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John MM, Starks H, Allam JS, Moore J, Frank JA, Bosslet GT, Burkart KM, Çoruh B. Variable Practice, Variable Results: Impact of Postinterview Communication Practices Among Critical Care Medicine/Pulmonary and Critical Care Medicine Fellowship Applicants and Program Directors. Chest 2024; 165:1186-1197. [PMID: 37977268 DOI: 10.1016/j.chest.2023.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 11/03/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Although postinterview communication (PIC) guidelines exist, adherence is voluntary. There are no studies of PIC practices in critical care medicine (CCM) and pulmonary and critical care medicine (PCCM) fellowship recruitment. RESEARCH QUESTION What is the frequency, format, goals, and content of PIC between CCM/PCCM applicants and program directors? What is the impact of PIC on applicant and program rank order lists (ROLs)? STUDY DESIGN AND METHODS CCM/PCCM applicants and program directors were separately surveyed after the 2022-2023 National Resident Matching Program Specialty Match. Surveys included multiple-choice, Likert-scale, and two free text questions. Thematic content analysis of free text responses was performed. RESULTS One-third of eligible participants responded (applicants: n = 373 [34%]; program directors: n = 86 [32%]). Applicant respondents applied to CCM (19%), PCCM (69%), or both (12%). Program directors represented CCM (17%), PCCM (57%), or both (26%) programs. Applicant (66%) and program director (49%) respondents reported initiating PIC. PIC did not impact ROL decision for most applicants (73%) or program directors (83%), though 21% of applicants and 17% of program directors moved programs or applicants up on their ROL in response to PIC. One-quarter (23%) of applicants strongly agreed or agreed that PIC was helpful in creating their ROL, 27% strongly disagreed or disagreed, and 29% were neutral. PIC challenges identified by both groups included time; lack of uniformity; peer pressure; misleading language; and uncertainty about motives, rules, and response protocols. INTERPRETATION PIC is common among CCM/PCCM applicants and program directors. About 50% of applicants and 20% of program directors share ranking intentions via PIC. Although PIC did not impact ROL for most applicants and program directors, a minority of applicants and program directors moved programs up on their ROL after receiving PIC from the other party. Applicants have mixed perspectives on PIC value. Applicants and program directors alike desire clear guidance on PIC to minimize ambiguous and misleading communication.
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Affiliation(s)
- Mira M John
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington School of Medicine, Seattle, WA.
| | - Helene Starks
- Department of Bioethics and Humanities, University of Washington School of Medicine, Seattle, WA
| | - J Shirine Allam
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Emory University School of Medicine, Atlanta, GA
| | - Jason Moore
- Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - James A Frank
- Division of Pulmonary and Critical Care, University of California San Francisco School of Medicine, San Francisco, CA
| | - Gabriel T Bosslet
- Division of Pulmonary, Critical Care, Allergy, and Occupational Medicine, Indiana University School of Medicine, Indianapolis, IN
| | - Kristin M Burkart
- Division of Pulmonary, Allergy, and Critical Care Medicine, Columbia University Irving School of Medicine, New York, NY
| | - Başak Çoruh
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington School of Medicine, Seattle, WA
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Smith CC, Barton T, Berman R, Chida N, Steinberg KP, Yialamas M, Zaas A, DeMelo N, Katz JT. Strengthening the Integrity of the Match: A Novel, Comprehensive, Standardized, and Transparent Postinterview Communication Policy. Ann Intern Med 2024; 177:529-531. [PMID: 38498877 DOI: 10.7326/m23-3164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/20/2024] Open
Affiliation(s)
- C Christopher Smith
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts (C.C.S.)
| | - Todd Barton
- University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania (T.B.)
| | - Rebecca Berman
- Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, California (R.B.)
| | - Natasha Chida
- Department of Medicine, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, Maryland (N.C.)
| | - Kenneth P Steinberg
- Department of Medicine, University of Washington School of Medicine, Seattle, Washington (K.P.S.)
| | - Maria Yialamas
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (M.Y.)
| | - Aimee Zaas
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina (A.Z.)
| | - Nikki DeMelo
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts (N.D.)
| | - Joel T Katz
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (J.T.K.)
