RESUMEN
In this rapid communication, accelerated undergraduate medical education is examined using prior literature as well as experiences of those who have completed or are in the process of completing accelerated medical curricula. The Consortium of Accelerated Medical Pathway Programs (CAMPP) hosts an annual multi-institutional conference for all its members. During the meeting in July 2023, a virtual panel was convened from multiple constituent programs (N = 4) including medical students (N = 2), resident physicians (N = 4), and faculty (N = 2). Panel participants represented current learners or graduates from accelerated pathways of varying specialties (N = 5) to share firsthand experiences about acceleration to an audience representing over 25 medical schools. Five key themes were identified for accelerated students and trainees: Reduced debt as motivating factor to accelerate, Feeling prepared for residency, Ideal accelerated students are driven, Ability to form early professional relationships, and Less time for additional clinical experiences. Discourse from the CAMPP panel can inform current and developing accelerated programs at institutions looking to create or improve accelerated learning.
Asunto(s)
Curriculum , Educación de Pregrado en Medicina , Facultades de Medicina , Estudiantes de Medicina , Humanos , Educación de Pregrado en Medicina/organización & administración , Facultades de Medicina/organización & administración , Estudiantes de Medicina/psicología , Motivación , Internado y Residencia/organización & administración , Apoyo a la Formación Profesional , Docentes Médicos/psicología , Factores de TiempoRESUMEN
BACKGROUND: Educational debt is commonly observed among applicants to orthopaedic surgery residency programs; however, an understanding of the debt burden among minority and nonminority applicants is not well established. Thus, this study aimed to fill these knowledge gaps by examining the extent of and factors shaping educational debt among orthopaedic surgery applicants. QUESTIONS/PURPOSES: (1) What is the educational debt burden among orthopaedic surgery residency applicants? (2) After controlling for relevant confounding variables, what factors are independently associated with increasing levels of educational debt? (3) After controlling for relevant confounding variables, are individuals classified as an underrepresented minority or those with educational debt and socioeconomic disadvantage less likely to match in orthopaedic surgery? METHODS: A retrospective evaluation of orthopaedic surgery residency application data from the American Association of Medical Colleges was analyzed from 2011 to 2021. The American Association of Medical Colleges database was selected because every residency applicant must register and apply through the American Association of Medical Colleges. Therefore, these data exist for every residency applicant, and the sample was comprehensive. Self-reported data including premedical, medical, and total educational debt burden as well as classification as socioeconomically disadvantaged and application fee waiver use were collected. Applicants were dichotomously categorized as an underrepresented minority or a not underrepresented minority based upon self-identified race and ethnicity. Monetary values were reported in USD and inflation-adjusted to 2021 using the Consumer Price Index. We performed t-tests and chi-square tests for continuous and categorical variables, respectively. Significance was considered at p < 0.05. In all, 12,112 applicants were available in the initial cohort, and 67% (8170 of 12,112) of applicants with complete data were included from 2011 to 2021 in the final study cohort. Of these, 18% (1510 of 8170) were women, 14% (1114 of 8170) were classified as underrepresented minorities, and 8% (643 of 8170) were classified as socioeconomically disadvantaged. Sixty-one percent (4969 of 8170) of applicants reported receiving at least one scholarship, 34% (2746 of 8170) had premedical school debt, and 72% (5909 of 8170) had any educational debt including medical school. Among all applicants, the median (IQR) educational debt was USD 197,000 (25,000 to 288,000). Among those with scholarships, the median amount was USD 25,000 (9000 to 86,000). RESULTS: After controlling for the potentially confounding variables of gender and socioeconomic disadvantage, classification as an underrepresented minority applicant was independently associated with higher scholarship amounts than applicants characterized as not underrepresented minorities (ß = USD 20,908 [95% confidence interval (CI) 15,395 to 26,422]; p < 0.001), whereas underrepresented minority classification was not independently associated with a difference in total educational debt (ß = USD 3719 [95% CI -6458 to 13,895]; p = 0.47). After controlling for the potentially confounding variables of gender and classification as an underrepresented minority, socioeconomic disadvantage was independently associated with higher scholarship amounts (ß = USD 20,341 [95% CI 13,300 to 27,382]; p < 0.001) and higher total educational debt (ß = USD 66,162 [95% CI 53,318 to 79,006]; p < 0.001) than applicants not classified as socioeconomically disadvantaged. After controlling for the potentially confounding variables of gender and classification as an underrepresented minority, socioeconomic disadvantage was independently associated with decreased match rates (OR 0.62 [95% CI 0.52 to 0.74]; p < 0.001). CONCLUSION: These findings underscore the need for comprehensive scholarship initiatives to ensure equitable financial accessibility for applicants from all backgrounds. CLINICAL RELEVANCE: In the future, orthopaedic surgery may benefit from research comparing the effectiveness of various initiatives aiming to improve fairness in the burden of debt among applicants to orthopaedic surgery residency programs.
