Defining the need for faculty in family medicine: results of a national survey.

BACKGROUND: Although numerous anecdotal reports are being offered about the growing number of unfilled faculty positions in US family medicine departments, virtually no literature exists on faculty recruitment. The objective of this study was to define the scope and nature of current faculty recruitment needs in family medicine. METHODS: A national survey was sent to all family medicine department chairs and family practice residency program directors concerning faculty positions unfilled at their sites and positions for which recruitment would occur within the next 5 years. The survey asked for information on currently available positions; academic title of position; percentage of time to be devoted to clinical, educational, administrative, and research activities; primary focus of the position; date when the position became available; and the length of time the position has been unfilled. Similar information was collected on positions anticipated to be available within the next 5 years. RESULTS: A total of 364 surveys were returned, for an overall response rate of 70%. Information from the survey revealed a current, substantial demand for family medicine faculty throughout the country, with an even greater demand anticipated for the near future. Respondents reported 496 currently unfilled positions for family medicine faculty and another 677 positions anticipated to be available within the next 19.5 months on average. A total of 89.7% of those anticipated positions were reported as either "certain" or "somewhat certain," in terms of likelihood of availability. CONCLUSIONS: The demand for family medicine faculty is increasing, and much of the demand is financially motivated. Clinical expectations appear to be higher among departments than for residencies. Finally, it was revealed that most positions had minimal allotments for research time. Family medicine must recommit itself to the development of a scholarly agenda as it recruits new faculty.

Cultural conceptions and the role of the psychiatrist in Germany and America.

Matched samples of mental hospital staff and high school students completed mental health questionnaires in Germany and America. The results were factor analysed. One factor concerned the role of the psychiatrist. The role of the psychiatrist in each culture seems to reflect basic cultural conceptions of mental disorders. Reference to two earlier papers indicates that patients, staff, and public share these basic conceptions and these conceptions affect patient-staff relationships.

Gender difference in mate preference among law students: divergence and convergence of criteria.

We examined six hypotheses derived from evolutionary theory regarding sex differences in mate-selection criteria. The subjects were 160 law students who viewed color photographs of live models that were paired with different status cues such as costume variation and descriptions of income and occupation. A multivariate analysis of variance and regression analyses revealed highly significant sex differences in the following responses: reported willingness to engage in unqualified sexual relations; reported willingness to have sexual relations with stimulus persons as compared with the willingness to engage in higher investment relationships such as dating and marriage; the effects of stimulus persons' status and physical attractiveness in determining thresholds of initial acceptability; and tradeoffs, that is the ability of high physical attractiveness to compensate for low status, and of high status to compensate for low physical attractiveness. Law students also responded to nine statements concerning prospective spouses' relative income, occupational prestige, and physical attractiveness. These responses exhibited sex differences consistent with those found in the experimental manipulation.

Sex differences in sexuality among medical students: effects of increasing socioeconomic status.

Research has consistently shown that, compared to men, women are more cautious and selective and maintain greater marital aspirations in entering and maintaining sexual relationships. One explanation of this sex difference is that women have traditionally had inferior access to earning power and social status and consequently were forced to acquire socioeconomic status (SES) through their choice of marriage partners. A contrasting view is that this difference is a component of the basic sex difference identified in the Kinsey studies: Men are more likely than women to dissociate coitus from emotional attachment and to desire and seek coitus with a variety of partners. These two explanations were explored in open-ended interviews with matched samples of 20 male and 20 female medical students. The results were more consistent with the perspective of basic sex differences than with the differential resources explanation. Increasing female SES does not appear to eliminate or even substantially reduce this sex difference. Increasing SES tends to enlarge the pool of acceptable, available sexual and marital partners for men while it tends to reduce the pool for women. Increasing SES thus tends to have different effects on men and women and may cause sex differences in the tendency to associate coitus with emotional attachments and marital aspirations to be more, rather than less, apparent. Extensive case data with verbatim quotations are presented to reveal the emotions and desires underlying subjects' overt behavior.

Sex without emotional involvement: an evolutionary interpretation of sex differences.

