Does Community- or University-Based Residency Sponsorship Affect Graduate Perceived Preparation or Performance?

BACKGROUND: Residency training occurs in varied settings. Whether there are differences in the training received by graduates of community- or medical school-based programs has been the subject of debate. OBJECTIVE: This study examined the perceived preparation for practice, scope of practice, and American Board of Family Medicine (ABFM) board examination pass rates of family physicians in relation to the type of residency program (community, medical school, or partnership) in which they trained. METHODS: Predetermined survey responses were abstracted from the 2016 and 2017 National Family Medicine Graduate Survey of ABFM and linked to data about residency programs obtained from the websites of national organizations. Descriptive statistics were used to summarize the data and logistic regression to examine differences between survey results based on type of residency training: community, medical school, or partnership. RESULTS: Differences in the perception of preparation as well as current scope of practice were noted for the 3 residency types. The differences in perception were mainly noted in hospital-based skills, such as intubation and ventilator management, and in women's health and family planning services, with different program types increasing preparedness perception in different domains. CONCLUSIONS: In general, graduates of family medicine community-based, non-affiliated, and partnership programs perceived they were prepared for and were providing more of the services queried in the survey than graduates of medical school-based programs.

Knowing Your Team: Rapid Assessment of Residents and Fellows for Effective Horizontal Care Delivery in Emergency Events.

BACKGROUND: Horizontal care, in which clinicians assume roles outside of their usual responsibilities, is an important health care systems response to emergency situations. Allocating residents and fellows into skill-concordant clinical roles, however, is challenging. The most efficient method to accomplish graduate medical education (GME) assessment and deployment for horizontal care is not known. OBJECTIVE: We designed a categorization schema that can efficiently facilitate clinical and educational horizontal care delivery for trainees within a given institution. METHODS: In September 2019, as part of a general emergency response preparation, a 4-tiered system of trainee categorization was developed at one academic medical center. All residents and fellows were mapped to this system. This single institution model was disseminated to other institutions in 2020 as the COVID-19 pandemic began to affect hospitals nationally. In March 2020, a multi-institution collaborative launched the Trainee Pandemic Role Allocation Tool (TPRAT), which allows institutions to map institutional programs to COVID-19 roles within minutes. This was disseminated to other GME programs for use and refinement. RESULTS: The emergency response preparation plan was disseminated and selectively implemented with a positive response from the emergency preparedness team, program directors, and trainees. The TPRAT website was visited more than 100 times in the 2 weeks after its launch. Institutions suggested rapid refinements via webinars and e-mails, and we developed an online user's manual. CONCLUSIONS: This tool to assess and deploy trainees horizontally during emergency situations appears feasible and scalable to other GME institutions.

Variations in Opioid Prescribing Behavior by Physician Training.

INTRODUCTION: Opioid abuse has reached epidemic proportions in the United States. Patients often present to the emergency department (ED) with painful conditions seeking analgesic relief. While there is known variability in the prescribing behaviors of emergency physicians, it is unknown if there are differences in these behaviors based on training level or by resident specialty. METHODS: This is a retrospective chart review of ED visits from a single, tertiary-care academic hospital over a single academic year (2014-2015), examining the amount of opioid pain medication prescribed. We compared morphine milligram equivalents (MME) between provider specialty and level of training (emergency medicine [EM] attending physicians, EM residents in training, and non-EM residents in training). RESULTS: We reviewed 55,999 total ED visits, of which 4,431 (7.9%) resulted in discharge with a prescription opioid medication. Residents in a non-EM training program prescribed higher amounts of opioid medication (108 MME, interquartile ratio [IQR] 75-150) than EM attendings (90 MME, lQR 75-120), who prescribed more than residents in an EM training program (75 MME, IQR 60-113) (p<0.01). CONCLUSION: In an ED setting, variability exists in prescribing patterns with non-EM residents prescribing larger amounts of opioids in the acute setting. EM attendings should closely monitor for both over- and under-prescribing of analgesic medications.

