Improving Graduate Medical Education Through Faculty Empowerment Instead of Detailed Guidelines.

Calls for improvement and reform in graduate medical education (GME) have led to more detail in educational and curricular guidelines. The current level of detail in curriculum guidelines for GME training programs is high, encompassing, for example, competency frameworks, entrustable professional activities, and milestones. In addition, faculty must employ an increasing number of assessment tools and elaborate portfolio systems for their residents. It is questionable whether any further increase in curriculum detail and assessment formats leads to better GME programs. Focusing on this type of system development may even lead to less engaged faculty if faculty are not encouraged to use their own professional judgment and creativity for teaching residents. Therefore, faculty members must be empowered to engage in curricular innovation, since system development alone will not result in better training programs. Raising faculty members' awareness of their virtues and value as teachers and involving them in the debate about how GME can be enhanced might increase their engagement in resident training.

Muchas sombras y pocas luces en el doctorado en ciencias biomédicas / No disponible

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Doctoral theses: a survival guide for radiologists. / La tesis doctoral: guía de supervivencia para radiólogos.

Nowadays, there are, surprisingly, many opportunities for research in the field of radiology, and these are accessible at any level. Thanks to radiological information systems and picture archiving and communication systems (PACS), a huge number of images and cases are available. Nevertheless, the daily workload and the lack of resources sometimes limit the advance of radiologic research. One of the routes of access is doctoral programs. The Bologna process has resulted in significant changes in the organization and in the prerequisites for doctoral theses. The new situation can be confusing for those who are further removed from the university. Given that many radiologists undertake their doctoral theses once their careers are well established, unfamiliarity with the new system can represent an added difficulty. This article aims to review the basic regulations that govern doctoral programs nowadays and to provide some useful advice for potential doctoral students.

Contributions to the Neurosurgery Political Action Committee (NeurosurgeryPAC): A Historical Perspective.

BACKGROUND: The political action committee (PAC) of the American Association of Neurological Surgeons, known as NeurosurgeryPAC, was formed in August 2005 to strengthen neurosurgical advocacy efforts. Since its establishment, NeurosurgeryPAC has made nonpartisan, direct campaign contributions to hundreds of candidates for the U.S. Senate and U.S. House of Representatives. METHODS: Historical contribution data for 2005-2018 was obtained from NeurosurgeryPAC. Data analyzed by year, and a 2-year election cycle included total amount raised, number of contributors, average donation, and percent participation. NeurosurgeryPAC contribution amounts for election cycles were also compared with those of other physician PACs. RESULTS: NeurosurgeryPAC has raised $2,953,870 since its inception in 2005, for an average of $210,991 per year. For this fundraising, the average annual donation amount is $796 per donor. The number of unique contributors per cycle has varied from 316-504, with an average of 389 individuals per annum and a participation rate of 7.8%. To date, the total amount raised in election years ($1,605,940) is 16.1% higher than that raised in nonelection years ($1,347,930). Among 28 physician PACs, NeurosurgeryPAC has ranked as high as 13 and as low as 17 in total hard money contributions. The orthopedic, neurology and general surgery PACs have consistently ranked higher than NeurosurgeryPAC, whereas the otolaryngology, spine, and plastic surgery PACs have ranked lower. CONCLUSIONS: Since its creation, NeurosurgeryPAC has collected a steady stream of donations to support political candidates. These donations have helped lawmakers who are supportive of policy issues important to neurosurgery, particularly physician reimbursement, medical liability reform, and graduate medical education. However, there remains a significant opportunity to increase the neurosurgeon participation rate in this vital organization. It is truly through advocacy that we will be able to positively affect the future of neurologic surgery in the United States.

The Implications of the Current Visa System for Foreign Medical Graduates During and After Graduate Medical Education Training.

The current and projected deficit in the physician workforce in the US is a challenge for primary care and specialty medical settings. Foreign medical graduates (FMGs) represent an important component of the US graduate medical education (GME) training pathway and can help to address the US physician workforce deficit. Availability of FMGs is particularly important to the internal medicine community, as recent data demonstrate that internal medicine is the specialty with the highest number of FMGs. System-based and logistical inefficiencies in the current US visa system represent significant obstacles to FMG trainees and have important psychological, emotional, and logistical consequences to FMG engagement and participation in US GME training and in the post-training workforce. In this article, we review the contemporary structure, process, and challenges of obtaining a visa for GME training. The H1B and J1 visa programs are compared and contrasted, with an emphasis on logistical specifics for FMG GME trainees and training programs. The process of and options for J1 visa waivers are reviewed. These considerations are specifically reviewed in the context of recent policy decisions by the Trump administration, with emphasis on the effects of these decisions on FMGs in medical training and practice.

Tesis doctorales de Medicina defendidas por mujeres pioneras en España (1882-1954) / Doctoral theses in Medicine by pioneer women in Spain (1882-1954)

FUNDAMENTO Y OBJETIVO: La presencia de mujeres pioneras en estudios superiores de Medicina en España cuenta con notables realizaciones. Este estudio indaga tesis doctorales en Medicina defendidas por mujeres en España desde 1882 a 1954 (el 1% de la producción total para ese periodo) e indexadas en las bases Cisne de la Universidad Complutense de Madrid. MATERIAL Y MÉTODO: Se recuperan y revisan 50 tesis doctorales. Se realiza un estudio longitudinal retrospectivo de análisis documental de tesis doctorales identificadas por año de defensa, título de cada tesis, nombre de la doctora, especialidad médica adscribible y palabras clave. RESULTADOS: El número de tesis de mujeres autoras se incrementa linealmente a lo largo del tiempo. Las especialidades médicas más comunes de tales tesis son: Ginecología y Obstetricia, Farmacología, Hematología, Pediatría y Endocrinología. También se realiza un conteo de frecuencias de los descriptores, en el cual destacan los términos: farmacología/terapia, educación, patogenia, enfermedad y niños. DISCUSIÓN Y CONCLUSIONES: La Medicina española dispone de 50 tesis doctorales pioneras defendidas por mujeres entre 1882 y 1954, aunque estas representan solo el 1% de la producción total de tesis doctorales en Medicina para ese periodo. Tan exiguo porcentaje alerta de un sesgo por techo de cristal que podría estar gravitando aún sobre las mujeres médicas. Una recomendación final se emite alentando a mejorar la situación de la mujer investigadora en Medicina

