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Adams MCB, Wandner LD, Kolber BJ. Challenges and opportunities for growing and retaining a pain research workforce. Pain Med 2024; 25:315-318. [PMID: 38459612 PMCID: PMC11063744 DOI: 10.1093/pm/pnae008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 01/24/2024] [Accepted: 02/01/2024] [Indexed: 03/10/2024]
Affiliation(s)
- Meredith C B Adams
- Departments of Anesthesiology, Biomedical Informatics, Translational Neuroscience, and Public Health Sciences, Wake Forest University School of Medicine, Winston Salem, NC 27157, United States
| | - Laura D Wandner
- National Institutes of Health, National Institutes of Neurological Disorders and Stroke, Bethesda, MD 20814, United States
| | - Benedict J Kolber
- Department of Neuroscience, Center for Advanced Pain Studies, University of Texas at Dallas, Richardson, TX 75080, United States
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Alizadeh M, Sampaio Moura N, Schledwitz A, Patil SA, Ravel J, Raufman JP. Gastroenterology Fellowship and Postdoctoral Training in Omics and Statistics-Part II: How Can It Be Achieved? Dig Dis Sci 2024; 69:22-26. [PMID: 37919515 PMCID: PMC10876148 DOI: 10.1007/s10620-023-08149-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 09/27/2023] [Indexed: 11/04/2023]
Abstract
Data are being generated, collected, and aggregated in massive quantities at exponentially increasing rates. This "big data," discussed in depth in the first section of this two-part series, is increasingly important to understand the nuances of the gastrointestinal tract and its complex interactions and networks involving a host of other organ systems and microbes. Creating and using these datasets correctly requires comprehensive training; however, current instruction in the integration, analysis, and interpretation of big data appears to lag far behind data acquisition. While opportunities exist for those interested in acquiring the requisite training, these appear to be underutilized, in part due to widespread ignorance of their existence. Here, to address these gaps in knowledge, we highlight existing big data learning opportunities and propose innovative approaches to attain such training. We offer suggestions at both the undergraduate and graduate medical education levels for prospective clinical and basic investigators. Lastly, we categorize training opportunities that can be selected to fit specific needs and timeframes.
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Affiliation(s)
- Madeline Alizadeh
- The Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, 20201, USA
| | - Natalia Sampaio Moura
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, 21201, USA
| | - Alyssa Schledwitz
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, 21201, USA
| | - Seema A Patil
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, 21201, USA
| | - Jacques Ravel
- The Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, 20201, USA
| | - Jean-Pierre Raufman
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, 21201, USA.
- VA Maryland Healthcare System, Baltimore, MD, 21201, USA.
- Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore, MD, 21201, USA.
- Department of Biochemistry and Molecular Biology, University of Maryland School of Medicine, Baltimore, MD, 21201, USA.
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3
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Pololi LH, Evans AT, Civian JT, Cooper LA, Gibbs BK, Ninteau K, Dagher RK, Bloom-Feshbach K, Brennan RT. Are researchers in academic medicine flourishing? A survey of midcareer Ph.D. and physician investigators. J Clin Transl Sci 2023; 7:e105. [PMID: 37251000 PMCID: PMC10225255 DOI: 10.1017/cts.2023.525] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 03/17/2023] [Accepted: 04/03/2023] [Indexed: 05/31/2023] Open
Abstract
Introduction Midcareer research faculty are a vital part of the advancement of science in U.S. medical schools, but there are troubling trends in recruitment, retention, and burnout rates. Methods The primary sampling frame for this online survey was recipients of a single R01 or equivalent and/or K-award from 2013 to 2019. Inclusion criteria were 3-14 years at a U.S. medical school and rank of associate professor or two or more years as assistant professor. Forty physician investigators and Ph.D. scientists volunteered for a faculty development program, and 106 were propensity-matched controls. Survey items covered self-efficacy in career, research, work-life; vitality/burnout; relationships, inclusion, trust; diversity; and intention to leave academic medicine. Results The majority (52%) reported receiving poor mentoring; 40% experienced high burnout and 41% low vitality, which, in turn, predicted leaving intention (P < 0.0005). Women were more likely to report high burnout (P = 0.01) and low self-efficacy managing work and personal life (P = 0.01) and to be seriously considering leaving academic medicine than men (P = 0.003). Mentoring quality (P < 0.0005) and poor relationships, inclusion, and trust (P < 0.0005) predicted leaving intention. Non-underrepresented men were very likely to report low identity self-awareness (65%) and valuing differences (24%) versus underrepresented men (25% and 0%; P < 0.0005). Ph.D.s had lower career advancement self-efficacy than M.D.s (P < .0005). Conclusions Midcareer Ph.D. and physician investigators faced significant career challenges. Experiences diverged by underrepresentation, gender, and degree. Poor quality mentoring was an issue for most. Effective mentoring could address the concerns of this vital component of the biomedical workforce.
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Affiliation(s)
| | | | | | - Lisa A. Cooper
- John Hopkins University School of Medicine and Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Brian K. Gibbs
- UMass Memorial Health Care, Worcester, Massachusetts, USA
| | - Kacy Ninteau
- Brandeis University, Waltham, Massachusetts, USA
| | - Rada K. Dagher
- National Institute on Minority Health Disparities (Division of Clinical and Health Services Research), National Institutes of health, USA
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Liao S, Lavender C, Zhai H, Zhou X. Predictors of academic career progression among early career physician-scientists via an intensive research training program abroad: a case study. BMC Med Educ 2023; 23:94. [PMID: 36747173 PMCID: PMC9900976 DOI: 10.1186/s12909-023-04069-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 01/31/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Despite extensive efforts to revitalize the physician-scientist pipeline, attrition has been observed along the physician-scientist developmental pathway. Research exposure during clinical training is considered an important factor favoring the decision to pursue an academic career pathway. METHODS The authors sought to identify factors associated with academic career progression among junior physician-scientists following the completion of an intensive research training program, using the framework of the Social Cognitive Career Theory (SCCT), to benefit the design of efforts to revitalize the physician-scientist career pipeline. We conducted a retrospective study of 108 physicians who completed a long-term research training program abroad during residency, or within a few years post-residency completion, between 2010 and 2017. With potential predictors of academic career progression prioritized by SCCT, multivariable logistic regression was used to identify predictors of sustained research involvement, high productivity and high research competency after training, respectively. The SCCT was used to illuminate our findings. RESULTS Co-publications with training supervisors abroad and medical oncology/pediatric oncology as a clinical specialty were positively associated with sustained research involvement and high productivity. Joining the training program after the age of 36 was negatively associated with high research competency. All of the predictors shared a common feature of high correlation with both self-efficacy and environmental elements, the reciprocal interactions of which may affect the career progression of physician-scientists. CONCLUSIONS Insights gained through this analysis provide policy recommendations for the designing of efforts to revitalize the physician-scientist career pipeline. Priorities should be given to institutional oversight to ensure strengthened self-efficacy at the beginning of one's academic career, by providing long-term research training opportunities to young residents and promoting co-publications with their training supervisors during the training. In order to avoid the negative impact to self-efficacy caused by patient-related burnout or academic isolation, academic medical centers should take measures to guarantee protected research time, and to develop a positive culture encouraging mentoring relationships between junior and experienced physician-scientists in medical departments.
