scholarly journals Mandated State Medical Licensing Board Disclosures Regarding Resident Performance

2019 ◽  
Vol 11 (3) ◽  
pp. 307-312 ◽  
Author(s):  
Tiffany Murano ◽  
Michal Gajewski ◽  
Michael Anana ◽  
Machteld Hillen ◽  
Anastasia Kunac ◽  
...  
Keyword(s):  
Performance Metrics ◽  
Core Competencies ◽  
Disciplinary Action ◽  
Washington Dc ◽  
Disciplinary Actions ◽  
Academic Competency ◽  
Residency Programs ◽  
Resident Performance ◽  
Medical Licensing ◽  
Leave Of Absence

ABSTRACT Background State medical licensing boards ask program directors (PDs) to complete verification of training (VOT) forms for licensure. While residency programs use Accreditation Council for Graduate Medical Education core competencies, there is no uniform process or set of metrics that licensing boards use to ascertain if academic competency was achieved. Objective We determined the performance metrics PDs are required to disclose on state licensing VOT forms. Methods VOT forms for allopathic medical licensing boards for all 50 states, Washington, DC, and 5 US territories were obtained via online search and reviewed. Questions were categorized by disciplinary action (investigated, disciplined, placed on probation, expelled, terminated); documents placed on file; resident actions (leave of absence, request for transfer, unexcused absences); and non-disciplinary actions (remediation, partial or no credit, non-renewal, non-promotion, extra training required). Three individuals reviewed all forms independently, compared results, and jointly resolved discrepancies. A fourth independent reviewer confirmed all results. Results Most states and territories (45 of 56) accept the Federation Credentials Verification Service (FCVS), but 33 states have their own VOT forms. Ten states require FCVS use. Most states ask questions regarding probation (43), disciplinary action (41), and investigation (37). Thirty-four states and territories ask about documents placed on file, 36 ask about resident actions, and 7 ask about non-disciplinary actions. Eight states' VOT forms ask no questions regarding resident performance. Conclusions Among the states and territories, there is great variability in VOT forms required for allopathic physicians. These forms focus on disciplinary actions and do not ask questions PDs use to assess resident performance.

Applications of Narrative Medicine to Surgical Education

2021 ◽  
pp. 000313482110298
Author(s):  
Carol EH Scott-Conner ◽  
Divyansh Agarwal
Keyword(s):  
Medical Education ◽  
Undergraduate Medical Education ◽  
Surgical Education ◽  
Core Competencies ◽  
Narrative Medicine ◽  
Medical Schools ◽  
Residency Programs ◽  
Surgical Residency

Narrative medicine describes the application of story to medical education and practice. Although it has been implemented successfully in many medical schools as a part of undergraduate medical education, applications to the residency environment have been relatively limited. There are virtually no data concerning the adoption of narrative medicine within surgical residencies. This paper provides a brief introduction to the formal discipline of narrative medicine. We further discuss how storytelling is already used in surgical education and summarize the literature on applications of narrative medicine to residents in other specialties. The relevance of narrative medicine to the ACGME core competencies is explored. We conclude with specific suggestions for implementation of narrative medicine within surgical residency programs.

scholarly journals Empathy Can Be Taught, and Patients Teach it Best

2021 ◽  
Vol 8 ◽  
pp. 238212052110003
Author(s):  
Sudhagar Thangarasu ◽  
Gowri Renganathan ◽  
Piruthiviraj Natarajan
Keyword(s):  
Medical Education ◽  
Graduate Medical Education ◽  
Core Competencies ◽  
Core Competency ◽  
Role Modeling ◽  
Residency Programs ◽  
Graduate Medical ◽  
Mixed Messages ◽  
Attending Physicians ◽  
Medical Education Curriculum

