Assuntos
Educação de Pós-Graduação , Pesquisadores , Apoio à Pesquisa como Assunto , Justiça Social , Brasil , Pesquisadores/economia , Pesquisadores/educação , Bolsas de Estudo/economia , Bolsas de Estudo/tendências , Apoio à Pesquisa como Assunto/economia , Apoio à Pesquisa como Assunto/tendências , Justiça Social/economia , Justiça Social/tendênciasAssuntos
Pesquisa Biomédica/organização & administração , Bolsas de Estudo/organização & administração , Equidade de Gênero/estatística & dados numéricos , Internato e Residência/organização & administração , Cirurgia Plástica/educação , Pesquisa Biomédica/economia , Pesquisa Biomédica/estatística & dados numéricos , Bases de Dados Factuais , Bolsas de Estudo/economia , Bolsas de Estudo/estatística & dados numéricos , Feminino , Humanos , Internato e Residência/economia , Internato e Residência/estatística & dados numéricos , Masculino , Cirurgia Plástica/economia , Inquéritos e Questionários/estatística & dados numéricosRESUMO
OBJECTIVES: Our 2011 report, reflecting data from 2007-2008, demonstrated that, for many pediatric subspecialties, pursuing fellowship training was a negative financial decision when compared with practicing as a general pediatrician. We provide an updated analysis on the financial impact of pediatric fellowship training and model interventions that can influence the results. METHODS: We estimated the financial returns a graduating pediatric resident might anticipate from fellowship training followed by a career as a pediatric subspecialist and compared them with the returns expected from starting a career as a general pediatrician immediately after residency. We evaluated the potential effects of eliminating medical school debt, shortening the length of fellowship training, and implementing a federal loan repayment program for pediatric subspecialists. We compared the financial returns of subspecialty training in 2018-2019 to those from our previous report. RESULTS: Pursuing fellowship training generated widely variable financial returns when compared with general pediatrics that ranged from +$852 129 for cardiology to -$1 594 366 for adolescent medicine. Twelve of 15 subspecialties analyzed yielded negative financial returns. The differences have become more pronounced over time: the spread between the highest and lowest earning subspecialties widened from >$1.4 million in 2007-2008 to >$2.3 million in 2018-2019. The negative financial impact of fellowship training could be partially ameliorated by shortening the length of training or by implementing pediatric subspecialist specific loan repayment programs. CONCLUSIONS: This report can be used to help guide trainees, educators, and policy makers. The interventions discussed could help maintain an adequate and balanced pediatric workforce.
Assuntos
Renda , Pediatras/economia , Especialização/economia , Bolsas de Estudo/economia , Humanos , Internato e Residência/economia , Pediatria/economia , Estados UnidosRESUMO
The number of Americans affected by diabetes continues to increase but the number of endocrinologists with specialty training to treat this population has not kept up with demand. Primary care outpatient visits can also not meet the projected diabetes population demands or the needs for other complex diabetes management issues. Treatments for diabetes including both medications and technologies continue to expand and become more complex. In response to these challenges there have been primary care physicians seeking specialized training to become diabetologists. This can fill some of the gaps left by a lack of resources in the U.S. healthcare system.
Assuntos
Diabetes Mellitus/terapia , Educação Médica/organização & administração , Bolsas de Estudo/organização & administração , Atenção Primária à Saúde/organização & administração , Acreditação , Diabetes Mellitus/economia , Bolsas de Estudo/economia , Bolsas de Estudo/normas , Humanos , Atenção Primária à Saúde/economia , Estados UnidosRESUMO
New treatments, new understanding, and new approaches to translational research are transforming the outlook for patients with kidney diseases. A number of new initiatives dedicated to advancing the field of nephrology-from value-based care to prize competitions-will further improve outcomes of patients with kidney disease. Because of individual nephrologists and kidney organizations in the United States, such as the American Society of Nephrology, the National Kidney Foundation, and the Renal Physicians Association, and international nephrologists and organizations, such as the International Society of Nephrology and the European Renal Association-European Dialysis and Transplant Association, we are beginning to gain traction to invigorate nephrology to meet the pandemic of global kidney diseases. Recognizing the timeliness of this opportunity, the American Society of Nephrology convened a Division Chief Retreat in Dallas, Texas, in June 2019 to address five key issues: (1) asserting the value of nephrology to the health system; (2) productivity and compensation; (3) financial support of faculty's and divisions' educational efforts; (4) faculty recruitment, retention, diversity, and inclusion; and (5) ensuring that fellowship programs prepare trainees to provide high-value nephrology care and enhance attraction of trainees to nephrology. Herein, we highlight the outcomes of these discussions and recommendations to the American Society of Nephrology.
