A dozen years of evolution of neurology clerkships in the United States

Neurology ◽  
2018 ◽  
Vol 91 (15) ◽  
pp. e1440-e1447 ◽  
Author(s):  
Joseph E. Safdieh ◽  
Adam D. Quick ◽  
Pearce J. Korb ◽  
Diego Torres-Russotto ◽  
Karissa L. Gable ◽  
...  

ObjectiveTo report a 2017 survey of all US medical school neurology clerkship directors (CDs) and to compare the results to similar surveys conducted in 2005 and 2012.MethodsAn American Academy of Neurology (AAN) Consortium of Neurology Clerkship Directors (CNCD) workgroup developed the survey that was sent to all neurology CDs listed in the AAN CNCD database. Comparisons were made to similar 2005 and 2012 surveys.ResultsThe response rate was 92 of 146 programs (63%). Among the responding institutions, neurology is required in 94% of schools and is 4 weeks in length in 75%. From 2005 to 2017, clerkships shifted out of a fourth-year-only rotation (p = 0.035) to earlier curricular time points. CD protected time averages 0.24 full-time equivalent (FTE), with 31% of CDs reporting 0.26 to 0.50 FTE support, a >4-fold increase from prior surveys (p < 0.001). CD service of >12 years increased from 9% in 2005 to 23% in 2017. Twenty-seven percent also serve as division chief/director, and 22% direct a preclinical neuroscience course. Forty-nine percent of CDs are very satisfied in their role, increased from 34% in 2012 (p = 0.046). The majority of CDs identify as white and male, with none identifying as black/African American.ConclusionChanges since 2005 and 2012 include shifting of the neurology clerkship to earlier in the medical school curriculum and an increase in CD salary support. CDs are more satisfied than reflected in previous surveys and stay in the role longer. There is a lack of racial diversity among neurology CDs.

Author(s):  
Edward C. Fletcher Jr.

The purpose of this article was to examine faculty characteristics of CTE programs across the nation as well as identify the challenges and successes of implementing programs. Findings pointed to the overall decline of CTE full-time-equivalent faculty and the increase of adjunct faculty. In addition, findings demonstrated a lack of ethnic and racial diversity among faculty in CTE programs as compared to white faculty. Further, faculty reported declining student enrollment, budget cuts and decreases in funding, and lack of faculty are growing challenges for implementing effective programs. They identified career placement of graduates, high-quality students and graduates, and student enrollment increases as areas of success. The viability of CTE undergraduate and graduate programs as well as the field-at-large are dependent on the creativity, success, productivity, and problem-solving of faculty as well as their abilities to address and overcome these challenges.


2021 ◽  
pp. 1-5
Author(s):  
Robin V. Horak ◽  
Shasha Bai ◽  
Bradley S. Marino ◽  
David K. Werho ◽  
Leslie A. Rhodes ◽  
...  

Abstract Objective: To assess current demographics and duties of physicians as well as the structure of paediatric cardiac critical care in the United States. Design: REDCap surveys were sent by email from May till August 2019 to medical directors (“directors”) of critical care units at the 120 United States centres submitting data to the Society of Thoracic Surgeons Congenital Heart Surgery Database and to associated faculty from centres that provided email lists. Faculty and directors were asked about personal attributes and clinical duties. Directors were additionally asked about unit structure. Measurements and main results: Responses were received from 66% (79/120) of directors and 62% (294/477) of contacted faculty. Seventy-six percent of directors and 54% of faculty were male, however, faculty <40 years old were predominantly women. The majority of both groups were white. Median bed count (n = 20) was similar in ICUs and multi-disciplinary paediatric ICUs. The median service expectation for one clinical full-time equivalent was 14 weeks of clinical service (interquartile range 12, 16), with the majority of programmes (86%) providing in-house attending night coverage. Work hours were high during service and non-service weeks with both directors (37%) and faculty (45%). Conclusions: Racial and ethnic diversity is markedly deficient in the paediatric cardiac critical care workforce. Although the majority of faculty are male, females make up the majority of the workforce younger than 40 years old. Work hours across all age groups and unit types are high both on- and off-service, with most units providing attending in-house night coverage.


