scholarly journals Milestone Level Changes From Residency to Fellowship: A Multicenter Cohort Study

2021 ◽  
Vol 13 (3) ◽  
pp. 377-384
Author(s):  
Taylor Sawyer ◽  
Megan Gray ◽  
Shilpi Chabra ◽  
Lindsay C. Johnston ◽  
Melissa M. Carbajal ◽  
...  
Keyword(s):  
Professional Development ◽  
Medical Knowledge ◽  
Fellowship Training ◽  
Multicenter Cohort Study ◽  
Perinatal Medicine ◽  
Linear Trajectory ◽  
Next Accreditation System ◽  
Fellowship Programs ◽  
The Individual ◽  
Vital Element

ABSTRACT Background A vital element of the Next Accreditation System is measuring and reporting educational Milestones. Little is known about changes in Milestones levels during the transition from residency to fellowship training. Objective Evaluate the Accreditation Council for Graduate Medical Education (ACGME) Milestones' ability to provide a linear trajectory of professional development from general pediatrics residency to neonatal-perinatal medicine (NPM) fellowship training. Methods We identified 11 subcompetencies that were the same for general pediatrics residency and NPM fellowship. We then extracted the last residency Milestone level and the first fellowship Milestone level for each subcompetency from the ACGME's Accreditation Data System on 89 subjects who started fellowship training between 2014 and 2018 at 6 NPM fellowship programs. Mixed-effects models were used to examine the intra-individual changes in Milestone scores between residency and fellowship after adjusting for the effects of the individual programs. Results A total of 1905 subcompetency Milestone levels were analyzed. The average first fellowship Milestone levels were significantly lower than the last residency Milestone levels (residency, mean 3.99 [SD = 0.48] vs fellowship 2.51 [SD = 0.56]; P < .001). Milestone levels decreased by an average of -1.49 (SD = 0.65) from the last residency to the first fellowship evaluation. Significant differences in Milestone levels were seen in both context-dependent subcompetencies (patient care and medical knowledge) and context-independent subcompetencies (professionalism). Conclusions Contrary to providing a linear trajectory of professional development, we found that Milestone levels were reset when trainees transitioned from general pediatrics residency to NPM fellowship.

Educational Perspectives: Boot Camps for Neonatal-Perinatal Medicine Fellows

NeoReviews ◽  
2014 ◽  
Vol 15 (2) ◽  
pp. e46-e55 ◽  
Author(s):  
Taylor Sawyer ◽  
Heather French ◽  
Lamia Soghier ◽  
James Barry ◽  
Lindsay Johnston ◽  
...  
Keyword(s):  
Curriculum Design ◽  
Neonatal Intensive Care ◽  
Fellowship Training ◽  
Perinatal Medicine ◽  
Design Elements ◽  
Care Experience ◽  
Boot Camps ◽  
Simulation Based ◽  
Fellowship Programs ◽  
Independent Practitioner

Fellowship training is a required component of the transformation of a pediatrician into an independent practitioner of neonatal-perinatal medicine (NPM). Exposure to neonatal intensive care, experience in the management of neonatal patients, and successful performance of neonatal procedures is lower in trainees entering NPM fellowship today as compared with the past. To address this change in the baseline competency of incoming fellows, many NPM fellowship programs have begun to conduct intensive, simulation-based training sessions at the beginning of fellowship, commonly called “boot camps.” In this article, we explore the concept of boot camps, examine curriculum design elements of boot camps for NPM fellows, provide examples of collaborative and regional NPM boot camps, explore challenges to conducting a boot camp for NPM fellows, and discuss future directions for NPM fellowship boot camps, on a national and international level.

scholarly journals Performance on the Nephrology In-Training Examination and ABIM Nephrology Certification Examination Outcomes