Asunto(s)
Internado y Residencia , Factores Socioeconómicos , Humanos , Internado y Residencia/economía , Internado y Residencia/estadística & datos numéricos , Estudios Retrospectivos , Femenino , Masculino , Estados Unidos , Ortopedia/educación , Ortopedia/economía , Adulto , Grupos Minoritarios/estadística & datos numéricos , Educación de Postgrado en Medicina/economía , Educación de Postgrado en Medicina/estadística & datos numéricos , Apoyo a la Formación Profesional/economía , Selección de Personal/economía , Selección de Personal/estadística & datos numéricosRESUMEN
OBJECTIVE: Given the substantial increases in student educational loan debt in recent years, the objective was to assess trends in educational debt-to-income ratios for graduates of pharmacy, medicine, dentistry, optometry, and veterinary medicine programs in the United States in the 2017-2022 period. METHODS: A retrospective analysis of 2017-2022 data for educational debt and income for select health professions was conducted. Annual income data were collected from the American Community Survey, and educational debt data were collected from health professions organizations. Educational debt-to-income ratios for each health profession were calculated, as was the mean change per year in debt-to-income ratio. RESULTS: With the exception of medicine, educational debt consistently exceeded income across the selected health professions in the 2017-2022 period. Debt-to-income ratios of pharmacists and the remaining health professionals decreased on average per year between 2017 and 2022. Physicians had the lowest debt-to-income ratios and dentists had the highest debt-to-income ratios in the study period. CONCLUSION: Debt-to-income ratios fell below the 2017 levels for the health professions of interest, suggesting that average growth in income outpaced that of debt for the study period. Regardless, debt remains high and may influence health care professionals' postgraduate training and career decisions, and in turn affect access to health care. Therefore, a call to action is proposed to address educational debt burden. Several strategies are suggested, including federal policy changes, implementing tuition reductions or minimal increases, facilitating financial aid options, and reducing underlying costs of health professions programs.
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Renta , Farmacéuticos , Apoyo a la Formación Profesional , Humanos , Farmacéuticos/economía , Farmacéuticos/estadística & datos numéricos , Farmacéuticos/tendencias , Estudios Retrospectivos , Estados Unidos , Apoyo a la Formación Profesional/economía , Apoyo a la Formación Profesional/estadística & datos numéricos , Apoyo a la Formación Profesional/tendencias , Personal de Salud/economía , Personal de Salud/estadística & datos numéricos , Personal de Salud/educación , Personal de Salud/tendencias , Educación en Farmacia/economía , Educación en Farmacia/tendencias , Educación en Farmacia/estadística & datos numéricos , Encuestas y CuestionariosAsunto(s)
Internado y Residencia , Humanos , Internado y Residencia/economía , Internado y Residencia/estadística & datos numéricos , Ortopedia/educación , Ortopedia/economía , Educación de Postgrado en Medicina/economía , Factores Socioeconómicos , Apoyo a la Formación Profesional/economía , Femenino , Masculino , Cirujanos Ortopédicos/economía , Procedimientos Ortopédicos/economía , Procedimientos Ortopédicos/educación , Estados Unidos , Selección de ProfesiónRESUMEN
Neurodivergent conditions such as autism, attention deficit hyperactivity disorder (ADHD), dyslexia, dyspraxia, dyscalculia and Tourette's syndrome are common, and it is highly likely that practice assessors and supervisors will be asked to support neurodivergent nursing students in their practice learning environments. This article details the strengths that neurodivergent students can bring to nursing, as well as some of the challenges they may experience in practice settings. It outlines how practice assessors and supervisors can develop neuro-inclusive learning environments where neurodivergent students can thrive, as well as how to support them if they are not meeting their required proficiencies. The authors also discuss how appropriate reasonable adjustments can be implemented by using a collaborative approach with students.
