Reforming medical education admission and training in low- and middle-income countries: who gets admitted and why it matters.

Recent studies reveal public-sector healthcare providers in low- and middle-income countries (LMICs) are frequently absent from work, solicit informal payments for service delivery, and engage in disrespectful or abusive treatment of patients. While extrinsic factors may foster and facilitate these negative practices, it is not often feasible to alter the external environment in low-resource settings. In contrast, healthcare professionals with strong intrinsic motivation and a desire to serve the needs of their community are less likely to engage in these negative behaviors and may draw upon internal incentives to deliver a high quality of care. Reforming medical education admission and training practices in LMICs is one promising strategy for increasing the prevalence of medical professionals with strong intrinsic motivation.

An Analysis of the Optometric Applicant Pool Relative to Matriculants.

SIGNIFICANCE: The interplay of applicants to optometry school and matriculants has not been explored systematically. It is vital that the profession examines these trends to ensure a viable pipeline of future doctors of optometry. PURPOSE: The purpose of this study was to describe the demographics and academic qualifications of entering optometry classes from autumn 2010 through autumn 2018 of U.S.-based optometric institutions' application pool and matriculants (enrollees). METHODS: Data were gathered from reports generated from accredited schools and colleges of optometry in the United States and compiled by the Association of Schools and Colleges of Optometry (publicly available) and the Optometry Centralized Application Service. Metrics included the annual number of verified applicants, the annual number of matriculants, the home region of U.S.-based applicants, and the Optometry Admission Test (OAT) performance and grade point average of verified applicants. RESULTS: The number of verified applicants for autumn 2018 was 0.95% higher than that for autumn 2010, yet the number of matriculants in 2018 compared with 2010 increased by 11.2% with an applicant-to-matriculant ratio in 2010 of 1.53 compared with 1.39 in 2018. Grade point average and academic average OAT scores were stable from 2010 to 2018. The ratios of verified applicants with an academic average OAT score of at least 300 to matriculants were 0.87 for autumn 2018 and 0.92 for autumn 2010. The ratios of verified applicants with a grade point average of at least 3.00 to matriculants were 1.13 for autumn 2018 and 1.23 for autumn 2015. CONCLUSIONS: Evidence supports the conclusion that the applicant pool has remained essentially flat for the last decade, whereas the number of matriculants has increased substantially; thus, the number of qualified applicants to matriculants has logically decreased. In the last 2 years, optometric programs have responded by decreasing their institution's number of matriculants to accommodate the national trends.

A study on the correlation between program contact hours and the successful matriculation into college.

Area Health Education Centers (AHECs) play an important role in the recruitment and training of students to serve as practicing health care professionals in rural, primary care, and medically underserved communities. To analyze the relationship between the accumulated contact hours of past students in AHEC programs and their known matriculation into college. 5,189 students, whom participated in Indiana AHEC Network programs, were grouped into eight categories based on accumulated contact hours and matched against two college matriculation databases. The relationship between the number of accumulated contact hours and known college matriculation was statistically significant. The analysis of the data suggests two significant break points in which the number of accumulated contact hours appears to be correlated with increased known college matriculation. The findings indicate accumulated contact hours are significantly correlated with known college matriculation. Furthermore, two significant break points in contact hours at the 5 and 20 contact hours demonstrated increased correlations between program contact hours and known college matriculation. The results of this analysis between participation in area health education center programming and matriculation into higher education may be transferable to other areas of health education.

Coming of Age in Physician Assistant Education: Evolution of Program Characteristics.

