scholarly journals From Medical School to Residency: Transitions During the COVID-19 Pandemic

2020 ◽  
Vol 12 (4) ◽  
pp. 507-511
Author(s):  
Lauren M. Byrne ◽  
Eric S. Holmboe ◽  
John R. Combes ◽  
Thomas J. Nasca
Keyword(s):  
Medical Education ◽  
Medical School ◽  
Graduate Medical Education ◽  
Medical Schools ◽  
The United States ◽  
Residency Programs ◽  
Graduate Medical ◽  
Time Period ◽  
Policies And Procedures ◽  
Academic Year

ABSTRACT Background The start of a new academic year in graduate medical education will mark a transition for postgraduate year 1 (PGY-1) residents from medical school into residency. The relocation of individuals has significant implications given the COVID-19 pandemic and variability of the outbreak across the United States, but little is known about the extent of the geographic relocation taking place. Objective We reported historical trends of PGY-1 residents staying in-state and those starting residency from out-of-state to quantify the geographic movement of individuals beginning residency training each year. Methods We analyzed historical data collected by the Accreditation Council for Graduate Medical Education in academic years 2016–2017, 2017–2018, and 2018–2019, comparing the locations of medical school and residency programs for PGY-1 residents to determine the number of matriculants from in-state medical schools and out-of-state medical schools. International medical school graduates (IMGs) were shown separately in the analysis and then combined with out-of-state matriculants. US citizens who trained abroad were counted among IMGs. Results The total number of PGY-1s increased by 10.3% during the 3-year time period, from 29 338 to 32 348. When combined, IMGs and USMGs transitioning from one state or country to another state accounted for approximately 72% of PGY-1s each year. Approximately 63% of USMGs matriculated to a residency program in a new state, and IMGs made up 24.6% to 23.1% of PGY-1s over the 3-year period. Conclusions Each year brings a substantial amount of movement among PGY-1s that highlights the need for policies and procedures specific to the COVID-19 pandemic.

scholarly journals Patterns of Change in ACGME-Accredited Residency Programs and Positions: Implication for the Adequacy of GME Positions and Supply of Physicians in the United States

2014 ◽  
Vol 6 (2) ◽  
pp. 399-403 ◽  
Author(s):  
Kathleen D. Holt ◽  
Rebecca S. Miller ◽  
Ingrid Philibert ◽  
Thomas J. Nasca
Keyword(s):  
Medical Education ◽  
Medical School ◽  
Graduate Medical Education ◽  
Primary Care Physicians ◽  
Population Data ◽  
The United States ◽  
Graduate Medical ◽  
The Past ◽  
Accredited Institutions ◽  
The Impact

Abstract Background Recent studies suggest that the supply of primary care physicians and generalist physicians in other specialties may be inadequate to meet the needs of the US population. Data on the numbers and types of physicians-in-training, such as those collected by the Accreditation Council for Graduate Medical Education (ACGME), can be used to help understand variables affecting this supply. Objective We assessed trends in the number and type of medical school graduates entering accredited residencies, and the impact those trends could have on the future physician workforce. Methods Since 2004, the ACGME has published annually its data on accredited institutions, programs, and residents to help the graduate medical education community understand major trends in residency education, and to help guide graduate medical education policy. We present key results and trends for the period between academic years 2003–2004 and 2012–2013. Results The data show that increases in trainees in accredited programs are not uniform across specialties, or the types of medical school from which trainees graduated. In the past 10 years, the growth in residents entering training that culminates in initial board certification (“pipeline” specialties) was 13.0%, the number of trainees entering subspecialty education increased 39.9%. In the past 5 years, there has been a 25.8% increase in the number of osteopathic physicians entering allopathic programs. Conclusions These trends portend challenges in absorbing the increasing numbers of allopathic and osteopathic graduates, and US international graduates in accredited programs. The increasing trend in subspecialization appears at odds with the current understanding of the need for generalist physicians.

scholarly journals Radiology Education Among Emergency Medicine Residencies: A National Needs Assessment

2021 ◽  
Vol 22 (5) ◽  
pp. 1110-1116
Author(s):  
Stephen Villa ◽  
Natasha Wheaton ◽  
Steven Lai ◽  
Jaime Jordan
Keyword(s):  
Emergency Medicine ◽  
Medical Education ◽  
Needs Assessment ◽  
Graduate Medical Education ◽  
Central Region ◽  
The United States ◽  
Residency Programs ◽  
Radiology Education ◽  
Graduate Medical ◽  
Program Leadership

