scholarly journals A Critical Disconnect: Residency Selection Factors Lack Correlation With Intern Performance

2020 ◽  
Vol 12 (6) ◽  
pp. 696-704
Author(s):  
John C. Burkhardt ◽  
Kendra P. Parekh ◽  
Fiona E. Gallahue ◽  
Kory S. London ◽  
Mary A. Edens ◽  
...  
Keyword(s):  
Clinical Performance ◽  
Selection Process ◽  
Wound Care ◽  
Core Competencies ◽  
Secondary Analysis ◽  
Advanced Degree ◽  
Linear Regression Models ◽  
Residency Programs ◽  
Residency Selection ◽  
Selection Factors

ABSTRACT Background Emergency medicine (EM) residency programs want to employ a selection process that will rank best possible applicants for admission into the specialty. Objective We tested if application data are associated with resident performance using EM milestone assessments. We hypothesized that a weak correlation would exist between some selection factors and milestone outcomes. Methods Utilizing data from 5 collaborating residency programs, a secondary analysis was performed on residents trained from 2013 to 2018. Factors in the model were gender, underrepresented in medicine status, United States Medical Licensing Examination Step 1 and 2 Clinical Knowledge (CK), Alpha Omega Alpha (AOA), grades (EM, medicine, surgery, pediatrics), advanced degree, Standardized Letter of Evaluation global assessment, rank list position, and controls for year assessed and program. The primary outcomes were milestone level achieved in the core competencies. Multivariate linear regression models were fitted for each of the 23 competencies with comparisons made between each model's results. Results For the most part, academic performance in medical school (Step 1, 2 CK, grades, AOA) was not associated with residency clinical performance on milestones. Isolated correlations were found between specific milestones (eg, higher surgical grade increased wound care score), but most had no correlation with residency performance. Conclusions Our study did not find consistent, meaningful correlations between the most common selection factors and milestones at any point in training. This may indicate our current selection process cannot consistently identify the medical students who are most likely to be high performers as residents.

scholarly journals Dermatology Residency Selection Criteria with an Emphasis on Program Characteristics: A National Program Director Survey

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Farzam Gorouhi ◽  
Ali Alikhan ◽  
Arash Rezaei ◽  
Nasim Fazel
Keyword(s):  
Medical School ◽  
Selection Criteria ◽  
Selection Process ◽  
Cross Sectional ◽  
Advanced Degrees ◽  
Residency Programs ◽  
Residency Selection ◽  
Program Characteristics ◽  
Reported Data ◽  
Resident Selection

Background. Dermatology residency programs are relatively diverse in their resident selection process. The authors investigated the importance of 25 dermatology residency selection criteria focusing on differences in program directors’ (PDs’) perception based on specific program demographics.Methods. This cross-sectional nationwide observational survey utilized a 41-item questionnaire that was developed by literature search, brainstorming sessions, and online expert reviews. The data were analyzed utilizing the reliability test, two-step clustering, andK-means methods as well as other methods. The main purpose of this study was to investigate the differences in PDs’ perception regarding the importance of the selection criteria based on program demographics.Results. Ninety-five out of 114 PDs (83.3%) responded to the survey. The top five criteria for dermatology residency selection were interview, letters of recommendation, United States Medical Licensing Examination Step I scores, medical school transcripts, and clinical rotations. The following criteria were preferentially ranked based on different program characteristics: “advanced degrees,” “interest in academics,” “reputation of undergraduate and medical school,” “prior unsuccessful attempts to match,” and “number of publications.”Conclusions. Our survey provides up-to-date factual data on dermatology PDs’ perception in this regard. Dermatology residency programs may find the reported data useful in further optimizing their residency selection process.

scholarly journals Incorporation of Video Vignettes into Pharmacy Residency Application Processes