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Pepin ME, Kamal Y, Reisman BJ, Rockman ME, Waller JP. Making the match and breaking it: values, perceptions, and obstacles of trainees applying into physician-scientist training programs. BMC MEDICAL EDUCATION 2023; 23:763. [PMID: 37828457 PMCID: PMC10571326 DOI: 10.1186/s12909-023-04736-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 09/28/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND Replenishing the physician-scientist workforce constitutes a central mission of medical education, but the loss of qualified trainees to non-academic positions remains an ongoing threat. Among the barriers facing physician-scientists today is the game-like model of U.S. medical residency matching through the National Research Matching Program (NRPM), which applies several assumptions regarding the comparability of applicant qualifications, cohort size, and the institutional breadth of applicants' training needs. METHODS The current report therefore summarizes the survey-based views and experiences of physician-scientist trainees obtained following the 2021-2022 application cycle for research-oriented residency programs, or physician-scientist training programs (PSTPs). From among this small cohort of applicants, we obtained survey-based feedback of 27 PSTP applicants across 17 U.S. medical universities, among whom 85% (23/27) matched into a PSTP. RESULTS Among these PSTP applicants, 25/27 (93%) recognized "scientific community" as the most important feature of a postgraduate training program, with applicants identifying as female placing a higher value on the program's infrastructure of personal and/or family support. Most (18/27) respondents found "waiting for interviews" as the most stressful phase of their application cycle, and roughly half of all respondents encountered at least one NRMP policy violation through post-interview communication. Specifically, 93% (25/27) respondents were contacted by at least one PSTP following interviews, and 1/3 of them admitted to feeling pressured into sharing their ranking preferences. CONCLUSION We highlight many previously unrecognized priorities among applicants to PSTPs, which include fostering community among its trainees and reinforcing structured mentoring. We uncover an inconsistency among PSTPs regarding the post-interview process, which represents an opportunity to better support applicants seeking to gauge programs according to their clinical, scientific, and academic interests as physician-scientists, while still adhering to NRMP policies.
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Affiliation(s)
- M E Pepin
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
- Institut Für Experimentelle Kardiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 669, 69120, Heidelberg, Germany.
| | - Y Kamal
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - B J Reisman
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - M E Rockman
- University of Wisconsin Hospitals & Clinics, Madison, WI, USA
| | - J P Waller
- Emory University Hospital, Atlanta, GA, USA
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Lessing JN, McGarry K, Schiffman F, Austin M, Hepokoski M, Keniston A, Tammaro D, Finn KM. The State of Morning Report in the Current Healthcare Landscape: a National Survey of Internal Medicine Program Directors. J Gen Intern Med 2022; 37:1665-1672. [PMID: 34585310 PMCID: PMC8477724 DOI: 10.1007/s11606-021-07010-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 06/24/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Case-based Morning Report (MR) has long been the predominant educational conference in Internal Medicine (IM) residency programs. The last comprehensive survey of IM MR was in 1986. Much has changed in the healthcare landscape since 1986 that may impact MR. OBJECTIVE We sought to determine the current state of MR across all US IM programs. DESIGN In 2018, US IM program directors (PDs) were surveyed about the dynamics of MR at their institutions, perceived pressures, and realized changes. KEY RESULTS The response rate was 70.2% (275/392). MR remains highly prevalent (97.5% of programs), although held less frequently (mean 3.9 days/week, SD 1.2), for less time (mean 49.4 min, SD 12.3), and often later in the day compared to 1986. MR attendees have changed, with more diversity of learners but less presence of educational leaders. PD presence at MR is associated with increased resident attendance (high attendance: 78% vs 61%, p=0.0062) and punctuality (strongly agree/agree: 59% vs 43%, p=0.0161). The most cited goal for MR is utilizing cases to practice clinical reasoning. Nearly 40% of PDs feel pressure to move or cancel MR; of those, 61.2% have done so, most commonly changing the timing (48.5%), reducing the length (18.4%), and reducing the number of sessions per week (11.7%). Compared to community-based and to community-based, university-affiliated programs, university-based programs have 2.9 times greater odds (95% CI: 1.3, 6.9; p = 0.0081) and 2.5 times greater odds (95% CI 1.5, 4.4; p =0.0007), respectively, of holding MR after 9 AM, and 1.8 times greater odds (95% CI: 0.8, 4.2; p = 0.1367) and 2.0 times greater odds (95% CI: 1.2, 3.5; p = 0.0117), respectively, of reporting pressure to cancel or move MR compared to their counterparts. CONCLUSIONS While MR ubiquity reflects its continued perceived value, PDs have modified MR to accommodate changes in the healthcare environment. This includes reduced frequency, shorter length, and moving conferences later in the day. Additional studies are needed to understand how these changes impact learning.
