Academic promotion at a medical school. Experience at Johns Hopkins University School of Medicine

We studied promotions at Johns Hopkins University School of Medicine to determine whether clinician-teachers are less likely to be promoted or are promoted later in life than researchers and whether those who are promoted have more articles published than those who are not promoted. Over a five-year period, 93 percent of candidates for the rank of associate professor and 79 percent of the candidates for the rank of professor were promoted. There were no significant differences between clinical and research faculty members in terms of the probability that they would be promoted or their age at promotion to either associate professor or professor. Despite these findings, the responses to a questionnaire indicated that former faculty members perceived clinician-teachers as less likely than researchers to be promoted. Those who were promoted had had about twice as many articles published in peer-reviewed journals as those who were not promoted. We recommend improved counseling of medical school faculty members and more extensive discussion of the criteria for promotion and the chances of academic success.     

Validity of the Medical College Admission Test for predicting medical school performance.

PURPOSE: Since the introduction of the revised Medical College Admission Test (MCAT(R)) in 1991, the Association of American Medical Colleges has been investigating the extent to which MCAT scores supplement the power of undergraduate grade point averages (uGPAs) to predict success in medical school. This report is a comprehensive summary of the relationships between MCAT scores and (1) medical school grades, (2) United States Medical Licensing Examination (USMLE) Step scores, and (3) academic distinction or difficulty. METHOD: This study followed two cohorts from entrance to medical school through residency. Students from 14 medical schools' 1992 and 1993 entering classes provided data for predicting medical school grades and academic difficulty/distinction, while their peers from all of the U.S. medical schools were used to predict performance on USMLE Steps 1, 2, and 3. Regression analyses assessed the predictive power of combinations of uGPAs, MCAT scores, and undergraduate-institution selectivity. RESULTS: Grades were best predicted by a combination of MCAT scores and uGPAs, with MCAT scores providing a substantial increment over uGPAs. MCAT scores were better predictors of USMLE Step scores than were uGPAs, and the combination did little better than MCAT scores alone. The probability of experiencing academic difficulty or distinction tended to vary with MCAT scores. MCAT scores were strong predictors of scores for all three Step examinations, particularly Step 1. CONCLUSIONS: MCAT scores almost double the proportion of variance in medical school grades explained by uGPAs, and essentially replace the need for uGPAs in their impressive prediction of Step scores. The MCAT performs well as an indicator of academic preparation for medical school, independent of the school-specific handicaps of uGPAs.     

Introduction of Department of Diagnostic Medicine, Graduate School of Medical Sciences, Kumamoto University

Pathologic informatics is an analysis of mechanism of pathogenesis using various medical information. Biologic reactions by many reactants are studied on molecules, cells, organs, and individuals by using various methods. Themes of our laboratory are as follows: 1) to analyze of the pathogenesis of various diseases by using novel diagnostic methods, 2) to elucidate amyloid formation mechanism in amyloidosis and to develop novel therapies, 3) to develop the methods for tests and diagnosis for DIC, 4) to study on activation mechanism of ribosomal proteins in the tissues by the blood cell function, 5) to study on the expression and suppression of neogenesis of blood vessels by physical invasion in the organ failure, and 6) to develop the diagnostic methods for autonomic dysfunction and to analyze the pathogenesis.     

Positioning a medical school for modern biomedical research: the department of genome sciences at the University of Washington School of Medicine.

The availability of genome sequences from a multitude of organisms, which began about a decade ago, has had enormous impact throughout the biomedical sciences. These sequence data have changed the way research studies are carried out and have led to the explosive growth of computational biology as an approach to analyze biological processes and evolution. In medicine, the completion of the human genome sequence has illuminated the function of many genes, facilitated the correlation of mutant genes to disease phenotypes, and provided a basis for the study of human variation.At the University of Washington, the two academic departments whose overall programs were most centrally affected by the sequencing revolution were Genetics and Molecular Biotechnology. These departments were fused in 2001 to form the Department of Genome Sciences in order to best exploit these developments and to become a prototype for the basic biomedical science department of the future. The department's goal is to address leading-edge questions in biology and medicine through the application of genetics, genomics, proteomics, and computational approaches to the increasing collection of known genome sequences and their encoded products. The authors review the events that led up to the founding of this department and discuss the initiatives that have been undertaken, which include the recruitment of faculty, the establishment of a new interdisciplinary graduate program, the continued development of an outreach program, and the construction of a building to house the department. Lessons learned in crafting this department are also discussed, as well as how these might apply to other medical schools.     

Founding a new College of Medicine at Florida State University.

