scholarly journals Why Internal Medicine Program Directors remain in their positions, are effective, and thrive: A qualitative study

2021 ◽  
Author(s):  
Emily A. Stewart ◽  
Michael Kisielewski ◽  
Kathlyn Fletcher ◽  
Gretchen Diemer ◽  
Susan Lane ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Qualitative Study ◽  
Program Directors

59. General medicine residents' perception of the mini-CEXs

2007 ◽  
Vol 30 (4) ◽  
pp. 61
Author(s):  
S. Malhotra ◽  
R. Hatala ◽  
C.-A. Courneya
Keyword(s):  
Internal Medicine ◽  
Medical Education ◽  
Focus Group ◽  
Qualitative Study ◽  
Focus Groups ◽  
General Medicine ◽  
Clinical History ◽  
Phenomenological Approach ◽  
Medical Teacher ◽  
The Impact

The mini-CEX is a 30 minute observed clinical encounter. It can be done in the outpatient, inpatient or emergency room setting. It strives to look at several parameters including a clinical history, physical, professionalism and overall clinical competence. Trainees are rated using a 9-point scoring system: 1-3 unsatisfactory, 4-6 satisfactory and 7-9 superior. Eight months after the introduction of the mini-CEX to the core University of British Columbia Internal Medicine Residents, a one hour semi-structured focus group for residents in each of the three years took place. The focus groups were conducted by an independent moderator, audio-recorded and transcribed. Using a phenomenological approach the comments made by the focus groups participants were read independently by three authors, organized into major themes. In doing so, several intriguing common patterns were revealed on how General Medicine Residents perceive their experience in completing a mini-CEX. The themes include Education, Assessment and Preparation for the Royal College of Physicians and Surgeons Internal Medicine exam. Resident learners perceived that the mini-CEX process provided insight into their clinical strengths and weaknesses. Focus group participants favored that the mini-CEX experience will benefit them in preparation, and successful completion of their licensing exam. Daelmans HE, Overmeer RM, van der Hem-Stockroos HH, Scherpbier AJ, Stehouwer CD, van der Vleuten CP. In-training assessment: qualitative study of effects on supervision and feedback in an undergraduate clinical rotation. Medical Education 2006; 40(1):51-8. De Lima AA, Henquin R, Thierer J, Paulin J, Lamari S, Belcastro F, Van der Vleuten CPM. A qualitative study of the impact on learning of the mini clinical evaluation exercise in postgraduate training. Medical Teacher January 2005; 27(1):46-52. DiCicco-Bloom B, Crabtree BF. The Qualitative Research Interview. Medical Education 2006; 40:314-32.

scholarly journals A comparison of orthopaedic surgery and internal medicine perceptions of USMLE Step 1 pass/fail scoring

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Frederick Mun ◽  
Alyssa R. Scott ◽  
David Cui ◽  
Erik B. Lehman ◽  
Seong Ho Jeong ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Extracurricular Activities ◽  
Residency Program ◽  
Medical Schools ◽  
Program Directors ◽  
Program Director ◽  
Personal Knowledge ◽  
Clinical Knowledge ◽  
Alpha Omega ◽  
Residency Program Directors

Abstract Background United States Medical Licensing Examination Step 1 will transition from numeric grading to pass/fail, sometime after January 2022. The aim of this study was to compare how program directors in orthopaedics and internal medicine perceive a pass/fail Step 1 will impact the residency application process. Methods A 27-item survey was distributed through REDCap to 161 U.S. orthopaedic residency program directors and 548 U.S. internal medicine residency program directors. Program director emails were obtained from the American Medical Association’s Fellowship and Residency Electronic Interactive Database. Results We received 58 (36.0%) orthopaedic and 125 (22.8%) internal medicine program director responses. The majority of both groups disagree with the change to pass/fail, and felt that the decision was not transparent. Both groups believe that the Step 2 Clinical Knowledge exam and clerkship grades will take on more importance. Compared to internal medicine PDs, orthopaedic PDs were significantly more likely to emphasize research, letters of recommendation from known faculty, Alpha Omega Alpha membership, leadership/extracurricular activities, audition elective rotations, and personal knowledge of the applicant. Both groups believe that allopathic students from less prestigious medical schools, osteopathic students, and international medical graduates will be disadvantaged. Orthopaedic and internal medicine program directors agree that medical schools should adopt a graded pre-clinical curriculum, and that there should be a cap on the number of residency applications a student can submit. Conclusion Orthopaedic and internal medicine program directors disagree with the change of Step 1 to pass/fail. They also believe that this transition will make the match process more difficult, and disadvantage students from less highly-regarded medical schools. Both groups will rely more heavily on the Step 2 clinical knowledge exam score, but orthopaedics will place more importance on research, letters of recommendation, Alpha Omega Alpha membership, leadership/extracurricular activities, personal knowledge of the applicant, and audition electives.

scholarly journals How Physicians Manage Medical Uncertainty: A Qualitative Study and Conceptual Taxonomy

2021 ◽  
pp. 0272989X2199234
Author(s):  
Paul K. J. Han ◽  
Tania D. Strout ◽  
Caitlin Gutheil ◽  
Carl Germann ◽  
Brian King ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Qualitative Study ◽  
Management Strategies ◽  
Acute Care Hospital ◽  
Uncertainty Management ◽  
Care Hospital ◽  
Convenience Sample ◽  
Medical Specialties ◽  
Tolerance Of Uncertainty ◽  
Medical Uncertainty

