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Mukit FA, Kim EY, Hilliard G, Pilkinton S, Walker ME, Wilson MW, Fowler BT. Scope of practice of oculofacial plastic and reconstructive surgeons: a public perception survey. Orbit 2024:1-7. [PMID: 38815176 DOI: 10.1080/01676830.2024.2348015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 04/21/2024] [Indexed: 06/01/2024]
Abstract
PURPOSE The purpose of this study is to determine the public's perception of the scope of practice for oculofacial plastic and reconstructive surgeons (OFPRS). METHODS A 49-question survey was distributed by QualtricsⓇ to a panel similar to the US demographic composition. Responses collected underwent bivariate statistical analysis. RESULT A total of 530 responses were obtained, with most respondents being white, female, over the age of 35, from the Midwest, and with at least a college education or above. Most respondents did not think ophthalmologists or optometrists were surgeons, and only 158 people (29.8%) knew the primary specialty of OFPRS was ophthalmology. Board certification was preferred by 98.87% of respondents, and 95.28% preferred ASOPRS-trained OFPRS. CONCLUSIONS Our study highlights the gap in knowledge about OFPRS as a field, the qualifications and training required, and the scope of practice. Notably, even for OFPRS-specific procedures, PRS remained the leading subspecialist chosen for interventions such as orbital decompression (58.5% vs. 71.5%), orbital reconstruction (57.9% vs. 74.2%), enucleation/evisceration (48.1% vs. 53.4%), optic nerve-related surgery (39.8% vs. 43.4%), orbital cancer resection (42.8% vs. 46.8%), and tear duct surgery (41.9% vs. 52.5%). Additionally, most respondents did not feel that facial fillers, laser skin resurfacing, eyelid cancer removal, or cataract surgery were within the OFPRS scope of practice.
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Affiliation(s)
- Fabliha A Mukit
- Oculofacial Plastic and Reconstructive Surgery, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Emily Y Kim
- College of Medicine, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Grant Hilliard
- College of Medicine, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Sophie Pilkinton
- College of Medicine, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Marc E Walker
- Plastic and Reconstructive Surgery, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Matthew W Wilson
- Oculofacial Plastic and Reconstructive Surgery, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Brian T Fowler
- Oculofacial Plastic and Reconstructive Surgery, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
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Rashid MA, Griffin A. Is West Really Best? The Discourse of Modernisation in Global Medical School Regulation Policy. TEACHING AND LEARNING IN MEDICINE 2023:1-12. [PMID: 37401838 DOI: 10.1080/10401334.2023.2230586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 04/21/2023] [Accepted: 06/07/2023] [Indexed: 07/05/2023]
Abstract
Phenomenon: In 2012, the World Federation for Medical Education (WFME) established a recognition programme to evaluate medical school regulatory agencies across the world, in response to a new U.S. accreditation policy. Given the predominantly Western origins and Eastern impacts of the WFME programme, this article deconstructs tensions in the programme using postcolonial theory. Approach: Critical discourse analysis examines the intersections of language, knowledge, and power relations to highlight what can or cannot be said about a topic. We employed it to delineate the dominant discourse underpinning the WFME recognition programme. We drew on the theoretical devices of Edward Said, whose work is foundational in postcolonial thinking but has not been widely used in medical education scholarship to date. An archive of literature about the WFME recognition programme dating back to 2003, when WFME first released global standards for medical education, was analyzed. Findings: In the globalization of medical school regulation, the discourse of modernization can be conceptualized as a means of holding knowledge and power in the West, and enacting this power on those in the East, playing on fears of marginalization in the event of non-engagement. The discourse allows these practices to be presented in an honorable and heroic way. Insights: By uncovering the representation of the WFME recognition programme as being modern and modernizing, this article explores how such conceptualisations can close off debate and scrutiny, and proposes further examination of this programme through a lens that recognizes the inherent inequities and geopolitical power differentials that it operates within.
