An Initiative to Increase Residency Program Diversity

Abstract Introduction Residency programs receive an institutional keyword report following the annual Ophthalmic Knowledge Assessment Program (OKAP) examination containing the raw number of incorrectly answered questions. Programs would benefit from a method to compare relative performance between subspecialty sections. We propose a technique of normalizing the keyword report to determine relative subspecialty strengths and weaknesses in trainee performance. Methods We retrospectively reviewed our institutional keyword reports from 2017 to 2019. We normalized the percentage of correctly answered questions for each postgraduate year (PGY) level by dividing the percent of correctly answered questions for each subspecialty by the percent correct across all subsections for that PGY level. We repeated this calculation for each PGY level in each subsection for each calendar year of analysis. Results There was a statistically significant difference in mean performance between the subspecialty sections (p = 0.038). We found above average performance in the Uveitis and Ocular Inflammation section (95% confidence interval [CI]: 1.02–1.18) and high variability of performance in the Clinical Optics section (95% CI: 0.76–1.34). Discussion The OKAP institutional keyword reports are extremely valuable for residency program self-evaluation. Performance normalized for PGY level and test year can reveal insightful trends into the relative strengths and weaknesses of trainee knowledge and guide data-driven curriculum improvement.

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

BMC Medical Education ◽

10.1186/s12909-021-02699-4 ◽

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.

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Teaching Ethics and Professionalism: A National Survey of Ophthalmology Residency Program Directors

Journal of Academic Ophthalmology ◽

10.1055/s-0040-1722741 ◽

2021 ◽

Vol 13 (01) ◽

pp. e88-e94

Author(s):

Alyssa M. Kretz ◽

Jennifer E. deSante-Bertkau ◽

Michael V. Boland ◽

Xinxing Guo ◽

Megan E. Collins

Keyword(s):

Residency Program ◽

Online Survey ◽

Optimal Strategies ◽

Program Directors ◽

Global Evaluation ◽

Teaching Ethics ◽

Residency Programs ◽

Unprofessional Behavior ◽

Residency Program Directors ◽

Trainee Competence

Abstract Background While ethics and professionalism are important components of graduate medical education, there is limited data about how ethics and professionalism curricula are taught or assessed in ophthalmology residency programs. Objective This study aimed to determine how U.S. ophthalmology residency programs teach and assess ethics and professionalism and explore trainee preparedness in these areas. Methods Directors from accredited U.S. ophthalmology residency programs completed an online survey about components of programs' ethics and professionalism teaching curricula, strategies for assessing competence, and trainee preparedness in these areas. Results Directors from 55 of 116 programs (46%) responded. The most common ethics and professionalism topics taught were informed consent (38/49, 78%) and risk management and litigation (38/49, 78%), respectively; most programs assessed trainee competence via 360-degree global evaluation (36/48, 75%). While most (46/48, 95%) respondents reported that their trainees were well or very well prepared at the time of graduation, 15 of 48 (31%) had prohibited a trainee from graduating or required remediation prior to graduation due to unethical or unprofessional conduct. Nearly every program (37/48, 98%) thought that it was very important to dedicate curricular time to teaching ethics and professionalism. Overall, 16 of 48 respondents (33%) felt that the time spent teaching these topics was too little. Conclusion Ophthalmology residency program directors recognized the importance of an ethics and professionalism curriculum. However, there was marked variation in teaching and assessment methods. Additional work is necessary to identify optimal strategies for teaching and assessing competence in these areas. In addition, a substantial number of trainees were prohibited from graduating or required remediation due to ethics and professionalism issues, suggesting an impact of unethical and unprofessional behavior on resident attrition.

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Implementing ERAS: how we achieved success within an anesthesia department

BMC Anesthesiology ◽

10.1186/s12871-021-01260-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Dan B. Ellis ◽

Aalok Agarwala ◽

Elena Cavallo ◽

Pam Linov ◽

Michael K. Hidrue ◽

...