Introduction: Radiology training is an important component of emergency medicine (EM) education, but its delivery has been variable. Program directors have reported a lack of radiology skills in incoming interns. A needs assessment is a crucial first step toward improving radiology education among EM residencies. Our objective was to explore the current state of radiology education in EM residency programs. Methods: This was a cross-sectional survey study of all Accreditation Council for Graduate Medical Education-accredited EM programs in the United States. Program leadership completed an online survey consisting of multiple choice, Likert scale, and free-response items. We calculated and reported descriptive statistics. Results: Of eligible EM programs, 142/252 (56%) completed the survey including 105 postgraduate year (PGY) 1-3 and 36 PGY 1-4 programs. One respondent opted out of answering demographic questions. 23/141 (16%) were from the Western region, 29/141 (21%) were from the North Central region, 14/141 (10%) were from the South-Central region, 28/141 (20%) were from the Southeast region, and 47/141 (33%) were from the Northeast region. A total of 88/142 (62%) of responding programs did not have formal radiology instruction. Of the education that is provided, 127/142 (89%) provide it via didactics/lectures and 115/142 (81%) rely on instruction during clinical shifts. Only 51/142 (36%) provide asynchronous opportunities, and 23/142 (16%) have a dedicated radiology rotation. The majority of respondents reported spending 0-2 hours per month on radiology instruction (108/142; 76%); 95/141 (67%) reported that EM faculty “often” or “always” provide radiology instruction; 134/142 (95%), felt that it was “extremely” or “very important” for ED providers to be able to independently interpret radiograph results; and 129/142 (90.84%) either “sometimes” or “always” rely on their independent radiograph interpretations to make clinical decisions. The radiology studies identified as most important to be able to independently interpret were radiographs obtained for lines/tubes, chest radiographs, and radiographs obtained for musculoskeletal-related complaints. Conclusion: A minority of EM residency programs have formal instruction in radiology despite the majority of responding program leadership believing that these are important skills. The most important curricular areas were identified. These results may inform the development of formal radiology curricula in EM graduate medical education.

scholarly journals Tracking Residents Through Multiple Residency Programs: A Different Approach for Measuring Residents' Rates of Continuing Graduate Medical Education in ACGME-Accredited Programs

2010 ◽  
Vol 2 (4) ◽  
pp. 616-623 ◽  
Author(s):  
Lauren M. Byrne ◽  
Kathleen D. Holt ◽  
Thomas Richter ◽  
Rebecca S. Miller ◽  
Thomas J. Nasca
Keyword(s):  
Medical Education ◽  
Medical School ◽  
Graduate Medical Education ◽  
Clinical Education ◽  
The United States ◽  
International Medical ◽  
International Medical Graduates ◽  
Graduate Medical ◽  
Medical Graduates ◽  
Longitudinal Tracking

Abstract Background Increased focus on the number and type of physicians delivering health care in the United States necessitates a better understanding of changes in graduate medical education (GME). Data collected by the Accreditation Council for Graduate Medical Education (ACGME) allow longitudinal tracking of residents, revealing the number and type of residents who continue GME following completion of an initial residency. We examined trends in the percent of graduates pursuing additional clinical education following graduation from ACGME-accredited pipeline specialty programs (specialties leading to initial board certification). Methods Using data collected annually by the ACGME, we tracked residents graduating from ACGME-accredited pipeline specialty programs between academic year (AY) 2002–2003 and AY 2006–2007 and those pursuing additional ACGME-accredited training within 2 years. We examined changes in the number of graduates and the percent of graduates continuing GME by specialty, by type of medical school, and overall. Results The number of pipeline specialty graduates increased by 1171 (5.3%) between AY 2002–2003 and AY 2006–2007. During the same period, the number of graduates pursuing additional GME increased by 1059 (16.7%). The overall rate of continuing GME increased each year, from 28.5% (6331/22229) in AY 2002–2003 to 31.6% (7390/23400) in AY 2006–2007. Rates differed by specialty and for US medical school graduates (26.4% [3896/14752] in AY 2002–2003 to 31.6% [4718/14941] in AY 2006–2007) versus international medical graduates (35.2% [2118/6023] to 33.8% [2246/6647]). Conclusion The number of graduates and the rate of continuing GME increased from AY 2002–2003 to AY 2006–2007. Our findings show a recent increase in the rate of continued training for US medical school graduates compared to international medical graduates. Our results differ from previously reported rates of subspecialization in the literature. Tracking individual residents through residency and fellowship programs provides a better understanding of residents' pathways to practice.

scholarly journals Pathology Informatics Essentials for Residents: A Flexible Informatics Curriculum Linked to Accreditation Council for Graduate Medical Education Milestones

2016 ◽  
Vol 141 (1) ◽  
pp. 113-124 ◽  
Author(s):  
Walter H. Henricks ◽  
Donald S. Karcher ◽  
James H. Harrison ◽  
John H. Sinard ◽  
Michael W. Riben ◽  
...  
Keyword(s):  
Medical Education ◽  
Graduate Medical Education ◽  
The United States ◽  
Residency Programs ◽  
Knowledge And Skills ◽  
Accreditation Council ◽  
Graduate Medical ◽  
Pathology Informatics ◽  
Informatics Training ◽  
Daunting Task