In 2000, the Florida State University (FSU) College of Medicine was founded, becoming the first new allopathic medical school in the United States in over 20 years. The new medical school was to use community-based clinical training for the education of its students, create a technology-rich environment, and address primary care health needs of Florida's citizens, especially the elderly, rural, minorities, and underserved. The challenges faced during the creation of the new school, including accreditation and a leadership change, as well as accomplishments are described here. The new school admits a diverse student body made possible through its extensive outreach programs, fosters a humane learning environment through creation of student learning communities, has a distributed clinical training model-with clinical campuses in Orlando, Pensacola, Sarasota and Tallahassee, and with 70% of training occurring in ambulatory settings-and utilizes 21st-century information technology. The curriculum focuses on patient-centered clinical training, using the biopsychosocial model of patient care throughout the entire medical curriculum, promotes primary care and geriatrics medicine through longitudinal community experiences, relies on a hybrid curriculum for delivery of the first two years of medical education with half of class sessions occurring in small groups and on a continuum of clinical skills development throughout the first three years, and uses an interdisciplinary departmental model for faculty, which greatly facilitates delivery of an integrated curriculum. The first class was admitted in 2001 and graduated in May 2005. In February 2005, the FSU College of Medicine received full accreditation from the Liaison Committee on Medical Education.     

Teaching of anatomy in a problem-based curriculum at the Arabian Gulf University: the new face of the museum

The College of Medicine and Medical Sciences of the Arabian Gulf University has an undergraduate medical curriculum that uses problem-based learning as the principal teaching strategy. Teaching of anatomy comes at various places in the curriculum, and the anatomy museum serves as an important resource and engages the students in self-directed learning. Although the museum had sufficient resource materials, the emphasis on individualized instruction and self-directed learning in anatomy has resulted in the need for an effective approach and a reorganization of the facilities in the museum. Thus, we recently rearranged the museum to create 42 modules or stations (learning carrels) focusing on specific organ systems for self-study by students. Computer-assisted programs, videocassettes, ultrasound, and structured living anatomy sessions in the clinical professional skills program facilitated such an arrangement. An increased utilization by the students was observed in the reorganized museum. Thus, the museum can play an effective role in the study of anatomy through problem-based integrated learning modules.     

Bringing the human genome and the revolution in bioinformatics to the medical school classroom: a case report from Washington University School of Medicine.

The human genome project is revolutionizing medical research and the practice of clinical medicine. To understand and participate in this revolution, physicians must be fluent in human genomics and bioinformatics. At Washington University School of Medicine (WUSM), the authors designed a module for teaching these skills to first-year students. The module uses clinical cases as a platform for accessing information stored in GenBank, Online Mendelian Inheritance in Man (OMIM), and PubMed databases at the National Center for Biotechnology Information (NCBI). This module, which is also designed to reinforce problem-solving skills, has been integrated into WUSM's first-year medical genetics course.     

医学生应付方式现状和类型

目的了解医学院大学生应付方式的现状和类型。方法采用基本情况调查表和应付方式问卷对403名医学院校大学生进行调查和测量。结果①医学生的应付方式依次为解决问题、求助、幻想、退避、合理化、自责，各分量表因子分差异显著iF=165．17,P=0．000）；（参女生在“求助”分量表得分明显高于男生（t=3．595,P=0．000）；来自城市的学生在“幻想”（t=2．283，P=0．023）和“自责”（t=2．357，P=0．019）的应付方式上明显高于来自农村的学生；在“合理化”和“自责”应付方式上不同年级的学生之间有差异显著（t=2．623，p=0．05）。结论医学生主要采用“解决问题——求助”成熟型应对方式，性别、年级和家庭来源上各因子分有差异。     

Medical students' exposure to pharmaceutical industry marketing: a survey at one U.S. medical school.

PURPOSE: While much is known about the interactions between the pharmaceutical industry and physicians, very little is known about pharmaceutical marketing directed toward medical students. This study sought to characterize the extent and forms of medical students' exposure to pharmaceutical industry marketing. METHOD: In 2001-02, an anonymous, 17-item questionnaire was distributed to 165 preclinical and 116 clinical students at the University of Minnesota Medical School-Twin Cities. The main outcome measures were the number and forms of exposures to pharmaceutical industry marketing reported by medical students and whether students had discussed these exposures with teachers or advisors. Preclinical and clinical students were compared using chi(2) analysis (p < .05). RESULTS: One hundred fourteen (69.1%) preclinical students and 107 (92.2%) clinical students responded. Nearly all students reported at least one exposure to pharmaceutical industry marketing. Seventy-six (71.7%) clinical students compared to 38 (33.3%) preclinical students recalled over 20 exposures (p < .005). Clinical students were more likely to have received a free meal (p < .01), textbook (p < .005), pocket text (p < .005), or trinket (p < .005) than were their preclinical colleagues. Most students (68.2%) had not discussed pharmaceutical marketing with an instructor or advisor; 59 (55.7%) clinical students as compared to 87 (80.6%) preclinical students recalled no such discussion (p < .005). CONCLUSION: Medical students have extensive exposure to pharmaceutical industry marketing during their early years of training. Given existing evidence that such exposure influences physicians' practice and prescribing patterns, the authors propose that medical school curricula include formal instruction to prepare students to critically assess these contacts.     

