Southern medical journal
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Southern medical journal · Nov 2024
A Cohort Study of Lt. Col. Luke J. Weathers VA Medical Center Patients with Positive FIT and Incomplete GI Evaluation during the COVID-19 Pandemic.
The reasons for and incidence of delay in screening colonoscopies during the coronavirus disease 2019 (COVID-19) pandemic are of major public health interest. The risks and reasons for delay likely vary between public and private institutions. This research sought to analyze data regarding the completion of screening colonoscopies after a positive fecal immunochemical test (FIT) before and during the COVID-19 pandemic and the reasons for a delay in obtaining these results at the Lt. Col. Luke Weathers, Jr. Veterans Affairs Medical Center. The goals were to evaluate the institutional resilience and analyze the problems associated with this major healthcare crisis. ⋯ There was a statistically significant increase in timely colonoscopy completion during the study period when compared with the pre-COVID-19 period. The completion rate was higher at the Lt. Col. Luke Weathers, Jr. VA Medical Center than a large population average in 2020, possibly related to community colonoscopies and an aggressive case management system. In addition, increasing age and White race were associated with decreased colonoscopy completion. Predictors of an increased delay in colonoscopy completion included a pre-COVID-19 positive FIT and colonoscopies performed within the VA rather than being referred to providers in the community. A common reason for delay in all of the groups was patients declining intervention and delay/lack of referral.
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Southern medical journal · Nov 2024
Clinical Shift Distribution in Academic Hospital Medicine Fellowship across 10 Years.
As hospital medicine (HM) has grown as a specialty, it has been paralleled by an increase in HM fellowship training programs. Limited data are available surrounding clinical exposure for HM fellows. Using data from a large academic medical center with a long-standing HM fellowship program, we reviewed the types of clinical shifts and distribution of shift data completed by HM fellows from 2013 to 2023. ⋯ HM fellows spend the majority of their clinical time on off-hours shifts, which does not reflect the clinical practice of an academic hospitalist. The least amount of time was spent attending on traditional teaching services. Because HM fellowships are designed to prepare HM fellows for careers as academic hospitalists, more work is necessary to determine how best to optimize and standardize clinical exposure while maintaining adequate time for opportunities to engage in academic development.
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Southern medical journal · Nov 2024
Neighborhood Ecologies, Cases, and Deaths during the Beginning of the COVID-19 Pandemic: Lessons for Current and Future Epidemics?
The coronavirus disease 2019 (COVID-19) pandemic has disproportionately affected Black and Latinx communities. Ecologic analyses have shown that counties with a higher percentage of Latinx and Black people have worse COVID-19 outcome rates. Few ecologic analyses have been published at the neighborhood (census tract) level. We sought to determine whether certain sociodemographic neighborhood ecologies were associated with COVID-19 case and death rates in metropolitan Atlanta, Georgia. ⋯ Neighborhoods were differentially at risk of COVID-19 cases or deaths depending on their sociodemographic ecology at the beginning of the COVID-19 pandemic. Prevention methods and interventions may need to consider different social determinants of health when addressing potential cases and deaths during future emergent epidemics.
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Southern medical journal · Nov 2024
Advancement of a Vertically Integrated Training Program (VITP): Introspective Assessment and Expansion.
With the number of medical school applicants more than doubling during the past 30 years, there has been an increased need to mentor premedical undergraduate students. The Vertically Integrated Training Program at the University of South Carolina School of Medicine, Columbia, was created to provide direct mentoring for college students interested in a career as a physician. ⋯ Data suggest a trend toward positive change in terms of increased confidence of undergraduate students regarding the process of applying to and finding success in medical school. This article reviews the development of the Vertically Integrated Training Program, evaluates the success of the program, and suggests next steps for the organization.