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Aprendizaje , Trastornos del Neurodesarrollo , Estudiantes de Enfermería , Apoyo a la Formación Profesional , Facultades de Enfermería/normas , HumanosRESUMEN
Introducción. La deuda económica durante la residencia en cirugía general puede afectar el desempeño profesional, las decisiones de vida y el bienestar psicológico. La información disponible en Colombia es limitada. El objetivo de este estudio fue cuantificar la deuda económica del residente de cirugía general, identificar los factores asociados y evaluar su efecto en el bienestar psicológico. Métodos. Estudio de corte transversal analítico. Se invitó a 380 residentes a diligenciar una encuesta sobre los aspectos relacionados con su deuda económica y se utilizó el WHO-index para evaluar su bienestar psicológico. Resultados. Un total de 259 residentes participaron en el estudio (67,6 %). El 56 % posee una deuda económica promedio de COP $88.000.000 ((US$21.826)). Un alto nivel de endeudamiento se relacionó con el año de residencia, el tipo de institución (privada) y la solicitud de préstamos. Se identificó algún trastorno mental en 14,7 % y un bajo nivel de bienestar psicológico en 56,4 % de los participantes. No se identificó ninguna asociación entre una elevada deuda económica y el bajo bienestar psicológico. Conclusiones. La deuda económica tiene un efecto sobre los residentes. El endeudamiento de los residentes de cirugía en Colombia es altamente prevalente, y no se correlaciona con un pobre bienestar psicológico. La autodeterminación favorece el bienestar psicológico en el posgrado en cirugía general. Existe la necesidad de educación financiera en los residentes. Se requieren nuevos estudios que evalúen las causas del pobre bienestar psicológico.
Introduction. Financial debt during surgery residency can affect professional performance, life decisions, and psychological well-being. The information available in Colombia is limited. The objective of this study is to quantify the financial debt of the general surgery resident, identify the associated factors and evaluate their effect on psychological well-being. Methods. A cross-sectional study was carried out. A total of 380 residents were invited to complete a survey on aspects related to their financial debt, and the WHO-index to evaluate their psychological well-being. Results. A total of 259 residents participated in the study (67.6%). 56% have an average economic debt of $88,000,000 COP (US$21,826). High debt was related to level of residence, type of institution (private), and loan application. Some mental disorder was identified in 14.7% and a low level of psychological well-being in 56.4% of the participants. No association was identified between high financial debt and low psychological well-being. Conclusions. Economic debt has an effect on residents. Financial debt among surgical residents in Colombia is highly prevalent; however, it does not correlate with poor psychological well-being. Self-determination favors psychological well-being in the postgraduate course in general surgery. Likewise, the need for financial education in residents is imminent. New studies are required that thoroughly evaluate the causes of poor well-being.
