Performance of residents who had academic difficulties in medical school

An assessment of how well graduates of one medical school performed in residency training was undertaken to assess the school's monitoring of students' performances. The minutes of the school's student progress committee for four years were reviewed to identify all students who had had academic difficulty. Seven students had been recommended for dismissal but ultimately graduated, 22 students were on academic probation for longer than one year, and 22 students were on academic probation for less than one year. The residency performance of 43 of these 51 students were compared with the performances of a randomly selected group of students who had had no academic difficulties and had graduated during the same period. Of 12 performance and knowledge items assessed by the residency directors for the studied graduates, the one dealing with quality of interaction with patients showed significant differences among the residents. The residents who had had academic difficulty had lower ratings on this item than the residents who had not had academic trouble. On all other items, those residents who had had academic difficulties received generally lower scores than the other residents, but the differences were not statistically significant. Of the seven students considered for dismissal, one had been dismissed and one had withdrawn from the residencies; the other five generally received positive ratings from their residency directors. The findings suggest that the medical school's overall monitoring of students' performance was working and confirmed the authors' opinion that each decision concerning a student with academic difficulties should be based on the student's individual situation.     

Prospective survey of performance of medical students during preclinical years

The performance during the preclinical course of 517 students who had applied to this medical school for admission in 1981 and who had been accepted by the school or by another British medical school was analysed in relation to variables measured at the time of application to find factors that predicted success in the preclinical course, whether students chose to take an intercalated degree, and the class achieved in the intercalated degree. Thirty one of the 507 students who entered medical school withdrew from the course or failed their examinations; these students were particularly likely not to have an A level in a biological science. O level grades were of minimal predictive value for performance during the preclinical course. A level grades discriminated between successful and unsuccessful students but had too low a specificity or sensitivity to be of use in individual prediction. Mature entrants performed better overall than school leavers. Background variables accounted for only 14.2% of the variance in performance, implying that motivation and personality may be more important in determining performance. The 80 students who chose to take an intercalated degree were more likely to be men and not to be mature entrants; for a further 50 students intercalated degrees were obligatory. Performance in the intercalated degree related to performance during the preclinical course and to assessments made at the selection interview but not to achievement at O or A level.     

Factors used by program directors to select residents

A national, stratified random sample of 405 graduate medical education program directors was surveyed on the way they selected their residents. The results from the 237 respondents reaffirm earlier studies which found that the interview was the most important selection variable. The results indicate that the recent increase in competition for residency positions has increased the importance of academic variables. For example, 86 percent of the respondents stated that they would not rank a candidate who had not passed the National Board of Medical Examiners Part I examination. Because 86 percent also stated that they give preference in ranking students to those who have done well in an elective at their hospitals, the senior year of medical school may be used as a "residency chase" rather than for the general professional education of the physician.     

Relationship of residents' emotional problems, coping behaviors, and gender

Family medicine residents were studied to test the hypotheses that a higher incidence and greater severity of personal or emotional problems are associated with a higher incidence of maladaptive coping behaviors among women than men residents. Self-report data were collected from 466 residents in six states on personal or emotional problems and on alcohol use, cigarette smoking, weight, diet, and exercise. The study provides evidence that the women residents experienced a higher incidence and greater severity of personal or emotional problems than men and that these problems were associated with an increased percentage of women than men who had used alcohol during the preceding year, had used alcohol daily, had increased use of alcohol over the two years before the survey, and had had perceptions of being overweight and were on calorie restricted diets. The gender differences in cigarette smoking and frequency of exercise were not significant. The author concludes that residency programs need to provide flexible programs that would better accommodate women's needs and to help residents develop healthy strategies for dealing with stress.     

