Neuroscience education of undergraduate medical students. Part I: role of neurosurgeons as educators

2000 ◽  
Vol 92 (4) ◽  
pp. 637-641 ◽  
Author(s):  
Daniel K. Resnick
Keyword(s):  
Primary Care ◽  
Medical Student ◽  
Medical Students ◽  
Primary Care Physicians ◽  
Carotid Artery Disease ◽  
Medical Student Education ◽  
Low Back ◽  
Content Type ◽  
Artery Disease ◽  
Fine Print

Object. Economic, demographic, and political pressures have mandated that medical schools increase the number of primary care physicians. The goal of this study was to determine the nature of the average medical student's exposure to neurosurgical issues.Methods. Surveys were sent to every neurosurgical program director in the United States and to the dean of every medical school in North America, querying the extent of neurosurgical involvement in medical student education. Specifically, the respondents were asked how medical students were educated about the management of low-back pain and radiculopathy, carotid artery disease, head and spine trauma, and headache.Survey results were obtained from 65 (67%) of 97 neurosurgery program directors and from 57 (40%) of 143 medical school deans. Only one program in North America reported having a required neurosurgical rotation for all medical students, and just over 50% (29 of 57 deans and 34 of 65 program directors) reported that neurosurgery was an option in a required neuroscience or surgical subspecialty course. Neurosurgeons were not listed among the top three sources for medical student education in the topics of low-back pain and radiculopathy or carotid artery disease. Neurosurgeons were the most frequently cited source of education regarding head and spinal injuries, despite the fact that the majority of medical schools do not have any required medical student exposure to neurosurgery.Conclusions. With rare exceptions, neurosurgeons are not significantly involved in the education of medical students concerning the management of common neurosurgical issues. As a result, most emerging primary care physicians are taught about these issues by other specialists or not at all. The implications of this situation are discussed.

Neuroscience education of undergraduate medical students. Part II: outcome improvement

2000 ◽  
Vol 92 (4) ◽  
pp. 642-645 ◽  
Author(s):  
Daniel K. Resnick ◽  
Lincoln F. Ramirez
Keyword(s):  
Primary Care ◽  
Medical Students ◽  
Student Performance ◽  
Primary Care Physicians ◽  
Pressure Head ◽  
Rehabilitation Medicine ◽  
Spine Injury ◽  
Undergraduate Medical Students ◽  
Content Type ◽  
Fine Print

Object. Because of political and economic pressures, primary care physicians are now charged with greater responsibility for the care of patients with disease processes definitively managed by neurosurgeons. The goal of this study was to establish the feasibility and efficacy of a neurosurgical curriculum designed to teach future primary care physicians about these diseases.Methods. A compact, seven-lecture curriculum was developed to teach 3rd-year medical students about degenerative spine disease, stroke, tumor- and hydrocephalus-related raised intracranial pressure, head and spine injury, and subarachnoid hemorrhage. This curriculum was given as part of a 6-week pilot course that included neurology, neurosurgery, ophthalmology, and rehabilitation medicine components. This course was administered to two groups of 18 medical students, and an examination was administered at the end of the pilot course. The same examination was administered to an additional 19 students immediately after their completion of the neurology course currently required.Students enrolled in the pilot neuroscience course performed significantly better (p < 0.001) on the examination than those who had completed the standard neurology course. Striking improvements were noted in the recognition and management of head injury, hydrocephalus, and radiculopathy.Conclusions. Inclusion of a short neurosurgery-related curriculum in a combined neuroscience course significantly improved student performance on an examination focusing on the recognition and management of common neurosurgical disorders. Because primary care physicians are responsible for the initial recognition and management of these disorders, the knowledge gained may lead to improved patient care.

The scotomata of carotid artery disease as I remember them

1973 ◽  
Vol 39 (3) ◽  
pp. 390-393 ◽  
Author(s):  
Francis Murphey
Keyword(s):  
Carotid Artery ◽  
Personal Experience ◽  
Carotid Artery Disease ◽  
Atheromatous Plaque ◽  
Content Type ◽  
Artery Disease ◽  
Fine Print

✓ The author relates his personal experience with scotomata, in particular as a forewarning of occlusion of the carotid artery in the neck. His hypotheses that the phenomena were due at least in part to flecks of atheromatous plaque was substantiated by the subsequent surgical findings when such a plaque was successfully removed and the scotomata ceased.

Neurosurgical manpower: the physician's viewpoint

1982 ◽  
Vol 56 (5) ◽  
pp. 609-614
Author(s):  
Clark Watts ◽  
Robert C. Mendenhall ◽  
Stephen E. Radecki ◽  
Roger A. Girard
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
National Study ◽  
Content Type ◽  
Fine Print

✓ This paper reports a national study of physicians in 24 medical and surgical specialties, and reveals the opinions of neurosurgeons and their professional colleagues with regard to the adequacy of the supply of neurosurgical manpower. Among neurosurgeons, 30.4% believe the supply to be excessive, 60.1% think it is about right, 7.5% believe that there is a shortage, and 2.0% have no opinion. Neurologists' opinions do not differ significantly from those of neurosurgeons, but physicians and surgeons in 22 other specialties are significantly less likely to regard the supply as excessive, and are more likely to perceive a shortage. Primary care physicians, as a group, are most likely to perceive a shortage, and least likely to indicate an excess. Among the 24 specialties studied, 9.3% of physicians believe the supply of neurosurgeons to be excessive, 55.1% think it is about right, 22.9% believe that there is a shortage, and 12.8% have no opinion.

