Whither medical education in the United States?

Medical education and JGIM

The tides of change: Are we ready for interprofessional collaboration?

The Future of Pediatric Residency Education: Prescription for More Flexibility

Council on Medical Student Education in Pediatrics

T radition has it that first anniversaries are celebrated with gifts of paper.Thus, it is fitting that on this first anniversary of our start as co-Editors in Chief of the Journal of General Internal Medicine, we should look back on the 12 paper issues we've published in 2010.The paper journal is sent to every member of the Society of General Internal Medicine and to a diminishing number of libraries who still choose to display the bound journal instead of relying solely on electronic access.As editors, we take the print journal seriously, striving to craft each issue to be a self-contained and coherent whole.This year has seen the addition of several new features that we hope add value to each issue.From the Editor's Desk directs readers' attention to articles and themes of special interest.Exercises in Clinical Reasoning examines the diagnostic process as highly skilled clinicians work through a tough clinical case.Innovations and Improvement explores the process of quality improvement and enlivens the journal through interviews and first person narratives, and Healing Arts sounds the lived experience of general internal medicine in essays, poems, and criticism.Although we choose the articles appearing in each issue of the print journal with care, most consumers of medical journals never touch the paper of each monthly issue and instead prefer to access JGIM and other journal content as if it were on iTunes, searching through titles and abstracts and downloading individual articles.They find JGIM content through on-line sources such as Google Scholar, PubMed Central, and others.In fact, over the past year, while Springer, our publisher, mailed just over 2,000 copies of the paper journal to subscribers or members each month, there have been more than 1 million JGIM articles downloaded by readers since the publication of our inaugural issue last January.This, of course, is the present and future of medical journals; the increasing 'webification' of journal content and the growing irrelevance of the print journal.We are well aware of these trends and will work over the remaining 4 years of our editorship to prepare JGIM for the inevitable demise of the print journal and the predominance of the web-based journal.With the help of Associate Editor Malathi Srinivasan and others, work on eJGIM has already begun.In addition, the next 12 months will see the reinvigoration of Innovations in Medical Education, a stunning series of articles on Health Policy, and new collaborations with AHRQ, the VA, and the Annals of Internal Medicine.JGIM depends on the generosity of a committed and outstanding group of reviewers.In 2009-2010, JGIM reviewers volunteered their time and expertise to review about half of the more than 1,000 manuscripts that JGIM receives each year.During this period, 986 reviewers provided a total of 1,294 reviews with a mean quality score of 2.98 on a scale of 1-6 (as judged by JGIM Deputy Editors).Of these, 276 provided at least two reviews, and 29 provided three or more.We are indebted to them for their service.Among this group of dedicated peer reviewers, there is a cohort that stands out.Reviewers included in this prestigious group performed at least two reviews between July 2009 and June 2010, returned all reviews within 30 days, and received no quality score on any review lower than 4 on our 1-6 scale.An asterisk identifies the 131 reviewers meeting these criteria.We thank them for their efforts on behalf of the Journal.In our first "From the Editor's Desk" in January 2010 we wrote: "In steering the journal forward over the next 5 years, we will be guided by the principle that JGIM is a journal for generalists committed to improving the world in which they practice and teach.Thus, we will seek to publish data derived from settings where real patients live and real doctors practice, as well as reviews and tools that clinicians and educators can use to do their jobs more effectively, efficiently, and humanely."We remain committed to this vision over the next 4 years and hope that you, our readers, will join us by continuing to submit to, review for, read, and respond to JGIM.Whether in print or on-line, JGIM is your journal, and we need to hear from you.Send us an e-mail (or a paper letter!) and share your thoughts for the future of medical journalism and the future of medicine.

University of Chicago Division of the Biological Sciences Pritzker School of Medicine

Celebrating the Sesquicentennial of Mayo Clinic: 150 Years of Advances in Medical Practice, Education, Research, and Professionalism

Scientific discourse, corporate ghostwriting, journal policy, and public trust

New York University Grossman School of Medicine.

Hospitalists in teaching hospitals: opportunities but not without danger.

Technology in medical education—Osler meets Watson.

The authors present an overview of the educational programs, infrastructure to support them, and the assessment strategies of 128 medical schools in the United States and Canada, based on reports submitted by those schools and published in this supplement to Academic Medicine. The authors explore many important changes that have occurred since the publication of the Flexner Report in 1910 as well as the progress that is evident since a similar collection of medical school reports was published in September 2000, also as a supplement to Academic Medicine. Drawing on the reports, the authors summarize, among other topics, the advances that have taken place in the support for faculty, the funding of medical student education, changes in pedagogy and assessment, and the expansion of medical education to distributed models and regional campuses.The authors observe that the reports from the 128 schools illustrate that medical student education has undergone and continues to undergo substantive change, has advanced markedly since the reforms stimulated by the Flexner Report, and has continued to evolve during the past decade. The reports illustrate the strength of support for the educational programs, even in a time of financial constraints, and the increasing recognition of the scholarly contributions of faculty through teaching. The authors provide examples of the changes in pedagogy and new topics in the required curriculum in the past decade and describe selected highlights of the 128 educational programs.