Characteristics of medical students who choose primary care as a career: the McMaster experience

We examined the relation between demographic characteristics and the career choices of medical students who entered McMaster University medical school between 1969 and 1975. In contrast to earlier work, this study found no significant differences in sex, age, marital status at the time of entry into medical school, undergraduate major, whether prerequisite premedical courses had been taken, undergraduate grade point average and academic performance between the graduates who chose primary care and those who chose a specialty. This suggests that many medical school graduates in the 1970s entered primary care by choice rather than by default.     

Medical student's access to information and resources for the residency selection process

In the study reported here, the authors analyzed senior medical students' attitudes regarding the availability of information and resources pertaining to the residency selection process. Results of a nationwide survey of students showed that when the students had access to information from medical professionals (that is, faculty members, deans, house staff physicians), they felt they had greater access to information than did students who made greater use of other sources (official directories, classmates and the "grapevine"). Furthermore, the findings suggest that greater availability of information from medical professionals was related to higher levels of overall satisfaction with the residency match. While no evidence is presented that demonstrates that medical school faculty members and administrators were unwilling to devote attention to any particular group of students, the data suggest that these professionals provided information regarding the residency selection process more often to medical students at high-prestige schools, students who chose high-prestige specialties, and students who perceived themselves as having high class rank than to other students. Also, students in publicly supported schools felt the cost of travel for interviews to be more burdensome than did the students in private schools.     

凉山州艾滋病重点地区中学生吸烟现状及影响因素

目的研究凉山州艾滋病重点地区中学生吸烟状况及影响因素,为对其进行行为干预提供决策依据。方法根据凉山州地区艾滋病流行状况,在重点地区所有中学中随机抽样确定调查点。自制调查问卷, 问卷内容包括人口学特征、吸烟行为、学校教育状况、家庭环境、家庭有无吸毒者或HIV感染者等。通过单因素和多因素分析影响凉山州艾滋病重点地区中学生吸烟状态的危险因素。结果尝试吸烟、现在吸烟、重度吸烟、≤13岁吸烟的报告率分别为33.4%、21.3%、5.0%和16.8%。多因素logistic回归分析结果显示,男生、高中生、自评学习成绩差、自评家庭经济条件为下、居住乡镇或农村、自报家庭有吸毒者和自报家庭有HIV感染者是尝试吸烟的危险因素;男生、少数民族、自评学习成绩为中、家庭结构残缺、自评家庭经济条件为上或中、自报家庭有吸毒者和自报家庭有HIV感染者是现在吸烟的危险因素;男生、高中生、自评学习成绩为中或差、居住乡镇或农村和自报家庭有吸毒者是重度吸烟的危险因素;男生、家庭结构残缺、自评学习成绩为中等、自评家庭经济条件为上或中、自报家庭有吸毒者和自报家庭有HIV感染者是≤13岁吸烟的危险因素。结论凉山州艾滋病重点地区中学生吸烟报告率较高,初次吸烟年龄较小。学校控制吸烟教育要更多的关注男生、少数民族、高年级、居住农村或乡镇、成绩较差、家庭有吸毒者和有HIV感染者的学生。     

The quality of deans' letters from medical schools

Residency training directors have noted considerable variability in the quality of deans' letters sent by medical schools on behalf of graduating students. A total of 212 deans' letters from 103 U.S. medical schools received by a large psychiatric residency program were rated by two of the authors. Of these, 26.9 percent were judged excellent, 49.5 percent average, and 23.6 percent poor. Excellent letters were characterized by detailed personal and academic comments; verbatim statements for each clinical clerkship; tactful , yet explicit, remarks about problems; and internal consistency. Poor letters were generally short regardless of content, offered global impressions about clerkship performance by fusing remarks from several different clerkships without identifying sources, or omitted important information that was quickly evident to the discriminating interviewer. Recommendations are offered for authors and readers of deans' letters and to medical students.     