Psychological aspects and quality of life in Medical Residency. / Aspectos psicológicos e qualidade de vida na Residência Médica.

OBJECTIVE: to evaluate the perception of quality of life among residents in the first year of Medical Residency compared to the one among residents in other years of training, given the importance of this issue in health. METHODS: a comparative and cross-sectional analytical study performed from February to April 2016 in a reference tertiary trauma hospital in Brazil. Resident physicians were voluntarily submitted to an online questionnaire on quality of life (called WHOQOL-BREF), validated by World Health Organization (WHO). They were divided into two groups: first year of residency (R1) and other years of residency. RESULTS: ninety-seven residents of several medical specialties answered the questionnaire. Of these, 59 were men and 38 were women. The mean age was 27.7 years. First-year residents accounted for 49.5% of the interviewees. Overall, quality of life was considered regular in both groups. In relation to psychological domain, there was a significant difference between the R1 group (with worse scores in this domain) and the non-R1 group (p<0.0000001). CONCLUSION: first-year residents' quality of life is worse than the one of the residents from other years, having a significant variation of positive feelings, learning capacity, memory, thought and concentration, self-esteem, body image and appearance, and negative feelings.

OBJETIVO: avaliar a percepção de qualidade de vida entre residentes no primeiro ano de Residência Médica em relação aos residentes de outros anos, dada a importância dessa questão na saúde. MÉTODOS: estudo comparativo, transversal e analítico realizado no período de fevereiro a abril de 2016, realizado em um hospital de trauma terciário de referência do Brasil. Médicos residentes foram submetidos voluntariamente ao questionário validado da Organização Mundial de Saúde (OMS) sobre qualidade de vida, o WHOQOL-BREF, com preenchimento online. Os residentes foram divididos em dois grupos: primeiro ano de residência (R1) e outros anos de residência. RESULTADOS: noventa e sete residentes de diversas especialidades médicas responderam ao questionário. Desses, 59 eram homens e 38, mulheres. A média de idade foi de 27,7 anos. Residentes do primeiro ano representaram 49,5% dos entrevistados. A qualidade de vida de maneira global foi considerada regular em ambos os grupos. Em relação ao domínio psicológico, houve diferença significativa entre o R1 (este, com piores escores neste domínio) e os demais anos de residência (p<0,0000001). CONCLUSÃO: a qualidade de vida dos residentes do primeiro ano é pior em relação aos demais, tendo uma variação significativa de sentimento positivo, capacidade de aprender, memória, pensamento e concentração, autoestima, imagem corporal e aparência e sentimentos negativos em relação aos médicos residentes dos outros anos.

Aspectos psicológicos e qualidade de vida na Residência Médica / Psychological aspects and quality of life in Medical Residency

RESUMO Objetivo: avaliar a percepção de qualidade de vida entre residentes no primeiro ano de Residência Médica em relação aos residentes de outros anos, dada a importância dessa questão na saúde. Métodos: estudo comparativo, transversal e analítico realizado no período de fevereiro a abril de 2016, realizado em um hospital de trauma terciário de referência do Brasil. Médicos residentes foram submetidos voluntariamente ao questionário validado da Organização Mundial de Saúde (OMS) sobre qualidade de vida, o WHOQOL-BREF, com preenchimento online. Os residentes foram divididos em dois grupos: primeiro ano de residência (R1) e outros anos de residência. Resultados: noventa e sete residentes de diversas especialidades médicas responderam ao questionário. Desses, 59 eram homens e 38, mulheres. A média de idade foi de 27,7 anos. Residentes do primeiro ano representaram 49,5% dos entrevistados. A qualidade de vida de maneira global foi considerada regular em ambos os grupos. Em relação ao domínio psicológico, houve diferença significativa entre o R1 (este, com piores escores neste domínio) e os demais anos de residência (p<0,0000001). Conclusão: a qualidade de vida dos residentes do primeiro ano é pior em relação aos demais, tendo uma variação significativa de sentimento positivo, capacidade de aprender, memória, pensamento e concentração, autoestima, imagem corporal e aparência e sentimentos negativos em relação aos médicos residentes dos outros anos.

