The Showcases of Dental History - A Time Machine in Miniature at the University of Puerto Rico: Part I.

The evolution of 20-year-old dental museum-like showcases located in the lobby and the main hallway of the School of Dental Medicine, Puerto Rico (PR) are described along with important professionals who impacted on this development.

Matching Against Men: 5 Years of Residency Match Data Show Disparities Still Exist.

OBJECTIVES: Despite progress toward equal representation by sex in medical practice, women remain underrepresented in many specialties. This study sought to examine the current state of gender equality among recently graduated doctors in multiple specialties. METHODS: Deidentified demographics, standardized examination scores, and Match results were gathered for 829 graduates. Participants were selected from an allopathic medical school between 2016 and 2020. Nineteen students (2.29%) were excluded from the study. Descriptive statistics were calculated, and χ2 tests for independence were used to compare proportions between reported sex and specialty and program Match results. One-way analysis of variance was then performed to test for differences in US Medical Licensing Examination Step 1 and Step 2 scores between sexes. P < 0.05 was considered statistically significant. RESULTS: Of the 829 individuals studied, 44.6% were women. A significantly smaller proportion of women matched into the most competitive specialties, despite no significant difference in US Medical Licensing Examination Step 1 scores between sexes. Furthermore, there was an overall significant trend of women matching into more competitive programs for any given specialty. CONCLUSIONS: In this study, we found that men matched into more highly competitive specialties, whereas women matched into more competitive residency program locations. Further research is needed to determine why women matched into specific specialties at lower rates than their male peers and seek to understand how sex affects the narrative of specialty choice.

Exploring the stability of the gender gap in faculty perceptions of gender climate at a rural regional university.

Increasing awareness of gender barriers and biases in academic institutions is an essential component of institutional change strategies to promote equity and inclusion. There is an established perception gap in recognizing gender inequities in the workplace, whereby men faculty under acknowledge the stressors, barriers, and biases faced by their women faculty colleagues. This study explored the gender gap in faculty perceptions of institutional diversity climate at a rural comprehensive regional university in the United States. In addition to gender, differences across academic discipline and time were explored using 2 (men and women) x 2 (STEM and other) x 2 (2017 and 2022) between-groups ANOVAs. Results revealed a gender gap that persisted across time and perceptions of stressors, diversity climate, student behavior, leadership, and fairness in promotion/tenure procedures, with marginalized (women) faculty consistently reporting greater barriers/concern for women faculty relative to the perceptions of their men faculty colleagues. These findings are largely consistent with the extant literature and are discussed both with regard to future research directions and recommendations for reducing the perception gap and addressing institutional barriers to gender equity.

Perceptions and experiences of undergraduate medical students regarding social accountability: a cross-sectional study at a Subsaharan African medical school.

BACKGROUND: Medical schools are called to be socially accountable by medical education and healthcare system stakeholders. Social accountability is a feature of excellent medical education. Medical students are essential to the development of socially accountable medical schools. Therefore, understanding the perceptions and experiences of medical students regarding social accountability is critical for efforts to improve social accountability practices and outcomes. METHODS: This cross-sectional online questionnaire-based survey used Google Forms and involved medical students in their fourth and fifth years of study at the Makerere University School of Medicine. The survey was conducted between September 2022 and October 2023. We used a study questionnaire and a validated toolkit designed by students as part of The Training for Health Equity Collaborative to gauge a school's progress towards social accountability in medical schools to collect data on demographics, perceptions and experiences and evaluate social accountability. RESULTS: Out of 555 eligible medical students, 426 responded to the online questionnaire. The response rate was 77%. The mean age of the students was 25.24 ± 4.4 years. Almost three fourths of the students were male (71.3%), and slightly less than two thirds were in their fourth year of study (65%). Almost half of the students (48.1%%) evaluated the school as doing well with regard to social accountability. The evaluation items referring to community-based research and positive impact on the community had the highest mean scores. Only 6 (3.6%) students who reported hearing of social accountability had a clear understanding of social accountability. Students receiving career guidance in secondary school was associated with evaluating social accountability in the medical school as strong (p-0.003). CONCLUSIONS: Medical students evaluated the medical school favorably forsocial accountability despite lacking a clear understanding of social accountability. Receiving career guidance in secondary school was significantly associated with a positive evaluation of social accountability.

Mental health and burnout during medical school: Longitudinal evolution and covariates.

