Subspecialization in clinical neurophysiology

Neurology ◽  
2020 ◽  
Vol 95 (15) ◽  
pp. 686-692 ◽  
Author(s):  
Dorthea Juul ◽  
Kerry H. Levin ◽  
Laurie Gutmann ◽  
Larry R. Faulkner
Keyword(s):  
Medical Education ◽  
Graduate Medical Education ◽  
Clinical Neurophysiology ◽  
Training Programs ◽  
Negative Impact ◽  
Sleep Medicine ◽  
Current Status ◽  
Substantial Portion ◽  
Practice Time ◽  
The Impact

ObjectiveTo describe the development and current status of training and certification in clinical neurophysiology (CNP); to explore the impact of the newer subspecialties in sleep medicine, neuromuscular medicine, and epilepsy; and to obtain information about aspects of practice in the subspecialty.MethodsInformation about training programs and certification was obtained from the records of the Accreditation Council for Graduate Medical Education and the American Board of Psychiatry and Neurology, and diplomates were surveyed about their CNP practice activities and attitudes toward certification/recertification.ResultsIn the years since the first examination was administered, a robust number of CNP training programs developed, but recently, there has been a decrease in the number of programs and fellows, although the number of programs and fellows in the subspecialties of epilepsy, neuromuscular medicine, and sleep medicine has increased. A diplomate survey indicated that most respondents devoted significant practice time to CNP procedures, especially to EEGs and EMGs. Although more diplomates performed EEGs than EMGs, a substantial portion performed both. Most diplomates were planning to or had maintained certification in CNP.ConclusionOver 3,000 neurologists, child neurologists, and psychiatrists have obtained certification in CNP, and the majority are participating in recertification. Although the newer and overlapping subspecialties of epilepsy, neuromuscular medicine, and sleep medicine may be having a negative impact on CNP, it continues to have a relatively large number of programs and attracts a relatively large number of fellows.

Integration of Web Analytics into Graduate Medical Education: Usability Study (Preprint)

2021 ◽  
Author(s):  
Jackson Massanelli ◽  
Kevin W Sexton ◽  
Chris T Lesher ◽  
Hanna K Jensen ◽  
Mary K Kimbrough ◽  
...  
Keyword(s):  
Medical Education ◽  
Graduate Medical Education ◽  
Web Applications ◽  
Group Analysis ◽  
User Engagement ◽  
Web Analytics ◽  
Graduate Medical ◽  
Main Page ◽  
Session Duration ◽  
The Impact

BACKGROUND Web analytics is the measurement, collection, analysis, and reporting of websites’ and web applications’ usage data. While common in the e-commerce arena, web analytics are underutilized in graduate medical education. OBJECTIVE The UAMS Department of Surgery website was revamped with input from in-house surgeons in August 2017. This study investigated the use of web analytics to gauge the impact of our department’s website redesign project. METHODS Google Analytics software was used to measure website performance before and after implementation of the new website. Eight-month matched periods were compared. Factors tracked included total users, new users, total sessions, sessions per user, pages per session, average session duration, total page views, and bounce rate (the percentage of visitors who visit a site then leave [i.e. bounce] without continuing to another page on the same site). RESULTS Analysis using a non-paired Student’s t-test demonstrated a statistically significant increase for total page views (33,065 vs 81,852; p<0.0001) and decrease for bounce rate (50.70% vs 0.23%; p<0.0001). Total users, new users, total sessions, sessions per user, and pages per sessions showed improvement; average session duration was unchanged. Sub-group analysis showed that after the main page, the next three most frequently visited pages relate to GME programs in our department. CONCLUSIONS Web analytics are practical measures of a website’s efficacy. Our data suggest that a modern website significantly improves user engagement. An up-to-date website is essential for contemporary GME recruitment, will likely enhance engagement of residency applicants with our GME programs, and warrants further investigation.

Hematology/medical oncology fellow responses to the initial development of an antiracism curriculum.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 11042-11042
Author(s):  
Erica C. Nakajima ◽  
Marcus Messmer ◽  
Jennifer Marie Jones ◽  
Luckson Mathieu ◽  
Tanyanika Phillips ◽  
...  
Keyword(s):  
Medical Education ◽  
Graduate Medical Education ◽  
Medical Oncology ◽  
Further Education ◽  
Underrepresented Minority ◽  
Initial Development ◽  
Graduate Medical ◽  
Set Up ◽  
Black Alumni ◽  
The Impact