2018 ◽  
Vol 13 (5) ◽  
pp. 710-717 ◽  
Author(s):  
Daniel Jurich ◽  
Lauren M. Duhigg ◽  
Troy J. Plumb ◽  
Steven A. Haist ◽  
Janine L. Hawley ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Confidence Interval ◽  
Predictive Value ◽  
Medical Knowledge ◽  
Medical Specialty ◽  
Fellowship Training ◽  
Certification Examination ◽  
Fellowship Programs ◽  
American Society ◽  
First Time

Background and objectivesMedical specialty and subspecialty fellowship programs administer subject-specific in-training examinations to provide feedback about level of medical knowledge to fellows preparing for subsequent board certification. This study evaluated the association between the American Society of Nephrology In-Training Examination and the American Board of Internal Medicine Nephrology Certification Examination in terms of scores and passing status.Design, setting, participants, & measurementsThe study included 1684 nephrology fellows who completed the American Society of Nephrology In-Training Examination in their second year of fellowship training between 2009 and 2014. Regression analysis examined the association between In-Training Examination and first-time Nephrology Certification Examination scores as well as passing status relative to other standardized assessments.ResultsThis cohort included primarily men (62%) and international medical school graduates (62%), and fellows had an average age of 32 years old at the time of first completing the Nephrology Certification Examination. An overwhelming majority (89%) passed the Nephrology Certification on their first attempt. In-Training Examination scores showed the strongest association with first-time Nephrology Certification Examination scores, accounting for approximately 50% of the total explained variance in the model. Each SD increase in In-Training Examination scores was associated with a difference of 30 U (95% confidence interval, 27 to 33) in certification performance. In-Training Examination scores also were significantly associated with passing status on the Nephrology Certification Examination on the first attempt (odds ratio, 3.46 per SD difference in the In-Training Examination; 95% confidence interval, 2.68 to 4.54). An In-Training Examination threshold of 375, approximately 1 SD below the mean, yielded a positive predictive value of 0.92 and a negative predictive value of 0.50.ConclusionsAmerican Society of Nephrology In-Training Examination performance is significantly associated with American Board of Internal Medicine Nephrology Certification Examination score and passing status.

The Association of Pediatric Critical Care Medicine Training Programs with Research Publication Productivity and Employment Outcomes of Their Graduates

2020 ◽  
Author(s):  
Sonali Basu ◽  
Robin Horak ◽  
Murray M. Pollack
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Medical School ◽  
Training Programs ◽  
Fellowship Training ◽  
Publication Productivity ◽  
Research Publication ◽  
Pediatric Critical Care ◽  
Publication Success ◽  
Fellowship Programs

AbstractOur objective was to associate characteristics of pediatric critical care medicine (PCCM) fellowship training programs with career outcomes of PCCM physicians, including research publication productivity and employment characteristics. This is a descriptive study using publicly available data from 2557 PCCM physicians from the National Provider Index registry. We analyzed data on a systematic sample of 690 PCCM physicians representing 62 fellowship programs. There was substantial diversity in the characteristics of fellowship training programs in terms of fellowship size, intensive care unit (ICU) bed numbers, age of program, location, research rank of affiliated medical school, and academic metrics based on publication productivity of their graduates standardized over time. The clinical and academic attributes of fellowship training programs were associated with publication success and characteristics of their graduates' employment hospital. Programs with greater publication rate per graduate had more ICU beds and were associated with higher ranked medical schools. At the physician level, training program attributes including larger size, older program, and higher academic metrics were associated with graduates with greater publication productivity. There were varied characteristics of current employment hospitals, with graduates from larger, more academic fellowship training programs more likely to work in larger pediatric intensive care units (24 [interquartile range, IQR: 16–35] vs. 19 [IQR: 12–24] beds; p < 0.001), freestanding children's hospitals (52.6 vs. 26.3%; p < 0.001), hospitals with fellowship programs (57.3 vs. 40.3%; p = 0.01), and higher affiliated medical school research ranks (35.5 [IQR: 14–72] vs. 62 [IQR: 32, unranked]; p < 0.001). Large programs with higher academic metrics train physicians with greater publication success (H index 3 [IQR: 1–7] vs. 2 [IQR: 0–6]; p < 0.001) and greater likelihood of working in large academic centers. These associations may guide prospective trainees as they choose training programs that may foster their career values.