2017 ◽  
Vol 8 (3) ◽  
pp. 2
Author(s):  
Kenric Ware ◽  
Jessica Johnson ◽  
Hannah Stroud
Keyword(s):  
Selection Process ◽  
Time Saving ◽  
Vast Number ◽  
Healthcare Facilities ◽  
Residency Programs ◽  
Residency Selection ◽  
Video Vignettes ◽  
Residency Application ◽  
Video Vignette ◽  
Methods Of Application

This commentary discusses the introduction of video vignettes (VVs) into the context of pharmacy residency application processes. An extension of the conversation around which items are requested of pharmacy candidates when applying to pharmacy residency programs is provided. In conjunction with other documents that provide insights into candidates’ abilities, video vignettes (VVs) are presented as viable considerations to gain additional perspective. Implications for time-saving and cost conservation by utilizing VVs are also in view. Hiring employees will presumably have the latitude to require the content of VVs to address aspects deemed more relevant to their institutional operating procedures. Foreseeable benefits and challenges to video vignette (VV) adoption are described within this setting. Counterpoints are presented in response to disadvantages to adoption that may surface. An example of a VV has been crafted to actualize sample components that may be feasible for future use. The challenges faced by healthcare facilities to filling pharmacy residency positions from a vast number of applicants remain pronounced. Creativity in the pharmacy residency selection process is often stifled by routinized methods of application review. Innovative models such as VVs could offer a refreshing alternative to candidates for showcasing individualities and perhaps afford evaluating bodies a unique resource for further candidate differentiation.   Type: Commentary

scholarly journals Impact of COVID-19 on radiology residency selection process: a survey of radiology residency programs in the US

2022 ◽  
Author(s):  
Henderson M Jones ◽  
Akhila Ankem ◽  
Erik A Seroogy ◽  
Alborz Kalantar ◽  
Dylan C Goldsmith ◽  
...  
Keyword(s):  
Selection Process ◽  
Residency Programs ◽  
The Us ◽  
Residency Selection ◽  
Radiology Residency

scholarly journals The Feasibility of Blinding Residency Programs to USMLE Step 1 Scores During GME Application, Interview, and Match Processes

2021 ◽  
Vol 13 (2) ◽  
pp. 276-280
Author(s):  
Kathy W. Smith ◽  
Richard Amini ◽  
Madhulika Banerjee ◽  
Conrad J. Clemens
Keyword(s):  
Selection Process ◽  
First Year ◽  
Factors Affecting ◽  
Residency Programs ◽  
Rank List ◽  
Residency Selection ◽  
Residency Recruitment ◽  
Usmle Step 1 ◽  
Final Rank ◽  
Second Year

ABSTRACT Background With the recent announcement that Step 1 score reporting will soon change to pass/fail, residency programs will need to reconsider their recruitment processes. Objective We (1) evaluated the feasibility of blinding residency programs to applicants' Step 1 scores and their number of attempts throughout the recruitment process; (2) described the selection process that resulted from the blinding; and (3) reviewed if a program's initial rank list, created before scores were known, would be changed before submission for the Match. Methods During the 2018–2019 and 2019–2020 recruitment seasons, all programs at a single sponsoring institution were invited to develop selection criteria in the absence of Step 1 data, and to remain blinded to this data throughout recruitment. Participating programs were surveyed to determine factors affecting feasibility and metrics used for residency selection. Once unblinded to Step 1 scores, programs had the option to change their initial rank lists. Results Of 24 residency programs, 4 participated (17%) in the first year: emergency medicine, neurology, pediatrics, and psychiatry. The second year had the same participants, with the addition of family and community medicine and radiation oncology (n = 6, 25%). Each program was able to determine mission-specific qualities in the absence of Step 1 data. In both years, one program made changes to the final rank list. Conclusions It was feasible for programs to establish metrics for residency recruitment in the absence of Step 1 data, and most programs made no changes to final rank lists after Step 1 scores were known.