BACKGROUND: Medical students' rate of depression, suicidal ideation, anxiety, and burnout have been shown to be higher than those of the same-age general population. However, longitudinal studies spanning the whole course of medical school are scarce and present contradictory findings. This study aims to analyze the longitudinal evolution of mental health and burnout from the first to the last year of medical school using a wide range of indicators. Moreover, biopsychosocial covariates that can influence this evolution are explored. METHOD: In an open cohort study design, 3066 annual questionnaires were filled in by 1595 different students from the first to the sixth year of the Lausanne Medical School (Switzerland). Depression symptoms, suicidal ideation, anxiety symptoms, stress, and burnout were measured along with biopsychosocial covariates. The longitudinal evolution of mental health and burnout and the impact of covariates were modelled with linear mixed models. RESULTS: Comparison to a same-aged general population sample shows that medical students reported significantly more depression symptoms and anxiety symptoms. Medical students' mental health improved during the course of the studies in terms of depression symptoms, suicidal ideation, and stress, although suicidal ideation increased again in the last year and anxiety symptoms remained stable. Conversely, the results regarding burnout globally showed a significant worsening from beginning to end of medical school. The covariates most strongly related to better mental health and less burnout were less emotion-focused coping, more social support, and more satisfaction with health. CONCLUSION: Both improvement of mental health and worsening of burnout were observed during the course of medical school. This underlines that the beginning and the end of medical school bring specific challenges with the first years' stressors negatively impacting mental health and the last year's difficulties negatively impacting burnout.

Competency-based and less time-bound: a new approach to the macro-structure of a medical school curriculum.

Shifting to a competency-based (CBME) and not time-bound curricular structure is challenging in the undergraduate medical education (UME) setting for a number of reasons. There are few examples of broad scale CBME-driven interventions that make the UME program less time-bound. However, given the range of student ability and varying speed of acquisition of competencies, this is an area in need of focus. This paper describes a model that uses the macro structure of a UME program to make UME curricula less time-bound, and driven more by student competency acquisition and individual student goals. The 3 + 1 curricular model was derived from the mission of the school, and includes a 3-year core curriculum that all students complete and an individualized phase. Students have an 18 month individualized educational program that meets their developmental needs and their educational and professional goals. This is achieved through a highly structured advising system, including the creation of an Individualized Learning Plan, driven by specific goals and targeted Entrustable Professional Activities (EPA). Students who struggle in achieving core competencies can use individualized time to support competency development and EPA acquisition. For students who have mastered core competencies, options include obtaining a masters degree, clinical immersion, research, and community-based experiences. Students can also graduate after the 3-year core curriculum, and enter residency one year early. Structural approaches such as this may contribute to the norming of the developmental nature of medical education, and can advance culture and systems that support CBME implementation at the UME level.

Understanding of 'generalist medical practice' in South African medical schools.

BACKGROUND: In South Africa, medical students are expected to have acquired a generalist competence in medical practice on completion of their training. However, what the students and their preceptors understand by 'generalist medical practice' has not been established in South African medical schools. AIM: This study aimed to explore what the students and their preceptors understood by 'generalist medical practice'. SETTING: Four South African medical schools: Sefako Makgatho Health Sciences University, University of KwaZulu-Natal, Walter Sisulu University and the University of the Witwatersrand. METHODS: The exploratory descriptive qualitative design was used. Sixteen focus group discussions (FGDs) and 27 one-on-one interviews were conducted among students and their preceptors, respectively. Participants were recruited through purposive sampling. The inductive and deductive data analysis methods were used. The MAXQDA 2020 (Analytics Pro) software was used to arrange data, yielding 2179 data segments. RESULTS: Ten themes were identified: (1) basic knowledge of medicine, (2) first point of contact with all patients regardless of their presenting problems, (3) broad field of common conditions prevalent in the community, (4) dealing with the undifferentiated patient without a diagnosis, (5) stabilising emergencies before referral, (6) continuity, (7) coordinated and (8) holistic patient care, necessitating nurturance of doctor-patient relationship, (9) health promotion and disease prevention, and (10) operating mainly in primary health care settings. CONCLUSION: The understanding of 'generalist medical practice' in accordance with internationally accepted principles augurs well in training undergraduate medical students on the subject. However, interdepartmental collaboration on the subject needs further exploration.Contribution: The study's findings can be used as a guide upon which the students' preceptors and their students can reflect during the training in generalist medical practice.

Eviatar Yemini.

Interview with Eviatar Yemini, who studies how neurobehavioral circuits grow and evolve to meet the needs at different stages of development at UMass Chan Medical School.

Professional values at the beginning of medical school: a quasi-experimental study.