Empathy toward patients is an essential skill for a physician to deliver the best care for any patient. Empathy also protects the physician from moral injury and decreases the chances for malpractice litigations. The current graduate medical education curriculum allows trainees to graduate without getting focused training to develop empathy as a core competency domain. The tools to measure empathy inherently lack validity. The accurate measure of the provider’s empathy comes from the patient’s perspectives of their experience and their feedback, which is rarely reaching the trainee. The hidden curriculum in residency programs gives mixed messages to trainees due to inadequate role modeling by attending physicians. This narrative style manuscript portrays a teachable moment at the bedside vividly. The teaching team together reflected upon the lack of empathy, took steps to resolve the issue. The attending demonstrated role modeling as an authentic and impactful technique to teach empathy. The conclusion includes a proposal to include the patient’s real-time feedback to trainees as an essential domain under Graduate Medical Education core competencies of professionalism and patient care.

scholarly journals Comprehensive Assessment of Struggling Learners Referred to a Graduate Medical Education Remediation Program

2017 ◽  
Vol 9 (6) ◽  
pp. 763-767 ◽  
Author(s):  
Karen M. Warburton ◽  
Eric Goren ◽  
C. Jessica Dine
Keyword(s):  
Core Competencies ◽  
Correct Diagnosis ◽  
Medical Knowledge ◽  
Comprehensive Assessment ◽  
Faculty Members ◽  
Assessment Process ◽  
Disciplinary Action ◽  
University Of Pennsylvania ◽  
Struggling Learners ◽  
Next Accreditation System

ABSTRACT Background  Implementation of the Next Accreditation System has provided a standardized framework for identifying learners not meeting milestones, but there is as yet no corresponding framework for remediation. Objective  We developed a comprehensive assessment process that allows correct diagnosis of a struggling learner's deficit(s) to promote successful remediation. Methods  At the University of Pennsylvania, resident learners within the Department of Medicine who are not meeting milestones are referred to the Early Intervention Remediation Committee (EIRC). The EIRC, composed of 14 faculty members with expertise in remediation, uses a standardized process to assess learners' deficits. These faculty members categorize primary deficits as follows: medical knowledge, clinical reasoning, organization and efficiency, professionalism, and communication skills. The standardized process of assessment includes an analysis of the learner's file, direct communication with evaluators, an interview focused on learner perception of the problem, screening for underlying medical or psychosocial issues, and a review of systems for deficits in the 6 core competencies. Participants were surveyed after participating in this process. Results  Over a 2-year period, the EIRC assessed and developed remediation plans for 4% of learners (14 of a total 342). Following remediation and reassessment, the identified problems were satisfactorily resolved in all cases with no disciplinary action. While the process was time intensive, an average of 45 hours per learner, the majority of faculty and residents rated it as positive and beneficial. Conclusions  This structured assessment process identifies targeted areas for remediation and adds to the tools available to Clinical Competency Committees.

scholarly journals Competency Matrix for Medical Residency Programmes in Endocrinology and Metabolism

2019 ◽  
Vol 43 (1 suppl 1) ◽  
pp. 195-206
Author(s):  
Ana Augusta Motta Oliveira Valente ◽  
Milena Coelho Fernandes Caldato
Keyword(s):  
Data Analysis ◽  
Core Competencies ◽  
Second Phase ◽  
Medical Residency ◽  
Fundamental Field ◽  
Delphi Methodology ◽  
Residency Programs ◽  
The Third ◽  
Third Phase ◽  
Structured Matrix

