.8%, 30.0%; Pworkforce. Given existing cancer disparities, further research and efforts are needed to ensure that the field is equipped to meet the needs of an increasingly diverse society. Copyright © 2013 Elsevier Inc. All rights reserved.

Burnout and satisfaction with work-life balance among US physicians relative to the general US population.

Science.gov (United States)

Shanafelt, Tait D; Boone, Sonja; Tan, Litjen; Dyrbye, Lotte N; Sotile, Wayne; Satele, Daniel; West, Colin P; Sloan, Jeff; Oreskovich, Michael R

2012-10-08

Despite extensive data about physician burnout, to our knowledge, no national study has evaluated rates of burnout among US physicians, explored differences by specialty, or compared physicians with US workers in other fields. We conducted a national study of burnout in a large sample of US physicians from all specialty disciplines using the American Medical Association Physician Masterfile and surveyed a probability-based sample of the general US population for comparison. Burnout was measured using validated instruments. Satisfaction with work-life balance was explored. Of 27 276 physicians who received an invitation to participate, 7288 (26.7%) completed surveys. When assessed using the Maslach Burnout Inventory, 45.8% of physicians reported at least 1 symptom of burnout. Substantial differences in burnout were observed by specialty, with the highest rates among physicians at the front line of care access (family medicine, general internal medicine, and emergency medicine). Compared with a probability-based sample of 3442 working US adults, physicians were more likely to have symptoms of burnout (37.9% vs 27.8%) and to be dissatisfied with work-life balance (40.2% vs 23.2%) (P < .001 for both). Highest level of education completed also related to burnout in a pooled multivariate analysis adjusted for age, sex, relationship status, and hours worked per week. Compared with high school graduates, individuals with an MD or DO degree were at increased risk for burnout (odds ratio [OR], 1.36; P < .001), whereas individuals with a bachelor's degree (OR, 0.80; P = .048), master's degree (OR, 0.71; P = .01), or professional or doctoral degree other than an MD or DO degree (OR, 0.64; P = .04) were at lower risk for burnout. Burnout is more common among physicians than among other US workers. Physicians in specialties at the front line of care access seem to be at greatest risk.

Profile of graduates of Israeli medical schools in 1981--2000: educational background, demography and evaluation of medical education programs.

Science.gov (United States)

Bitterman, Noemi; Shalev, Ilana

2005-05-01

In light of changes in the medical profession, the different requirements placed on physicians and the evolving needs of the healthcare system, the need arose to examine the medical education curriculum in Israel. This survey, conducted by the Samuel Neaman Institute for Science and Technology, summarizes 20 years of medical education in Israel's four medical schools, as the first stage in mapping the existing state of medical education in Israel and providing a basis for decision-making on future medical education programs. To characterize the academic background of graduates, evaluate their attitudes towards current and alternative medical education programs, and examine subgroups among graduates according to gender, medical school, high school education, etc. The survey included graduates from all four Israeli medical schools who graduated between the years 1981 and 2000 in a sample of 1:3. A questionnaire and stamped return envelope were sent to every third graduate; the questionnaire included open and quantitative questions graded on a scale of 1 to 5. The data were processed for the entire graduate population and further analyzed according to subgroups such as medical schools, gender, high school education, etc. The response rate was 41.3%. The survey provided a demographic profile of graduates over a 20 year period, their previous educational and academic background, additional academic degrees achieved, satisfaction, and suggestions for future medical education programs. The profile of the medical graduates in Israel is mostly homogenous in terms of demographics, with small differences among the four medical schools. In line with recommendations of the graduates, and as an expression of the changing requirements in the healthcare system and the medical profession, the medical schools should consider alternative medical education programs such as a bachelor's degree in life sciences followed by MD studies, or education programs that combine medicine with

Integrating Doulas Into First-Trimester Abortion Care: Physician, Clinic Staff, and Doula Experiences.

Science.gov (United States)

Chor, Julie; Lyman, Phoebe; Ruth, Jean; Patel, Ashlesha; Gilliam, Melissa

2018-01-01

Balancing the need to provide individual support for patients and the need for an efficient clinic can be challenging in the abortion setting. This study explores physician, staff, and specially trained abortion doula perspectives on doula support, one approach to patient support. We conducted separate focus groups with physicians, staff members, and doulas from a high-volume, first-trimester aspiration abortion clinic with a newly established volunteer abortion doula program. Focus groups explored 1) abortion doula training, 2) program implementation, 3) program benefits, and 4) opportunities for improvement. Interviews were transcribed and computer-assisted content analysis was performed; salient findings are presented. Five physicians, 5 staff members, and 4 abortion doulas participated in separate focus group discussions. Doulas drew on both their prior personal skills and experiences in addition to their abortion doula training to provide women with support at the time of abortion. Having doulas in the clinic to assist with women's emotional needs allowed physicians and staff to focus on technical aspects of the procedure. In turn, both physicians and staff believed that introducing doulas resulted in more patient-centered care. Although staff did not experience challenges to integrating doulas, physicians and doulas experienced initial challenges in incorporating doula support into the clinical flow. Staff and doulas reported exchanging skills and techniques that they subsequently used in their interactions with patients. Physicians, clinic staff, and doulas perceive abortion doula support as an approach to provide more patient-centered care in a high-volume aspiration abortion clinic. © 2018 by the American College of Nurse-Midwives.

The Attitudes and Behaviours of Physicians Working in Burdur, Turkey Toward Rational Medicine Use

Directory of Open Access Journals (Sweden)

Ozgur Onal

2017-05-01

Full Text Available Aim: This study aimed to define the manner and behaviour of first line treatment physicians%u2019 and general practitionars that work in the second line treatment hospitals regarding rational medicine use (RMU in the centre of Burdur and its surrounding districts. Material and Method:This descriptive study includes first line treatment physicians%u2019 prescribing medication and general practitionars that work in the second line treatment hospitals (total N=102 in the centre of Burdur, Turkey and its surrounding districts. There was no sampling for the study. All the physicians who agreed to participate were reached through a survey taker with a face-to-face interview between April 1, 2015 and July 7, 2015. 98 physicians participated in the study. The data from the study were analysed using the SPSS 17.0 for Windows program. Measurable values were described as arithmetic mean and standard deviation, and countable values were calculated as numbers and percentage. Results: In the study including 98 physicians, 78 (79.6% of them were males, 75 (76.5% were married, and their average age was 40.77±8.77. The leading factors affecting physicians%u2019 prescriptions were post-graduate studies as cited by 82 (83.7% and pharmacology lessons for 75 (76.5%. Drug company presentations were the least important factor, cited by 22 physicians (22.4%. The most important criteria for physicians in prescribing were the effectiveness of the drug as cited by 97 (99% and reliability of the drug for 96 (98%. Also, 98 of the physicians (100% stated that patients asked them to prescribe certain drugs. However, only eight physicians (8.2% indicated that they always prescribed the drug demanded by the patient while 88 physicians (89.8% indicated that they sometimes did this. Discussion: Physicians are frequently asked by patients to prescribe painkillers and antibiotics. However, the physicians cannot always meet these demands from the RMU point of view. Our study

Evaluating topic model interpretability from a primary care physician perspective.

Science.gov (United States)

Arnold, Corey W; Oh, Andrea; Chen, Shawn; Speier, William

2016-02-01

Probabilistic topic models provide an unsupervised method for analyzing unstructured text. These models discover semantically coherent combinations of words (topics) that could be integrated in a clinical automatic summarization system for primary care physicians performing chart review. However, the human interpretability of topics discovered from clinical reports is unknown. Our objective is to assess the coherence of topics and their ability to represent the contents of clinical reports from a primary care physician's point of view. Three latent Dirichlet allocation models (50 topics, 100 topics, and 150 topics) were fit to a large collection of clinical reports. Topics were manually evaluated by primary care physicians and graduate students. Wilcoxon Signed-Rank Tests for Paired Samples were used to evaluate differences between different topic models, while differences in performance between students and primary care physicians (PCPs) were tested using Mann-Whitney U tests for each of the tasks. While the 150-topic model produced the best log likelihood, participants were most accurate at identifying words that did not belong in topics learned by the 100-topic model, suggesting that 100 topics provides better relative granularity of discovered semantic themes for the data set used in this study. Models were comparable in their ability to represent the contents of documents. Primary care physicians significantly outperformed students in both tasks. This work establishes a baseline of interpretability for topic models trained with clinical reports, and provides insights on the appropriateness of using topic models for informatics applications. Our results indicate that PCPs find discovered topics more coherent and representative of clinical reports relative to students, warranting further research into their use for automatic summarization. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Association between education in EOL care and variability in EOL practice: a survey of ICU physicians.

Science.gov (United States)

Forte, Daniel Neves; Vincent, Jean Louis; Velasco, Irineu Tadeu; Park, Marcelo

2012-03-01

This study investigated the association between physician education in EOL and variability in EOL practice, as well as the differences between beliefs and practices regarding EOL in the ICU. Physicians from 11 ICUs at a university hospital completed a survey presenting a patient in a vegetative state with no family or advance directives. Questions addressed approaches to EOL care, as well physicians' personal, professional and EOL educational characteristics. The response rate was 89%, with 105 questionnaires analyzed. Mean age was 38 ± 8 years, with a mean of 14 ± 7 years since graduation. Physicians who did not apply do-not-resuscitate (DNR) orders were less likely to have attended EOL classes than those who applied written DNR orders [0/7 vs. 31/47, OR = 0.549 (0.356-0.848), P = 0.001]. Physicians who involved nurses in the decision-making process were more likely to be ICU specialists [17/22 vs. 46/83, OR = 4.1959 (1.271-13.845), P = 0.013] than physicians who made such decisions among themselves or referred to ethical or judicial committees. Physicians who would apply "full code" had less often read about EOL [3/22 vs. 11/20, OR = 0.0939 (0.012-0.710), P = 0.012] and had less interest in discussing EOL [17/22 vs. 20/20, OR = 0.210 (0.122-0.361), P EOL is associated with variability in EOL decisions in the ICU. Moreover, actual practice may differ from what physicians believe is best for the patient.

Physician participation in clinical research and trials: issues and approaches

Directory of Open Access Journals (Sweden)

Sami F Shaban

2011-03-01

Full Text Available Sayeeda Rahman1, Md Anwarul Azim Majumder1, Sami F Shaban2, Nuzhat Rahman3, Moslehuddin Ahmed4, Khalid Bin Abdulrahman5, Urban JA D’Souza61Department of Clinical Sciences, School of Life Sciences, University of Bradford, West Yorkshire, Bradford, UK; 2Department of Medical Education, Faculty of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates; 3Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, USA; 4Department of Community Medicine, Uttara Adhunik Medical College, Dhaka, Bangladesh; 5Department of Family Medicine and Medical Education, College of Medicine, Al-Imam University, Riyadh, Saudi Arabia; 6Department of Post Graduate Studies, School of Medicine, University Malaysia Sabah, Kota Kinabalu, Sabah, MalaysiaAbstract: The rapid development of new drugs, therapies, and devices has created a dramatic increase in the number of clinical research studies that highlights the need for greater participation in research by physicians as well as patients. Furthermore, the potential of clinical research is unlikely to be reached without greater participation of physicians in research. Physicians face a variety of barriers with regard to participation in clinical research. These barriers are system- or organization-related as well as research- and physician-related. To encourage physician participation, appropriate organizational and operational infrastructures are needed in health care institutes to support research planning and management. All physicians should receive education and training in the fundamentals of research design and methodology, which need to be incorporated into undergraduate medical education and postgraduate training curricula and then reinforced through continuing medical education. Medical schools need to analyze current practices of teaching–learning and research, and reflect upon possible changes needed to develop a ‘student-focused teaching–learning and

The Importance of Exercise in the Well-Rounded Physician: Dialogue for the Inclusion of a Physical Fitness Program in Neurosurgery Resident Training.

Science.gov (United States)

Fargen, Kyle M; Spiotta, Alejandro M; Turner, Raymond D; Patel, Sunil

2016-06-01

Exercise, diet, and personal fitness programs are essentially lacking in modern graduate medical education. In the context of long hours and alternating shift and sleep cycles, the lack of exercise and poor dietary choices may have negative consequences on physician physical and mental health. This opinion piece aims to generate important dialogue regarding the scope of the problem, the literature supporting the health benefits of exercise, potential solutions to enhancing diet and exercise among resident trainees, and possible pitfalls to the adoption of exercise programs within graduate medical education. Copyright © 2016 Elsevier Inc. All rights reserved.

Implementing the 2009 Institute of Medicine recommendations on resident physician work hours, supervision, and safety

Science.gov (United States)

Blum, Alexander B; Shea, Sandra; Czeisler, Charles A; Landrigan, Christopher P; Leape, Lucian

2011-01-01

Long working hours and sleep deprivation have been a facet of physician training in the US since the advent of the modern residency system. However, the scientific evidence linking fatigue with deficits in human performance, accidents and errors in industries from aeronautics to medicine, nuclear power, and transportation has mounted over the last 40 years. This evidence has also spawned regulations to help ensure public safety across safety-sensitive industries, with the notable exception of medicine. In late 2007, at the behest of the US Congress, the Institute of Medicine embarked on a year-long examination of the scientific evidence linking resident physician sleep deprivation with clinical performance deficits and medical errors. The Institute of Medicine’s report, entitled “Resident duty hours: Enhancing sleep, supervision and safety”, published in January 2009, recommended new limits on resident physician work hours and workload, increased supervision, a heightened focus on resident physician safety, training in structured handovers and quality improvement, more rigorous external oversight of work hours and other aspects of residency training, and the identification of expanded funding sources necessary to implement the recommended reforms successfully and protect the public and resident physicians themselves from preventable harm. Given that resident physicians comprise almost a quarter of all physicians who work in hospitals, and that taxpayers, through Medicare and Medicaid, fund graduate medical education, the public has a deep investment in physician training. Patients expect to receive safe, high-quality care in the nation’s teaching hospitals. Because it is their safety that is at issue, their voices should be central in policy decisions affecting patient safety. It is likewise important to integrate the perspectives of resident physicians, policy makers, and other constituencies in designing new policies. However, since its release

Burnout among U.S. medical students, residents, and early career physicians relative to the general U.S. population.

Science.gov (United States)

Dyrbye, Liselotte N; West, Colin P; Satele, Daniel; Boone, Sonja; Tan, Litjen; Sloan, Jeff; Shanafelt, Tait D

2014-03-01

To compare the prevalence of burnout and other forms of distress across career stages and the experiences of trainees and early career (EC) physicians versus those of similarly aged college graduates pursuing other careers. In 2011 and 2012, the authors conducted a national survey of medical students, residents/fellows, and EC physicians (≤ 5 years in practice) and of a probability-based sample of the general U.S. population. All surveys assessed burnout, symptoms of depression and suicidal ideation, quality of life, and fatigue. Response rates were 35.2% (4,402/12,500) for medical students, 22.5% (1,701/7,560) for residents/fellows, and 26.7% (7,288/27,276) for EC physicians. In multivariate models that controlled for relationship status, sex, age, and career stage, being a resident/fellow was associated with increased odds of burnout and being a medical student with increased odds of depressive symptoms, whereas EC physicians had the lowest odds of high fatigue. Compared with the population control samples, medical students, residents/fellows, and EC physicians were more likely to be burned out (all P prevalence of burnout, depressive symptoms, and recent suicidal ideation are relatively small. At each stage, burnout is more prevalent among physicians than among their peers in the U.S. population.

Advancing resident assessment in graduate medical education.

Science.gov (United States)

Swing, Susan R; Clyman, Stephen G; Holmboe, Eric S; Williams, Reed G

2009-12-01

The Outcome Project requires high-quality assessment approaches to provide reliable and valid judgments of the attainment of competencies deemed important for physician practice. The Accreditation Council for Graduate Medical Education (ACGME) convened the Advisory Committee on Educational Outcome Assessment in 2007-2008 to identify high-quality assessment methods. The assessments selected by this body would form a core set that could be used by all programs in a specialty to assess resident performance and enable initial steps toward establishing national specialty databases of program performance. The committee identified a small set of methods for provisional use and further evaluation. It also developed frameworks and processes to support the ongoing evaluation of methods and the longer-term enhancement of assessment in graduate medical education. The committee constructed a set of standards, a methodology for applying the standards, and grading rules for their review of assessment method quality. It developed a simple report card for displaying grades on each standard and an overall grade for each method reviewed. It also described an assessment system of factors that influence assessment quality. The committee proposed a coordinated, national-level infrastructure to support enhancements to assessment, including method development and assessor training. It recommended the establishment of a new assessment review group to continue its work of evaluating assessment methods. The committee delivered a report summarizing its activities and 5 related recommendations for implementation to the ACGME Board in September 2008.

Your Graduates and You: Effective Strategies for Graduate Recruitment and Development. IES Report.

Science.gov (United States)

Connor, H.; Hirsh, W.; Barber, L.

Many employing organizations in the United Kingdom and elsewhere are finding it increasingly important to have an effective strategy for recruiting and developing higher education graduates. Numerous external and internal factors affect employers' graduate recruitment and development strategies. The following main approaches to graduates' entry…

The new generation of family physicians--career motivation, life goals and work-life balance.

Science.gov (United States)

Buddeberg-Fischer, Barbara; Stamm, Martina; Buddeberg, Claus; Klaghofer, Richard

2008-05-31

The present study aimed to investigate the differences between future family physicians, and physicians aspiring to other medical specialities, in terms of sociodemographic factors and variables concerning personality factors, career motivation, career success, importance of life goals and work-life balance; further, the stability in career choice of family physicians from medical school through to residency was evaluated. Data reported are from four assessments of the Swiss physicians' longitudinal career development study, begun in 2001 (T1). At T4, in 2007, 543 residents (76% of the initial sample at T1) completed a questionnaire concerning their personal and professional goals. The difference between family physicians and specialists was studied by multivariate analyses of covariance adjusted for gender. Of the study sample, 84 (17%) decided on family medicine, 66% of them as early as medical school or at the beginning of residency. Compared to specialists, more family physicians are married and more have children. Their intrinsic and extrinsic career motivation is lower, their extraprofessional concerns are greater and they rate their objective and subjective career success lower. The favoured models of work-family and work-life balance respectively are part-time oriented. Future family physicians, both females and males, are less career-oriented. The results suggest that the waning reputation of family medicine and the uncertain development of this medical discipline in the Swiss healthcare system attract less career-oriented applicants. A well-balanced integration of professional and private life is an essential goal for the new generation of doctors; this applies even more to female doctors and family physicians. Considering this trend, the question arises whether the current number of medical school graduates is sufficient to ensure the population's healthcare provision in the future.

Competencies for first year residents - physicians' views from medical schools with different undergraduate curricula.

Science.gov (United States)

Fürstenberg, Sophie; Schick, Kristina; Deppermann, Jana; Prediger, Sarah; Berberat, Pascal O; Kadmon, Martina; Harendza, Sigrid

2017-09-07

Frameworks like the CanMEDS model depicting professional roles and specific professional activities provide guidelines for postgraduate education. When medical graduates start their residency, they should possess certain competencies related to communication, management and professionalism while other competencies will be refined during postgraduate training. Our study aimed to evaluate the relevance of different competencies for a first year resident required for entrustment decision from the perspective of physicians from medical faculties with different undergraduate medical curricula. Nine hundred fifty-two surgeons and internists from three medical schools with different undergraduate medical curricula were invited to rank 25 competencies according to their relevance for first year residents. The rankings were compared between universities, specialties, physicians' positions, and gender. Two hundred two physicians participated, 76 from Hamburg University, 44 from Oldenburg University, and 82 from Technical University Munich. No significant differences were found regarding the top 10 competencies relevant for first year residents between the universities. 'Responsibility' was the competency with the highest rank overall. Internists ranked 'Structure, work planning and priorities' higher while surgeons ranked 'Verbal communication with colleagues and supervisors' higher. Consultants evaluated 'Active listening to patients' more important than department directors and residents. Female physicians ranked 'Verbal communication with colleagues and supervisors' and 'Structure, work planning and priorities' significantly higher while male physicians ranked 'Scientifically and empirically grounded method of working' significantly higher. Physicians from universities with different undergraduate curricula principally agreed on the competencies relevant for first year residents. Some differences between physicians from different positions, specialties, and gender were

Patients' assessment of professionalism and communication skills of medical graduates.

Science.gov (United States)

Abadel, Fatima T; Hattab, Abdulla S

2014-02-11

Professionalism and communication skills constitute important components of the integral formation of physicians which has repercussion on the quality of health care and medical education. The objective of this study was to assess medical graduates' professionalism and communication skills from the patients' perspective and to examine its association with patients' socio-demographic variables. This is a hospital based cross-sectional study. It involved 315 patients and 105 medical graduates selected by convenient sampling method. A modified and validated version of the American Board of Internal Medicine's (ABIM) Patient Assessment survey questionnaire was used for data collection through a face to face interview. Data processing and analysis were performed using the Statistical Package for Social Science (SPSS) 16.0. Mean, frequency distribution, and percentage of the variables were calculated. A non-parametric Kruskal Wallis test was applied to verify whether the patients' assessment was influenced by variables such as age, gender, education, at a level of significance, p ≤ 0.05. Female patients constituted 46% of the sample, whereas males constituted 54%. The mean age was 36 ± 16. Patients' scoring of the graduate's skills ranged from 3.29 to 3.83 with a mean of 3.64 on a five-point Likert scale. Items assessing the "patient involvement in decision-making" were assigned the minimum mean values, while items dealing with "establishing adequate communication with patient" assigned the maximum mean values. Patients, who were older than 45 years, gave higher scores than younger ones (p communication skills at a good level. Patients' age and educational level were significantly associated with the rating level.

Physician practice management companies: should physicians be scared?

Science.gov (United States)

Scott-Rotter, A E; Brown, J A

1999-01-01

Physician practice management companies (PPMCs) manage nonclinical aspects of physician care and control physician groups by buying practice assets. Until recently, PPMCs were a favorite of Wall Street. Suddenly, in early 1998, the collapse of the MedPartners-PhyCor merger led to the rapid fall of most PPMC stock, thereby increasing wariness of physicians to sell to or invest in PPMCs. This article explores not only the broken promises made by and false assumptions about PPMCs, but also suggests criteria that physicians should use and questions would-be PPMC members should ask before joining. Criteria include: demonstrated expertise, a company philosophy that promotes professional autonomy, financial stability, freedom from litigation, and satisfied physicians already in the PPMC. The authors recommend that physicians seek out relatively small, single-specialty PPMCs, which hold the best promise of generating profits and permitting professional control over clinical decisions.

Teen CHAT: Development and Utilization of a Web-Based Intervention to Improve Physician Communication with Adolescents About Healthy Weight

Science.gov (United States)

Bravender, Terrill; Tulsky, James A.; Farrell, David; Alexander, Stewart C.; Østbye, Truls; Lyna, Pauline; Dolor, Rowena J.; Coffman, Cynthia J.; Bilheimer, Alicia; Lin, Pao-Hwa; Pollak, Kathryn I.

2013-01-01

Objective To describe the theoretical basis, use, and satisfaction with Teen CHAT, an online educational intervention designed to improve physician-adolescent communication about healthy weight. Methods Routine health maintenance encounters between pediatricians and family practitioners and their overweight adolescent patients were audio recorded, and content was coded to summarize adherence with motivational interviewing techniques. An online educational intervention was developed using constructs from social cognitive theory and using personalized audio recordings. Physicians were randomized to the online intervention or not, and completed post-intervention surveys. Results Forty-six physicians were recruited, and 22 physicians were randomized to view the intervention website. The educational intervention took an average of 54 minutes to complete, and most physicians thought it was useful, that they would use newly acquired skills with their patients, and would recommend it to others. Fewer physicians thought it helped them address confidentiality issues with their adolescent patients. Conclusion The Teen CHAT online intervention shows potential for enhancing physician motivational interviewing skills in an acceptable and time-efficient manner. Practice Implications If found to be effective in enhancing motivational interviewing skills and changing adolescent weight-related behaviors, wide dissemination will be feasible and indicated. PMID:24021419

The relationship between physician humility, physician-patient communication, and patient health.