Keyword(s):

General Hospital ◽

Residency Program ◽

Enhanced Recovery ◽

Enhanced Recovery After Surgery ◽

Massachusetts General Hospital ◽

Educational Interventions ◽

Nurse Anesthetists ◽

Intervention Period ◽

Post Intervention ◽

Anesthesia Group

Abstract Background The Massachusetts General Hospital is a large, quaternary care institution with 58 operating rooms, 164 anesthesiologists, 76 certified nurse anesthetists (CRNAs), an anesthesiology residency program that admits 25 residents annually, and 35 surgeons who perform laparoscopic, vaginal, and open hysterectomies. In March of 2018, our institution launched an Enhanced Recovery After Surgery (ERAS) pathway for patients undergoing hysterectomy. To implement the anesthesia bundle of this pathway, an intensive 14-month educational endeavor was created and put into effect. There were no subsequent additional educational interventions. Methods We retrospectively reviewed records of 2570 patients who underwent hysterectomy between October 2016 and March 2020 to determine adherence to the anesthesia bundle of the ERAS Hysterectomy pathway. RESULTS: Increased adherence to the four elements of the anesthesia bundle (p < 0.001) was achieved during the intervention period. Compliance with the pathway was sustained in the post-intervention period despite no additional actions. Conclusions Implementing the anesthesia bundle of an ERAS pathway in a large anesthesia group with diverse providers successfully occurred using implementation science-based approach of intense interventions, and these results were maintained after the intervention ceased.

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Engage me: Will residency program directors listen?

Annals of Medicine and Surgery ◽

10.1016/j.amsu.2021.102549 ◽

2021 ◽

pp. 102549

Author(s):

Sruthi Selvakumar ◽

Mark McKenney ◽

Adel Elkbuli

Keyword(s):

Residency Program ◽

Program Directors ◽

Residency Program Directors

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Initial Experience Integrating a Hands-On Innovation Curriculum Into a Radiology Residency Program and Department

Journal of the American College of Radiology ◽

10.1016/j.jacr.2020.04.020 ◽

2020 ◽

Vol 17 (10) ◽

pp. 1329-1333

Author(s):

Marc D. Succi ◽

Brian F. Zamarron ◽

Florian J. Fintelmann ◽

Katherine P. Andriole ◽

Mark P. Ottensmeyer ◽

...

Keyword(s):

Residency Program ◽

Initial Experience ◽

Hands On ◽

Radiology Residency

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A Resident-Driven Mobile Evaluation System Can Be Used to Augment Traditional Surgery Rotation Evaluations

The American Surgeon ◽

10.1177/00031348211011130 ◽

2021 ◽

pp. 000313482110111

Author(s):

Kurun Partap S Oberoi ◽

Akia D Caine ◽

Jacob Schwartzman ◽

Sayeeda Rab ◽

Amber L Turner ◽

...

Keyword(s):

Medical Education ◽

Graduate Medical Education ◽

General Surgery ◽

Residency Program ◽

Evaluation System ◽

Clinical Rotation ◽

Web Based ◽

General Surgery Residency ◽

Surgery Residency Program ◽

To Receive

Background The Accreditation Council for Graduate Medical Education requires residents to receive milestone-based evaluations in key areas. Shortcomings of the traditional evaluation system (TES) are a low completion rate and delay in completion. We hypothesized that adoption of a mobile evaluation system (MES) would increase the number of evaluations completed and improve their timeliness. Methods Traditional evaluations for a general surgery residency program were converted into a web-based form via a widely available, free, and secure application and implemented in August 2017. After 8 months, MES data were analyzed and compared to that of our TES. Results 122 mobile evaluations were completed; 20% were solicited by residents. Introduction of the MES resulted in an increased number of evaluations per resident ( P = .0028) and proportion of faculty completing evaluations ( P = .0220). Timeliness also improved, with 71% of evaluations being completed during one’s clinical rotation. Conclusions A resident-driven MES is an inexpensive and effective method to augment traditional end-of-rotation evaluations.

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