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Affiliation(s)
- Shuang Liao
- Department of Scientific Research and Education, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, No. 651 Dongfeng East Road, Guangzhou, 510060, Guangdong, People's Republic of China
| | - Christopher Lavender
- Department of Scientific Research and Education, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, No. 651 Dongfeng East Road, Guangzhou, 510060, Guangdong, People's Republic of China
| | - Huiwen Zhai
- Department of Scientific Research and Education, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, No. 651 Dongfeng East Road, Guangzhou, 510060, Guangdong, People's Republic of China
- School of Sociology and Anthropology, Sun Yat-Sen University, Guangzhou , 510275, Guangdong, People's Republic of China
| | - Xinxi Zhou
- Department of Scientific Research and Education, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, No. 651 Dongfeng East Road, Guangzhou, 510060, Guangdong, People's Republic of China.
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Dabaj I, Lahmar I, Gomez A, Barbey L, Verdier A, Delage C, Galateau E, Aubert R, Gehanno A, Schaal P, Feldmann L, Tebani A, Estour F, Bekri S. Le Double Cursus Santé Sciences à l’UFR Santé de Rouen. Med Sci (Paris) 2022; 38:698-706. [DOI: 10.1051/medsci/2022106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Le Double Cursus Santé Sciences (DCSS) permet de former précocement les futurs acteurs de santé à la recherche. La profonde transformation du système de santé et l’avènement de nouvelles techniques analytiques et numériques ont conduit à reconsidérer la place de la recherche dans la pratique clinique. L’expérience internationale de ce type de programme de formation, notamment aux États-Unis, a révélé le rôle prépondérant que jouent les acteurs de santé ayant acquis une double compétence, médicale et scientifique. En France, un DCSS précoce, pendant les études médicales, a été mis en place dans les années 2000. Cette formation reste cependant disparate et hétérogène, et ne concerne pas toutes les universités. En 2016, l’UFR Santé de Rouen a constaté que le nombre d’étudiants engagés dans ce double cursus était très faible, voire nul selon les années. Aussi, en 2017, un accompagnement institutionnel a été introduit. Celui-ci a abouti à la création d’un tutorat étudiant dédié à cette formation. Il a permis une augmentation du nombre de candidats intéressés et la reconnaissance institutionnelle de ce double parcours. Nous présentons ici les contours de cette formation impliquant étudiants et institution.
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Jones JL, Barth KS, Brown DG, Halliday CA, Brady KT, Book SW, Bristol EJ, Back SE. The Drug Abuse Research Training (DART) Program for Psychiatry Residents and Summer Fellows: 15-Year Outcomes. Acad Psychiatry 2022; 46:317-324. [PMID: 35113391 PMCID: PMC9232963 DOI: 10.1007/s40596-022-01593-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 01/11/2022] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To increase the number of physician-scientists in research, the Drug Abuse Research Training (DART) program at the Medical University of South Carolina offers a 2-year research track for psychiatry residents and a 10-week summer fellowship for students. The goal of this study was to examine program outcomes and alumni diversity levels over DART's 15-year history. METHODS To date, 215 trainees (44 residents, 171 summer fellows) have completed the program. An anonymous online survey was sent to the 143 program alumni with valid contact information. Survey data included demographic characteristics, post-program research involvement, and self-reported barriers to continued research engagement. RESULTS Overall survey completion response was 83.5% (N = 122). The alumni included 59.0% women, and 36.1% of respondents identified as a member of a minority racial/ethnic group. Following program completion, 77.0% of the alumni reported continued research involvement. More than half of the alumni reported scientific publications (57.4%) and conference presentations (63.1%) since completing DART. Among respondents who did not subsequently engage in research, the most common modifiable barriers included difficulty finding a mentor, self-perceived deficits in statistical skills and research methodology, and overall lack of confidence in research ability. CONCLUSIONS Over the past 15 years, the DART program has established a diverse research training program that now spans the educational spectrum from undergraduate to residency training. Future program goals include additional training to address self-reported modifiable research barriers. This program provides a model for other training programs designed to cultivate research interests and promote the diversity of clinical researchers.
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Affiliation(s)
| | - Kelly S Barth
- Medical University of South Carolina, Charleston, SC, USA
| | - Delisa G Brown
- Medical University of South Carolina, Charleston, SC, USA
| | | | | | - Sarah W Book
- Medical University of South Carolina, Charleston, SC, USA
| | | | - Sudie E Back
- Medical University of South Carolina, Charleston, SC, USA
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Marr MC, Heffron AS, Kwan JM. Characteristics, barriers, and career intentions of a national cohort of LGBTQ+ MD/PhD and DO/PhD trainees. BMC Med Educ 2022; 22:304. [PMID: 35449040 PMCID: PMC9027045 DOI: 10.1186/s12909-022-03378-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 04/04/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Lesbian, gay, bisexual, transgender, queer, non-binary, intersex, and/or asexual (LGBTQ+) individuals continue to suffer worse health outcomes compared to the general population. Data on LGBTQ+ individuals in medicine, particularly in medical training, remain sparse. National studies of LGBTQ+ students in MD/PhD and DO/PhD training programs have not been reported. METHODS Trainees pursuing MD, DO, MD/PhD, and DO/PhD degrees at 32 nationally representative institutions completed a 70-item survey about their future career and anticipated challenges using an online survey tool from September 2012 to December 2014. There were 4,433 respondents to the survey. Of those, 2,837 completed the gender identity questions and 2,849 completed the sexual orientation questions. Completion of these questions was required for inclusion. Survey results were analyzed to examine differences between LGBTQ+ and non-LGBTQ+ medical and dual degree trainees. RESULTS LGBTQ+ students were underrepresented among MD/PhD and DO/PhD trainees (8.70%) compared to the US population, though their representation was higher than among MD and DO trainees (5.20%). LGBTQ+ dual degree trainees endorsed the greatest interest in pursuing careers involving academic medicine, with varying career focuses including research, clinical duties, education, and advocacy. LGBTQ+ dual degree trainees prioritized opportunities in patient care, work-life balance, and research as the most important factors for their career selection. Importantly, a higher percentage of LGBTQ+ dual degree trainees (15.50%) identified sexual harassment as a past barrier to career advancement compared to their non-LGBTQ+ peers (8.27%). LGBTQ+ dual degree trainees were more likely to report having a mentor who advocated for them. CONCLUSIONS LGBTQ+ physician scientist trainees remain under-represented and under-studied. It is vital that medical institutions devote more time and resources towards identifying and addressing the unique needs of this group in training. Training programs should be aware of the current and prior challenges faced by their LGBTQ+ dual degree trainees, work to overcome the unique barriers they face, highlight the strengths and unique perspectives they bring, and foster their professional growth and goals during and beyond their training.
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Affiliation(s)
- Mollie C Marr
- Oregon Health & Science University Medical Scientist Training Program, Portland, OR, USA
| | - Anna S Heffron
- University of Wisconsin School of Medicine and Public Health Medical Scientist Training Program, Madison, WI, USA
| | - Jennifer M Kwan
- Yale School of Medicine in New Haven, New Haven, CT, 06520, USA.
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Ghosh-Choudhary S, Carleton N, Flynn JL, Kliment CR. Strategies for Achieving Gender Equity and Work-Life Integration in Physician-Scientist Training. Acad Med 2022; 97:492-496. [PMID: 34292189 PMCID: PMC8770678 DOI: 10.1097/acm.0000000000004246] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Substantial gender inequities persist across academic medicine. These issues are not new: Recent evidence still points to a chilly climate for women in academic medicine, including those in physician-scientist training. The discussion for how to address gender equity and issues of work-life integration typically centers around faculty and rarely includes trainees. The authors delineate specific strategies to address gender inequity in physician-scientist training by identifying key stakeholders for implementation and proposing areas to integrate these strategies with current training timelines. Strategies discussed include multiple-role mentoring, allyship training for trainees and faculty, early implementation of professional development sessions, incorporation of childcare and family-friendly policies, and additional policies for funding bodies to prioritize gender equity practices. The goal of this article is to equip trainees and the academic community with proactive strategies to create a more equitable environment for future generations of trainees in academic medicine.
