scholarly journals Students with global experiences during medical school are more likely to work in settings that focus on the underserved: an observational study from a public U.S. institution

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shay E. Slifko ◽  
Nadja A. Vielot ◽  
Sylvia Becker-Dreps ◽  
Donald E. Pathman ◽  
Justin G. Myers ◽  
...  
Keyword(s):  
Global Health ◽  
Medical School ◽  
Underserved Populations ◽  
Medical Schools ◽  
The United States ◽  
School Experiences ◽  
Perceived Benefits ◽  
Application Service ◽  
Global Health Electives ◽  
The U.S

Abstract Background Global health interest has grown among medical students over the past 20 years, and most medical schools offer global health opportunities. Studies suggest that completing global health electives during medical school may increase the likelihood of working with underserved populations in a clinical or research capacity. This study aimed to assess the association of global electives in medical school on subsequently working in global health and with underserved populations in the United States (U.S.), additionally considering students’ interests and experiences prior to medical school. We also examined whether respondents perceived benefits gained from global electives. Methods We surveyed medical school graduates (classes of 2011-2015) from a large public medical school in the U.S. to describe current practice settings and previous global health experience. We evaluated work, volunteer, and educational experiences preceding medical school, socioeconomic status, race and ethnicity using American Medical College Application Service (AMCAS) data. We assessed the association between students’ backgrounds, completing global health electives in medical school and current work in global health or with underserved populations in the U.S. Results In the 5 to 8 years post-graduation, 78% of 161 respondents reported work, research, or teaching with a focus on global or underserved U.S. populations. Completing a global health elective during medical school (p = 0.0002) or during residency (p = 0.06) were positively associated with currently working with underserved populations in the U.S. and pre-medical school experiences were marginally associated (p = 0.1). Adjusting for pre-medical school experiences, completing a global health elective during medical school was associated with a 22% greater prevalence of working with an underserved population. Perceived benefits from global electives included improved cultural awareness, language skills, public health and research skills, and ability to practice in technology-limited settings. Conclusion Medical school graduates who participated in global electives as students were more likely than their peers to pursue careers with underserved populations, independent of experiences prior to medical school. We hypothesize that by offering global health experiences, medical schools can enhance the interests and skills of graduates that will make them more likely and better prepared to work with underserved populations in the U.S. and abroad.

scholarly journals Are Global Experiences During Medical School Associated with Future Medical Practice? A Cross-Sectional Analysis of Survey and Medical School Application Data

2020 ◽  
Author(s):  
Shay E Slifko ◽  
Nadja A. Vielot ◽  
Sylvia Becker-Dreps ◽  
Donald E. Pathman ◽  
Justin G. Myers ◽  
...  
Keyword(s):  
Public Health ◽  
Global Health ◽  
Medical School ◽  
Race And Ethnicity ◽  
Underserved Populations ◽  
The United States ◽  
Perceived Benefits ◽  
Application Service ◽  
Global Health Electives ◽  
The U.S

Abstract Background: Global health interest has grown among medical students over the past twenty years. Most medical schools offer global health opportunities. Studies suggest completing global health electives during medical school may increase likelihood of choosing a primary care discipline or working with underserved populations, yet they have generally not considered students’ interests and experiences prior to medical school. This study aimed to assess the associations of pre-medical school factors and global electives in medical school on subsequently working in global health and with underserved populations in the United States (U.S.) and whether respondents reported perceived benefits from global electives. Methods: We surveyed medical school graduates (classes of 2011-2015) from a large public medical school in the U.S. to describe current practice settings and previous global health experience. We evaluated work, volunteer, and educational experiences preceding medical school, socioeconomic status, race and ethnicity using American Medical College Application Service (AMCAS) data. We assessed the association between students’ backgrounds, completing global health electives in medical school and current work in global health or with underserved populations in the U.S.Results: Of 161 respondents, five to eight years post-graduation, 78% reported work, research, or teaching with a focus on global or underserved U.S. populations. Completing a global health elective during medical school (p=0.0002) or during residency (p=0.01) were positively associated with currently working with underserved populations, and pre-medical school experiences were not associated (p=0.1). Adjusting for race and ethnicity, completing a global health elective during medical school was associated with a 38% greater prevalence of working with an underserved population. Perceived benefits from global electives included improved cultural awareness, language skills, public health and research skills, and ability to practice in technology-limited settings. Conclusion: Medical school graduates who participated in global electives as students were more likely than their peers to pursue careers with underserved populations in the U.S. They reported the experience improved their cultural competency and public health skills. These data can be used to design medical school curricula that encourage global health electives, and support skills that will benefit future work with underserved populations, either in the U.S. or abroad.