Context.—Recognition of the importance of informatics to the practice of pathology has surged. Training residents in pathology informatics has been a daunting task for most residency programs in the United States because faculty often lacks experience and training resources. Nevertheless, developing resident competence in informatics is essential for the future of pathology as a specialty. Objective.—To develop and deliver a pathology informatics curriculum and instructional framework that guides pathology residency programs in training residents in critical pathology informatics knowledge and skills, and meets Accreditation Council for Graduate Medical Education Informatics Milestones. Design.—The College of American Pathologists, Association of Pathology Chairs, and Association for Pathology Informatics formed a partnership and expert work group to identify critical pathology informatics training outcomes and to create a highly adaptable curriculum and instructional approach, supported by a multiyear change management strategy. Results.—Pathology Informatics Essentials for Residents (PIER) is a rigorous approach for educating all pathology residents in important pathology informatics knowledge and skills. PIER includes an instructional resource guide and toolkit for incorporating informatics training into residency programs that vary in needs, size, settings, and resources. PIER is available at http://www.apcprods.org/PIER (accessed April 6, 2016). Conclusions.—PIER is an important contribution to informatics training in pathology residency programs. PIER introduces pathology trainees to broadly useful informatics concepts and tools that are relevant to practice. PIER provides residency program directors with a means to implement a standardized informatics training curriculum, to adapt the approach to local program needs, and to evaluate resident performance and progress over time.

scholarly journals Trends in US Medical School Contributions to the Family Physician Workforce: 2018 Update From the American Academy of Family Physicians

2019 ◽  
Vol 51 (3) ◽  
pp. 241-250 ◽  
Author(s):  
Julie P. Phillips ◽  
Andrea Wendling ◽  
Ashley Bentley ◽  
Rae Marsee ◽  
Christopher P. Morley
Keyword(s):  
Primary Care ◽  
Medical Education ◽  
Medical School ◽  
Primary Care Physicians ◽  
Census Data ◽  
Family Physicians ◽  
Medical Schools ◽  
The United States ◽  
Care Needs ◽  
Residency Programs

Background and Objectives: The United States needs more family physicians. Projections based on current trends show a deficit of 52,000 primary care physicians by 2025. Eight national family medicine (FM) organizations have set an ambitious goal of increasing the proportion of US medical school graduates who enter FM residencies to 25% by 2030. This paper describes the most recent number and percentage of students from each US medical school entering Accreditation Council for Graduate Medical Education (ACGME)-accredited FM residency programs, long-term trends in the contribution of allopathic and osteopathic medical schools to the FM workforce, and medical school characteristics associated with higher proportions of FM graduates. Methods: Data about graduates entering US ACGME-accredited FM residency programs were collected using an annual program census and supplemental sources. Longitudinal census data from allopathic and osteopathic schools were combined to examine trends over time. ANOVA analyses were conducted to compare schools by percent of graduates entering FM, public/private ownership, allopathic/osteopathic, size, and presence of FM department. Medical school length of operation was correlated with percentage of students entering FM. Results: The overall proportion of US students entering ACGME-accredited FM programs has increased modestly over the past decade. Currently, only 12.6% of US allopathic and osteopathic seniors enter ACGME-accredited FM programs. Individual medical schools’ contributions to the FM workforce are described. Conclusions: The proportion of US medical students beginning ACGME-accredited FM residency programs has increased slightly over the last decade. However, significant changes to undergraduate medical education are needed to meet the nation’s primary care needs.

Graduate Medical Education

1987 ◽  
Author(s):  
William G. Rothstein
Keyword(s):  
Medical Education ◽  
Medical School ◽  
Patient Care ◽  
Graduate Medical Education ◽  
General Medicine ◽  
Medical Specialty ◽  
Medical Schools ◽  
University Hospital ◽  
Graduate Medical ◽  
Interns And Residents