A healthy lifestyle is fundamental for the prevention and treatment of cardiovascular disease and other noncommunicable diseases (NCDs). Investment in primary prevention, including modification of health risk behaviors, could result in a 4-fold improvement in health outcomes compared with secondary prevention based on pharmacological treatment. The American Heart Association (AHA) emphasized the importance of lifestyle in its 2020 goals for cardiovascular health promotion and disease reduction. In addition to defining “cardiovascular health” based on criteria for blood pressure and biochemical markers (lipids and glycemia), the AHA Strategic Planning Committee further identified lifestyle characteristics of central importance: nutrition, physical activity, smoking, and maintenance of a healthy body weight.1 The World Health Organization estimated that ≈80% of NCDs could be prevented if 4 key lifestyle practices were followed: a healthy diet, being physically active, avoidance of tobacco, and alcohol intake in moderation.2 To support healthy lifestyle initiatives, major changes are necessary at the societal level to improve population health. Numerous strategies might help to create a culture that promotes and facilitates healthy behaviors, including creating laws and regulations, mounting large-scale public awareness and education campaigns, implementing local community programs, and providing individual counseling.3 Physicians are uniquely positioned to encourage individuals to adopt healthy lifestyle behaviors: Approximately 80% of Americans visit their primary care physician at least once a year. Physicians directly communicate with their patients during clinical encounters across numerous settings, and research indicates that patients highly value recommendations provided by their physicians.4,5 However, data further indicate that lifestyle counseling does not routinely occur in physicians’ offices, thereby representing a lost opportunity. Physicians report that they perform lifestyle counseling during ≈34% of clinic visits.4 Patients, in turn, report an even lower frequency of physician lifestyle counseling. For example, obese patients reported receiving physical activity and …

Studies reveal that 44.5% of abstracts presented at national meetings are subsequently published in indexed journals, with lower rates for abstracts of medical education scholarship. We sought to determine whether the quality of medical education abstracts is associated with subsequent publication in indexed journals, and to compare the quality of medical education abstracts presented as scientific abstracts versus innovations in medical education (IME). Retrospective cohort study. Medical education abstracts presented at the Society of General Internal Medicine (SGIM) 2009 annual meeting. Publication rates were measured using database searches for full-text publications through December 2013. Quality was assessed using the validated Medical Education Research Study Quality Instrument (MERSQI). Overall, 64 (44%) medical education abstracts presented at the 2009 SGIM annual meeting were subsequently published in indexed medical journals. The MERSQI demonstrated good inter-rater reliability (intraclass correlation range, 0.77-1.00) for grading the quality of medical education abstracts. MERSQI scores were higher for published versus unpublished abstracts (9.59 vs. 8.81, p = 0.03). Abstracts with a MERSQI score of 10 or greater were more likely to be published (OR 3.18, 95% CI 1.47-6.89, p = 0.003). ). MERSQI scores were higher for scientific versus IME abstracts (9.88 vs. 8.31, p < 0.001). Publication rates were higher for scientific abstracts (42 [66%] vs. 37 [46%], p = 0.02) and oral presentations (15 [23%] vs. 6 [8%], p = 0.01). The publication rate of medical education abstracts presented at the 2009 SGIM annual meeting was similar to reported publication rates for biomedical research abstracts, but higher than publication rates reported for medical education abstracts. MERSQI scores were associated with higher abstract publication rates, suggesting that attention to measures of quality--such as sampling, instrument validity, and data analysis--may improve the likelihood that medical education abstracts will be published.

The authors describe the impact of the Title VII, Section 747 Training in Primary Care Medicine and Dentistry (Title VII) grant program on the development, growth, and expansion of general and pediatric dentistry residency programs in the United States. They first briefly review the legislative history of the Title VII program as it pertains to dental education, followed by a historical overview of dental education in the United States, including a description of the differences between dental and medical education and the routes to professional practice. The authors then present an extensive assessment of the role of the Title VII grant program in building general and pediatric dental training capacity, diversifying the dental workforce, providing outreach and service to underserved and vulnerable populations, stimulating innovations in dental education, and engaging collaborative and interdisciplinary training with medicine. Finally, the authors call for broadening the scope of the Title VII program to allow for predoctoral training (dental student education) and faculty development in general and pediatric dentistry. In doing so, the Title VII program can more effectively address current and future challenges in dental education, dentist workforce, and disparities in oral health and access to care.This article is part of a theme issue of Academic Medicine on the Title VII health professions training programs.