CHILD-PARENT RELATIONS AS A FACTOR IN THE FORMATION OF PROFESSIONAL PREFERENCES IN PEDAGOGICAL DYNASTIES

2020 ◽  
Vol 2 (4) ◽  
pp. 126-130
Author(s):  
N. V. SHAMANIN ◽  
Keyword(s):  
Professional Development ◽  
The Family ◽  
The Individual ◽  
Relationship Of ◽  
The Relationship ◽  
Parent Child Relationships ◽  
Professional Preferences ◽  
Parent Child

The article raises the issue of the relationship of parent-child relationships and professional preferences in pedagogical dynasties. Particular attention is paid to the role of the family in the professional development of the individual. It has been suggested that there is a relationship between parent-child relationships and professional preferences.

Michel Foucault and Western Medicine

2019 ◽  
Vol 29 (2) ◽  
pp. 64-81
Keyword(s):  
Western Medicine ◽  
18Th Century ◽  
Medical Knowledge ◽  
Social Medicine ◽  
Western Society ◽  
1960S And 1970S ◽  
The Veil ◽  
The 1960S ◽  
The Individual ◽  
The 19Th Century

The article analyzes Michel Foucault’s philosophical ideas on Western medicine and delves into three main insights that the French philosopher developed to expose the presence of power behind the veil of the conventional experience of medicine. These insights probe the power-disciplining function of psychiatry, the administrative function of medical institutions, and the role of social medicine in the administrative and political system of Western society. Foucault arrived at theses insights by way of his intense interest in three elements of the medical system that arose almost simultaneously at the end of the 18th century - psychiatry as “medicine for mental illness”, the hospital as the First and most well-known type of medical institution, and social medicine as a type of medical knowledge focused more on the protection of society and far less on caring for the individual. All the issues Foucault wrote about stemmed from his personal and professional sensitivity to the problems of power and were a part of the “medical turn” in the social and human sciences that occurred in the West in the 1960s and 1970s and led to the emergence of medical humanities. The article argues that Foucault’s stories about the power of medical knowledge were philosophical stories about Western medicine. Foucault always used facts, dates, and names in an attempt to identify some of the general tendencies and patterns in the development of Western medicine and to reveal usually undisclosed mechanisms for managing individuals and populations. Those mechanisms underlie the practice of providing assistance, be it the “moral treatment” practiced by psychiatrists before the advent of effective medication, or treating patients as “clinical cases” in hospitals, or hospitalization campaigns that were considered an effective “technological safe-guard ” in the 18th and most of the 19th century.

scholarly journals 1132. Professional Development Curriculum for Fellows in Infectious Diseases

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S595-S595
Author(s):  
jessica B Wells ◽  
Vera Luther
Keyword(s):  
Professional Development ◽  
Job Search ◽  
Career Paths ◽  
Fellowship Training ◽  
Formative Assessments ◽  
Billing And Coding ◽  
Continued Learning ◽  
Fellowship Training Program ◽  
General Topic ◽  
Training Demands