PURPOSE: This study aimed to describe the characteristics of physician assistant (PA) programs developed in 3 previously defined time periods. METHODS: Data were extracted from the websites of 238 PA programs, including admissions, curriculum, faculty, and program characteristics. Institutional characteristics were gathered from the Carnegie Classification website and the US Census Bureau. Program characteristics were analyzed in 3 groups based on when the program was first accredited-early (before 1980), middle (1980-1999), and current (2000-2019). RESULTS: Early (n = 40), middle (n = 69), and current (n = 129) phase programs are similar regarding the number of admissions, curriculum, faculty, program, and institutional characteristics. Program phase had the greatest effect on undergraduate GPA of matriculating students, the number of PA faculty at the rank of professor, and the size of the admitted cohort. The effect size was medium for outcomes including the number of required biology, chemistry, or physics prerequisites; the probability that the program required a graduate record examination for admission; the number of PA program faculty at the rank of associate professor; the annual tuition and fees; and the probability that the PA program was housed with a medical school. CONCLUSION: The data describe some of the similarities and differences among the programs established in the 3 previously described time periods in the history of PA education. With the recent surge in new programs, there is value in deepening our understanding of how newer programs compare with more established programs.

Using the Core Competencies for New Physician Assistant Graduates to Prioritize Admission Criteria for PA Practice in 2025.

In a fast-changing medical and educational environment, it is incumbent upon the physician assistant (PA) education community to periodically consider what the future practice environment might look like for our graduates. Changes in technology, regulation, reimbursement, health system economics, and health care delivery are among the many forces shaping the practice environment of the future. The 2018 Physician Assistant Education Association (PAEA) Presidents Commission reflected on what PA practice might look like in 2025 and used the Association's Core Competencies for New PA Graduates to consider what characteristics might therefore be required of the PA graduates who will practice in this future. We postulate that the future PA practice environment will require enhanced skills in such areas as interpreting technology-driven clinical data for patients and practices, consulting effectively with increasingly specialized members of health care teams, understanding population health and predictive analytics, and knowing how to access and critically assess new medical information. Working backward, we identify certain noncognitive attributes that will likely need to be prioritized in our admission processes and suggest some tools that can be used to assess them. These attributes include ethical responsibility, communication, critical thinking, situational judgment, and professionalism. As with all Presidents Commission articles, this piece is intended primarily to stimulate thought, dialogue, and future research. We encourage all faculty to participate in this dialogue, through the new PAEA Digital Learning Hub (https://paealearning.org/learn/digital-learning-hub/) and other channels.

Education of military veterans in physician assistant programs.

PURPOSE: To assess the admission policies, experiences, and attitudes of physician assistant (PA) program directors regarding recruiting, admitting, and training military veterans after the announcement of the "Helping Veterans Become Physician Assistants" initiative. METHODS: A descriptive survey of 22 questions was distributed to all 173 PA program directors in the United States in April 2013. The survey covered years 2011 to 2013, although it was completed in June of 2013. The results of the survey were compared with the results of a similar survey that covered years 2008 through 2010. RESULTS: One hundred and five (60.7%) program directors participated in this survey. Veterans were admitted into 88.1% of responding programs and accounted for an average of 4.0% of all students. One-third of programs (33%) accepted transfer credits for veterans' military training, and 20% accepted credits for off-duty education. One-third (33%) of programs participated in the Yellow Ribbon Program. Almost 60% of programs had military veteran faculty members. Active recruitment of military veteran students occurred in 31.2% of programs. Program directors described multiple benefits of, and barriers to, admitting and educating veterans. CONCLUSIONS: For the years 2011 through 2013, as compared to 2008 through 2010, there was an increase in the percentage of PA programs that actively recruited veterans, considered veteran status in the admission process, admitted veterans, and contributed to their financial support. There was also an increased percentage of students with military experience matriculating into PA programs. However, barriers still exist for veterans seeking admission into PA programs, the most significant of which is academic preparedness for a graduate-level PA program.

Information collected during the residency match process does not predict clinical performance.