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Affiliation(s)
- Shohini Ghosh-Choudhary
- S. Ghosh-Choudhary is a fourth-year MD-PhD student, Medical Scientist Training Program, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Neil Carleton
- N. Carleton is a fourth-year MD-PhD student, Medical Scientist Training Program, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - JoAnne L Flynn
- J.L. Flynn is professor of microbiology and molecular genetics, University of Pittsburgh, and assistant dean and codirector, Medical Scientist Training Program, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Corrine R Kliment
- C.R. Kliment is assistant professor of medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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Abstract
MD-PhD trainees constitute an important source of physician-scientists. Persistence on this challenging path is facilitated by success in garnering independent (R grant) support from the NIH. Published research tracks academic appointments and global R01 success for MD-PhD trainees but has not included information on future funding success of individual MD-PhD predoctoral grant holders. Here, we used data from the NIH RePORTER database to identify and track the funding trajectory of physician-scientists who received predoctoral grant support through the F30 mechanism, which is specific for dual-degree candidates. Male and female F30 awardees did not differ in their success in garnering K (postdoctoral training) grants, but, among F30 grant awardees, men were 2.6 times more likely than women to receive R funding. These results underscore the need for analysis of factors that contribute to the disproportionate loss of NIH-supported female physician-scientists between the predoctoral F30 and the independent R grant-supported stages.
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Affiliation(s)
| | | | - S. Mehdi Nouraie
- Division of Pulmonary, Allergy, and Critical Medicine, Department of Medicine
| | - Corrine R. Kliment
- Division of Pulmonary, Allergy, and Critical Medicine, Department of Medicine
| | - Richard A. Steinman
- Department of Medicine, and
- Department of Pharmacology and Chemical Biology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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Kayser RR, Arbuckle M, Simpson HB. Pipeline in Jeopardy-Challenges in Developing Patient-Oriented Interventions Researchers in Psychiatry and Opportunities for Action. JAMA Psychiatry 2022; 79:95-96. [PMID: 34910123 DOI: 10.1001/jamapsychiatry.2021.3262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Reilly R Kayser
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York.,Research Foundation for Mental Hygiene, New York State Psychiatric Institute, New York
| | - Melissa Arbuckle
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York.,Research Foundation for Mental Hygiene, New York State Psychiatric Institute, New York
| | - H Blair Simpson
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York.,Research Foundation for Mental Hygiene, New York State Psychiatric Institute, New York.,Associate Editor , JAMA Psychiatry
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D’Arrietta LM, Vangaveti VN, Crowe MJ, Malau-Aduli BS. Rethinking Health Professionals’ Motivation to Do Research: A Systematic Review. J Multidiscip Healthc 2022; 15:185-216. [PMID: 35115782 PMCID: PMC8801363 DOI: 10.2147/jmdh.s337172] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 12/15/2021] [Indexed: 11/23/2022] Open
Abstract
Background Health professionals’ engagement in translational health and medical research (HMR) is fundamental to evidence-based practice leading to better patient health outcomes. However, there is a decline in the number of health professionals undertaking research which has implications for patient health and the economy. Informed by the motivation-based expectancy-value-cost (EVC) and self determination theories (SDT), this systematic literature review examined the barriers and facilitators of health professionals’ (HPs) motivation to undertake research. Methods The literature was searched between 2011 and 2021 for relevant peer-reviewed articles written in English, using CINAHL Complete, Informit, Medline Ovid, Medline (PubMed), Scopus, Web of Science and Google Scholar databases. This systematic review was performed and reported in accordance with the PRISMA guidelines. Results Identified barriers to HPs’ engagement with research included the lack of knowledge, skills, and competence to conduct research, lack of protected research time, lack of funding and lack of organisational support. Integration of the findings of this review based on the EVC and SDT theories indicate that research capacity, ie, expectancy and competence is highly influenced by attitude, ie, the type of value (attainment, intrinsic or utility) and connection attributed to research. HPs who had very positive attitude towards research demonstrated all three values and were keen to take up research despite the barriers. Those who had a positive attitude were only motivated to do research because of its utility value and did not necessarily see it as having personal relevance for themselves. HPs who were unmotivated did not see any personal connection or relatedness to the research experience and saw no value in research. Conclusion The attitude HPs hold in their value of research is a catalyst for motivation or amotivation to engage in research as it directly influences the relevance of barriers. Facilitators that expedite the research journey have been attributed to research training, mentorship programs and supportive organisational research culture. Motivation of HPs explored through EVC and SDT is critical to the maintenance of a research culture and the clinician-researcher development pipeline.
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Affiliation(s)
- Louisa M D’Arrietta
- College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
- Library Services, Townsville University Hospital, Townsville Hospital and Health Service, Townsville, Queensland, Australia
- Correspondence: Louisa M D’Arrietta College of Medicine and Dentistry, James Cook University, Townsville, Queensland, 4811, AustraliaTel +61 7 4781 4060Fax +61 7 4779 6371 Email
| | - Venkat N Vangaveti
- College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| | - Melissa J Crowe
- Division of Tropical Health and Medicine, James Cook University, Queensland, Australia
| | - Bunmi S Malau-Aduli
- College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
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12
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Li S, Yancey KB, Cruz PD, Le LQ. Training Physician‒Scientists for Careers in Investigative Dermatology. JID Innov 2022; 2:100061. [PMID: 35146478 PMCID: PMC8801527 DOI: 10.1016/j.xjidi.2021.100061] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/14/2021] [Accepted: 09/16/2021] [Indexed: 11/20/2022] Open
Abstract
Physician‒scientists have made countless discoveries, and their dwindling numbers are a significant concern. Although dermatology has become an increasingly popular destination for physician‒scientist trainees, the proportion of trainees who pursue scientific research careers after training is among the lowest of all medical specialties. To investigate this problem, we surveyed a national cohort of dermatology educators, physician‒scientist track program directors, and National Institute of Arthritis and Musculoskeletal and Skin Diseases T32 directors for opinions regarding physician‒scientist training in dermatology. On the basis of these findings and to help address the issue, we propose a training practicum and provide a resource for funding opportunities to help guide trainees and institutions interested in supporting investigative dermatologists. We also discuss the important roles of department chairs and institutions in fashioning an environment conducive to physician‒scientist training. The information and recommendations provided in this paper may help to improve the recruitment, training, development, and retention of investigative dermatologists and future leaders in this field.
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Key Words
- ABD, American Board of Dermatology
- ASCI, American Society of Clinical Investigators
- CDA, Career Development Award
- CV, curriculum vitae
- LRP, loan repayment program
- MD, medical degree
- MSTP, Medical Scientist Training Program
- NIAMS, National Institute of Arthritis and Musculoskeletal and Skin Diseases
- NIGMS, National Institute of General Medical Sciences
- NIH, National Institutes of Health
- PGY, postgraduate year
- PSTP, physician‒scientist training program
- PSW, physician‒scientist workforce
- STAR, Specialty Training and Advanced Research
- URM, under-represented minority
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Affiliation(s)
- Stephen Li
- Department of Dermatology, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Medical Scientist Training Program, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Hamon Center for Regenerative Science and Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Kim B. Yancey
- Department of Dermatology, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Ponciano D. Cruz
- Department of Dermatology, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Lu Q. Le
- Department of Dermatology, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Hamon Center for Regenerative Science and Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Harold C. Simmons Comprehensive Cancer Center, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Peter O'Donnell Jr. Brain Institute, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
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13
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Wang G. Training and Retaining Physician‒Scientists in Dermatology: China. JID Innov 2022; 2:100080. [PMID: 35072141 PMCID: PMC8762070 DOI: 10.1016/j.xjidi.2021.100080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Physician‒scientists play a crucial role in the development and advancement of medical science. The number of physician‒scientists has been decreasing in recent years, and this phenomenon is also very prominent in the field of dermatology. In China, on the one hand, the quality and quantity of dermatological science research are rapidly increasing. On the other hand, there are many problems and challenges in physician‒scientist training that hinder young students from choosing to enter an MD‒PhD path over an MD-only path. Continuous efforts should be made to attract medical students to the dermatology specialty, to guide and spur their interests in scientific research, and to provide them with excellent research conditions and environment.