Assuntos
Comitês Consultivos , Bolsas de Estudo/normas , Nefrologistas/economia , Nefrologia/educação , Nefrologia/organização & administração , Sociedades Médicas/organização & administração , Eficiência , Docentes de Medicina , Bolsas de Estudo/economia , Humanos , Seleção de Pessoal , Salários e BenefíciosRESUMO
STUDY OBJECTIVE: To present updated information regarding compensation patterns for Fellowship in Minimally Invasive Gynecologic Surgery (FMIGS)-graduated physicians in the United States beginning practice during the last 10 years, focusing on the variables that have an impact on differences in salary, including gender, fellowship duration, geographic region, practice setting, and practice mix. DESIGN: An online survey was sent to FMIGS graduates between March 15, 2019 and April 12, 2019. Information on physicians' demographics, compensation (on the basis of location, practice model, productivity benchmarks, academic rank, and years in practice), and attitudes toward fairness in compensation was collected. SETTING: Online survey. PARTICIPANTS: FMIGS graduates practicing in the United States. INTERVENTION: E-mail survey. MEASUREMENTS AND MAIN RESULTS: We surveyed 298 US FMIGS surgeons who had graduated during the last 10 years (2009-2018). The response rate was 48.7%. Most of the respondents were women (69%). Most of the graduates (84.8%) completed 2- or 3-year fellowship programs. After adjustment for inflation, the median starting salary for the first postfellowship job was $252 074 ($223 986-$279 983) (Table 1). The median time spent in the first job was 2.6 years, and the median total salary at the current year rose to $278 379.4 ($241 437-$350 976). The median salary for respondents entering a second postfellowship job started at $280 945 ($261 409-$329 603). Significantly lower compensation was reported for female FMIGS graduates in their initial postfellowship jobs and was consistently lower than for that of men over time. Most FMIGS graduates (59.7%) reported feeling inadequately compensated for their level of specialization. CONCLUSION: A trend toward higher self-reported salaries is noted for FMIGS graduates in recent years, with significant differences in compensation between men and women. Among obstetrics and gynecology subspecialists, FMIGS graduates earn significantly less than other fellowship-trained physicians, with median salaries that are lower than those of generalist obstetrics and gynecology physicians.
Assuntos
Bolsas de Estudo/tendências , Ginecologia/tendências , Procedimentos Cirúrgicos Minimamente Invasivos , Salários e Benefícios/tendências , Adulto , Bolsas de Estudo/economia , Bolsas de Estudo/estatística & dados numéricos , Feminino , Seguimentos , Procedimentos Cirúrgicos em Ginecologia/economia , Procedimentos Cirúrgicos em Ginecologia/educação , Procedimentos Cirúrgicos em Ginecologia/tendências , Ginecologia/economia , Ginecologia/educação , Humanos , Masculino , Procedimentos Cirúrgicos Minimamente Invasivos/economia , Procedimentos Cirúrgicos Minimamente Invasivos/educação , Procedimentos Cirúrgicos Minimamente Invasivos/estatística & dados numéricos , Procedimentos Cirúrgicos Minimamente Invasivos/tendências , Obstetrícia/economia , Obstetrícia/educação , Obstetrícia/estatística & dados numéricos , Obstetrícia/tendências , Salários e Benefícios/estatística & dados numéricos , Fatores Sexuais , Cirurgiões/economia , Cirurgiões/educação , Cirurgiões/estatística & dados numéricos , Cirurgiões/tendências , Inquéritos e Questionários , Estados Unidos/epidemiologiaRESUMO
PROBLEM: Medical education academies have been instrumental in providing greater recognition of and promotion for clinician-educators. However, producing education scholarship is essential for clinician-scholar-educator career advancement. Grant funding for education research and protected time to produce scholarship are still lacking for interested physicians, in part due to institutional budget constraints and competing priorities. APPROACH: The Hospital for Special Surgery Academy of Rheumatology Medical Educators was founded in 2011 to promote education scholarship through grants awarded to educators interested in research. Educators were asked to submit proposals aimed at the development of new teaching programs and curricular change. Selected applicants received up to $50,000 per year for one year. Grant money was obtained through directed fundraising from donors. Information from annual grant updates and survey responses from grant recipients in 2017 were used to assess the academy's effectiveness. OUTCOMES: Since 2012, 32 grants have been awarded, totaling $954,045 in funding. Recipients have produced national meeting abstracts, posters, oral presentations, and manuscripts and created unique curricula and electronic learning tools for medical students, residents, fellows, faculty, and patients. Four educators with demonstrated interest and research outcomes were identified during the pilot and received additional funding and support from a dedicated education research assistant. NEXT STEPS: The academy and the innovations grants program highlight the talents of under-supported and under-recognized teaching faculty by allowing them to distinguish themselves academically as clinician-scholar-educators. The success of these educators emphasizes the clear advantages of a formalized structure to achieve the hospital's education goals. Next steps include providing support for a rheumatology fellow to develop an education research career rather than one in bench, clinical, or translational research.
