Dissuasion in women surgical trainees pursuing cardiothoracic surgery.

BACKGROUND: The reasons for persistent gender disparity in cardiothoracic surgery (CTS) are multifaceted. The objective of this paper is to understand if and why women surgical trainees are dissuaded from pursuing CTS. METHODS: A survey was sent to self-identified women participating in Women in Thoracic Surgery speed mentoring. Statistical analysis was performed to determine dissuasion rates. Open-ended responses describing examples of dissuasion were characterized and categorized. RESULTS: Of all participants, 76 â€‹% (163/215) reported dissuasion from a CTS career. Third- and fourth-year medical students experienced the highest rate by training (81 â€‹%, 48/59) and those interested in Congenital CTS experienced the highest rate based on subspecialty interest (94 â€‹%, 17/18). The most cited dissuasion examples included work/life balance, lifestyle with children, and gender. CONCLUSIONS: Most women surveyed had been dissuaded from pursuing a career in CTS. Examples of dissuasion provided are heavily associated with traditional gender roles, supporting the presence of continued gender bias in CTS.

Emergency Medical Technician Training in Medical School on Preparation for Required National Board Exams and Clerkship Rotations: Results from a Student Survey.

Purpose: The University of South Carolina School of Medicine Greenville has incorporated Emergency Medical Technician (EMT) training into the first semester curriculum with students becoming state-certified EMTs and completing one ambulance shift per month throughout their pre-clerkship years. Although there have been programs that have reported EMT experiences in the pre-clinical years of medical education, student perceptions of how the EMT experiences help prepare them for board exams and clerkships is limited. Therefore, the aim of this study was to measure student perceptions regarding the impact of an EMT course and training in the pre-clerkship curriculum in medical school on helping prepare them for national board exams (ie USMLE® Step 1, 2 Clinical Knowledge (CK), 2 Clinical Skills (CS)) and clerkship rotations. Methods: Second-, third-, and fourth-year medical students at the University of South Carolina School of Medicine Greenville completed an anonymous voluntary survey with response rates of 66.3%, 55.2%, and 56.9%, respectively. The study was reviewed and exempted by the University of South Carolina Institutional Review Board. Results: Seventeen percent, 14%, and 41% of students agreed/strongly agreed an EMT course helped prepare them for the USMLE Step 1, Step 2 CK, and Step 2 CS exam, respectively. Sixty-four percent of students agreed/strongly agreed that an EMT course and experience helped prepare them for clerkship rotations. Conclusion: The findings in this study support EMT training and experience as an EMT as one method to help prepare students for clerkship rotations.

A Student Survey: Influence of Emergency Medical Technician Training on Student's Application, Matriculation, and Transition into Medical School.

Purpose: Medical education seeks to develop active methods of learning in addition to skills for patient interaction. With this in mind, the University of South Carolina (UofSC) School of Medicine Greenville developed a curriculum with an integrated emergency medical technician (EMT) certification course designed to provide a meaningful clinical experience for students; however, no data exists on whether this type of course influences a student's decision to apply to or attend a medical school and how such a course affects the transition to the medical school environment. The purpose of this study was to determine if an EMT course, as part of the medical school curriculum, influences students' decision to apply and attend a particular medical school and if this course influences students' transition to medical school while providing awareness of patients' lives and circumstances. Methods: A voluntary anonymous survey was distributed in Spring 2019 to first-, second-, third-, and fourth- year medical students at the UofSC School of Medicine Greenville. Response rates were 68.5%, 66.3%, 55.2%, and 56.9%, respectively. Results: Forty-three percent of students agreed/strongly agreed that the EMT course at UofSC School of Medicine Greenville factored into their decision to apply while 52% of students agreed/strongly agreed that it factored into their decision to attend. Students agreed/strongly agreed (82%) that the program helped with medical school transition. Ninety-one percent of students reported that EMT experiences increased awareness of patients' lives and circumstances. Conclusion: Students felt an EMT certification course at the beginning of the first year helped with the transition to medical school and increased awareness of patients' lives and circumstances.

Morbidity and Mortality in the Obese Trauma Intensive Care Unit Patient.

INTRODUCTION: Obesity is an epidemic in the United States, known to be associated with comorbidities. However, some data show that obesity may be a protective factor in some instances. The purpose of this study is to determine if there are differences in morbidity and mortality when comparing the obese and non-obese critically ill trauma patient populations. MATERIALS AND METHODS: This was a retrospective study conducted at Prisma Health Upstate in Greenville, South Carolina, an Adult Level 1 Trauma Center. Patients over the age of 18 years admitted due to trauma from February 6, 2016 to February 28, 2019 were included in this study. Burn patients were excluded. An online trauma database was used to obtain age, sex, body mass index, Glasgow coma score (GCS), injury severity score (ISS), revised trauma score (RTS), days on mechanical ventilation, hospital length of stay (LOS), and intensive care unit (ICU) LOS. RESULTS: There were 2365 critically ill trauma patients who met inclusion criteria for this study. 1570 patients were men (66.38%) and mean age was 53.2 ± 20.9. Of the patients, 2166 patients had blunt trauma (91.59%). Median GCS was 15 (interquartilerange [IQR]: 12, 15), median RTS was 12 (IQR: 11, 12), and median ISS was 17 (IQR: 9, 22). Obese critically ill trauma patients had significantly lower odds of mortality than nonobese (OR .686, CI 0.473-.977). Penetrating traumas (OR: 4.206, CI: 2.478, 6.990), increased ISS (OR: 1.095, CI: .473, 1.112), and increased age (OR: 1.036, CI: 1.038, 1.045) were associated with significantly increased odds of mortality. DISCUSSION: The obesity paradox is observed in the obese critically ill trauma patient population.