The Unexamined Diversity: Disability Policies and Practices in US Graduate Medical Education Programs

ABSTRACT Background Graduate medical education (GME) institutions must ensure equal access for trainees with disabilities through appropriate and reasonable accommodations and policies. To date, no comprehensive review of the availability and inclusiveness of GME policies for residents with disabilities exists. Objective We examined institutions' compliance with Accreditation Council for Graduate Medical Education (ACGME) requirements and alignment with Association of American Medical Colleges (AAMC) policy considerations. Methods Between June and August 2019, we conducted a directed content analysis of GME institutional policies using the AAMC report on disability considerations and the ACGME institutional requirements as a framework. Results Of the 47 GME handbooks available for review, 32 (68%) included a disability policy. Forty-one of the 47 (87%) handbooks maintained a nondiscrimination statement that included disability. Twelve of the 32 (38%) handbooks included a specific disability policy and language that encouraged disclosure, and 17 (53%) included a statement about the confidential documentation used to determine reasonable accommodations. Nineteen of the 32 (59%) maintained a clear procedure for disclosing disabilities and requesting accommodations. Conclusions While disability policies are present in many of the largest GME institutions, it is not yet a standardized practice. For institutions maintaining a disability policy, many lack key elements identified as best practices in the AAMC considerations.

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A Survey of the Work Effort of Full-time Surgeons of the Southeastern Surgical Congress

The American Surgeon ◽

10.1177/000313480507100811 ◽

2005 ◽

Vol 71 (8) ◽

pp. 674-681

Author(s):

Thomas R. Gadacz ◽

James J. Bason

Keyword(s):

Medical Education ◽

Graduate Medical Education ◽

Statistical Significance ◽

Professional Activity ◽

Full Time ◽

Work Effort ◽

Education Programs ◽

Graduate Medical ◽

Community Activities ◽

Significant Difference

This is a survey research project to determine the work hours of practicing surgeons and compare those hours with hours that have been mandated for graduate medical education programs by the Accreditation Council for Graduate Medical Education (ACGME). The survey conducted of the membership of the Southeastern Surgical Congress focused on the amount of time devoted to professional activity. Although several categories of membership were surveyed, those surgeons in full-time practice were used for this report. Five hundred ninety-two general surgeons and some surgical specialties from 17 states reported a total professional work effort of 65 hours per week averaged over a month. Twenty per cent reported working more than 80 hours per week. Statistically significant ( P < 0.05) factors that characterized these individuals included years in practice (1 to 10 years), more clinical hours per week, fewer administrative hours per week, fewer teaching hours per week, fewer continuing medical education (CME) hours per year, and an increase in recent clinical practice. Interestingly, there was no significant difference in CME over a 2- or 5-year period. Other factors such as type of practice did not have statistical significance. There was no difference between states and no difference in time commitment to political or community activities. This survey indicates that surgeons going into practice in the Southeast from general surgery graduate medical education programs can expect to have a mean work week of 65 hours, and 20 per cent can expect to exceed an 80-hour work week.

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Interest in part-time graduate medical education programs

Academic Medicine ◽

10.1097/00001888-198005000-00010 ◽

1980 ◽

Vol 55 (5) ◽

pp. 447-9

Author(s):

A I Sutnick ◽

G L Burkett ◽

I W Gabrielson

Keyword(s):

Medical Education ◽

Graduate Medical Education ◽

Education Programs ◽

Graduate Medical ◽

Part Time

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Mechanical Ventilation Training During Graduate Medical Education: Perspectives and Review of the Literature

Journal of Graduate Medical Education ◽

10.4300/jgme-d-18-00828.1 ◽

2019 ◽

Vol 11 (4) ◽

pp. 389-401 ◽

Cited By ~ 2

Author(s):

Jonathan M. Keller ◽

Dru Claar ◽

Juliana Carvalho Ferreira ◽

David C. Chu ◽

Tanzib Hossain ◽

...

Keyword(s):

Mechanical Ventilation ◽

Medical Education ◽

Critical Care ◽

Best Practices ◽

Graduate Medical Education ◽

Assessment Tools ◽

Critical Care Medicine ◽

Subspecialty Training ◽

Review Of The Literature ◽

Graduate Medical

ABSTRACT Background Management of mechanical ventilation (MV) is an important and complex aspect of caring for critically ill patients. Management strategies and technical operation of the ventilator are key skills for physicians in training, as lack of expertise can lead to substantial patient harm. Objective We performed a narrative review of the literature describing MV education in graduate medical education (GME) and identified best practices for training and assessment methods. Methods We searched MEDLINE, PubMed, and Google Scholar for English-language, peer-reviewed articles describing MV education and assessment. We included articles from 2000 through July 2018 pertaining to MV education or training in GME. Results Fifteen articles met inclusion criteria. Studies related to MV training in anesthesiology, emergency medicine, general surgery, and internal medicine residency programs, as well as subspecialty training in critical care medicine, pediatric critical care medicine, and pulmonary and critical care medicine. Nearly half of trainees assessed were dissatisfied with their MV education. Six studies evaluated educational interventions, all employing simulation as an educational strategy, although there was considerable heterogeneity in content. Most outcomes were assessed with multiple-choice knowledge testing; only 2 studies evaluated the care of actual patients after an educational intervention. Conclusions There is a paucity of information describing MV education in GME. The available literature demonstrates that trainees are generally dissatisfied with MV training. Best practices include establishing MV-specific learning objectives and incorporating simulation. Next research steps include developing competency standards and validity evidence for assessment tools that can be utilized across MV educational curricula.

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