OBJECTIVE: To determine whether information collected during the National Resident Matching Program (NRMP) predicts clinical performance during residency. METHODS: Ten faculty members rated the overall quality of 69 pediatric house officers as clinicians. After rating by the faculty, folders were reviewed for absolute rank on the NRMP match list; relative ranking (where they ranked in their postgraduate year 1 [PGY-1] group); scores on part I of the National Board of Medical Examiners (NBME) examination; grades during medical school pediatrics and internal medicine rotations; membership in the Alpha Omega Alpha Medical Honor Society; scores of faculty interviews during intern application; scores on the pediatric in-service examination during PGY-1; and scores on the American Board of Pediatrics certification examination. RESULTS: There was substantial agreement among faculty raters as to the overall quality of the residents (agreement rate, 0.60; kappa = 0.50; P = .001). There was little correlation between faculty ratings and absolute (r = 0.19; P = .11) or relative (r = 0.20; P = .09) ranking on the NRMP match list. Individuals ranked in the top 10 of the match list had higher faculty ratings than did their peers (mean +/- SD, 3.66+/-1.22 vs. 3.0+/-1.27; P = .03), as did individuals ranked highest in their PGY-1 group (mean +/- SD, 3.88+/-1.45 vs. 3.04+/-1.24; P = .03). There was no correlation between faculty ratings and scores on part I of the NBME examination (r = 0.10; P = .49) or scores on the American Board of Pediatrics certification examination (r = 0.22; P = . 11). There were weak correlations between faculty ratings and scores of faculty interviews during the intern application process (r = 0.27; P = .02) and scores on the pediatric in-service examination during PGY-1 (r = 0.28; P = .02). There was no difference in faculty ratings of residents who were elected to Alpha Omega Alpha during medical school (mean +/- SD, 3.32+/-1.21) as compared with those who were not (mean +/- SD, 3.08+/-1.34) (P = .25). CONCLUSIONS: There is significant agreement among faculty raters about the clinical competence of pediatric residents. Medical school grades, performance on standardized examinations, interviews during the intern application process, and match-list ranking are not predictors of clinical performance during residency.

Results of the 1996 National Resident Matching Program: family practice.

The results of the 1996 National Resident Matching Program (NRMP) set records in the number of positions filled in family practice residencies, with a 10.8% increase over 1995 (2,840 vs 2,563) and a 9.4% increase in positions filled with US seniors (2,276 vs 2,081). This is the largest number of US seniors choosing family practice in the history of the NRMP. A total of 196 (6.7%) more positions were offered in family practice through the NRMP, compared with 1995 (3,137 vs 2,941). Thus, 195 of these additional 196 positions were filled with US seniors. In keeping with the trend begun in 1992, 242 more positions were filled on July 1, 1996, than 1995 (3,494 vs 3,252), for a fill rate of 97.8%. Internal medicine residencies matched 67 fewer US seniors in 1996, while pediatric residencies matched 85 more US seniors. During the past 4 years, family practice has been the choice of 82.6% of the additional US seniors choosing a primary care residency. With continued record increased interest in family practice as a career choice and the need for more family physicians, priority support for the nation's family practice residency programs continues to be of critical importance.

[Profile of candidates to the technical nursing course at a private school in the city of Sao Paulo]. / O perfil dos candidatos ao curso técnico de enfermagem de uma escola particular da cidade de São Paulo.

The result showed the candidate's profile as they are adult; with age middle of 31.09 years old; familiar income are 9.65 minimum salary; single; predominant female; 12.5% with university course complete or incomplete; 43.8% have a children. The age of a children vary of 6-13 years old. The candidates refer affinity to work with patient of major risk and absence of affinity to pediatric patient. The work in oncology, demonstrated the positive way the personal learning and the negative, the personal and patient suffering.

An analysis of theme content in CASPA personal statements.