Asunto(s)
Humanos , Cirugía General , Economía , Bienestar Psicológico , Apoyo a la Formación Profesional , Educación de Postgrado en MedicinaRESUMEN
OBJECTIVE: Federal loan repayment programs (LRPs) are one strategy to address the shortage of behavioral health providers. This scoping review aimed to identify and characterize the federal LRPs' impact on the U.S. behavioral health workforce. METHODS: A scoping review was conducted in accordance with JBI (formerly known as the Joanna Briggs Institute) methodology for scoping reviews. The authors searched the Ovid MEDLINE, Web of Science, APA PsycInfo, EconLit, PAIS Index, and Embase databases, and gray literature was also reviewed. Two coders screened each article's abstract and full text and extracted study data. Findings were narratively synthesized and conceptually organized. RESULTS: The full-text screening identified 17 articles that met eligibility criteria. Of these, eight were peer-reviewed studies, and all but one evaluated the National Health Service Corps (NHSC) LRP. Findings were conceptually organized into five categories: descriptive studies of NHSC behavioral health needs and the NHSC workforce (k=4); providers' perceptions of, and experiences with, the NHSC (k=2); associations between NHSC funding and the number of NHSC behavioral health providers (k=4); NHSC behavioral health workforce productivity and capacity (k=3); and federal LRP recruitment and retention (k=4). CONCLUSIONS: The literature on federal LRPs and their impact on the behavioral health workforce is relatively limited. Although federal LRPs are an important and effective tool to address the behavioral health workforce shortage, additional federal policy strategies are needed to attract and retain behavioral health providers and to diversify the behavioral health workforce.
Asunto(s)
Fuerza Laboral en Salud , Servicios de Salud Mental , Humanos , Estados Unidos , Servicios de Salud Mental/economía , Personal de Salud , Apoyo a la Formación Profesional/economía , Financiación GubernamentalRESUMEN
OBJECTIVE: Research years during medical school are becoming increasingly common amongst applicants to competitive residency programs. As many of these positions are unpaid, it is important to consider the financial implications of these experiences and the feasibility of participation from students of all backgrounds. This study aims to quantify the cost of a research year during medical school. DESIGN/SETTING: We identified the top 50 NIH-funded medical schools of 2022 and obtained cost-of-living information for each of their respective counties. Estimated loan interest accrual resulting from a research year was calculated using information on the cost of attendance to medical school and annual interest rates for federal education loans. Cost-of-living calculations were stratified by geographic region, and interest accrual calculations by timing of research year and attendance at public versus private medical schools. RESULTS: Top 50 NIH-funded medical schools in the West are located in counties with the highest mean and median costs of living, each approaching nearly $45,000 per year. Medical schools in the Midwest are located in counties with the lowest mean and median cost of living, at less than $36,000 annually. Estimated loan interest accrual resulting from a research year ranges from $3177 to $17,789, depending on timing of the research year and type of medical school attended. CONCLUSIONS: This study exemplifies the significant financial burden that a research year can impose on medical students. As more residency applicants pursuing competitive specialties opt for research years during medical school, it is important to consider the associated financial implications. Many research year opportunities are unpaid or underpaid, which may prevent interested individuals from participating; this is especially the case for those who are from lower socioeconomic backgrounds. Moving forward, it is imperative that we ensure the availability of equitable and funded research year opportunities for students of all backgrounds.
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Internado y Residencia , Medicina , Estudiantes de Medicina , Humanos , Facultades de Medicina , Apoyo a la Formación Profesional , EficienciaRESUMEN
PURPOSE: The review had two purposes. The first was to examine the nature and extent of published literature on student loan and the second was to systematically review the literature on student loans and mental health. MATERIALS AND METHODS: Data from academic databases (1900-2019) were analyzed using two methods. First, topic modeling (a text-mining tool that utilized Bayesian statistics to extract hidden patterns in large volumes of texts) was used to understand the topical coverage in peer-reviewed abstracts (n = 988) on student debt. Second, using PRISMA guidelines, 46 manuscripts were systematically reviewed to synthesize literature linking student debt and mental health. RESULTS: A model with 10 topics was selected for parsimony and more accurate clustered representation of the patterns. Certain topics have received less attention, including mental health and wellbeing. In the systematic review, themes derived were categorized into two life trajectories: before and during repayment. Whereas stress, anxiety, and depression dominated the literature, the review demonstrated that the consequences of student loans extend beyond mental health and negatively affect a person's wellbeing. Self-efficacy emerged as a potential solution. DISCUSSION AND CONCLUSION: Across countries and samples, the results are uniform and show that student loan burdens certain vulnerable groups more. Findings indicate diversity in mental health measures has resulted into a lack of a unified theoretical framework. Better scales and consensus on commonly used terms will strengthen the literature. Some areas, such as impact of student loans on graduate students or consumers repaying their loans, warrant attention in future research.