Modeling COVID-19 Growing Trends to Reveal the Differences in the Effectiveness of Non-Pharmaceutical Interventions among Countries in the World (Preprint)

2020 ◽  
Author(s):  
You Chen ◽  
Yubo Feng ◽  
Chao Yan ◽  
Xinmeng Zhang ◽  
Cheng Gao
Keyword(s):  
Secondary Analysis ◽  
Reproduction Rate ◽  
Cumulative Number ◽  
Linear Regression Models ◽  
Growth Data ◽  
Dynamic Changes ◽  
The World ◽  
Four Levels ◽  
Almost All ◽  
Pharmaceutical Interventions

BACKGROUND Adopting non-pharmaceutical interventions (NPIs) can affect COVID-19 growing trends, decrease the number of infected cases, and thus reduce mortality and healthcare demand. Almost all countries in the world have adopted non-pharmaceutical interventions (NPIs) to control the spread rate of COVID-19; however, it is unclear what are differences in the effectiveness of NPIs among these countries. OBJECTIVE We hypothesize that COVID-19 case growth data reveals the efficacy of NPIs. In this study, we conduct a secondary analysis of COVID-19 case growth data to compare the differences in the effectiveness of NPIs among 16 representative countries in the world. METHODS This study leverages publicly available data to learn patterns of dynamic changes in the reproduction rate for sixteen countries covering Asia, Europe, North America, South America, Australia, and Africa. Furthermore, we model the relationships between the cumulative number of cases and the dynamic reproduction rate to characterize the effectiveness of the NPIs. We learn four levels of NPIs according to their effects in the control of COVID-19 growth and categorize the 16 countries into the corresponding groups. RESULTS The dynamic changes of the reproduction rate are learned via linear regression models for all of the studied countries, with the average adjusted R-squared at 0.96 and the 95% confidence interval as [0.94 0.98]. China, South Korea, Argentina, and Australia are at the first level of NPIs, which are the most effective. Japan and Egypt are at the second level of NPIs, and Italy, Germany, France, Netherlands, and Spain, are at the third level. The US and UK have the most inefficient NPIs, and they are at the fourth level of NPIs. CONCLUSIONS COVID-19 case growth data provides evidence to demonstrate the effectiveness of the NPIs. Understanding the differences in the efficacy of the NPIs among countries in the world can give guidance for emergent public health events. CLINICALTRIAL NA

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 OP0268 TREATMENT STATUS AFFECTS HOW PULMONARY BIOMARKERS PREDICT PROGRESSION OF SYSTEMIC SCLEROSIS-RELATED INTERSTITIAL LUNG DISEASE

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 163.1-163
Author(s):  
E. Volkmann ◽  
D. Tashkin ◽  
M. Leng ◽  
N. LI ◽  
G. Kim ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Growth Factor ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Transforming Growth Factor ◽  
Selection Process ◽  
Linear Regression Models ◽  
Research Support ◽  
Gm Csf ◽  
Treatment Status

