JAMA : the journal of the American Medical Association
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While exposure to and attitudes about drug company interactions among residents have been studied extensively, relatively little is known about relationships between drug companies and medical students. ⋯ Student experiences and attitudes suggest that as a group they are at risk for unrecognized influence by marketing efforts. Research should focus on evaluating methods to limit these experiences and affect the development of students' attitudes to ensure that physicians' decisions are based solely on helping each patient achieve the greatest possible benefit.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Comparison of the instructional efficacy of Internet-based CME with live interactive CME workshops: a randomized controlled trial.
Despite evidence that a variety of continuing medical education (CME) techniques can foster physician behavioral change, there have been no randomized trials comparing performance outcomes for physicians participating in Internet-based CME with physicians participating in a live CME intervention using approaches documented to be effective. ⋯ Appropriately designed, evidence-based online CME can produce objectively measured changes in behavior as well as sustained gains in knowledge that are comparable or superior to those realized from effective live activities.
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Comparative Study
Neurobehavioral performance of residents after heavy night call vs after alcohol ingestion.
Concern exists about the effect of extended resident work hours; however, no study has evaluated training-related performance impairments against an accepted standard of functional impairment. ⋯ Post-call performance impairment during a heavy call rotation is comparable with impairment associated with a 0.04 to 0.05 g% blood alcohol concentration during a light call rotation, as measured by sustained attention, vigilance, and simulated driving tasks. Residents' ability to judge this impairment may be limited and task-specific.
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The educational environment affects the outcomes of medical education, including the characteristics and distribution of medical school graduates. ⋯ Although most students remain in their home state for medical school, most students leave the medical school state for residency. Factors external to the medical school, such as funding mechanisms and regulations from the public and private sectors, may be having an impact on faculty size and composition, and on the geographic pipeline of students into medical school and residency training.
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Over the last decade, the primary care specialties have experienced an ebb and flow in popularity. A description of the future primary care workforce may inform planning for the health care needs of our population. ⋯ An increasing proportion of physicians are pursuing subspecialty training, while the number in primary care specialties has leveled off. Trends in GME suggest that the primary care medical workforce of the future will include more women, more IMGs, and more DOs.