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Affiliation(s)
- Gang Wang
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi’an, China
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14
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Abstract
SUMMARY With plastic surgery being at the forefront of innovation and discovery in multiple research disciplines, plastic surgery is poised for M.D./Ph.D. and research-focused M.D. trainees to be attracted to this field. Surprisingly, recent reports have shown that the number of surgeon-scientists pursuing research is on the decline, with these declines being even more pronounced within plastic surgery. It is essential that plastic surgery remains a leader in translational research by cultivating a group of individuals who have been trained in basic research and are thereby competitive to obtain extramural grant funding. To address this need, the authors review data elucidating why the research-oriented trainee may forego pursuing a career in plastic surgery. Although much of the existing literature is speculative, the authors identified the current number of M.D./Ph.D.s in plastic surgery using data obtained from the American Society of Plastic Surgeons and investigated number of grants in plastic surgery compared to other medical and surgical fields using the National Institutes of Health Research Portfolio Online Reporting Tools Expenditures and Results. The authors hypothesize that economic constraints and difficulty securing protected research time may be contributing to fewer trainees pursuing plastic surgery. The purpose of this article is (1) to discuss potential reasons deterring research-oriented trainees from pursuing careers as surgeon-scientists within plastic surgery; (2) to propose solutions that may attract more trainees interested in careers as surgeon-scientists to the field of plastic surgery; (3) to highlight the lack of quantitative data regarding surgeon-scientist training in plastic surgery; and (4) to propose and encourage future research avenues to help attract and nurture surgeon-scientists in plastic surgery.
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Snyder A, Xiang D, Smith A, Esswein S, Toubat O, Di Capua J, Kwan JM, Daye D. Gender disparities among medical students choosing to pursue careers in medical research: a secondary cross-sectional cohort analysis. BMC Med Educ 2021; 21:591. [PMID: 34823508 PMCID: PMC8620216 DOI: 10.1186/s12909-021-03004-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 11/01/2021] [Indexed: 05/31/2023]
Abstract
BACKGROUND Though the proportion of women in medical schools has increased, gender disparities among those who pursue research careers still exists. In this study, we seek to better understand the main factors contributing to the existing gender disparities among medical students choosing to pursue careers in medical research. METHODS A secondary cross-sectional cohort analysis of previously published data was conducted using a 70-item survey that was sent to 16,418 medical students at 32 academic medical centers, and was IRB exempt from the need for ethical approval at the University of Illinois at Chicago and the University of Pennsylvania. Data was collected from September 2012 to December 2014. Survey results were analyzed using chi-square tests and Cramer's V to determine gender differences in demographic characteristics (training stage, race/ethnicity, marital status, parental status, financial support, and parental career background), career sector choice, career content choice, specialty choice, foreseeable career obstacles, and perceptions about medical research careers. RESULTS Female respondents were more likely to be enrolled in MD-only programs, while male respondents were more likely to be enrolled in MD/PhD programs. More male students selected academia as their first-choice career sector, while more female respondents selected hospitalist as their first-choice career sector. More female respondents identified patient care and opportunities for community service as their top career selection factors, while more male respondents identified research and teaching as their top career selection factors. Student loan burden, future compensation, and work/life balance were the most reported obstacles to pursuing a career in medical research. CONCLUSIONS There are many factors from a medical student's perspective that may contribute to the existing gender disparities in pursuing a career in medical research. While much progress has been made in attracting nearly equal numbers of men and women to the field of medicine, active efforts to bridge the gap between men and women in medical research careers are needed.
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Affiliation(s)
| | | | - Alison Smith
- Keck School of Medicine of USC, Los Angeles, USA
| | | | - Omar Toubat
- Keck School of Medicine of USC, Los Angeles, USA
| | - John Di Capua
- Department of Interventional Radiology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Jennifer M Kwan
- Section of Cardiovascular Medicine, Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA.
| | - Dania Daye
- Department of Interventional Radiology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.
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Abstract
Professional identity formation (PIF) is a dynamic developmental process by which individuals merge the knowledge and skills of clinical practice with the values and behaviors of their personal identity. For an individual physician, this process is a continuum which begins with their nascent interest in the field of medicine and extends through the end stages of a medical career. The impact of PIF has become a growing focus of medical education research in the last decade, and in that time, little attention has been paid to the influence underrepresented in medicine (UIM) identities may have on this fundamental process. Importantly, in discussions of how medical educators can support and encourage successful PIF, there is little discussion on the distinct challenges and different needs UIM learners may have. The purpose of this paper is to address the current literature around PIF for UIM trainees. This review explores various threats to identity formation, including identity fusion, stereotype threat, minority tax, implicit bias, and lack of mentorship. Evidence-based strategies to mitigate these challenges is also presented, including furthering institutional support for PIF, building the community of practice, supporting an inclusive environment, and developing PIF assessment tools. Through exploring these challenges and solutions, we are better able to address the needs of UIM trainees and physicians as they proceed in their PIF during their lifelong journey in medicine.
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Howell K. Enhancing research and scholarly experiences based on students' awareness and perception of the research-teaching nexus: A student-centred approach. PLoS One 2021; 16:e0257799. [PMID: 34570801 PMCID: PMC8475989 DOI: 10.1371/journal.pone.0257799] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 09/10/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Research is a core competency of a modern-day doctor and evidence-based practice underpins a career in medicine. Early exposure encourages graduates to embed research in their medical career and improves graduate attributes and student experience. However, there is wide variability of research and scholarly experiences offered in medicals schools, many developed with a significant degree of pragmatism based on resources and financial and time constraints. We examined undergraduate medical students' awareness and experience of research throughout their degree to provide recommendations for implementation and improvement of research and scholarly experiences. METHOD Focus groups were conducted with medical students at all five stages of the medical degree programme. Data was coded to facilitate qualitative analysis for identification of important themes from each stage. RESULTS Students reported positive impacts of research on undergraduate experience, future career and society in general. Two important themes emerged from the data, the opportunity for research and timing of research experiences. Early-stage students were concerned by their lack of experience and opportunity, whereas later-stage students identified the importance of research to employability, personal development and good medical practice, but ironically suggested it should be integrated in early stages of the course due to limitations of time. CONCLUSIONS Students provided feedback for improving research and scholarly experiences, ideally involving early exposure, a clear programme overview, with equality of access and a longitudinal approach. An emerging framework is proposed summarising the important issues identified by students and the positive impacts research experiences provide for them. These recommendations can be applied to both existing and new research programmes to provide a student-centred approach designed to augment the students' critical analysis, inspire life-long learning, enhance the student experience and inevitably train better physicians.