2019 ◽  
Vol 134 (4) ◽  
pp. 386-394
Author(s):  
Meghan D. McGinty ◽  
Nancy Binkin ◽  
Jessica Arrazola ◽  
Mia N. Israel ◽  
Chrissie Juliano

Objectives: The Council of State and Territorial Epidemiologists (CSTE) has periodically assessed the epidemiological capacity of states since 2001, but the data do not reflect the total US epidemiology capacity. CSTE partnered with the Big Cities Health Coalition (BCHC) in 2017 to assess epidemiology capacity in large urban health departments. We described the epidemiology workforce capacity of large urban health departments in the United States and determined gaps in capacity among BCHC health departments. Methods: BCHC, in partnership with CSTE, modified the 2017 State Epidemiology Capacity Assessment for its 30 member departments. Topics in the assessment included epidemiology leadership, staffing, funding, capacity to perform 4 epidemiology-related Essential Public Health Services, salary ranges, hiring requirements, use of competencies, training needs, and job vacancies. Results: The 27 (90%) BCHC-member health departments that completed the assessment employed 1091 full-time equivalent epidemiologists. All or nearly all health departments provided epidemiology services for programs in infectious disease (n = 27), maternal and child health (n = 27), preparedness (n = 27), chronic diseases (n = 25), vital statistics (n = 25), and environmental health (n = 23). On average, funding for epidemiology activities came from local (47%), state (24%), and federal (27%) sources. Health departments reported needing a 40% increase from the current number of epidemiologists to achieve ideal epidemiology capacity. Twenty-five health departments reported substantial-to-full capacity to monitor health problems, 21 to diagnose health problems, 11 to conduct evaluations, and 9 to perform applied research. Conclusions: Strategies to meet 21st century challenges and increase substantial-to-full epidemiological capacity include seeking funds from nongovernmental sources, partnering with schools and programs of public health, and identifying creative solutions to hiring and retaining epidemiologists.


2019 ◽  
Vol 3 (8) ◽  
pp. 1485-1502
Author(s):  
Matthew D Ringel ◽  
Elizabeth J Murphy ◽  
Stephen R Hammes

Abstract The landscape for academic endocrinology divisions has continued to evolve rapidly;thus, finding reliable data that can be used as benchmarks has become more difficult. Resources are available for salary and relative value units, with the Association of American Medical Colleges, Medical Group Management Association, and Faculty Practice Solutions Center the most commonly used databases. However, details regarding how these data are collected and what they include are unclear. For example, does the income include bonus and/or incentive payments? How are work relative value units defined (individual rendering vs supervising advanced practitioners or fellows or residents)? How is a clinical full-time equivalent defined? In addition, other important data that would be relevant to running an academic division of endocrinology are not available from these, or any other resources, including support staff numbers and compensation or fellowship funding and training information. Therefore, an unmet need exists for reliable data that divisions can use to help shape their visions and goals. To address this demand, the Association of Endocrine Chiefs and Directors, in collaboration with the Endocrine Society, developed a detailed survey for members to address the financial, productivity, composition, and educational issues that they regularly face. Twenty academic institutions throughout the United States completed in the survey in 2018. In the present report, we have provided the results of the survey and some initial interpretations of the findings. Our hope is that the information presented will prove useful as academic endocrinology divisions continue to evolve.


Author(s):  
Amanda M. Nevius ◽  
A’Llyn Ettien ◽  
Alissa P. Link ◽  
Laura Y. Sobel

Objective: The most recent survey on instruction practices in libraries affiliated with accredited medical institutions in the United States was conducted in 1996. The present study sought to update these data, while expanding to include Canadian libraries. Additional analysis was undertaken to test for statistically significant differences between library instruction in the United States and Canada and between libraries affiliated with highly ranked and unranked institutions.Methods: A twenty-eight-question survey was distributed to libraries affiliated with accredited US and Canadian medical schools to assess what and how often librarians teach, as well as how librarians are involved in the curriculum committee and if they are satisfied with their contact with students and faculty. Quantitative data were analyzed with SAS, R, and MedCalc.Results: Most of the seventy-three responding libraries provided instruction, both asynchronously and synchronously. Library instruction was most likely to be offered in two years of medical school, with year one seeing the most activity. Database use was the most frequently taught topic, and libraries reported a median of five librarians providing instruction, with larger staffs offering slightly more education sessions per year. Libraries associated with highly ranked schools were slightly more likely to offer sessions that were integrated into the medical school curriculum in year four and to offer sessions in more years overall.Conclusions: In US and Canadian libraries, regardless of the rank of the affiliated medical school, librarians’ provision of instruction in multiple formats on multiple topics is increasingly common.


