Medical School Administrators Research Articles

Educational Exhibit Abstract No. 429 - ■ FEATURED POSTER Time for an intervention? The current state of medical student interventional radiology education

Learning Objectives What is the current state of IR education in medical schools? What trends exist in IR education and how can these trends focus future efforts of IR student education? Background Many have evaluated medical student understanding and perceptions of IR. However, to our knowledge, there has never been a national U.S. survey that assessed the status of IR education on the medical student level. In 2011, members of the IR Medical Student Council (IRMSC), which is housed under the Student and Resident Committee of SIR, sent separate electronic surveys to medical school students and administrators across the U.S. Three reminder surveys were sent with the collection period lasting from 9/2011-2/2012. Clinical Findings/Procedure Details A total of 49 responses were obtained from medical students (n=25) and administrators (n=24) representing 44 unique institutions. Of these responders, 85% (42/49) stated they had a radiology interest group whereas only 12% (6/49) stated they had an IR interest group (IRIG). Moreover, only 24% (12/49) said there is pre-clinical (MSI-II) exposure to IR. Only 8% (2/24) of administrators claimed clinical (MSIII-IV) requirements in IR education. Additionally, 96% (24/25) of students stated that an IR website would be informative. Conclusion and/or Teaching Points There is a paucity of IR-related education at the medical student level. The discordance in the prevalence of the two interest groups and lack of required clinical exposure suggest two areas on which to focus future efforts. The IRMSC is actively forming new IRIGs at institutions around the country. Members are also developing an IR website and Facebook page to meet the demands of the 96% of students who said such a resource would be informative. In addition, with such little IR exposure in the pre-clinical setting, Council members have recruited IRs to give lectures ranging from anatomy to hosting ultrasound-guided procedure workshops. It is important to continue such collaboration in order to ensure an efficient transition between identifying ways to increase IR exposure on the medical school campus and implementing these ideas into tangible educational resources.

Exposure to, Understanding of, and Interest in Interventional Radiology in American Medical Students

The purposes of this study were to determine the degree to which medical students are exposed to interventional radiology (IR) in medical school, to assess their knowledge of the field, and to gauge their interest in IR as a career choice. An institutional review board-approved survey was generated using the website www.surveymonkey.com. Medical student participation nationwide was elicited by sending e-mails to administrators of medical schools and radiology residency program directors and asking them to distribute the survey link to their students. Seven hundred twenty-nine medical students from 21 states responded to the survey. Although 58% of students said they were interested in a hands-on career, only 5.5% of students said they had participated in an IR rotation and only 12.7% were interested in IR. Less than half of the IR domain-related questions used to assess understanding of IR were answered correctly, with greater understanding found among the students who had participated in an IR rotation. Exposure to IR in accredited US medical education programs is inconsistent, although interest in the field is moderate among medical students compared with interest in other hands-on specialties. Understanding of IR is limited among the study population. Improved understanding of the field and recruitment could result from greater exposure.

The advantages of virtual microscopy for teaching histology

The use of high resolution scanned digital images, which can be stored in virtual archives on local or distant servers, has resulted in novel approaches in e-learning (both in the classroom and also for distance learning) [1]. This is leading to major changes in the way practical histology and histopathology classes are taught. After an initial investment in the scanning stage microscope and associated software and servers, the financial and administrative advantages allow enormous economic savings in the long-term with regard to equipment, technical staff and laboratory facilities. There is no longer a need for individual student microscopes, for technical staff for microscope maintenance or repair or worries about the loss of valuable specimens. There is no longer a need for individual slide sets or to prepare new slides. It is a win-win situation that medical school administrators, teachers and students appreciate and which has led to widespread adoption of virtual microscopy systems in the life sciences. Students today, are all highly computer competent, and greatly appreciate the advantages of the virtual microscopy systems. If the virtual histology archive is web-based (and not just on a local server) then students can access the laboratory material at any time, day or night, prepare assignments and prepare for examinations. The virtual microscopy systems are ideal for computerized examinations of histology and histopathology material. The lecture will deal with the various hardware options (light microscope scanning stage systems), commercial software for e-learning, problems of copyright, and also the establishment of national repositories for virtual image archives. A description will be presented of the experience of introducing a virtual microscopy system in the Faculty of Medicine in Haifa, where some 450 of the most outstanding histology slides have been scanned and placed on the virtual microscopy archive and made available for students. In addition to e-learning, establishment of a virtual microscopy system allows telepathology, storage of histopathology archives especially in hospital environments including tissue array images, automated diagnostics of specific diseases, and quantitative image analysis. It is likely that in the coming decade all medical and nursing teaching units will move to virtual microscopy. This is an inevitable process and it is important to understand the advantages and disadvantages before taking decisions on the specific system to be adopted.