ABSTRACT Introduction Medical competencies have become the focus of Medical Education at all levels around the world. In this context the Medical Residency Programs (MRP) in Brazil have begun to seek a competency-based curriculum to improve the specialist training. Objective To develop a proposed Competency Matrix for Medical Residency Programs in Endocrinology and Metabolism (MREM). Methodology The study was divided into four phases. The first phase consisted of a bibliographical review and construction of the Pilot Matrix. In the second phase the Pilot Matrix was applied to endocrinologists from Belém, with subsequent data analysis and construction of the Structured Matrix. The third phase started with the implementation of the Structured Matrix at the Brazilian Congress of Endocrinology and Metabolism – CBEM 2016 with a total of 49 responses. Based on the Delphi methodology, the 230 competencies of each one of the matrices were analyzed and a questionnaire containing competences with a discrepancy level greater than 10% was created, including some suggestions from the experts. In the fourth and last phase, also using Delphi methodology, the questionnaire was sent by email and data analysis and construction of the MREM proposal was performed. Results In the second, third and fourth phases, the response rate of Endocrinologists was 73.3%, 51% and 76.4%, respectively. With the Southeast region of Brazil presenting the largest number of participants. There are 219 competencies in the Pilot Matrix, 230 in the Structured Matrix and 244 in the final MREM proposal. The competency areas of Diabetes and Obesity, Metabolic Syndrome and Alterations of Appetite were those which showed major change and suggestions. In all phases, only 2 competencies were excluded. The suggestions made in the third phase were unanimously accepted. Conclusion The MREM proposal was concluded with 21 areas and 244 competencies, 33 classified as prerequisites, 157 as essential competencies, 36 as desirable and 18 as advanced. The competencies were distributed as follows in the MCPRMEM: “Fundamental” field with 100 competencies, with 15 prerequisites, 65 core competencies, 14 desirable and 6 advanced ones; “Specific Knowledge” field with 132 competences, with 18 prerequisites, 87 essential competences, 19 desirable and 8 advanced; and “Complementary Training” field with 12 skills, no prerequisites, 5 core competencies, 3 desirable and 4 advanced skills.

scholarly journals Achieving the Right Balance in Oversight of Physician Opioid Prescribing for Pain: The Role of State Medical Boards

2003 ◽  
Vol 31 (1) ◽  
pp. 21-40 ◽  
Author(s):  
Diane E. Hoffmann ◽  
Anita J. Tarzian
Keyword(s):  
Pain Management ◽  
Pain Treatment ◽  
Chronic Pain Patient ◽  
Disciplinary Action ◽  
Pain Patient ◽  
Disciplinary Actions ◽  
Noncancer Pain ◽  
The Right ◽  
State Medical Boards

Uncertainty regarding potential disciplinary action may give physicians pause when considering whether to accept a chronic pain patient or how to treat a patient who may require long-term or high doses of opioids. Surveys have shown that physicians fear potential disciplinary acrion for prescribing controlled substances and that physicians will, in some cases, inadequately prescribe opioids due to fear of regulatory scrutiny. Prescribing opioids for long-term pain management, particularly noncancer pain management, has been controversial; and boards have investigated and, in some cases, disciplined physicians for such prescribing. While in virtually all of these cases the disciplinary actions were successfully appealed, news of the success was not often as well-publicized as news of the disciplinary actions, leaving some physicians confused about their potential liability when prescribing opioids for pain. The confusion has perhaps increased as a result of two relatively recent cases, one where a physician was successfully disciplined by a state medical board for undertreatment of his patients’ pain, and another where the physician was successfully sued for inadequate pain treatment.

scholarly journals Identifying Students at Risk of Failing the USMLE Step 2 Clinical Skills Examination

2019 ◽  
Vol 51 (6) ◽  
pp. 483-499
Author(s):  
Susan Rosenthal ◽  
Stefani Russo ◽  
Katherine Berg ◽  
Joseph Majdan ◽  
Jennifer Wilson ◽  
...  
Keyword(s):  
Student Performance ◽  
Performance Metrics ◽  
Clinical Skills ◽  
Students At Risk ◽  
National Board ◽  
Medical College ◽  
Subject Examination ◽  
Medical Licensing ◽  
Faculty Ratings ◽  
Medical Examiners

Background and Objectives: New standards announced in 2017 could increase the failure rate for Step 2 Clinical Skills (CS). The purpose of this study was to identify student performance metrics associated with risk of failing. Methods: Data for 1,041 graduates of one medical school from 2014 through 2017 were analyzed, including 30 (2.9%) failures. Metrics included Medical College Admission Test, United States Medical Licensing Examination Step 1, and clerkship National Board of Medical Examiners (NBME) Subject Examination scores; faculty ratings in six clerkships; and scores on an objective structured clinical examination (OSCE). Bivariate statistics and regression were used to estimate risk of failing. Results: Those failing had lower Step 1 scores, NBME scores, faculty ratings, and OSCE scores (P<.02). Students with four or more low ratings were more likely to fail compared to those with fewer low ratings (relative risk [RR], 12.76, P<.0001). Logistic regression revealed other risks: low surgery NBME scores (RR 3.75, P=.02), low pediatrics NBME scores (RR 3.67, P=.02), low ratings in internal medicine (RR 3.42, P=.004), and low OSCE Communication/Interpersonal Skills (RR 2.55, P=.02). Conclusions: Certain medical student performance metrics are associated with risk of failing Step 2 CS. It is important to clarify these and advise students accordingly.