Science.gov (United States)

Ruberton, Peter M; Huynh, Ho P; Miller, Tricia A; Kruse, Elliott; Chancellor, Joseph; Lyubomirsky, Sonja

2016-07-01

Cultural portrayals of physicians suggest an unclear and even contradictory role for humility in the physician-patient relationship. Despite the social importance of humility, however, little empirical research has linked humility in physicians with patient outcomes or the characteristics of the doctor-patient visit. The present study investigated the relationship between physician humility, physician-patient communication, and patients' perceptions of their health during a planned medical visit. Primary care physician-patient interactions (297 patients across 100 physicians) were rated for the physician's humility and the effectiveness of the physician-patient communication. Additionally, patients reported their overall health and physicians and patients reported their satisfaction with the interaction. Within-physician fluctuations in physician humility and self-reported patient health positively predicted one another, and mean-level differences in physician humility predicted effective physician-patient communication, even when controlling for the patient's and physician's satisfaction with the visit and the physician's frustration with the patient. The results suggest that humble, rather than paternalistic or arrogant, physicians are most effective at working with their patients. Interventions to improve physician humility may promote better communication between health care providers and patients, and, in turn, better patient outcomes. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Undergraduate grade point average and graduate record examination scores: the experience of one graduate nursing program.

Science.gov (United States)

Newton, Sarah E; Moore, Gary

2007-01-01

Graduate nursing programs frequently use undergraduate grade point average (UGPA) and Graduate Record Examination (GRE) scores for admission decisions. The literature indicates that both UGPA and GRE scores are predictive of graduate school success, but that UGPA may be the better predictor. If that is so, one must ask if both are necessary for graduate nursing admission decisions. This article presents research on one graduate nursing program's experience with UGPA and GRE scores and offers a perspective regarding their continued usefulness for graduate admission decisions. Data from 120 graduate students were examined, and regression analysis indicated that UGPA significantly predicted GRE verbal and quantitative scores (p < .05). Regression analysis also determined a UGPA score above which the GRE provided little additional useful data for graduate nursing admission decisions.

Impact of policies regulating foreign physician migration to Switzerland: a modelling case study in anaesthesia.

Science.gov (United States)

Haller, Guy; Combescure, Christophe; Mamie, Chantal; Zoccatelli, Davide; Clergue, François

2015-05-22

Several countries have developed policies that restrict or limit duration of stay, clinical privileges or the number of residency permits allocated to migrating physicians. Switzerland is currently preparing a new law limiting overall foreign immigration. The impact of such restrictive policies is currently unknown. In a case study of anaesthesia care in Switzerland we modelled, trends in the size of physicians' workforce until 2024, following the implementation of a strict quota policy for foreign medical trainees. We developed a computer-based Markov model with Monte-Carlo simulations to project, in the context of a strict quota policy for foreign trainees, supply and demand for anaesthesia positions until 2024. We used data from a cross-sectional study performed in the French- and Italian-speaking cantons of Switzerland and the Health dataset from the OECD. With 8 to 12 (95% CI 4-20) anaesthetists retiring per year, the implementation of strict quotas of foreign graduates would result in a 38% decrease in the number of anaesthetists in intermediary (senior registrars) positions by 2024. This decrease would be particularly important in district hospitals where nearly half (49%) of the non-Swiss anaesthetists are practising. Swiss graduates are unlikely to balance the shortage. Despite efforts by Swiss universities to increase the number of medical graduates, their number has dropped from 10.5 to 9.7/100 000 inhabitants between 2000 and 2012, due to the growth of the population. This case study in Latin Switzerland shows that a restrictive policy limiting foreign immigration of trainees would result in a major deficit in the number of anaesthetists available to meet population needs. These aspects should be carefully considered when countries develop restrictions and limitations of foreign immigration.

Tracking Residents Through Multiple Residency Programs: A Different Approach for Measuring Residents' Rates of Continuing Graduate Medical Education in ACGME-Accredited Programs.

Science.gov (United States)

Byrne, Lauren M; Holt, Kathleen D; Richter, Thomas; Miller, Rebecca S; Nasca, Thomas J

2010-12-01

Increased focus on the number and type of physicians delivering health care in the United States necessitates a better understanding of changes in graduate medical education (GME). Data collected by the Accreditation Council for Graduate Medical Education (ACGME) allow longitudinal tracking of residents, revealing the number and type of residents who continue GME following completion of an initial residency. We examined trends in the percent of graduates pursuing additional clinical education following graduation from ACGME-accredited pipeline specialty programs (specialties leading to initial board certification). Using data collected annually by the ACGME, we tracked residents graduating from ACGME-accredited pipeline specialty programs between academic year (AY) 2002-2003 and AY 2006-2007 and those pursuing additional ACGME-accredited training within 2 years. We examined changes in the number of graduates and the percent of graduates continuing GME by specialty, by type of medical school, and overall. The number of pipeline specialty graduates increased by 1171 (5.3%) between AY 2002-2003 and AY 2006-2007. During the same period, the number of graduates pursuing additional GME increased by 1059 (16.7%). The overall rate of continuing GME increased each year, from 28.5% (6331/22229) in AY 2002-2003 to 31.6% (7390/23400) in AY 2006-2007. Rates differed by specialty and for US medical school graduates (26.4% [3896/14752] in AY 2002-2003 to 31.6% [4718/14941] in AY 2006-2007) versus international medical graduates (35.2% [2118/6023] to 33.8% [2246/6647]). The number of graduates and the rate of continuing GME increased from AY 2002-2003 to AY 2006-2007. Our findings show a recent increase in the rate of continued training for US medical school graduates compared to international medical graduates. Our results differ from previously reported rates of subspecialization in the literature. Tracking individual residents through residency and fellowship programs provides

PLAB and UK graduates' performance on MRCP(UK) and MRCGP examinations: data linkage study.

Science.gov (United States)

McManus, I C; Wakeford, Richard

2014-04-17

To assess whether international medical graduates passing the two examinations set by the Professional and Linguistic Assessments Board (PLAB1 and PLAB2) of the General Medical Council (GMC) are equivalent to UK graduates at the end of the first foundation year of medical training (F1), as the GMC requires, and if not, to assess what changes in the PLAB pass marks might produce equivalence. Data linkage of GMC PLAB performance data with data from the Royal Colleges of Physicians and the Royal College of General Practitioners on performance of PLAB graduates and UK graduates at the MRCP(UK) and MRCGP examinations. Doctors in training for internal medicine or general practice in the United Kingdom. 7829, 5135, and 4387 PLAB graduates on their first attempt at MRCP(UK) Part 1, Part 2, and PACES assessments from 2001 to 2012 compared with 18,532, 14,094, and 14,376 UK graduates taking the same assessments; 3160 PLAB1 graduates making their first attempt at the MRCGP AKT during 2007-12 compared with 14,235 UK graduates; and 1411 PLAB2 graduates making their first attempt at the MRCGP CSA during 2010-12 compared with 6935 UK graduates. Performance at MRCP(UK) Part 1, Part 2, and PACES assessments, and MRCGP AKT and CSA assessments in relation to performance on PLAB1 and PLAB2 assessments, as well as to International English Language Testing System (IELTS) scores. MRCP(UK), MRCGP, and PLAB results were analysed as marks relative to the pass mark at the first attempt. PLAB1 marks were a valid predictor of MRCP(UK) Part 1, MRCP(UK) Part 2, and MRCGP AKT (r=0.521, 0.390, and 0.490; all PIELTS scores correlated significantly with later performance, multiple regression showing that the effect of PLAB1 (β=0.496) was much stronger than the effect of IELTS (β=0.086). Changes to PLAB pass marks that would result in international medical graduate and UK medical graduate equivalence were assessed in two ways. Method 1 adjusted PLAB pass marks to equate median performance of PLAB

Medicaid HMO penetration and its mix: did increased penetration affect physician participation in urban markets?

Science.gov (United States)

Adams, E Kathleen; Herring, Bradley

2008-02-01

To use changes in Medicaid health maintenance organization (HMO) penetration across markets over time to test for effects on the extent of Medicaid participation among physicians and to test for differences in the effects of increased use of commercial versus Medicaid-dominant plans within the market. The nationally representative Community Tracking Study's Physician Survey for three periods (1996-1997, 1998-1999, and 2000-2001) on 29,866 physicians combined with Centers for Medicare and Medicaid Services (CMS) and InterStudy data. Market-level estimates of Medicaid HMO penetration are used to test for (1) any participation in Medicaid and (2) the degree to which physicians have an "open" (i.e., nonlimited) practice accepting new Medicaid patients. Models account for physician, firm, and local characteristics, Medicaid relative payment levels adjusted for geographic variation in practice costs, and market-level fixed effects. There is a positive effect of increases in commercial Medicaid HMO penetration on the odds of accepting new Medicaid patients among all physicians, and in particular, among office-based physicians. In contrast, there is no effect, positive or negative, from expanding the penetration of Medicaid-dominant HMO plans within the market. Increases in cost-adjusted Medicaid fees, relative to Medicare levels, were associated with increases in the odds of participation and of physicians having an "open" Medicaid practice. Provider characteristics that consistently lower participation among all physicians include being older, board certified, a U.S. graduate and a solo practitioner. The effects of Medicaid HMO penetration on physician participation vary by the type of plan. If states are able to attract and retain commercial plans, participation by office-based physicians is likely to increase in a way that opens existing practices to more new Medicaid patients. Other policy variables that affect participation include the presence of a federally

Physician supply and demand in anatomical pathology in Taiwan.

Science.gov (United States)

Hsu, Chih-Yi; Jung, Shih-Ming; Chuang, Shih-Sung

2011-02-01

Anatomical pathology was not popular in Taiwan a few decades ago, with a severe shortage of pathologists. However, there has been a steady increase in recent years, and now there is a threat of oversupply We evaluated supply and demand over the past three decades and compared the findings with other countries. We collected the enrollment data of pathologists and physicians from the Taiwan Society of Pathology, the Department of Health, Executive Yuan, and Taiwan Medical Association, and analyzed equivalent data from other countries. We sent questionnaires to pathology chiefs to inquire about future job vacancies. The number of pathologists has increased at an annual rate of 4.93% between 2004 and 2008, in contrast to 3.7% for all physicians. There has been a net annual increase of 12 pathologists in the past 13 years. The estimated average number of consultant posts per year was nine, which was only one-third of the average number of first-year residents (R1s). The number of pathologists/million population in Taiwan was 14.83, which was comparable to that in Japan and South Korea but much smaller than that in Canada and the United States. The ratio of pathologists to physicians in Taiwan was 0.97%, which was higher than that in Japan (0.68%) and South Korea (0.64%), but lower than in Canada (1.32%) and the United States (1.46%). On average, 1.79% of medical graduates chose pathology for their R1 training in Taiwan, which was higher than that in the United States (1.50%) and Canada (1.10-1.20%). Anatomical pathology is no longer a specialty that is facing a physician shortage in Taiwan, and there is now a relatively high pathologist/physician ratio among Asian countries. We suggest that a decrease in the number of R1s in pathology is needed to maintain a balance between supply and demand. Copyright © 2011 Formosan Medical Association & Elsevier. Published by Elsevier B.V. All rights reserved.

Parental bonding and self-esteem as predictors of severe depressive symptoms: a 10-year follow-up study of Norwegian physicians.

Science.gov (United States)

Grotmol, Kjersti S; Ekeberg, Øivind; Finset, Arnstein; Gude, Tore; Moum, Torbjørn; Vaglum, Per; Tyssen, Reidar

2010-01-01

Elevated rates of suicide and depression among physicians have been reported. The associations between perceived parental bonding and depressive symptoms have yet to be studied longitudinally in this occupational group. In a nationwide cohort, we sought to study parental bonding as a predictor for severe depressive symptoms and to determine whether self-esteem mediates this relationship. After graduation (T1), medical students (N = 631) were followed-up after 1 (T2), 4 (T3), and 10 (T4) years. There were no gender differences in mean depressive scores. Female physicians reported higher levels of care from their mothers (p self-esteem for both sexes.

Cegep Graduates with Disabilities: College Exit (CRC) Scores of Graduates Registered for Disability Related Services Compared to Non-Registered Graduates and Graduates without Disabilities. Final Report Presented to PAREA, Spring 2007

Science.gov (United States)

Jorgensen, Shirley; Fichten, Catherine; Havel, Alice

2007-01-01

The goal of the study was to determine the relative competitiveness in gaining access to university of graduates with and without disabilities, and to determine whether the ease with which graduates experienced aspects of their college environment was related to their college exit scores. We found that graduates who responded to surveys, whether…

A Software Application for Managing Graduates and Graduation Diploma in the University

Directory of Open Access Journals (Sweden)

Mîzgaciu C.

2009-12-01

Full Text Available This paper presents the structure mode of organization and storage of data that is contained in a graduation diploma. The graduation diploma is of three types, based on the three important cycles of study (bachelor, master, and doctoral degree. We do an analysis of the information that is included in the graduation diploma and how we can manage this from the quality point of view.We print the graduation diploma once on the form, elaborated by our Ministry of Education, Research and Innovation (MECI, we can make a duplicate in certain cases.We suggest an online application which is based on a software solution using Apache, PHP and MySQL.

Noncognitive Attributes in Physician Assistant Education.

Science.gov (United States)

Brenneman, Anthony E; Goldgar, Constance; Hills, Karen J; Snyder, Jennifer H; VanderMeulen, Stephane P; Lane, Steven

2018-03-01

Physician assistant (PA) admissions processes have typically given more weight to cognitive attributes than to noncognitive ones, both because a high level of cognitive ability is needed for a career in medicine and because cognitive factors are easier to measure. However, there is a growing consensus across the health professions that noncognitive attributes such as emotional intelligence, empathy, and professionalism are important for success in clinical practice and optimal care of patients. There is also some evidence that a move toward more holistic admissions practices, including evaluation of noncognitive attributes, can have a positive effect on diversity. The need for these noncognitive attributes in clinicians is being reinforced by changes in the US health care system, including shifting patient demographics and a growing emphasis on team-based care and patient satisfaction, and the need for clinicians to help patients interpret complex medical information. The 2016 Physician Assistant Education Association Stakeholder Summit revealed certain behavioral and affective qualities that employers of PAs value and sometimes find lacking in new graduates. Although there are still gaps in the evidence base, some tools and technologies currently exist to more accurately measure noncognitive variables. We propose some possible strategies and tools that PA programs can use to formalize the way they select for noncognitive attributes. Since PA programs have, on average, only 27 months to educate students, programs may need to focus more resources on selecting for these attributes than teaching them.

Those Who Graduate: A Brief Look at the UNO Graduating Class of 1986.

Science.gov (United States)

Crawford, A. E.

1989-01-01

The University of Nebraska at Omaha (UNO) conducted a study of 1,358 bachelor's degree graduates of the class of 1986 to examine two factors: (1) age at entrance and graduation, and (2) length of time required for graduation from several specified beginning points. The study required four sets of data: demographic, age related data, time-frame…

Graduation Exam Participation and Performance, Graduation Rates, and Advanced Coursetaking Following Changes in New Mexico Graduation Requirements, 2011-15. REL 2018-277

Science.gov (United States)

Walston, Jill; Tucker, Clyde; Ye, Cong; Lee, Dong Hoon

2017-01-01

The New Mexico graduation rate has lagged behind the national graduation rate in recent years. In 2015 the graduation rate was 69 percent in New Mexico and 83 percent nationwide (New Mexico Public Education Department, 2016; U.S. Department of Education, 2017). Of particular interest to education leaders in New Mexico are differences in graduation…

Calculating graduation rates.

Science.gov (United States)

Starck, Patricia L; Love, Karen; McPherson, Robert

2008-01-01

In recent years, the focus has been on increasing the number of registered nurse (RN) graduates. Numerous states have initiated programs to increase the number and quality of students entering nursing programs, and to expand the capacity of their programs to enroll additional qualified students. However, little attention has been focused on an equally, if not more, effective method for increasing the number of RNs produced-increasing the graduation rate of students enrolling. This article describes a project that undertook the task of compiling graduation data for 15 entry-level programs, standardizing terms and calculations for compiling the data, and producing a regional report on graduation rates of RN students overall and by type of program. Methodology is outlined in this article. This effort produced results that were surprising to program deans and directors and is expected to produce greater collaborative efforts to improve these rates both locally and statewide.

Physician Order Entry Clerical Support Improves Physician Satisfaction and Productivity.

Science.gov (United States)

Contratto, Erin; Romp, Katherine; Estrada, Carlos A; Agne, April; Willett, Lisa L

2017-05-01

To examine the impact of clerical support personnel for physician order entry on physician satisfaction, productivity, timeliness with electronic health record (EHR) documentation, and physician attitudes. All seven part-time physicians at an academic general internal medicine practice were included in this quasi-experimental (single group, pre- and postintervention) mixed-methods study. One full-time clerical support staff member was trained and hired to enter physician orders in the EHR and conduct previsit planning. Physician satisfaction, productivity, timeliness with EHR documentation, and physician attitudes toward the intervention were measured. Four months after the intervention, physicians reported improvements in overall quality of life (good quality, 71%-100%), personal balance (43%-71%), and burnout (weekly, 43%-14%; callousness, 14%-0%). Matched for quarter, productivity increased: work relative value unit (wRVU) per session increased by 20.5% (before, April-June 2014; after, April-June 2015; range -9.2% to 27.5%). Physicians reported feeling more supported, more focused on patient care, and less stressed and fatigued after the intervention. This study supports the use of physician order entry clerical personnel as a simple, cost-effective intervention to improve the work lives of primary care physicians.

[The disgrace of Antoine Daquin, first physician of Louis XIV (1693)].

Science.gov (United States)

Peumery, J J

1996-12-01

Antoine Daquin, Principal Physician of Louis XIV and Earl of Jouy-en-Josas, was born in Paris. He was the son of Louis-Henri Daquin, Physician to Queen Marie de Médicis; his paternal grandfather, born in the Jewish religion, became converted to catholicism at Aquino, in Italy, whence his name d'Aquin, then Daquin. A. Daquin studied to be a doctor at Montpellier and graduated on 18 May 1648. He married Marguerite Gayant, Antoine Vallot's niece, Antoine Vallot being the Principal Physician of Louis XIV. This relationship permitted him to get the position of Principal Physician of the Queen, then, after Vallot's death, to succeed him, on 18 April 1672, as Principal Physician of the King. The kindliness of the King's mistress, Mme de Montespan, helped him in that appointment. Daquin was a good doctor, he turned out awkward: "great courtier, but rich, miser, grasping, wanting to establish his family anyway" said the Duc de Saint-Simon. He dared ask the King for the Archbishopric of Tours for his son: "it was the rock on which he broke up" said again Saint-Simon. On 2 November 1693, the comte de Pontchartrain came to his home by order of the King, to tell him, he was ordered to retire from Court without delay. It was forbidden him to come back or to write to the King. Guy-Crescent Fagon was designated "Premier Médecin" instead of him; but Fagon had worked at the undoing of Daquin, with a view to robbing him of his position, with the complicity of the King's new mistress, Mme de Maintenon. After his disgrace, Daquin retired probably to Moulins; he died obscurely in Vichy, on 17 May 1696. Today, Daquin is regarded as a victim of intrigues of Court, which explains his celebrity.

The geography of graduate medical education: imbalances signal need for new distribution policies.

Science.gov (United States)

Mullan, Fitzhugh; Chen, Candice; Steinmetz, Erika

2013-11-01

Graduate medical education (GME) determines the overall number, specialization mix, and geographic distribution of the US physician workforce. Medicare GME payments-which represent the largest single public investment in health workforce development-are allocated based on an inflexible system whose rationale, effectiveness, and balance are increasingly being scrutinized. We analyzed Medicare cost reports from teaching hospitals and found large state-level differences in the number of Medicare-sponsored residents per 100,000 population (1.63 in Montana versus 77.13 in New York), total Medicare GME payments ($1.64 million in Wyoming versus $2 billion in New York), payments per person ($1.94 in Montana versus $103.63 in New York), and average payments per resident ($63,811 in Louisiana versus $155,135 in Connecticut). Ways to address these imbalances include revising Medicare's GME funding formulas and protecting those states that receive less Medicare GME support in case funding is decreased and making them a priority if it is increased. The GME system badly needs a coordinating body to deliberate and make policy about public investments in graduate medical education.

Factors Associated With Medical School Graduates' Intention to Work With Underserved Populations: Policy Implications for Advancing Workforce Diversity.

Science.gov (United States)

Garcia, Andrea N; Kuo, Tony; Arangua, Lisa; Pérez-Stable, Eliseo J

2018-01-01

Given projected U.S. physician shortages across all specialties that will likely impact underserved areas disproportionately, the authors sought to explore factors most correlated with medical school graduates' intention to work with underserved populations (IWUP). Data from the 2010-2012 Association of American Medical Colleges Medical School Graduation Questionnaire (n = 40,846) were analyzed. Variables (demographics, career preference, debt burden, intention to enter loan forgiveness programs) were examined using chi-square tests and logistic regression models. Respondents included 49.5% (20,228/40,846) women, 16.6% (6,771/40,837) underrepresented minorities (URMs), and 32.4% (13,034/37,342) with primary care intent. The median educational debt was $160,000. Respondents who were women (adjusted odds ratio [aOR] 1.59, 95% confidence interval [CI] 1.49, 1.70), URMs (aOR 2.50, 95% CI 2.30, 2.72), intended to enter loan forgiveness programs (aOR 2.44, 95% CI 2.26, 2.63), intended to practice primary care (aOR 1.65, 95% CI 1.54, 1.76), and intended to emphasize nonclinical careers (aOR 1.23, 95% CI 1.11, 1.37) had greater odds of reporting IWUP. Among those who chose specialties and careers with a nonclinical emphasis, and among those with greater burdens of educational and consumer debt, URMs were nearly twice as likely as other minorities and whites to report IWUP. Findings suggest physician characteristics that may be associated with filling workforce gaps in underserved areas. Restructuring financial incentive programs to support physician leaders and specialists with characteristics associated with IWUP may complement similar policies in primary care and could have key impacts on health equity in underserved areas.

Which young physicians are satisfied with their work? A prospective nationwide study in Norway

Directory of Open Access Journals (Sweden)

Ekeberg Oivind

2005-06-01

Full Text Available Abstract Background Few studies have investigated personality and medical school variables in regard to job satisfaction after graduation. It is of great importance to investigate these factors because this information may be used in the recruitment/admittance process to medical schools, and possibly to improve medical education. Methods We conducted a nationwide prospective 10-year follow-up study of medical students at all medical schools in Norway. They were approached three times during their medical training: at very beginning (T1, in the middle (T2, in the last year of medical school (T3, and then four years after graduation (T4. There were 210 participants who responded on all four occasions. Job satisfaction was measured with the Job Satisfaction Scale, which was used as the outcome variable. In addition to conducting multiple regression analysis for the total sample, we also conducted similar analyses separately for men and women. Results Among the demographic and personality variables, 'having a father who is a physician' and 'interpersonal functioning (being withdrawn' were significantly associated with job satisfaction at T4. Among the medical school variables, 'well-being with peers', 'identification with the doctor's role at the end of curriculum', 'perceived medical school stress', and 'perceived clinical skills' were significantly associated with job satisfaction. In the multiple regression analysis only 'father as a physician' and 'perceived clinical skills' yielded an independent influence on the outcome variable in separate analyses within sub-groups of male and female students, 'perceived clinical skills' differentiated among woman only, while 'well-being with peers' differentiated only among men. Conclusion The main finding of this study is that the young physicians who are the most satisfied in their work are those whose fathers are physicians and those who have a high level of perceived clinical skills at the end of

Applying lessons learned from the USAID family planning graduation experience to the GAVI graduation process.