scholarly journals A Call to Action Against Rising Medical Student Tuition

2019 ◽  
Vol 9 (1) ◽  
pp. 28-32
Author(s):  
Nawid Sayed ◽  
Craig Rodrigues ◽  
Victoria Reedman ◽  
Sydney McQueen
Keyword(s):  
Primary Care ◽  
Socioeconomic Status ◽  
Medical Student ◽  
Medical Students ◽  
Medical School ◽  
Primary Care Physicians ◽  
Primary Caregivers ◽  
Tuition Fees ◽  
Call To Action ◽  
Student Demographics

There is growing concern among medical students regarding the unprecedented increases in medical school tuition fees, which has been far exceeding inflation. One consideration is how these increasing fees and resulting debt may be impacting student demographics, particularly with respect to socioeconomic status, as well the types of clinical careers that medical students are pursuing, given the lower average salaries earned by primary caregivers. This second point is concerning given the shortage of primary care physicians in Canada.

scholarly journals The Effect of Teaching Family Medicine Clerkship Students on Preceptor Productivity

PRiMER ◽  
2020 ◽  
Vol 4 ◽  
Author(s):  
Tomoko Sairenji ◽  
Samuel Griffin ◽  
Misbah Keen
Keyword(s):  
Primary Care ◽  
Medical Student ◽  
Family Medicine ◽  
Student Teaching ◽  
Primary Care Physicians ◽  
Clinical Teaching ◽  
Medical Student Education ◽  
Billing Data ◽  
Medicine Clerkship ◽  
Number Of Patients

Introduction: High-quality, experiential learning in outpatient settings is indispensable for medical student education; however these settings are difficult to recruit and retain. The majority of primary care physicians are employed by organizations and are under pressure to increase their relative value unit (RVU) production. Although the common perception that teaching medical students decreases productivity is unproven, it is likely a barrier for primary care physicians pursuing clinical teaching. We sought to investigate whether medical student teaching affects clinical productivity. Methods: We recruited 15 family medicine (FM) clerkship sites to participate in our study via email and at an in-person meeting. For each preceptor, we collected billing data in the form of current procedural terminology (CPT) codes for all patient encounters and the number of patients seen per half-day for when the preceptor had a student and when they did not. We converted CPT codes to RVU data. We compared differences in productivity for each individual preceptor, and we used a paired t test to examine collective data with and without a student. Results: Ten preceptors at six FM clerkship sites provided reliable data. The average RVU per half-day without a student was 10.84, and it was slightly higher at 11.25 when a student was present (P=.74). The average number of patients seen per half-day without a student was 8.32 and it was slightly lower at 7.87 when a student was present (P=.58). Conclusion: This study shows promising data that teaching students in the outpatient setting does not decrease preceptor productivity. This pilot study can lead to a larger-scale exploration of family medicine preceptor productivity in different settings and institutions.

Ultrasonic diagnosis of carotid artery disease

1971 ◽  
Vol 35 (1) ◽  
pp. 40-44 ◽  
Author(s):  
Jørgen Kvist Kristensen ◽  
Mogens Eiken ◽  
Fritz von Wowern
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Carotid Artery Disease ◽  
Ultrasonic Diagnosis ◽  
Diagnostic Aid ◽  
Content Type ◽  
Oscilloscope Screen ◽  
Artery Disease ◽  
Fine Print

✓ Ultrasonic echoes from an artery, registered on an oscilloscope screen as vertical deflections from a horizontal baseline, exhibit pulse-synchronous displacements on the x-axis as well as variations in amplitude. The visualization of these echo movements can constitute the basis for an evaluation of arterial conditions comparable to palpation of the pulse but has the advantage of being applicable to arteries that cannot be palpated. The method has been applied to the internal carotid artery in 325 patients, and an evaluation of the method is given on the basis of a comparison with 166 angiograms of the artery. The method has proven to be a valuable diagnostic aid in studying patients suspected of having carotid artery disease.

Stent placement for the treatment of occlusive atherosclerotic carotid artery disease in patients with concomitant coronary artery disease

2002 ◽  
Vol 96 (3) ◽  
pp. 490-496 ◽  
Author(s):  
Demetrius K. Lopes ◽  
Robert A. Mericle ◽  
Giuseppe Lanzino ◽  
Ajay K. Wakhloo ◽  
Lee R. Guterman ◽  
...  
Keyword(s):  
New York ◽  
Coronary Artery ◽  
Carotid Artery ◽  
Stent Placement ◽  
Carotid Artery Disease ◽  
Heart Association ◽  
Content Type ◽  
Carotid Artery Stent ◽  
Artery Disease ◽  
Fine Print