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Affiliation(s)
- Katherine Howell
- School of Medicine, University College Dublin, Belfield, Dublin, Ireland
- * E-mail:
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18
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Naqvi IA, Mahajan A. Immigrant Neurologists in the Physician-Scientist Pipeline: An Intervenable Stenosis. Ann Neurol 2021; 90:542-545. [PMID: 34382247 DOI: 10.1002/ana.26192] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 08/06/2021] [Accepted: 08/09/2021] [Indexed: 11/06/2022]
Abstract
Immigrant neurologists on a visa make up one-fourth of our neurology resident workforce. In this article, we describe the challenges faced by them in pursuit of a career as physician-scientists. We highlight the key role that immigration status plays in various aspects of research advancement early along the neurology pipeline, pertaining to clinical career decisions and the associated delay in achieving these milestones. We conclude with a call to action to address these key roadblocks, which would have the additional potential benefit of improving inclusion and diversity in clinical and translational science. ANN NEUROL 2021.
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Affiliation(s)
- Imama A Naqvi
- Department of Neurology, Division of Stroke and Cerebrovascular Diseases, Columbia University, New York City, NY
| | - Abhimanyu Mahajan
- Rush Parkinson's Disease and Movement Disorders Program, Department of Neurological Sciences, Rush University Medical Center, Chicago, IL
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Li Y, Li J, Li B, Cao Y, Liu M, Zhang L, Zeng Z. Factors associated with the research efficiency of clinical specialties in a research-oriented hospital in China. PLoS One 2021; 16:e0250577. [PMID: 33909686 DOI: 10.1371/journal.pone.0250577] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 04/12/2021] [Indexed: 02/05/2023] Open
Abstract
Research-oriented hospitals are responsible for medical services tasks, medical education, and scientific research, playing an important role in medical research and application. The research efficiency of a clinical specialty is influenced by factors such as the characteristics of the specialty, the organizational atmosphere, and the clinical director’s leadership. The present study aimed to describe the research efficiency of clinical specialties, explore the factors influencing it, and clarify the argument of co-evolution theory regarding the collaborative development of medical services, education, and research. Logistic regression and multiple linear regression were adopted to estimate the correlation between influencing factors and scientific research efficiency. Hospital H, which is representative of research hospitals in China, was taken as an example. Taking three efficiency values—comprehensive technical efficiency (CTE), pure technical efficiency (PTE), and scale efficiency (SE)—as dependent variables, the independent variables affecting research productivity were statistically analyzed. This study also examined the scientific research efficiency of 41 specialties between 2013 and 2017, and found that the independent variables affected CTE, PTE, and SE to various degrees. Collaborative innovation in medical education and research must be based on clinical research; how to balance medical and teaching quality, and research efficiency requires further discussion. While young people play a major role on the research team because of their creativity and initiatives, which improve CTE and PTE, high-level researchers with better research and leadership abilities lead to the rational allocation and effective utilization of resources, thus improving SE. In 2013–2017, discipline construction focused on scale expansion, resulting in the decline of SE in China. Therefore, this study suggests further improvements for the efficiency of clinical specialties in research hospitals.
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Loescher LJ, Love R, Badger T. Breaking new ground? The dual (PhD-DNP) doctoral degree in Nursing. J Prof Nurs 2021; 37:429-34. [PMID: 33867101 DOI: 10.1016/j.profnurs.2020.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 05/03/2020] [Accepted: 05/05/2020] [Indexed: 11/21/2022]
Abstract
PURPOSE 1) Provide background information on the PhD-DNP dual doctoral degree, specifically historical perspectives and existing programs; 2) Describe one PhD-DNP program as an exemplar to illustrate program data challenges and solutions; and 3) Discuss the national landscape of the dual doctoral degree program. PRINCIPAL RESULTS PhD-DNP dual doctoral degree programs have existed for 10 years; there are five known programs nationally. Reported here for one dual doctoral degree program are data collected from the program's inception (2010) through 2019. These data include demographic program characteristics, time to degree, and achievements during and after the program. Challenges pertaining to mentorship, progression to degree, socialization and student productivity also are described. Strategies for moving the dual degree forward nationally depend on a collaborative effort for data generation and collection from existing PhD-DNP programs. These data can be instrumental for seeking funding for dual doctoral degree programs. CONCLUSIONS The dual PhD-DNP degree has not yet gained a foothold nationally. There is demand for the program by nursing doctoral students and availability of these programs is slowly increasing. National nursing leaders and organizations can consider developing metrics and collecting data that will lend support to future funding initiatives for the dual degree.
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21
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Affiliation(s)
| | - Melvin B Heyman
- Department of Pediatrics, University of California, San Francisco, CA, USA
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22
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Dos Santos Rocha A, Combescure C, Negro F. The MD-PhD program in Geneva: a 10-year analysis of graduate demographics and outcomes. BMC Med Educ 2020; 20:425. [PMID: 33183299 PMCID: PMC7663876 DOI: 10.1186/s12909-020-02364-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 11/06/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND MD-PhD programs confer degrees that empower medical doctors with in-depth scientific skills to contribute to biomedical research and academic medicine, alongside clinical practice. Whilst the career options and research opportunities related to graduates following these programs in the US are well documented, little is known about their European counterparts. In this article, we studied graduates who had completed the MD-PhD program at the University of Geneva between 2010 and 2019. METHODS A cross-sectional survey was performed in April 2019, targeting all medical doctors who had obtained the MD-PhD degree from the University of Geneva since 2010. Demographics, opinions, and career outcomes of the MD-PhD graduates were assessed through an online anonymous questionnaire. RESULTS Twenty-one questionnaires were collected from 31 MD-PhD graduates (response rate 65.5%). Most respondents (57.1%) had performed an MD-PhD training in basic sciences; however, only 14.3% had pursued this type of research thereafter. Most of the respondents held a position at a University hospital (90.5%), although a significant number of them were no longer involved in research in their current position (28.6%). 85.7% mentioned obstacles and challenges in combining clinical duties with research. Despite this, the majority (85.7%) declared that the MD-PhD degree had given them advantages in their career path, granting access to clinical and academic positions, as well as funding. CONCLUSIONS Graduates from the MD-PhD program in Geneva were for the most part, satisfied with their training. However, because of the challenges and obstacles in combining clinical duties with research, the implementation of research activities in their current position proved difficult.
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Affiliation(s)
- Andre Dos Santos Rocha
- Unit for Anaesthesiological Investigations, Department of Acute Medicine, University of Geneva, Rue Michel-Servet 1, 1206, Geneva, Switzerland.
- European MD-PhD Association, Groningen, The Netherlands.
| | - Cristophe Combescure
- Division of Clinical Epidemiology, University Hospitals of Geneva, Geneva, Switzerland
| | - Francesco Negro
- MD-PhD Committee, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Divisions of Gastroenterology and Hepatology and of Clinical Pathology, University Hospitals of Geneva, Geneva, Switzerland
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Siebert AL, Chou S, Toubat O, Adami AJ, Kim H, Daye D, Kwan JM. Factors associated with underrepresented minority physician scientist trainee career choices. BMC Med Educ 2020; 20:422. [PMID: 33176758 PMCID: PMC7656762 DOI: 10.1186/s12909-020-02328-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 10/21/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Recently, there have been concerted efforts to improve racial and ethnic diversity in the physician-scientist workforce. Identifying factors associated with career choices among those underrepresented in medicine and science is a necessary first step to advance this objective. The aim of the present study was to assess the attitudes and factors associated with academic and research career interests among underrepresented predoctoral physician-scientists. METHODS A cross-sectional 70-question survey was distributed to all predoctoral single degree (MD or DO) and dual degree (MD/PhD or DO/PhD) trainees at 32 medical schools in the United States from 2012 to 2014. Main outcomes included factors important to advancement in academic medicine, intended medical specialty, and future career plans. To test the post-hoc hypothesis of whether trainees from underrepresented groups have differing perceptions of career trajectories and obstacles than their counterparts, we evaluated responses according to self-identified race/ethnic status using Chi-square and Fisher's exact tests. All tests were two-sided and significance level of < 0.05 was used. RESULTS There were a total of 4433 responses representing all predoctoral training stages. The response rate was 27%. Most respondents were single degree trainees (MD/DO 79% vs MD/DO-PhD 21%). Most respondents self-identified as White (67%), followed by Multi-racial or Other (14.3%), Asian or Pacific Islander (10.4%), Hispanic (6%), and Black or African American (4.1%). Desired career sector, career intention, and clinical specialty interest differed across race/ethnic groups. With respect to career selection factors, anticipated non-work related responsibilities during residency were also significantly different between these groups. By multivariable regression analysis, Black or African American trainees were significantly less likely than White trainees to indicate a career in academia (OR 0.496, 95% CI 0.322-0.764) and basic research (OR 0.314, 95% CI 0.115-0.857), while Multi-racial or Other trainees were also less likely than White trainees to indicate a career in academia (OR 0.763, 95% CI 0.594-0.980). CONCLUSIONS These data represent the first in-depth survey of career aspirations, perceptions, and interests between demographically underrepresented and non-underrepresented predoctoral physician-scientist trainees. Our results identify key differences between these cohorts, which may guide efforts to improve diversity within the physician-scientist workforce.