Science.gov (United States)

Shen, Angela K; Farrell, Marguerite M; Vandenbroucke, Mary F; Fox, Elizabeth; Pablos-Mendez, Ariel

2015-07-01

As low income countries experience economic transition, characterized by rapid economic growth and increased government spending potential in health, they have increased fiscal space to support and sustain more of their own health programmes, decreasing need for donor development assistance. Phase out of external funds should be systematic and efforts towards this end should concentrate on government commitments towards country ownership and self-sustainability. The 2006 US Agency for International Development (USAID) family planning (FP) graduation strategy is one such example of a systematic phase-out approach. Triggers for graduation were based on pre-determined criteria and programme indicators. In 2011 the GAVI Alliance (formerly the Global Alliance for Vaccines and Immunizations) which primarily supports financing of new vaccines, established a graduation policy process. Countries whose gross national income per capita exceeds $1570 incrementally increase their co-financing of new vaccines over a 5-year period until they are no longer eligible to apply for new GAVI funding, although previously awarded support will continue. This article compares and contrasts the USAID and GAVI processes to apply lessons learned from the USAID FP graduation experience to the GAVI process. The findings of the review are 3-fold: (1) FP graduation plans served an important purpose by focusing on strategic needs across six graduation plan foci, facilitating graduation with pre-determined financial and technical benchmarks, (2) USAID sought to assure contraceptive security prior to graduation, phasing out of contraceptive donations first before phasing out from technical assistance in other programme areas and (3) USAID sought to sustain political support to assure financing of products and programmes continue after graduation. Improving sustainability more broadly beyond vaccine financing provides a more comprehensive approach to graduation. The USAID FP experience provides a

Forms of Graduate Capital and Their Relationship to Graduate Employability

Science.gov (United States)

Tomlinson, Michael

2017-01-01

Purpose: In the context of far-reaching changes in higher education and the labour market, there has been extensive discussion on what constitutes graduate employability and what shapes graduates' labour market outcomes. Many of these discussions are based on skills-centred approaches and related supply-side logic. The purpose of this paper is to…

Transferring experience labs for production engineering students to universities in newly industrialized countries

Science.gov (United States)

Leiden, A.; Posselt, G.; Bhakar, V.; Singh, R.; Sangwan, K. S.; Herrmann, C.

2018-01-01

The Indian economy is one of the fastest growing economies in the world and the demand for the skilled engineers is increasing. Subsequently the Indian education sector is growing to provide the necessary number of skilled engineers. Current Indian engineering graduates have broad theoretical background but lack in methodological, soft and practical skills. To bridge this gap, the experience lab ideas from the engineering education at “Die Lernfabrik” (learning factory) of the Technische Universität Braunschweig (TU Braunschweig) is transferred to the Birla Institute of Technology and Science in Pilani (BITS Pilani), India. This Lernfabrik successfully strengthened the methodological, soft and practical skills of the TU Braunschweig production-engineering graduates. The target group is discrete manufacturing education with focusing on energy and resource efficiency as well as cyber physical production systems. As the requirements of industry and academia in India differs from Germany, the transfer of the experience lab to the Indian education system needs special attention to realize a successful transfer project. This publication provides a unique approach to systematically transfer the educational concept in Learning Factory from a specific university environment to a different environment in a newly industrialized country. The help of a bilateral university driven practice partnership between the two universities creates a lighthouse for the Indian university environment.

Proposing a Model of Co-Regulated Learning for Graduate Medical Education.

Science.gov (United States)

Rich, Jessica V

2017-08-01

Primarily grounded in Zimmerman's social cognitive model of self-regulation, graduate medical education is guided by principles that self-regulated learning takes place within social context and influence, and that the social context and physical environment reciprocally influence persons and their cognition, behavior, and development. However, contemporary perspectives on self-regulation are moving beyond Zimmerman's triadic reciprocal orientation to models that consider social transactions as the central core of regulated learning. Such co-regulated learning models emphasize shared control of learning and the role more advanced others play in scaffolding novices' metacognitive engagement.Models of co-regulated learning describe social transactions as periods of distributed regulation among individuals, which instrumentally promote or inhibit the capacity for individuals to independently self-regulate. Social transactions with other regulators, including attending physicians, more experienced residents, and allied health care professionals, are known to mediate residents' learning and to support or hamper the development of their self-regulated learning competence. Given that social transactions are at the heart of learning-oriented assessment and entrustment decisions, an appreciation for co-regulated learning is likely important for advancing medical education research and practice-especially given the momentum of new innovations such as entrustable professional activities.In this article, the author explains why graduate medical educators should consider adopting a model of co-regulated learning to complement and extend Zimmerman's models of self-regulated learning. In doing so, the author suggests a model of co-regulated learning and provides practical examples of how the model is relevant to graduate medical education research and practice.

The effectiveness of strategies and interventions that aim to assist the transition from student to newly qualified nurse.

Science.gov (United States)

Edwards, Deborah; Hawker, Clare; Carrier, Judith; Rees, Colin

2011-01-01

Background: The transition period from student to newly qualified nurse where nurses are adjusting to their new role and consolidating their knowledge and skills can be stressful. It is a time when many newly qualified nurses are left feeling inadequately prepared. A variety of strategies to ease the transition process have been reported, which aim to increase confidence, competence, sense of belonging of new graduates, improve recruitment and retention and reduce turnover costs. To synthesise the best available evidence on the effectiveness of support strategies and interventions aimed for newly qualified nurses. A comprehensive search was undertaken on major electronic databases to identify both published and unpublished studies from 2000 to the present date. Reference lists of retrieved papers were searched and authors contacted. Only quantitative studies published in English language were considered.Methodological quality and data extraction: Two reviewers independently assessed methodological quality and extracted data from the included studies. A third reviewer resolved any disagreements through discussion. The review did not identify comparable Randomised Controlled Trials (RCTs), and as such meta-analysis of the data was not appropriate. The data extracted from the included studies were synthesized into a narrative summary. Thirty three studies were included in the review: RCT (1), Quasi-experimental (3) and observational/descriptive studies (29). Countries of origin were: USA (25), Australia (4), England (2), New Zealand (1) and Thailand (1). Studies were categorised according to the type of programme or support strategy provided: nurse internship/residency programmes (14) and graduate nurse orientation programmes (7), preceptorship (4), simulation (3) and mentoring (2), final year nursing students transition programs (2) and externship (1).Outcomes were categorised as being important to the employer (recruitment, retention, turnover rates, competence

Graduate Attributes and Employability Skills: Graduates' Perspectives on Employers' Expectations in Oman

Science.gov (United States)

Belwal, Rakesh; Priyadarshi, Pushpendra; Al Fazari, Mariam Humaid

2017-01-01

Purpose: Supply and demand characteristics, influenced by the pre- and post-oil economy of Oman, have caused unemployment challenges to Omani graduates. The purpose of this paper is to explore the most common graduate attributes as they apply to graduates' employability in Oman. Design/methodology/approach: The study uses the principles of…

Linking Work Integrated Learning and Competency of Graduates Pursuing Graduate Diploma in Teaching Profession

Science.gov (United States)

Puncreobutr, Vichian; Malee; Somjate

2016-01-01

The objective of this research was to study the level of work integrated learning (WIL), and the competency of the teaching profession based on the standards of knowledge of the graduates at St. Theresa International College. The study group consisted of 115 graduates pursuing Graduate Diploma in Teaching Profession Program. The questionnaire was…

Communication skills training for physicians performing work disability assessments increases knowledge and self-efficacy: results of a randomised controlled trial.

Science.gov (United States)

van Rijssen, Jolanda; Schellart, Antonius J M; Anema, Johannes R; van der Beek, Allard J

2015-07-21

It was assessed whether a post-graduate communication skills training course would increase physicians' competence and knowledge with regard to communication during work disability assessment interviews, and would change the determinants of their communication behaviour. A randomised controlled trial was performed. At baseline and at follow-up, 42 physicians completed questionnaires. The primary outcome measures were competence and knowledge about communication. The secondary outcome measures were 21 self-reported determinants of communication behaviour. One-way analyses of variance and covariance were performed. There was no significant difference between the intervention and control groups in overall competence, but there was for the introduction phase (intervention: mean = 7.0, SD 2.7; control: mean = 4.8, SD 2.7; p = 0.014). Knowledge about communication was significantly higher (p = 0.001) in the intervention group (mean = 79.6, SD 9.2) than in the control group (mean = 70.9, SD 6.7), especially concerning the information-gathering phase of the interview (intervention: mean = 80.0, SD 10.2; control: mean = 69.4, SD 8.9; p = 0.001). The intervention group scored significantly better on 7 of the 21 self-reported determinants (secondary outcomes), including self-efficacy, intentions, skills and knowledge. The communication skills training course may improve some aspects of physician communication, but not all. Because physicians were unanimously positive about the course, further development is warranted. Implications for Rehabilitation Even though optimal communication is essential in face-to-face assessment interviews for determining entitlement to work disability benefits, and there is a lot at stake for the claimants, this issue has scarcely been addressed in scientific research. A tailor-made two-day communication skills training course, based on scientific research, increases physicians' knowledge about communication

Graduate Study in Psychology, 2013 Edition

Science.gov (United States)

APA Books, 2012

2012-01-01

"Graduate Study in Psychology" is the best source of information related to graduate programs in psychology and provides information related to approximately 600 graduate programs in psychology in the U.S. and Canada. "Graduate Study in Psychology" contains information about: (1) number of applications received by a program;…

A qualitative study of the learning processes in young physicians treating suicidal patients: from insecurity to personal pattern knowledge and self-confidence

Directory of Open Access Journals (Sweden)

Talseth Anne-Grethe

2007-07-01

Full Text Available Abstract Background Little empirical work has been done in studying learning processes among newly educated physicians in the mental health field. The aim of the study was to shed light on the meaning of newly educated physicians' lived experiences of learning processes related to treating suicidal patients. Methods Thirteen newly educated physicians narrated their learning experiences while treating suicidal patients in their own practice. The interview texts were transcribed and interpreted using a phenomenological-hermeneutical method inspired by Ricoeur's philosophy. Results There was one main theme, four themes and eleven sub themes. The main theme was: Being in a transitional learning process. The themes and sub themes were: Preparing for practice (Getting tools and training skills, Becoming aware of one's own attitudes; Gaining experience from treating patients (Treating and following up patients over time, Storing memories and recognizing similarities and differences in patients; Participating in the professional community (Being an apprentice, Relating clinical stories and receiving feedback, Sharing emotions from clinical experiences, Receiving support from peers; and Developing personal competence (Having unarticulated awareness, Having emotional knowledge, Achieving self-confidence. The informants gave a detailed account of the learning process; from recognising similarities and differences in patients they have treated, to accumulating pattern knowledge, which then contributed to their personal feelings of competence and confidence. They described their personal competence with cognitive and emotional elements consisting of both articulated and less articulated knowledge. The findings are interpreted in relation to different learning theories that focus on both individual factors and the interaction with the learning environment. Conclusion This study provides additional information about learning experiences of young physicians

Job and life satisfaction and preference of future practice locations of physicians on remote islands in Japan.

Science.gov (United States)

Nojima, Yoshiaki; Kumakura, Shunichi; Onoda, Keiichi; Hamano, Tsuyoshi; Kimura, Kiyoshi

2015-05-26

The objective of this research is to investigate job and life satisfaction and preference of future practice locations of physicians in rural and remote islands in Japan. A cross-sectional study was conducted for physicians who reside or resided on the Oki islands: isolated islands situated in the Sea of Japan between the Eurasian continent and the mainland of Japan. A questionnaire was sent to physicians on the Oki islands to evaluate physician satisfaction regarding job environment, career development, living conditions, salary, and support by local government. Data was analysed for 49 physicians; 47 were male and 2 were female, and the mean ± SD age was 44.3 ± 10.9 years. Among the variables related to physicians' satisfaction, most of the physicians (>90%) were satisfied with "team work" and "salary". On the other hand, the majority of physicians (approximately 70%) were not satisfied with the "opportunity to continue professional development". Age ≥ 50 years, graduates of medical schools other than Jichi Medical University (established in 1972 with the aim to produce rural physicians), self-selected the Oki islands as a practice location, and satisfaction in "work as a doctor", "opportunity to consult with peers about patients", "relationship with people in the community", and "acceptance by community" were found to be significant factors influencing the choice of the Oki islands as a future practice location. Factors influencing future practice locations on the remote islands were included in a self-reported questionnaire which illustrated the importance of factors that impact both the spouses and children of physicians. Improving work satisfaction, providing outreach support programmes for career development and professional support in rural practice, and building appropriate relationships between physicians and people in the community, which can in turn improve work satisfaction, may contribute to physicians' choices of practising medicine on rural and

Guidelines adherence in the treatment of patients with newly diagnosed type 2 diabetes: a historical cohort comparing the use of metformin in Quebec pre and post-Canadian Diabetes Association guidelines.

Science.gov (United States)

Wang, Ting-Yu; Eguale, Tewodros; Tamblyn, Robyn

2013-10-25

Given the high prevalence of diabetes, guidelines are updated frequently to reflect optimal treatment recommendations. Our study aims to measure the response of primary care physicians to changes in choice of initial therapy for patients with type 2 diabetes in relationship to a change in Canadian Diabetes Association (CDA) Guidelines in 2008. We also assessed patients' and physicians' factors which may affect this change. Historical cohort study of primary care physicians' participating in an electronic medical record research network in Quebec, Canada. 111 primary care physicians and 1279 newly treated patients with diabetes with a prescription of an oral hypoglycemic agent (OHA) between January 20 2003 and December 29 2011 were included. Multivariate GEE logistic regression was used to estimate the impact of guideline change on treatment choice controlling for patients' and physicians' characteristics. After the new CDA guidelines, there was an increase in incident use of metformin from 89.7% to 94.6% (OR 1.86, 95% CI 1.20-2.90) with an accompanying reduction in the use of thiazolidinediones (OR 0.21, 95% CI 0.08-0.55), and reduction in the initiation of sulfonylureas (OR 0.78, 95% CI 0.43-1.09). Physicians' attitudes to evidence-based practice did not significantly modify response to a change in guidelines recommendations. However, older patients and those with renal failure were less likely to receive metformin. Metformin initiation in newly diagnosed diabetes patients has increased post 2008 CDA guidelines. However, due to the nature of the study design, we can not determine whether the observed change in metformin prescribing was causally related to the change in the guideline.

Differences between patient and physician opinions on adherence to medication for hypertension and diabetes mellitus.

Science.gov (United States)

Liguori, Yuji; Murase, Katsuhito; Hamamura, Misako

2016-09-01

Non-adherence to prescribed medication presents a barrier to effective treatment. In order to find improved ways of tackling non-adherence, it is important to understand the perspective of both patients and physicians. A web-based survey study was performed to obtain the views and opinions of patients receiving medical treatment for hypertension or diabetes mellitus in Japan, and physicians treating such patients, on adherence to medication. Forty-four percent of both physicians and patients placed great importance on medication adherence, but 11% of patients considered it of low importance. Overall, 85% of patients reported taking their medication correctly. Patients missed a mean of 4.8 or 5.4 daily doses per 30 day prescription based on patient and physician estimates, respectively. Both patients (64%) and physicians (23%) considered the main reason patients forgot to take their medication was that they "inadvertently forgot". Only 1% of physicians said they do not specifically check for residual drugs, but 46% of patients said they do not report missed doses to their doctor. Measures taken by physicians to reduce residual drugs included use of single packs (64%) and reductions in administration frequency (55%); 63% adjusted prescriptions to take account of any remaining drugs. Only 4% of physicians were satisfied with the effectiveness of measures to reduce non-adherence, whereas 59% of patients felt they managed to successfully perform measures to avoid forgetting to take drugs. The study questionnaires were newly developed and did not incorporate validated instruments to assess adherence. Similar proportions of physicians and patients consider medication adherence to be important, but their opinions about measures used to improve adherence differ to some extent. Importantly, almost half of patients do not tell their doctor about missed doses.

The Siemens graduate program

International Nuclear Information System (INIS)

Schaeffler, I.

2000-01-01

Siemens is an international company acting in different domains: power generation, communication and information, traffic, health, etc. To be more flexible and active in a world in constant evolution, the company proposes a graduate program where young people with a special background have the possibility to start an international career in all the domains of activity. This graduate program is especially important in the domain of nuclear energy, where the know-how transfer between the previous generation and the new one is a constant point of interest. This article presents the conditions to be accepted in this graduate program, and the supplementary training supporting this program. The Siemens graduate program (Sg) proposes a global concept with a main emphasis being international. (authors)

Female Surgeons as Counter Stereotype: The Impact of Gender Perceptions on Trainee Evaluations of Physician Faculty.

Science.gov (United States)

Fassiotto, Magali; Li, Jie; Maldonado, Yvonne; Kothary, Nishita

2018-02-02

Similar to women in Science, Technology, Engineering and Mathematics disciplines, women in medicine are subject to negative stereotyping when they do not adhere to their sex-role expectations. These biases may vary by specialty, largely dependent on the gender's representation in that specialty. Thus, females in male-dominated surgical specialties are especially at risk of stereotype threat. Herein, we present the role of gender expectations using trainee evaluations of physician faculty at a single academic center, over a 5-year period (2010-2014). Using Graduate Medical Education evaluation data of physician faculty from MedHub, we examined the differences in evaluation scores for male and female physicians within specialties that have traditionally had low female representation (e.g., surgical fields) compared to those with average or high female representation (e.g., pediatrics). Stanford Medicine residents and fellows' MedHub ratings of their physician faculty from 2010 to 2014. A total of 3648 evaluations across 1066 physician faculty. Overall, female physicians received lower median scores than their male counterparts across all specialties. When using regression analyses controlling for race, age, rank, and specialty-specific characteristics, the negative effect persists only for female physicians in specialties with low female representation. This finding suggests that female physicians in traditionally male-dominated specialties may face different criteria based on sex-role expectations when being evaluated by trainees. As trainee evaluations play an important role in career advancement decisions, dictate perceptions of quality within academic medical centers and affect overall job satisfaction, we propose that these differences in evaluations based merely on gender stereotypes could account, in part, for the narrowing pipeline of women promoted to higher ranks in academic medicine. Copyright © 2018 Association of Program Directors in Surgery. Published

Physicians' perceptions of physician-nurse interactions and information needs in China.

Science.gov (United States)

Wen, Dong; Guan, Pengcheng; Zhang, Xingting; Lei, Jianbo

2018-01-01

Good communication between physicians and nurses is important for the understanding of disease status and treatment feedback; however, certain issues in Chinese hospitals could lead to suboptimal physician-nurse communication in clinical work. Convenience sampling was used to recruit participants. Questionnaires were sent to clinical physicians in three top tertiary Grade-A teaching hospitals in China and six hundred and seventeen physicians participated in the survey. (1) Common physician-nurse interactions were shift-change reports and provisional reports when needed, and interactions expected by physicians included face-to-face reports and communication via a phone or mobile device. (2) Most respondents believed that the need for information in physician-nurse interactions was high, information was moderately accurate and timely, and feedback regarding interaction time and satisfaction indicated that they were only average and required improvement. (3) Information needs in physician-nurse interactions differed significantly according to hospital category, role, workplace, and educational background (p < .05). There was a considerable need for information within physician-nurse interactions, and the level of satisfaction with the information obtained was average; requirements for the improvement of communication differed between physicians and nurses because of differences in their characteristics. Currently, the use of information technology in physician-nurse communication was less common but was highly expected by physicians.

Occupational status of Shaheed Beheshti University of Medical Sciences Graduates in 1993-7

Directory of Open Access Journals (Sweden)

Davood Yadegarinia

2009-02-01

Full Text Available Background and purpose: Job Satisfaction of the physicians and factors influencing it, are the issues receiving special attention by the health systems of every country. The present study aimed at revealing the current status of the employment and academic achievements of our physician and their attitude toward their job, in order to provide required information for the relevant authorities.Methods: In this descriptive cross-sectional study, an 8-item questionnaire was developed including 7 closed as well as 1 open question. The list of the physicians who were graduated from the Medical School of Shaheed Beheshti University of Medical Sciences and Health Services (SBMU from 1993 to 1997, was obtained from the Education Deputy of the University and Islamic Republic of Iran Medical Council. The questionnaires were then posted to the target group of physicians. The returned questionnaires were controlled and the related data was entered into the SPSS software.Results: Of all respondents, 356(67.3% were male and others were female; 363(68.4% were married; 260 (50.8% had completed the military service, and others were exempted. One hundred ninety(55.1% of the men and 103 (62% of the women had entered the university using open quota. Ninety four (61% of the single participants were dissatisfied with their jobs. This was 174 (49.2% in the married group. The most dissatisfied (162, 57.4% were among open quota group. More than half of the men and half of the women were dissatisfied with their jobs Conclusion: Physician’s workforce are among the most expensive human resources. A general dissatisfaction which has been shown in this study should be viewed as warning for policymakers and authorities to take measures to safeguard this expensive human capitals.Key word: JOB SATISFACTION, PHYSICIAN OCCUPATION

Reducing the physician workforce crisis: Career choice and graduate medical education reform in an emerging Arab country.

Science.gov (United States)

Ibrahim, Halah; Nair, Satish Chandrasekhar; Shaban, Sami; El-Zubeir, Margaret

2016-01-01

In today's interdependent world, issues of physician shortages, skill imbalances and maldistribution affect all countries. In the United Arab Emirates (UAE), a nation that has historically imported its physician manpower, there is sustained investment in educational infrastructure to meet the population's healthcare needs. However, policy development and workforce planning are often hampered by limited data regarding the career choice of physicians-in-training. The purpose of this study was to determine the specialty career choice of applicants to postgraduate training programs in the UAE and factors that influence their decisions, in an effort to inform educational and health policy reform. To our knowledge, this is the first study of career preferences for UAE residency applicants. All applicants to residency programs in the UAE in 2013 were given an electronic questionnaire, which collected demographic data, specialty preference, and factors that affected their choice. Differences were calculated using the t-test statistic. Of 512 applicants, 378 participated (74%). The most preferred residency programs included internal medicine, pediatrics, emergency medicine and family medicine. A variety of clinical experience, academic reputation of the hospital, and international accreditation were leading determinants of career choice. Potential future income was not a significant contributing factor. Applicants to UAE residency programs predominantly selected primary care careers, with the exception of obstetrics. The results of this study can serve as a springboard for curricular and policy changes throughout the continuum of medical education, with the ultimate goal of training future generations of primary care clinicians who can meet the country's healthcare needs. As 65% of respondents trained in medical schools outside of the UAE, our results may be indicative of medical student career choice in countries throughout the Arab world.

Decision-Making Capacity for Chemotherapy and Associated Factors in Newly Diagnosed Patients with Lung Cancer.

