Academic medicine : journal of the Association of American Medical Colleges
-
To examine the stability and switching patterns of student career interests over the course of medical school. ⋯ Student career choice is relatively stable with a number of careers showing approximately 50% of stability from the entrance to the exit of medical school. Students tend to switch to careers with similar MDS, but some specific switching patterns exist.
-
Since 1995, the David Geffen School of Medicine at UCLA (DGSOM) has created policies to prevent medical student mistreatment, instituted safe mechanisms for reporting mistreatment, provided resources for discussion and resolution, and educated faculty and residents. In this study, the authors examined the incidence, severity, and sources of perceived mistreatment over the 13-year period during which these measures were implemented. ⋯ Despite a multipronged approach at DGSOM across a 13-year period to eradicate medical student mistreatment, it persists. Aspects of the hidden curriculum may be undermining these efforts. Thus, eliminating mistreatment requires an aggressive approach both locally at the institution level and nationally across institutions.
-
As the modern medical system becomes increasingly complex, a debate has arisen over the place of advocacy efforts within the medical profession. The authors argue that advocacy can help physicians fulfill their social contract. For physicians to become competent in patient-centered, clinical, administrative, or legislative advocacy, they require professional training. ⋯ Undergraduate medical education, especially, is an ideal time for this training because a standard competency can be instilled across all specialties. Although the Accreditation Council for Graduate Medical Education includes advocacy training in curricula for residency programs, few medical schools or residency programs have advocacy electives. By understanding the challenges of the health care system and how to change it for the better, physicians can experience increased professional satisfaction and effectiveness in improving patient care, systems-based practice, and public health.
-
Health advocacy is being formalized as a professional activity for physicians across North America, but the accommodation of this activity into conceptions of daily practice has been controversial and confusing. There appears to be a lack of clarity around what a physician should do as a health advocate and how this should manifest in daily practice. In this article, the authors explore how the medical community has characterized the health advocate role and the roots of the debates regarding its place within training and practice, using the example of the CanMEDS Health Advocate Role. ⋯ They propose that these activities and their associated skills are sufficiently distinct as to merit separate discussions. Agency involves advancing the health of individual patients ("working the system"), and activism involves advancing the health of communities and populations ("changing the system"). The authors suggest that distinguishing between agency and activism within health advocacy provides opportunities to explore their distinct goals and skill sets in a manner that will advance the debate about health advocacy, a conversation that remains critically important to the medical profession.
-
This commentary is a celebration of the 10th anniversary of the Academic Medicine feature Teaching and Learning Moments. The authors reflect that the moments highlighted in these columns are everyday moments in every medical school, in every residency program, in every clinic, in every hospital. ⋯ The invitation to honor these moments and value our subjective experiences is an invitation to integrity, to unite "soul" and "role." Yet the power of these narratives is not truly unleashed until they are discussed in community. In conversation, these personal narratives or "stories of self" have the potential to find common cause with the stories of others and become "stories of us." Through conversation that is rooted in a particular time and place, these stories of self and stories of us are linked to a "story of now." And these public narratives have the power to catalyze movements for change.