History of not completing courses as predictor of academic difficulty among first-year students

The study reported here was undertaken to determine whether the prediction of academic difficulty in the first year of medical school is enhanced by a consideration of the number of courses withdrawn from, repeated courses, and incomplete courses on a student's undergraduate academic record. All students enrolled from 1981 through 1985 at Southern Illinois University School of Medicine who experienced academic difficulty in the first year were selected for the study. Successful students were matched with these students in terms of minority or majority status and served as a control group. Discriminant and classification analyses were performed in a hierarchical stepwise manner to predict success or difficulty in the first year. The variables that were significant in discriminating between minority students who had academic difficulty and those who did not were the science grade-point average (grades in biology, chemistry, physics, and mathematics), the score on the reading subtest of the Medical College Admission Test (MCAT), and the number of withdrawals from courses. For majority students, the significant discriminating variables were the score on the MCAT biology subtest and the number of incompletes taken for courses. The results of this study have implications for medical school admissions committees, premedical advisers, and premedical students.     

Impact of undergraduate courses on medical student performance in basic sciences

Many students planning to apply to medical school take undergraduate courses (for example, biochemistry, embryology, histology, and vertebrate anatomy) covering concepts that are taught within the medical school curriculum. Do these students perform better in similar courses in medical school than students without prior exposure? In the study reported here of 310 medical students, approximately 50 percent had taken biochemistry, 50 percent had taken a course dealing with vertebrate anatomy, 25 percent had taken embryology, and 25 percent had taken histology as undergraduates. In comparisons of the students with prior exposure to these courses and those without prior exposure, no statistical difference was noted in cumulative grade-point averages for the first year in medical school or in the students' scores in three of the four individual medical courses examined. In addition, there was no significant difference in the academic performances in the four courses between the students in the upper and the lower quartiles of the class. Implications regarding undergraduate preparation of medical school applicants are discussed.     

Evaluation of a preentrance enrichment program for minority students admitted to medical school

The authors report on an enrichment program for minority students and its effect on those students' performance in the first year of medical school. The six-week preentrance enrichment program (PEP) offers a curriculum of basic science courses, study skills training, and a seminar on special topics, typically on sociomedical issues. From 1973 through 1984, 115 students who had been admitted to Boston University School of Medicine participated in the PEP prior to matriculation. The PEP participants had lower scores on the Medical College Admission Test than minority nonparticipants admitted to the medical school. Analysis of the first-year performance of PEP participants, however, indicated that the participants had significantly higher proportions of pass and honors grades than minority nonparticipants in two courses and slightly higher (though not significant) proportions of pass and honors grades in six other courses of the nine courses in the first-year curriculum. In a related study, preliminary analysis showed that participation in the PEP was one of the consistent predictors of overall academic performance during the first year. Questionnaires completed by participants before and after the program and their responses to a survey at the end of their first year of medical school indicated the participants felt they had gained benefits from the program that enhanced their academic adjustment.     

Undergraduate medical education

There were 31,323 applicants to US medical schools for the 1986-1987 academic year. Of this number, 17,092 were accepted by at least one school. First-year enrollment equaled 16,779. Because some students were repeating the first year, the number of first-time enrolled students was 16,206. This represents a decrease of 131 from the previous year. The number of students enrolled in 127 US medical schools in 1986-1987 was 66,142; of this number 22,082 (33.4%) were women. The estimated number of graduates in 1986-1987 was 15,872. The total enrollment of students from underrepresented ethnic/racial groups was 6650 (10.1%), of which 3853 (5.8%) were blacks not of Hispanic origin. The number of new entry first-year students from underrepresented groups was 1679 (10.4%), of which 987 (6.1%) were blacks. The number of full-time medical school faculty was 63,991; another 130,379 were part-time and volunteer faculty. Medical school faculties also have teaching responsibility for a variety of other students, in addition to patient care and research responsibility. The average time needed to complete the curriculum requirements leading to the MD degree is 152 weeks. Twenty-two medical schools offered a combined college-medical school program. The length of these combined programs averaged 254 weeks. More than 93% of students entering medical school in 1986-1987 had completed at least four years of college. More than two fifths of students had a premedical grade point average of 3.50 or higher. The number of schools offering a Fifth Pathway Program has decreased and the number of applicants for these programs has also declined. The net attrition rate, which excludes students who withdraw temporarily to pursue advanced study or research, has remained at about 2%. Only half of 1% of students were dismissed because of poor academic standing.     