Straight talk with...Joel Kupersmith

The US Department of Veteran Affairs (VA) last month announced plans to expand its Million Veteran Program, a massive data collection effort launched earlier this year, to all 109 of the agency's research-equipped medical centers across the country. Leading the charge is Joel Kupersmith, the Veterans Health Administration's chief research and development officer. As the effort ramps up, Elie Dolgin spoke to Kupersmith to learn what sets VA medical and prosthetic research apart from other biomedical research in the country. The US Department of Veteran Affairs (VA) last month announced plans to expand its Million Veteran Program, a massive data collection effort launched earlier this year, to all 109 of the agency's research-equipped medical centers across the country. Over the next five to seven years, investigators plan to collect DNA samples from former service personnel who volunteer for the program and link the genetic data to the VA's nationwide electronic medical record. With the goal of a million participants, the VA hopes to create the world's largest research database of genetic, military exposure and health information. Leading the charge is Joel Kupersmith, the Veterans Health Administration's chief research and development officer. A cardiology researcher, former medical school administrator and Navy veteran from the Vietnam era, Kupersmith joined the VA in 2005 with a mission: to improve the way clinical research is done. To that end, Kupersmith has helped create a central institutional review board (IRB), overseen an increase in research related to the Iraq and Afghanistan conflicts, cut bureaucratic red tape at the agency and launched a major genomics initiative that includes the Million Veteran Program. As the effort ramps up, Elie Dolgin spoke to Kupersmith to learn what sets VA medical and prosthetic research apart from other biomedical research in the country.

Transfusion medicine in American undergraduate medical education

Blood transfusion is the most common procedure performed in American hospitals, and transfusions are commonly ordered by physicians without formal training in transfusion medicine. Several transfusion medicine curricula have been proposed, including those developed through the Transfusion Medicine Academic Awards (TMAA). To our knowledge, no comprehensive study has assessed how transfusion medicine is incorporated into undergraduate medical education. We conducted an online survey to determine the manner in which transfusion medicine is incorporated into American undergraduate medical education. The survey was e-mailed to administrators of medical education at all of the 129 American medical schools accredited by the Association of American Medical Colleges. Eighty-six (67%) of the 129 identified medical school administrators responded. Seventy-one (83%) of the 86 administrators reported that their undergraduate medical education curriculum provides didactic lectures in transfusion medicine, with 48% of medical schools providing 1 or 2 hours of lecture-based instruction. A minority reported small group sessions devoted to transfusion medicine topics. While a slim majority reported the availability of transfusion medicine electives, only one of 84 administrators reported that such a rotation is required. Seventy-six of 83 (92%) administrators were unfamiliar with either the 1989 or the 1995 TMAA transfusion medicine curricula. Transfusion medicine content in American undergraduate medical education is variable and the influence of the TMAA program on contemporary medical school curricula is questionable. Future efforts in this area should focus on standardizing and improving undergraduate medical education in transfusion medicine.