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Affiliation(s)
- Juan N Lessing
- Division of Hospital Medicine, Department of Medicine, Anschutz Medical Center, University of Colorado School of Medicine, Aurora, CO, USA.
| | - Kelly McGarry
- Department of Medicine, Alpert Medical School at Brown University, Providence, RI, USA
| | - Fred Schiffman
- Department of Medicine, Alpert Medical School at Brown University, Providence, RI, USA
| | - Matthew Austin
- Department of Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Mark Hepokoski
- Department of Medicine, University of California San Diego School of Medicine, CA and the VA San Diego Healthcare System, San Diego, CA, USA
| | - Angela Keniston
- Division of Hospital Medicine, Department of Medicine, Anschutz Medical Center, University of Colorado School of Medicine, Aurora, CO, USA
| | - Dominick Tammaro
- Department of Medicine, Alpert Medical School at Brown University, Providence, RI, USA
| | - Kathleen M Finn
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Where Do International Medical Graduates Matriculate for Internal Medicine Training? A National Longitudinal Study. J Gen Intern Med 2021; 36:2230-2236. [PMID: 33575907 PMCID: PMC7878164 DOI: 10.1007/s11606-020-06519-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 12/20/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION In 2020, roughly 25% of applicants who matched into internal medicine (IM) residencies were international medical graduates (IMGs). We examine 12-year trends in distribution of IMGs among IM training programs and explore differences in program perceptions towards IMG recruitment. METHODS Since 2007, Association of Program Directors in Internal Medicine Annual Surveys have collected data about trainees by medical school graduate type. Sixteen additional questions regarding perceptions of IMGs were included in the 2017 spring survey. RESULTS The 2017 survey response rate was 63.3% (236/373) and ranged from 61.9 to 70.2% for the 2007-2019 Annual Surveys. During that 12-year period, 55-70% of community programs' and 22-30% of university programs' PGY1 positions were filled by IMGs. In 2017, 45% of community programs' and 15% of university programs' interview and ranking positions were allocated to IMGs. Departmental pressure (university 45.6% [95% CI 43.7-47.5]; community 28.2% [95% CI 26.6-29.7]; p = 0.007), institutional priority (university 64.0% [95% CI 62.1-66.0]; community 41% [95% CI 36.9-44.6]; p = 0.001), and reputational concerns (university 52.8% [95% CI 50.0-55.6]; community 38.5% [95% CI 36.0-40.9]; p = 0.045) were cited as factors influencing recruitment of IMGs. CONCLUSION Our study was limited to exploring program factors in residency recruitment and did not assess applicant preferences. There is a large, longstanding difference in the recruitment of IMGs to US community-based and university residencies, beginning during the interview and ranking process. Further research in disparities in IMG recruitment is needed, including exploring pressures, preferences, and potential biases associated with the recruitment of IMGs.
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Bearman M, Mahoney P, Tai J, Castanelli D, Watling C. Invoking culture in medical education research: A critical review and metaphor analysis. MEDICAL EDUCATION 2021; 55:903-911. [PMID: 33539558 DOI: 10.1111/medu.14464] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 01/14/2021] [Accepted: 01/28/2021] [Indexed: 06/12/2023]
Abstract
INTRODUCTION 'Culture' is a word frequently invoked within medical education literature to explain challenges faced by learners in practice. While social settings and practices are widely acknowledged as critical influences on medical education, there is vast variability in how the term 'culture' is employed. This may lead to confusion, resulting in assumptions and oversights. OBJECTIVE This critical literature review aims to characterise how the term 'culture' is explicitly and implicitly conceptualised in medical education research. METHODS Four leading English language journals in the medical education field were searched in a twelve-month period for research papers or reviews that mentioned culture in title or abstract in a substantive way. A content analysis was undertaken of extracted definitions. In addition, metaphor analysis was used to identify conceptual metaphors, which were subsequently clustered thematically. RESULTS Our search yielded 26 papers, 8 of which contained definitions, mostly from the organisational literature. We interpreted nine conceptual metaphors related to how the term culture was employed (terroir, divider, dominant force, toxic force, obstacle, microclimate, object, brand and holdall) in four categories (unchanging, powerful, can adapt around, can be used). DISCUSSION This critical review reveals that medical education as a field: 1) draws most explicitly from the organisational literature; 2) invokes culture in multiple means but in ways that privilege either acontextual human agency or all-powerful social forces; and 3) regards culture as a negative or neutral force but rarely a positive one. There is a notable absence around conceptualisations of 'culture' that allow educator, student and administrator agency but at the same time acknowledge the deep forces that various social settings and practices exert. Other literatures investigating learning cultures and cultural reflexivity focus on this nexus and may provide possible means to advance considerations of culture within medical education research.