11042 Background: While the American Council on Graduate Medical Education (ACGME) set up a Planning Committee for Diversity in GME in 2018, no formalized milestones or training mandates have been announced. The nation-wide protests for racial justice following the senseless killings of Breonna Taylor, Ahmaud Arbery and George Floyd further brought to the forefront the need for immediate action to address widespread inequities across graduate medical education, our healthcare system and society as a whole. Therefore, the Johns Hopkins Hematology/Medical Oncology Fellowship Program focused on creating an anti-racism curriculum to foster dialogue on systemic racism and discrimination, grounded in the institutional and geographic context of our training program. Methods: Using the Kern six step curriculum development method, we created a comprehensive anti-racism initiative, which included virtual townhalls with Black alumni of the fellowship, book clubs, readings, and lectures. We sought to deepen the fellowship’s awareness of the impact of racism and inequity upon trainees, underrepresented minority oncologists and hematologists, and patients in order to develop initiatives to confront them productively. Trainees received a survey 6 months after the start of the curriculum to assess the impact of the initiatives upon trainees, and inform iterative changes to the curriculum. Results: 25 of 34 fellows across all post-graduate years (PGY) completed the survey. Fellows agreed that the curriculum was helpful (68%) and encouraging (60%). Collectively, fellows reported that the curriculum increased their awareness of instances of racism in medicine, caused them to think about next steps that the fellowship could take to address racism, and enabled them to identify available resources for support and further education. Respondents selected community engagement and recruitment of diverse fellowship classes as the most pressing priorities for the program. Conclusions: Social justice and anti-racism education belong in the formalized training of our hematology/medical oncology fellows. To this end, our ongoing curricular expansion is focusing on anti-racism training, diverse recruitment and youth mentorship. Collectively, a comprehensive yet program-specific approach facilitates opportunities for learning, engagement and development of the skills necessary to engage in this life-long work for ourselves, our communities and our patients.

scholarly journals ReCAP: Attitudes, Beliefs, and Awareness of Graduate Medical Education Trainees Regarding Palliative Care at a Comprehensive Cancer Center

2016 ◽  
Vol 12 (2) ◽  
pp. 149-150 ◽  
Author(s):  
Angelique Wong ◽  
Akhila Reddy ◽  
Janet L. Williams ◽  
Jimin Wu ◽  
Diane Liu ◽  
...  
Keyword(s):  
Palliative Care ◽  
Medical Education ◽  
Graduate Medical Education ◽  
Surgical Oncology ◽  
Comprehensive Cancer Center ◽  
Graduate Medical ◽  
Care Services ◽  
Palliative Care Services ◽  
Care Training ◽  
The Impact

QUESTION ASKED: What are graduate medical education trainees’ attitudes and beliefs regarding palliative care, what is their awareness of the availability and role of palliative care services, and does previous exposure to a palliative care rotation facilitate a better awareness of palliative care? SUMMARY ANSWER: A vast majority of oncology trainees perceived palliative care services to be beneficial for patient care (92%) and were supportive of mandatory palliative care training (74%). Surgical oncology trainees and trainees with no previous palliative care exposure were significantly less likely to consult palliative care and had significantly less awareness of palliative care. METHODS: We conducted an institutional review board–approved online survey to determine awareness of palliative care among graduate medical trainees at MD Anderson. One hundred seventy oncology trainees who completed at least 9 months of training in medical, surgical, gynecologic, and radiation oncology fellowship and residency program during the 2013 academic year completed an online questionnaire. Descriptive, univariate, and multivariate analyses were performed. BIAS, CONFOUNDING FACTOR(S), DRAWBACKS: Although there was a substantial response rate (78%), the results may not be generalizable as the survey was conducted at a single institution. Also, the frequency of palliative care referrals is self-reported. REAL-LIFE IMPLICATIONS: Our findings suggest that exposure to palliative care training may lead to increased awareness of palliative care among oncologists, and thus, increased overall and early referrals to palliative care. Surgical oncology trainees may benefit from increased exposure to palliative care rotations. More research is needed to characterize the impact of training on referral patterns to palliative care. In the meantime, efforts should be made to include formal palliative care rotations in oncology training. [Table: see text]

scholarly journals Patterns of Change in ACGME-Accredited Residency Programs and Positions: Implication for the Adequacy of GME Positions and Supply of Physicians in the United States

2014 ◽  
Vol 6 (2) ◽  
pp. 399-403 ◽  
Author(s):  
Kathleen D. Holt ◽  
Rebecca S. Miller ◽  
Ingrid Philibert ◽  
Thomas J. Nasca
Keyword(s):  
Medical Education ◽  
Medical School ◽  
Graduate Medical Education ◽  
Primary Care Physicians ◽  
Population Data ◽  
The United States ◽  
Graduate Medical ◽  
The Past ◽  
Accredited Institutions ◽  
The Impact