Developing a Research-Focused Learning Community at One Medical School

This report describes the development of a research-focused learning community at Wright State University Boonshoft School of Medicine in Dayton, Ohio (USA). At its outset, the collaboration among students, faculty, and administrators was not perceived to be a learning community. It formed around the goal of helping students to find faculty research mentors for student-initiated elective courses and extracurricular projects. It brought together peer-based academic support efforts and student services provided by the medical school administration. Over time it developed into a series of meetings, lectures, workshops, and symposia where students and faculty could discuss research and career issues in professional settings. In the past year, the collaboration was named the Research Learning Community (RLC) as the organizing principle for two new student research elective courses. With its emphasis on research experiences for students, the RLC represents a new application of a learning community model at a medical school, and it suggests promising directions for educational research about student and faculty engagement in the learning environments.

The role of the medical students in influenza pandemic response

Objectives: To better define the role of the medical students in the event of a disaster requiring a surge response in healthcare systems.Setting: The University of Michigan Medical School and Health System, where staffing plans for a pandemic flu were actively taking place.Subjects: All medical students at the University of Michigan.Interventions: The authors surveyed medical students to evaluate how they felt they could contribute during a pandemic flu.Results: Of the students who completed the survey, 88 percent of the respondents felt that students should formally be incorporated into the health system’s staffing plan during a pandemic. This survey further identified the specific patient care tasks that students felt comfortable performing, which may be of value to medical school and hospital administration that are considering inclusion of medical students into their pandemic planning.Conclusions: There should be formal inclusion of medical students into health systems’ staffing plans in the case of pandemic flu, as they are valuable first responders who are both willing and able to participate in the pandemic response.

Effect of civil war on medical education in Liberia

BackgroundFrom 1980 to 2003 Liberia entered into a period of conflict and civil wars. During this time Liberia's health and educational services were severely disrupted. Equipment and supplies were stolen from the Medical School and the buildings damaged severely. A majority of health care workers, university faculty, and hospital and medical school administrators fled the country.ObjectiveThe objective of this study was to evaluate the impact of civil war on the training of medical students and physicians, and to identify a feasible intervention.MethodsThe authors compiled data from three sources at an Emergency Medicine symposium held at the A.M. Dogliotti School of Medicine, in Monrovia, Liberia, in September 2007. These were (1) data from 13 anonymous surveys completed by symposium participants who were physicians or physicians in training, and (2) answers from six open discussion groups at the symposium concerning perceived barriers to medical training. (3) Supporting documents volunteered by the Dean from interviews in 2002, 2007 and 2009 or published on line in 2002 and 2006 were incorporated, and a focused literature review was performed.ResultsThe 12 medical students and 1 physician who returned completed surveys and attended the symposium all reported a delay in their training, with 75% of respondents citing a past and current lack of Clinical and Basic Science faculty as a major delaying factor. The six open discussion groups at the symposium and the information provided by the Dean substantiated these findings.ConclusionsVolunteer Basic Science and Clinical faculty for the medical school and teaching hospitals from a coalition of concerned partnering institutions would be a targeted intervention to assist in re-building the medical educational capacity of Liberia.

Facilitators and Barriers to Adopting Robotic-Assisted Surgery: Contextualizing the Unified Theory of Acceptance and Use of Technology

Robotic-assisted surgical techniques are not yet well established among surgeon practice groups beyond a few surgical subspecialties. To help identify the facilitators and barriers to their adoption, this belief-elicitation study contextualized and supplemented constructs of the unified theory of acceptance and use of technology (UTAUT) in robotic-assisted surgery. Semi-structured individual interviews were conducted with 21 surgeons comprising two groups: users and nonusers. The main facilitators to adoption were Perceived Usefulness and Facilitating Conditions among both users and nonusers, followed by Attitude Toward Using Technology among users and Extrinsic Motivation among nonusers. The three main barriers to adoption for both users and nonusers were Perceived Ease of Use and Complexity, Perceived Usefulness, and Perceived Behavioral Control. This study's findings can assist surgeons, hospital and medical school administrators, and other policy makers on the proper adoption of robotic-assisted surgery and can guide future research on the development of theories and framing of hypotheses.