Object. The authors report their experience with carotid artery stent placement (CASP) in patients with concomitant carotid artery (CA) and coronary artery (CorA) diseases. Methods. In a review of 320 consecutive patients who underwent CASP, the authors identified 49 with severe CorA disease in addition to significant CA stenosis, who had undergone CASP before planned CorA bypass grafting (CorABG). The average age of these 49 patients was 68 years. In 39 patients (80%) the New York Heart Association functional classification grade was IV and in 10 the grade was III. In 26 patients 50% or greater stenosis of the left main CorA was found. Seventeen patients (35%) suffered from either significant hemodynamic contralateral CA stenosis (> 60% stenosis; eight patients) or contralateral CA occlusion (nine patients). Sixteen patients (33%) had symptomatic CA disease. No cerebrovascular events occurred during CorABG. Four patients (8%) died of cardiac arrest and one patient (2%) suffered a major stroke within 30 days after the CorABG procedure. No patient experienced clinically significant recurrent CA stenosis during the study period (average clinical follow-up period 27 months). Conclusions. Carotid artery stent placement should be considered as an alternative for the management of concomitant CA and CorA diseases. These preliminary results support the feasibility and durability of CASP in the population studied.

High frequency of otolaryngology/ENT encounters in Canadian primary care despite low medical undergraduate

2021 ◽  
Author(s):  
Brendan Sorichetti ◽  
Julie Pauwels ◽  
Thomas Jacobs ◽  
Neil Chadha ◽  
Emelie Kozak ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Students ◽  
Primary Care Physicians ◽  
Pediatric Population ◽  
Adult Population ◽  
Care Facility ◽  
Symptom Presentation ◽  
Undergraduate Medical Students ◽  
Related Symptom ◽  
Medical Undergraduate

Otolaryngology involves the treatment of patients with diseases and disorders of the ear, nose, throat (ENT), and related structures of the head and neck. Many medical students in Canada have limited experiences in ENT and a vast majority of these students go on to pursue a career as primary care physicians. Physicians at a primary care facility classified patient’s visits as either being “ENT” related or not, to assess the amount of ENT related concerns they typically encounter. The data was collected separately in the summer and winter months to assess any seasonal variability. One in eight patient encounters presented with an ENT related concern. The percentage of ENT related symptom presentation visits in the pediatric population for both data collection periods (29%) was more than three times that of the adult population (9%). The rate of ENT symptom presentation in both adult and pediatric populations was not affected by seasonality. Primary care physicians will encounter new patients presenting with ENT related concerns quite frequently. This is especially true in the pediatric patient population. Increased ENT medical education is both necessary and essential for undergraduate medical students, residents, and primary care physicians.

scholarly journals Primary Care Tracks in Medical Schools

PRiMER ◽  
2019 ◽  
Vol 3 ◽  
Author(s):  
Maribeth P. Williams ◽  
Denny Fe Agana ◽  
Benjamin J. Rooks ◽  
Grant Harrell ◽  
Rosemary A. Klassen ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Students ◽  
Family Medicine ◽  
Primary Care Physicians ◽  
Response Rate ◽  
Positive Impact ◽  
Medical Schools ◽  
Clerkship Director ◽  
Medicine Clerkship ◽  
Faculty Mentorship

Introduction: With the estimated future shortage of primary care physicians there is a need to recruit more medical students into family medicine. Longitudinal programs or primary care tracks in medical schools have been shown to successfully recruit students into primary care. The aim of this study was to examine the characteristics of primary care tracks in departments of family medicine.  Methods: Data were collected as part of the 2016 CERA Family Medicine Clerkship Director Survey. The survey included questions regarding the presence and description of available primary care tracks as well as the clerkship director’s perception of impact. The survey was distributed via email to 125 US and 16 Canadian family medicine clerkship directors.  Results: The response rate was 86%. Thirty-five respondents (29%) reported offering a longitudinal primary care track. The majority of tracks select students on a competitive basis, are directed by family medicine educators, and include a wide variety of activities. Longitudinal experience in primary care ambulatory settings and primary care faculty mentorship were the most common activities. Almost 70% of clerkship directors believe there is a positive impact on students entering primary care.  Conclusions: The current tracks are diverse in what they offer and could be tailored to the missions of individual medical schools. The majority of clerkship directors reported that they do have a positive impact on students entering primary care.

scholarly journals Video in situ simulation for medical student education during the COVID-19 pandemic

2021 ◽  
Author(s):  
Monika Bilic ◽  
Alim Nagji ◽  
Erich Hanel
Keyword(s):  
Medical Student ◽  
Medical Students ◽  
Small Groups ◽  
Medical Student Education ◽  
Simple Design ◽  
In Situ Simulation ◽  
Student Education

Implication statement The COVID-19 pandemic has limited in-person experiences for medical students, especially in situations involving aerosol-generating procedures. We designed a video in situ simulation to orient students to critical steps in COVID-19 intubation algorithms. Small groups of students were paired virtually with facilitators (faculty and residents) and watched a video of an in situ simulation of emergency staff performing a protected intubation, with discussion points appearing on screen at discrete times. The simple design drives engagement, discussion and allows for scheduling flexibility with no risk to the learners. It can be adapted to several different scenarios or levels of training.

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