scholarly journals FSMB Census of Licensed Physicians in the United States, 2018

2019 ◽  
Vol 105 (2) ◽  
pp. 7-23 ◽  
Author(s):  
Aaron Young ◽  
Humayun J. Chaudhry ◽  
Xiaomei Pei ◽  
Katie Arnhart ◽  
Michael Dugan ◽  
...  
Keyword(s):  
United States ◽  
Health Care ◽  
Medical School ◽  
Census Data ◽  
Medical Schools ◽  
The United States ◽  
Geographic Region ◽  
Physician Workforce ◽  
Care Needs ◽  
State Medical Boards

ABSTRACT There are 985,026 physicians with Doctor of Medicine (MD) and Doctor of Osteopathic Medicine (DO) degrees licensed to practice medicine in the United States and the District of Columbia, according to physician census data compiled by the Federation of State Medical Boards (FSMB). These qualified physicians graduated from 2,089 medical schools in 167 countries and are available to serve a U.S. national population of 327,167,434. While the percentage of physicians who are international medical graduates have remained relatively stable over the last eight years, the percentage of physicians who are women, possess a DO degree, have three or more licenses, or are graduates of a medical school in the Caribbean have increased by varying degrees during that same period. This report marks the fifth biennial physician census that the FSMB has published, highlighting key characteristics of the nation's available physician workforce, including numbers of licensees by geographic region and state, type of medical degree, location of medical school, age, gender, specialty certification and number of active licenses per physician. The number of licensed physicians in the United States has been growing steadily, due in part to an expansion in the number of medical schools and students during the past two decades, even as concerns of a physician shortage to meet health care demands persist. The average age of licensed physicians continues to increase, and more licensed physicians appear to be specialty certified, though the latter finding may reflect more comprehensive reporting. This census was compiled using the FSMB's Physician Data Center (PDC), which collects, collates and analyzes physician data directly from the nation's state medical and osteopathic boards and is uniquely positioned to provide a comprehensive snapshot of information about licensed physicians. A periodic national census of this type offers useful demographic and licensure information about the available physician workforce that may be useful to policy makers, researchers and related health care organizations to better understand and address the nation's health care needs.

Pre-Departure Training for Global Health Electives at US Medical Schools

2017 ◽  
Vol 27 (3) ◽  
pp. 535-541 ◽  
Author(s):  
Taylor Goller ◽  
Alexandra Miller ◽  
Molly Moore ◽  
Anne Dougherty
Keyword(s):  
Global Health ◽  
Medical Schools ◽  
Global Health Electives

scholarly journals The power of language-concordant care: a call to action for medical schools

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Rose L. Molina ◽  
Jennifer Kasper
Keyword(s):  
Global Health ◽  
Health Outcomes ◽  
Health Equity ◽  
Limited English Proficiency ◽  
English Proficiency ◽  
Medical Schools ◽  
Dental Students ◽  
Language Concordance ◽  
The World ◽  
The U.S

Abstract We live in a world of incredible linguistic diversity; nearly 7000 languages are spoken globally and at least 350 are spoken in the United States. Language-concordant care enhances trust between patients and physicians, optimizes health outcomes, and advances health equity for diverse populations. However, historical and contemporary trauma have impaired trust between communities of color, including immigrants with limited English proficiency, and physicians in the U.S. Threats to informed consent among patients with limited English proficiency persist today. Language concordance has been shown to improve care and serves as a window to broader social determinants of health that disproportionately yield worse health outcomes among patients with limited English proficiency. Language concordance is also relevant for medical students engaged in health care around the world. Global health experiences among medical and dental students have quadrupled in the last 30 years. Yet, language proficiency and skills to address cultural aspects of clinical care, research and education are lacking in pre-departure trainings. We call on medical schools to increase opportunities for medical language courses and integrate them into the curriculum with evidence-based teaching strategies, content about health equity, and standardized language assessments. The languages offered should reflect the needs of the patient population both where the medical school is located and where the school is engaged globally. Key content areas should include how to conduct a history and physical exam; relevant health inequities that commonly affect patients who speak different languages; cultural sensitivity and humility, particularly around beliefs and practices that affect health and wellbeing; and how to work in language-discordant encounters with interpreters and other modalities. Rigorous language assessment is necessary to ensure equity in communication before allowing students or physicians to use their language skills in clinical encounters. Lastly, global health activities in medical schools should assess for language needs and competency prior to departure. By professionalizing language competency in medical schools, we can improve patients’ trust in individual physicians and the profession as a whole; improve patient safety and health outcomes; and advance health equity for those we care for and collaborate with in the U.S. and around the world.