Science.gov (United States)

Ogawa, Asao; Kondo, Kyoko; Takei, Hiroyuki; Fujisawa, Daisuke; Ohe, Yuichiro; Akechi, Tatsuo

2018-04-01

The objective of this study was to assess decision-making capacity in patients newly diagnosed with lung cancer, clinical factors associated with impaired capacity, and physicians' perceptions of patients' decision-making capacity. We recruited 122 patients newly diagnosed with lung cancer. One hundred fourteen completed the assessment. All patients were receiving a combination of treatments (e.g., chemotherapy, chemo-radiotherapy, or targeted therapy). Decision-making capacity was assessed using the MacArthur Competence Tool for Treatment. Cognitive impairment, depressive symptoms, and frailty were also evaluated. Physicians' perceptions were compared with the ascertainments. Twenty-seven (24%, 95% confidence interval [CI], 16-31) patients were judged to have incapacity. Clinical teams had difficulty in judging six (22.2%) patients for incapacity. Logistic regression identified frailty (odds ratio, 3.51; 95% CI, 1.13-10.8) and cognitive impairment (odds ratio, 5.45; 95% CI, 1.26-23.6) as the factors associated with decision-making incapacity. Brain metastasis, emphysema, and depression were not associated with decision-making incapacity. A substantial proportion of patients diagnosed with lung cancer show impairments in their capacity to make a medical decision. Assessment of cognitive impairment and frailty may provide appropriate decision-making frameworks to act in the best interest of patients. Decision-making capacity is the cornerstone of clinical practice. A substantial proportion of patients with cancer show impairments in their capacity to make a medical decision. Assessment of cognitive impairment and frailty may provide appropriate decision-making frameworks to act in the best interest of patients. © AlphaMed Press 2017.

Egyptian future physicians are packing to leave but may be willing to return.

Science.gov (United States)

Fouad, Yousef A; Fahmy, Yara M; Abdel Hady, Sarah M; Elsabagh, Abdelrahman E

2015-05-01

The migration of physicians from the developing to the developed world remains a controversial topic with many proposed negative effects. Although Egypt remains a major supplier of international medical graduates, no exploration of the root causes of the issue or the required policy changes was attempted before. An online questionnaire was used to survey 940 Egyptian undergraduates enrolled at the Faculty of Medicine, Ain Shams University exploring their intentions of mobility following graduation and the factors impacting such intentions. Of the responding students, 85.7% (n=806) intended to leave the country for training following graduation, mostly seeking better research opportunities (mean 4.74) and working conditions (mean 4.64). Of those, 81.8% (659) reported their plan to eventually return after training, although at different intervals, principally driven by the feeling of belonging and desire to serve their country (mean 4.01). Due attention should be given to such an unnoticed country's issue with the adoption of evidence-based policy changes to minimize its negative effects. The affinity of the students to eventually return (driven by the desire to serve the country) could prove a valuable point to consider in policy-making. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Behavioral science priorities in residency education: The perspective of practicing family physicians.

Science.gov (United States)

Brandt-Kreutz, Richard L; Ferguson, Kyle E; Sawyer, Devin

2015-12-01

The family medicine residency behavioral science curriculum is more effective if prioritized to match what is needed in practice after graduation. Two prior studies (Kendall, Marvel, & Cruickshank, 2003; Marvel & Major, 1999) identified physician priorities for behavioral science education. The present study extends this research to include topics from more recent curriculum guidelines and examines the extent to which size of community and perceived competence correlate with prioritization of Washington state family physicians. Practicing family physicians in Washington state (N = 2,270) were invited to complete the survey. Respondents provided demographic and practice information. Respondents then rated, on a scale from 1 to 4, 35 behavioral science topics on 2 different scales including (a) priority to be given in residency education and (b) perceived level of competence. A total of 486 responded and 430 completed both priority and competence scales for a response rate of 19%. The top half of 35 topics of the present study included the top 13 topics found in the 2 prior studies. Priority and competence scales were moderately correlated (r = .48, n = 430, p = .001). There was a small significant correlation with size of community and priority ratings (r = .13, n = 435, p = .006). Family physicians in Washington state prioritize behavioral science topics in residency education similar to Colorado and Mississippi. The results of this study support recent ACGME guidelines, in that training should focus on common psychiatric illnesses, including depression and anxiety, and interpersonal processes. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

'The chearful haunts': John Armstrong (1709-1779), physician, poet, satirist and leveller of medical knowledge.

Science.gov (United States)

Bryan, Charles S; Scott, Patrick

2015-11-01

John Armstrong, the first honours graduate of the University of Edinburgh School of Medicine, was famous in his day for a lengthy didactic poem entitled The Art of Preserving Health (1744). He is now obscure except to scholars specializing in the 18th century and, when discussed at all, often dismissed as a failed physician who wrote mediocre poetry in a quest for money and fame. A new exegesis by Adam Budd exhumes Armstrong as an original voice who offered timely and reassuring advice to Britons as they braced for another epidemic of plague; who depicted illness through the lens of a vulnerable and sympathetic physician, and who was perhaps above all else a leveller of medical knowledge. Elaborating on Budd's thesis, it would seem that Armstrong, a complicated man, has frequently been misread and was in some ways ahead of his time. © The Author(s) 2014.

Getting physicians to open the survey: little evidence that an envelope teaser increases response rates

Directory of Open Access Journals (Sweden)

Ziegenfuss Jeanette Y

2012-03-01

Full Text Available Abstract Background Physician surveys are an important tool to assess attitudes, beliefs and self-reported behaviors of this policy relevant group. In order for a physician to respond to a mailed survey, they must first open the envelope. While there is some evidence that package elements can impact physician response rates, the impact of an envelope teaser is unknown. Here we assess this by testing the impact of adding a brightly colored "$25 incentive" sticker to the outside of an envelope on response rates and nonresponse bias in a survey of physicians. Methods In the second mailing of a survey assessing physicians' moral beliefs and views on controversial health care topics, initial nonrespondents were randomly assigned to receive a survey in an envelope with a colored "$25 incentive" sticker (teaser group or an envelope without a sticker (control group. Response rates were compared between the teaser and control groups overall and by age, gender, region of the United States, specialty and years in practice. Nonresponse bias was assessed by comparing the demographic composition of the respondents to the nonrespondents in the experimental and control condition. Results No significant differences in response rates were observed between the experimental and control conditions overall (p = 0.38 or after stratifying by age, gender, region, or practice type. Within the teaser condition, there was some variation in response rate by years since graduation. There was no independent effect of the teaser on response when simultaneously controlling for demographic characteristics (OR = 0.875, p = 0.4112. Conclusions Neither response rates nor nonresponse bias were impacted by the use of an envelope teaser in a survey of physicians in the United States.

A qualitative study of factors influencing different generations of Newfoundland and Saskatchewan trained physicians to leave a work location.

Science.gov (United States)

Mathews, Maria; Seguin, Maureen; Chowdhury, Nurun; Card, Robert T

2012-07-25

Some studies have suggested that young physicians may have different expectations and practice behaviours than their older generational counterparts, including their reasons for wanting to remain or leave a community. This study examined the factors associated with a physician's decision to leave a work location. We compared different generations of physicians to assess whether these factors have changed over generations. We conducted semi-structured, qualitative interviews with 48 physicians who graduated from two Canadian medical schools. We asked each physician about the number and nature of work location changes and the factors related to their decisions to leave each location. Interview transcripts and notes were analysed using a thematic analysis approach. Dissatisfaction with the working environment was the most frequently cited reason for leaving a location for physicians of all generations. Elements which contributed to the quality of the work environment included the collaborative nature of the practice, the relationship with administrators, and access to resources and personnel. For younger physicians, the work environment had to meet their personal expectations for work-life balance. While remuneration level was given by some physicians as the key reason for leaving a location, for others it was the "last straw" if the work environment was poor. A small number of older generation physicians moved in response to political events and/or policies We documented generational differences in physicians' reasons for choosing a work location. We found that a poor work environment was universally the most important reason why a physician chose to leave a location. A few physicians who were unsatisfied with their work location identified level of remuneration as an additional reason for leaving. Some older generation physicians cited political climate as a reason for leaving a work location. While economic factors have largely been the focus of recruitment and

The future of the pharmaceutical sciences and graduate education: recommendations from the AACP Graduate Education Special Interest Group.

Science.gov (United States)

Wu-Pong, Susanna; Gobburu, Jogarao; O'Barr, Stephen; Shah, Kumar; Huber, Jason; Weiner, Daniel

2013-05-13

Despite pharma's recent sea change in approach to drug discovery and development, U.S. pharmaceutical sciences graduate programs are currently maintaining traditional methods for master's and doctoral student education. The literature on graduate education in the biomedical sciences has long been advocating educating students to hone soft skills like communication and teamwork, in addition to maintaining excellent basic skills in research. However, recommendations to date have not taken into account the future trends in the pharmaceutical industry. The AACP Graduate Education Special Interest Group has completed a literature survey of the trends in the pharmaceutical industry and graduate education in order to determine whether our graduate programs are strategically positioned to prepare our graduates for successful careers in the next few decades. We recommend that our pharmaceutical sciences graduate programs take a proactive leadership role in meeting the needs of our future graduates and employers. Our graduate programs should bring to education the innovation and collaboration that our industry also requires to be successful and relevant in this century.

Sickness presenteeism: The prevalence of coming to work while ill among paediatric resident physicians in Canada.

Science.gov (United States)

Mitchell, Kevin J; Vayalumkal, Joseph V

2017-05-01

Sickness presenteeism is defined as the act of attending one's job despite ill-health. Recently, physicians and other health care workers have become the focus of sickness presenteeism research, because presenteeism in this population can put patients at risk of infection. There are currently no data on this topic among physicians in Canada. The aim of this study was to investigate sickness presenteeism in paediatric resident physicians in Canada. We conducted an anonymous, online, cross-sectional survey study in which all paediatric residents in Canada were eligible. Outcomes of interest included prevalences of sickness presenteeism, sickness during the study period and voluntary self-appointed personal protective equipment use when engaging in sickness presenteeism. Response rate was 56.5% (N=323). During the previous 2 months, 61% (95% confidence interval [CI] 55.7 to 66.3) of respondents reported having experienced an illness and 59% (95% CI 53.7 to 64.5) of respondents had come to work sick. Of those who reported becoming ill during the study period, 97.0% (95% CI 94.6 to 99.4) reported coming to work while sick. There was no difference in prevalence when comparing across post-graduate year training levels. Extra personal protective equipment was used by 86% (95% CI 82.1 to 91.7) when engaging in sickness presenteeism. Sickness presenteeism is a common phenomenon among paediatric resident physicians. Our results should influence residents and supervising staff physicians to encourage appropriate self-care at home, rather than presenteeism.

Impact of Generalist Physician Initiatives on Residency Selection

Directory of Open Access Journals (Sweden)

Michael H. Malloy

2001-10-01

Full Text Available Objective:To compare the residency selection choices of students who experienced courses resulting from generalist physician initiatives to choices made by students prior to the implementation of those courses and to describe the characteristics of students selecting primary care residencies. Background:In the fall of 1994 a first year Community Continuity Experience course was initiated and in the summer of 1995 a third year Multidisciplinary Ambulatory Clerkship was begun at the University of Texas Medical Branch in Galveston. These courses were inserted into the curriculum to enhance and promote primary care education. Design/Methods:We examined the residency selections of cohorts of graduating medical students before (1992-1996 and after (1997-1999 the implementation of the primary care courses. Survey information on career preferences at matriculation and in the fourth year of medical school were available for students graduating after the programs began. We compared the career preferences and characteristics of those students who selected a primary care residency to those who did not. Results:Prior to the implementation of the programs, 45%(425/950 of students graduating selected primary care residencies compared to 45% (210/465 of students participating in the programs (p=0.88. At matriculation, 45% of students had listed a primary care discipline as their first career choice. Among the students who had indicated this degree of primary care interest 61% ended up matching in a primary care discipline. At year 4, 31% of students indicated a primary care discipline as their first career choice and 92% of these students matched to a primary care residency. By univariate analysis, minority students (53% were more likely to select a primary care residency than non-minority students (40%; students in the two lowest grade point average quartiles (55% and 50% selected primary care residencies compared to 37% and 38% of students in the top 2

Evolution and application of the competencies and educational milestones in physician graduate education in the United States

Directory of Open Access Journals (Sweden)

Ingrid Philibert

2015-01-01

The development of the milestones and initial testing by communities of practice in internal medicine, pediatrics, surgery, emergency medicine, neurological surgery and urology establishes the initial validity argument for the milestones. Further validity evidence will require study of the value of the milestones in assessment and accreditation, and linking educational outcomes to the performance and clinical outcomes of physicians in practice.

Care Provision and Prescribing Practices of Physicians Treating Children and Adolescents With ADHD.

Science.gov (United States)

Patel, Ayush; Medhekar, Rohan; Ochoa-Perez, Melissa; Aparasu, Rajender R; Chan, Wenyaw; Sherer, Jeffrey T; Alonzo, Joy; Chen, Hua

2017-07-01

Care provision and prescribing practices of physicians treating children with attention-deficit hyperactivity disorder (ADHD) were compared. A retrospective cohort study was conducted with the 1995-2010 General Electric Centricity Electronic Medical Record database. The sample included children (≤18 years) with newly diagnosed ADHD (ICD-9-CM code 314.XX) who received a prescription for a stimulant or atomoxetine. Identification of comorbid psychiatric disorders, duration from initial ADHD diagnosis to treatment, prescription of other psychotropic medications, and follow-up care during the ten months after the ADHD treatment initiation were compared across provider type (primary care physicians [PCPs], child psychiatrists, and physicians with an unknown specialty). The associations between provider type and practice variations were further determined by multivariate logistic regression accounting for patient demographic characteristics, region, insurance type, and prior mental health care utilizations. Of the 66,719 children identified, 75.8% were diagnosed by PCPs, 2.6% by child psychiatrists, and 21.6% by physicians whose specialty was unknown. Child psychiatrists were less likely than PCPs to initiate ADHD medication immediately after the diagnosis. However, once the ADHD treatment was initiated, they were more likely to prescribe psychotropic polytherapy even after analyses accounted for the comorbid psychiatric disorders identified. Only one-third of ADHD cases identified by both PCPs and child psychiatrists have met the HEDIS quality measure for ADHD medication-related follow-up visits. Differences were found by physician type in care of children with ADHD. Additional studies are needed to understand clinical consequences of these differences and the implications for care coordination across provider specialties.

Social media: physicians-to-physicians education and communication.

Science.gov (United States)

Fehring, Keith A; De Martino, Ivan; McLawhorn, Alexander S; Sculco, Peter K

2017-06-01

Physician to physician communication is essential for the transfer of ideas, surgical experience, and education. Social networks and online video educational contents have grown exponentially in recent years changing the interaction among physicians. Social media platforms can improve physician-to-physician communication mostly through video education and social networking. There are several online video platforms for orthopedic surgery with educational content on diagnosis, treatment, outcomes, and surgical technique. Social networking instead is mostly centered on sharing of data, discussion of confidential topics, and job seeking. Quality of educational contents and data confidentiality represent the major drawbacks of these platforms. Orthopedic surgeons must be aware that the quality of the videos should be better controlled and regulated to avoid inaccurate information that may have a significant impact especially on trainees that are more prone to use this type of resources. Sharing of data and discussion of confidential topics should be extremely secure according the HIPAA regulations in order to protect patients' confidentiality.

Examining intercultural sensitivity and competency of physician assistant students.

Science.gov (United States)

Huckabee, Michael J; Matkin, Gina S

2012-01-01

Training in intercultural competency for health care professionals is necessary to bring greater balance to the disparity currently found among those needing health care. The purpose of this study was to determine what, if any, improvements in cultural competency were measurable in physician assistant (PA) students as they matriculated, using the Multicultural Awareness, Knowledge and Skills Survey-Revised as a pretest upon program entry and again as a posttest on the final day of the program. Ninety-three PA students from four successive classes graduating from a private midwest college between 2003 and 2007 participated in the pre and post measurements. All students were enrolled in specific didactic studies and clinical experiences in cultural sensitivity and competency. The results demonstrated significant improvement in knowledge (pretest 2.63, posttest 2.76, p=0.001) and skills (pretest 2.63, posttest 2.93, pIntercultural Development Inventory was administered to the most recent graduating class to further explore these results. This cohort showed the highest scores (group mean 3.58 on scale of 1-5) in the Minimization developmental stage, which emphasizes cultural commonality over cultural distinctions. Enhanced curricular instruction such as exploring cultural assessment methods and controversies in health care differences, combined with increased clinical experiences with diverse cultures, are recommended to help move students past the minimization stage to gain greater cultural competency.

Disease surveillance among newly arriving refugees and immigrants--Electronic Disease Notification System, United States, 2009.

Science.gov (United States)

Lee, Deborah; Philen, Rossanne; Wang, Zanju; McSpadden, Pamela; Posey, Drew L; Ortega, Luis S; Weinberg, Michelle S; Brown, Clive; Zhou, Weigong; Painter, John A

2013-11-15

Approximately 450,000 legal permanent immigrants and 75,000 refugees enter the United States annually after receiving required medical examinations by overseas panel physicians (physicians who follow the CDC medical screening guidelines provided to the U.S. Department of State). CDC has the regulatory responsibility for preventing the introduction, transmission, and spread of communicable diseases into the United States as well as for developing the guidelines, known as technical instructions, for the overseas medical examinations. Other conditions that are not infectious might preclude an immigrant or refugee from entering the United States and also are reported as part of the medical examination. After arrival in the United States, all refugees are recommended to obtain a medical assessment by a health-care provider or a health department within 30 days. In addition, immigrants with certain medical conditions such as noninfectious tuberculosis at the time of the original medical examination are recommended to be evaluated after arrival to ensure that appropriate prevention or treatment measures are instituted. Health departments need timely and accurate notifications of newly arriving immigrants, refugees, and persons with other visa types to facilitate these evaluations. Notifications for all newly arriving refugees (with or without medical conditions) and immigrants with medical conditions are provided by CDC's Electronic Disease Notification (EDN) system. This is the first report describing EDN. This report summarizes notifications by the EDN system during January-December 2009. The EDN system is a centralized electronic reporting system that collects health information on newly arriving refugees and immigrants with Class A and Class B medical conditions. Class A conditions render applicants inadmissible and require a waiver for entry; Class B conditions are admissible but might require treatment or follow-up. Information in the EDN system is used to notify

Valuing teamwork: Insights from newly-registered nurses working in specialist mental health services.

Science.gov (United States)

Cleary, Michelle; Horsfall, Jan; Mannix, Judy; O'Hara-Aarons, Maureen; Jackson, Debra

2011-12-01

In this qualitative study, the experiences of a small cohort of registered nurses (RN) during the first 2 years of mental health employment were documented. A total of 13 semistructured interviews were completed from within a specialist mental health setting. Eleven issues were identified: (i) teamwork; (ii) experiential learning; (iii) self-development; (iv) confidence; (v) listening; (vi) rapport; (vii) keen observation; (viii) patience; (ix) empathy; (x) learning from colleagues; and (xi) maintaining a positive approach towards patients. The nurses focused on the here-and-now circumstances, rather than on future plans, or past preparation, and were able to elucidate the qualities and skills that they brought to their clinical work. Participants were most proud of achievements that bridged the personal and professional, such as self-development, working closely with patients to develop rapport, experiential learning, and teamwork. Findings highlight the importance of teamwork to newly-graduated RN entering the mental health environment. It is known that teamwork can convey a sense of belonging and help create an environment in which applied experiential clinical learning can occur. Therefore, it is important that efforts are made to facilitate team building and opportunities for teamwork when new graduates are transitioning into the mental health clinical practice environment. © 2011 The Authors; International Journal of Mental Health Nursing © 2011 Australian College of Mental Health Nurses Inc.

An Innovative Interactive Modeling Tool to Analyze Scenario-Based Physician Workforce Supply and Demand

Science.gov (United States)

Gupta, Saurabh; Black-Schaffer, W. Stephen; Crawford, James M.; Gross, David; Karcher, Donald S.; Kaufman, Jill; Knapman, Doug; Prystowsky, Michael B.; Wheeler, Thomas M.; Bean, Sarah; Kumar, Paramhans; Sharma, Raghav; Chamoli, Vaibhav; Ghai, Vikrant; Gogia, Vineet; Weintraub, Sally; Cohen, Michael B.

2015-01-01

Effective physician workforce management requires that the various organizations comprising the House of Medicine be able to assess their current and future workforce supply. This information has direct relevance to funding of graduate medical education. We describe a dynamic modeling tool that examines how individual factors and practice variables can be used to measure and forecast the supply and demand for existing and new physician services. The system we describe, while built to analyze the pathologist workforce, is sufficiently broad and robust for use in any medical specialty. Our design provides a computer-based software model populated with data from surveys and best estimates by specialty experts about current and new activities in the scope of practice. The model describes the steps needed and data required for analysis of supply and demand. Our modeling tool allows educators and policy makers, in addition to physician specialty organizations, to assess how various factors may affect demand (and supply) of current and emerging services. Examples of factors evaluated include types of professional services (3 categories with 16 subcategories), service locations, elements related to the Patient Protection and Affordable Care Act, new technologies, aging population, and changing roles in capitated, value-based, and team-based systems of care. The model also helps identify where physicians in a given specialty will likely need to assume new roles, develop new expertise, and become more efficient in practice to accommodate new value-based payment models. PMID:28725751

An Innovative Interactive Modeling Tool to Analyze Scenario-Based Physician Workforce Supply and Demand

Directory of Open Access Journals (Sweden)

Saurabh Gupta BPharm

2015-10-01

Full Text Available Effective physician workforce management requires that the various organizations comprising the House of Medicine be able to assess their current and future workforce supply. This information has direct relevance to funding of graduate medical education. We describe a dynamic modeling tool that examines how individual factors and practice variables can be used to measure and forecast the supply and demand for existing and new physician services. The system we describe, while built to analyze the pathologist workforce, is sufficiently broad and robust for use in any medical specialty. Our design provides a computer-based software model populated with data from surveys and best estimates by specialty experts about current and new activities in the scope of practice. The model describes the steps needed and data required for analysis of supply and demand. Our modeling tool allows educators and policy makers, in addition to physician specialty organizations, to assess how various factors may affect demand (and supply of current and emerging services. Examples of factors evaluated include types of professional services (3 categories with 16 subcategories, service locations, elements related to the Patient Protection and Affordable Care Act, new technologies, aging population, and changing roles in capitated, value-based, and team-based systems of care. The model also helps identify where physicians in a given specialty will likely need to assume new roles, develop new expertise, and become more efficient in practice to accommodate new value-based payment models.

An Innovative Interactive Modeling Tool to Analyze Scenario-Based Physician Workforce Supply and Demand.

Science.gov (United States)

Gupta, Saurabh; Black-Schaffer, W Stephen; Crawford, James M; Gross, David; Karcher, Donald S; Kaufman, Jill; Knapman, Doug; Prystowsky, Michael B; Wheeler, Thomas M; Bean, Sarah; Kumar, Paramhans; Sharma, Raghav; Chamoli, Vaibhav; Ghai, Vikrant; Gogia, Vineet; Weintraub, Sally; Cohen, Michael B; Robboy, Stanley J

2015-01-01

Effective physician workforce management requires that the various organizations comprising the House of Medicine be able to assess their current and future workforce supply. This information has direct relevance to funding of graduate medical education. We describe a dynamic modeling tool that examines how individual factors and practice variables can be used to measure and forecast the supply and demand for existing and new physician services. The system we describe, while built to analyze the pathologist workforce, is sufficiently broad and robust for use in any medical specialty. Our design provides a computer-based software model populated with data from surveys and best estimates by specialty experts about current and new activities in the scope of practice. The model describes the steps needed and data required for analysis of supply and demand. Our modeling tool allows educators and policy makers, in addition to physician specialty organizations, to assess how various factors may affect demand (and supply) of current and emerging services. Examples of factors evaluated include types of professional services (3 categories with 16 subcategories), service locations, elements related to the Patient Protection and Affordable Care Act, new technologies, aging population, and changing roles in capitated, value-based, and team-based systems of care. The model also helps identify where physicians in a given specialty will likely need to assume new roles, develop new expertise, and become more efficient in practice to accommodate new value-based payment models.

