Types of medical writing and teaching of writing in U.S. medical schools

U.S. medical schools were surveyed to determine which types of medical writing are most important for physicians, house officers, and medical students to learn and whether such types are formally taught. According to the responding schools, the five most important types were: write-up of the patient history and physical examination, progress note and discharge summary (tied), peer-reviewed published paper (of either clinical or laboratory research), and grant proposal. Certain types, however, were considered more important for some categories of physicians and trainees than others. Although these major types of writing represent complex and diverse writing tasks, they are not taught extensively in medical schools or thoroughly explained in the literature on medical writing.     

Private physicians in ambulatory care training in U.S. medical schools

The contribution of private physicians to medical student education in ambulatory care was determined by a questionnaire directed to departments of family practice, internal medicine, and pediatrics in 124 U.S. medical schools and their branch campuses. The response rate was 84 percent. Of the responding departments, 82 percent offered an ambulatory care course in curricular years three and/or four, and 56 percent utilized private physicians in their courses. Departments of internal medicine were least likely to offer such a course, and their courses less frequently included teaching by private physicians (p less than 0.0001). When offered, internal medicine courses in ambulatory care were least likely to be required for graduation and involved the fewer students. Departments of family practice were most likely to offer ambulatory care courses and were most likely to utilize private physicians in their courses.     

Instruction in research-related topics in U.S. and Canadian medical schools

The authors conducted a study to collect information on the teaching of research-related topics at medical schools. A questionnaire was developed and mailed to appropriate administrators of all accredited United States, Canadian, and Puerto Rican medical schools that asked for information on courses offered in epidemiology, statistics, evaluation of medical literature, and research design. Ninety-seven percent of the medical schools responded to the questionnaire. All but one of the 139 respondents reported offering formal instruction in at least one of the four topics; epidemiology and statistics were offered by 98 percent and 96 percent, respectively, of the responding schools. Training in evaluating medical literature was required by slightly less than half of the responding schools, and research methodology was required by one-third. Future studies should evaluate the effectiveness of such courses.     

Survey on curriculum committees at U.S. and Canadian medical schools

A 27-item questionnaire was sent to 144 U.S. and Canadian medical schools to identify prevailing patterns in the organization, philosophy, and function of curriculum committees. Overall, 76 percent responded, with 67 percent of the respondents being school administrators and 33 percent being faculty members. Fifty-one percent rated their school's committee as exerting a significant impact on the educational program over the previous five years. Fifty-six percent of the committees had a routine procedure for course review and used data from multiple sources when conducting curriculum evaluations. The committees that annually received a specific assignment from the dean were the most likely (91 percent) to be rated as having a significant impact, followed by committees that conducted frequent course reviews (66 percent). Thirty-eight percent of the committees were primarily faculty oriented, 29 percent were decidedly administrative in composition, and the remaining committees exhibited a mixture of membership.     

Substance use by fourth-year students at 13 U.S. medical schools

Fourth-year medical students at 13 medical schools in different regions of the United States received an anonymous questionnaire designed to examine their current and prior use of 11 substances and their attitudes toward substance use among physicians. Of 1,427 questionnaires distributed, 41 percent were returned. The questionnaire and distribution method were derived from an ongoing survey on drug use in order to permit comparison of the medical students with a national sample of age- and sex-matched cohorts. The rates of substance use during the 30 days preceding receipt of the questionnaire were: alcohol, 87.8 percent; marijuana, 17.3 percent; cigarettes, 9.0 percent; cocaine, 5.6 percent; heroin, 0.0 percent; other opiates, 0.9 percent; LSD, 0.2 percent; other psychedelics, 0.5 percent; barbiturates, 0.5 percent; tranquilizers, 2.2 percent; and amphetamines, 1.2 percent. Compared with their age and sex cohorts nationally, the medical students reported less use of marijuana, cocaine, cigarettes, LSD, barbiturates, and amphetamines. However, their use of other opiates was approximately the same and their use of tranquilizers and alcohol was slightly higher than that of the other cohorts. Data on their sources of knowledge about drug abuse indicate the need for greater attention to this issue in the medical curriculum.     

Drug abuse and alcoholism teaching in U.S. medical and osteopathic schools

This is a report of the principal findings of a survey of drug abuse and alcoholism teaching in U.S. medical and osteopathic schools. It was found that required teaching activities during all four years of medical school averaged 25.7 hours, with a range of 0 to 126. The proportion of the total required hours devoted to substance abuse was 0.0 to 3.1 percent, with a mean of 0.6 percent. Schools also differed widely in the number and type of electives offered in drug abuse and alcoholism, as well as in number of clinical assignments available. Findings in osteopathic schools were generally similar. Two factors which were significantly related to the number of required hours were the presence of a career teacher in the addictions and the size of the school.