The validity and reliability of the sixth-year internal medical examination administered at the King Abdulaziz University Medical College

Background

Exams are essential components of medical students’ knowledge and skill assessment during their clinical years of study. The paper provides a retrospective analysis of validity evidence for the internal medicine component of the written and clinical exams administered in 2012 and 2013 at King Abdulaziz University’s Faculty of Medicine.

Methods

Students’ scores for the clinical and written exams were obtained. Four faculty members (two senior members and two junior members) were asked to rate the exam questions, including MCQs and OSCEs, for evidence of content validity using a rating scale of 1–5 for each item.Cronbach’s alpha was used to measure the internal consistency reliability. Correlations were used to examine the associations between different forms of assessment and groups of students.

Results

A total of 824 students completed the internal medicine course and took the exam. The numbers of rated questions were 320 and 46 for the MCQ and OSCE, respectively. Significant correlations were found between the MCQ section, the OSCE section, and the continuous assessment marks, which include 20 long-case presentations during the course; participation in daily rounds, clinical sessions and tutorials; the performance of simple procedures, such as IV cannulation and ABG extraction; and the student log book.Although the OSCE exam was reliable for the two groups that had taken the final clinical OSCE, the clinical long- and short-case exams were not reliable across the two groups that had taken the oral clinical exams. The correlation analysis showed a significant linear association between the raters with respect to evidence of content validity for both the MCQ and OSCE, r?=?.219 P?<?.001 and r?=?.678 P?<?.001, respectively, and r?=?.241 P?<?.001 and r?=?.368 P?=?.023 for the internal structure validity, respectively. Reliability measured using Cronbach’s alpha was greater for assessments administered in 2013.

Conclusion

The pattern of relationships between the MCQ and OSCE scores provides evidence of the validity of these measures for use in the evaluation of knowledge and clinical skills in internal medicine. The OSCE exam is more reliable than the short- and long-case clinical exams and requires less effort on the part of examiners and patients.

     

University hygiene school of I.M.Sechenov Moscow Medical Academy

Different aspects of evolvement and development of university hygiene in this country are considered. The first studies on learning environment, living conditions and health status of students were conducted in the late 19th and early 20th centuries in main Russian scientific centres. Researchers and specialists of their hygiene departments greatly contributed to the development of this discipline. Systematic studies date back to the foundation of the university hygiene laboratory at I.M.Sechenov Moscow Medical Academy. Today the laboratory focuses on the complex problem "Lifestyle and health status of main participants of the educational process, students and professors".     

Value Socialization of Black Medical Students at the Howard University College of Medicine: A Case Report

The major objective of this research is to examine whether or not medical students acquire values other than those related to traditional orientations to medical service. These values are approached in the context of the medical training of the student physician at a predominantly black medical college. The research setting is the Howard University College of Medicine in Washington, DC, one of the two black four-year medical colleges in the United States.     

The Medical Academic Advancement Program at the University of Virginia School of Medicine.

Since 1984 the University of Virginia School of Medicine has conducted the Medical Academic Advancement Program for minority and disadvantaged students interested in careers in medicine. The program is a six-week residential program for approximately 130 undergraduate and post-baccalaureate students per year. It emphasizes academic course work--biology, chemistry, physics, and essay writing--to prepare the participants for the Medical College Admission Test. Non-graded activities, such as a clinical medicine lecture series, clinical experiences, and a special lecture series, and special workshops are also offered. The participants take two simulated MCAT exams. Between 1984 and 1998, 1,497 students have participated in the program, with complete follow-up information available for 690 (46%). Of the 1,487 participants, 80 (5%) have graduated from the University of Virginia School of Medicine and 174 (12%) from other medical schools; 44 (3%) are attending the medical school now, and 237 (16%) are at other medical schools; 44 (3%) have graduated from other health professions schools, and 54 (3%) are attending such schools. The retention rate for participants at the University of Virginia School of Medicine is 91% (that is, all but seven of the 80 who matriculated have been retained past the first year). The Medical Academic Advancement Program has been successful in increasing the number of underrepresented minority students matriculating into and continuing in medical education. Such programs warrant continued support and encouragement.