Physician self-referral and physician-owned specialty facilities.

Science.gov (United States)

Casalino, Lawrence P

2008-06-01

Physician self-referral ranges from suggesting a follow-up appointment, to sending a patient to a facility in which the doctor has an ownership interest or financial relationship. Physician referral to facilities in which the physicians have an ownership interest is becoming increasingly common and not always medically appropriate. This Synthesis reviews the evidence on physician self-referral arrangements, their effect on costs and utilization, and their effect on general hospitals. Key findings include: the rise in self-referral is sparked by financial, regulatory and clinical incentives, including patient convenience and doctors trying to preserve their income in the changing health care landscape. Strong evidence suggests self-referral leads to increased usage of health care services; but there is insufficient evidence to determine whether this increased usage reflects doctors meeting an unmet need or ordering clinically inappropriate care. The more significant a physician's financial interest in a facility, the more likely the doctor is to refer patients there. Arrangements through which doctors receive fees for patient referrals to third-party centers, such as "pay-per-click," time-share, and leasing arrangements, do not seem to offer benefits beyond increasing physician income. So far, the profit margins of general hospitals have not been harmed by the rise in doctor-owned facilities.

Internal medicine rounding practices and the Accreditation Council for Graduate Medical Education core competencies.

Science.gov (United States)

Shoeb, Marwa; Khanna, Raman; Fang, Margaret; Sharpe, Brad; Finn, Kathleen; Ranji, Sumant; Monash, Brad

2014-04-01

The Accreditation Council for Graduate Medical Education (ACGME) has established the requirement for residency programs to assess trainees' competencies in 6 core domains (patient care, medical knowledge, practice-based learning, interpersonal skills, professionalism, and systems-based practice). As attending rounds serve as a primary means for educating trainees at academic medical centers, our study aimed to identify current rounding practices and attending physician perceived capacity of different rounding models to promote teaching within the ACGME core competencies. We disseminated a 24-question survey electronically using educational and hospital medicine leadership mailing lists. We assessed attending physician demographics and the frequency with which they used various rounding models, as defined by the location of the discussion of the patient and care plan: bedside rounds (BR), hallway rounds (HR), and card-flipping rounds (CFR). Using the ACGME framework, we assessed the perceived educational value of each model. We received 153 completed surveys from attending physicians representing 34 institutions. HR was used most frequently for both new and established patients (61% and 43%), followed by CFR for established patients (36%) and BR for new patients (22%). Most attending physicians indicated that BR and HR were superior to CFR in promoting the following ACGME competencies: patient care, systems-based practice, professionalism, and interpersonal skills. HR is the most commonly employed rounding model. BR and HR are perceived to be valuable for teaching patient care, systems-based practice, professionalism, and interpersonal skills. CFR remains prevalent despite its perceived inferiority in promoting teaching across most of the ACGME core competencies. © 2014 Society of Hospital Medicine.

Speaking in Tongues: Can International Graduate Students Read International Graduate Admissions Materials?

Science.gov (United States)

Taylor, Zachary W.

2017-01-01

A recent Educational Testing Services report (2016) found that international graduate students with a TOEFL score of 80--the minimum average TOEFL score for graduate admission in the United States--usually possess reading subscores of 20, equating to a 12th-grade reading comprehension level. However, one public flagship university's international…

Top Information Need Priorities of Older Adults Newly Diagnosed With Active Myeloma.

Science.gov (United States)

Tariman, Joseph D; Doorenbos, Ardith; Schepp, Karen G; Singhal, Seema; Berry, Donna L

2015-01-01

Prioritizing patients' information needs maximizes efficiency. This study examined the information sources and priorities in a sample of older adults newly diagnosed with symptomatic myeloma requiring immediate therapy. An association analysis of whether information needs were influenced by sociodemographic variables such as age, gender, education, marital status, and income was also conducted. The Information Needs Questionnaire (INQ) and an investigator-developed interview schedule were administered to 20 older adults diagnosed with symptomatic myeloma during a 30- to 45-minute semistructured interview. We found that older adults newly diagnosed with symptomatic myeloma have different priorities of information needs when compared with younger patients diagnosed with various types of cancer. The top three priorities related to treatment, prognosis, and self-care. Sociodemographic variables did not influence the priorities of information needs among older adults with symptomatic myeloma. The Internet, physicians, family, and friends were among the top sources of information. Advanced practitioners in oncology should support and identify interventions that can enhance patients' learning process from these sources. Well poised to assist patients in searching credible and reliable Internet sources, advanced practitioners in oncology can provide patient education about different treatments and the impact of such treatments on prognosis (e.g., overall survival and likelihood of cure).

Correlations between PANCE performance, physician assistant program grade point average, and selection criteria.

Science.gov (United States)

Brown, Gina; Imel, Brittany; Nelson, Alyssa; Hale, LaDonna S; Jansen, Nick

2013-01-01

The purpose of this study was to examine correlations between first-time Physician Assistant National Certifying Exam (PANCE) scores and pass/fail status, physician assistant (PA) program didactic grade point average (GPA), and specific selection criteria. This retrospective study evaluated graduating classes from 2007, 2008, and 2009 at a single program (N = 119). There was no correlation between PANCE performance and undergraduate grade point average (GPA), science prerequisite GPA, or health care experience. There was a moderate correlation between PANCE pass/fail and where students took science prerequisites (r = 0.27, P = .003) but not with the PANCE score. PANCE scores were correlated with overall PA program GPA (r = 0.67), PA pharmacology grade (r = 0.68), and PA anatomy grade (r = 0.41) but not with PANCE pass/fail. Correlations between selection criteria and PANCE performance were limited, but further research regarding the influence of prerequisite institution type may be warranted and may improve admission decisions. PANCE scores and PA program GPA correlations may guide academic advising and remediation decisions for current students.

A qualitative study of factors influencing different generations of Newfoundland and Saskatchewan trained physicians to leave a work location

Directory of Open Access Journals (Sweden)

Mathews Maria

2012-07-01

Full Text Available Abstract Background Some studies have suggested that young physicians may have different expectations and practice behaviours than their older generational counterparts, including their reasons for wanting to remain or leave a community. This study examined the factors associated with a physician’s decision to leave a work location. We compared different generations of physicians to assess whether these factors have changed over generations. Methods We conducted semi-structured, qualitative interviews with 48 physicians who graduated from two Canadian medical schools. We asked each physician about the number and nature of work location changes and the factors related to their decisions to leave each location. Interview transcripts and notes were analysed using a thematic analysis approach. Results Dissatisfaction with the working environment was the most frequently cited reason for leaving a location for physicians of all generations. Elements which contributed to the quality of the work environment included the collaborative nature of the practice, the relationship with administrators, and access to resources and personnel. For younger physicians, the work environment had to meet their personal expectations for work-life balance. While remuneration level was given by some physicians as the key reason for leaving a location, for others it was the “last straw” if the work environment was poor. A small number of older generation physicians moved in response to political events and/or policies Conclusions We documented generational differences in physicians’ reasons for choosing a work location. We found that a poor work environment was universally the most important reason why a physician chose to leave a location. A few physicians who were unsatisfied with their work location identified level of remuneration as an additional reason for leaving. Some older generation physicians cited political climate as a reason for leaving a work

Long working hours and pregnancy complications: women physicians survey in Japan.

Science.gov (United States)

Takeuchi, Masumi; Rahman, Mahbubur; Ishiguro, Aya; Nomura, Kyoko

2014-07-23

Previous studies have investigated the impact of occupational risk factors on health outcomes among physicians. However, few studies have investigated the effects on pregnancy outcomes among physicians. In this study, we examined the association between working hours during pregnancy and pregnancy complications among physicians. A cross-sectional study was based on a survey conducted in 2009-2011 of 1,684 alumnae (mean age, 44 ± 8 years) who had graduated from 13 private medical schools in Japan. Data on threatened abortion (TA), preterm birth (PTB), and the number of working hours during the first trimester of pregnancy were obtained via retrospective assessments. Of the 939 physicians with a first pregnancy, 15% experienced TA and 12% experienced PTB. Women who experienced TA (mean weekly working hours: 62 h vs. 50 h, P working hours during the first trimester than did those without pregnancy complications. Compared with women who worked 40 hours or less per week, women who worked 71 hours or more per week had a three-fold higher risk of experiencing TA (95% confidence interval (CI): 1.7-6.0) even after adjusting for medical specialty, maternal age, and current household income. The risk of experiencing PTB was 2.5 times higher (95% CI:1.2-5.2) in women who worked 51-70 hours and 4.2 times higher (95% CI: 1.9-9.2) in women who worked 71 hours or more even after adjusting for specialty, maternal age, and current household income. The trend in the P statistic reflecting the effect of the quartile of hours worked per week (40 hours, 41-50 hours, 51-70 hours, ≥ 71 hours) on TA or PTB was 0.0001 in the multivariate logistic regression models. These results suggest that working long hours during the first trimester of pregnancy is associated with TA and PTB.

Moving Beyond Accidental Leadership: A Graduate Medical Education Leadership Curriculum Needs Assessment.

Science.gov (United States)

Hartzell, Joshua D; Yu, Clifton E; Cohee, Brian M; Nelson, Michael R; Wilson, Ramey L

2017-07-01

Despite calls for greater physician leadership, few medical schools, and graduate medical education programs provide explicit training on the knowledge, skills, and attitudes necessary to be an effective physician leader. Rather, most leaders develop through what has been labeled "accidental leadership." A survey was conducted at Walter Reed to define the current status of leadership development and determine what learners and faculty perceived as key components of a leadership curriculum. A branching survey was developed for residents and faculty to assess the perceived need for a graduate medical education leadership curriculum. The questionnaire was designed using survey best practices and established validity through subject matter expert reviews and cognitive interviewing. The survey instrument assessed the presence of a current leadership curriculum being conducted by each department, the perceived need for a leadership curriculum for physician leaders, the topics that needed to be included, and the format and timing of the curriculum. Administered using an online/web-based survey format, all 2,041 house staff and educators at Walter Reed were invited to participate in the survey. Descriptive statistics were conducted using SPSS (version 22). The survey response rate was 20.6% (421/2,041). Only 17% (63/266) of respondents stated that their program had a formal leadership curriculum. Trainees ranked their current leadership abilities as slightly better than moderately effective (3.22 on a 5-point effectiveness scale). Trainee and faculty availability were ranked as the most likely barrier to implementation. Topics considered significantly important (on a 5-point effectiveness scale) were conflict resolution (4.1), how to motivate a subordinate (4.0), and how to implement change (4.0). Respondents ranked the following strategies highest in perceived effectiveness on a 5-point scale (with 3 representing moderate effectiveness): leadership case studies (3.3) and

Physician's practices and perspectives regarding tobacco cessation in a teaching hospital in Mysore City, Karnataka.

Science.gov (United States)

Saud, Mohammed; Madhu, B; Srinath, K M; Ashok, N C; Renuka, M

2014-01-01

Tobacco is a leading cause of disease and premature death. Most of the smokers visit a doctor for various health related ailments and thus such clinic visits provide many opportunities for interventions and professional tobacco cessation advice. The primary aim of the following study is to assess the physician practices, perspectives, resources, barriers and education relating to tobacco cessation and their perceived need for training for the same. The secondary aim is to compare the physician's cessation practices from patient's perspective. A descriptive study was conducted in a hospital attached to Medical College in Mysore city, Karnataka. Information about doctor's practices, perspectives and their perceived need for training in tobacco cessation were collected using pre-structured self-administered Questionnaire, which were distributed in person. Patient's practices and perspectives were assessed using a pre-structured Oral Questionnaire. Almost 95% of physicians said that they ask patients about their smoking status and 94% advise them to quit smoking, but only 50% assist the patient to quit smoking and only 28% arrange follow-up visits. Thus, they do not regularly provide assistance to help patients quit, even though 98% of the physicians believed that helping patients to quit was a part of their role. Only 18% and 35% of the physicians said that Undergraduate Medical Education and Post Graduate Medical Education respectively prepared them very well to participate in smoking cessation activities. Tobacco cessation requires repeated and regular assistance. Such assistance is not being provided to patients by attending doctors. Our medical education system is failing to impart the necessary skills to doctors, needed to help patients quit smoking. Reforms in education are needed so as to prepare the physician to effectively address this problem.

Military medical graduates' perceptions of organizational culture in Turkish military medical school.

Science.gov (United States)

Ozer, Mustafa; Bakir, Bilal; Teke, Abdulkadir; Ucar, Muharrem; Bas, Turker; Atac, Adnan

2008-08-01

Organizational culture is the term used to describe the shared beliefs, perceptions, and expectations of individuals in organizations. In the healthcare environment, organizational culture has been associated with several elements of organizational experience that contribute to quality, such as nursing care, job satisfaction, and patient safety. A range of tools have been designed to measure organizational culture and applied in industrial, educational, and health care settings. This study has been conducted to investigate the perceptions of military medical graduates on organizational culture at Gülhane Military Medical School. A measurement of organizational culture, which was developed by the researchers from Akdeniz University, was applied to all military medical graduates in 2004. This was a Likert type scale that included 31 items. Designers of the measurement grouped all these items into five main dimensions in their previous study. The items were scored on a five-point scale anchored by 1: strongly agree and 5: strongly disagree. Study participants included all military physicians who were in clerkship training period at Gulhane Military Medical Academy in 2004. A total of 106 graduates were accepted to response the questionnaire. The mean age of participants was 25.2 +/- 1.1. At the time of study only 8 (7.5%) graduates were married. The study results have showed that the measurement tool with 31 items had a sufficient reliability with a Cronbach's alpha value of 0.91. Factor analysis has resulted a final measurement tool of 24 items with five factors. Total score and the scores of five subdimensions have been estimated and compared between groups based on living city and marital status. The study has shown the dimension of symbol received positive perceptions while the dimension of organizational structure and efficiency received the most negative perceptions. GMMS has a unique organizational culture with its weak and strong aspects. Conducting this kind

How do physicians discuss e-health with patients? the relationship of physicians' e-health beliefs to physician mediation styles.

Science.gov (United States)

Fujioka, Yuki; Stewart, Erin

2013-01-01

A survey of 104 physicians examined the role of physicians' evaluation of the quality of e-health and beliefs about the influence of patients' use of e-health in how physicians discuss e-health materials with patients. Physicians' lower (poor) evaluation of the quality of e-health content predicted more negative mediation (counter-reinforcement of e-health content). Perceived benefits of patients' e-health use predicted more positive (endorsement of e-health content). Physician's perceived concerns (negative influence) regarding patients' e-health use were not a significant predictor for their mediation styles. Results, challenging the utility of restrictive mediation, suggested reconceptualizing it as redirective mediation in a medical interaction. The study suggested that patient-generated e-health-related inquiries invite physician mediation in medical consultations. Findings and implications are discussed in light of the literature of physician-patient interaction, incorporating the theory of parental mediation of media into a medical context.

Study on radiation dose and its protection for the physician performing the retrograde urethrography for male

International Nuclear Information System (INIS)

Inui, Saburo; Suzuki, Toshiyuki; Kashino, Teiichi; Abe, Hitoshi.

1982-01-01

The status quo of the various techniques used in retrograde urethrography (R.U.) is examined by the questionnaire method with the data of radiation doses to medical personnels, and new methods are devised to reduce unnecessary radiation dose. Manual injection of the radio-opaquee contrast medium has been employed by 92.5% out of 8,259 physicians in 67 institutions. They expose themselves as well as patients to the radiation during the course of the examination. In most of these occasions the physician is not sufficiently protected from radiation leaving the possibility of his somatic damage. From these observations, the followings were studied: 1) Application of our newly developed protective barrier, exclusive for R.U., made of lead-impregnated acryl-resin plate (KYOW GLAS-XA). 2) Employment of the high speed screen made of rare earth metal. The results were encouraging in reducing the radiation exposure dose. In conclusion, the employment of the above two methods are efficient in obviating unnecessary radiation exposure to the physician during R.U. (author)

42 CFR 415.172 - Physician fee schedule payment for services of teaching physicians.

Science.gov (United States)

2010-10-01

... teaching physicians. 415.172 Section 415.172 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS Physician Services in Teaching Settings § 415.172 Physician fee schedule payment for services of teaching physicians. (a...

Nature and nurture in the family physician's choice of practice location.

Science.gov (United States)

Orzanco, Maria Gabriela; Lovato, Chris; Bates, Joanna; Slade, Steve; Grand'Maison, Paul; Vanasse, Alain

2011-01-01

An understanding of the contextual, professional, and personal factors that affect choice of practice location for physicians is needed to support successful strategies in addressing geographic maldistribution of physicians. This study compared two categories of predictors of family practice location in non-metropolitan areas among undergraduate medical students: individual characteristics (nature), and the rural program component of their training program (nurture). The study aimed to identify factors that predict the location of practice 2 years post-residency training and determine the predictive value of combining nature and nurture variables using administrative data from two undergraduate medical education programs. Databases were developed from available administrative sources for a retrospective analysis of two undergraduate medical education programs in Canada: Université de Sherbrooke (UdeS) and University of British Columbia (UBC). Both schools have a strong mandate to evaluate the impact of their programs on physician distribution. The dependent variable was location of practice 2 years after completing postgraduate training in family medicine. Independent variables included individual and program characteristics. Separate analyses were conducted for each program using multiple logistic regression. The nature and nurture variables considered in the models explained only 21% to 27% of the variance in the eventual location of practice of family physician graduates. For UdeS, having an address in a rural/small-town environment at application to medical school (OR=2.61, 95% CI: 1.24-6.06) and for UBC, location of high school in a rural/small town (OR=4.03, 95% CI: 1.05-15.41), both increased the chances of practicing in a non-metropolitan area. For UdeS the nurture variable (ie length of clerkship in a non-metropolitan area) was the most significant predictor (OR=1.14, 95% CI: 1.067-1.22). For both medical schools, adding a single nurture variable to the

Does the physician's emotional intelligence matter? Impacts of the physician's emotional intelligence on the trust, patient-physician relationship, and satisfaction.

Science.gov (United States)

Weng, Hui-Ching

2008-01-01

Much of the literature pertinent to management indicates that service providers with high emotional intelligence (EI) receive higher customer satisfaction scores. Previous studies offer limited evidence regarding the impact of physician's EI on patient-physician relationship. Using a multilevel and multisource data approach, the current study aimed to build a model that demonstrated the impact of a physician's EI on the patient's trust and the patient-physician relationship. The survey sample included 983 outpatients and 39 physicians representing 11 specialties. Results of path analyses demonstrated that the ratio of patient's follow-up visits (p impact of patient's trust on patient's satisfaction was mediated by the patient-physician relationship at a significant level (p relationship had a significantly positive effect on patient's satisfaction (p relationship; however, mutual trust and professional respect between nurses and physicians play a critical role in reinforcing the patient-physician relationship to effect improvements in the provision of patient-centered care.

Are physicians aware of their role in tobacco control? A conference-based survey in Portugal.

Science.gov (United States)

Ravara, Sofia B; Castelo-Branco, Miguel; Aguiar, Pedro; Calheiros, Jose M

2014-09-20

The crucial role of physicians in tobacco control (TC) is widely recognized. In 2008, Portugal implemented a non-comprehensive smoke-free policy (SFP). In 2009, a conference-survey was carried out to explore Portuguese physicians' engagement in tobacco control, by evaluating the following: 1) attendance at TC training and awareness of training needs; 2) participation in TC activities; 3) attitudes and beliefs regarding SFPs. Questionnaire-based cross-sectional study conducted during two major national medical conferences targeting GPs, hospitalists, and students/recent graduates. Descriptive analysis and logistic regression were performed. Response rate was 63.7% (605/950). Of the 605 participants, 58.3% were GPs, 32.4% hospitalists, 9.3% others; 62.6% were female; mean age was 39.0 ± 12.9 years. Smoking prevalence was 29.2% (95% CI: 23.3-35.1) in males; 15.8% (95% CI: 12.1-19.5) in females, p health, awareness of SFP benefits and TC law was limited, p outdoors bans in healthcare/schools settings and smoking restrictions in the home/car, p outdoors and private settings. The findings suggest that Portuguese physicians are not aware of their role in tobacco control. Poor engagement of physicians in TC may contribute to the current lack of comprehensive policies in Portugal and Europe and undermine social norm change. Medical and professional continuing education on tobacco control should be made top priorities.

Systematic development of a communication skills training course for physicians performing work disability assessments: from evidence to practice.

Science.gov (United States)

van Rijssen, H Jolanda; Schellart, Antonius J M; Anema, Johannes R; de Boer, Wout E L; van der Beek, Allard J

2011-06-03

Physicians require specific communication skills, because the face-to-face contact with their patients is an important source of information. Although physicians who perform work disability assessments attend some communication-related training courses during their professional education, no specialised and evidence-based communication skills training course is available for them. Therefore, the objectives of this study were: 1) to systematically develop a training course aimed at improving the communication skills of physicians during work disability assessment interviews with disability claimants, and 2) to plan an evaluation of the training course. A physician-tailored communication skills training course was developed, according to the six steps of the Intervention Mapping protocol. Data were collected from questionnaire studies among physicians and claimants, a focus group study among physicians, a systematic review of the literature, and meetings with various experts. Determinants and performance objectives were formulated. A concept version of the training course was discussed with several experts before the final training course programme was established. The evaluation plan was developed by consulting experts, social insurance physicians, researchers, and policy-makers, and discussing with them the options for evaluation. A two-day post-graduate communication skills training course was developed, aimed at improving professional communication during work disability assessment interviews. Special focus was on active teaching strategies, such as practising the skills in role-play. An adoption and implementation plan was formulated, in which the infrastructure of the educational department of the institute that employs the physicians was utilised. Improvement in the skills and knowledge of the physicians who will participate in the training course will be evaluated in a randomised controlled trial. The feasibility and practical relevance of the communication

Systematic development of a communication skills training course for physicians performing work disability assessments: from evidence to practice

Science.gov (United States)

2011-01-01

Background Physicians require specific communication skills, because the face-to-face contact with their patients is an important source of information. Although physicians who perform work disability assessments attend some communication-related training courses during their professional education, no specialised and evidence-based communication skills training course is available for them. Therefore, the objectives of this study were: 1) to systematically develop a training course aimed at improving the communication skills of physicians during work disability assessment interviews with disability claimants, and 2) to plan an evaluation of the training course. Methods A physician-tailored communication skills training course was developed, according to the six steps of the Intervention Mapping protocol. Data were collected from questionnaire studies among physicians and claimants, a focus group study among physicians, a systematic review of the literature, and meetings with various experts. Determinants and performance objectives were formulated. A concept version of the training course was discussed with several experts before the final training course programme was established. The evaluation plan was developed by consulting experts, social insurance physicians, researchers, and policy-makers, and discussing with them the options for evaluation. Results A two-day post-graduate communication skills training course was developed, aimed at improving professional communication during work disability assessment interviews. Special focus was on active teaching strategies, such as practising the skills in role-play. An adoption and implementation plan was formulated, in which the infrastructure of the educational department of the institute that employs the physicians was utilised. Improvement in the skills and knowledge of the physicians who will participate in the training course will be evaluated in a randomised controlled trial. Conclusions The feasibility and

Systematic development of a communication skills training course for physicians performing work disability assessments: from evidence to practice

Directory of Open Access Journals (Sweden)

Anema Johannes R

2011-06-01

Full Text Available Abstract Background Physicians require specific communication skills, because the face-to-face contact with their patients is an important source of information. Although physicians who perform work disability assessments attend some communication-related training courses during their professional education, no specialised and evidence-based communication skills training course is available for them. Therefore, the objectives of this study were: 1 to systematically develop a training course aimed at improving the communication skills of physicians during work disability assessment interviews with disability claimants, and 2 to plan an evaluation of the training course. Methods A physician-tailored communication skills training course was developed, according to the six steps of the Intervention Mapping protocol. Data were collected from questionnaire studies among physicians and claimants, a focus group study among physicians, a systematic review of the literature, and meetings with various experts. Determinants and performance objectives were formulated. A concept version of the training course was discussed with several experts before the final training course programme was established. The evaluation plan was developed by consulting experts, social insurance physicians, researchers, and policy-makers, and discussing with them the options for evaluation. Results A two-day post-graduate communication skills training course was developed, aimed at improving professional communication during work disability assessment interviews. Special focus was on active teaching strategies, such as practising the skills in role-play. An adoption and implementation plan was formulated, in which the infrastructure of the educational department of the institute that employs the physicians was utilised. Improvement in the skills and knowledge of the physicians who will participate in the training course will be evaluated in a randomised controlled trial

Leadership Training in Graduate Medical Education: A Systematic Review.