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Affiliation(s)
| | | | - Omar Toubat
- Keck School of Medicine of USC, University of Southern California, Los Angeles, USA
| | - Alexander J Adami
- Department of Internal Medicine, University of Washington, Seattle, WA, USA
| | - Hajwa Kim
- University of Illinois, Chicago, IL, USA
| | - Dania Daye
- Massachusetts General Hospital, Boston, USA.
| | - Jennifer M Kwan
- Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, CT, 06511, USA.
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Awofeso OM, Roberts AA, Okonkwor CO, Nwachukwu CE, Onyeodi I, Lawal IM, Ebrubaoghene O, Osakwe GI, Buchi-Njere O, Solahudeen ZO. Factors Affecting Undergraduates' Participation in Medical Research in Lagos. Niger Med J 2020; 61:156-162. [PMID: 33100468 PMCID: PMC7547749 DOI: 10.4103/nmj.nmj_94_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 02/27/2020] [Accepted: 05/01/2020] [Indexed: 11/21/2022] Open
Abstract
Background: The current situation regarding the scope and contribution of undergraduate medical research to the health space in Nigeria is still largely unreported in formal literature. This study examined the knowledge, attitudes, and the perceived barriers faced by medical students in Lagos toward research. Materials and Methods: A cross-sectional study design was conducted among all medical students in 200–600 levels of study at the College of Medicine, University of Lagos. With the aid of Self-administered questionnaires, we examined their knowledge of research and the analytical tools used in research, their attitudes and the perceived barriers to their participation in research. Results: The data were obtained from 221 medical students, of whom 52.9% had prior involvement in research and 14.0% and 6.3% had presented or published their research, respectively. The overall knowledge of medical research was low (21.3%) and reported barriers included lack of funding for research' (79.6%), “lack of research and biostatistics curriculum” (76.0%), “inadequate training in research methodology” (74.7%), “insufficient time allocation to undergraduate research” (73.3%), “lack of professional supervisors and proper mentoring” (58.8%), and “lack of equipped laboratory facilities to conduct research” (77.8%). Conclusion: Our results highlight the need for more mentored supervision and training to improve their knowledge of the principles and techniques of clinical research to increase involvement.
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Affiliation(s)
- Opeyemi Mercy Awofeso
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Alero Ann Roberts
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Christian Oyor Okonkwor
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Chiamaka Elise Nwachukwu
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Ifeanyichukwu Onyeodi
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Ilerioluwa M Lawal
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Okoro Ebrubaoghene
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Gift I Osakwe
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Oluchi Buchi-Njere
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Zaynab O Solahudeen
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
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Steinman RA, Proulx CN, Levine AS. The Highly Structured Physician Scientist Training Program (PSTP) for Medical Students at the University of Pittsburgh. Acad Med 2020; 95:1373-1381. [PMID: 32079926 PMCID: PMC7447180 DOI: 10.1097/acm.0000000000003197] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The University of Pittsburgh School of Medicine Physician Scientist Training Program (PSTP) is a 5-year medical student training program designed to prepare the next generation of MD-only physician-scientists engaging in preclinical research. This article provides an overview of the program, including the novel longitudinal structure and competency goals, which facilitate success and persistence in a laboratory-based physician-scientist career. The authors present data on 81 medical students accepted to the program from academic year 2007-2008 through 2018-2019. Extrinsic outcomes, such as publications, grant funding, and residency matching, indicate that PSTP trainees have actively generated research deliverables. A majority of eligible PSTP trainees have earned Howard Hughes Medical Institute Medical Research Fellow funding. PSTP students have produced a mean of 1.6 first-authored publications (median, 1.0) and a mean of 5.1 total publications (median, 4.0) while in medical school and have authored 0.9 publications per year as residents/fellows, excluding internship. Nearly 60% of PSTP students (26/46) have matched to top-10 National Institutes of Health-funded residency programs in their specialty (based on Blue Ridge Institute rankings). PSTP alumni are twice as likely as their classmates to match into research-heavy departments and to publish first-authored papers. Results of a 2018 program evaluation survey indicate that intrinsic outcomes, such as confidence in research skills, significantly correlate with extrinsic outcomes. The program continues to evolve to maximize both scientific agency and career navigation skills in participants. This medical student PSTP model has potential to expand the pool of physician-scientist researchers in preclinical research beyond the capacity of dedicated MD-PhD and postgraduate training programs.
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Affiliation(s)
- Richard A. Steinman
- R.A. Steinman is associate professor of medicine, director, Medical Scientist Training Program and Physician Scientist Training Program, and associate dean, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; ORCID: https://orcid.org/0000-0002-8354-418X
| | - Chelsea N. Proulx
- C.N. Proulx is evaluation coordinator, Clinical and Translational Science Institute and Department of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; ORCID: https://orcid.org/0000-0001-9269-2355
| | - Arthur S. Levine
- A.S. Levine is senior vice chancellor, Health Sciences, and Petersen Dean, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; ORCID: https://orcid.org/0000-0002-1847-3055
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May JT, Littzen CO, Morrison HW, Loescher LJ. Experiences of dual PHD-DNP nursing students during doctoral education. J Prof Nurs 2020; 36:348-55. [DOI: 10.1016/j.profnurs.2020.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 02/10/2020] [Accepted: 02/12/2020] [Indexed: 11/23/2022]
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Kwan JM, Toubat O, Harrison AM, Riddle M, Wu B, Kim H, Basta DW, Adami AJ, Daye D. A nationwide assessment of perceptions of research-intense academic careers among predoctoral MD and MD-PhD trainees. J Clin Transl Sci 2020; 4:307-16. [PMID: 33244411 DOI: 10.1017/cts.2020.18] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction: While previous studies have described career outcomes of physician-scientist trainees after graduation, trainee perceptions of research-intensive career pathways remain unclear. This study sought to identify the perceived interests, factors, and challenges associated with academic and research careers among predoctoral MD trainees, MD trainees with research-intense (>50%) career intentions (MD-RI), and MD-PhD trainees. Methods: A 70-question survey was administered to 16,418 trainees at 32 academic medical centers from September 2012 to December 2014. MD vs. MD-RI (>50% research intentions) vs. MD-PhD trainee responses were compared by chi-square tests. Multivariate logistic regression analyses were performed to identify variables associated with academic and research career intentions. Results: There were 4433 respondents (27% response rate), including 2625 MD (64%), 653 MD-RI (15%), and 856 MD-PhD (21%) trainees. MD-PhDs were most interested in pursuing academia (85.8%), followed by MD-RIs (57.3%) and MDs (31.2%). Translational research was the primary career intention for MD-PhD trainees (42.9%). Clinical duties were the primary career intention for MD-RIs (51.9%) and MDs (84.2%). While 39.8% of MD-PhD respondents identified opportunities for research as the most important career selection factor, only 12.9% of MD-RI and 0.5% of MD respondents shared this perspective. Interest in basic research, translational research, clinical research, education, and the ability to identify a mentor were each independently associated with academic career intentions by multivariate regression. Conclusions: Predoctoral MD, MD-RI, and MD-PhD trainees are unique cohorts with different perceptions and interests toward academic and research careers. Understanding these differences may help to guide efforts to mentor the next generation of physician-scientists.