scholarly journals Trends in the Financing of United States Medical Schools: 1970-1999

2016 ◽  
Vol 20 (2) ◽  
pp. 50
Author(s):  
Philip O Ozuah ◽  
Sheldon L Stick
Keyword(s):  
United States ◽  
Medical School ◽  
Public Service ◽  
Medical Schools ◽  
The United States ◽  
Medical Services ◽  
Tuition Fees ◽  
Federal Support ◽  
Using Data ◽  
Different Sources

We examined 30-year trends in the financing of allopathic medical schools in the United States using data from the Annual Medical School Questionnaire administered to United States medical schools. We calculated relative proportions for total revenues derived from different sources. Federal support for teaching/training/public service represented 18.8% of total revenues in 1970-1971, but only 0.3% of total revenues in 1998-1999. The proportion of revenues derived from state/localgovernment appropriations also declined across this period. In contrast, the proportion of revenues derived from medical services increased substantially. The proportion of revenues derived from tuition/fees, gifts, and endowments remained constant.

scholarly journals The Role of the Medical School Training on Physician Opioid Prescribing Practices: Evidence from Ontario, Canada: Le rôle de la formation à la faculté de médecine à l’égard des pratiques de prescription d’opioïdes des médecins: données probantes d’Ontario, Canada

2020 ◽  
Vol 65 (10) ◽  
pp. 710-720
Author(s):  
Claire de Oliveira ◽  
Tomisin Iwajomo ◽  
Tara Gomes ◽  
Paul Kurdyak
Keyword(s):  
United States ◽  
Medical School ◽  
Medical Schools ◽  
The United States ◽  
Prescribing Patterns ◽  
Opioid Epidemic ◽  
Opioid Prescribing ◽  
Medical School Training ◽  
School Training

Background: Recent research found that physicians who completed medical school training at top-ranked U.S. medical schools prescribed fewer opioids than those trained at lower ranked schools, suggesting that physician training may play a role in the opioid epidemic. We replicated this analysis to understand whether this finding holds for Ontario, Canada. Methods: We used data on all opioid prescriptions written by Ontario physicians between 2013 and 2017 from the Narcotics Monitoring System. Using the Corporate Provider Database and ICES Physician Database, which contain medical school of training, we linked patients who filled opioid prescriptions with their respective prescribing physician. Available data on Canadian medical school rankings were obtained from Maclean’s news magazine. We used regression analysis to assess the relationship between number of opioid prescriptions and medical school ranking. Results: Compared to the United States, average annual number of opioid prescriptions per physician was lower in Ontario (236 vs. 78). Unlike the United States, we found little evidence that physicians trained at lower ranked medical schools prescribed more than their top-ranked school counterparts after controlling for specialty and location of practice. However, primary care physicians trained at non-English-speaking foreign schools prescribed the most opioids even after excluding opioid maintenance therapy–related prescriptions. Conclusion: The role of medical school training on opioid prescribing patterns among Ontario physicians differs from that in the United States likely due to greater homogeneity of curricula among Canadian schools. Ensuring physicians trained abroad receive additional pain management/addiction training may help address part of the opioid epidemic in Ontario.

Health Promotion in Medical Education

1988 ◽  
Vol 3 (1) ◽  
pp. 37-51 ◽  
Author(s):  
Steven Jonas
Keyword(s):  
Health Promotion ◽  
Medical Education ◽  
Disease Prevention ◽  
Medical School ◽  
Care Delivery ◽  
Medical Science ◽  
Problem Based Learning ◽  
Medical Schools ◽  
The United States ◽  
Care Hospital

A significant portion of the deaths in the United States could have been prevented or postponed using known interventions. One reason this did not occur is because medical science and medical education are disease, not health, oriented. Since physicians are at the center of the health care delivery system, their disease orientation pervades the industry. Historically, there have been calls for physicians to focus more on disease prevention; however, medical education does not teach disease prevention/health promotion. There are several reasons for this: 1) medical school faculty conceptual discordance between “certainty” of curative disease vs. the “probability” of risk factor reduction; 2) gaps in the knowledge of effective interventions; 3) the concept that health promotion/disease prevention are outside the province of physicians; 4) the significant role of biomedical research grants on medical school funding; 5) the close association of medical education and the acute care hospital; and 6) the use of rote memory/lecture based teaching methods of traditional medicine vs. the problem-based learning necessary to teach disease prevention/health promotion. Some medical schools have begun to use problem based learning and to introduce health promotion concepts. Widespread and long-lasting change requires support of the leadership in medical schools and the preventive medicine/public health community, and grant funding from state and federal sources to support research on medical education research and change.