Science.gov (United States)

Sadowski, Brett; Cantrell, Sarah; Barelski, Adam; O'Malley, Patrick G; Hartzell, Joshua D

2018-04-01

Leadership is a critical component of physician competence, yet the best approaches for developing leadership skills for physicians in training remain undefined. We systematically reviewed the literature on existing leadership curricula in graduate medical education (GME) to inform leadership program development. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, we searched MEDLINE, ERIC, EMBASE, and MedEdPORTAL through October 2015 using search terms to capture GME leadership curricula. Abstracts were reviewed for relevance, and included studies were retrieved for full-text analysis. Article quality was assessed using the Best Evidence in Medical Education (BEME) index. A total of 3413 articles met the search criteria, and 52 were included in the analysis. Article quality was low, with 21% (11 of 52) having a BEME score of 4 or 5. Primary care specialties were the most represented (58%, 30 of 52). The majority of programs were open to all residents (81%, 42 of 52). Projects and use of mentors or coaches were components of 46% and 48% of curricula, respectively. Only 40% (21 of 52) were longitudinal throughout training. The most frequent pedagogic methods were lectures, small group activities, and cases. Common topics included teamwork, leadership models, and change management. Evaluation focused on learner satisfaction and self-assessed knowledge. Longitudinal programs were more likely to be successful. GME leadership curricula are heterogeneous and limited in effectiveness. Small group teaching, project-based learning, mentoring, and coaching were more frequently used in higher-quality studies.

Jewish Medical Students and Graduates at the Universities of Padua and Leiden: 1617–1740

Directory of Open Access Journals (Sweden)

Kenneth Collins

2013-01-01

Full Text Available The first Jewish medical graduates at the University of Padua qualified in the fifteenth century. Indeed, Padua was the only medical school in Europe for most of the medieval period where Jewish students could study freely. Though Jewish students came to Padua from many parts of Europe the main geographical sources of its Jewish students were the Venetian lands. However, the virtual Padua monopoly on Jewish medical education came to an end during the seventeenth century as the reputation of the Dutch medical school in Leiden grew. For aspiring medieval Jewish physicians Padua was, for around three hundred years, the first, simplest, and usually the only choice.

The medical profession and young physicians' lifestyles in flux: challenges for specialty training and health care delivery systems.

Science.gov (United States)

Buddeberg-Fischer, Barbara; Stamm, Martina

2010-12-07

The profile of the medical profession is changing in terms of employment conditions, attitudes towards the profession and the lifestyle of young physicians. The aim of this study was to investigate (1) what modifications should be made in the specialty-qualification curriculum to allow for a better balance of career and personal life, (2) what institutional conditions and (3) what personal attitudes and behaviour are required for physicians to successfully combine career and family. As part of a prospective survey on the career development of Swiss medical school graduates (SwissMedCareer Study) begun in 2001, 526 physicians (274 females, 52.1%; 252 males, 47.9%) participated in the sixth assessment in 2010. The graduates were asked by mail-out questionnaires to provide free response answers to the three questions formulated above. Their statements were transcribed, content categories were inductively formulated for each question, and their descriptions were written down in a code manual. Responses were encoded according to the said manual and assigned to content categories (Mayring's content analysis). Frequency distributions were given for categories and tested with chi-square tests for gender differences. The 526 participants made 457 statements on the first question, 1,038 on the second, and 937 on the third. Content analysis of the physicians' answers yielded nine categories dealing with desired changes to the specialty qualification curriculum, eight categories addressing changes in institutional conditions, and nine categories concerning personal attitudes and behaviour. Of all responses to the first question, 70% fell into the top three ranking categories of "specialty qualification requirements", "part-time jobs" and "structured residency programmes". The three top-ranking categories ("childcare facilities", part-time jobs", "working hours") yielded by responses to the second question accounted for 87% of the statements. Distribution of the responses

Self-perception and knowledge of evidence based medicine by physicians.

Science.gov (United States)

Aguirre-Raya, Karen A; Castilla-Peón, María F; Barajas-Nava, Leticia A; Torres-Rodríguez, Violeta; Muñoz-Hernández, Onofre; Garduño-Espinosa, Juan

2016-06-29

The influence, legitimacy and application of Evidence Based Medicine (EBM) in the world is growing as a tool that integrates, the best available evidence to decision making in patient care. Our goal was to identify the relationship between self-perception about the relevance of Evidence Based Medicine (EBM) and the degree of basic knowledge of this discipline in a group of physicians. A survey was carried out in a third level public hospital in Mexico City. Self-perception was measured by means of a structured scale, and the degree of knowledge through parameter or "rubrics" methodology. A total of 320 questionnaires were given to 55 medical students (17 %); 45 pre-graduate medical interns (14 %); 118 medical residents (37 %) and 102 appointed physicians of different specialties (32 %). Self-perception of EBM: The majority of those surveyed (n = 274, 86 %) declared that they were very or moderately familiar with EBM. The great majority (n = 270, 84 %) believe that EBM is very important in clinical practice and 197 physicians (61 %) said that they implement it always or usually. The global index of self-perception was 75 %. Knowledge of EBM: Definition of EBM; Seven of those surveyed (2 %) included 3 of the 4 characteristics of the definition, 82 (26 %) mentioned only two characteristics of the definition, 152 (48 %) mentioned only one characteristic and 79 (25 %) did not include any characteristic of EBM. Phases of the EBM process: The majority of those surveyed (n = 218, 68 %) did not include the steps that characterize the practice of EBM, of which 79 participants (25 %) mentioned elements not related to it. The global index of knowledge was 19 %. The majority of the surveyed physicians have a high self-perception of the relevance of EBM. In spite of this, the majority of them did not know the characteristics that define the EBM and phases of the process for its practice. A major discrepancy was found between self-perception and the

First and foremost, physicians: the clinical versus leadership identities of physician leaders.

Science.gov (United States)

Quinn, Joann Farrell; Perelli, Sheri

2016-06-20

Purpose - Physicians are commonly promoted into administrative and managerial roles in US hospitals on the basis of clinical expertise and often lack the skills, training or inclination to lead. Several studies have sought to identify factors associated with effective physician leadership, yet we know little about how physician leaders themselves construe their roles. The paper aims to discuss these issues. Design/methodology/approach - Phenomenological interviews were performed with 25 physicians at three organizational levels with physicians affiliated or employed by four hospitals within one health care organization in the USA between August and September 2010. A rigorous comparative methodology of data collection and analysis was employed, including the construction of analytic codes for the data and its categorization based on emergent ideas and themes that are not preconceived and logically deduced hypotheses, which is characteristic of grounded theory. Findings - These interviews reveal differences in how part- vs full-time physician leaders understand and value leadership roles vs clinical roles, claim leadership status, and identify as physician leaders on individual, relational and organizational basis. Research limitations/implications - Although the physicians in the sample were affiliated with four community hospitals, all of them were part of a single not-for-profit health care system in one geographical locale. Practical implications - These findings may be of interest to hospital administrators and boards seeking deeper commitment and higher performance from physician leaders, as well as assist physicians in transitioning into a leadership role. Social implications - This work points to a broader and more fundamental need - a modified mindset about the nature and value of physician leadership. Originality/value - This study is unique in the exploration of the nature of physician leadership from the perspective of the physician on an individual, peer

Spatial Graduation of Fuel Taxes

Energy Technology Data Exchange (ETDEWEB)

Rietveld, P.; Van Vuuren, D. [Tinbergen Institute, Labor, Region and Environment, Amsterdam/Rotterdam (Netherlands); Bruinsma, F. [Department of Spatial Economics, Faculty of Economics and Econometrics, Vrije Universiteit Amsterdam, Amsterdam (Netherlands)

1999-06-01

Substantial differences exist among fuel taxes in various countries. These differences represent a form of fiscal competition that has undesirable side effects because it leads to cross-border fuelling and hence to extra kilometres driven. One possible way of solving the problem of low fuel taxes in neighbouring countries is to introduce a spatial differentiation of taxes: low near the border and higher further away. This paper contains an empirical analysis of the consequences of such a spatial graduation of fuel taxes for the Netherlands. We will analyse impacts on fuelling behaviour, vehicle kilometres driven, tax receipts, and sales by owners of gas stations. The appropriate slope of the graduation curve is also discussed. Our conclusion is that in a small country such as the Netherlands, a spatial graduation of fuel taxes will lead to substantial changes in fuelling behaviour, even when the graduation curve is not steep. Depending on the graduation profile implemented, the spatial differentiation of fuel tax will give rise to substantial problems for owners of gas stations in areas with decreasing fuel sales. 9 refs.

Spatial Graduation of Fuel Taxes

International Nuclear Information System (INIS)

Rietveld, P.; Van Vuuren, D.; Bruinsma, F.

1999-06-01

Substantial differences exist among fuel taxes in various countries. These differences represent a form of fiscal competition that has undesirable side effects because it leads to cross-border fuelling and hence to extra kilometres driven. One possible way of solving the problem of low fuel taxes in neighbouring countries is to introduce a spatial differentiation of taxes: low near the border and higher further away. This paper contains an empirical analysis of the consequences of such a spatial graduation of fuel taxes for the Netherlands. We will analyse impacts on fuelling behaviour, vehicle kilometres driven, tax receipts, and sales by owners of gas stations. The appropriate slope of the graduation curve is also discussed. Our conclusion is that in a small country such as the Netherlands, a spatial graduation of fuel taxes will lead to substantial changes in fuelling behaviour, even when the graduation curve is not steep. Depending on the graduation profile implemented, the spatial differentiation of fuel tax will give rise to substantial problems for owners of gas stations in areas with decreasing fuel sales. 9 refs

Physician Compare

Data.gov (United States)

U.S. Department of Health & Human Services — Physician Compare, which meets Affordable Care Act of 2010 requirements, helps you search for and select physicians and other healthcare professionals enrolled in...

Sleep deprivation in resident physicians, work hour limitations, and related outcomes: a systematic review of the literature.

Science.gov (United States)

Mansukhani, Meghna P; Kolla, Bhanu Prakash; Surani, Salim; Varon, Joseph; Ramar, Kannan

2012-07-01

Extended work hours, interrupted sleep, and shift work are integral parts of medical training among all specialties. The need for 24-hour patient care coverage and economic factors have resulted in prolonged work hours for resident physicians. This has traditionally been thought to enhance medical educational experience. These long and erratic work hours lead to acute and chronic sleep deprivation and poor sleep quality, resulting in numerous adverse consequences. Impairments may occur in several domains, including attention, cognition, motor skills, and mood. Resident performance, professionalism, safety, and well-being are affected by sleep deprivation, causing potentially adverse implications for patient care. Studies have shown adverse health consequences, motor vehicle accidents, increased alcohol and medication use, and serious medical errors to occur in association with both sleep deprivation and shift work. Resident work hour limitations have been mandated by the Accreditation Council for Graduate Medical Education in response to patient safety concerns. Studies evaluating the impact of these regulations on resident physicians have generated conflicting reports on patient outcomes, demonstrating only a modest increase in sleep duration for resident physicians, along with negative perceptions regarding their education. This literature review summarizes research on the effects of sleep deprivation and shift work, and examines current literature on the impact of recent work hour limitations on resident physicians and patient-related outcomes.

[Empathy, inter-professional collaboration, and lifelong medical learning in Spanish and Latin-American physicians-in-training who start their postgraduate training in hospitals in Spain. Preliminary outcomes].

Science.gov (United States)

San-Martín, Montserrat; Roig-Carrera, Helena; Villalonga-Vadell, Rosa M; Benito-Sevillano, Carmen; Torres-Salinas, Miquel; Claret-Teruel, Gemma; Robles, Bernabé; Sans-Boix, Antonia; Alcorta-Garza, Adelina; Vivanco, Luis

2017-01-01

To identify similarities and differences in empathy, abilities toward inter-professional collaboration, and lifelong medical learning, between Spanish and Latin-American physicians-in-training who start their posgraduate training in teaching hospitals in Spain. Observational study using self-administered questionnaires. Five teaching hospitals in the province of Barcelona, Spain. Spanish and Latin-American physicians-in-training who started their first year of post-graduate medical training. Empathy was measured using the Jefferson scale of empathy. Abilities for inter-professional collaboration were measured using the Jefferson scale attitudes towards nurse-physician collaboration. Learning was measured using the Jefferson scale of medical lifelong learning scale. From a sample of 156 physicians-in-training, 110 from Spain and 40 from Latin America, the Spanish group showed the highest empathy (pempathy and inter-professional collaboration for the whole sample (r=+0.34; pempathy in the development of inter-professional collaboration abilities. In Latin-American physicians who start posgraduate training programs, lifelong learning abilities have a positive influence on the development of other professional competencies. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

The Economic Returns to Graduating with Honors - Evidence from Law Graduates

OpenAIRE

Schumann, Mathias; Freier, Ronny; Siedler, Thomas

2014-01-01

This paper studies the causal effects of graduating from university with an honors degree on subsequent labor market outcomes. While a rich body of literature has focused on estimating returns to human capital, few studies have analyzed returns at the very top of the education distribution. We highlight the importance of honors degrees for future labor market success in the context of German law graduates. Using a difference-in-differences research design combined with entropy balancing, we f...

High School Graduation Rates:Alternative Methods and Implications

Directory of Open Access Journals (Sweden)

Jing Miao

2004-10-01

Full Text Available The No Child Left Behind Act has brought great attention to the high school graduation rate as one of the mandatory accountability measures for public school systems. However, there is no consensus on how to calculate the high school graduation rate given the lack of longitudinal databases that track individual students. This study reviews literature on and practices in reporting high school graduation rates, compares graduation rate estimates yielded from alternative methods, and estimates discrepancies between alternative results at national, state, and state ethnic group levels. Despite the graduation rate method used, results indicate that high school graduation rates in the U.S. have been declining in recent years and that graduation rates for black and Hispanic students lag substantially behind those of white students. As to graduation rate method preferred, this study found no evidence that the conceptually more complex methods yield more accurate or valid graduation rate estimates than the simpler methods.

Graduates Performance in the Workplace: Employers‟ Perspective

Directory of Open Access Journals (Sweden)

Ariel M. Plantilla

2017-05-01

Full Text Available This paper is an assessment of the employers feedback on the performance of business graduates of University of Rizal System Pililla from batch 2010 – 2014 in the workplace with respect to knowledge and understanding, skills and personal qualities. The researcher used descriptive method of research utilizing the employers and managers of employed graduates as key informants of the study. The findings revealed that employers were very much satisfied on the performance of graduates in terms of knowledge and understanding of the job, general skills, specialized skills and personal qualities demonstrated in the workplace. There was significant difference on the performance of graduates in terms of positions and length of service as revealed by the variations on the level of satisfaction of the employers on graduates’ performance in work. Relationship exists between the degree of importance of the four aspects of job performance and the level of satisfaction on the performance of business graduates. Employers placed a strong preference to the business graduates of the campus. There is no mismatch of knowledge and skills of graduates and what the employers are expecting among the business graduates.

Medical education in Israel 2016: five medical schools in a period of transition.

Science.gov (United States)

Reis, Shmuel; Urkin, Jacob; Nave, Rachel; Ber, Rosalie; Ziv, Amitai; Karnieli-Miller, Orit; Meitar, Dafna; Gilbey, Peter; Mevorach, Dror

2016-01-01

We reviewed the existing programs for basic medical education (BME) in Israel as well as their output, since they are in a phase of reassessment and transition. The transition has been informed, in part, by evaluation in 2014 by an International Review Committee (IRC). The review is followed by an analysis of its implications as well as the emergent roadmap for the future. The review documents a trend of modernizing, humanizing, and professionalizing Israeli medical education in general, and BME in particular, independently in each of the medical schools. Suggested improvements include an increased emphasis on interactive learner-centered rather than frontal teaching formats, clinical simulation, interprofessional training, and establishment of a national medical training forum for faculty development. In addition, collaboration should be enhanced between medical educators and health care providers, and among the medical schools themselves. The five schools admitted about 730 Israeli students in 2015, doubling admissions from 2000. In 2014, the number of new licenses, including those awarded to Israeli international medical graduates (IMGs), surpassed for the first time in more than a decade the estimated need for 1100 new physicians annually. About 60 % of the licenses awarded in 2015 were to IMGs. Israeli BME is undergoing continuous positive changes, was supplied with a roadmap for even further improvement by the IRC, and has doubled its output of graduates. The numbers of both Israeli graduates and IMGs are higher than estimated previously and may address the historically projected physician shortage. However, it is not clear whether the majority of newly licensed physicians, who were trained abroad, have benefited from similar recent improvements in medical education similar to those benefiting graduates of the Israeli medical schools, nor is it certain that they will benefit from the further improvements that have recently been recommended for the Israeli

U.K. physicians' attitudes toward active voluntary euthanasia and physician-assisted suicide.

Science.gov (United States)

Dickinson, George E; Lancaster, Carol J; Clark, David; Ahmedzai, Sam H; Noble, William

2002-01-01

A comparison of the views of geriatric medicine physicians and intensive care physicians in the United Kingdom on the topics of active voluntary euthanasia and physician-assisted suicide revealed rather different attitudes. Eighty percent of geriatricians, but only 52% of intensive care physicians, considered active voluntary euthanasia as never justified ethically. Gender and age did not play a major part in attitudinal differences of the respondents. If the variability of attitudes of these two medical specialties are anywhere near illustrative of other physicians in the United Kingdom, it would be difficult to formulate and implement laws and policies concerning euthanasia and assisted suicide. In addition, ample safeguards would be required to receive support from physicians regarding legalization.

Physician heal thyself

African Journals Online (AJOL)

Compared to overweight or obese physicians, normal‑weight physicians were significantly more likely to discuss weight loss with their obese patients, according to a study among. 500 primary care physicians, undertaken by researchers at the Johns Hopkins Bloomberg School of Public Health.[4]. A recent, highly accessed ...

[Medical terminology and lay users. A quali-quantitative survey of a group of young motivated graduates].

Science.gov (United States)

Conti, A A

2013-01-01

Medical terms occupy growing spaces in dictionaries and the media daily propose a great number of medical words. Nevertheless scientific data regarding the actual degree of comprehension of medical terminology on the part of lay users are scanty. Aim of this study was the evaluation, in a group of young motivated graduates, of the degree of understanding of a set of medical terms normally adopted by physicians in specialistic language, and also used when speaking with patients. Nine medical terms used by physicians in daily practice were selected (“aphasia”, “edema”, “erythema”, “fibrillation”, “fibroma”, “jaundice”, “paraplegia”, “polypus”, “sclerosis”) and they were administered in paper form to eighteen young graduates, non-health operators who were asked to furnish one definition for each of the terms. A subsequent structured oral discussion integrated the recorded written findings. Erythema and fibrillation were the most well-known and understood terms. Among the selected medical terms, the more difficult ones to understand were sclerosis and jaundice. Interesting features emerged from the characterization of the site attributed to some of the investigated terms, in particular edema was mainly perceived as the pulmonary one, fibroma was more often interpreted as a benign tumor localized in the uterus and polypus was more frequently associated with its collocation in the nose. The participants involved in this quali-quantitative survey demonstrated a general good knowledge and comprehension of the medical terms proposed. Some limits in knowledge documented in this group, however, indicate that the use of medical terminology needs more clarification within the doctor-patient context. Such clarification appears even more mandatory in subjects with low scholastic-education levels.

Iranian Physicians' Perspectives Regarding Nurse-Physician Professional Communication: Implications for Nurses.

Science.gov (United States)

Esmaeilpour-Bandboni, Mohammad; Vaismoradi, Mojtaba; Salsali, Mahvash; Snelgrove, Sherrill; Sheldon, Lisa Kennedy

2017-08-01

Nurse-physician professional communication affects the effectiveness and performance of the health care team and the quality of care delivered to the patient. This study aimed to explore the perspectives and experiences of physicians on nurse-physician professional communication in an urban area of Iran. Semistructured interviews were conducted with 15 physicians selected using a purposive sampling method. Physicians from different medical specialties were chosen from 4 teaching hospitals in an urban area of Iran. The data were analyzed with content analysis and themes developed. Three themes developed during data analysis: "seeking the formal methods of communication to ensure patient care," "nurses' professional attributes for professional communication," and "patients' health conditions as the mediators of professional communication." Nurses need to be informed of the perspectives and experiences of physicians on professional communication. Our findings can improve nurses' understandings of professional communication that could inform the development of educational and training programs for nurses and physicians. There is a need to incorporate communication courses during degree education and design interprofessional training regarding communication in clinical settings to improve teamwork and patient care. Open discussions between nurses and physicians, training sessions about how to improve their knowledge about barriers to and facilitators of effective professional communication, and key terms and phrases commonly used in patient care are suggested.

Where have all the graduates gone?

Science.gov (United States)

1999-03-01

Key facts and figures about the labour market for new graduates in the UK were published recently in the IES Annual Graduate Review 1998-99, which indicates that the demand for graduates amongst the traditional recruiters has continued to grow steadily, along with reports of recruitment difficulties. It is noteworthy that last year one in three graduates went into fixed-term or temporary appointments, while many of those who took up permanent jobs went into lower level work that did not make use of their graduate skills. Many graduates are taking more than a year, and sometimes up to three years, to find their way into permanent jobs and careers. Those graduating in computer science, engineering and mathematics, medicine and related subjects, or education have been the most likely to gain high level managerial, professional or technical jobs and have the lowest unemployment rates. In contrast, those with biological science, humanities, social sciences or creative arts degrees are most likely to be unemployed initially. Many new graduates commenced their jobs by earning salaries in the range £10 000-15 000, but they should of course continue to earn more than those lesser qualified, as well as having lower unemployment rates. Of the 400 000 students who graduated in 1998 (more than double the total of a decade ago), over half had first degrees and the rest undergraduate or postgraduate qualifications. Despite the growth, entry to the physical sciences, engineering and technology has been falling, as has the proportion on sandwich courses. Women now comprise the majority of entrants to first degrees but remain under-represented in mathematics, physical science and engineering or technology courses. Interestingly more than one in three students now has a paid job during their course; such work experience can be beneficial to their long-term job searches. In the longer term, numbers of graduates are expected to stay broadly constant over the next three years

An assessment of attitudes towards people with mental illness among medical students and physicians in Ibadan, Nigeria.