2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
K S Lee ◽  
J J Y Zhang ◽  
A Alamri ◽  
A Chari

Abstract Introduction Worldwide, there is no specific medical school curriculum in neurosurgery despite a high burden of neurosurgical disease that is often assessed, investigated and managed by generalists. This scoping review was carried out to map available evidence pertaining to the provision of neurosurgery education in the medical school curriculum across the world. Method This review was conducted in accordance to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews. Results Ten studies were included. Six were from the United Kingdom, two from the United States, and one each from Canada and Ireland. Two studies evaluated perceptions of both medical students and practicing clinicians, five studies evaluated the perceptions of medical students and three studies reported perceptions of clinicians only. Three main themes were identified. Neurosurgery was perceived as an important part of the general medical student curriculum. Exposure to neurosurgery teaching was varied but when received, deemed useful and students were keen to receive more. Interest in a neurosurgical career amongst medical students was high. Conclusions There is a lack of a specialty-specific medical school curriculum and variability of medical students’ exposure to neurosurgery teaching exists. Our findings highlight the need to systematically assess specialty-specific teaching and determine adequacy.


2010 ◽  
Vol 28 (35) ◽  
pp. 5160-5165 ◽  
Author(s):  
Benjamin D. Smith ◽  
Bruce G. Haffty ◽  
Lynn D. Wilson ◽  
Grace L. Smith ◽  
Akshar N. Patel ◽  
...  

Purpose Prior studies forecasted an incipient shortage of medical oncologists as a result of the aging US population, but the radiation oncology workforce has not been studied. Accordingly, we projected demand for radiation therapy and supply of radiation oncologists in 2010 and 2020 to determine whether a similar shortage may exist for this specialty. Methods Demand for radiation therapy in 2010 and 2020 was estimated by multiplying current radiation utilization rates (as calculated with Surveillance, Epidemiology, and End Results data) by population projections from the Census Bureau. Supply of radiation oncologists was projected using data from the American Board of Radiology inclusive of current radiation oncologists and active residents, accounting for variation in full-time equivalent status and expected survival by age and sex. Results Between 2010 and 2020, the total number of patients receiving radiation therapy during their initial treatment course is expected to increase by 22%, from 470,000 per year to 575,000 per year. In contrast, assuming that the current graduation rate of 140 residents per year remains constant, the number of full-time equivalent radiation oncologists is expected to increase by only 2%, from 3,943 to 4,022. The size of residency training classes for the years 2014 to 2019 would have to double to 280 residents per year in order for growth in supply of radiation oncologists to equal expected growth in demand. Conclusion Demand for radiation therapy is expected to grow 10 times faster than supply between 2010 and 2020. Research is needed to explore strategies to enhance capacity to deliver quality radiation therapy despite increased patient loads.


