Editors' note: Residency training: The need for an integrated diversity curriculum for neurology residency

Abstract Introduction Fellowship-trained hand surgeons may have residency training in either orthopedic, plastic, or general surgery, generating significant variability in education background. To study the effect of different training backgrounds on practice pattern variations, we utilized the NSQIP (National Surgical Quality Improvement Database) database to assess hand surgery volumes and case variety by specialty. Materials and Methods NSQIP years 2008 to 2017 was queried with hand surgery current procedural terminology codes defined by the American Board of Orthopedic Surgery. Procedures were grouped according to type and specialty, and relative rates calculated. Hand society membership data were used to determine if procedural volume for each specialty in each category and overall contribution to the volume of hand surgery performed nationally was distributed in accordance with membership data. Results A total of 145,015 hand surgeries were performed; 13,267 (9.1%) by general surgeons, 28,402 (19.6%) by plastic surgeons, and 103,346 (71.3%) by orthopedic surgeons. Orthopedic surgeons performed significantly more bone, fracture, joint, and tendon cases. General surgeons and plastic surgeons performed higher than expected numbers of soft tissue coverage and cases overall with respective excesses of 183 and 22%. Conclusion Hand surgery is an available fellowship pathway from multiple residencies. Fellowship training does not level the field of real-world practice patterns. Residency training experiences significantly impact practice.

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Development of residency training in preventive medicine

JAMA ◽

10.1001/jama.198.3.270 ◽

1966 ◽

Vol 198 (3) ◽

pp. 270-274 ◽

Cited By ~ 1

Author(s):

J. C. Hume

Keyword(s):

Residency Training ◽

Preventive Medicine

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70. Supporting IMG integration into residency trainings

Clinical & Investigative Medicine ◽

10.25011/cim.v30i4.2831 ◽

2007 ◽

Vol 30 (4) ◽

pp. 67

Author(s):

S. Glover Takahashi ◽

M. Alameddine ◽

D. Martin ◽

S. Verma ◽

S. Edwards

Keyword(s):

Training Program ◽

Residency Training ◽

Training Programs ◽

Comprehensive Evaluation ◽

International Medical ◽

Full Time ◽

Design Development ◽

Course Content ◽

Medical Trainees ◽

Personal Wellness

This paper is describes the design, development, implementation and evaluation of a preparatory training program for international medical trainees. The program was offered for one week full time shortly before they begin their residency training programs. First the paper reports on the survey and focus groups that guided the learning objectives and the course content. Next the paper describes the curriculum development phase and reports on the topical themes, session goals and objectives and learning materials. Three main themes emerged when developing the program: understanding the educational, health and practice systems in Canada; development of communication skills; and supporting personal success in residency training including self assessment, reflection and personal wellness. Sample lesson plans and handouts from each of the theme areas are illustrated. The comprehensive evaluation of the sessions and the overall program is then also described. The paper then summarizes the identified key issues and challenges in the design and implementation of a preparatory training program for international medical trainees before they begin their residency training programs. Allan GM, Manca D, Szafran O, Korownyk C. Workforce issues in general surgery. Am Surg. 2007 Feb; 73(2):100-8. Dauphinee, WD. The circle game: understanding physician migration patterns within Canada. Acad Med. 2006 (Dec); 81(12 Suppl):S49-54. Spike NA. International medical graduates: the Australian perspective. Academic Medicine. 2006 (Sept); 81(9):842-6.

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68. The resident experience in a large urban teaching setting: Results of the 2005-2006 resident exit survey, University of Torontos

Clinical & Investigative Medicine ◽

10.25011/cim.v30i4.2829 ◽

2007 ◽

Vol 30 (4) ◽

pp. 66

Author(s):

N. Tenn-Lyn ◽

S. Verma ◽

R. Zulla

Keyword(s):