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Salud Mental , Humanos , Estudiantes/psicología , Apoyo a la Formación ProfesionalRESUMEN
OBJECTIVES: A need persists for graduates with public health training in government public health roles; however, earnings for these positions tend to be lower when compared with earnings for people with undergraduate or graduate training who are working in other sectors, such as private health care or pharmaceuticals. This study assessed federal student loan debt associated with education for public health, with an aim to quantify the need that may be met through the federal Public Health Workforce Loan Repayment Program (PHWLRP), which is one tool that policy makers have proposed to incentivize people with public health training to pursue employment in government public health. METHODS: We analyzed federal student loan data provided by the National Center for Education Statistics College Scorecard for the 2018-2019 academic year. We merged these data with the Integrated Postsecondary Education Data System to estimate the number of degrees awarded. We used Spearman rank correlation to compare associations between debt and annual earnings by award level (bachelor's, master's, and doctoral degrees). RESULTS: Across all award levels, the median level of federal student loan debt associated with education for public health was $33 366. The median annual earnings 1 year after graduation were $80 687 for graduates with doctoral degrees and $33 279 for graduates with bachelor's degrees. CONCLUSIONS: As policy makers attempt to strengthen the public health workforce with a focus on funding and implementing the PHWLRP, the existing levels of student debt should be considered to ensure that programs such as the PHWLRP are funded and reflect the needs of graduates and government public health employers.
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Salud Pública , Apoyo a la Formación Profesional , Humanos , Apoyo a la Formación Profesional/economía , Apoyo a la Formación Profesional/estadística & datos numéricos , Estados Unidos , Salud Pública/economía , Educación en Salud Pública Profesional/economía , Financiación Gubernamental/estadística & datos numéricosRESUMEN
BACKGROUND: Medical training is known to impose financial burden on trainees, which has been shown to contribute to burnout, even possibly compromising patient care. Financial literacy allows for management of financial situations affecting professional and personal life. The authors aimed to evaluate the financial status and knowledge among plastic surgery residents. METHODS: A survey regarding finances and financial literacy of plastic surgery residents was sent to all the current accredited U.S. residency programs. The same survey was distributed internally. A descriptive analysis was performed, and multiple Fisher exact tests and a t test evaluated comparisons. RESULTS: Eighty-six residents were included. Most trainees had a student loan (59.3%), with 22.1% having loans more than $300,000. A majority had at least one personal loan debt other than educational (51.1%). Residents with more debt were significantly less likely to pay off their balances monthly. A total of 17.4% of trainees had no plan for how to invest their retirement savings, whereas 55.8% reported not knowing how much they need to save to retire. One in five trainees did not feel prepared to manage personal finances/retirement planning after graduation, a majority had no formal personal finance education in their curriculum, and 89.5% agreed that financial literacy education would be beneficial. Our institutional data largely mirrored national data. CONCLUSIONS: Many residents are lacking in financial knowledge, despite most having significant debt. Additional financial literacy education is needed in plastic surgery training. Curricula development at an institutional or national society level are possible paths toward a coordinated response to this need.
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Internado y Residencia , Cirugía Plástica , Humanos , Alfabetización , Renta , Apoyo a la Formación Profesional , Encuestas y CuestionariosRESUMEN
Este artigo partilha reflexões acerca da construção do estágio obrigatório curricular no campo da Psicologia Escolar/Educacional em uma perspectiva crítica. O estágio é um momento privilegiado da formação, por aproximar teoria e prática, em direção à práxis crítica, aspecto central nessa abordagem psicológica. Visando conhecer como tem sido construída a experiência de estágio e supervisão na área, foram realizadas entrevistas com um supervisor de estágio que atua em uma Universidade Pública do Piauí, dada a relevância de sua atuação e militância, buscando compreender: as concepções e práticas desenvolvidas pelo supervisor; os atravessamentos ético-políticos que emergem da experiência de estágio e supervisão; e os elementos de criticidade que marcam tal experiência. O artigo põe em foco as estratégias de organização do estágio, o papel da supervisão e os desafios vivenciados na relação estagiários-escola-supervisor. Esperamos contribuir com a reflexão acerca dos desafios implicados na construção de estágios supervisionados na área de Psicologia Escolar e Educacional em uma perspectiva crítica, tanto no campo, quanto nos encontros de supervisão.