Abstract Background ID fellowship training demands that fellows must learn a wealth of information to master ID content and become experts in the field. As such, there is often a limited amount of formal curricular time devoted to career development and to the business of medicine. We designed and implemented a professional development educational series for ID fellows. Methods Surveys of fellowship graduates indicated an increased need for training on the business aspects of medicine and careers in ID during fellowship. The primary aim of this project was to develop a professional development curriculum to meet identified needs while still being feasible to implement given all the other topic areas about which fellows must learn. WE developed a 6-part series comprised of: careers in ID, physician contracts, compensation models, and job search (table). Each of the 6 educational activities included pre-reading and a 1-hour small group activity. Outside speakers were utilized in 2 of the sessions. Fellows completed surveys pre- and post- curriculum implementation and also provided formative assessments of curricular activities throughout the year. Results All (n= 6) ID fellows completed the curriculum. All 6 (100%) reported an increased understanding of careers in ID, physician contracts, and resources for continued learning on career paths. All fellows reported that this was a meaningful addition to the existing curriculum. Strengths of the curriculum as identified by fellows were the general topic areas and the interactive format. Fellows identified areas for improvement for upcoming years: expand the session on compensation models, include more information on careers in industry, and add billing and coding workshops. All fellows strongly agreed that the professional development curriculum should be continued in future years. Conclusion The professional development curriculum was a valuable addition to our existing ID fellowship training program. Implementing a professional development curriculum for ID fellows is feasible. Disclosures All Authors: No reported disclosures

The Entextualization of Ayurveda as Intellectual Property

2012 ◽  
Vol 19 (3) ◽  
pp. 313-343 ◽  
Author(s):  
Matthew Wolfgram
Keyword(s):  
Intellectual Property ◽  
Global Economy ◽  
Medical Knowledge ◽  
Linguistic Anthropology ◽  
Medical Discourse ◽  
Complex Nature ◽  
Multiple Sources ◽  
The Social ◽  
Rights Discourse ◽  
The Individual

AbstractThis article documents the practices of pharmaceutical creativity in Ayurveda, focusing in particular on how practitioners appropriate multiple sources to innovate medical knowledge. Drawing on research in linguistic anthropology on the social circulation of discourse—a process calledentextualization—I describe how the ways in which Ayurveda practitioners innovate medical knowledge confounds the dichotomous logic of intellectual property (IP) rights discourse, which opposes traditional collective knowledge and modern individual innovation. While it is clear that these categories do not comprehend the complex nature of creativity in Ayurveda, I also use the concept of entextualization to describe how recent historical shifts in the circulation of discourse have caused a partial entailment of this opposition between the individual and the collectivity. Ultimately, I argue that the method exemplified in this article of tracking the social circulation of medical discourse highlights both the empirical complexity of so-called traditional creativity, and the politics of imposing the categories of IP rights discourse upon that creativity, situated as it often is, at the margins of the global economy.

Statement on Pediatric Fellowship Training

PEDIATRICS ◽  
1991 ◽  
Vol 87 (2) ◽  
pp. 265-265
Author(s):  
Keyword(s):  
Research Training ◽  
Clinical Care ◽  
Fellowship Training ◽  
The Body ◽  
Pediatric Residents ◽  
Pediatric Society ◽  
Research Fellowship ◽  
Research Activities ◽  
Fellowship Programs ◽  
Interest In Research

The following statement was adopted by the Federation of Pediatric Organizations in February, 1990. The Federation consists of the following pediatric organizations: Ambulatory Pediatric Association, American Academy of Pediatrics, American Board of Pediatrics, American Pediatric Society, Association of Medical School Pediatric Department Chairmen, Association of Pediatric Program Directors, Society for Pediatric Research. The Federation supports the concept that "the principal goal of fellowship training should be the development of future academic pediatricians." Graduates of pediatric fellowship programs usually work in academic centers with significant time set aside for research. Some fellowship-trained pediatricians, particularly neonatologists, allergists, and neurologists, may not work in hospitals or ambulatory settings that are associated closely with academic programs. Fellowship-trained pediatricians in all settings should be encouraged to continue their interest in research to add to the body of pediatric knowledge. To achieve the goal of training pediatric scientists, the following guidelines for fellowship education are recommended: 1. Upon completion of a pediatric fellowship, the trainee should be proficient in clinical care, teaching, and research. Fellowship training should prepare a pediatrician to care for children with complex illnesses within his/her area of special expertise and to serve as a consultant for the general pediatrician. In addition, the fellowship-trained pediatrician should be responsible for the education of pediatric residents and the continuing education of practicing pediatricians. For this reason, fellowship training should include interpersonal skills and pedagogical techniques. 2. Research training should begin as soon as possible; premedical students, medical students, and pediatric residents should be encouraged strongly to participate in meaningful research, and research activities should be carried out throughout fellowship training.

