Academic Achievement, Professionalism, and Burnout in Family Medicine Residents

Background and Objectives: Physician burnout has been shown to have roots in training environments. Whether burnout in residency is associated with the attainment of critical educational milestones has not been studied, and is the subject of this investigation. Methods: We used data from a cohort of graduating family medicine residents registering for the 2019 American Board of Family Medicine initial certification examination with complete data from registration questionnaire, milestone data, in-training examination (ITE) scores, and residency characteristics. We used bivariate and multilevel multivariate analyses to measure the associations between four professionalism milestones ratings and ITE performance with burnout. Results: Our sample included 2,509 residents; 36.8% met the criteria for burnout. Multilevel regression modeling showed a correlation between burnout and failure to meet only one of four professionalism milestones, specifically professional conduct and accountability (OR 1.41, 95% CI 1.07-1.87), while no statistically significant relationship was demonstrated between burnout and being in the lowest quartile of ITE scores. Other factors negatively associated with burnout included international medical education (OR 0.60, 95% CI 0.48-0.76) and higher salary compared to cost of housing (OR 0.62, 95% CI 0.46-0.82). Conclusions: We found significant association between self-reported burnout and failing to meet expectations for professional conduct and accountability, but no relationship between burnout and medical knowledge as measured by lower ITE performance. Further investigation of how this impacts downstream conduct and accountability behaviors is needed, but educators can use this information to examine program-level interventions that can specifically address burnout and development of physician professionalism.

Specialties of systemic hemodynamics in Russian and foreign medical students

SummaryIn this work, the purpose of the study was to evaluate the parameters of systemic hemodynamics in students of the Russian and foreign departments of the Privolzhsky research Medical University. The study included 48 Russian students of medical, pediatric and dental faculties, as well as 54 students studying at the faculty of international medical education. To register ECG and analyze hemodynamic parameters, we used the Medical Soft sports testing system (MS FIT Pro version, Russia). Standard hemodynamic parameters (blood pressure level, pulse rate, stroke volume, cardiac output, etc.), statistical and spectral parameters of heart rate variability, as well as the integral criterion of microcirculation status were used for monitoring. Data analysis was performed in accordance with age standards formed by the equipment developers. The presence of sufficient adaptive reserves in both groups of subjects was revealed, but foreign students have a lower arteriole tone, a greater risk of arrhythmogenicity, higher intensity of microcirculation and a predisposition to moderate bradycardia.

Agglomeration effect of medical education: Based on the web of science database

By retrieving the 1900–2016 medical education-related essays from the web of science database, UCINET software was used to build the national cooperation network and its nested visualization software, and NetDraw was used to visualize the country cooperation networks in different time windows. We found that international medical education papers began to show exponential growth until 1945 and international cooperation did not begin to become dense until 1961. With the increasing number of participating countries in international medical education, the cooperation factions formed more complicated. The intensity of international cooperation between the United States, Britain and other major international medical education powers has been declining from 1991 to 2016. Between Brazil and China, during 1996–2016, the center of cooperation network has been on the rise for a long time, and the intensity of Canada's cooperation in medical education research has been on the rise for nearly 25 years. The center of international medical education is gradually being transferred from the United States to Canada.