The Mount Sinai journal of medicine, New York
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The Meyerhoff Scholars Program at the University of Maryland, Baltimore County is widely viewed as a national model of a program that enhances the number of underrepresented minority students who pursue science, technology, engineering, and mathematics PhDs. The current article provides an overview of the program and the institution-wide change process that led to its development, as well as a summary of key outcome and process evaluation research findings. African American Meyerhoff students are 5× more likely than comparison students to pursue a science, technology, engineering, and mathematics PhD. ⋯ Qualitative findings from interviews and focus groups demonstrate the importance of the Meyerhoff Program in creating a sense of belonging and a shared identity, encouraging professional development, and emphasizing the importance of academic skills. Among Meyerhoff students, several precollege and college factors have emerged as predictors of successful entrance into a PhD program in the science, technology, engineering, and mathematics fields, including precollege research excitement, precollege intrinsic math/science motivation, number of summer research experiences during college, and college grade point average. Limitations of the research to date are noted, and directions for future research are proposed.
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With growing numbers of patient-centered medical homes and accountable care organizations, and the potential implementation of the Patient Protection and Affordable Care Act, the provision of primary care in the United States is expanding and changing. Therefore, there is an urgent need to create more primary-care physicians and to train physicians to practice in this environment. In this article, we review the impact that the changing US healthcare system has on trainees, strategies to recruit and retain medical students and residents into primary-care internal medicine, and the preparation of trainees to work in the changing healthcare system. ⋯ Retaining residents in primary-care careers may be encouraged via focused postgraduate fellowships or continuing medical education to prepare primary-care physicians as both teachers and practitioners in the changing environment. Finally, to prepare primary-care trainees to effectively and efficiently practice within the changing system, educators should consider shifting ambulatory training to community-based practices, encouraging resident participation in team-based care, providing interprofessional educational experiences, and involving trainees in quality-improvement initiatives. Medical educators in primary care must think innovatively and collaboratively to effectively recruit and train the future generation of primary-care physicians.
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The growing disparity between organ availability for transplantation and the number of patients in need has challenged the donation and transplantation community of practice to develop innovative processes, ideas, and techniques to bridge the gaps. Advances in the sharing of best practices in the donation community have contributed greatly over the last 8 years. ⋯ New techniques for organ preservation and organ resuscitation have allowed for better utilization of the potential donor pool. This review will highlight processes, ideas, and techniques in organ donation.
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Review Historical Article
Indications for heart transplantation in current era of left ventricular assist devices.
Although both heart transplantation and left ventricular assist device therapy have enjoyed clinical success in the treatment of patients with end-stage heart disease, newer left ventricular assist devices currently undergoing testing are likely to have a tremendous impact on the management of these patients. Smaller, more durable devices with improved safety profiles will allow for longer duration of therapy and make biventricular support more feasible, obviating the need for the total artificial heart. In this article we review the historical aspects of both forms of therapy and highlight the current use of left ventricular assist device therapy on patients awaiting heart transplantation.
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Much has been written about the need for and barriers to achievement of greater diversity in the biomedical workforce from the perspectives of gender, race, and ethnicity; this is not a new topic. These discussions often center around a "pipeline" metaphor that imagines students flowing through a series of experiences to eventually arrive at a science career. Here we argue that diversity will only be achieved if the primary focus is on (1) what is happening within the pipeline, not just counting individuals entering and leaving it; (2) de-emphasizing the achievement of academic milestones by typical ages; and (3) adopting approaches that most effectively develop talent. ⋯ Emphasizing talent development opens up many new approaches for science training outside of traditional degree programs. This article provides examples of such approaches, including interventions at the postbaccalaureate and PhD levels, as well as a novel coaching model that incorporates well-established social science theories and complements traditional mentoring. These approaches could significantly impact diversity by developing scientific talent, especially among currently underrepresented minorities.