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Affiliation(s)
- Mohammed Ahmed Rashid
- UCL Medical School, Faculty of Medical Sciences, University College London, London, UK
| | - Ann Griffin
- UCL Medical School, Faculty of Medical Sciences, University College London, London, UK
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Rashid MA. Altruism or nationalism? Exploring global discourses of medical school regulation. MEDICAL EDUCATION 2023; 57:31-39. [PMID: 35365925 PMCID: PMC10084281 DOI: 10.1111/medu.14804] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/23/2022] [Accepted: 03/25/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Although medical school regulation is ubiquitous, the extent to which it should be based on global principles is unclear. In 2010, the Educational Commission for Foreign Medical Graduates (ECFMG) announced that from 2023, overseas doctors would only be eligible for certification to practise in the United States if they had graduated from a medical school that was accredited by a 'recognised' agency. This policy empowered the World Federation for Medical Education (WFME) to create a recognition programme for regulatory agencies around the world, despite a lack of empirical evidence to support medical school regulation. METHODS This study employs critical discourse analysis, drawing on the theoretical perspectives of Michel Foucault and Edward Said, to identify discourses that enabled this 'globalising' policy decision to take place. The dataset includes a series of 250 documents gathered around three key events: the Edinburgh declaration by WFME in 1988, the first set of global standards for medical schools by WFME in 2003 and the ECFMG ruling about medical school accreditation in 2010. FINDINGS Two discourses, endorsement and modernisation, were dominant throughout this entire period and framed the move to globalise medical school regulation in terms of altruism and improving medical education worldwide. A discourse of resistance was present in the earlier period of this study but faded away as WFME aligned itself with ECFMG after 2010. Two further discourses, protection and control, emerged in the later period of this study and framed the ECFMG ruling in terms of nationalism and protecting American interests. DISCUSSION This study proposes a new conceptualisation of the relationship between ECFMG and WFME in light of the apparently contradictory policy motivations of altruism and nationalism. It goes on to consider the implications of this association for the legitimacy of WFME as an organisation that represents all of the world's medical schools.
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Han H, Clithero-Eridon A, Costa MJ, Dennis CA, Dorsey JK, Ghias K, Hopkins A, Jabeen K, Klamen D, Matos S, Mellinger JD, Peters H, Pitama S, Smith CL, Smith SF, Suh B, Suh S, Zdravković M. On pandemics and pivots: a COVID-19 reflection on envisioning the future of medical education. KOREAN JOURNAL OF MEDICAL EDUCATION 2021; 33:393-404. [PMID: 34875155 PMCID: PMC8655362 DOI: 10.3946/kjme.2021.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 08/13/2021] [Accepted: 10/06/2021] [Indexed: 06/13/2023]
Abstract
The required adjustments precipitated by the coronavirus disease 2019 crisis have been challenging, but also represent a critical opportunity for the evolution and potential disruptive and constructive change of medical education. Given that the format of medical education is not fixed, but malleable and in fact must be adaptable to societal needs through ongoing reflexivity, we find ourselves in a potentially transformative learning phase for the field. An Association for Medical Education in Europe ASPIRE Academy group of 18 medical educators from seven countries was formed to consider this opportunity, and identified critical questions for collective reflection on current medical education practices and assumptions, with the attendant challenge to envision the future of medical education. This was achieved through online discussion as well as asynchronous collective reflections by group members. Four major themes and related conclusions arose from this conversation: Why we teach: the humanitarian mission of medicine should be reinforced; what we teach: disaster management, social accountability and embracing an environment of complexity and uncertainty should be the core; how we teach: open pathways to lean medical education and learning by developing learners embedded in a community context; and whom we teach: those willing to take professional responsibility. These collective reflections provide neither fully matured digests of the challenges of our field, nor comprehensive solutions; rather they are offered as a starting point for medical schools to consider as we seek to harness the learning opportunities stimulated by the pandemic.