Este artículo intercambia reflexiones acerca de la construcción de la pasantía obligatoria curricular en el campo de la Psicología Escolar/Educacional en una perspectiva crítica. La pasantía es un momento privilegiado de la formación, por acercar teoría y práctica, en dirección a la praxis crítica, aspecto central en ese abordaje psicológico. Visando conocer de qué forma ha sido construida la experiencia de pasantía y supervisión en el área, se realizaron entrevistas con un supervisor de pasantía que actúa en una Universidad Pública da Piauí, dada la relevancia de su actuación y militancia, buscando comprender: las concepciones y prácticas desarrolladas por el supervisor; los atravesamientos ético-políticos que surgen de la experiencia de pasantía y supervisión; y los elementos de criticidad que marcan tal experiencia. El artículo pone de relieve las estrategias de organización de la pasantía, el papel de la supervisión y los desafíos vivenciados en la relación alumno en formación-escuela-supervisor. Esperamos contribuir con la reflexión acerca de los desafíos implicados en la construcción de pasantías tuteladas en el área de Psicología Escolar y Educacional en una perspectiva crítica, en el campo y en los encuentros de supervisión.
This article shares reflections about the construction of mandatory curricular internship in the field of School and Educational Psychology from a critical perspective. The internship is a privileged moment in training, as it brings theory and practice closer together, towards critical praxis, a central aspect of this psychological approach. In order to know how the experience of internship and supervision in the area has been constructed, interviews were conducted with an internship supervisor who works at a Public University of Piauí, given the relevance of his work and militancy, seeking to understand: the concepts and practices developed by the supervisor; the ethical-political crossings that emerge from the internship and supervision experience; and the elements of criticality that mark such an experience. The article focuses on internship organization strategies, the role of supervision and the challenges experienced in the relationship between interns-school-supervisor. We hope to contribute to reflection on the challenges involved in building supervised internships in the area of School and Educational Psychology from a critical perspective, both in the field and in supervisory meetings.
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Organización y Administración , Psicología Educacional , Apoyo a la Formación ProfesionalRESUMEN
OBJECTIVE: Pharmacy students with substantial educational debt are at risk for excessive workloads, burnout, and clinical errors. During the COVID-19 pandemic, policies addressing economic hardships for all student debt borrowers included temporary suspension of monthly payments and 0% interest during the pause. This study aimed to understand student-level factors regarding student debt from the lived experiences of current pharmacy students and aimed to understand how current pharmacy students view temporary loan relief. METHODS: We used semi-structured interviews of pharmacy students across 4 years of progression in their pharmacy program to better understand student experiences with debt, different factors that may influence the impact of student debt on short-term and long-term outcomes for students, and student perspectives on debt relief policies and potential solutions. Our thematic analysis was grounded in existing evidence and a conceptual framework, while also allowing codes to emerge directly from the data. RESULTS: A total of 20 pharmacy students were interviewed with a median student debt of $77,000, with debt amounts ranging from $0 to $209,000. Students described what mediating factors influenced their experiences, the influence of student debt on clinician burnout, and other outcomes impacted by student debt. Six overarching themes emerged relevant to current students: student debt influences education and career decisions, debt is risky given the saturated pharmacy market, debt is an accepted burden, debt will inhibit starting a life, the COVID-19 loan relief is revealing, and early financial education is needed. CONCLUSION: Pharmacy students burdened with debt described a variety of different experiences and attitudes toward that debt and provided their perspectives on how student debt influences short-term education and career decisions. While students accept the trade-off of debt for their education as an inevitable burden, reported coping mechanisms and strategies shared suggest some solutions may be available to ameliorate this burden.