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Abstract
AIM/PURPOSE In response to widespread efforts to increase the size and diversity of the biomedical-research workforce in the U.S., a large-scale qualitative study was conducted to examine current and former students' training experiences in MD (Doctor of Medicine), PhD (Doctor of Philosophy), and MD-PhD dual-degree programs. In this paper, we aimed to describe the experiences of a subset of study participants who had dropped out their MD-PhD dual-degree training program, the reasons they entered the MD-PhD program, as well as their reasons for discontinuing their training for the MD-PhD. BACKGROUND The U.S. has the longest history of MD-PhD dual-degree training programs and produces the largest number of MD-PhD graduates in the world. In the U.S., dual-degree MD-PhD programs are offered at many medical schools and historically have included three phases-preclinical, PhD-research, and clinical training, all during medical-school training. On average, it takes eight years of training to complete requirements for the MD-PhD dual-degree. MD-PhD students have unique training experiences, different from MD-only or PhD-only students. Not all MD-PhD students complete their training, at a cost to funding agencies, schools, and students themselves. METHODOLOGY We purposefully sampled from 97 U.S. schools with doctoral programs, posting advertisements for recruitment of participants who were engaged in or had completed PhD, MD, and MD-PhD training. Between 2011-2013, semi-structured, one-on-one phone interviews were conducted with 217 participants. Using a phenomenological approach and inductive, thematic analysis, we examined students' reasons for entering the MD-PhD dual-degree program, when they decided to leave, and their reasons for leaving MD-PhD training. CONTRIBUTION Study findings offer new insights into MD-PhD students' reasons for leaving the program, beyond what is known about program attrition based on retrospective analysis of existing national data, as little is known about students' actual reasons for attrition. By more deeply exploring students' reasons for attrition, programs can find ways to improve MD-PhD students' training experiences and boost their retention in these dual-degree programs to completion, which will, in turn, foster expansion of the biomedical-research-workforce capacity. FINDINGS Seven participants in the larger study reported during their interview that they left their MD-PhD programs before finishing, and these were the only participants who reported leaving their doctoral training. At the time of interview, two participants had completed the MD and were academic-medicine faculty, four were completing medical school, and one dropped out of medicine to complete a PhD in Education. Participants reported enrolling in MD-PhD programs to work in both clinical practice and research. Very positive college research experiences, mentorship, and personal reasons also played important roles in participants' decisions to pursue the dual MD-PhD degree. However, once in the program, positive mentorship and other opportunities that they experienced during or after college, which initially drew candidates to the program was found lacking. Four themes emerged as reasons for leaving the MD-PhD program: 1) declining interest in research, 2) isolation and lack of social integration during the different training phases, 3) suboptimal PhD-advising experiences, and 4) unforeseen obstacles to completing PhD research requirements, such as loss of funding. RECOMMENDATIONS FOR PRACTITIONERS Though limited by a small sample size, findings highlight the need for better integrated institutional and programmatic supports for MD-PhD students, especially during PhD training. RECOMMENDATIONS FOR RESEARCHERS Researchers should continue to explore if other programmatic aspects of MD-PhD training (other than challenges experienced during PhD training, as discussed in this paper) are particularly problematic and pose challenges to the successful completion of the program. IMPACT ON SOCIETY The MD-PhD workforce comprises a small, but highly -trained cadre of physician-scientists with the expertise to conduct clinical and/or basic science research aimed at improving patient care and developing new diagnostic tools and therapies. Although MD-PhD graduates comprise a small proportion of all MD graduates in the U.S. and globally, about half of all MD-trained physician-scientists in the U.S. federally funded biomedical-research workforce are MD-PhD-trained physicians. Training is extensive and rigorous. Improving experiences during the PhD-training phase could help reduce MD-PhD program attrition, as attrition results in substantial financial cost to federal and private funding agencies and to medical schools that fund MD-PhD programs in the U.S. and other countries. FUTURE RESEARCH Future research could examine, in greater depth, how communications among students, faculty and administrators in various settings, such as classrooms, research labs, and clinics, might help MD-PhD students become more fully integrated into each new program phase and continue in the program to completion. Future research could also examine experiences of MD-PhD students from groups underrepresented in medicine and the biomedical-research workforce (e.g., first-generation college graduates, women, and racial/ethnic minorities), which might serve to inform interventions to increase the numbers of applicants to MD-PhD programs and help reverse the steady decline in the physician-scientist workforce over the past several decades.
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Affiliation(s)
| | - Donna B. Jeffe
- Washington University in St. Louis, St. Louis, MO, U.S.A
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Alamri Y, Magner K, Wilkinson TJ. Would you do it again? A qualitative study of student and supervisor perceptions of an intercalated MBChB/PhD programme. BMC Med Educ 2019; 19:471. [PMID: 31878974 PMCID: PMC6933645 DOI: 10.1186/s12909-019-1909-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 12/16/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Several studies have warned about the diminishing physician-scientist breed. Limited studies, however, have attempted to assess what factors (if any) enhanced or hindered the experience of trainee physician-scientists and their supervisors. Using Vroom's expectancy theory as a conceptual framework, we explored the highlights, motivations and barriers of an intercalated MBChB/PhD programme as experienced by students of the programme and their supervisors. METHODS Previous and current students of the MBChB/PhD programme at the University of Otago, and their supervisors, were invited to provide comments on the programme. Data were analysed using a general inductive approach which involved coding responses, and grouping codes into common themes via an iterative process. A deductive approach was used to interpret the themes and relate them to Vroom's expectancy theory. RESULTS A total of 22 students (88% response rate) and 36 supervisors (58.3% response rate) responded to our survey. Three themes were identified through the analysis of the students' responses. These were: motives for undertaking the intercalated degree, effect on career development, and perceived barriers. Supervisors' survey yielded two themes: characteristics of successful students, and optimising the intercalated programme. CONCLUSIONS The current study sheds light on the successes and challenges of an intercalated MBChB/PhD programme by considering the views of those most involved. Whereas the combined programme has its advantages for student research and career development, extending the research-time may be worthwhile. Further studies involving a larger cohort of intercalating students and their supervisors may allow for extrapolation of data to address these concerns.
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Affiliation(s)
- Yassar Alamri
- New Zealand Brain Research Institute, Christchurch, New Zealand.
- Department of Medicine, Christchurch Public Hospital, Christchurch, New Zealand.