Factors influencing choice of paediatrics as a career among medical students at the University of Nairobi, Kenya

Objective. We aimed to determine factors influencing choice of a career in paediatrics by medical students in Kenya. Methods. A cross-sectional survey of 450 medical students from the University of Nairobi, Kenya, was undertaken using a questionnaire designed to assess their preferences with regard to future specialisation, and timing of and factors influencing this choice. The data were analysed using the Statistical Package for Social Sciences. Results. The response rate was 385/450 (85.6%). Paediatrics was the second most preferred specialty after surgery, and was chosen by 50 students (13.0%). Female students were five times more likely than males to select paediatrics. Choice of paediatrics as a career was mainly determined by perceived intellectual challenge, presence of a role model, and ease of combining a career with raising a family. Those who had completed a clerkship in the specialty reported that they were encouraged by the teaching and clinical staff ( p =0.006), but found the specialty less prestigious than others ( p =0.030). None of the male students but 12 of the female students (30%) considered gender distribution to be a factor influencing their career choice ( p =0.046). Conclusion. This study indicates that paediatrics is popular among female students and that several factors influence choice of this specialty. Understanding these factors may help medical school administrators and faculty plan future recruitment strategies.

Singapore and the Nanyang Technological University—A young country with a young university on the move

Singapore is a unique environment for research and one that has become a global phenomenon and model for a country truly embracing the concept of the knowledge-based economy. Over the first 10 years of the 21st century, Singapore has advanced into the “Ivy League” of research by a sustained and high investment in research both in government research institutes, notably those of the Agency for Science, Technology, and Research A Star , and in the university sector. Unusually, for a country with its population of approximately 4.5 million, there are only four universities in Singapore with one only very recently established with two of these being very major and successful institutions, of which Nanyang Technological University NTU is one. It is a relatively young university still undergoing rapid evolution and development, yet has consistently been ranked among the top 100 universities worldwide. In the most established ranking system for universities that of the Quacquarelli Symonds World University Rankings , there are no younger universities in the top 100 category. It was originally founded in 1955 as a privately funded university Nanyang University teaching in Chinese and was the only such institution outside China and Taiwan. It aimed at serving the Chinese diaspora in South East Asia and it still retains strong links in China itself. Nanyang University was merged with the University of Singapore in 1980 to form the National University of Singapore NUS —the other major tertiary level institution—and in 1981, it was reformed as the Nanyang Technological Institute with the objective of providing training and education of engineering manpower and with the medium of instruction being English, the language of government and business in Singapore. It became a fully fledged university with its own charter in 1991. Since then, NTU has moved consistently and rapidly into the top echelon of high performing research intensive universities, especially during the 2000s Fig. 1 . Over the recent past, it has become a much more comprehensive university but still with engineering at its core and, indeed, engineering in all its guises remains two-thirds of the institution. As such, it is probably the world’s largest engineering-based institution on a single campus. Its route toward enlarging its portfolio started with the addition of the Nanyang Business School, now the top rated school in Singapore and also considered one of the best schools in the Asia-Pacific region. More recently, the addition of the College of Science, although new, is developing rapidly with a very international faculty, and the College of Humanities, Arts, and Social Sciences with a School of Art, Design, and Media housed in one of the university’s many iconic buildings, see Fig. 2 , Singapore’s only school of journalism, have added greatly to the educational and research opportunities at the university and provided the basis for a complex web of interdisciplinary activities. NTU includes the National Institute of Education NIE , responsible for the education and training of all of Singapore’s school teachers at all levels, and the Rajeratnam School of Strategic and International Studies RSIS , a graduate school and think-tank concentrating on security and, again, very highly regarded both in the region and globally. The move toward a more comprehensive institution will be completed following Prime Minister Lee’s announcement August 2010 that NTU has been entrusted with a new medical school, a joint venture offering a joint qualification with Imperial College London, which has also developed a medical school on what is a predominantly engineering base. Imperial College is now the largest medical school and hospital administrator within the British university medical system. NTU has also gained ground in other areas as we host two out of the five nationally awarded and prestigious Research Centres of Excellence RCEs —the Earth Observatory of Singapore EOS and the Singapore Centre for Environmental Life Sciences and Engineering SCELSE . The university is also a partner in one of the other RCEs— Mechanobiology—hosted at the NUS. The RCE scheme itself has promoted the rapid evolution of Singapore into the upper ranks in the world “league” of research in selected areas. For example, in 2007, top level Earth sciences hardly existed in the region, but by attracting world-leading researchers such as Kerry Sieh from California Institute of Technology Caltech Fig. 3 , Paul Tapponnier from Institut de Physique du Globe de Paris, and Chris Newhall from the U.S. Geological Survey a “dream team” of tectonicists and volcanologists , together with more than $S200 million in funding for EOS, we have leap-frogged into the premier league of Earth science research and embedded these new disciplines within the university in establishing a new division of Earth and environmental sciences.

