Journal of general internal medicine
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There has been a growing disconnect between learners and educators within medical education. As the landscape of medical education has been altered post-pandemic and cultural shifts favor "safe spaces," we sought to explore the tension that exists between a sense of safety and the discomfort inherent within the learning process. Through separate focus groups conducted with trainees and faculty, a common theme emerged: a sense of vulnerability. ⋯ Educators feel a sense of vulnerability that their feedback will be interpreted as "retaliatory teaching." This sense of vulnerability was heightened in situations that emphasized the tension between personal well-being vs altruism, safe spaces vs accountability to high standards, and advocacy for system change vs power hierarchy. We must acknowledge this vulnerability and the resulting tensions that can ensue due to the competing commitments of medical training. By cultivating a culture of mutual growth and respect, we can create a learning environment that embodies the highest standards of medicine.
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Enhancing residency recruitment with modifications to interviews has been an area of national interest, further catalyzed by the transition to universal virtual interviewing (UVI). In 2018, our internal medicine residency program redesigned the recruitment process using virtual interviews. ⋯ Virtual interviews were highly rated with increased preference following universal adoption. Optional AVDs separated from virtual interviews enhance applicant understanding of the program and were more effective when offered in-person before the pandemic-related restrictions. As programs begin to reintroduce in-person elements, the SPLIT recruitment model offers an innovative approach that addresses applicant and program needs.
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Reports of mistreatment are an important first step to improving medical students' learning environment. Students may not report mistreatment due to a lack of awareness of institutional policies, reporting procedures, or for fear of reprisal. ⋯ Not applicable.
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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.