Two samples of male (n = 243) and female (n = 298) college students completed sexual surveys, and in-depth, oral interviews were conducted with 28 highly sexually active female college students. Findings supported five predictions derived from evolutionary (parental-investment) theory. Even when females voluntarily engaged in low-investment copulation, coitus typically caused them to feel emotionally vulnerable, and to have thoughts expressing anxiety about partners' willingness to invest. For females, increasing numbers of partners correlated positively with the incidence of these feelings and thoughts; for males, these correlations were negative. Females' attempts to continue regular coitus when they desired more investment than partners were willing to give produced feelings of distress, degradation, and exploitation despite acceptance of liberal sexual morality. Increasing numbers of partners did not mitigate these reactions in females and may exacerbate them. Multiple-partner females developed techniques for dealing with their emotional reactions to low-investment copulation: They frequently tested their partners for signs of ability and willingness to invest (e.g., dominance, prowess, jealousy, nurturance), and they limited or terminated sexual relations when they perceived partners' investment as inadequate. Results were consistent with the view that the emotional-motivational mechanisms that mediate sexual arousal and attraction are sexually dimorphic.

Stereotypes of mental illness: a comparison with ethnic stereotypes.

This paper draws on empirical and theoretical studies to argue that popular and professional conceptions of mental illness share specific traits with ethnic stereotypes: (1) they are exaggerated and serve to erect a qualitative boundary where none objectively exists: (2) they are maintained through selective perception, rationalization, and sanctions; (3) they help to erect the "thresholds,' i.e., the criteria, for crossing or recrossing the boundary; (4) they serve to define relations, including those of power, between groups; (5) because they perform these important cognitive and conative functions, they persist despite a flow of personnel across them and despite repeated demonstrations of their inaccuracy. They cannot be expected to change until the actual relations between groups change.

Cultural conceptions and mental illness. A controlled comparison of Germany and America.

This study attempts to test, in a bicultural, controlled comparison, two sociological theories of mental disorders. The first of these theories proposes that the stereotypes of mental illness profoundly shape the symptoms of mental illness in America. The second theory maintains that the requirements and needs of the mental hospital largely determine the "symptoms" of the chronic mental patient. To test these theories, matched samples of 100 mental patients in Germany and America were subjected to in-depth interviews and were administered semantic differentials. Patients were divided into groups according to length of confinement in order to investigate the thesis that the institution conditions chronic patient roles. The results revealed statistically significant differences between the two nationalities. German patients generally agreed that mental illness is a biologically determined, and rather incurable condition. In contrast, American patients generally believed that the individual is partially responsible for his condition and with the proper motivation and help, he can improve. Patients' statements about themselves and about proper behavior in the hospital were consistent with these national differences. It was concluded that institutionalization consists more in conditioning the patient to accept his status than in convincing him that he is insane.

Menopausal syndrome: illness or social role--a transcultural analysis.

In recent years the medical diagnosis and treatment of "menopausal syndrome" has come under a barrage of criticism. Critics of the conventional clinical approach claim that menopausal syndrome is largely a social role foisted on middle-aged women in this society. The physician plays a very active part (albeit an inadvertent one) in recruiting women into this role. This paper examines the evidence for this thesis, including cross-cultural and intracultural variation. The evidence examined suggests that the more psychological and psychosomatic symptoms do seem to vary with cultural role expectations. Research paradigms for further testing of this thesis are adapted from the study of mental disorders and described. In contrast, those organic changes directly associated with estrogen insufficiency do lead in some women to definite pathologies, e.g., osteoporosis and an increased rate of bone fractures. Whether these organic concomitants of aging in women should be viewed and treated medically is a moot question, and one which involves values and politics more than medical facts.

Appendictiis in pregnancy.

Twenty-nine cases of acute appendicitis during pregnancy are presented, and the recent literature is reviewed. Occurring once in 1,600 gestations, appendicitis carries a pregnancy loss of 10.8%. Difficulties in diagnosis and delays in treatment increase with advancing gestational age. Aggressive management may minimize the resultant maternal morbidity and fetal mortality.

Effects of potential partners' physical attractiveness and socioeconomic status on sexuality and partner selection.

Male (n = 170) and female (n = 212) college students viewed photographs, which had been prerated for physical attractiveness, of three opposite-sex individuals. These photographs were paired with three levels of occupational status and income. Subjects indicated their willingness to engage in relationships of varying levels of sexual intimacy and marital potential with the portrayed individuals. Analyses of variance, correlations, and trend analyses supported the hypotheses. Compared to men, women are more likely to prefer or insist that sexual intercourse occur in relationships that involve affection and marital potential, and women place more emphasis than men do on partners' SES in such relationships. Consequently, men's SES and their willingness and ability to invest affection and resources in relationships may often outweigh the effects of their physical attractiveness in women's actual selection of partners. These results and the literature reviewed are more consistent with parental investment theory than with the view that these sex differences are solely the result of differential access to resources and differential socialization.