Background Medical uncertainty is a pervasive and important problem, but the strategies physicians use to manage it have not been systematically described. Objectives To explore the uncertainty management strategies employed by physicians practicing in acute-care hospital settings and to organize these strategies within a conceptual taxonomy that can guide further efforts to understand and improve physicians’ tolerance of medical uncertainty. Design Qualitative study using individual in-depth interviews. Participants Convenience sample of 22 physicians and trainees (11 attending physicians, 7 residents [postgraduate years 1–3), 4 fourth-year medical students), working within 3 medical specialties (emergency medicine, internal medicine, internal medicine–pediatrics), at a single large US teaching hospital. Measurements Semistructured interviews explored participants’ strategies for managing medical uncertainty and temporal changes in their uncertainty tolerance. Inductive qualitative analysis of audio-recorded interview transcripts was conducted to identify and categorize key themes and to develop a coherent conceptual taxonomy of uncertainty management strategies. Results Participants identified various uncertainty management strategies that differed in their primary focus: 1) ignorance-focused, 2) uncertainty-focused, 3) response-focused, and 4) relationship-focused. Ignorance- and uncertainty-focused strategies were primarily curative (aimed at reducing uncertainty), while response- and relationship-focused strategies were primarily palliative (aimed at ameliorating aversive effects of uncertainty). Several participants described a temporal evolution in their tolerance of uncertainty, which coincided with the development of greater epistemic maturity, humility, flexibility, and openness. Conclusions Physicians and physician-trainees employ a variety of uncertainty management strategies focused on different goals, and their tolerance of uncertainty evolves with the development of several key capacities. More work is needed to understand and improve the management of medical uncertainty by physicians, and a conceptual taxonomy can provide a useful organizing framework for this work.

Usefulness of the ACGME Resident Survey: A View from Internal Medicine Program Directors

2014 ◽  
Vol 127 (4) ◽  
pp. 351-355 ◽  
Author(s):  
Michael Adams ◽  
Lisa L. Willett ◽  
Sandhya Wahi-Gururaj ◽  
Andrew J. Halvorsen ◽  
Steven V. Angus
Keyword(s):  
Internal Medicine ◽  
Program Directors

scholarly journals Changes in the National Residency Matching Program Policy: Are Internal Medicine Program Directors “All-In”?

2012 ◽  
Vol 4 (2) ◽  
pp. 148-153 ◽  
Author(s):  
Michael Adams ◽  
Thomas B. Morrison ◽  
Stephanie Call ◽  
Andrew J. Halvorsen ◽  
Jared Moore ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Program Directors ◽  
Program Policy

scholarly journals Major Concerns About Internal Medicine: Insights from Program Directors

2011 ◽  
Vol 104 (2) ◽  
pp. 89-94 ◽  
Author(s):  
Janet Record ◽  
Brent Beasley ◽  
Furman S. McDonald ◽  
Scott Wright
Keyword(s):  
Internal Medicine ◽  
Program Directors

scholarly journals Benchmarks for Support and Outcomes for Internal Medicine-Pediatrics Residency Programs: A 5-Year Review

2015 ◽  
Vol 7 (4) ◽  
pp. 574-579 ◽  
Author(s):  
Michael Aronica ◽  
Ronald Williams ◽  
Princess E. Dennar ◽  
Robert H. Hopkins
Keyword(s):  
Internal Medicine ◽  
Online Survey ◽  
Hospital Medicine ◽  
Program Directors ◽  
Program Director ◽  
Full Time ◽  
Full Time Equivalent ◽  
Ambulatory Training ◽  
Match Rate ◽  
Program Characteristics

ABSTRACT Background Combined internal medicine and pediatrics (medicine-pediatrics) residencies were Accreditation Council for Graduate Medical Education (ACGME) accredited separately from their corresponding categorical residencies in June 2006. Objective We investigated how ACGME accreditation of medicine-pediatrics programs has affected the levels of support (both financial and personnel), the National Resident Matching Program (NRMP) match rate, performance on the board examination, and other graduate outcomes. Methods From 2009 through 2013 we sent an annual SurveyMonkey online survey to members of the Medicine-Pediatrics Program Directors Association. Questions pertained to program characteristics, program director support, recruitment, ambulatory training, and graduate data. More than 79% of responders completed the entire survey for each year (sample size was 60 program directors). Results Compared to the time prior to accreditation of the specialty, there was an increase in program directors who are dually trained (89% versus 93%), an increase in program director salary ($134,000 before accreditation versus $185,000 in 2013, P < .05), and an increase in the average full-time equivalent support (0.32 before accreditation versus 0.42 in 2013, P < .05). There was also an increase in programs with associate program directors (35% versus 78%), programs with chief residents (71% versus 91%), and an increase in program budgets controlled by program directors (52% versus 69%). The 2013 NRMP match rates increased compared to those of 2005 (99% versus 49%). Performance on the American Board of Pediatrics examination was comparable to that for pediatrics residents. Since accreditation, a larger number of residents are choosing careers in hospital medicine. Conclusions Our data show widespread improved support for medicine-pediatrics programs since the 2006 start of ACGME accreditation.

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