Survey of women physicians on issues relating to pregnancy during a medical career

Many women in medical training want to combine a family life and a career. Of major interest to these women is determining the most desirable time for pregnancy during their medical education and career. The results of a study on women physicians' timing of pregnancy are reported. A 53 percent response rate was obtained in a randomized national survey of women physicians who had completed residency training and were less than 50 years of age. Their first pregnancies (of which 77 percent were planned) occurred as follows: prior to medical school, 4 percent; during medical school, 7 percent; in first year as house officer, 11 percent; in other residency year, 32 percent; in fellowship year(s), 13 percent; in practice, 28 percent, on leave or other, 5 percent. Seventy percent of the respondents considered "after completion of residency" to be the best time to become pregnant. Sixty percent of the respondents' maternity leaves were six weeks or less in duration. Seventeen percent required some medical leave before delivery, although only 5 percent required more than eight weeks of medical leave. Only a third reported that their training or work sites had maternity leave policies. Ninety-one percent of the respondents reported satisfaction in their careers.     

Timing and motivation in pediatric career choices

A total of 257 third-year residents in pediatrics, internal medicine, and family practice were asked about their career goals for the year following their residency and in five years, and information was obtained from them about their motives for career choices. The authors specifically examined the following: humanitarian interests; intellectual motivation; service motives; and practical, personal, and financial considerations. The characteristics of the residency training program which may have influenced their career choices were also examined. A majority of the 214 pediatric residents said they had not considered going into pediatrics on entry to medical school. Of these residents, 109 planned academic pursuits for the following year, while only 81 of the 109 anticipated an academic career within five years. Intellectual stimulation, geographic location, and an "opportunity to clarify goals" were the three most frequently mentioned factors in choosing positions for the following year.     

Helping medical students to find their moral compasses: ethics teaching for second and third year undergraduates

The paper describes a two week course that has been offered as a special study module to intermediate level (second and third year) undergraduate medical students at Dundee University Medical School for the past five years. The course requires students to research the various aspects of ethical dilemmas that they have identified themselves, and to "teach" these issues to their colleagues in a short PowerPoint presentation as well as to prepare an extended 3000 word essay discussion. The course specifically asks students not to disclose their own ethical positions, as these are probably still in formation and the objective is to promote critical thinking capacity in ethical and moral issues as a prelude to the development of practical skills in dealing with clinical problems. The course is easy to resource for the school and has received universally high evaluations from the students since its inception.     

Graduate medical education

The annual surveys of residency programs on which this statistical report is based have had a higher than 95% response for the past four years. The number of accredited programs increased in 1984 and again in 1985, primarily as a result of the accreditation of additional subspecialty programs. Discussions about the sources and methods of financing graduate medical education may have an impact on the number and the size of programs in the near future. The count of available residency positions is a fluid entity and seems to be dependent on many factors, one of which appears to be the number of qualified candidates seen by program directors. The number of PGY-1 positions has not changed significantly over the past three years. The number of reported unfilled positions, including PGY-1 unfilled positions, has been declining since 1983. The special survey of PGY-1 programs conducted for the past three years reveals that about 10% of programs withdrew positions between October and July. However, another group of programs (some of which are new) added to the number of positions offered. The primary reason cited for withdrawing positions has changed. In 1983, the reason was cited as "financial" by 32% of program directors. In 1985, despite the national discussions about financing medical education, a financial reason was cited by only 16% of program directors. Reasons related to candidates, ie, "absence of suitable candidate" and giving the position to an "applicant at the PGY-2 or higher level," were cited by 49% of program directors in 1983 and by 67% in 1985. The total number of residents on duty (exclusive of newly accredited subspecialties) increased in 1983 and 1984 but decreased in 1985. Decreases were noted in family practice, internal medicine, pathology, and surgery. The number of new entry residents (PGY-1) decreased in 1983 (when the number of US graduates had decreased), increased in 1984, and decreased again in 1985. Forty-two percent of residents were training in family practice, internal medicine, or pediatrics. This statistic has not changed significantly over the past three years. (ABSTRACT TRUNCATED AT 400 WORDS)     

