scholarly journals Out-of-Match Residency Offers: The Possible Extent and Implications of Prematching in Graduate Medical Education

2010 ◽  
Vol 2 (3) ◽  
pp. 327-333 ◽  
Author(s):  
Robert V. Wetz ◽  
Charles B. Seelig ◽  
Georges Khoueiry ◽  
Kera F. Weiserbs
Keyword(s):  
Internal Medicine ◽  
United States ◽  
Primary Care ◽  
Medical Education ◽  
Family Medicine ◽  
Rank Order ◽  
Medical Doctors ◽  
Spearman Rank ◽  
Fellowship Programs ◽  
Career Preferences

Abstract Background When the data from the National Resident Matching Program (NRMP) are used to analyze trends in medical students' career preferences, positions offered outside the match are omitted. The purpose of the study was to evaluate the extent and nature of out-of-match residency offers. Methods We obtained total resident complements and postgraduate year-1 positions offered in 7 specialties in 2007 and compared these with the 2007 NRMP match data. We compared the percentage of positions offered outside the match to “success” in matching United States medical doctors (USMDs) and to the availability of fellowship positions, using the Spearman rank order test (SROT). Results A total of 18 030 postgraduate year-1 positions were offered in 9 specialty areas. Of 15 205 positions offered in the match, 54% were taken by USMDs. The percentage of outside-the-match offers was found to vary by specialty, from 7% in obstetrics-gynecology to 23% in internal medicine, and was inversely correlated with the specialty's “success” in matching USMDs (SROT  =  −0.87). The 3 nonprocedural primary care specialties (internal medicine, family medicine, and pediatrics) accounted for 10 091 (46.2%) of the 21 845 total positions offered in the match, with 4401 (43.6%) offered almost entirely to non-USMDs. Another 2467 positions were offered outside the match, resulting in 6868 positions offered to non-USMDs (55% of all primary care positions). In internal medicine, the percentage of outside-the-match offers was significantly and inversely associated with the availability of intrainstitutional fellowship programs (P < .0001). Prematching of independent applicants was significantly higher in primary care than in procedural-lifestyle programs (P < .0001). Conclusion The NRMP's match data do not account for positions filled outside the match, a finding that appears to be significant. In 2007, 1 in 5 positions in primary care was offered outside the match.

scholarly journals Medicine in the 21st Century: Recommended Essential Geriatrics Competencies for Internal Medicine and Family Medicine Residents

2010 ◽  
Vol 2 (3) ◽  
pp. 373-383 ◽  
Author(s):  
Brent C. Williams ◽  
Gregg Warshaw ◽  
Anne Rebecca Fabiny ◽  
Nancy Lundebjerg, MPA ◽  
Annette Medina-Walpole ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Primary Care ◽  
Medical Education ◽  
Family Medicine ◽  
Graduate Medical Education ◽  
Care Hospital ◽  
Residency Programs ◽  
Accreditation Council ◽  
Graduate Medical ◽  
Family Medicine Residents

Abstract Background Physician workforce projections by the Institute of Medicine require enhanced training in geriatrics for all primary care and subspecialty physicians. Defining essential geriatrics competencies for internal medicine and family medicine residents would improve training for primary care and subspecialty physicians. The objectives of this study were to (1) define essential geriatrics competencies common to internal medicine and family medicine residents that build on established national geriatrics competencies for medical students, are feasible within current residency programs, are assessable, and address the Accreditation Council for Graduate Medical Education competencies; and (2) involve key stakeholder organizations in their development and implementation. Methods Initial candidate competencies were defined through small group meetings and a survey of more than 100 experts, followed by detailed item review by 26 program directors and residency clinical educators from key professional organizations. Throughout, an 8-member working group made revisions to maintain consistency and compatibility among the competencies. Support and participation by key stakeholder organizations were secured throughout the project. Results The process identified 26 competencies in 7 domains: Medication Management; Cognitive, Affective, and Behavioral Health; Complex or Chronic Illness(es) in Older Adults; Palliative and End-of-Life Care; Hospital Patient Safety; Transitions of Care; and Ambulatory Care. The competencies map directly onto the medical student geriatric competencies and the 6 Accreditation Council for Graduate Medical Education Competencies. Conclusions Through a consensus-building process that included leadership and members of key stakeholder organizations, a concise set of essential geriatrics competencies for internal medicine and family medicine residencies has been developed. These competencies are well aligned with concerns for residency training raised in a recent Medicare Payment Advisory Commission report to Congress. Work is underway through stakeholder organizations to disseminate and assess the competencies among internal medicine and family medicine residency programs.

