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Training the physician-scientist: views from program directors and aspiring young investigators.
Williams CS, Iness AN, Baron RM, Ajijola OA, Hu PJ, Vyas JM, Baiocchi R, Adami AJ, Lever JM, Klein PS, Demer L, Madaio M, Geraci M, Brass LF, Blanchard M, Salata R, Zaidi M
(2018) JCI Insight 3:
MeSH Terms: Awards and Prizes, Biomedical Research, Career Choice, Charities, Education, Education, Medical, Education, Medical, Graduate, Foundations, Humans, National Institutes of Health (U.S.), Physicians, Research Personnel, Societies, Medical, Students, Medical, Surveys and Questionnaires, Training Support, United States, Workforce
Show Abstract · Added April 15, 2019
There is growing concern that the physician-scientist is endangered due to a leaky training pipeline and prolonged time to scientific independence (1). The NIH Physician-Scientist Workforce Working Group has concluded that as many as 1,000 individuals will need to enter the pipeline each year to sustain the workforce (2). Moreover, surveys of postgraduate training programs document considerable variability in disposition and infrastructure (3). Programs can be broadly grouped into two classes: physician-scientist training programs (PSTPs) that span residency and fellowship training, and research-in-residency programs (RiRs), which are limited to residency but trainees are able to match into PSTPs upon transitioning to fellowship (Figure 1). Funding sources for RiRs and PSTPs are varied and include NIH KL2 and T32 awards, charitable foundations, philanthropy, and institutional support. Furthermore, standards for research training and tools for evaluating programmatic success are lacking. Here, we share consensus generated from iterative workshops hosted by the Alliance of Academic Internal Medicine (AAIM) and the student-led American Physician Scientists Association (APSA).
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18 MeSH Terms
Best Practices for Physician-Scientist Training Programs: Recommendations from the Alliance for Academic Internal Medicine.
Blanchard M, Burton MC, Geraci MW, Madaio MP, Marsh JD, Proweller A, Rockey DC, Salata RA, Tan W, Williams CS, Zaidi M, Todd RF
(2018) Am J Med 131: 578-584
MeSH Terms: Biomedical Research, Curriculum, Education, Medical, Graduate, Humans, Internship and Residency, Mentoring, Research Support as Topic, United States
Added April 15, 2019
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8 MeSH Terms
Interventional Pulmonology Fellowship Accreditation Standards: Executive Summary of the Multisociety Interventional Pulmonology Fellowship Accreditation Committee.
Mullon JJ, Burkart KM, Silvestri G, Hogarth DK, Almeida F, Berkowitz D, Eapen GA, Feller-Kopman D, Fessler HE, Folch E, Gillespie C, Haas A, Islam SU, Lamb C, Levine SM, Majid A, Maldonado F, Musani AI, Piquette C, Ray C, Reddy CB, Rickman O, Simoff M, Wahidi MM, Lee H
(2017) Chest 151: 1114-1121
MeSH Terms: Accreditation, Bronchoscopy, Clinical Competence, Curriculum, Education, Medical, Graduate, Faculty, Medical, Fellowships and Scholarships, Humans, Pulmonary Medicine, Societies, Medical, Thoracoscopy, Time Factors
Show Abstract · Added April 3, 2017
Interventional pulmonology (IP) is a rapidly evolving subspecialty of pulmonary medicine. In the last 10 years, formal IP fellowships have increased substantially in number from five to now > 30. The vast majority of IP fellowship trainees are selected through the National Resident Matching Program, and validated in-service and certification examinations for IP exist. Practice standards and training guidelines for IP fellowship programs have been published; however, considerable variability in the environment, curriculum, and experience offered by the various fellowship programs remains, and there is currently no formal accreditation process in place to standardize IP fellowship training. Recognizing the need for more uniform training across the various fellowship programs, a multisociety accreditation committee was formed with the intent to establish common accreditation standards for all IP fellowship programs in the United States. This article provides a summary of those standards and can serve as an accreditation template for training programs and their offices of graduate medical education as they move through the accreditation process.
Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
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12 MeSH Terms
The Limitations of the GRE in Predicting Success in Biomedical Graduate School.
Moneta-Koehler L, Brown AM, Petrie KA, Evans BJ, Chalkley R
(2017) PLoS One 12: e0166742
MeSH Terms: Education, Medical, Graduate, Educational Measurement, Female, Humans, Male, Models, Theoretical, Predictive Value of Tests
Show Abstract · Added March 9, 2018
Historically, admissions committees for biomedical Ph.D. programs have heavily weighed GRE scores when considering applications for admission. The predictive validity of GRE scores on graduate student success is unclear, and there have been no recent investigations specifically on the relationship between general GRE scores and graduate student success in biomedical research. Data from Vanderbilt University Medical School's biomedical umbrella program were used to test to what extent GRE scores can predict outcomes in graduate school training when controlling for other admissions information. Overall, the GRE did not prove useful in predicating who will graduate with a Ph.D., pass the qualifying exam, have a shorter time to defense, deliver more conference presentations, publish more first author papers, or obtain an individual grant or fellowship. GRE scores were found to be moderate predictors of first semester grades, and weak to moderate predictors of graduate GPA and some elements of a faculty evaluation. These findings suggest admissions committees of biomedical doctoral programs should consider minimizing their reliance on GRE scores to predict the important measures of progress in the program and student productivity.
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7 MeSH Terms
Cardio-Oncology Training: A Proposal From the International Cardioncology Society and Canadian Cardiac Oncology Network for a New Multidisciplinary Specialty.
Lenihan DJ, Hartlage G, DeCara J, Blaes A, Finet JE, Lyon AR, Cornell RF, Moslehi J, Oliveira GH, Murtagh G, Fisch M, Zeevi G, Iakobishvili Z, Witteles R, Patel A, Harrison E, Fradley M, Curigliano G, Lenneman CG, Magalhaes A, Krone R, Porter C, Parasher S, Dent S, Douglas P, Carver J
(2016) J Card Fail 22: 465-71
MeSH Terms: Canada, Cardiology, Cardiovascular Diseases, Consensus, Education, Medical, Graduate, Humans, Interprofessional Relations, Medical Oncology, Societies, Medical
Show Abstract · Added March 26, 2017
There is an increasing awareness and clinical interest in cardiac safety during cancer therapy as well as in optimally addressing cardiac issues in cancer survivors. Although there is an emerging expertise in this area, known as cardio-oncology, there is a lack of organization in the essential components of contemporary training. This proposal, an international consensus statement organized by the International Cardioncology Society and the Canadian Cardiac Oncology Network, attempts to marshal the important ongoing efforts for training the next generation of cardio-oncologists. The necessary elements are outlined, including the expectations for exposure necessary to develop adequate training. There should also be a commitment to local, regional, and international education and research in cardio-oncology as a requirement for advancement in the field.
Copyright © 2016 Elsevier Inc. All rights reserved.
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9 MeSH Terms
SCCT curriculum guidelines for general (level 1) cardiovascular CT training.
Maroules CD, Cheezum MK, Joshi PH, Williams M, Simprini LA, Nelson KH, Bittencourt MS, Carr JJ, Weigold WG, Cury RC, Blankstein R, Abbara S
(2015) J Cardiovasc Comput Tomogr 9: 81-8
MeSH Terms: Cardiac Imaging Techniques, Cardiovascular Diseases, Clinical Competence, Curriculum, Education, Medical, Graduate, Female, Guidelines as Topic, Humans, Internship and Residency, Male, Radiology, Societies, Medical, Tomography, X-Ray Computed, United States
Show Abstract · Added August 24, 2015
The Society of Cardiovascular Computed Tomography has developed general (level 1) cardiovascular CT (CCT) training guidelines for radiology resident and cardiology fellow education. As CCT use has expanded over the past decade, it is essential to incorporate such training in both diagnostic radiology residency programs and cardiology fellowship programs. This curriculum will ensure residents and fellows-in-training obtain a fundamental understanding of CCT to stay current in the evolving landscape of cardiovascular imaging and know how and when to use CCT. The curriculum will also help narrow the present knowledge and training gap that exists for CCT between different programs and may encourage trainees to pursue additional training in advanced cardiovascular imaging.