ABSTRACT Objective: to evaluate the perception of quality of life among residents in the first year of Medical Residency compared to the one among residents in other years of training, given the importance of this issue in health. Methods: a comparative and cross-sectional analytical study performed from February to April 2016 in a reference tertiary trauma hospital in Brazil. Resident physicians were voluntarily submitted to an online questionnaire on quality of life (called WHOQOL-BREF), validated by World Health Organization (WHO). They were divided into two groups: first year of residency (R1) and other years of residency. Results: ninety-seven residents of several medical specialties answered the questionnaire. Of these, 59 were men and 38 were women. The mean age was 27.7 years. First-year residents accounted for 49.5% of the interviewees. Overall, quality of life was considered regular in both groups. In relation to psychological domain, there was a significant difference between the R1 group (with worse scores in this domain) and the non-R1 group (p<0.0000001). Conclusion: first-year residents' quality of life is worse than the one of the residents from other years, having a significant variation of positive feelings, learning capacity, memory, thought and concentration, self-esteem, body image and appearance, and negative feelings.

Association of Mentor-to-Program Contact and Applicant Rank Disclosure With Vitreoretinal Fellowship Applicant's Final Match Outcome in 2016 and 2017.

Importance: Communication between applicants, mentors, and training programs is common before the residency and fellowship match. Few studies have examined the association of prematch communication on final match outcomes. Objectives: To report various characteristics of the vitreoretinal surgery fellowship match and to examine the association of mentor-to-program communication and applicant disclosure of their number 1 ranking with the probability of matching number 1. Design, Setting, and Participants: In this cross-sectional study of the 2016 and 2017 vitreoretinal surgery fellowship matches, an online survey examined (1) number of applications submitted, (2) number of programs ranked, (3) rank order of final match, (4) total application and interview-related costs, (5) mentor-to-program contact, (6) applicant disclosure of number 1 ranking, and (7) mentor disclosure of number 1 ranking. A link to an anonymous online survey was sent to 198 matched fellows (105 fellows from the 2016 match and 93 from the 2017 match). Main Outcomes and Measures: Survey responses regarding the vitreoretinal surgery fellowship application process. Results: The survey was sent to 198 matched fellowship applicants, and 152 (77%) completed the survey. Of the 105 matched applicants in 2016, 21 (20%) were women. Of the 93 matched applicants in 2017, 24 (26%) were women. Matched applicants applied to a mean (SD) of 34 (17) programs (range, 1-85) and ranked a mean (SD) of 12 (4) programs (range, 1-27). Of 152 applicants, 66 (43%) matched at their number 1 ranked program, 23 (15%) matched number 2, and 21 (14%) matched number 3. The mean (SD) total cost was $5500 ($2776) (range, $500-$13 500). Two-sided χ2 testing found no association (odds ratio, 0.70; 95% CI, 0.34-1.4; P = .33) between mentor-to-program contact and the probability of applicants matching at their number 1 ranked program. Matched applicants who revealed their number 1 ranking either personally or via a mentor matched at a program ranked lower (more desirable) on their rank list (mean match ranking, 2.8) compared with those who did not reveal their number 1 ranking (mean match ranking, 4.2; 95% CI, 0.2-2.5; P = .01). Applicant disclosure of their intention to rank a program number 1, either personally or via a mentor, was associated with matching number 1 (odds ratio, 2.6; range, 1.1-6.0; P = .03). Conclusions and Relevance: Vitreoretinal fellowship applicants who disclosed their number 1 ranking, either personally or via a mentor, were associated with improved match outcomes compared with their cohorts who did not make such disclosures.