BACKGROUND: Teaching professionalism in medical schools is central to medical education and society. We evaluated how medical students view the values of the medical profession on their first day of medical school and the influence of a conference about the competences of this profession on these students' levels of reflection. METHODS: We studied two groups of medical students who wrote narratives about the values of the medical profession and the influence of the COVID-19 pandemic on these values. The first group wrote the narratives after a conference about the competences of the medical profession (intervention group), and the second group wrote the same narratives after a biochemistry conference (control group). We also compared the levels of reflection of these two groups of students. RESULTS: Among the 175 medical students entering in the 2022 academic year, 159 agreed to participate in the study (response rate = 90.8%). There were more references to positive than negative models of doctor‒patient relationships experienced by the students (58.5% and 41.5% of responses, respectively). The intervention group referred to a more significant number of values than the control group did. The most cited values were empathy, humility, and ethics; the main competences were technical competence, communication/active listening, and resilience. The students' perspectives of the values of their future profession were strongly and positively influenced by the pandemic experience. The students realized the need for constant updating, basing medical practice on scientific evidence, and employing skills/attitudes such as resilience, flexibility, and collaboration for teamwork. Analysis of the levels of reflection in the narratives showed a predominance of reflections with a higher level in the intervention group and of those with a lower level in the control group. CONCLUSIONS: Our study showed that medical students, upon entering medical school, already have a view of medical professionalism, although they still need to present a deeper level of self-reflection. A single, planned intervention in medical professionalism can promote self-reflection. The vision of medical professional identity was strongly influenced by the COVID-19 pandemic, positively impacting the formation of a professional identity among the students who decided to enter medical school.

Medical school origins of award-winning physicians; analysis of a complete national dataset.

BACKGROUND: Educators and medical students share the same objective of achieving success in medical practice. Both groups consider doctors' successes to include optimum patient care outcomes and positive career progressions. Accordingly, identifying common educational features of such high-achieving doctors facilitates the generation of excellence amongst future medical trainees. In this study we use data from the British clinical merit award schemes as outcome measures in order to identify medical school origins of doctors who have achieved national or international prominence. METHODS: Britain has Clinical Excellence Awards/Distinction Awards schemes that financially reward all National Health Service doctors in England, Scotland and Wales who are classified as high achievers. We used these outcome measures in a quantitative observational analysis of the 2019-20 dataset of all 901 national award-winning doctors. Where appropriate, Pearson's Chi-Square test was applied. RESULTS: The top five medical schools (London university medical schools, Glasgow, Edinburgh, Oxford and Cambridge) were responsible for 51.2% of the physician merit award-winners in the 2019-20 round, despite the dataset representing 85 medical schools. 91.4% of the physician merit award-winners were from European medical schools. The lowest national award-winners (tier 3) originated from 61 medical schools representing six continents. International medical graduates comprised 11.4% of all award-winners. CONCLUSIONS: The majority of physicians who were national merit award-winners originated from only five, apparently overrepresented, UK university medical schools. In contrast, there was a greater diversity in medical school origin among the lower grade national merit awards; the largest number of international medical graduates were in these tier 3 awards (13.3%). As well as ranking educationally successful university medical schools, this study assists UK and international students, by providing a roadmap for rational decision making when selecting physician and non-physician medical education pathways that are more likely to fulfil their career ambitions.

[Modification of Maze Procedure in Nippon Medical School:Striving Towards Restoration of Sinus Rhythm with Physiological Activation of Atria].

Atrial fibrillation surgery is beneficial for restoring sinus rhythm and maintaining the physiological atrial contraction to prevent left atrial thrombus formation. The radial procedure, a good alternative to the maze procedure, has been performed at Nippon Medical School;it was designed to maintain physiological atrial excitation and blood flow. The design reduces the incision line and avoids conduction delay in the atrium through the use of ablation devices and intraoperative mapping of atrial excitation patterns. In addition, it preserves sinus node function and cardiac conduction pathway;this could prevent postoperative pacemaker implantation.

Impact of Faculty Mentorship in the Orthopedic Surgery Interest Group at a New Medical School: A Blueprint for Future Initiatives.

OBJECTIVES: Orthopedic surgery is a highly competitive field. The residency applicant pool is expected to grow with the increasing number of new medical schools in the United States, posing significant challenges for applicants. This study explored the impact of an engaged faculty mentor in an orthopedic surgery interest group (OSIG) at a new medical school and the impact it has on students. The study aimed to uncover the most valuable features of an OSIG at a new medical school to create a blueprint for other student-leaders and/or faculty in future initiatives. METHODS: An observational study was conducted via survey responses from active OSIG members at a new medical school in Texas. Questions were mostly in a "before and after" format asking about students' perspectives of the group before and after the addition of an engaged faculty advisor. Descriptive and inferential statistics were used to analyze the data. RESULTS: Twenty of 21 (95.2%) eligible OSIG members participated in the study. The survey results revealed that faculty engagement significantly enhanced the OSIG and its members' medical school experience. Following faculty involvement, average OSIG event attendance more than tripled, there was a statistically significant increase in medical student well-being, and confidence in their ability to be a competitive orthopedic surgery applicant nearly doubled. OSIG participation influenced their career interests significantly more after faculty engagement. A total of 93.3% of participants voted that they felt having an engaged faculty advisor is critical for the OSIG. CONCLUSIONS: Mentorship was identified as the most crucial activity for career development, followed by clinical exposure and research. The study provides valuable insights for new medical schools in establishing and optimizing OSIGs and potentially other interest groups, particularly in competitive specialties.