2011 ◽  
Vol 6 (1) ◽  
pp. 53 ◽  
Author(s):  
Diana K. Wakimoto

A Review of: Dinkins, D., & Ryan, S. M. (2010). Measuring referrals: The use of paraprofessionals at the reference desk. The Journal of Academic Librarianship, 36(4), 279-286. Objective — To determine the type and percentage of questions referred to a librarian by a paraprofessional (i.e., an individual without an MLIS) staffing the reference desk, whether the percentage of referrals would decrease over time, and any consequences from having a paraprofessional rather than a librarian staffing the desk. Design — Quantitative analysis of reference desk transaction statistics. Setting — Reference desk at the main library of Stetson University, a private university in the United States of America with approximately 2,500 FTE (full-time equivalent) students. Subjects — A total of 486 reference desk transactions recorded by a paraprofessional staffing the reference desk during the Fall and Spring semesters of the 2008-2009 academic year. Methods — The first year that he worked in the Library at Stetson University, a paraprofessional recorded all reference desk transactions during his shift from 10:00am to 12:00pm, four days a week, for the Fall and Spring semesters of the 2008-2009 academic year. This paraprofessional, with computer expertise, received “relatively minimal” (p. 281) training on “reference desk policies and procedures… the use of the catalogue and the subscription databases” (p. 281). For each transaction, the paraprofessional categorized the question as “direction,” “reference,” or “machine.” He was instructed to contact a librarian if he could not answer a reference question. The paraprofessional also completed a questionnaire regarding his level of comfort answering questions and his thoughts on the training at the end of his first year of staffing the reference desk. Main Results — In the Fall semester, 9.5% of all reference desk transactions were referred to a librarian. This decreased to 4.2% of the total transactions during the Spring semester. The percentage of reference questions referred to a librarian in the Fall semester was 21.9% and only 5.0% in the Spring semester. There was a 49.5% decrease in the number of reference desk transactions during the paraprofessional’s hours on the desk compared to the previous year when the desk was staffed by professional librarians. Overall, reference desk transactions for all hours decreased 4.1% compared to the previous year. The results from the questionnaire on his experiences at the reference desk showed that the paraprofessional was satisfied with his training, comfortable with referring questions to the librarians, did not use the print reference collection extensively, thought the “interface for searching the library’s catalogue/databases is dated at best” (p. 285), and felt that being close in age to many of the students was a disadvantage while working at the reference desk. Conclusion — The authors concluded that staffing the reference desk with a paraprofessional was a success and that the “referrals to librarians had been made appropriately and when necessary” (p. 285). The results corroborated previous studies that showed only a “small percentage of reference desk transactions would need to be referred to a librarian” (p. 285). In part, because of the success of staffing the desk with a paraprofessional, the authors suggest that reference desk staffing configurations at academic libraries should be reevaluated. Librarians freed from duties at the physical reference desk could use this time to “develop virtual reference services” and expand information literacy programs (p. 286). To explain the decrease in number of transactions during the paraprofessional’s time on the reference desk, the authors surmised four possibilities: patrons’ reluctance to ask questions of someone new on the desk, their dissatisfaction with the paraprofessional’s answers, the similarity in age between the paraprofessional and the “age of the student population” (p. 284), or the librarians being more conscientious in tallying every transaction. However, the authors doubted that users perceived the paraprofessional’s answers as “less satisfactory” as “patrons likely got a higher level of service on computer-related queries from the computer science-trained paraprofessional” (p. 284). Computer-related queries, coded as “machine” transactions, formed the majority of queries answered by the paraprofessional.


2013 ◽  
Vol 5 (4) ◽  
pp. 646-651 ◽  
Author(s):  
Laura Robbins ◽  
Mathias Bostrom ◽  
Robert Marx ◽  
Timothy Roberts ◽  
Thomas P. Sculco

Abstract Background Limited time and funding are challenges to meeting the research requirement of the orthopedic residency curriculum. Objective We report a reorganized research curriculum that increases research quality and productivity at our academic orthopedic medical center. Methods Changes made to the curriculum, which began in 2006 and were fully phased in by 2008, included research milestones for each training year, a built-in support structure, use of an accredited bio-skills laboratory, mentoring by National Institutes of Health–funded scientists, and protected time to engage in required research and prepare scholarly peer-reviewed publications. Results Total grant funding of resident research increased substantially, from $15,000 in 2007 (8 graduates) to $380,000 in 2010 (9 graduates), and the number of publications also increased. The 12 residents who graduated in 2005 published 16 papers from 2000 to 2006, compared to 84 papers published by the 9 residents who graduated in 2010. The approximate costs per year included $19,000 (0.3 full-time equivalent) for an academic research coordinator; $16,000 for resident travel to professional meetings; reimbursement for 213 faculty hours; and funding for resident salaries while on the research rotation, paid through the general hospital budget. Conclusions The number of grants and peer-reviewed publications increased considerably after our residency research curriculum was reorganized to allow dedicated research time and improved mentoring and infrastructure.


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