¿Qué opinan los residentes sobre sus profesores? Un enfoque cualitativo / What do residents think about their tutors? A qualitative approach

INTRODUCCIÓN: La interacción de los profesores con los estudiantes, la supervisión de las prácticas clínicas y el profesionalismo son temas que explora el instrumento de evaluación del desempeño docente que recoge la opinión de los residentes sobre las competencias educativas de profesores titulares y adjuntos. OBJETIVO: 1)Recuperar los testimonios de los residentes sobre el modelo de rol y el compromiso de sus profesores con su aprendizaje; 2)reconocer las estrategias educativas empleadas por los docentes en contextos clínicos; 3)visibilizar las dificultades de contratación en la planta académica actual del PUEM que afectan el proceso educativo, y 4)reportar las menciones de maltrato y percepción de injusticia de los residentes por sus profesores. MATERIAL Y MÉTODO: Estudio cualitativo que consideró los comentarios a pregunta abierta de 1.628 residentes sobre el desempeño docente en las residencias médicas. Se clasificaron en 10 categorías con subcategorías y se cuantificaron las tendencias positiva y negativa. Posteriormente se analizaron los testimonios de acuerdo a los 3 temas del cuestionario. RESULTADOS: Para los residentes, las categorías del profesor como modelo a seguir y el compromiso académico del docente obtuvieron el mayor número de opiniones positivas, mientras que la contratación del profesor y las estrategias educativas empleadas por este último reportaron el mayor número de comentarios negativos. DISCUSIÓN: Los comentarios libres que plasmaron los residentes sobre el desempeño docente reflejan las fortalezas y debilidades del proceso educativo en contextos hospitalarios, lo que permite un acercamiento cualitativo a la relación con sus profesores

INTRODUCTION: Teacher and student interaction, the monitoring of clinical practices, and professionalism are the issues that the teaching performance assessment tool examines by gathering the opinions of the residents on the educational skills of teaching staff and lecturers. OBJECTIVE: The aim of this study was to: (I)gathering the comments of the residents about the role model and commitment of tutors to their training; (II)to determine the educational strategies used by teachers in clinical settings; (III)to show the current recruitment difficulties of the Medical Specialisations Plan (PUEM) affect the educational process, and (IV)to report the residents mentions of abuse and perceived unfairness by their teachers. MATERIAL AND METHOD: Qualitative study that considered the written comments by 1,628 residents in an open question regarding teaching performance in medical residencies. They were classified into 10 categories with sub-categories and the positive and negative trends were quantified. The comments were analysed according to the 3 topics of the questionnaire. RESULTS: For residents, the categories of the educator as role model and academic commitment of the teacher obtained the largest number of positive reviews, while hiring of teachers and educational strategies employed by the latter reported the highest number of negative comments. DISCUSSION: The free comments expressed by the residents on the teaching performance reflect the strengths and weaknesses of the teaching process in hospital contexts, which provides a qualitative approach to the relationship with their teachers

Ethical violations and discriminatory behavior in the MedPhys Match.

PURPOSE: The purpose of this survey study is to investigate behaviors in conflict with the ethical standards of the Medical Physics Residency (MedPhys) Match (MPM) process as stated in the MPM rules (a) and with the nondiscrimination regulations of the Equal Employment Opportunity Commission (EEOC) (b), in addition to other behaviors that may in other ways erode the fairness of the system. METHODS: A survey was sent to all applicants and program directors registered for the 2015 and 2016 MPM. Survey questions asked about application, interview, and postinterview experiences, match results, and overall satisfaction with the process. RESULTS: Thirteen percent of 2015 respondents and 20% of 2016 respondents were asked by at least one program how highly they planned to rank them or which program they would rank first. Thirty-seven percent of 2015 and 40% of 2016 program directors indicated that candidates communicated to the program their rank intent, with 22.0% in 2015 and 12.5% in 2016 being told that their program would be ranked first. Twenty-three percent of 2015 respondents indicated being asked by at least one program during the interview about children or plans to have children; including 19% of males and 33% of females. In 2016, these values were 28% overall, 22% male, and 36% female. Fifty-seven percent of 2015 respondents who were asked this question indicated being uncomfortable or very uncomfortable answering, including 27.3% of males and 88.9% of females. In 2016, 42.9% of all respondents indicated being uncomfortable or very uncomfortable answering, including 10.0% of males and 80.0% of females. CONCLUSIONS: In the first two years of the MPM, there were widespread instances of ethical violations and discriminatory questioning during the interview process. Educating both interviewers and candidates on the MPM rules and general EEOC guidelines should decrease these instances and increase the fairness of the residency selection process.