Medical school origins of award-winning psychiatrists; analysis of a complete national dataset.

BACKGROUND: Britain attracts doctors from all over the world to work in the National Health Service. Elucidating the educational backgrounds of award-winning doctors working in the country is potentially an important medical education issue and a merit award audit. Using the British clinical merit award schemes as outcome measures, we identify medical school origins of award-winning doctors who have been identified as having achieved national or international prominence. METHODS: The Clinical Excellence Awards/Distinction Awards schemes select doctors in Britain who are classified as high achievers, with categories for national prominence and above. We used this outcome measure in a quantitative observational analysis of the 2019-20 dataset of all 901 award-winning doctors. Pearson's Chi-Square test was used where appropriate. RESULTS: Five university medical schools (London university medical schools, Glasgow, Edinburgh, Aberdeen and Cambridge) accounted for 59.1% of the psychiatrist award-winning doctors in the 2019 round, despite the dataset representing 85 medical schools. 84.1% of the psychiatrist award-winners were from European medical schools, compared to 92.1% of the non-psychiatrist award-winners. International medical graduates accounted for 22.7% of the award-winning psychiatrists. Psychiatrists with the lower grade national awards came from a more diverse educational background of 17 medical schools. IMGs represented diverse medical schools from five continents and were most represented in the lowest grade of national merit awards at 24.2%. CONCLUSIONS: The majority of the award-winning psychiatrists originated from only five medical schools. A greater diversity of medical school origin existed for the lowest grade national psychiatrist award-winners. International medical graduates contributed substantially to these award-winners; psychiatrist award-winners were more likely to be international medical graduates (22.7%) than non-psychiatrist award-winners (10.8%). This study not only indicates educational centres associated with the production of award-winners but also provides students with a roadmap for rational decision making when selecting medical schools.

A blueprint for success: lessons learned from developing the official guide to Iranian undergraduate medical education accreditation.

We are excited to contribute our thoughts and insights to the discussion initiated by Gandomkar et al. in their article on the accreditation system in Iran (Gandomkar et al., BMC Med Educ 23:379, 2023). As individuals who have been directly involved in the process of meta-accreditation and possess a comprehensive understanding of the various stages of Undergraduate Medical Education (UME) accreditation in Iran, we would like to highlight additional points that were identified through a rigorous hermeneutic phenomenology process proposed by Gadamer (Gadamer, Truth and Method, 2013) and offer a complementary point of view to the previous work. By sharing our insights, we hope to contribute to the ongoing discourse surrounding UME accreditation.

Clearing the confusion about post-accreditation monitoring, meta-evaluation and meta-accreditation.

We have recently published the experience of the accreditation body of undergraduate medical education in Iran on developing and validating standards based on the WFME framework (Gandomkar et al., BMC Med Educ 23:379, 2023). Agabagheri et al. extended our work and proposed a blueprint for post-accreditation monitoring based on their experience in developing an official guide in their Matters Arising (Aghabagheri et al., BMC Med Educ). The authors have used post-accreditation monitoring as a process of monitoring and controlling accreditation activities, procedures often referred to as meta-evaluation or meta-accreditation (depending on the objectives of evaluation) in the literature. On the contrary, post-accreditation monitoring alludes to the process of continuous quality improvement of educational programs after accreditation. We would like to make clarifications between post-accreditation monitoring, meta-evaluation and meta-accreditation which have been used interchangeably in their paper. Considering the emerging interests in scholarship and non-scholarship activities and reports in undergraduate medical education accreditation, this clarification provides a better understanding of the roles of these crucial concepts in the accreditation process.

Analyzing the characteristics of mission statements in Korean medical schools based on the Korean Doctor's Role framework.

PURPOSE: This study assessed the alignment between Korean medical schools' mission statements (MSs) and Korean Doctor's Role (KDR) domains, considering school characteristics. METHODS: We analyzed the South Korean medical school's MS characteristics using a mixed-methods approach. Quantitative analysis preprocessed MS text data to identify concept words, while qualitative content analysis categorized information into predefined KDR domains and extracted themes from other parts. RESULTS: At the KDR domain level, "social accountability" was the most frequent, followed by "education and research" and "patient care," while "professionalism" had the least frequency. At the competency level, the most frequent domains were "involvement in public and global health initiatives," while "self-regulation based on professional leadership" and "professionalism and self-management" were not present. CONCLUSION: The study found that the majority of MSs had a homogeneous pattern and included traditional themes. Medical schools should evaluate and incorporate missing elements in their MSs to reflect the institution's own purpose and current societal needs.