Psychiatry student interest groups: what they are and what they could be.

OBJECTIVE: Medical student interest groups across all specialties help students explore various specialties. There are no published reports on psychiatry student interest group (PSIG) curricula. The aim was to develop elements of a curriculum for such groups, based on data elicited from medical students and faculty members through a multi-institutional online survey. METHOD: The authors electronically surveyed 172 United States psychiatric residency training directors to determine the activities they felt to be important for inclusion in PSIG curricula. Similarly, they surveyed U.S. medical student PSIG leaders to ascertain the activities they felt important to include in such groups, and the current content of their groups. RESULTS: Authors received responses from 64 program directors and 44 PSIG leaders. Based on integration of the results of both surveys, and the practices of existing groups, they propose elements of a curriculum for PSIGs. Medical student PSIG leaders are particularly interested in activities that involve residents. Other curricular topics of interest both to students and training directors include those that focus on student/physician mental health and various psychiatry subspecialties or practice settings. Training directors are willing to be involved with a wide variety of PSIG activities. CONCLUSIONS: The results of these surveys should help to guide PSIG leaders and faculty members in optimizing their PSIG curricula by helping them to include those activities felt to be of most interest by students and of most relevance by training directors.

An effective curriculum for teaching third-year medical students about medical errors and disclosure.

The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) requires disclosure of medical errors related to sentinel events. At the University of Wisconsin School of Medicine and Public Health, we have developed an effective curriculum for teaching third-year medical students this content. The instructional program lasts a half day and consists of large group lectures combined with small group exercises. Lecture information is provided by patient relations, hospital administrators, and hospital defense attorneys. In small groups, students are given 2 clinical case scenarios to role play on disclosure facilitated by a physician and a legal representative. Student evaluations rate this course highly.

Is that your pager or mine: a survey of women academic family physicians in dual physician families.

OBJECTIVE: This study explored the unique challenges and strategies of women in academic family medicine who are in dual physician families. METHODS: An e-mail survey was sent to all female physician members of the Society of Teachers of Family Medicine (STFM) who were listed in the on-line database. The survey collected demographic information, details of job descriptions and family life, and included 3 open-ended questions about the experiences of dual physician families. RESULTS: Over 1200 surveys were sent to women physicians in academic family medicine. One hundred fifty-nine surveys were returned. Half of all women worked full time compared to 87% of their partners. Most women reported benefits of having a physician partner including support and having an understanding person at home, though scheduling conflicts and childcare responsibilities contributed to the need for job compromises. Women prioritized finding work-life balance and having supportive partners and mentors as most important to their success as academic family physicians. CONCLUSION: Dual physician relationships involve rewards and conflicts. More research should explore the competing demands of family life with success in academic medicine.

Can specialists and generalists teach clinical skills to second-year medical students with equal effectiveness?

PURPOSE: To compare the effectiveness of specialists and generalists as small-group leaders teaching basic physical examination skills to preclinical medical students. METHOD: Specialists and generalists were randomly assigned to teach physical examination skills to 69 groups of second-year students (n = 288). At the conclusion of the course, the specialist- and generalist-led groups were compared using three measures: students' scores on an objective structured clinical exam (OSCE), students' evaluations of their small-group leaders, and leaders' self-evaluations of confidence in teaching. RESULTS: OSCE scores did not differ between students taught by specialists and generalists (93.5% and 93.8% respectively, p = NS). Students' evaluations of their leaders were similar for nine characteristics rated on a seven-point scale (7 = strongly agree/outstanding; range of results for specialists: 6.20-6.62, for generalists 6.34-6.75, p = NS). Leaders expressed similar levels of confidence (on a seven-point scale; 7 = very confident) in their abilities to teach the neurologic exam (specialists 5.52, generalists 6.19, mean effect size difference 0.44, p = NS) and complete history and physical exam (6.03 and 6.53, mean effect size difference 0.43, p = NS). Specialists were significantly less confident in teaching the cardiovascular exam (5.80 and 6.50, mean effect size difference 0.51, p <.05) and pulmonary exam (5.56 and 6.60, mean effect size difference, 0.80, p <.01). CONCLUSIONS: Specialists and generalists can teach preclinical medical students with equal effectiveness as rated by the students and the students' scores on the OSCE examination, but specialists do not rate themselves as confident as do generalists to teach some skills.

Statistical criteria for setting thresholds in medical school admissions.

In 2001, Dr Jordan Cohen, President of the AAMC, called for medical schools to consider using an Medical College Admission Test (MCAT) threshold to eliminate high-risk applicants from consideration and then to use non-academic qualifications for further consideration. This approach would seem to be consistent with the recent Supreme Court ruling on the University of Michigan admissions cases. Research to support a threshold approach has been reported in many different ways, making comparability problematic. This study examines an assortment of statistical indices that have been used to determine thresholds in undergraduate science grade point average (USGPA) and MCAT sub-scores and total sum and compares them in terms of their sensitivity and specificity for determining Medical Licensing Exam (USMLE Step 1) first time failure. Data for medical school entering classes of 1992-1998 (N=752) from a large Midwestern medical school are used to determine the set of statistics that provide the most useful information for this purpose. The results support plots of risk differences, odds-ratios, sensitivity and specificity for setting cut-scores.

A comparison of statistical criteria for setting optimally discriminating MCAT and GPA thresholds in medical school admissions.

BACKGROUND: Using Medical College Admission Test-grade point average (MCAT-GPA) scores as a threshold has the potential to address issues raised in recent Supreme Court cases, but it introduces complicated methodological issues for medical school admissions. PURPOSE: To assess various statistical indexes to determine optimally discriminating thresholds for MCAT-GPA scores. METHODS: Entering classes from 1992 through 1998 (N = 752) are used to develop guidelines for cut scores that optimize discrimination between students who pass and do not pass the United States Medical Licensing Examination (USMLE) Step 1 on the first attempt. RESULTS: Risk differences, odds ratios, sensitivity, and specificity discriminated best for setting thresholds. Compensatory versus noncompensatory procedures both accounted for 54% of Step 1 failures, but demanded different performance requirements (noncompensatory MCAT-biological sciences = 8, physical sciences = 7, verbal reasoning = 7--sum of scores = 22; compensatory MCAT total = 24). CONCLUSIONS: Rational and defensible intellectual achievement thresholds that are likely to comply with recent Supreme Court decisions can be set from MCAT scores and GPAs.