Copyright © 2015 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.
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14 MeSH Terms
Achieving competency in bronchoscopy: challenges and opportunities.
Fielding DI, Maldonado F, Murgu S
(2014) Respirology 19: 472-82
MeSH Terms: Bronchoscopy, Clinical Competence, Computer Simulation, Education, Medical, Graduate, Educational Measurement, Educational Status, Humans, Problem-Based Learning, Pulmonary Medicine, Respiratory Tract Diseases, United States
Show Abstract · Added July 28, 2015
Bronchoscopy education is undergoing significant changes in step with other medical and surgical specialties that seek to incorporate simulation-based training and objective measurement of procedural skills into training programmes. Low- and high-fidelity simulators are now available and allow learners to gain fundamental bronchoscopy skills in a zero-risk environment. Testing trainees on simulators is currently possible by using validated assessment tools for both essential bronchoscopy and endobronchial ultrasound skills, and more tools are under development for other bronchoscopic techniques. Educational concepts including the 'flipped classroom' model and problem-based learning exercises are increasingly used in bronchoscopy training programmes. These learner-centric teaching modalities require well-trained educators, which is possible thorough the expansion of existing faculty development programmes.
© 2014 Asian Pacific Society of Respirology.
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11 MeSH Terms
Early experience in establishing and evaluating an ACGME-approved international general surgery rotation.
Tarpley M, Hansen E, Tarpley JL
(2013) J Surg Educ 70: 709-14
MeSH Terms: Accreditation, Adult, Clinical Competence, Competency-Based Education, Education, Medical, Graduate, Female, General Surgery, Guidelines as Topic, Humans, Interdisciplinary Communication, International Educational Exchange, Internship and Residency, Kenya, Male, Program Evaluation, Societies, Medical, Time Factors, United States
Show Abstract · Added March 7, 2014
BACKGROUND - In 2011, the Accreditation Council for Graduate Medical Education Surgery Residency Review Committee first provided guidelines for elective international general surgery rotations. The Vanderbilt general surgery residency program received Surgery Residency Review Committee approval for a fourth-year elective in Kenya beginning in the 2011-2012 academic year. Because this rotation would break ground culturally and geographically, and as an educational partnership, a briefing and debriefing process was developed for this ground-breaking year.
OBJECTIVES - Our objectives were to prepare residents to maximize the experience without competing for cases with local trainees or overburdening the host institution and to perform continuous quality assessment and improvement as each resident returned back.
METHODS - Briefing included health protection strategies, a procedures manual containing step-by-step preparation activities, and cultural-sensitivity training. Institutional Review Board exemption approval was obtained to administer a questionnaire created for returning residents concerning educational value, relations with local trainees, physical environment, and personal perceptions that would provide the scaffold for the debriefing conference.
RESULTS - The questionnaire coupled with the debriefing discussion for the first 9 participants revealed overall satisfaction with the rotation and the briefing process, good health, and no duty hours or days-off issues. Other findings include the following: (1) emotional effect of observing African families weigh cost in medical decision making; (2) satisfactory access to educational resources; (3) significant exposure to specialties such as urology and radiology; and (4) toleration of 4 weeks as a single and expressed need for leisure activity materials such as books, DVDs, or games. The responses triggered adjustments in the briefing sessions and travel preparation. The host institution invited the residents to return for the 2012-2013 year as well as 2013-2014.