- Canterbury District Health Board, 2 Riccarton Avenue, Christchurch, 8011, New Zealand.
| | - Kate Magner
- Department of Medicine, Christchurch Public Hospital, Christchurch, New Zealand
| | - Tim J Wilkinson
- Department of Medicine, Christchurch Public Hospital, Christchurch, New Zealand
- Canterbury District Health Board, 2 Riccarton Avenue, Christchurch, 8011, New Zealand
- Medical Education Unit, University of Otago, Christchurch, New Zealand
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Singh U, Levy J, Armstrong W, Bedimo R, Creech CB, Lautenbach E, Popovich KJ, Snowden J, Vyas JM. Policy Recommendations for Optimizing the Infectious Diseases Physician-Scientist Workforce. J Infect Dis 2019; 218:S49-S54. [PMID: 30124981 DOI: 10.1093/infdis/jiy246] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The Infectious Diseases Society of America, HIV Medicine Association, and Pediatric Infectious Diseases Society are concerned by the continued decline in the number of infectious diseases trainees pursuing careers as physician-scientists and the attrition of junior and midcareer physician-scientists. The inability to replace the aging physician-scientist workforce will have a negative, long-lasting impact our biomedical research enterprise and its ability to drive the discovery of new treatments for important infectious diseases. We discuss policy recommendations for securing and optimizing the infectious diseases physician-scientist workforce in the areas of education, training, compensation, and mentorship, as well as ways to improve federal research funding, cross-sector collaboration, and workforce diversity.
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Affiliation(s)
| | - Jaclyn Levy
- Infectious Diseases Society of America, Arlington, Virginia
| | | | | | | | | | | | - Jessica Snowden
- University of Arkansas for Medical Sciences, Little Rock, Arkansas
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van Dijk SJ, Domenighetti AA, Gomez-Ospina N, Hunter P, Lindemans CA, Melotte V, van Rossum AMC, Rosenblum ND. Building a Professional Identity and an Academic Career Track in Translational Medicine. Front Med (Lausanne) 2019; 6:151. [PMID: 31334235 PMCID: PMC6618343 DOI: 10.3389/fmed.2019.00151] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 06/18/2019] [Indexed: 11/13/2022] Open
Abstract
Biomedical scientists aim to contribute to further understanding of disease pathogenesis and to develop new diagnostic and therapeutic tools that relieve disease burden. Yet the majority of biomedical scientists do not develop their academic career or professional identity as “translational scientists,” and are not actively involved in the continuum from scientific concept to development of new strategies that change medical practice. The collaborative nature of translational medicine and the lengthy process of bringing innovative findings from bench to bedside conflict with established pathways of building a career in academia. This collaborative approach also poses a problem for evaluating individual contributions and progress. The traditional evaluation of scientific success measured by the impact and number of publications and grants scientists achieve is inadequate when the product is a team effort that may take decades to complete. Further, where scientists are trained to be independent thinkers and to establish unique scientific niches, translational medicine depends on combining individual insights and strengths for the greater good. Training programs that are specifically geared to prepare scientists for a career in translational medicine are not widespread. In addition, the legal, regulatory, scientific and clinical infrastructure and support required for translational research is often underdeveloped in academic institutions and funding organizations, further discouraging the development and success of translational scientists in the academic setting. In this perspective we discuss challenges and potential solutions that could allow for physicians, physician scientists and basic scientists to develop a professional identity and a fruitful career in translational medicine.
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Affiliation(s)
- Sabine J van Dijk
- Department of Pharmacology, University of California, Davis, Davis, CA, United States
| | - Andrea A Domenighetti
- The Shirley Ryan AbilityLab, Chicago, IL, United States.,Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL, United States
| | - Natalia Gomez-Ospina
- Division of Medical Genetics, Department of Pediatrics, Stanford University, Stanford, CA, United States
| | - Patricia Hunter
- UCL Great Ormond Street Institute of Child Health, University College of London, London, United Kingdom
| | - Caroline A Lindemans
- University Medical Center Utrecht, Wilhelmina Children's Hospital (WKZ), Utrecht University, Utrecht, Netherlands.,Princess Maxima Center for Pediatric Oncology, Utrecht, Netherlands
| | - Veerle Melotte
- Department of Pathology, Maastricht University Medical Center, GROW School for Oncology and Developmental Biology, Maastricht, Netherlands.,Department of Clinical Genetics, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Annemarie M C van Rossum
- Division of Infectious Diseases and Immunology, Department of Pediatrics, Erasmus MC University Medical Center-Sophia Children's Hospital, Rotterdam, Netherlands
| | - Norman D Rosenblum
- Laboratory Medicine and Pathobiology, Departments of Paediatrics, Physiology, University of Toronto, Toronto, ON, Canada
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Wu A, Kielstein H, Sakurai T, Noel G, Viranta-Kovanen S, Chien CL, Bernd P. Internationalization of Medical Education-Building a Program to Prepare Future Leaders in Healthcare. Med Sci Educ 2019; 29:535-547. [PMID: 34457511 PMCID: PMC8368475 DOI: 10.1007/s40670-019-00695-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
In a globally interconnected world, internationalization of medical education has become increasingly important. While many programs focus on international programs for clinical students, the number of programs for preclinical medical and dental students is small. Based in the Anatomy course, the program presented here involves early international collaborations between preclinical students from six countries. Our work involves small-group video sessions and a large international student videoconference (including cultural and didactic components). The online connections progress with in-person basic sciences summer internships undertaken at the international partner institutions. This collaborative program features unique elements that facilitate cultural exchange and help develop leadership skills in healthcare early in a student's career. We present recommendations for international program implementation.
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Affiliation(s)
- Anette Wu
- Department of Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University, 650 W 168th St, New York, NY 10032 USA
| | - Heike Kielstein
- Department of Anatomy and Cell Biology, Medical Faculty, Martin Luther University Halle-Wittenberg, Grosse Steinstrasse 52, 06108 Halle (Saale), Germany
| | - Takeshi Sakurai
- Department of Drug Discovery Medicine, Medical Innovation Center, Kyoto University Graduate School of Medicine, 53 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507 Japan
| | - Geoffroy Noel
- Department of Anatomy and Cell Biology, Faculty of Medicine, McGill University, Montreal, Canada
| | - Suvi Viranta-Kovanen
- Department of Anatomy, School of Medicine, University of Helsinki, Helsinki, Finland
| | - Chung-Liang Chien
- Department of Anatomy and Cell Biology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Paulette Bernd
- Department of Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University, 650 W 168th St, New York, NY 10032 USA
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Snowden J, James SH. Developing a Career in Pediatric Infectious Diseases. J Pediatric Infect Dis Soc 2018; 7:S57-S59. [PMID: 30590623 PMCID: PMC7739955 DOI: 10.1093/jpids/piy123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This article presents an overview of the Career Development session at the 17th Annual St. Jude/PIDS Pediatric Infectious Diseases Research Conference. This annual conference discusses key academic skills, such as grant writing and negotiating for protected time for research and academic endeavors, as well as highlighting the many career options available in infectious disease. This year's session included discussions about basic science, public health, health outcomes research, and private practice pediatric infectious disease careers. The combination of practical career advice, mentoring, and inspiration offered in the career-development track talks at the St. Jude/PIDS Pediatric Infectious Diseases Research Conference this and every year helps trainees to faculty navigate the path to building a satisfying career in pediatric infectious disease.
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Affiliation(s)
- Jessica Snowden
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock,Correspondence: J. Snowden, MD, University of Arkansas for Medical Sciences, Department of Pediatrics, Little Rock, AR ()
| | - Scott H James
- Department of Pediatrics, University of Alabama at Birmingham
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Patel CB. From Subsistence to Sustenance in Physician-Scientist Training. Acad Med 2018; 93:521. [PMID: 29342000 DOI: 10.1097/acm.0000000000002139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Chirag B Patel
- Neuro-oncology fellow, Department of Neurology and Neurological Sciences, and postdoctoral scholar, Department of Radiology, Stanford University School of Medicine, Stanford, California;
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