BACKGROUND AND OBJECTIVE: The presence of pioneer women in Spanish Medical Education has a notable impact. The objective of this study is to investigate doctoral theses in Medicine written by women in Spain between 1882 and 1954 and indexed in the Cisne library catalogue of Madrid Complutense University. These theses account for 1% of the total output for the period. MATERIAL AND METHOD: This retrospective longitudinal document analysis study examines doctoral theses identified by year of submission, title, author's name, ascribable medical speciality, and keywords. A total of 50 doctoral theses were identified and reviewed. RESULTS: The number of theses by female authors increased linearly over time. The most common medical specialities studied by female candidates were gynaecology and obstetrics, pharmacology, haematology, paediatrics, and endocrinology. The frequency of study descriptors was also calculated, and the following key terms detected: pharmacology/therapy, education, pathogenesis, disease, and children. DISCUSSION AND CONCLUSIONS: A total of 50 doctoral theses in medicine were written by pioneer female candidates in Spain between 1882 and 1954, accounting for just 1% of total output during this period. This tiny percentage indicates potential bias due to a glass ceiling that may continue to be a barrier to female doctors today. More still needs to be done to improve conditions for female medical researchers

Making Progress: The University of Hawai'i at Manoa's (UHM) Department of Surgery's Cross-Cultural Health Care Efforts from 2008-2018.

In 2008 the University of Hawai'i at Manoa's (UHM) Department of Surgery introduced the concept of cross-cultural health care (aka cultural competency) to its faculty and trainees. Much work remains before the cultural efforts wellknown outside the department are embraced within, but it has been prioritized for curriculum development and research. An example of the department's efforts include the Cross-Cultural Health Care Research Collaborative, which was created as a forum for faculty who have an interest in cultural issues related to healthcare and healthcare delivery. Participants from 14 UHM departments and other organizations developed projects and mentored students, resulting in over ten peer-reviewed publications. A related effort is the JABSOM Cultural Competency Resource Guide, which is in its 7th edition and reflects JABSOM activities and those of its collaborators. Another highlight is the Biennial Cross-Cultural Health Care Conference: Collaborative and Multidisciplinary Interventions, with six conferences held since 2010, hosting attendees from 28 US Mainland states and 11 countries. Additionally, the department has been recognized as one of the first to develop a cultural standardized patient exam for surgical residents. These nationally-recognized efforts resulted in invitations to serve on the very first cultural competency panel at the American College of Surgeons Clinical Congress and as a consultant on the development of Brigham and Women's Hospital's Center for Surgery and Public Health's Provider Awareness and Cultural dexterity Toolkit for Surgeons (PACTS), a standardized curriculum for surgical residents. The department plans to continue its work on these projects and document outcomes.

Academic Orthopaedic Leadership: Current Challenges and Lessons Learned: AOA Critical Issues.

Health-care reform, market competition, cost containment, and pressure for productivity have dramatically impacted the practice of orthopaedic surgery and academic surgical training. Orthopaedic leaders and training programs are striving to identify and solve these contemporary challenges. Herein, we focus on 4 areas that currently pose important challenges to modern orthopaedic surgical departments and academic hospital systems, including the demanding and evolving skill sets that are required of physician leaders, the effects of the changing medical-legal environment on academic medicine, the impact of increased clinical productivity emphasis on surgical education, and departmental leadership transitions.

[Private medical education in Germany]. / Medizinische Studienangebote privater Träger in Deutschland.

Through the years, a range of privately funded medical training opportunities has been established in Germany. Only a few of them operate along the German Medical Licensure Act and thus underlie quality assurance regulations in Germany. Most of the courses are a result of German hospitals cooperating with universities from other EU countries. The content of the courses and the examinations underlie the regulations of the university's home country. This article aims to give an overview of the private medical training opportunities offered in Germany and to show differences compared to state funded German medical schools. The authors discuss the opportunities of private medical training as well as its challenges and risks. Basic principles concerning finances and quality assurance of national and international private medical training are provided. Regardless of their mode of financing, the superior goal of the training, according to the German Medical Licensure Act, should always be to enable young doctors to pursue further professional training, so that they can maintain the best possible quality in patient care, research, and medical education.

[Model study programs in medicine : Innovations in medical education in Hamburg and Berlin]. / Modellstudiengänge in der Medizin : Lehrinnovationen am Beispiel der Studiengänge in Hamburg und Berlin.

Medical science is constantly evolving. Teaching and training must keep pace with these innovations and react in a flexible fashion to new requirements. Model medical education programs, which are governed by the provisions of Sect. 41 of the Regulations for the Licensing of Medical Practitioners (ÄAppO), permit the piloting of innovative teaching programs, which support the continuous development of medical training through incorporation into the standard curricula. This paper reports on the model study programs at the University Medical Centre Hamburg-Eppendorf (iMED) and Charité - University Medicine Berlin (MSM). It describes the reform objectives, the curricula and selected projects accompanying both models and concludes by exploring the significance of various training concepts for the development of medical education.