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Affiliation(s)
- Margaret Bearman
- Centre for Research in Assessment and Digital Learning (CRADLE), Deakin University, Melbourne, Vic., Australia
| | - Paige Mahoney
- Centre for Research in Assessment and Digital Learning (CRADLE), Deakin University, Melbourne, Vic., Australia
| | - Joanna Tai
- Centre for Research in Assessment and Digital Learning (CRADLE), Deakin University, Melbourne, Vic., Australia
| | - Damian Castanelli
- Centre for Research in Assessment and Digital Learning (CRADLE), Deakin University, Melbourne, Vic., Australia
- School of Clinical Sciences at Monash Health, Monash University, Melbourne, Vic., Australia
- Department of Anaesthesia and Perioperative Medicine, Monash Health, Melbourne, Vic., Australia
| | - Christopher Watling
- Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
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Monir RL, Michaudet K, Monir JG, Rahmanian KP, Michaudet C, Cooper LA, Harrell H. Impact of Match Violations on Applicants' Perceptions and Rankings of Residency Programs. Cureus 2021; 13:e12823. [PMID: 33628688 PMCID: PMC7895534 DOI: 10.7759/cureus.12823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction The National Resident Matching Program (NRMP) requires all Match participants to adhere to a strict code of conduct known as the Match Participation Agreement, yet Match violations continue to occur. We sought to determine how interview experiences, including Match violations, impact applicants' perceptions and rankings of residency programs. Methods An electronic survey was sent to all accredited medical school Deans of Student Affairs and Association of American Medical Colleges Student Representatives for distribution to fourth-year medical students. Questions assessed pressures that residency programs placed on applicants during interview season and their impact on applicants. Both quantitative and qualitative data were collected. Results Of the 433 included respondents, 31.2% (n = 135) reported breaches of the NRMP Match Participation Agreement. Of those, 63% (n = 85) had a negative perception of the violating programs, and 37.8% (n = 51) were less likely to rank those programs highly. Violations included asking applicants about the locations of their other interviews (60.3%, n = 261), pressuring applicants to reveal their ranking (24.0%, n = 104), explicitly requesting applicants to reveal their ranking (6.5%, n = 28), asking applicants to provide a commitment before Match day (3.9%, n = 17), and other behavior that was felt to ignore the spirit of the Match (16.4%, n = 71). Implying that applicants would match into a program if they ranked it highly (37.2%, n = 161) was received positively by 65.2% (n = 105) of applicants experiencing this breach, with 42.2% (n = 68) ranking the program more highly. Three major themes impacting applicants' impressions of residency programs emerged from the qualitative data: interview experience, professionalism, and post-interview communication (PIC). Respondents overwhelmingly agreed that PIC should either be eliminated or that programs should set clear expectations for PIC. Conclusions Match violations continue to occur, despite the NRMP Match Participation Agreement. With the notable exception of communication implying that applicants would match into a program, applicants overwhelmingly view programs that commit these violations negatively and often rank these programs lower as a result.
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Affiliation(s)
- Reesa L Monir
- Dermatology, University of Florida College of Medicine, Gainesville, USA
| | | | - Joseph G Monir
- Orthopedics and Rehabilitation, University of Florida College of Medicine, Gainesville, USA
| | | | | | - Lou Ann Cooper
- Medical Education, University of Florida College of Medicine, Gainesville, USA
| | - Heather Harrell
- Internal Medicine, University of Florida College of Medicine, Gainesville, USA
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Fletcher KE, O'Connor AB, Kisielewski M, Willett LL. Why Do Residency Program Directors Consider Resigning? A Mixed-Methods Analysis of a National Program Director Survey. Am J Med 2020; 133:761-767. [PMID: 32165188 DOI: 10.1016/j.amjmed.2020.02.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 01/15/2020] [Accepted: 02/20/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Kathlyn E Fletcher
- Department of Internal Medicine, Medical College of Wisconsin and the Clement J. Zablocki VAMC, Milwaukee, Wisc.
| | - Alec B O'Connor
- Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY
| | | | - Lisa L Willett
- Department of Medicine, University of Alabama at Birmingham
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Weaver AN, Willett LL. Is It Safe to Ask the Questions That Matter Most to Me? Observations From a Female Residency Applicant. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2019; 94:1635-1637. [PMID: 31192805 DOI: 10.1097/acm.0000000000002837] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Tens of thousands of senior medical students interview for medical residency positions each year. As the applicant pool shifts to include more women, married individuals, and young parents, the criteria by which interviewees evaluate programs are also changing. Concerns including parental leave policies, lactation facilities, access to childcare, partner recruitment resources, and inclusivity in the work environment are important in selecting an ideal program. However, the National Resident Matching Program Match Communication Code of Conduct prohibits interviewers from addressing gender, marital status, and intent to bear children, so the burden of introducing such topics falls on the interviewees. These topics can be difficult to discuss with potential employers, especially when weighed against the pressure to obtain a competitive position through the Match.In this Invited Commentary, the authors draw on personal experience to examine the questions that residency programs need to answer, encouraging both applicants and programs to improve communication during the residency interview process.