[Evaluation of a new residency program at the department of ophthalmology of the Heinrich Heine University Düsseldorf]. / Evaluation eines neuen Weiterbildungsprogramms in der Augenklinik der Heinrich-Heine-Universität Düsseldorf.

BACKGROUND: The German ophthalmological training is still a very individually organized system with only one final oral examination at the end of the 5-year residency. At the beginning of 2013 a new residency program was introduced at the department of ophthalmology of the Heinrich-Heine University Duesseldorf. This study evaluated the resident satisfaction with the new concept. MATERIAL AND METHODS: The new residency program consists of three main changes: firstly a structured training with fixed rotation in the various subdisciplines of ophthalmology, secondly a list of practical skills examinations that has to be completed during the 5-year program and thirdly annual intermediate oral examinations. The satisfaction of the residents with the new program was anonymously evaluated with a Likert scale-based questionnaire with 15 items and additional free text comments. RESULTS: (1) The structured training was mostly rated positively and 9 out of 12 of residents favored a continuation of the training concept in this form. (2) Only 7 out of 11 residents (64 %) wanted to continue the practical skills examinations in this form and only approximately half of the residents saw a positive effect of these examinations. (3) Regarding the annual examinations 8 out of 11 residents (73 %) reported that the examinations helped them to assess their skills better, 91 % (10 out of 11) reported a learning motivation, 90 % (9 out of 10) an improvement in learning due to the examinations and 73 % (8 out of 11) were of the opinion that the examinations should take place regularly. DISCUSSION: The structured training and the annual examinations were positively evaluated. These changes could be effectively implemented even with a relatively small personnel structure. In comparison the practical skill examinations were rated relatively negatively, probably because of the further increase of daily work. The number of skills to be demonstrated is currently reduced and the integration of testing into the clinical routine of examiners and examinees is under revision.

Applicant Characteristics Associated With Selection for Ranking at Independent Surgery Residency Programs.

OBJECTIVES: This study evaluated characteristics of applicants selected for interview and ranked by independent general surgery residency programs and assessed independent program application volumes, interview selection, rank list formation, and match success. DESIGN: Demographic and academic information was analyzed for 2014-2015 applicants. Applicant characteristics were compared by ranking status using univariate and multivariable statistical techniques. Characteristics independently associated with whether or not an applicant was ranked were identified using multivariable logistic regression modeling with backward stepwise variable selection and cluster-correlated robust variance estimates to account for correlations among individuals who applied to multiple programs. SETTING: The Electronic Residency Application Service was used to obtain applicant data and program match outcomes at 33 independent surgery programs. PARTICIPANTS: All applicants selected to interview at 33 participating independent general surgery residency programs were included in the study. RESULTS: Applicants were 60% male with median age of 26 years. Birthplace was well distributed. Most applicants (73%) had ≥1 academic publication. Median United States Medical Licensing Exams (USMLE) Step 1 score was 228 (interquartile range: 218-240), and median USMLE Step 2 clinical knowledge score was 241 (interquartile range: 231-250). Residency programs in some regions more often ranked applicants who attended medical school within the same region. On multivariable analysis, significant predictors of ranking by an independent residency program were: USMLE scores, medical school region, and birth region. Independent programs received an average of 764 applications (range: 307-1704). On average, 12% interviews, and 81% of interviewed applicants were ranked. Most programs (84%) matched at least 1 applicant ranked in their top 10. CONCLUSIONS: Participating independent programs attract a large volume of applicants and have high standards in the selection process. This information can be used by surgery residency applicants to gauge their candidacy at independent programs. Independent programs offer a select number of interviews, rank most applicants that they interview, and successfully match competitive applicants.