52. Simulation based training improves resident competence in the performance of critical resuscitation procedures

2007 ◽  
Vol 30 (4) ◽  
pp. 56
Author(s):  
I. Rigby ◽  
I. Walker ◽  
T. Donnon ◽  
D. Howes ◽  
J. Lord
Keyword(s):  
Internal Medicine ◽  
Emergency Medicine ◽  
Medical Education ◽  
Family Medicine ◽  
Training Program ◽  
Correlation Coefficient ◽  
Training Programs ◽  
Self Assessment ◽  
Procedural Skills ◽  
Simulation Based

We sought to assess the impact of procedural skills simulation training on residents’ competence in performing critical resuscitation skills. Our study was a prospective, cross-sectional study of residents from three residency training programs (Family Medicine, Emergency Medicine and Internal Medicine) at the University of Calgary. Participants completed a survey measuring competence in the performance of the procedural skills required to manage hemodynamic instability. The study intervention was an 8 hour simulation based training program focused on resuscitation procedure psychomotor skill acquisition. Competence was criterion validated at the Right Internal Jugular Central Venous Catheter Insertion station by an expert observer using a standardized checklist (Observed Structured Clinical Examination (OSCE) format). At the completion of the simulation course participants repeated the self-assessment survey. Descriptive Statistics, Cronbach’s alpha, Pearson’s correlation coefficient and Paired Sample t-test statistical tools were applied to the analyze the data. Thirty-five of 37 residents (9 FRCPC Emergency Medicine, 4 CCFP-Emergency Medicine, 17 CCFP, and 5 Internal Medicine) completed both survey instruments and the eight hour course. Seventy-two percent of participants were PGY-1 or 2. Mean age was 30.7 years of age. Cronbach’s alpha for the survey instrument was 0.944. Pearson’s Correlation Coefficient was 0.69 (p < 0.001) for relationship between Expert Assessment and Self-Assessment. The mean improvement in competence score pre- to post-intervention was 6.77 (p < 0.01, 95% CI 5.23-8.32). Residents from a variety of training programs (Internal Medicine, Emergency Medicine and Family Medicine) demonstrated a statistically significant improvement in competence with critical resuscitation procedural skills following an intensive simulation based training program. Self-assessment of competence was validated using correlation data based on expert assessments. Dawson S. Procedural simulation: a primer. J Vasc Interv Radiol. 2006; 17(2.1):205-13. Vozenilek J, Huff JS, Reznek M, Gordon JA. See one, do one, teach one: advanced technology in medical education. Acad Emerg Med. 2004; 11(11):1149-54. Ziv A, Wolpe PR, Small SD, Glick S. Simulation-based medical education: an ethical imperative. Acad Med. 2003; 78(8):783-8.

scholarly journals Osteopathic students and graduates matching into pathology residency, 2011–2020

2021 ◽  
Vol 121 (2) ◽  
pp. 149-156
Author(s):  
Ryan Philip Jajosky ◽  
Hannah C. Coulson ◽  
Abric J. Rosengrant ◽  
Audrey N. Jajosky ◽  
Philip G. Jajosky
Keyword(s):  
United States ◽  
Primary Care ◽  
Medical Education ◽  
Accreditation System ◽  
Senior Year ◽  
Medical Specialties ◽  
Residency Programs ◽  
The Third ◽  
The Past ◽  
Residency Match