Assuntos
Academias e Institutos/organização & administração , Pesquisa Biomédica/economia , Educação Médica/métodos , Hospitais Especializados/economia , Reumatologia/educação , Pesquisa Biomédica/estatística & dados numéricos , Currículo/estatística & dados numéricos , Bolsas de Estudo/economia , Feminino , Hospitais Especializados/organização & administração , Humanos , Aprendizagem , Masculino , Tutoria/economia , Cidade de Nova Iorque , Médicos/estatística & dados numéricos , Estudantes de Medicina/estatística & dados numéricos , Apoio ao Desenvolvimento de Recursos Humanos/economiaRESUMO
Introduction The COVID 19 pandemic has affected education at all levels. Surgical fellows have faced unique challenges. PROBLEMS: The authors address aspects of Canadian surgical fellowships that have been impacted by the pandemic. These include case volumes, training objectives, funding models, burden of stress and research productivity. SOLUTIONS: Solutions are proposed including varying the mix of cases to meet objectives, pursuing alternative finance structures and leveraging technology for both research and advancing surgical technique. CONCLUSION: These solutions are offered to help mitigate the effects of future pandemics for both current and future surgical fellows.
Assuntos
COVID-19/epidemiologia , Educação de Pós-Graduação em Medicina/tendências , Bolsas de Estudo , Cirurgia Geral/educação , Cirurgiões/economia , Cirurgiões/psicologia , Canadá/epidemiologia , Eficiência , Bolsas de Estudo/economia , Humanos , Pandemias , SARS-CoV-2 , Carga de Trabalho/estatística & dados numéricosAssuntos
Medicina Aeroespacial/economia , Pesquisa Biomédica/economia , Bolsas de Estudo/economia , Pesquisadores/economia , Desemprego , United States National Aeronautics and Space Administration/economia , Medicina Aeroespacial/educação , Currículo , Humanos , Salários e Benefícios , Estados UnidosRESUMO
BACKGROUND: Fellowship program directors have a considerable influence on the future practice patterns of their trainees. Multiple studies have demonstrated that industry can also exert substantial influence on the practice patterns of physicians as a whole. The purpose of this study is to quantify industry support of fellowship program directors across surgical subspecialties and to assess the prevalence of this support within specific subspecialties. METHODS: Fellowship program directors for acute care, breast, burn, cardio-thoracic, critical care, colon and rectal, endocrine, hepato-pancreato-biliary, minimally invasive, plastic, oncologic, pediatric, and vascular surgery for 2017 were identified using a previously described database. The Open Payments Database for 2017 was queried and data regarding general payments, research, associated research payments, and ownership were obtained. The national mean and median payouts to nonfellowship program director surgeons were used to determine subspecialties with substantial industry support. RESULTS: Five hundred and seventy-six fellowship program directors were identified. Of these, 77% of the fellowship program directors had a presence on the Open Payments Database. The subspecialties with the most fellowship program directors receiving any industry payment, regardless of amount, included vascular (93.5%), cardio-thoracic (92.8%), minimally invasive surgery (90.5%), plastics (85.3%), and colon and rectal (81.0%). The subspecialty with the greatest mean payment was minimally invasive surgery (21,175 US dollars); the greatest median payment was vascular (1,871 US dollars). The 3 most common types of payments were for general compensation (31.4%), consulting fees (28.7%), and travel and lodging (14.7%). Vascular surgery had the greatest percentage of fellowship program directors receiving research payments (48%). The greatest amount paid to any individual fellowship program director was 382,368 US dollars. Excluding outliers, fellowship program directors received substantially more payments than those received on average by general surgeons. CONCLUSION: The majority of fellowship program directors receive some industry support. Most payments are for compensation for noncontinuing medical education related services and consulting fees. Certain specialties were more likely to have industry payments than others. Overall, only a minority of fellowship program directors received research support from industry. We advocate for transparent discussions between fellowship program directors and their trainees to help foster healthy academic-industry collaborations.