Science.gov (United States)

Ighodaro, Adesuwa; Stefanovics, Elina; Makanjuola, Victor; Rosenheck, Robert

2015-06-01

The authors surveyed attitudes towards mental illness among Nigerian medical personnel at three different levels of training and experience: medical students who had not completed their psychiatry rotation, medical students who had competed their psychiatry rotation, and graduate physicians. Six questions addressed beliefs about the effectiveness of treatments for four specific mental illnesses (schizophrenia, bipolar disorder, depression, and anxiety) and two medical illnesses (diabetes and hypertension) among the three groups. A self-report questionnaire including 56 dichotomous items was used to compare beliefs about and attitudes towards people with mental illness. Factor analysis was used to identify key attitudes and analysis of covariance (ANCOVA) was used to compare the groups adjusting for age and personal experience with people with mental illness. There were no significant trends in attitudes towards the effectiveness of medication. Exploratory factor analysis of the beliefs and attitudes items identified four factors: (1) comfort socializing with people with mental, illness; (2) non-superstitious beliefs about the causes of mental illness; (3) neighborly feelings towards people with mental illness; and (4) belief that stress and abuse are part of the etiology of mental illness. ANCOVA comparing attitudes among the three groups showed that on three (1, 2, and 4) of the four factors medical students who had completed a rotation in psychiatry had significantly higher scores than the medical students who had not completed a rotation in psychiatry. Graduate physicians showed a similar pattern scoring higher than the medical students who had not completed a rotation in psychiatry in two factors (1 and 4) but showed no differences from students who had completed their psychiatry rotation. While beliefs about medication effectiveness do not differ between medical trainees and graduate professionals, stigmatizing attitudes towards people with mental illness seem

An intervention to increase patients' trust in their physicians. Stanford Trust Study Physician Group.

Science.gov (United States)

Thom, D H; Bloch, D A; Segal, E S

1999-02-01

To investigate the effect of a one-day workshop in which physicians were taught trust-building behaviors on their patients' levels of trust and on outcomes of care. In 1994, the study recruited 20 community-based family physicians and enrolled 412 consecutive adult patients from those physicians' practices. Ten of the physicians (the intervention group) were randomly assigned to receive a one-day training course in building and maintaining patients' trust. Outcomes were patients' trust in their physicians, patients' and physicians' satisfaction with the office visit, continuity in the patient-physician relationship, patients' adherence to their treatment plans, and the numbers of diagnostic tests and referrals. Physicians and patients in the intervention and control groups were similar in demographic and other data. There was no significant difference in any outcome. Although their overall ratings were not statistically significantly different, the patients of physicians in the intervention group reported more positive physician behaviors than did the patients of physicians in the control group. The trust-building workshop had no measurable effect on patients' trust or on outcomes hypothesized to be related to trust.

Cost of education and earning potential for non-physician anesthesia providers.

Science.gov (United States)

MacIntyre, Philip; Stevens, Bradley; Collins, Shawn; Hewer, Ian

2014-02-01

Potential non-physician anesthesia students gauge many different aspects of a graduate program prior to applying, but cost of education and earning potential are typically high priorities for students. Our analysis evaluated the cost of tuition for all certified registered nurse anesthetist (CRNA) and anesthesiologist assistant (AA) programs in the United States, as well as earning potential for both professions. We collected educational cost data from school websites and salary data from the Medical Group Management Association's Physician Compensation and Production Survey: 2012 Report in order to compare the two groups. We found that the median cost of public CRNA programs is $40,195 and the median cost of private programs is $60,941, with an overall median of $51,720. Mean compensation for CRNAs in 2011 was $156,642. The median cost of public AA programs is $68,210 compared with $77,155 for private AA education, and an overall median cost of $76,037. Average compensation for AAs in 2011 was $123,328. Considering these factors, nurse anesthesia school is a better choice for candidates who already possess a nursing license; however, for those prospective students who are not nurses, AA school may be a more economical choice, depending on the type and location of practice desired.

Physician Appraisals: Key Challenges

Directory of Open Access Journals (Sweden)

Klich Jacek

2017-06-01

Full Text Available The main purpose of the article is to identify key criteria being used for physician appraisals and to find how communication skills of physicians are valued in those appraisals. ScienceDirect and EBSCOhost databases were used for this search. The results show that a physician appraisal is underestimated both theoretically and empirically. The particular gap exists with respect to the communication skills of physicians, which are rarely present in medical training syllabi and physician assessments. The article contributes to the theoretical discourse on physician appraisals and points out at the inconsistency between the high status of physicians as a key hospital resource on the one hand and, on the other hand, at inadequate and poorly researched assessment of their performance with a special emphasis on communication skills. The article may inspire health managers to develop and implement up-to-date assessment forms for physicians and good managerial practices in this respect in hospitals and other health care units.

Support Vector Machines as tools for mortality graduation

Directory of Open Access Journals (Sweden)

Alberto Olivares

2011-01-01

Full Text Available A topic of interest in demographic and biostatistical analysis as well as in actuarial practice,is the graduation of the age-specific mortality pattern. A classical graduation technique is to fit parametric models. Recently, particular emphasis has been given to graduation using nonparametric techniques. Support Vector Machines (SVM is an innovative methodology that could be utilized for mortality graduation purposes. This paper evaluates SVM techniques as tools for graduating mortality rates. We apply SVM to empirical death rates from a variety of populations and time periods. For comparison, we also apply standard graduation techniques to the same data.

Adolescents, Graduated Autonomy, and Genetic Testing

Directory of Open Access Journals (Sweden)

Susan Fox

2012-01-01

Full Text Available Autonomy takes many shapes. The concept of “graduated autonomy” is conceived as comprising several unique features: (1 it is incremental, (2 it is proportional, and (3 it is related to the telos of the life stage during which it occurs. This paper focuses on graduated autonomy in the context of genetic testing during adolescence. Questions can be raised about other life stages as well, and some of these questions will be addressed by discussing a possible fourth characteristic of graduated autonomy, that is, its elasticity. Further scholarship and analysis is needed to refine the concept of graduated autonomy and examine its applications.

Edward Gantt (1742-1837): US senate chaplain and first White House physician to Thomas Jefferson.

Science.gov (United States)

Cavanagh, Harrison Dwight

2017-08-01

In his long and eventful life, Edward Gantt (1742-1837) made important contributions to the newly independent American Republic, as well as to the development of scientific evidence-based American medicine. Unfortunately, his achievements have gone unrecognized and unreported in mainstream historical publications. Specifically, his service as the first designated White House doctor, and personal physician to President Thomas Jefferson from 1801 to 1809 has not been reported. The purpose of this paper is to document the biographical and scientific details of his extraordinary life and notable contributions.

Physicians and euthanasia: a Canadian print-media discourse analysis of physician perspectives.

Science.gov (United States)

Wright, David Kenneth; Fishman, Jennifer R; Karsoho, Hadi; Sandham, Sarah; Macdonald, Mary Ellen

2015-01-01

Recent events in Canada have mobilized public debate concerning the controversial issue of euthanasia. Physicians represent an essential stakeholder group with respect to the ethics and practice of euthanasia. Further, their opinions can hold sway with the public, and their public views about this issue may further reflect back upon the medical profession itself. We conducted a discourse analysis of print media on physicians' perspectives about end-of-life care. Print media, in English and French, that appeared in Canadian newspapers from 2008 to 2012 were retrieved through a systematic database search. We analyzed the content of 285 articles either authored by a physician or directly referencing a physician's perspective. We identified 3 predominant discourses about physicians' public views toward euthanasia: 1) contentions about integrating euthanasia within the basic mission of medicine, 2) assertions about whether euthanasia can be distinguished from other end-of-life medical practices and 3) palliative care advocacy. Our data showed that although some medical professional bodies appear to be supportive in the media of a movement toward the legalization of euthanasia, individual physicians are represented as mostly opposed. Professional physician organizations and the few physicians who have engaged with the media are de facto representing physicians in public contemporary debates on medical aid in dying, in general, and euthanasia, in particular. It is vital for physicians to be aware of this public debate, how they are being portrayed within it and its potential effects on impending changes to provincial and national policies.

Graduation in Denmark

DEFF Research Database (Denmark)

Warburg, Margit

2009-01-01

all the characteristics of a rite of passage. The graduates wear a traditional cap with a cross as cockade emblem; this special cross is a symbol of Denmark. For graduates of non-Christian background, alternative cockade emblems are available, e.g. a Star of David or a crescent; this shows...... that the cross emblem is also perceived as a Christian symbol. Social anthropologists Sally Moore and Barbara Myerhoff have suggested a scheme of the categories of religious versus scared for analysing secular rituals where religious symbols are sometimes exhibited. The applicability of their approach...

The graduate as a tool of institutional assessment: an analysis of academic knowledge and employability with FEARP/USP graduates

Directory of Open Access Journals (Sweden)

Claudio de Souza Miranda

2015-02-01

Full Text Available The assessment process in education has been the target of many studies, including higher education. The assessment process can occur during several levels; this study is done with the graduates. The focus of this study was the Faculty of Economics, Business and Accouting of Ribeirão Preto – USP, in order to answer the following research question: How is the integration of graduate students in the market? The faculty had 17 graduate groups that was composed of 1,520 graduates in its three courses. The researchers were able to connect 1,185, and they obtained 725 answers. Most of the graduates are in the Southeast, especially in São Paulo (84.7%. In terms of post-graduation courses, 32.1% were at MBA courses and 28.1% were at Mastering courses. Regarding employability was observed 91.8% are employed, 5.0% are looking for jobs and only 3.2% are inactive. Among the employed, 80.9% acts at their graduation area. These employees are at public and private sector, and they have an average income of R$ 9,6313. About the graduation course they scored 8.2 out of 10, despite some criticism of undergraduate learning and the market.

Practicing on Newly Dead

Directory of Open Access Journals (Sweden)

Jewel Abraham

2015-07-01

Full Text Available A newly dead cadaver simulation is practiced on the physical remains of the dead before the onset of rigor mortis. This technique has potential benefits for providing real-life in-situ experience for novice providers in health care practices. Evolving ethical views in health care brings into question some of the ethical aspects associated with newly dead cadaver simulation in terms of justification for practice, autonomy, consent, and the need of disclosure. A clear statement of policies and procedures on newly dead cadaver simulation has yet to be implemented. Although there are benefits and disadvantages to an in-situ cadaver simulation, such practices should not be carried out in secrecy as there is no compelling evidence that suggests such training as imperative. Secrecy in these practices is a violation of honor code of nursing ethics. As health care providers, practitioners are obliged to be ethically honest and trustworthy to their patients. The author explores the ethical aspects of using newly dead cadaver simulation in training novice nursing providers to gain competency in various lifesaving skills, which otherwise cannot be practiced on a living individual. The author explores multiple views on cadaver simulation in relation to ethical theories and practices such as consent and disclosure to family.

Family physician perceptions of working with LGBTQ patients: physician training needs.

Science.gov (United States)

Beagan, Brenda; Fredericks, Erin; Bryson, Mary

2015-01-01

Medical students and physicians report feeling under-prepared for working with patients who identify as lesbian, gay, bisexual, transgender or queer (LGBTQ). Understanding physician perceptions of this area of practice may aid in developing improved education. In-depth interviews with 24 general practice physicians in Halifax and Vancouver, Canada, were used to explore whether, when and how the gender identity and sexual orientation of LGBTQ women were relevant to good care. Inductive thematic analysis was conducted using ATLAS.ti data analysis software. Three major themes emerged: 1) Some physicians perceived that sexual/gender identity makes little or no difference; treating every patient as an individual while avoiding labels optimises care for everyone. 2) Some physicians perceived sexual/gender identity matters primarily for the provision of holistic care, and in order to address the effects of discrimination. 3) Some physicians perceived that sexual/gender identity both matters and does not matter, as they strove to balance the implications of social group membership with recognition of individual differences. Physicians may be ignoring important aspects of social group memberships that affect health and health care. The authors hold that individual and socio-cultural differences are both important to the provision of quality health care. Distinct from stereotypes, generalisations about social group differences can provide valuable starting points, raising useful lines of inquiry. Emphasizing this distinction in medical education may help change physician approaches to the care of LGBTQ women.

Family physician perceptions of working with LGBTQ patients: physician training needs

Directory of Open Access Journals (Sweden)

Brenda Beagan

2015-04-01

Full Text Available Background: Medical students and physicians report feeling under-prepared for working with patients who identify as lesbian, gay, bisexual, transgender or queer (LGBTQ. Understanding physician perceptions of this area of practice may aid in developing improved education. Method: In-depth interviews with 24 general practice physicians in Halifax and Vancouver, Canada, were used to explore whether, when and how the gender identity and sexual orientation of LGBTQ women were relevant to good care. Inductive thematic analysis was conducted using ATLAS.ti data analysis software. Results: Three major themes emerged: 1 Some physicians perceived that sexual/gender identity makes little or no difference; treating every patient as an individual while avoiding labels optimises care for everyone. 2 Some physicians perceived sexual/gender identity matters primarily for the provision of holistic care, and in order to address the effects of discrimination. 3 Some physicians perceived that sexual/gender identity both matters and does not matter, as they strove to balance the implications of social group membership with recognition of individual differences. Conclusions: Physicians may be ignoring important aspects of social group memberships that affect health and health care. The authors hold that individual and socio-cultural differences are both important to the provision of quality health care. Distinct from stereotypes, generalisations about social group differences can provide valuable starting points, raising useful lines of inquiry. Emphasizing this distinction in medical education may help change physician approaches to the care of LGBTQ women.

Triggering risk factors of the burnout syndrome in OB/GYN physicians from a reference public university of Brazil.

Science.gov (United States)

Ferreira Bortoletti, Fátima; Teresa Benevides-Pereira, Ana Maria; Vasconcellos, Esdras Guerreiro; Siqueira, José Oliveira; Araujo Júnior, Edward; Nardozza, Luciano Marcondes Machado; Sebastiani, Ricardo Werner; Moron, Antonio Fernandes

2012-01-01

Objective. To identify the risk factors to the development of Burnout Syndrome in Ob/Gyn Brazilian physicians in four dimensions: emotional exhaustion (EE), professional repression (PR), dehumanization (De), and emotional distancing (EmD). Methods. A prospective cross-sectional study was realized with 48 Ob/Gyn physicians (12 lecturers, 12 attending physicians, 12 medical residents, and 12 graduate students) from Department of Obstetrics, São Paulo Federal University (UNIFESP). We used a sociodemographic questionnaire focusing on the activities (administrative, educational, healthcare, and research). We applied a Burnout Syndrome Inventory (BSI) composed of two parts: triggering factors (ISB1) and the Burnout Syndrome (ISB2). The ISB1 is composed of two scales: positive organizational conditions (POC) and negative organizational conditions (NOC). The ISB2 is composed of four scales: EE, PR, De, and EmD. Results. We observed a rate below and above average to POC and NOC, respectively. The dimensions recorded a level above average to EE, an index at the upper limit of the average to De, a median index to EmD, and a median index to PR. Conclusions. The Ob/Gyn physicians are in an area of vulnerability for the development of Burnout Syndrome due to the high level of EE and De, associated with a median index of PR. The high rate of NOC contributes to the triggering of this scenery.

Clinical experience and skills of physicians in hospital cardiac arrest teams in Denmark: a nationwide study

Directory of Open Access Journals (Sweden)

Lauridsen KG

2017-03-01

attended an ERC Advanced Life Support course, and only very few physicians know the ERC guidelines on when to abandon resuscitation. Keywords: cardiopulmonary resuscitation, Advanced Cardiac Life Support, graduate medical education, resuscitation orders 

Non-physician Clinicians in Sub-Saharan Africa and the Evolving Role of Physicians.

Science.gov (United States)

Eyal, Nir; Cancedda, Corrado; Kyamanywa, Patrick; Hurst, Samia A

2015-12-30

Responding to critical shortages of physicians, most sub-Saharan countries have scaled up training of non-physician clinicians (NPCs), resulting in a gradual but decisive shift to NPCs as the cornerstone of healthcare delivery. This development should unfold in parallel with strategic rethinking about the role of physicians and with innovations in physician education and in-service training. In important ways, a growing number of NPCs only renders physicians more necessary - for example, as specialized healthcare providers and as leaders, managers, mentors, and public health administrators. Physicians in sub-Saharan Africa ought to be trained in all of these capacities. This evolution in the role of physicians may also help address known challenges to the successful integration of NPCs in the health system. © 2016 by Kerman University of Medical Sciences.

[500 years since the birth of G. Agricola, a physician and pharmacist in Jáchymov].

Science.gov (United States)

Drábek, P

1994-10-01

Georgius Agricola (1494-1555) had graduated in medicine and then he chose the mining town of Jáchymov as the first place for practicing his profession and became the municipal physician and pharmacist there in 1527. There he wrote his first book on mining as well as a comparative study of ancient measures and weights, necessary for correct preparation of medicines according to the recipes of ancient authors. In 1533 he moved house to the Saxon town of Chemnitz. Besides practicing medicine he dedicated himself to mineralogy and mining, which made him famous. The paper also draws attention to some other writings of his, particularly his treatise on plague (1554).

Envisioning a Future Governance and Funding System for Undergraduate and Graduate Medical Education.

Science.gov (United States)

Gold, Jeffrey P; Stimpson, Jim P; Caverzagie, Kelly J

2015-09-01

Funding for graduate medical education (GME) and undergraduate medical education (UME) in the United States is being debated and challenged at the national and state levels as policy makers and educators question whether the multibillion dollar investment in medical education is succeeding in meeting the nation's health care needs. To address these concerns, the authors propose a novel all-payer system for GME and UME funding that equitably distributes medical education costs among all stakeholders, including those who benefit most from medical education. Through a "Medical Education Workforce (MEW) trust fund," indirect and direct GME dollars would be replaced with a funds-flow mechanism using fees paid for services by all payers (Medicaid, Medicare, private insurers, others) while providing direct compensation to physicians and institutions that actively engage medical learners in providing clinical care. The accountability of those receiving MEW funds would be improved by linking their funding levels to their ability to meet predetermined institutional, program, faculty, and learner benchmarks. Additionally, the MEW fund would cover learners' UME tuition, potentially eliminating their UME debt, in return for their provision of health care services (after completing GME training) in an underserved area or specialty. This proposed model attempts to increase transparency and enhance accountability in medical education by linking funding to the development of a physician workforce that is able to excel in the evolving health delivery system. Achieving this vision requires physician educators, leaders of academic health centers, policy makers, insurers, and patients to muster the courage to embrace transformational change.

Certified nurse-midwife and physician collaborative practice. Piloting a survey on the Internet.

Science.gov (United States)

Miller, S; King, T; Lurie, P; Choitz, P

1997-01-01

This pilot study was designed to describe the clinical areas of collaboration, financial structures, and sources of conflict for certified nurse-midwives (CNMs) involved in nurse-midwife and physician collaborative practice (CP). A questionnaire was posted on an electronic bulletin board maintained by the Community-Based Nurse Midwifery Education Program of the Frontier School of Nursing. The nonrandom, convenience sample consisted of 78 respondents. Their mean age was 42 years; they had been in practice for a mean of 10 years, and 56% had graduate degrees. Eighty-nine percent reported involvement in CP. Eighty-three percent co-managed higher-risk women, and 46% performed vacuum-assisted deliveries or were first assistants at cesarean sections. Forty-eight percent of CNMs did not bill in their own names, and only 12% had full hospital privileges. The most common sources of conflict in CPs were clinical practice issues (100% ever encountered), power inequities (92%), financial issues (66%), and gender relations (58%). Collaborative practice is a common form of practice for CNMs and suggests a model for collaboration in other sectors of the health care system. Future research should explore methods of reducing the potential for conflict between CNMs and physicians.

Strategy Precedes Operational Effectiveness: Aligning High Graduation Rankings with Competitive Graduation Grade Point Averages

Science.gov (United States)

Apprey, Maurice; Bassett, Kimberley C.; Preston-Grimes, Patrice; Lewis, Dion W.; Wood, Beverly

2014-01-01

Two pivotal and interconnected claims are addressed in this article. First, strategy precedes program effectiveness. Second, graduation rates and rankings are insufficient in any account of academic progress for African American students. In this article, graduation is regarded as the floor and not the ceiling, as it were. The ideal situation in…

Associations Between Physician Empathy, Physician Characteristics, and Standardized Measures of Patient Experience.

Science.gov (United States)

Chaitoff, Alexander; Sun, Bob; Windover, Amy; Bokar, Daniel; Featherall, Joseph; Rothberg, Michael B; Misra-Hebert, Anita D

2017-10-01

To identify correlates of physician empathy and determine whether physician empathy is related to standardized measures of patient experience. Demographic, professional, and empathy data were collected during 2013-2015 from Cleveland Clinic Health System physicians prior to participation in mandatory communication skills training. Empathy was assessed using the Jefferson Scale of Empathy. Data were also collected for seven measures (six provider communication items and overall provider rating) from the visit-specific and 12-month Consumer Assessment of Healthcare Providers and Systems Clinician and Group (CG-CAHPS) surveys. Associations between empathy and provider characteristics were assessed by linear regression, ANOVA, or a nonparametric equivalent. Significant predictors were included in a multivariable linear regression model. Correlations between empathy and CG-CAHPS scores were assessed using Spearman rank correlation coefficients. In bivariable analysis (n = 847 physicians), female sex (P empathy scores. In multivariable analysis, female sex (P empathy scores. Of the seven CG-CAHPS measures, scores on five for the 583 physicians with visit-specific data and on three for the 277 physicians with 12-month data were positively correlated with empathy. Specialty and sex were independently associated with physician empathy. Empathy was correlated with higher scores on multiple CG-CAHPS items, suggesting improving physician empathy might play a role in improving patient experience.

Career choices on graduation a study of recent graduates from University College Cork.

LENUS (Irish Health Repository)

McKenna, Gerald

2009-12-01

Irish dental graduates are eligible to enter general dental practice immediately after qualification. Unlike their United Kingdom counterparts, there is no requirement to undertake vocational training (VT) or any pre-registration training. VT is a mandatory 12-month period for all UK dental graduates who wish to work within the National Health Service. It provides structured, supervised experience in training practices and through organised study days.

Factors associated to the career choice of family medicine among Japanese physicians: the dawn of a new era.

Science.gov (United States)

Ie, Kenya; Tahara, Masao; Murata, Akiko; Komiyama, Manabu; Onishi, Hirotaka

2014-01-01

Despite recent developments in post-graduate family medicine training in Japan, the numbers of junior doctors entering family medicine residencies are still limited. The objective of this qualitative study was to investigate the possible factors associated to the career choice of family medicine, especially in the context of the newly established family medicine programs in Japan. From December 2010 to January 2011, we distributed a semi-structured questionnaire about career choice to 58 physician members of the Japan Primary Care Association, and 41 of them responded. Four researchers used the Modified Grounded Theory Approach (Kinoshita, 2003) for three-stage conceptualization. We extracted a conceptual model of the choice of newly established family medicine as a career in Japan, consisting of six categories and 77 subordinate concepts from 330 variations. The subcategories of personal background affecting the family-medicine career choice were characteristics ("self-reliance," "pioneering spirit"), career direction ("community/rural-orientedness," "multifaceted orientation") and experience (e.g., "discomfort with fragmented care"). We divided the influencing factors that were identified for career choice into supporters (e.g., "role model"), conflict of career choice (e.g., "anxiety about diverse/broad practice"), and the dawn of a new era in family medicine in Japan (e.g., "lack of social recognition," "concern about livelihood," and "too few role models"). Although the dawn of a new era seemed a rather negative influencer, it was unique to our study that the dawn itself could attract those with a "pioneering spirit" and an "attitude of self-training." Unlike previous studies, the positive factors such as lifestyle and the short residency program were not shown to be part of family medicine's attractiveness. In contrast, "concern about livelihood" was specific among our respondents and was related to career choice in the dawn period. "Community

Social Origin and Graduation Age

DEFF Research Database (Denmark)

Klausen, Trond Beldo

2016-01-01

This paper investigates whether social origin has an impact on graduation age among university students. A large number of social background factors are applied on a large data set of 4 successive cohorts of Danish university graduates born 1960–1975. These are cohorts for whom university...