Abstract Context In the past decade, two changes have affected the pathology residency match. First, the American Osteopathic Association (AOA) Match, which did not offer pathology residency, became accredited under a single graduate medical education (GME) system with the Main Residency Match (MRM), which offers pathology residency. Second, substantially fewer United States senior-year allopathic medical students (US MD seniors) matched into pathology residency. Objective To determine whether there were major changes in the number and percentage of osteopathic students and physicians (DOs) matching into pathology residency programs over the past decade. Methods Pathology match outcomes for DOs from 2011 to 2020 were obtained by reviewing AOA Match data from the National Matching Services and MRM data from the National Resident Matching Program (NRMP). The number of DOs that filled pathology positions in the MRM was divided by the total number of pathology positions filled in the MRM to calculate the percentage of pathology positions taken by DOs. Results Over the past decade, there was a 109% increase in the total number of DOs matching into pathology residency (34 in 2011 vs. 71 in 2020). During this time, there was a 23.3% increase in the total number of pathology positions filled in the MRM (476 in 2011 vs. 587 in 2020). Thus, the percentage of pathology residency positions filled by DOs increased from 7.1% in 2011 to 12.1% in 2020. The substantial increase of DOs in pathology occurred simultaneously with a 94.2% increase in the total number of DOs filling AOA/MRM “postgraduate year 1” (PGY-1) positions (3201 in 2011 vs. 6215 in 2020). Thus, the percentage of DOs choosing pathology residency has remained steady (1.06% in 2011 and 1.14% in 2020). In 2020, pathology had the third lowest percentage of filled PGY-1 residency positions taken by DOs, out of 15 major medical specialties. Conclusion The proportion of DOs choosing pathology residency was stable from 2011 to 2020 despite the move to a single GME accreditation system and the stark decline in US MD seniors choosing pathology. In 2020, a slightly higher percentage of DOs (1.14%) chose pathology residency than US MD seniors (1.13%). Overall, DOs more often choose other medical specialties, including primary care. Additional studies are needed to determine why fewer US MD seniors, but not fewer DOs, are choosing pathology residency.

scholarly journals Unverifiable Academic Work by Applicants to Primary Care Sports Medicine Fellowship Programs in the United States

2016 ◽  
Vol 8 (5) ◽  
pp. 767-770
Author(s):  
Robert B. Stevens ◽  
John R. Hatzenbuehler ◽  
William W. Dexter ◽  
Amy E. Haskins ◽  
Christina T. Holt
Keyword(s):  
United States ◽  
Primary Care ◽  
Sports Medicine ◽  
The United States ◽  
Medical Society ◽  
Medical Librarian ◽  
Conference Organization ◽  
Fellowship Programs ◽  
Medical Subspecialty ◽  
Application Requirements

ABSTRACT Background  In 2008, it was shown that 11% of applications to a primary care sports medicine program contained unverifiable citations for publications. In 2009, the American Medical Society for Sports Medicine changed the application requirements, requiring proof that all claimed citations (publications and presentations) be included with the fellowship application. Objective  We determined the rate of unverifiable academic citations in applications to primary care sports medicine fellowship programs after proof of citations was required. Methods  We retrospectively examined all applications submitted to 5 primary care sports medicine fellowship programs across the country for 3 academic years (2010–2013), out of 108 to 131 programs per year. For claimed citations that did not include proof of publication or presentation, we attempted to verify them using PubMed and Google Scholar searches, a medical librarian search, and finally directly contacting the publisher or sponsoring conference organization for verification. Results  Fifteen of 311 applications contained at least 1 unverifiable citation. The total unverifiable rate was 4.8% (15 of 311) for publications and 11% (9 of 85) for presentations. These rates were lower than previously published within the same medical subspecialty. Conclusions  After requiring proof of publication and presentation citations within applications to primary care sports medicine fellowship programs, unverifiable citations persisted but were less than previously reported.

scholarly journals International Medical Graduates in the US Physician Workforce and Graduate Medical Education: Current and Historical Trends