PURPOSE: Personal statements are a required component of the Central Application Service for Physician Assistants (CASPA) application package submitted to physician assistant (PA) programs that participate in the service. Prior research involving the use of personal statements in the selection process of graduate and professional programs has found a significant amount of homogeneity within the statements. This study sought to determine the major theme content and frequency of occurrence of these themes in the personal statements submitted by applicants to a Midwestern PA program. METHODS: After receiving signed consent, personal statements were extracted from the application packages of 63 students. Statements were identified with a random number. Each statement was reviewed and content themes were identified and manually coded by two separate reviewers. The reviewers and primary investigator then met and determined the major content categories by consensus. RESULTS: The review identified seven major content themes. Four of these themes were present in 70% or more of the statements: health care experience, altruism, patient interaction, medical profession. CONCLUSION: The personal statements reviewed contained similar content, confirming prior research that these statements may follow some formula for success. This may be evidence that applicants feel these attributes demonstrate that they are qualified candidates for admission. Further study should be conducted to see how these statements are used in the PA program admissions process.

The effect of the graduate record examination on minority applications: experience at New York Institute of Technology.

PURPOSE: The purpose of this study is to determine if requiring the graduate record exam (GRE) had an effect on minority applications submitted to New York Institute of Technology's (NYIT) physician assistant (PA) program. METHODS: Minorities applying from 2008-2011 were identified by the Central Application Service for Physician Assistants (CASPA). Data was obtained from two application cycles before and after the GRE was made an admissions requirement. Data was analyzed using descriptive statistics. RESULTS: Despite the CASPA pool of minority applicants remaining stable NYIT's pool of Black/African American applicants decreased substantially from 8.6% to 4.8% after the GRE was added to our admissions criteria. This resulted in a 44.1% decrease in NYIT's pool of Black/African American applicants. CONCLUSION: Adopting the GRE as part of our admissions criteria appears to have created an additional barrier for minority applicants, specifically Black/African American applicants. Every program should question whether or not the benefit of the GRE as an academic predictor outweighs the negative effect it may have on their program's minority application pool. Using the GRE as part of the admissions process appears to be a potential barrier and may result in greater ethnic disparity as more programs adopt its use.

Use of preadmission criteria and performance in the doctor of pharmacy program to predict success on the North American Pharmacists Licensure Examination.

OBJECTIVE: To determine which student characteristics and performance criteria in the prepharmacy and doctor of pharmacy (PharmD) program predict success on the North American Pharmacist Licensure Examination (NAPLEX). METHODS: Transcripts and NAPLEX scores were reviewed for 432 graduates from the Xavier University of Louisiana College of Pharmacy between 2008 and 2011. RESULTS: The preadmission variables that correlated with NAPLEX scores included math-science grade point average (GPA), cumulative GPA, student type (internal or transfer), and having no unsatisfactory grades (p<0.001). In the PharmD program, cumulative GPA, on-time graduation, and having no unsatisfactory grades in the prepharmacy and PharmD programs correlated with NAPLEX scores (p<0.001). CONCLUSION: Having no unsatisfactory grades in the prepharmacy program and a high cumulative GPA in the PharmD program were identified as significant predictors of success on the NAPLEX.

[Access tests to specialized health training for doctors and other healthcare professionals in Spain: examining the exam and the examined candidates]. / Pruebas de acceso a la formación sanitaria especializada para médicos y otros profesionales sanitarios en España: examinando el examen y los examinados.

OBJECTIVES: This study examines the accessing tests to Specialised Health Training for 2005 and 2006 calls. It aims to assess the quality of exams and explore candidates' variables that allow predicting the final score. METHODS: The Ministry of Health provided the 23,136 candidates' answer from both calls, plus demographic variables and the normalised value of their student record. RESULTS: Item's analysis is made from candidates' answers for evaluating the test reliability. In addition, it's been calculated linear regression models for studying which variables allow predicting a candidate's final score. CONCLUSIONS: the accessing tests to Specialised Health Training have excellent psychometric quality. It would be improved by reducing the number of choices and eliminating some items more afterwards. Finally, Spanish students are the ones who achieved best adjusted mean score.