Attitudes of Irish dental graduates to vocational training.

LENUS (Irish Health Repository)

McKenna, G

2010-05-01

Vocational training (VT) is a mandatory 12 month period for UK dental graduates after graduation. Graduates of Irish Dental Schools are eligible to enter the general dental service in Ireland or obtain an NHS performers list number in the UK immediately after qualification. Reports would suggest that some graduates of Irish Dental Schools are choosing to take part in VT in the UK and find the experience beneficial. This study aimed to record the uptake of VT amongst recent graduates from University College Cork and to document their experiences. It was designed to compare the attitudes and experiences of graduates of Irish Dental Schools who undertook VT compared with those who entered the general dental service.

Recent Changes in the Number of Nurses Graduating from Undergraduate and Graduate Programs.

Science.gov (United States)

Buerhaus, Peter I; Auerbach, David I; Staiger, Douglas O

2016-01-01

Since the 1970s, a number of initiatives have attempted to increase the proportion of nursing graduates with a baccalaureate degree, but with little national effect. Now market forces, health reforms, and an Institute of Medicine report (2011) have combined to transform the educational composition of the nursing workforce. Today, there are considerably more graduates of baccalaureate nursing programs than associate degree programs. The educational transformation of the nursing workforce is not limited to baccalaureate education but includes the rapidly increasing numbers of registered nurses who have earned graduate degrees. These changes in nursing education are increasing the readiness of nursing professionals to capitalize on new opportunities, overcome challenges, and take on new roles and responsibilities as the nation's health care delivery and payments systems evolve in coming years.

7 CFR 765.101 - Borrower graduation requirements.

Science.gov (United States)

2010-01-01

... reasonable rates and terms. (b) The Agency may require partial or full graduation. (1) In a partial... 7 Agriculture 7 2010-01-01 2010-01-01 false Borrower graduation requirements. 765.101 Section 765..., DEPARTMENT OF AGRICULTURE SPECIAL PROGRAMS DIRECT LOAN SERVICING-REGULAR Borrower Graduation § 765.101...

Developing the Intercultural Competence of Graduate Students

Science.gov (United States)

Dimitrov, Nanda; Dawson, Debra L.; Olsen, Karyn C.; Meadows, Ken N.

2014-01-01

This study explores how teaching development programs may facilitate the development of intercultural competence in graduate students and prepare them for communicating effectively in the global workplace after graduation. First, we describe the concept of intercultural teaching competence and examine the skills that graduate students may need to…

Personality traits and career choices among physicians in Finland: employment sector, clinical patient contact, specialty and change of specialty.

Science.gov (United States)

Mullola, Sari; Hakulinen, Christian; Presseau, Justin; Gimeno Ruiz de Porras, David; Jokela, Markus; Hintsa, Taina; Elovainio, Marko

2018-03-27

Personality influences an individual's adaptation to a specific job or organization. Little is known about personality trait differences between medical career and specialty choices after graduating from medical school when actually practicing different medical specialties. Moreover, whether personality traits contribute to important career choices such as choosing to work in the private or public sector or with clinical patient contact, as well as change of specialty, have remained largely unexplored. In a nationally representative sample of Finnish physicians (N = 2837) we examined how personality traits are associated with medical career choices after graduating from medical school, in terms of employment sector, patient contact, medical specialty and change of specialty. Personality was assessed using the shortened version of the Big Five Inventory (S-BFI). An analysis of covariance with posthoc tests for pairwise comparisons was conducted, adjusted for gender and age with confounders (employment sector, clinical patient contact and medical specialty). Higher openness was associated with working in the private sector, specializing in psychiatry, changing specialty and not practicing with patients. Lower openness was associated with a high amount of patient contact and specializing in general practice as well as ophthalmology and otorhinolaryngology. Higher conscientiousness was associated with a high amount of patient contact and specializing in surgery and other internal medicine specialties. Lower conscientiousness was associated with specializing in psychiatry and hospital service specialties. Higher agreeableness was associated with working in the private sector and specializing in general practice and occupational health. Lower agreeableness and neuroticism were associated with specializing in surgery. Higher extraversion was associated with specializing in pediatrics and change of specialty. Lower extraversion was associated with not practicing with

Job satisfaction among obstetrician-gynecologists: a comparison between private practice physicians and academic physicians.

Science.gov (United States)

Bell, Darrel J; Bringman, Jay; Bush, Andrew; Phillips, Owen P

2006-11-01

Physician job satisfaction has been the subject of much research. However, no studies have been conducted comparing academic and private practice physician satisfaction in obstetrics and gynecology. This study was undertaken to measure satisfaction levels for academic and private practice obstetrician-gynecologists and compare different aspects of their practice that contributed to their satisfaction. A survey was mailed to randomly selected obstetrician-gynecologists in Memphis, TN; Birmingham, AL; Little Rock, AR; and Jackson, MS. Physicians were asked to respond to questions concerning demographics and career satisfaction. They were also asked to assess the contribution of 13 different aspects of their practice in contributing to their job selection and satisfaction using a Likert scale. A score of 1 meant the physician completely disagreed with a statement regarding a factor's contribution or was completely dissatisfied; a score of 5 meant the physician completely agreed with a factor's contribution or was completely satisfied. Simple descriptive statistics, as well as the 2-sample t test, were used. Likert scale values were assumed to be interval measurements. Of the 297 questionnaires mailed, 129 (43%) physicians responded. Ninety-five (74%) respondents rated their overall satisfaction as 4 or 5. No significant difference was found between academic and private physicians when comparing overall job satisfaction (P = .25). When compared to private practice physicians, the aspects most likely contributing to overall job satisfaction for academic physicians were the ability to teach, conduct research, and practice variety (P = .0001, P = .0001, and P = .007, respectively). When compared with academic physicians, the aspects most likely contributing to job satisfaction for private practice physicians were autonomy, physician-patient relationship, and insurance reimbursement (P = .0058, P = .0001, and P = .0098, respectively). When choosing a practice setting

Nurse practitioner graduates "Speak Out" about the adequacy of their educational preparation to care for older adults: A qualitative study.

Science.gov (United States)

Jones, Jacqueline; Kotthoff-Burrell, Ernestine; Kass-Wolff, Jane; Brownrigg, Vicki

2015-12-01

With a shortage of primary care providers prepared to care for an aging U.S. population, nurse practitioner (NP) programs are integrating gerontological content. This qualitative descriptive study explored NP graduate perceptions on the adequacy of their education to prepare them to care for seniors. Twenty-three graduates of NP program options at two universities in the western U.S. participated in focus group discussions or interviews. Participants shared their perceptions of their NP educational preparation and suggestions for enhancing gerontologic curriculum. Four main domains emerged from analysis of qualitative data: (a) "Getting your boots on and getting into the role"; (b) "Older people are more complex than we were prepared to care for"; (c) "It is very different as a provider, but I am so glad I was a nurse with experience first"; (d) "NPs have a scope of practice, physician assistants (PAs) have a job description-but I wish we had their [procedural] preparation." Graduates identified a need for more educational content and clinical experiences specific to the care of older adults. Some suggested a postgraduate residency or mentoring option to assist NP role transition and progression and limit role confusion. ©2015 American Association of Nurse Practitioners.

Technical and Soft Skills Expectations During the Transition from Recent Graduate to New Hire

Science.gov (United States)

Keane, C. M.

2001-12-01

Employer-applicant skill compatibility represents a major component of the career development process, particularly for new entrants to the job market. Newly minted geoscientists largely bring a distinct set of skills learned during their formal education and training, which combined with a broader view of the person are evaluated for career potential in today's major employers. University departments possess a strong view of their role in educating future geoscientists, including the skill sets imparted, the basis of education provided, and the expectation for how their students will evolve into colleagues in the profession. Regretfully, based on numerous surveys by both the American Geological Institute's Human Resources program and other independent studies, the formally transferred skills and expectations do not necessarily match those of many geoscience employers. While academia has increased its focus on increasing technical skills and greater specialization, most geoscience employers have further increased the technology gap between themselves and academia, leading most employers to seek broadly trained and well-educated graduates. Additionally, soft skills represent an area of major disagreement between what is considered important and what is considered feasible in a formal education. While debate continues both within industry and academia over the ideal set of soft skills, the great variance in soft skill demands lead to better opportunities for matching of graduate to employer. This debate further enhances the ongoing discussion of the role of the university, the importance of employer needs, and the health of the geoscience discipline within society. Fundamentally, the hiring and career development process remains as sequence of compromises for both the employer and the recent graduate.

New graduate separations from New Zealand's nursing workforce in the first 5 years after registration: a retrospective cohort analysis of a national administrative data set 2005-2010.

Science.gov (United States)

North, Nicola; Leung, William; Lee, Rochelle

2014-08-01

To describe workforce separation rates and its relationship with demographic and work characteristics in the 2005 new graduate cohort's first 5 years as practising RNs in NZ. Retaining new graduate RNs is critical to nursing workforce sustainability; one study showed that if an RN is still employed in a hospital setting 5 years after graduation, he/she tends to remain active in the health industry. Retrospective analysis using the Nursing Council of New Zealand's registration data set for years 2005-2010. All newly registered NZ graduates practising in NZ in 2005 (n = 1236) were tracked for 5 years. Within 5 years of graduation, 26% of the cohort had separated from the NZ nursing workforce, 18% in the first year. The under-25s (n = 517), 42% of the cohort, had the highest loss, 32%, in 5 years. Separations were significantly lower for graduates in their 30s vs. their 20s and for those who gained postgraduate tertiary qualifications post-registration (10%) vs. those who did not (29%). Hospitals were the most frequent employment setting over 5 years, the largest increase being community settings. Five-year retention rates in the four largest practice areas were surgical 26%, medical 16%, mental health 60% and continuing care 10%. After 5 years, 24% of those still practising (n = 920) worked in a different health board region. New graduate RN losses were higher than in previous research, with younger RNs at most risk, threatening future sustainability of the nursing workforce and highlighting the need for evidence-based targeted strategies to retain them. © 2013 John Wiley & Sons Ltd.

Expectations and Influencing Factors of IS Graduates and Education in Thailand: A Perspective of the Students, Academics and Business Community

Directory of Open Access Journals (Sweden)

Teay Shawyun Ph.D.

1999-01-01

Full Text Available As academic we have always been entrusted with developing the knowledge, skills, and capability of our IS students. In the strive for excellence in education, there is always the question of what has been implemented is appropriate and finally achieves its ultimate goals of delivering quality, capable and intellectual students as workforce for the business. To this end, this exploratory research tries to discover what knowledge, skills and capability are expected of an IS graduate, the facilities expected to develop these qualities and what influencing factors make the students go for an IS education. The research will be based on the perspectives of the student, academic and business community. The major findings highlight the overall tendency of higher mean expectation of the business community in most of the fundamental expectations of the type of knowledge, skills and capability and the facilities essential to the development of these attributes. The academics are normally supportive of the business community’s perspectives except in the dimensions of skill expectation and attitudinal factors. Overall, it also appears that the students show a lower average means on most attributes as compared to the academics and business community. Based on this research, there appears to be distinctive expectations of an IS graduate. Based on the balanced technology approach of looking at the development of the IS graduate from degree of sophistication of the Technoware (T, Humaware (H, Inforware (I and Orgaware (O, it is hoped that the following can be achieved: 1. A newly revised and revamped IS curriculum, 2. A linkage of the THIO to develop the IS graduate and 3. A linkage of the academia-industry THIO linkage to develop the IS graduate.

Physician assistant education: five countries.

Science.gov (United States)

Hooker, Roderick S; Kuilman, Luppo

2011-01-01

Physician assistant (PA) education has undergone substantial change since the late 1960s. After four decades of development, other countries have taken a page from the American experience and launched their own instructional initiatives. The diversity in how different countries approach education and produce a PA for their nation's needs provides an opportunity to make comparisons. The intent of this study was to document and describe PA programs in Australia, Canada, the United Kingdom, The Netherlands, and the United States. We reviewed the literature and contacted a network of academics in various institutions to obtain primary information. Each contact was asked a set of basic questions about the country, the PA program, and the deployment of graduates. Information on US PA programs was obtained from the Physician Assistant Education Association. At year's end 2010, the following was known about PA development: Australia, one program; Canada, four programs; United Kingdom, four programs; The Netherlands, five programs; the United States, 154 programs. Trends in program per capita growth remain the largest in the United States, followed by The Netherlands and Canada. The shortest program length was 24 months and the longest, 36 months. Outside the United States, almost all programs are situated in an academic health center ([AHC] defined as a medical university, a teaching hospital, and a nursing or allied health school), whereas only one-third of US PA programs are in AHCs. All non-US programs receive public/government funding whereas American programs are predominately private and depend on tuition to fund their programs. The PA movement is a global phenomenon. How PAs are being educated, trained, and deployed is known only on the basic level. We identify common characteristics, unique aspects, and trends in PA education across five nations, and set the stage for collaboration and analysis of optimal educational strategies. Additional information is needed on

Physician-patient communication in HIV disease: the importance of patient, physician, and visit characteristics.

Science.gov (United States)

Wilson, I B; Kaplan, S

2000-12-15

Although previous work that considered a variety of chronic conditions has shown that higher quality physician-patient communication care is related to better health outcomes, the quality of physician-patient communication itself for patients with HIV disease has not been well studied. To determine the relationship of patient, visit, physician, and physician practice characteristics to two measures of physician-patient communication for patients with HIV disease. Cross-sectional survey of physicians and patients. Cohort study enrolling patients from throughout eastern Massachusetts. 264 patients with HIV disease and their their primary HIV physicians (n = 69). Two measures of physician-patient communication were used, a five-item general communication measure (Cronbach's alpha = 0.93), and a four-item HIV-specific communication measure that included items about alcohol, drug use, and sexual behaviors (Cronbach's alpha = 0.92). The mean age of patients was 39. 5 years, 24% patients were women, 31.1% were nonwhite, and 52% indicated same-sex contact as their principal HIV risk factor. The mean age of physicians was 39.1 years, 33.3% were female, 39.7% were specialists, and 25.0% self-identified as gay, lesbian, or bisexual. In multivariable models relating patient and visit characteristics to general communication, longer reported visit length (pbetter communication. The interaction of patient gender and visit length was also significant (p =.02); longer visit length was more strongly associated with better general communication for male than female patients. In similar models relating patient and visit characteristics to HIV-specific communication, longer visit length (p better communication. In multivariable models relating physician and practice characteristics to general communication no variables were significant. However, both female physician gender (p =.002) and gay/lesbian/bisexual sexual preference (p =.003) were significantly associated with better HIV

Student perception about working in rural United States/Canada after graduation: a study in an offshore Caribbean medical school [v1; ref status: indexed, http://f1000r.es/4vz

Directory of Open Access Journals (Sweden)

P Ravi Shankar

2014-12-01

Full Text Available Introduction: Rural residents of the United States (US and Canada face problems in accessing healthcare. International medical graduates (IMGs play an important role in delivering rural healthcare. IMGs from Caribbean medical schools have the highest proportion of physicians in primary care.  Xavier University School of Medicines admits students from the US, Canada and other countries to the undergraduate medical (MD course and also offers a premedical program. The present study was conducted to obtain student perception about working in rural US/Canada after graduation.   Methods: The study was conducted among premedical and preclinical undergraduate medical (MD students during October 2014. The questionnaire used was modified from a previous study. Semester of study, gender, nationality, place of residence and occupation of parents were noted. Information about whether students plan to work in rural US/Canada after graduation, possible reasons why doctors are reluctant to work in rural areas, how the government can encourage rural practice, possible problems respondents anticipate while working in rural areas were among the topics studied. Results: Ninety nine of the 108 students (91.7% participated. Forty respondents were in favor of working in rural US/Canada after graduation. Respondents mentioned good housing, regular electricity, water supply, telecommunication facilities, and schools for education of children as important conditions to be fulfilled. The government should provide higher salaries to rural doctors, help with loan repayment, and provide opportunities for professional growth.  Potential problems mentioned were difficulty in being accepted by the rural community, problems in convincing patients to follow medical advice, lack of exposure to rural life among the respondents, and cultural issues. Conclusions: About 40% of respondents would consider working in rural US/Canada. Conditions required to be fulfilled have been

Non-physician Clinicians in Sub-Saharan Africa and the Evolving Role of Physicians

Directory of Open Access Journals (Sweden)

Nir Eyal

2016-03-01

Full Text Available Responding to critical shortages of physicians, most sub-Saharan countries have scaled up training of nonphysician clinicians (NPCs, resulting in a gradual but decisive shift to NPCs as the cornerstone of healthcare delivery. This development should unfold in parallel with strategic rethinking about the role of physicians and with innovations in physician education and in-service training. In important ways, a growing number of NPCs only renders physicians more necessary – for example, as specialized healthcare providers and as leaders, managers, mentors, and public health administrators. Physicians in sub-Saharan Africa ought to be trained in all of these capacities. This evolution in the role of physicians may also help address known challenges to the successful integration of NPCs in the health system.

Comprehensive Revenue and Expense Data Collection Methodology for Teaching Health Centers: A Model for Accountable Graduate Medical Education Financing.

Science.gov (United States)

Regenstein, Marsha; Snyder, John E; Jewers, Mariellen Malloy; Nocella, Kiki; Mullan, Fitzhugh

2018-04-01

Despite considerable federal investment, graduate medical education financing is neither transparent for estimating residency training costs nor accountable for effectively producing a physician workforce that matches the nation's health care needs. The Teaching Health Center Graduate Medical Education (THCGME) program's authorization in 2010 provided an opportunity to establish a more transparent financing mechanism. We developed a standardized methodology for quantifying the necessary investment to train primary care physicians in high-need communities. The THCGME Costing Instrument was designed utilizing guidance from site visits, financial documentation, and expert review. It collects educational outlays, patient service expenses and revenues from residents' ambulatory and inpatient care, and payer mix. The instrument was fielded from April to November 2015 in 43 THCGME-funded residency programs of varying specialties and organizational structures. Of the 43 programs, 36 programs (84%) submitted THCGME Costing Instruments. The THCGME Costing Instrument collected standardized, detailed cost data on residency labor (n = 36), administration and educational outlays (n = 33), ambulatory care visits and payer mix (n = 30), patient service expenses (n =  26), and revenues generated by residents (n = 26), in contrast to Medicare cost reports, which include only costs incurred by residency programs. The THCGME Costing Instrument provides a model for calculating evidence-based costs and revenues of community-based residency programs, and it enhances accountability by offering an approach that estimates residency costs and revenues in a range of settings. The instrument may have feasibility and utility for application in other residency training settings.

Graduates' Perceptions towards UKM's Infrastructure

Science.gov (United States)

Omar, Ramli; Khoon, Koh Aik; Hamzah, Mohd Fauzi; Ahmadan, Siti Rohayu

2009-01-01

This paper reports on the surveys which were conducted between 2006 and 2008 on graduates' perceptions towards the infrastructure at Universiti Kebangsaan Malaysia (UKM). It covered three major aspects pertaining to learning, living and leisure on campus. Eight out of 14 components received overwhelming approval from our graduates. (Contains 1…

Preparing Graduate Students as Science Communicators

Science.gov (United States)

Knudson, K.; Gutstein, J.

2012-12-01

Our presentation introduces our interdisciplinary curriculum that teaches graduate students at our R-1 university to translate their research to general audiences. We also discuss the challenges we have faced and strategies we have employed to broaden graduate education at our campus to include preparation in science communication. Our "Translating Research beyond Academia" curriculum consists of three separate thematically based courses taught over the academic year: Education and Community Outreach, Science Communication and Writing, Communicating with Policy- and Decision-makers. Course goals are to provide professional development training so that graduate students become more capable professionals prepared for careers inside and outside academia while increasing the public understanding of science and technology. Open to graduate students of any discipline, each course meets weekly for two hours; students receive academic credit through a co-sponsoring graduate program. Students learn effective strategies for communicating research and academic knowledge with the media, the general public, youth, stakeholders, and decision- and policy-makers. Courses combine presentations from university and regional experts with hands-on work sessions aimed towards creating effective communications, outreach and policy plans, broader impacts statements, press releases, blogs, and policy briefs. A final presentation and reflections are required. Students may opt for further training through seminars tailored to student need. Initial results of our analyses of student evaluations and work indicate that students appreciate the interdisciplinary, problem-based approach and the low-risk opportunities for learning professional development skills and for exploring non-academic employment. Several students have initiated engaged work in their disciplines, and several have secured employment in campus science communication positions. Two have changed career plans as a direct result of

Seasonal variation in family member perceptions of physician competence in the intensive care unit: findings from one academic medical center.

Science.gov (United States)

Stevens, Jennifer P; Kachniarz, Bart; O'Reilly, Kristin; Howell, Michael D

2015-04-01

Researchers have found mixed results about the risk to patient safety in July, when newly minted physicians enter U.S. hospitals to begin their clinical training, the so-called "July effect." However, patient and family satisfaction and perception of physician competence during summer months remain unknown. The authors conducted a retrospective observational cohort study of 815 family members of adult intensive care unit (ICU) patients who completed the Family Satisfaction with Care in the Intensive Care Unit instrument from eight ICUs at Beth Israel Deaconess Medical Center, Boston, Massachusetts, between April 2008 and June 2011. The association of ICU care in the summer months (July-September) versus other seasons and family perception of physician competence was examined in univariable and multivariable analyses. A greater proportion of family members described physicians as competent in summer months as compared with winter months (odds ratio [OR] 1.9; 95% confidence interval [CI] 1.2-3.0; P = .003). After adjustment for patient and proxy demographics, severity of illness, comorbidities, and features of the admission in a multivariable model, seasonal variation of family perception of physician competence persisted (summer versus winter, OR of judging physicians competent 2.4; 95% CI 1.3-4.4; P = .004). Seasonal variation exists in family perception of physician competence in the ICU, but opposite to the "July effect." The reasons for this variation are not well understood. Further research is necessary to explore the role of senior provider involvement, trainee factors, system factors such as handoffs, or other possible contributors.

CONSIDERATIONS REGARDING ROMANIAN HIGHER EDUCATION GRADUATES

Directory of Open Access Journals (Sweden)

Popovici (Barbulescu Adina

2012-07-01

Full Text Available The paper aims at analyzing the dynamics of in Romanian higher education graduates in the 2006-2010 period, both in Romania and by the Romanian development regions. After highlighting the importance of human capital and its education, the paper analyzes the dynamics of Romanian higher education graduates in the targeted period, at both of the above-mentioned levels. The conclusions reveal that, during the analysed period: 2006-2010, the number of female, and, respectively, male higher education graduates, as well as the total number of higher education graduates, continuously increased in the 2006-2010 period at the whole country level and registered an increase trend, as well, by the eight development regions of Romania in the 2006-2010 period, with very few exceptions in some years of the period, in some of the the eight development regions of Romania. Therefore, the Romanian higher education system must correlate the graduates number with the number of work places in the Romanian economy, and take into account the necessities imposed by the participation at international competition.

The role of gender in MPH graduates' salaries.