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Affiliation(s)
- Alice N Weaver
- A.N. Weaver is a first-year resident, Internal Medicine Residency Program, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama. L.L. Willett is professor and program director, Internal Medicine Residency Program, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
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Alweis RL, Williams CM, Luther VP, Simmons DL, Kopelman R, Angus SV, Liao S, Nagalla S, Muchmore EA. AAIM Guidelines for Interview and Post-Interview Communication for Graduate Medical Education Recruitment. Am J Med 2019; 132:1106-1111. [PMID: 31175844 DOI: 10.1016/j.amjmed.2019.05.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 05/28/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Richard L Alweis
- Associate Chief Medical Officer for Medical Education, Rochester Regional Health, Department of Medicine, University of Rochester, NY
| | | | - Vera P Luther
- Associate Professor, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC
| | | | - Richard Kopelman
- Vice-Chair for Education and Professor of Medicine, Tufts University School of Medicine, Boston
| | - Steven V Angus
- Associate Professor of Medicine, University of Connecticut Health, Farmington, Conn
| | - Solomon Liao
- Associate Professor of Medicine, UC Irvine School of Medicine, Irvine, Calif
| | - Sri Nagalla
- Associate Professor of Medicine, University of Texas Southwestern Medical Center, Dallas
| | - Elaine A Muchmore
- Associate Vice Chair for Medicine and Professor, University of California, San Diego; Associate Chief of Staff for Education, Veterans' Administration, San Diego, Calif.
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Williams CM, Alweis RL, O'Connor AB, Dalal B, Rai D, Abdullah A, Kopelman R, Cornett P, Frank MO, Luther VP, Muchmore EA. Inappropriate Communication During Internal Medicine Fellowship Recruitment: A Mixed-Methods Analysis. Am J Med 2019; 132:770-775. [PMID: 30851262 DOI: 10.1016/j.amjmed.2019.02.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 02/20/2019] [Indexed: 10/27/2022]
Affiliation(s)
| | - Richard L Alweis
- Department of Graduate Medical Education, Rochester Regional Health, NY; Department of Medicine, University of Rochester, NY
| | | | - Bhavin Dalal
- Oakland University William Beaumont School of Medicine, Rochester, Mich
| | - Devesh Rai
- Department of Internal Medicine, Rochester Regional Health, NY
| | | | - Richard Kopelman
- Departments of Education and Medicine, Tufts University School of Medicine, Boston, Mass
| | - Patricia Cornett
- Departments of Medicine for Education and Medicine, University of California, San Francisco
| | - Michael O Frank
- Department of Medicine, Medical College of Wisconsin, Milwaukee
| | - Vera P Luther
- Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC
| | - Elaine A Muchmore
- Department of Medicine, University of California, San Diego; Department of Education, Veterans Affairs San Diego, Calif.
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Frush BW, Byerley J. High-Value Interviewing: A Call for Quality Improvement in the Match Process. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2019; 94:324-327. [PMID: 30520808 DOI: 10.1097/acm.0000000000002545] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Within the Match process, current residency interview practices are inefficient for both applicants and programs. Problems include disorganized interview offers and scheduling, excessive numbers of applicant interviews, unclear postinterview communication policies, and the significant expenses entailed. To address these issues, the authors propose applying a quality improvement approach to create a high-value interview process that would decrease investments of time, money, and energy and improve the quality of the Match experience for both applicants and programs. They propose establishing an interview offer week to streamline and systematize the interview offer and scheduling process; placing an evidence-based cap on the number of interviews that applicants are allowed to schedule; and enforcing a moratorium on postinterview communication that would apply to both applicants and programs. Implementing these proposals would decrease expenses, improve the efficiency of this process for all involved, and demonstrate that quality improvement methods used to improve patient care can also be applied to improving medical student and physician experiences.
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Affiliation(s)
- Benjamin W Frush
- B.W. Frush is a first-year resident in internal medicine-pediatrics, Vanderbilt University Medical Center and Monroe Carell Jr Children's Hospital at Vanderbilt, Nashville, Tennessee. The author was a fourth-year medical student, University of North Carolina School of Medicine, Chapel Hill, North Carolina, at the time of writing. J. Byerley is professor of pediatrics, vice dean for education, and chief education officer, University of North Carolina School of Medicine, Chapel Hill, North Carolina
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