Student loneliness through the pandemic: How, why and where?

Loneliness has emerged as a problem for individuals and society. A group whose loneliness has recently grown in severity and visibility is students in higher education. Complementing media reports and surveys of students' lockdown loneliness, this paper presents qualitative research findings on students loneliness during the COVID-19 pandemic. It explores the how, why and where of student loneliness through research co-produced with undergraduate and postgraduate students. Student-researchers investigated loneliness as a function of relationships and interactions through self-interviews and peer interviews (n = 46) and through objects, chosen by participants to represent their experiences of lockdown. This research led to three conclusions, each with a geographical focus. First, as the spaces in which students live and study were fragmented, interactions and relationships were disrupted. Second, students struggled to put down roots in their places of study. Without a sense of belonging-to the city and institution where they studied, and the neighbourhood and accommodation where they lived-they were more likely to experience loneliness. Third, many students were unable to progress through life transitions associated with late adolescence including leaving home, learning social skills, forming sexual relationships and emerging into adulthood. Those facing bigger changes such as bereavement struggled to process these events and spoke of feeling 'neither here nor there'-in limbo. But students displayed resilience, finding ways to cope with and mitigate their loneliness. Their coping strategies speak to the efforts of policymakers and practitioners-including those in universities, government, health and wellbeing services, and accommodation services-who are seeking ways to tackle students' (and other peoples') loneliness.

Evaluating Urology Program Directors' Perception on Resident Application Parameters Following the Transition of USMLE Step 1 to Pass/Fail.

OBJECTIVE: To investigate how the shift of the United States Medical Licensing Examination (USMLE) Step 1 to a Pass/Fail (P/F) scoring system impacts the perceptions of Urology Program Directors (PDs) on evaluating urology residency applicants. METHODS AND MATERIALS: A cross-sectional survey was sent to 117 PDs, including questions about program characteristics, perceptions of shelf scores and medical school rank post-transition, beliefs about the predictive value of Step 1 and Step 2 Clinical Knowledge (CK) scores for board success and residency performance, and changes in applicant parameter ranking. RESULTS: Forty-five PDs (38% response rate) participated. Notably, 49% favored releasing quantitative clerkship grades, and 71% valued medical school rank more. Opinions on Step 1 scores' correlation with board success were split (49% agreed), and 44% endorsed Step 2 CK scores' connection to board performance. As predictors of good residents, only 9% and 22% considered Step 1 and Step 2 CK scores, respectively, indicative. Clerkship grades and Urology rotation recommendation letters maintained significance, while research experience gained importance. Step 2 CK scores' importance rose but did not match Step 1 scores' previous significance. CONCLUSION: The transition to P/F for USMLE Step 1 adds intricacies to urology residency selection, exposing PDs' uncertainties regarding clerkship grades and the relevance of medical school rank. This research underscores the dynamic nature of urology residency admissions, emphasizing the increasing importance of research in evaluating applicants and a diminishing emphasis on volunteering and leadership.

Assessing the debt and current state of financial literacy in a cohort of diagnostic & interventional radiology residents.

RATIONALE AND OBJECTIVES: The purpose of this study is to assess diagnostic and interventional radiology resident physicians' knowledge of core facets of financial literacy: loans, real estate, investments and retirement, and insurance, with the goal of determining the need for formal financial literacy education within radiology residency programs. METHODS: From May 2021 to March 2022, surveys were sent to 196 diagnostic and 90 interventional radiology residency programs. Residents were asked 10 knowledge multiple choice questions to assess areas of financial literacy. Custom R programming was used to evaluate responses. RESULTS: A total of 149 diagnostic radiology residents and 49 interventional radiology residents responded to portions of the survey, for a total of 198 respondents. Of the cohort with demographic data collected, 84 out of 141 residents (60 %) had over $100,000 of debt following medical school graduation, with 115 out of 146 DR residents (79 %) and 41 out of 47 (87 %) IR residents reporting no coursework in finance. CONCLUSIONS: Many radiology resident physicians have a significant debt burden, no official financial education, and clear knowledge gaps in areas of financial literacy. A structured financial education curriculum could better prepare residents for the financial realities of post-residency life.

Diagnostic & interventional radiology residency program directors' perspectives on the USMLE step 1 exam shift to pass/fail scoring.

RATIONALE AND OBJECTIVES: As of January 2022, Step 1 of the United States Medical Licensing Examination (USMLE) has changed to pass/fail grading. The purpose of this study was to share survey results and communicate changes Diagnostic (DR) and integrated Interventional (IR) Radiology residency program directors (PDs) will make and aspire to make, given this change. MATERIALS AND METHODS: An online survey was sent to DR and IR PDs. Data was collected over four months. Custom R programming and MATLAB language scripts were used to evaluate the survey responses. Chi squared tests were used to determine statistical significance for multiple choice questions regarding PD views of Step 1 transitioning to pass-fail. Paired t-tests were used to differentiate pre- and post-values for questions in which PDs ranked criteria for resident selection. RESULTS: After USMLE Step 1 becomes pass/fail, most respondents will use Step 2 CK scores as a more important factor than previously, believe medical schools should share National Board of Medical Examiners (NBME) shelf exam scores, do not believe students will be better prepared clinically, and believe a student's medical school rank will be considered more. CONCLUSION: The added emphasis on Step 2 CK scores, NBME shelf exam scores, class rank, and a student's medical institution may negate the positive impacts of changing Step 1 to pass/fail. Alternatively, it may present an opportunity for programs to evaluate students more broadly.

Assessing the Impact of Changes to USMLE Step 1 Grading on Evaluation of Neurosurgery Residency Applicants in the United States: A Program Director Survey.

BACKGROUND: Neurosurgery (NS) is among the most selective specialties in the United States. As the United States Medical Licensing Examination (USMLE) Step 1 transitions to a binary pass/fail score, residency programs face unclear challenges in screening and evaluating applicants. The aim of this study is to provide insights into the perceived impact of changes to the USMLE Step 1 grading in the applicant selection process. METHODS: We created a survey using questions regarding NS program demographics, the perceived predictive abilities of Step 1 and Step 2 clinical knowledge (CK), and several factors that programs consider when assessing applicants. We queried program directors (PDs), program coordinators (PCs), and assistant PDs at 117 NS residency programs. Respondents were asked to rank these factors in order of importance for selection at their respective training program. We used descriptive statistics and a Wilcoxon matched-pairs signed-rank test to evaluate the effects of these changes using STATA 17. RESULTS: A total of 35 (30%) residency programs responded with 26 (74%) completing the factor ranking questions. 86% (95% confidence interval, 71.5%-94.3%) disagreed that the changes will better prepare students clinically. USMLE Step 2 CK scores, class rank, and away rotations saw significant increases in priority in the absence of a graded Step 1, whereas letters of recommendation and surrogates for research productivity saw notable, but not significant, changes after adjusting for multiple testing. CONCLUSIONS: Reporting binary Step 1 grades marks a significant shift in assessing applicants for NS residency by emphasizing Step 2 CK, class rank, and research productivity.