2018 ◽  
Vol 10 (2) ◽  
pp. 214-218 ◽  
Author(s):  
Awad A. Ahmed ◽  
Wei-Ting Hwang ◽  
Charles R. Thomas ◽  
Curtiland Deville
Keyword(s):  
Internal Medicine ◽  
Medical Education ◽  
Family Medicine ◽  
Graduate Medical Education ◽  
International Medical ◽  
Physician Workforce ◽  
International Medical Graduates ◽  
Graduate Medical ◽  
Medical Graduates ◽  
The Us

ABSTRACT Background  Data show that international medical graduates (IMGs), both US and foreign born, are more likely to enter primary care specialties and practice in underserved areas. Comprehensive assessments of representation trends for IMGs in the US physician workforce are limited. Objective  We reported current and historical representation trends for IMGs in the graduate medical education (GME) training pool and US practicing physician workforce. Methods  We compared representation for the total GME and active practicing physician pools with the 20 largest residency specialties. A 2-sided test was used for comparison, with P &lt; .001 considered significant. To assess significant increases in IMG GME trainee representation for the total pool and each of the specialties from 1990–2015, the slope was estimated using simple linear regression. Results  IMGs showed significantly greater representation among active practicing physicians in 4 specialties: internal medicine (39%), neurology (31%), psychiatry (30%), and pediatrics (25%). IMGs in GME showed significantly greater representation in 5 specialties: pathology (39%), internal medicine (39%), neurology (36%), family medicine (32%), and psychiatry (31%; all P &lt; .001). Over the past quarter century, IMG representation in GME has increased by 0.2% per year in the total GME pool, and 1.1% per year for family medicine, 0.5% for obstetrics and gynecology and general surgery, and 0.3% for internal medicine. Conclusions  IMGs make up nearly a quarter of the total GME pool and practicing physician workforce, with a disproportionate share, and larger increases over our study period in certain specialties.

scholarly journals Ophthalmology training and competency levels in caring for patients with ophthalmic complaints among United States internal medicine, emergency medicine, and family medicine residents

2019 ◽  
Vol 16 ◽  
pp. 25 ◽  
Author(s):  
Christopher Daniel Gelston ◽  
Jennifer Landrigan Patnaik
Keyword(s):  
Internal Medicine ◽  
United States ◽  
Emergency Medicine ◽  
Family Medicine ◽  
Educational Training ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Residency Programs ◽  
Confidence Levels ◽  
Family Medicine Residents

Purpose: To evaluate ophthalmic educational training and confidence in caring for patients with ophthalmic complaints among internal, emergency, and family medicine residents in the United States.Methods: A 41-item cross-sectional survey was sent to the directors of 529 internal medicine, 237 emergency medicine, and 629 family medicine residency programs, who distributed it to residents in those programs. The survey included the number of ophthalmic education hours residents received. Respondents were asked to rate their confidence in performing an ophthalmic exam and treating patients with ocular conditions using a 5-point Likert scale ranging from “not confident” to “very confident.”Results: In total, 92.5% of internal medicine, 66.8% of emergency medicine, and 74.5% of family medicine residents received less than 10 hours of ophthalmic education during residency. Most respondents (internal medicine, 59.1%; emergency medicine, 76.0%; family medicine, 65.7%) reported that patients with ocular complaints constituted 1%–5% of visits. Mean±standard deviation confidence levels in performing an eye exam and treating patients with ophthalmic conditions were highest in emergency medicine residency programs (2.9±0.7), followed by family medicine (2.3±0.6) and internal medicine (2.2±0.6). A higher reported number of ophthalmic education hours in residency was associated with greater confidence among emergency (P<0.001), family (P<0.001), and internal (P=0.005) medicine residents.Conclusion: Internal, emergency, and family medicine residents receive limited ophthalmic education, as reflected by their overall low confidence levels in performing an ophthalmic exam and treating patients with ocular complaints. An increase in ophthalmic educational hours during their residencies is recommended to improve upon this knowledge gap.

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