scholarly journals Food for Thought: The Process of Bringing a Universal Medical Curriculum to the Plate – Part I of III

2014 ◽  
Vol 1 ◽  
pp. JMECD.S17495 ◽  
Author(s):  
Aaron M. McGuffin
Keyword(s):  
Medical Education ◽  
Medical Student ◽  
Medical Students ◽  
Medical School ◽  
Education System ◽  
Medical Curriculum ◽  
Burden Of Proof ◽  
Medical Schools ◽  
The United States ◽  
Medical Education System

There is currently no universally accepted core collection of competencies or medical education material for medical students. Individual medical schools create their own competencies and set of educational material using a variety of approaches. What has resulted is a medical education system wherein medical students are trained without any burden of proof that they are indeed competent in agreed upon areas of knowledge, skills, attitudes and behaviors befit of a graduating medical student. In fact, the only uniform assurance a member of the public in the United States can have for a graduating allopathic medical student is that the student has successfully passed USMLE Step 1 and 2 by correctly answering a rumored 55–65% of questions correctly (yes, that is an F) and that they have maintained at least a “C” average or “Pass” equivalent in all of their medical school courses. This article discusses these inadequacies within the current medical education system, and the need to standardize the competencies and curricula for all medical schools through a narrative disclosing this author's experience with trying to initiate such a movement at his own medical school.

Disciplining empathy: Differences in empathy with U.S. medical students by college major

2020 ◽  
pp. 136345932096705
Author(s):  
Lauren D. Olsen ◽  
Hana Gebremariam
Keyword(s):  
Social Sciences ◽  
Medical School ◽  
American Medical ◽  
College Major ◽  
The United States ◽  
American Medical College ◽  
School Students ◽  
Data Set ◽  
Application Service ◽  
Medical Educators

Citing their students’ low levels of empathy, medical educators have scrambled to implement curricula with the hopes of buffering against the corrosive effects of biomedical and clinical experiences in medical school. The assumption undergirding these studies by social scientists and medical educators alike is that immersion in biomedical education and clinical experience erodes students’ empathic capacities, and that exposure to humanities and social sciences content will amend these losses. But we do not know if this assumption is correct. In this project, we empirically assess this assumption by utilizing a unique data set constructed from student applicant and survey data from the American Medical College Application Service (AMCAS) and the Association of American Medical Colleges (AAMC). We test whether medical school students ( N = 8255) from the United States (U.S.) with different academic backgrounds represented by their college major have different levels of empathy, net of demographic control variables. We report two findings. First, we find that students who majored in humanities or interpretive social sciences disciplines have higher empathy scores than their peers who majored in the positivistic social sciences and STEM (science, technology, engineering, and mathematics) disciplines. Second, we find that the relationship between empathy and time in medical school is more nuanced than we would expect from the existing literature.

scholarly journals Asymmetry And Tension: A Brief History of Medical Student Involvement In the U.S. Licensure Process

2007 ◽  
Vol 93 (1) ◽  
pp. 7-14
Author(s):  
S. Ryan Gregory
Keyword(s):  
Clinical Skills ◽  
Medical Schools ◽  
The United States ◽  
Professional Autonomy ◽  
Licensure Examination ◽  
Resident Participation ◽  
Practice Of Medicine ◽  
Resident Involvement ◽  
History Of ◽  
The U.S

ABSTRACT A little more than two years ago, the first nationally standardized clinical skills exam was added to the United States Medical Licensure Examination (USMLE) series. The implementation of this exam was troubled by vigorous resistance from medical students whose objections were supported by several prominent and powerful medical organizations. This article suggests that beyond obvious sources of tension inherent in the exam (chiefly, expense and inconvenience) a real and overlooked source of antagonism is the lack of direct involvement by examinees (students and residents) in the licensure process. Students and residents were able to promote a much larger (and acrimonious) debate than anticipated largely because of their recent ascendancy to positions of influence in medical schools and organizations. This article traces the evolution of student and resident involvement in medical schools and organizations and further suggests that the lack of parallel involvement by students and residents in the licensure process creates asymmetry in an otherwise balanced system of professional autonomy. Such asymmetry in a system balanced between medical schools, organizations and licensing authorities has led and can again lead to unproductive tension and undermine efforts on all parts to advance the practice of medicine and assure the best care possible to the American public. The author closes with a call to forum to discuss openly the possibility of increased student and resident participation in the licensure process; details of how, when and where this participation could occur should be the first items of discussion in such a forum.

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