Medical Education in the United States and Canada, 2010

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.

Program Evaluation in Medical Education: An Overview of the Utilization-focused Approach

Medical school administrators, educators, and other key personnel must often make difficult choices regarding the creation, retention, modification, or termination of the various programs that take place at their institutions. Program evaluation is a data-driven strategy to aide decision-makers in determining the most appropriate outcome for programs within their purview. The purpose of this brief article is to describe one program evaluation model, the utilization-focused approach. In particular, we address the focus of this model, the personal factor, the role of the evaluator, and the evaluation process. Based on the flexibility of this model as well as its focus on stakeholder involvement, we encourage readers to consider the utilization-focused approach when evaluating programs.

Call to Action: Medical Students for Regenerative Medicine

Medical students face a challenge with the rising tide of increasingly elderly patients. By the year 2020, people age 65 and older will outnumber children under age 5 around the globe. Additionally, by the year 2030, there will be a globally increased burden in caring for chronic noncommunicable diseases as they become the major cause for loss of health and life. As the baby boomer population begins to reach 65, elder care will become inescapable, because it will extend beyond geriatrics, pervading every medical discipline and specialty. Doctors and students alike find treating age-related degeneration to be a losing battle because existing methods cannot effectively defer the constant barrage from causative agents, a failure that ultimately results in recurrence and advancement of original and secondary afflictions. The causes of such morbidity are multifactorial and a consequence of healthy metabolism that result in an age-related degeneration. This renders the conditions impervious to the traditional prevention and curative approaches. A regenerative medicine approach to age-related degenerative disease is uniquely positioned to meet this situation because it is based around repair of damage, rather than direct intervention in highly complex metabolic processes. Here, the authors promote regenerative medicine as a prospective approach to age-related degenerative disease that is outside the limits of preventive and curative therapies that currently dominate the medical curriculum. Regenerative medicine therapies present the potential to provide care without increasing frailty, thus serving the medical ideal of restoring health rather than protracting decline. Such an approach has yet to be sufficiently impressed upon the ranks of the current medical student cohort, which is largely unaware of the demographic realities facing their careers. It is important that medical school administrators and students recognize the vast potential in regenerative medicine and actively facilitate the development and distribution of such knowledge among the medical education community. Acknowledging the need for therapies focused on aging demographics is not new. Despite decades of research in the basic science of medicine, the curative model of disease has shown itself ineffective at restoring population health. While single-factor diseases were cured with antibiotics or vaccines, such approaches have not had success when applied to multifactorial conditions such as age-related degenerative diseases. In lieu of cures, the management of degenerative disease has successfully reduced symptoms and suffering. However, disease management fails to address the underlying conditions and ultimately promotes extended morbidity, suffering, and costs. The alternative approach has been prevention. Although prevention does slow the onset of frailty by laudably attending to the underlying causes of degeneration, it does not prevent nor reverse the pathology. For senior patients presenting with such disease, many of whom having eschewed prevention in favor of the curative approaches, prevention is simply too late. Medical students must continue to promote prevention while simultaneously focusing on ways to target the damage of age-related degeneration, rather than simply continuing to manage the frail state. Emerging biotechnology does indeed give us reason to be optimistic about cures. Paradoxically, the staggering nature of our advances in understanding may represent a complexity trap. It is tempting to predict reductions in morbidity and mortality based on the genomics revolution to be commensurate with the development of antibiotics and vaccines. However, those tools were used against diseases caused by single factors. Age-related degenerative diseases are multifactorial conditions caused by a host of different genes and environmental factors that are deeply rooted within healthy metabolism. Ironically, as our technology peers ever deeper into the root causes, we may be discovering our own impotence in the face of an intractably complicated metabolism. Rather than being confident with such novel discoveries as RNA interference and the role of epigenetics, their detection should caution that we are still only scratching the surface of metabolic realities. Because cures depend on the extent to which we understand metabolism, optimism toward such curative efforts may be misplaced. The question for medical students centers on how we can target age-related degeneration in a way that improves health span. Such an approach would intervene after the appearance of signs and symptoms, but before sufficient damage has accumulated to tip the patient into overwhelming system decline; regenerative medicine is such an approach. Regenerative medicine can be applied when prevention is too late, and it sidesteps the metabolic complexity that may waylay the curative approach. Regenerative medicine therapies focus on repairing injured, lost, or aging cells in the human body and aim to restore the structure and function of tissues and organs. Disease treatment and function