[The situation of residents in ophthalmology in Germany: Results of an online survey]. / Situation der Assistenzärztinnen und -ärzte in der Ophthalmologie in Deutschland : Ergebnisse einer Online-Umfrage.

PURPOSE: The main purpose of the present survey was to describe the situation of residents in ophthalmology in Germany, including professional aims and plans for the future. By evaluating the current conditions, potential deficits should be identified which could lead to demand-oriented approaches for improvement. METHODS: The online questionnaire was sent out per e-mail to 1100 German residents. The rate of received answers was 30.1 % (334 completed questionnaires). RESULTS: Of the participants 68 % were female,32 % were male (mean age 31.8 years), one third of the participants had children, 44.6 % worked at university institutions, 54.4 % at non-university institutions and 45.5 % considered themselves as well-trained. Deficits during residency training were seen in the field of neuro-ophthalmology and ophthalmic surgery. The evaluation of the residency in total revealed an overall average grade of 2.9 ("satisfactory"). Of the physicians 35.5 % reported to be actively involved in research projects and 21.9 % reported pursuing an academic career. Almost 50 % of the participant residents aimed to work in a private practice after residency and 15 % aimed to work at an university hospital. CONCLUSION: The present survey revealed representative data because of the acceptable return rate and participating residents from all different educational levels (1st to 5th year). The survey can therefore help to characterize the current situation of residents in ophthalmology in Germany and to develop demand-oriented possibilities for improvement.

Ranking Surgical Residency Programs: Reputation Survey or Outcomes Measures?

OBJECTIVE: The release of general surgery residency program rankings by Doximity and U.S. News & World Report accentuates the need to define and establish measurable standards of program quality. This study evaluated the extent to which program rankings based solely on peer nominations correlated with familiar program outcomes measures. DESIGN: Publicly available data were collected for all 254 general surgery residency programs. To generate a rudimentary outcomes-based program ranking, surgery programs were rank-ordered according to an average percentile rank that was calculated using board pass rates and the prevalence of alumni publications. A Kendall τ-b rank correlation computed the linear association between program rankings based on reputation alone and those derived from outcomes measures to validate whether reputation was a reasonable surrogate for globally judging program quality. RESULTS: For the 218 programs with complete data eligible for analysis, the mean board pass rate was 72% with a standard deviation of 14%. A total of 60 programs were placed in the 75th percentile or above for the number of publications authored by program alumni. The correlational analysis reported a significant correlation of 0.428, indicating only a moderate association between programs ranked by outcomes measures and those ranked according to reputation. Seventeen programs that were ranked in the top 30 according to reputation were also ranked in the top 30 based on outcomes measures. CONCLUSIONS: This study suggests that reputation alone does not fully capture a representative snapshot of a program's quality. Rather, the use of multiple quantifiable indicators and attributes unique to programs ought to be given more consideration when assigning ranks to denote program quality. It is advised that the interpretation and subsequent use of program rankings be met with caution until further studies can rigorously demonstrate best practices for awarding program standings.

Pathways for foreign-trained dentists to pursue careers in the United States.

With the U.S. population growing ever more diverse and the need for dentists in many areas of the United States, there is increasing opportunity for foreign-trained dentists to pursue dental careers in this country. This article provides a broad overview of dental education and career pathways available for foreign-trained dentists in the United States. Educational opportunities include pursuing advanced standing dental degree programs and advanced graduate education (residency programs). Career pathways include working in academic and private practice settings. This article also describes the licensure and visa requirements foreign-trained dentists must satisfy to work legally in the United States.

Supervised classification of psychomotor competence in minimally invasive surgery based on instruments motion analysis.

