The Journey to ACGME Accreditation: A Program's Perspectives and Practical Guidance From the ACGME

The Latino Resident Physician Shortage: A Challenge and Opportunity for Equity, Diversity, and Inclusion

PURPOSE

The purpose of this study is to examine the number of Latino physicians in residency training and Latino resident physician trends in the nation's 10 largest medical specialties in the United States and in the 4 states with the largest Latino populations: California, Florida, New York, and Texas.

METHOD

The authors used data from the United States Census Bureau's American Community Survey to determine Latino populations and a special report from the Association of American Medical Colleges to determine rates of Latino resident physicians in the United States and in California, Florida, New York, and Texas from 2001 to 2017. Rates of Latino residents in the nation's 10 specialties with the largest number of residents were also determined.

RESULTS

From 2001 to 2017, the United States had an average of 37 resident physicians per 100,000 population. At the national level, however, Latino residents were underrepresented, with only 14 per 100,000 Latino population. At the state level, California and Texas, the 2 states with the largest Latino populations (39.4% and 39.7% of their population, respectively), had 5 and 9 Latino residents per 100,000 Latino population, respectively. Latino residents in California, Texas, Florida, and New York were also very underrepresented in the primary care specialties examined.

CONCLUSIONS

The findings show a severe shortage of Latino resident physicians. While a similar shortage also exists in primary care specialties, the majority of Latinos in states with large Latino populations are consistently choosing to train in primary care. Investment and greater improvement in the representation of certain population groups in medicine and for combating the inequities existing in the current educational system is needed. The authors offer recommendations to increase the number of Latinos in residency programs and for increasing the number of Spanish-speaking physicians and Latino international medical graduates in residency programs.

Design, Implementation, and Evaluation of a Distance Learning Framework to Adapt to the Changing Landscape of Anatomy Instruction in Medical Education During COVID-19 Pandemic: A Proof-of-Concept Study

This study presents the design of a DL-framework to deliver anatomy teaching that provides a microfiche of the onsite anatomy learning experience during the mandated COVID-19 lockdown. First, using nominal-group technique, we identified the DL learning theories to be employed in blueprinting the DL-framework. Effectiveness of the designed DL-framework in anatomy teaching was demonstrated using the exemplar of the Head and Neck (H&N) course during COVID-19 lockdown, in the pre-clerkship curriculum at our medical school. The dissemination of the DL-framework in the anatomy course was informed by the Analyse, Design, Develop, Implement, and Evaluate (ADDIE) model. The efficiency of the DL-framework was evaluated using the first two levels of Kirkpatrick's model. Versatility of the DL-framework was demonstrated by aligning its precepts with individual domains of key learning outcomes framework. The framework's blueprint was designed amalgamating principles of: Garrison's community inquiry, Siemens' connectivism and Harasim's online-collaborative-learning; and improved using Anderson's DL-model. Following the implementation of the DL-framework in the H&N course informed by ADDIE, the framework's efficiency was evaluated. In total, 70% students responded to the survey assessing perception toward DL (Kirkpatrick's Level: 1). Descriptive analysis of the survey results showed that the DL-framework was positively received by students and attested that students had an enriched learning experience, which promoted collaborative-learning and student-autonomy. For, Kirkpatrick's Level: 2 i.e., cognitive development, we compared the summative assessment performance in the H&N course across three cohort of students. The results show that the scores of the cohort, which experienced the course entirely through DL modality was statistically higher (P < 0.01) than both the other cohorts, indicating that shift to DL did not have an adverse effect on students' learning. Using Bourdieu's Theory of Practice, we showed that the DL-framework is an efficient pedagogical approach, pertinent for medical schools to adopt; and is versatile as it attests to the key domains of students' learning outcomes in the different learning outcomes framework. To our knowledge this is the first-study of its kind where a rationale and theory-guided approach has been availed not only to blueprint a DL framework, but also to implement it in the MBBS curriculum.

Impact of the Single Accreditation System on Missouri Osteopathic Graduate Medical Education

The single accreditation system (SAS) through the Accreditation Council for Graduate Medical Education was introduced in 2014. Its goals included increasing consistency in training and providing a dedicated place for delivery of osteopathic educational competencies. From 2015 to 2020, most osteopathic primary care and specialty residencies in Missouri successfully achieved accreditation. Nearly all osteopathic surgical specialty residencies and traditional internships did not make the transition. The current article examines the challenges and opportunities of SAS.

Trends in Fellow Education Research Among Obstetric and Gynecologic Subspecialties

OBJECTIVE

To evaluate the frequency at which fellow education-related abstracts are presented at national meetings and compare presentation rates before and after the accreditation transition.

METHODS

This cross-sectional study evaluated abstracts from the five most recent national meetings of the Society for Maternal-Fetal Medicine (SMFM), the Society of Gynecologic Oncology, the American Society for Reproductive Medicine (ASRM), the American Urogynecologic Society (AUGS), and the Council on Resident Education in Obstetrics and Gynecology (CREOG) and Association of Professors of Gynecology and Obstetrics (APGO). Three independent reviewers assessed abstracts for education-specific content. Abstracts were included if two or greater reviewers identified them as related to fellow education. Descriptive statistics were used for data analysis.

RESULTS

Fourteen thousand six hundred thirty abstracts were presented at obstetric and gynecologic subspecialty meetings between 2012 and 2017. Of these, 29 (0.20%) pertained to fellows' education. The percent of total abstracts that were fellow-related remained relatively constant over time. Of the four subspecialties, the AUGS presented fellow education research almost five times more frequently than ASRM (P<.01) or SMFM (P<.01). Over the study period, 1,283 abstracts were presented at the CREOG and APGO meeting, with four (0.31%) pertaining to fellows' education. At the CREOG and APGO meeting, fellow-related abstracts did not appear to increase over the period studied.

CONCLUSION

Research regarding fellows' education is rarely presented at national meetings, representing less than 1% of all abstracts, and has not substantially increased since the transition to the Accreditation Council for Graduate Medical Education.