scholarly journals Ações Disciplinares em Ginecologia e Obstetrícia na Região Norte de Portugal nos Anos 2008 a 2012

2015 ◽  
Vol 28 (2) ◽  
pp. 194
Author(s):  
Francisco Silva ◽  
Manuel Rodrigues e Rodrigues ◽  
João Bernardes
Keyword(s):  
Medical Malpractice ◽  
Disciplinary Action ◽  
Obstetrics And Gynecology ◽  
Medical Doctors ◽  
Disciplinary Actions ◽  
The North ◽  
Obstetrics And Gynaecology ◽  
Anonymized Data ◽  
Annual Activity ◽  
Medical Specialities

<strong>Introduction:</strong> Disciplinary actions may have a significant impact in medical doctors’ and patients’ lives. The objective of this study was the assessment of the disciplinary actions in Obstetrics and Gynecology that occurred in the north of Portugal in years 2008 to 2012.<br /><strong>Material and Methods:</strong> Retrospective descriptive study based on the anonymized data contained in the annual activity reports of Conselho Disciplinar da Seção Regional Norte da Ordem dos Médicos from 2008 to 2012. We calculated the proportion of disciplinary actions in Obstetrics and Gynaecology over the total number of registered specialists in that speciality. We also analysed the type of complainers, accused, institutions, complaints and decisions. For statistical inference proportions with 95% confidence intervals were estimated.<br /><strong>Results:</strong> From years 2008 to 2012, we registered 1040 complaints in all medical specialities in the north of Portugal. Obstetrics and Gynecology was the forth most affected specialty, with a total of 54 complaints. Forty-three complaints were related with medical malpractice and if we only consider this type of complaint Obstetrics and Gynecology was the most affected specialty. The most frequent complainers and accused were, respectively, patients themselves and female physicians, with 41 to 60 years of age. Fifty-two complaints were archived without punishment while two still await conclusion.<br /><strong>Discussion:</strong> The overall results of this study are in agreement with those reported by other authors.<br /><strong>Conclusions:</strong> Obstetrics and Gynecology was the forth speciality with highest risk for any disciplinary action in the north of Portugal in years 2008 to 2012 and the first one in relation with alleged negligence. All presented and already concluded complaints were archived without penalty, except two that are still under evaluation.

Sense of Futility as Subject of Disciplinary Action: Do Students With Negative Attitudes Toward the Educational System Get Disciplined More Often?

2020 ◽  
pp. 019874292096135
Author(s):  
Emma Degroote ◽  
Mieke Van Houtte
Keyword(s):  
Multilevel Analysis ◽  
Educational System ◽  
School Discipline ◽  
International Study ◽  
Disciplinary Action ◽  
School Staff ◽  
Student Behaviors ◽  
Disciplinary Actions ◽  
Negative Attitudes ◽  
Selective Process

School discipline research has demonstrated that the labeling of student behaviors as requiring disciplinary action is a selective process in which school staff take into account other factors than the characteristics of the behaviors. We argue that school staff react in a disciplinary way to students with negative attitudes toward the educational system. Concretely, we examined if feelings of futility caused students to suffer disciplinary consequences more often. Multilevel analysis was carried out on data of 2,358 students in 28 Ghentian (Belgium) schools that participated in the International Study of City Youth (ISCY). Results indicate that school staff do not react to students’ sense of futility directly by means of disciplinary actions, however, they impose disciplinary actions following disruptive behaviors on students displaying higher feelings of futility more often.

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