Quality Control ◽

Residency Training ◽

Royal College ◽

Online Survey ◽

Career Guidance ◽

Training Programs ◽

Program Planning ◽

Educational Experience ◽

Care Experience

We developed and implemented an annual online survey to administer to residents exiting residency training in order to (1) assess the quality of the residency experience and (2) identify areas of strength and areas requiring improvement. Long-term goals include program planning, policy-making and maintenance of quality control. Survey content was developed from an environmental scan, pre-existing survey instruments, examination of training criteria established by the CFPC and the CanMEDS criteria established by the RCPSC. The survey included evaluation benchmarks and satisfaction ratings of program director and faculty, preparation for certification and practice, quality of life, quality of education, and work environment. The response rate was 28%. Seventy-five percent of respondents were exiting from Royal College training programs. Results of descriptive statistics determined that the overall educational experience was rated highly, with 98.9% of respondents satisfied or very satisfied with their overall patient care experience. Ninety-six percent of respondents were satisfied or very satisfied with the overall quality of teaching. Preparation for practice was identified as needing improvement, with 26% and 34% of respondents giving an unsatisfactory rating to career guidance and assistance with finding employment, respectively. Although 80% of respondents reported receiving ongoing feedback and 84% discussed their evaluations with their supervisors, only 38% of evaluations were completed by the end of the rotation. The results indicate that residents are generally satisfied with their experiences during residency training, especially with their overall educational experience. Areas of improvement include preparation for practice and timeliness of evaluations. Further iterations of this survey are needed to refine the instrument, identify data trends and maintain quality control in residency training programs. Frank JR (ed.). The CanMEDS competency framework: better standards, better physicians, better care. Ottawa: The Royal College of Physicians and Surgeons of Canada, 2005. Merritt, Hawkins and Associates. Summary Report: 2003 Survey of final-year medical residents. http://www.merritthawkins.com/pdf/MHA2003residentsurv.pdf. Accessed May 1, 2006. Regnier K, Kopelow M, Lane D, Alden A. Accreditation for learning and change: Quality and improvement as the outcome. The Journal of Continuing Education in the Health Professions 2005; 25:174-182.

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63. Developing a program for resident wellness at the postgraduate medical education office, University of Torontos

Clinical & Investigative Medicine ◽

10.25011/cim.v30i4.2824 ◽

2007 ◽

Vol 30 (4) ◽

pp. 63 ◽

Cited By ~ 1

Author(s):

S. Edwards ◽

S. Verma ◽

R. Zulla

Keyword(s):

Mental Health ◽

Medical Education ◽

Stress Management ◽

Residency Training ◽

Medical Training ◽

Postgraduate Medical Education ◽

Program Directors ◽

University Of Toronto ◽

Resident Wellness ◽

The University

Prevalence of stress-related mental health problems in residents is equal to, or greater than, the general population. Medical training has been identified as the most significant negative influence on resident mental health. At the same time, residents possess inadequate stress management and general wellness skills and poor help-seeking behaviours. Unique barriers prevent residents from self-identifying and seeking assistance. Stress management programs in medical education have been shown to decrease subjective distress and increase wellness and coping skills. The University of Toronto operates the largest postgraduate medical training program in the country. The Director of Resident Wellness position was created in the Postgraduate Medical Education Office to develop a systemic approach to resident wellness that facilitates early detection and intervention of significant stress related problems and promote professionalism. Phase One of this new initiative has been to highlight its presence to residents and program directors by speaking to resident wellness issues at educational events. Resources on stress management, professional services, mental health, and financial management have been identified and posted on the postgraduate medical education website and circulated to program directors. Partnerships have been established with physician health professionals, the University of Toronto, and the Professional Association of Residents and Internes of Ontario. Research opportunities for determining prevalence and effective management strategies for stress related problems are being identified and ultimately programs/resources will be implemented to ensure that resident have readily accessible resources. The establishment of a Resident Wellness Strategy from its embryonic stags and the challenges faced are presented as a template for implementing similar programs at other medical schools. Earle L, Kelly L. Coping Strategies, Depression and Anxiety among Ontario Family Medicine Residents. Canadian Family Physician 2005; 51:242-3. Cohen J, Patten S. Well-being in residency training: a survey examining resident physician satisfaction both within and outside of residency training and mental health in Alberta. BMC Medical Education; 5(21). Levey RE. Sources of stress for residents and recommendations for programs to assist them. Academic Med 2001; 70(2):142-150.

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