Journal of general internal medicine
-
The acting internship (AI) in internal medicine plays a key role in the transition from medical school to residency. While there have been recent changes in medical education including a pass/fail USMLE Step 1 and increasing use of competency-based assessment, there has not been a large survey of the state of the AI in many years. ⋯ The internal medicine AI continues to be a staple in the medical school experience, but there is variation in the structure, curriculum, and expectations on the rotation. Opportunities exist to improve standardization of the AI experience and expectations to better prepare medical students for the transition from medical school to residency.
-
Holistic review has become the gold standard for residency selection. As a result, many programs are de-emphasizing standardized exam scores and other normative metrics. However, if standardized exam scores predict passing of an initial certifying exam, this may lead to an increase in board failure rates within specific residency training programs who do not emphasize test scores on entry. ⋯ All programs do not recruit students entering residency with an identical chance of passing boards. Therefore, we believe the ABMS member boards should stop publicly reporting raw certifying exam rates above a certain threshold for normative comparison. We strongly encourage the use of learning analytics to create a residency "expected board pass rate" that would be a better metric for program evaluation and accreditation.
-
A set of core competencies in sex- and gender-based women's health (SGWH) has been endorsed by the Society of General Internal Medicine (SGIM), but many residencies lack the resources to implement curricula and clinical assessments that would support achievement of these competencies. ⋯ As residency education moves towards a competency-based structure, EPAs are needed to translate broad competencies into observable clinical skills. The SGWH EPAs provide a rigorously developed and ready-made tool for programs to link the SGWH core competencies to residency curriculum development, clinical assessment, and program evaluation.
-
While 26% of US adults are disabled, only 3.1 to 9.3% of practicing physicians report having a disability. Ableism within medical training and practice diminishes physician diversity and wellbeing and contributes to healthcare disparities. ⋯ PDs held contradictory views of RWDs. PD insights revealed opportunities to alleviate PD-RWD information asymmetry in recruitment/accommodation processes, which could help align needs and improve representation and inclusion.
-
Observational Study
Improving Behavioral Healthcare Access Disparities by Training Providers in Disadvantaged Communities - Evidence of Strategy Effectiveness.
Inadequate access to behavioral health services disproportionately impacts marginalized populations who live in disadvantaged areas. To reduce this gap, programs dedicated to optimizing behavioral health education and training must focus their efforts to enroll providers who practice in these disadvantaged areas. ⋯ The TNT program strategy for recruiting PCPs from high medical need geographical areas is associated with bringing primary care psychiatry education to areas considered underserved and disadvantaged. Equipping PCPs practicing in underserved areas with enhanced knowledge and skills in behavioral medicine has the potential to significantly improve the existing access gap in disadvantaged communities.