Graduate medical education has become as important as attendance at medical school in the training of physicians. Up to 1970, most graduates of medical schools first took an internship in general medicine and then a residency in a specialty. After 1970, practically all medical school graduates entered residency training in a specialty immediately after graduation. Residency programs have been located in hospitals affiliated with medical schools and have been accredited by specialty boards, which have been controlled by medical school faculty members. This situation has led to insufficient breadth of training and lax regulation of the programs. The internship, which followed graduation from medical school until its elimination after 1970, consisted of one or two years of hospital training, usually unconnected with any medical specialty. It was designed to provide gradually increasing responsibility for patient care, supplemented by formal teaching in rounds and seminars. In practice, as George Miller observed in 1963, it was “virtually impossible to find an internship [program with] a graded and sequential course of study leading to relatively well-defined goals.” This was also the finding of several surveys of interns and physicians. A 1959 survey of 2,616 interns found that the two most frequently cited deficiencies of internships were lack of “sufficient review and criticism of your work with patients,” cited by 47 percent, and “adequate instruction in the application of scientific knowledge to patient care,” cited by 34 percent. A 1952 survey of 6,662 graduates of the medical school classes of 1937 and 1947 and a later survey of over 3,000 interns and residents produced similar findings. Formal instruction during the internship was usually casual and unsystematic. Stephen Miller's study of one university hospital found that interns spent only a few hours per week in formal lectures and conferences and on rounds. In teaching on rounds, “the visiting physician does not prepare a lecture or other teaching material. He simply walks onto the ward and responds to patients and their problems with opinions and examples from his own clinical experience.” The educational value of rounds therefore depended on the illnesses of the patients and the relevant skills of the physicians.

scholarly journals The Impact of Coronavirus Disease 2019 (COVID-19) on Graduate Medical Education (GME): An Exploration of Behavioral Health Aspects

2021 ◽  
Author(s):  
Jordan C. Holter ◽  
Christine Marchionni ◽  
James A. James III
Keyword(s):  
United States ◽  
Medical Education ◽  
Behavioral Health ◽  
Graduate Medical Education ◽  
Well Being ◽  
The United States ◽  
Medical Community ◽  
Physician Burnout ◽  
Graduate Medical ◽  
Policies And Procedures

The Coronavirus Disease 2019, regularly referred to as “COVID-19”, has had an unprecedented impact on not only the state of graduate medical education (GME) for post-doctoral trainees, but also their well-being and welfare. Trainees comprise approximately 14% of physicians in the United States. This crucial portion of personnel in healthcare has irrefutably represented the resilience that personifies the medical community. The prevalence of physical and emotional exertion by these trainees, necessitated by the pandemic, has precipitated behavioral health ailments like mood disorders including depression and anxiety, diminished satisfaction in their corresponding specialties and impaired their ability to achieve balance between professional and personal responsibilities. This excerpt examines the pervasiveness of the adverse psychosocial implications the COVID-19 pandemic has had on this susceptible practitioner population in addition to the examination of physical and emotional exhaustion that exacerbate physician burnout including the implementation of policies and procedures to address the emergent problem of physician burnout throughout the COVID-19 pandemic by the GME. Also, this excerpt examines the adaptation of GME, including the reformation and implementation of innovative policies and procedures that has incontestably created an imprint on medical education for descendants of ACGME residency and fellowship programs in the United States.

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 International Residency Program Evaluation: Assessing the Reliability and Initial Validity of the ACGME-I Resident Survey in Abu Dhabi, United Arab Emirates

2014 ◽  
Vol 6 (3) ◽  
pp. 517-520 ◽  
Author(s):  
Halah Ibrahim ◽  
Brenessa Lindeman ◽  
Steven A. Matarelli ◽  
Satish Chandrasekhar Nair
Keyword(s):  
Medical Education ◽  
Focus Group ◽  
United Arab Emirates ◽  
Graduate Medical Education ◽  
Residency Program ◽  
High Reliability ◽  
The United States ◽  
Abu Dhabi ◽  
Convenience Sample ◽  
Graduate Medical

Abstract Background Educators agree on the importance of assessing the quality of graduate medical education. In the United States, the Accreditation Council for Graduate Medical Education (ACGME) resident survey is an important part of the accreditation process, yet some studies have questioned its validity. Objective We assessed the reliability and acceptance of the ACGME-International (ACGME-I) resident survey in the culturally distinct, nonnative English-speaking resident population of Abu Dhabi in the United Arab Emirates. Methods A total of 158 residents in ACGME-I accredited institutions in Abu Dhabi received an online link to the ACGME-I survey. Reliability analysis was conducted using the Cronbach α. A focus group was then held with a convenience sample of 25 residents from different institutions and specialties to understand potential challenges encountered by survey participants. Results Completed surveys were received from 116 residents (73.4%). The 39 items in the survey demonstrated high reliability, with a Cronbach α of 0.918. Of the 5 subscales, 4 demonstrated acceptable to very good reliability, ranging from 0.72 to 0.888. The subscale “resources” had lower reliability at 0.584. Removal of a single item increased the Cronbach α to a near-acceptable score of 0.670. Focus group results indicated that the survey met standards for readability, length, and time for completion. Conclusions The ACGME-I resident survey demonstrates acceptable reliability and validity for measuring the perceptions of residents in an international residency program. The data derived from the survey can offer an important set of metrics for educational quality improvement in the United Arab Emirates.

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