STATEMENT OF PEDIATRIC FELLOWSHIP TRAINING

PEDIATRICS ◽  
1996 ◽  
Vol 98 (2) ◽  
pp. A8-A8
Keyword(s):  
Clinical Care ◽  
Fellowship Training ◽  
The Body ◽  
Current Position ◽  
Pediatric Residents ◽  
Body Of Knowledge ◽  
Area Of Interest ◽  
Fellowship Programs ◽  
Special Expertise ◽  
Research Mentor

In 1990, the Federation of Pediatric Organizations adopted a statement on pediatric fellowship training.1 This revised statement represents the current position of the federation regarding the purpose and objectives of fellowship training. The federation continues to support the concept that "the principal goal of fellowship training should be the development of future academic pediatricians." Within academic and teaching centers, there is a need for master clinicians, skilled teachers, and productive investigators who conduct research with varied interests. Graduates of pediatric fellowship programs should be proficient in both direct and consultative clinical care, teaching, and a selected area of research. Thereafter, differentiation of interests and activities should be expected and encouraged, but graduates of the fellowship programs in all settings should continue their involvement in research, whether collaborative or direct, to add to the body of knowledge in their area of interest. The following guidelines for fellowships are recommended: 1. Fellowship training should prepare pediatricians to care for children with complex problems within their areas of special expertise and to serve as consultants. Fellows should participate directly in the care of patients and should serve as consultants, with guidance and supervision provided by senior clinical mentors. 2. Fellowship training should include the development of skills as an educator, including presentation skills, curriculum development, and evaluation. Fellows should participate in the education of pediatric residents and the continuing education of practicing pediatricians. 3. Each fellow should have a mutually agreed on research mentor(s). It is essential for the fellow to have mentor(s) capable of fostering the trainee's career development.

I nuovi scambi tra medici e pazienti: le parole della medicina

2021 ◽  
Vol 9788879169776 ◽  
pp. 35-45
Author(s):  
Antonio M. Carrassi
Keyword(s):  
Search Engines ◽  
Health Workers ◽  
Medical Knowledge ◽  
Medical Field ◽  
Average Life ◽  
Average Life Span ◽  
Research Activities ◽  
Field Information ◽  
The One ◽  
The Individual

Medicine showed enormous progresses since the middle of the last century and, thanks to the overwhelming research activities, which characterized that period, the average life span of people has increased extraordinarily. Many diseases that once were considered incurable are now being successfully treated. However, the disease has often been placed at the core of the clinical process rather than the person, the individual, the patient. Even in recent years, the patient doesn’t always find in his doctor the appropriate degree of empathy, and the level of communication that would be desirable. Moreover, today we are living an extraordinary development and spreading use of digital resources and search engines. Patients exploit these tools to obtain any kind of information, included the one in the medical field. Information technology and search engines play an extremely important role in medicine, and they can be seen a pivotal communication instrument between clinicians and patients, although they can also provide inaccurate or incorrect feedback to laypeople looking for answers to health questions, who do not have enough medical knowledge to evaluate the reliability of the source. This problem has been raised by clinicians and, more generally, by health workers, who today operate with a view to greater psychological proximity to the patient, passing from a so-called Disease Centred Medicine to a clinical practice much more sensitive to the needs of the patient, to his experience, to the context in which he lives, thus achieving a Patient Centred Medicine. Listening, attention, empathy and the words that a clinician is required to use towards each patient, during the clinical routine, take on more and more value for a correct doctor-patient exchange and alliance.

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