CONCLUSION - Detailed preparation and the follow-up evaluation for assessment and improvement of this nascent international surgery experience are associated with resident satisfaction and the host institution has agreed to continue the rotation.
Copyright © 2013 Association of Program Directors in Surgery. All rights reserved.
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18 MeSH Terms
"Boot camp" simulator training in open hilar dissection in early cardiothoracic surgical residency.
Macfie RC, Webel AD, Nesbitt JC, Fann JI, Hicks GL, Feins RH
(2014) Ann Thorac Surg 97: 161-6
MeSH Terms: Adult, Animals, Clinical Competence, Computer Simulation, Curriculum, Education, Medical, Graduate, Female, Humans, Internship and Residency, Lung, Male, Models, Animal, Pneumonectomy, Swine, Task Performance and Analysis, Thoracic Surgical Procedures
Show Abstract · Added March 7, 2014
BACKGROUND - We evaluated focused training in lung hilar dissection with a reanimated porcine lung model in the boot camp setting.
METHODS - A total of 64 first-year cardiothoracic surgical residents participated in four consecutive hours devoted to training in open hilar dissection as part of the Thoracic Surgical Directors Association boot camps. Each resident participated in two open hilar dissections. Component tasks were assessed on a 5-point rating scale for the first and second dissections.
RESULTS - Immediate assessment performed after completion of the session showed improvements in all graded components. The mean total score on a 50-point scale improved significantly between the first and second repetition (36.03 ± 7.03 to 41.16 ± 6.95; p = 0.001).
CONCLUSIONS - Focused massed (single-session) practice in the boot camp setting improved the ability of residents to perform hilar dissection on simulators using reanimated porcine lung models. Given these early successes in massed simulation-based surgical education, there is good reason to expect that deliberate and distributed practice on similar simulators would improve resident education in cardiothoracic surgery.
Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
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16 MeSH Terms
Acute care of pediatric patients with sickle cell disease: a simulation performance assessment.
Burns TL, DeBaun MR, Boulet JR, Murray GM, Murray DJ, Fehr JJ
(2013) Pediatr Blood Cancer 60: 1492-8
MeSH Terms: Anemia, Sickle Cell, Child, Education, Medical, Continuing, Education, Medical, Graduate, Female, Humans, Male, Manikins, Process Assessment, Health Care
Show Abstract · Added October 14, 2013
BACKGROUND - Sickle cell disease (SCD) is a rare disorder with cardinal features including hospitalization for vaso-occlusive pain episodes, acute pulmonary injury, and increased infection rates. For physician-trainees, learning optimal SCD management is challenging because of limited exposure to life threatening complications requiring timely interventions.
PROCEDURE - To create, demonstrate reliability, and validate simulation-based, acute care SCD scenarios for physician-trainees, seven scenarios were derived from SCD patient cases. For each scenario, participants had 5 minutes to complete diagnostic and treatment interventions. Participants were divided into two groups based on clinical experience: interns or residents/fellows. Two raters scored performances using diagnostic and therapeutic checklists--indicating whether specific actions were performed and a global, 1 (poor) to 9 (excellent), rating. Scenario scores were calculated by averaging rater scores on each metric. Reliability was defined through uniformity in rater scoring and consistency of participant performance over scenarios. Validity was demonstrated by the performance gradient where the more experienced trainees outperform those early in training.
RESULTS - Twenty-eight pediatric residents and hematology fellows took part in the study. Reliability for assessment scores overall was moderate. Performance on all but one scenario was moderately predictive of overall performance. Senior resident/fellows performed significantly better than interns. Positive associations existed between overall performance scores (P < 0.01) and months of postgraduate training (P < 0.01).
CONCLUSIONS - Mannequin-based simulation is a novel method for teaching pediatric residents SCD-specific acute care skills. The assessment provided reliable and valid measures of trainees' performance. Further studies are needed to determine simulation's utility in education and evaluation.
Copyright © 2013 Wiley Periodicals, Inc.
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9 MeSH Terms