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How Common is Medical Student Mistreatment?

How Common is Medical Student Mistreatment?

Mistreatment of medical students has long been a problem nationwide and is not unique to any school. A recent study published in Academic Medicine, a publication of the Association of American Medical Colleges, assessed the prevalence of medical school mistreatment and the associated effects on burnout. More Common Than You’d Think Researchers surveyed a nationally representative sample of third-year medical students from 24 different medical schools. Over 600 completed the survey and the results were the following: – 64% experienced at least one incident of mistreatment by faculty – 76% experienced at least on incident of mistreatment by residents – 10% reported experiencing recurrent mistreatment by faculty – 13% reported experiencing recurrent mistreatment by residents When compared with no or infrequent mistreatment, recurrent mistreatment was associated with higher burnout at 57% vs 33% when it occurred by faculty, and 48% vs 32% when it occurred by residents. These rates, and others reported in literature over the recent years, are significantly higher than those reported by the Association of American Medical Colleges (AAMC) from their Medical School Graduation Questionnaire (GQ). The AAMC has stated that between 2000 to 2011, between 12% and 20% of students reported mistreatment—public humiliation, which is considered mistreatment by some, hit 34% in their 2012 GQ. Challenges in Addressing Mistreatment David P. Sklar, MD, in a letter from the editor published in Academic Medicine in May, discusses a conversation he had with residents about their mistreatment experiences, particularly by one doctor who had a reputation of mistreating his residents. When the school’s program director and chair of the department failed to handle it, Dr. Sklar attempted...
Remediation & Attrition in General Surgery Residents

Remediation & Attrition in General Surgery Residents

The Accreditation Council for Graduate Medical Education (ACGME) unveiled a new model to measure resident performance in 1999 that endorsed six general competencies. These include patient care, medical knowledge, practice-based learning, interpersonal and communication skills, professionalism, and system-based practice. The purpose behind the ACGME’s shift in measuring resident performance was to create an effective way to educate and evaluate physicians, explains Christian de Virgilio, MD. “The ultimate goal was to breed physicians who are well trained, educated, ethical, and compassionate.” Few studies have examined how successful surgical residency programs have been at achieving the ACGME-endorsed competencies. “The advent of the 80-hour workweek restriction and a 16-hour shift limit for interns has affected educational quality,” says Dr. de Virgilio. “Residents are now forced to compress required tasks into a shorter timeframe with reduced work hours. In turn, this can increase the likelihood that future surgical residents will be inadequately trained.” Examining Remediation Among Surgery Residents There are several measures of the adequacy of education for surgery residents. One of these measures is whether or not residents require any form of remediation during their residency. In the September 2012 Archives of Surgery, Dr. de Virgilio and colleagues had a study published that aimed to determine the frequency of resident remediation with regard to the six ACGME competencies. The study team also sought to identify factors predictive of the need for remediation and the rate of attrition by surgical residents. Dr. de Virgilio says “this information may provide insights into ways that we can more effectively modify the surgical curriculum in this new era of limited hours.” After conducting an 11-year retrospective...
Revising the MCAT for 2015

Revising the MCAT for 2015

The Medical College Admission Test (MCAT), a test that hasn’t been revised in over 20 years, will be getting an overhaul come 2015. Two new sections will be added that will place focus on critical thinking and the sociocultural and behavioral determinants of health—increasing the length of the test from about 5.5 hours to 6.5 hours. The writing section, however, will be eliminated. “Being a good doctor is about more than scientific knowledge,” says Darrell Kirch, MD, president and chief executive officer of the Association of American Medical Colleges in a news release. “It also requires an understanding of people.” As of 2015, the MCAT will continue to test a student’s knowledge of the natural sciences, such as physics, chemistry, biology, and biochemistry, but there will be a new emphasis on the basic principles of psychology, behavior, and sociology. The revised test will also evaluate a student’s understanding of basic research methods, statistics, and ability to comprehend, evaluate, and apply information. The committee examining the current MCAT chose to eliminate the writing section in the 2015 MCAT because they found the section offered medical school admissions departments little information about an applicant’s qualifications for medical school. The evolving demography of the U.S. population calls for physicians to not only have a better understanding of human health, but also to be able to interpret and apply new research to their patients.   Physician’s Weekly wants to know…as an experienced physician, do you feel the changes to the MCAT will better reflect the skills necessary to be good doctor? What other changes to the test would you...
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