Background:The course of interstitial lung disease (ILD) varies considerably in patients with systemic sclerosis (SSc), and no biomarkers have been found to consistently predict ILD progression in this population. Treatment may affect how a candidate biomarker correlates with improvement/worsening of SSc-ILD. We hypothesized that specific proteins recovered from bronchoalveolar lavage (BAL) would differentially predict progression of SSc-ILD based on whether a patient was receiving ILD therapy.Objectives:(1) To assess the relationship between 68 unique BAL proteins measured in participants of Scleroderma Lung Study (SLS) I1 and changes in radiographic extent of SSc-ILD; (2) To determine if treatment affects whether a specific protein predicts improvement or worsening of SSc-ILD.Methods:Bronchoscopy was performed on 144 of the 158 participants in SLS I (Cyclophosphamide [CYC] vs. placebo) with 103 BAL samples available for analysis. BAL was lyophilized, concentrated 10X and used in a multiplex protein analysis of 68 distinct cytokines, chemokines and growth factors. Quantitative imaging analysis (QIA) was used to calculate the extent of radiographic fibrosis (QLF) in the whole lung using HRCT of the chest at baseline and 12 months. Multivariable linear regression models were created to determine the key BAL proteins associated with change in QLF scores using a backward selection process adjusting for treatment arm and ILD severity. The bootstrap procedure was employed for internal validation.Results:A number of BAL proteins were significantly associated with change in QLF scores at 12 months; however, the directionality of these associations was often based on the presence/absence of treatment. For example, increased levels of granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin (IL)-1, monocyte chemoattractant protein (MCP)-3, chemokine ligand (CCL)-5, transforming growth factor (TGF)-β, hepatocyte growth factor (HGF), stem cell factor (SCF), IL-4, TGF-α, were associated with worse QLF scores in patients who received placebo; whereas, increased levels of these same proteins were associated with improved QLF scores in patients who received CYC (Figure). Increased levels of Fractalkine were associated with worse in QLF scores, and increased levels of IL-7 were associated with improved QLF scores, regardless of treatment arm. In the multivariable model adjusting for treatment arm and baseline severity of ILD, IL-1, MCP-3, surfactant protein C, IL-7, and CCL-5 were independently associated with change in QLF scores.Figure 1.Example of a specific BAL protein (GM-CSF) that predicts worse QLF scores in patients receiving placebo (Group B, Red dotted line) and improved QLF scores in patients receiving CYC (Group A, Blue solid line). Shaded areas represent 95% confidence intervals.Conclusion:Proteins that mediate both inflammation and fibrosis differentially affected progression of SSc-ILD based on treatment status. Higher levels of certain proteins predicted worsening of ILD in patients receiving placebo, but improvement in patients receiving CYC. Measuring these proteins could help to identify patients who: (1) are at risk for ILD progression, and (2) may preferentially benefit from treatment with immunosuppression.References:[1]Tashkin DP, et al. NEJM 2006.Disclosure of Interests:Elizabeth Volkmann Consultant of: Boehringer Ingelheim, Grant/research support from: Corbus, Forbius, Donald Tashkin: None declared, Mei Leng: None declared, Ning Li: None declared, Grace Kim: None declared, Jonathan Goldin: None declared, Airi Harui: None declared, Michael Roth Grant/research support from: Genentech/Roche

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 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 Residency Setting Association With Resident Substance Use Disorder Training: A CERA Secondary Data Analysis

2020 ◽  
Vol 52 (3) ◽  
pp. 198-201
Author(s):  
Joshua St. Louis ◽  
Emma Worringer ◽  
Wendy B. Barr
Keyword(s):  
Substance Use ◽  
Family Medicine ◽  
Residency Program ◽  
Secondary Analysis ◽  
Secondary Data ◽  
The United States ◽  
Resident Training ◽  
Addiction Medicine ◽  
Residency Programs ◽  
Family Medicine Residency

Background and Objectives: As the opioid crisis worsens across the United States, the factors that impact physician training in management of substance use disorders become more relevant. A thorough understanding of these factors is necessary for family medicine residency programs to inform their own residency curricula. The objective of our study was to identify factors that correlate with increased residency training in addiction medicine across a broad sample of family medicine residencies. Methods: We performed secondary analysis of a national family medicine residency program director survey conducted in 2015-2016 (CERA Survey PD-8). We obtained data from the Council of Academic Family Medicine Educational Research Alliance (CERA) Data Clearinghouse. We analyzed residency clinic site designation as a patient-centered medical home (PCMH), federally-qualified health center (FQHC), or both, for their correlation with faculty member possession of DEA-X buprenorphine waiver license, as well as required residency curriculum in addiction medicine. Results: Residency programs situated in an FQHC were more likely to have faculty members who possessed DEA-X buprenorphine waiver licenses (P=.025). Residency clinics that were both a PCMH as well as an FQHC also correlated strongly (P=.001). Furthermore, residencies with faculty who possessed a DEA-X license were significantly more likely to have a required curriculum in addiction medicine (P=.002). Conclusions: Our quantitative secondary analysis of CERA survey data of family medicine residency program directors revealed that resident training in addiction medicine is strongly correlated with both residency clinic setting (FQHC or FQHC/PCMH) as well as residency faculty possession of DEA-X licenses.

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