BACKGROUND: Objective assessment of psychomotor skills has become an important challenge in the training of minimally invasive surgical (MIS) techniques. Currently, no gold standard defining surgical competence exists for classifying residents according to their surgical skills. Supervised classification has been proposed as a means for objectively establishing competence thresholds in psychomotor skills evaluation. This report presents a study comparing three classification methods for establishing their validity in a set of tasks for basic skills' assessment. METHODS: Linear discriminant analysis (LDA), support vector machines (SVM), and adaptive neuro-fuzzy inference systems (ANFIS) were used. A total of 42 participants, divided into an experienced group (4 expert surgeons and 14 residents with >10 laparoscopic surgeries performed) and a nonexperienced group (16 students and 8 residents with <10 laparoscopic surgeries performed), performed three box trainer tasks validated for assessment of MIS psychomotor skills. Instrument movements were captured using the TrEndo tracking system, and nine motion analysis parameters (MAPs) were analyzed. The performance of the classifiers was measured by leave-one-out cross-validation using the scores obtained by the participants. RESULTS: The mean accuracy performances of the classifiers were 71 % (LDA), 78.2 % (SVM), and 71.7 % (ANFIS). No statistically significant differences in the performance were identified between the classifiers. CONCLUSIONS: The three proposed classifiers showed good performance in the discrimination of skills, especially when information from all MAPs and tasks combined were considered. A correlation between the surgeons' previous experience and their execution of the tasks could be ascertained from results. However, misclassifications across all the classifiers could imply the existence of other factors influencing psychomotor competence.

James Cook University MBBS graduate intentions and intern destinations: a comparative study with other Queensland and Australian medical schools.

INTRODUCTION: Since 1999 the number of medical school places in Australia has increased substantially in response to workforce shortages, with some of the increased capacity in regional and rural communities. The James Cook University (JCU) School of Medicine, the first of a number of new medical schools, was established with a mission to address the health needs of rural, remote and tropical Australia through aligning student selection, curriculum and assessment practices to encourage generalist postgraduate careers needed in rural and regional areas. This article reports early evidence on the career outcomes of graduates in the first six cohorts from 2005 to 2010, and compares this with available data from other Queensland and Australian medical schools. METHODS: Data were gathered from two sources to allow comparisons of career intentions and intern allocations of graduates from JCU with those from other Australian medical schools. An exit survey of JCU graduates provided JCU student data while the Medical Students Outcomes Database provided comparable data for eight other, largely metropolitan, schools. RESULTS: At graduation, 88% of JCU medical students intended to practise outside Australian capital cities compared with 31% of graduates from other medical schools (odds ratio [OR]: 16.5). More JCU medical graduates than others planned to work in rural towns or regional centres with a population of less than 100 000 (46% compared with 16% for the rest of Australia; OR: 4.6). Sixty-seven percent of JCU graduates undertook their internship outside a metropolitan centre compared with 17% of others (OR: 10.0), and 47% in outer regional centres compared with 5% (OR: 16.6), respectively. Medical graduates from JCU were more likely to prefer general practice as a career (OR: 1.5), particularly rural medicine (OR 2.5), but otherwise had similar preferences to others. Interest in 'working in a rural area' increased over the course duration from 68% at entry to 76% at graduation. CONCLUSION: While further follow up is needed to track career progression over a longer time, the data so far suggest that the career outcomes of JCU medical graduates are aligned with the workforce needs of the region, and different from those graduating from Australia's predominantly metropolitan medical schools, as predicted by the program's design.

Disaster preparedness: what training do our interns receive during medical school?

Disaster preparedness training is a critical component of medical student education. Despite recent natural and man-made disasters, there is no national consensus on a disaster preparedness curriculum. The authors designed a survey to assess prior disaster preparedness training among incoming interns at an academic teaching hospital. In 2010, the authors surveyed incoming interns (n = 130) regarding the number of hours of training in disaster preparedness received during medical school, including formal didactic sessions and simulation, and their level of self-perceived proficiency in disaster management. Survey respondents represented 42 medical schools located in 20 states. Results demonstrated that 47% of interns received formal training in disaster preparedness in medical school; 64% of these training programs included some type of simulation. There is a need to improve the level of disaster preparedness training in medical school. A national curriculum should be developed with aspects that promote knowledge retention.