JAMA : the journal of the American Medical Association
-
International medical graduates (IMGs) consistently represent approximately one fourth of both the physician workforce and the graduate medical education (GME) population of the United States. To enter into accredited US GME programs, IMGs must be certified by the Educational Commission for Foreign Medical Graduates (ECFMG). Changes in the number and characteristics of those seeking certification directly affect the GME population and the future physician workforce in the United States. ⋯ For this period, we found that the number of IMG candidates taking the Step 1 examination decreased by 45.5% (36,983 vs 16,828), and the number of IMGs registered to take Step 2 decreased by 38.1% (31 751 vs 12 122). The number of ECFMG certificates issued annually decreased, from a range of 9000 to 12,000 (1995-1998) to fewer than 6000 (1999-2001). Although the number of IMGs annually seeking and receiving certification has decreased, the quality of the applicants appears to have improved and the number of IMGs certified annually continues to adequately fill GME positions not taken by US medical graduates.
-
We used data mainly from the 2001-2002 Liaison Committee on Medical Education Annual Medical School Questionnaire, which had a 100% response rate, to describe the status of US medical education programs. In 2001-2002, the number of full-time medical school faculty members was 104 949, a 2.4% increase from 1999-2000. The 34,859 applicants for the class entering in 2001 represented a 9.5% decrease from the number of applicants in 1999-2000. ⋯ Of all first-year students, 67% were in-state residents. Most medical schools had mandatory required night call during at least some required clinical clerkships, but only 17 had formal policies on medical student work hours. In 74 schools (60%), medical students were required to pass Steps 1 and 2 of the United States Medical Licensing Examination to advance or graduate.
-
Randomized Controlled Trial Multicenter Study Clinical Trial
Effect of treatment with low doses of hydrocortisone and fludrocortisone on mortality in patients with septic shock.
Septic shock may be associated with relative adrenal insufficiency. Thus, a replacement therapy of low doses of corticosteroids has been proposed to treat septic shock. ⋯ In our trial, a 7-day treatment with low doses of hydrocortisone and fludrocortisone significantly reduced the risk of death in patients with septic shock and relative adrenal insufficiency without increasing adverse events.