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Affiliation(s)
- Heeyoung Han
- Southern Illinois University School of Medicine, Springfield, IL, USA
| | | | | | | | - J. Kevin Dorsey
- Southern Illinois University School of Medicine, Springfield, IL, USA
| | | | - Alex Hopkins
- Southern Illinois University School of Medicine, Springfield, IL, USA
| | | | - Debra Klamen
- Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Sophia Matos
- Southern Illinois University School of Medicine, Springfield, IL, USA
| | - John D. Mellinger
- Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Harm Peters
- Charité, Universitätsmedizin Berlin, Berlin, Germany
| | | | - C. Leslie Smith
- Southern Illinois University School of Medicine, Springfield, IL, USA
| | | | - Boyung Suh
- Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Sookyung Suh
- Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Marko Zdravković
- University Medical Centre Maribor, Maribor
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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Carmody JB. Match Statistics Underestimate the Number of Doctors Unable to Obtain Residency Training Positions. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2021; 96:164. [PMID: 33492824 DOI: 10.1097/acm.0000000000003822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- J Bryan Carmody
- Associate professor of pediatrics, Eastern Virginia Medical School, Norfolk, Virginia; ; ORCID: https://orcid.org/0000-0001-9079-1835
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Schork NJ, Goetz LH, Lowey J, Trent J. Strategies for Testing Intervention Matching Schemes in Cancer. Clin Pharmacol Ther 2020; 108:542-552. [PMID: 32535886 DOI: 10.1002/cpt.1947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 06/04/2020] [Indexed: 01/02/2023]
Abstract
Personalized medicine, or the tailoring of health interventions to an individual's nuanced and often unique genetic, biochemical, physiological, behavioral, and/or exposure profile, is seen by many as a biological necessity given the great heterogeneity of pathogenic processes underlying most diseases. However, testing and ultimately proving the benefit of strategies or algorithms connecting the mechanisms of action of specific interventions to patient pathophysiological profiles (referred to here as "intervention matching schemes" (IMS)) is complex for many reasons. We argue that IMS are likely to be pervasive, if not ubiquitous, in future health care, but raise important questions about their broad deployment and the contexts within which their utility can be proven. For example, one could question the need to, the efficiency associated with, and the reliability of, strategies for comparing competing or perhaps complementary IMS. We briefly summarize some of the more salient issues surrounding the vetting of IMS in cancer contexts and argue that IMS are at the foundation of many modern clinical trials and intervention strategies, such as basket, umbrella, and adaptive trials. In addition, IMS are at the heart of proposed "rapid learning systems" in hospitals, and implicit in cell replacement strategies, such as cytotoxic T-cell therapies targeting patient-specific neo-antigen profiles. We also consider the need for sensitivity to issues surrounding the deployment of IMS and comment on directions for future research.
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Affiliation(s)
- Nicholas J Schork
- The Translational Genomics Research Institute (TGen), Phoenix, Arizona, USA.,Department of Population Sciences, The City of Hope National Medical Center, Duarte, California, USA.,Department of Molecular and Cell Biology, The City of Hope National Medical Center, Duarte, California, USA
| | - Laura H Goetz
- The Translational Genomics Research Institute (TGen), Phoenix, Arizona, USA.,Department of Medical Oncology, The City of Hope National Medical Center, Duarte, California, USA
| | - James Lowey
- The Translational Genomics Research Institute (TGen), Phoenix, Arizona, USA
| | - Jeffrey Trent
- The Translational Genomics Research Institute (TGen), Phoenix, Arizona, USA.,Department of Medical Oncology, The City of Hope National Medical Center, Duarte, California, USA
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Ahmed H, Carmody JB. On the Looming Physician Shortage and Strategic Expansion of Graduate Medical Education. Cureus 2020; 12:e9216. [PMID: 32821567 PMCID: PMC7430533 DOI: 10.7759/cureus.9216] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Among many other things, the novel coronavirus pandemic of 2020 highlighted the significance of physician shortages in the United States. Current projections anticipate a national shortage of up to 122,000 physicians by 2032, with shortfalls in both primary care physicians and specialists. Yet while this figure highlights the magnitude of the problem, it does not capture the distributional aspect of American physician shortages. Though some specialties and geographic areas have a surplus of physicians, others have a chronic undersupply. Appropriately addressing the looming physician shortage therefore requires not only creating more physicians, but also ensuring that those physicians practice in the areas of greatest societal need. This review explores the nature of physician shortages in the United States, identifies the present bottleneck in physician training at the level of graduate medical education, and considers potential legislative and policy solutions to allow strategic and deliberate expansion of graduate medical education and physician practice.
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Affiliation(s)
- Harris Ahmed
- Ophthalmology, Loma Linda University Medical Center, Loma Linda, USA
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Roberts LW. Belonging, Respectful Inclusion, and Diversity in Medical Education. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2020; 95:661-664. [PMID: 32345871 DOI: 10.1097/acm.0000000000003215] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
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Roberts LW. The New MCAT Exam and the Continuing Imperative of Holistic Review in the Selection of Medical Students. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2020; 95:323-326. [PMID: 32097142 DOI: 10.1097/acm.0000000000003123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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