Abstract Background Recent studies suggest that the supply of primary care physicians and generalist physicians in other specialties may be inadequate to meet the needs of the US population. Data on the numbers and types of physicians-in-training, such as those collected by the Accreditation Council for Graduate Medical Education (ACGME), can be used to help understand variables affecting this supply. Objective We assessed trends in the number and type of medical school graduates entering accredited residencies, and the impact those trends could have on the future physician workforce. Methods Since 2004, the ACGME has published annually its data on accredited institutions, programs, and residents to help the graduate medical education community understand major trends in residency education, and to help guide graduate medical education policy. We present key results and trends for the period between academic years 2003–2004 and 2012–2013. Results The data show that increases in trainees in accredited programs are not uniform across specialties, or the types of medical school from which trainees graduated. In the past 10 years, the growth in residents entering training that culminates in initial board certification (“pipeline” specialties) was 13.0%, the number of trainees entering subspecialty education increased 39.9%. In the past 5 years, there has been a 25.8% increase in the number of osteopathic physicians entering allopathic programs. Conclusions These trends portend challenges in absorbing the increasing numbers of allopathic and osteopathic graduates, and US international graduates in accredited programs. The increasing trend in subspecialization appears at odds with the current understanding of the need for generalist physicians.

scholarly journals Dietary Care for ADPKD Patients: Current Status and Future Directions

Nutrients ◽  
2019 ◽  
Vol 11 (7) ◽  
pp. 1576 ◽  
Author(s):  
Sol Carriazo ◽  
Maria Vanessa Perez-Gomez ◽  
Adrian Cordido ◽  
Miguel Angel García-González ◽  
Ana Belen Sanz ◽  
...  
Keyword(s):  
Negative Impact ◽  
Aerobic Glycolysis ◽  
Evidence Base ◽  
Current Status ◽  
Dietary Recommendations ◽  
Preclinical Research ◽  
Ketogenic Diets ◽  
Modifiable Factors ◽  
Autosomal Dominant Polycystic Kidney ◽  
The Impact

Autosomal dominant polycystic kidney disease (ADPKD) is the most common genetic nephropathy, and tolvaptan is the only therapy available. However, tolvaptan slows but does not stop disease progression, is marred by polyuria, and most patients worldwide lack access. This and recent preclinical research findings on the glucose-dependency of cyst-lining cells have renewed interest in the dietary management of ADPKD. We now review the current dietary recommendations for ADPKD patients according to clinical guidelines, the evidence base for those, and the potential impact of preclinical studies addressing the impact of diet on ADPKD progression. The clinical efficacy of tolvaptan has put the focus on water intake and solute ingestion as modifiable factors that may impact tolvaptan tolerance and ADPKD progression. By contrast, dietary modifications suggested to ADPKD patients, such as avoiding caffeine, are not well supported and their impact is unknown. Recent studies have identified a chronic shift in energy production from mitochondrial oxidative phosphorylation to aerobic glycolysis (Warburg effect) as a contributor to cyst growth, rendering cyst cells exquisitely sensitive to glucose availability. Therefore, low calorie or ketogenic diets have delayed preclinical ADPKD progression. Additional preclinical data warn of potential negative impact of excess dietary phosphate or oxalate in ADPKD progression.

A challenging and rewarding time: The early days of graduate medical education in dermatology

2017 ◽  
Vol 27 (3) ◽  
pp. 173-178
Author(s):  
Margaret Maria Cocks
Keyword(s):  
Medical Education ◽  
20Th Century ◽  
Residency Training ◽  
Graduate Medical Education ◽  
Training Programs ◽  
Subspecialty Training ◽  
Scientific Journals ◽  
Graduate Medical ◽  
Personal Reflections

Specialized residency training was still in its infancy in mid-20th century America. While specialty boards in various fields such as ophthalmology and otolaryngology had been established in the 1920s and 1930s, the details of training programs were still being fine-tuned and formal curricula were lacking. In dermatology, three prominent physicians including Harry L. Arnold Jr., J. Lamar Callaway and Walter B. Shelley trained during these experimental days of medical education. Each of them captured personal reflections of their own training experiences in brief memoirs published in scientific journals. A closer examination of these texts provides unique insights into how dermatology subspecialty training in particular and medical education more broadly evolved during this period.

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