Emotional disorders among medical students in a Malaysian private medical school

INTRODUCTION: A study was done between December 2005 and January 2006 to determine the prevalence of emotional disorders among medical students in a private medical school in Ipoh, Perak, Malaysia and to determine the demographical characteristics, contributing factors and the key person consulted for emotional problems. METHODS: Medical students in the private medical school completed the 12-item English version of the General Health Questionnaire (GHQ-12) and a demographical questionnaire. A cut-off point of 3/4 for the GHQ was used to determine negative and positive scores for emotional disorders. RESULTS: Out of 292 medical students, 86.6 percent completed the questionnaires. A total of 117 students (46.2 percent) were found to have emotional disorders. There was no significant association of ethnicity, gender, age group, number of examinations sat, examination performances, past medical conditions and relationships with parents, siblings, course-mates and lecturers with positive GHQ scores. A significant association, however, was found between positive GHQ scores for emotional disorders and the year of study, pressure faced due to examinations, and not having a love relationship. 39 percent of the students stated friends as their main preference for consultation of any emotional problem. CONCLUSION: The prevalence of emotional disorders among medical students was high. Further studies and diagnostic measures are recommended, including a more systematic screening and counselling programme by the medical school for early diagnosis and treatment to prevent complications.     

Response of faculty members to medical students' personal problems

In the study reported here, the authors examined the interpersonal helping behaviors of medical educators. Ninety-six faculty members from 12 randomly selected medical schools completed a detailed questionnaire providing data on the nature and frequency of their interpersonal behaviors with students experiencing personal problems. The faculty members reported spending an average of 48.6 minutes a week discussing personal problems with students. Student problems reported most frequently pertained to financial concerns, emotional health, and interactions with faculty members. Medical educators used various techniques to offer help; the most commonly reported techniques were listening, asking questions to draw the student out, offering support and sympathy, and offering empathy. Most medical faculty members felt positive about their role as "helper" and rated that component of their job as extremely important. The implications of these findings, especially for staffing and personnel policy, are discussed.     

Computer instruction as part of a course on analytic medicine for first-year students

The Medical University of South Carolina integrated instruction in information science and computer technology into a required freshman-level course. Analytic and Community Medicine. The advantages of this placement in the curriculum are two-fold. First, the course provides an opportunity to integrate computer methodology with clinically relevant topics such as medical decision-making. This integration enhances the students' view of the computer as a useful tool that can aid the physician in the practice of medicine. Course organizers are convinced that the success of the first offering is attributable to this integration. Second, the instruction comes early in the medical education process and allows the concepts learned to be utilized throughout the students' medical school careers. The degree to which these concepts and methods are actually utilized by students will depend upon the degree of reinforcement of these ideas in the clinical years and residency. Thus, faculty members must act as role models who not only acknowledge the importance of mastering the use of computers in medicine but also manifest those skills.     

医学生紧张性生活事件评定量表——Ⅱ.对827名医学生的评定

827名医学生紧张性生活事件评定量表观察值的分布情况,确定95％的医学生生活事件年心理紧张总值在121以下,相应T分在66.4以下。由于本量表具有较好的预测SCL—90总分的效度,可用来作为心理健康水平粗估的预测量表。医学生一年心理压力最大的是学习、社交问题,但回归分析发现影响心理健康水平的事件主要是经济、个人方面的问题,其次才是学习、社交问题。