The National Evaluation of Senior Mentor Programs: Older Adults in Medical Education

To identify models for senior mentor programs (SMPs), critical factors in program development, achievement of goals and objectives, effect on medical school environment, and future of programs. Ten SMPs were systematically selected to represent a variety of medical schools, geographic regions, and program types. The National Senior Mentor Program Evaluation relied upon archived data within the programs and new data collected during site visits. Archived data included internally conducted program evaluations, student course evaluations, and survey and focus group results. Site visit data were collected from key informant interviews with program staff and faculty, medical school leadership and students, and older adults serving as mentors. Ten U.S. medical schools with SMPs. Evaluation participants at each site included program faculty, key medical school administrators, participating students, and mentors. Program evaluation. All 10 programs demonstrated a positive effect on student attitudes toward older adults. Student acceptance of the programs was strong, and mentor acceptance and support were extraordinary. Eight of the 10 programs were operating in 2008 and having considerable effect on medical school environments. Most of the operating programs expect to be continuing for 5 or more years into the future. The findings of the national evaluation point toward continuation and likely growth of the senior mentor phenomenon in U.S. medical education.

Diversity in academic medicine no. 1 case for minority faculty development today

For the past 20 years, the percentage of the American population consisting of nonwhite minorities has been steadily increasing. By 2050, these nonwhite minorities, taken together, are expected to become the majority. Meanwhile, despite almost 50 years of efforts to increase the representation of minorities in the healthcare professions, such representation remains grossly deficient. Among the underrepresented minorities are African and Hispanic Americans; Native Americans, Alaskans, and Pacific Islanders (including Hawaiians); and certain Asians (including Hmong, Vietnamese, and Cambodians). The underrepresentation of underrepresented minorities in the healthcare professions has a profoundly negative effect on public health, including serious racial and ethnic health disparities. These can be reduced only by increased recruitment and development of both underrepresented minority medical students and underrepresented minority medical school administrators and faculty. Underrepresented minority faculty development is deterred by barriers resulting from years of systematic segregation, discrimination, tradition, culture, and elitism in academic medicine. If these barriers can be overcome, the rewards will be great: improvements in public health, an expansion of the contemporary medical research agenda, and improvements in the teaching of both underrepresented minority and non-underrepresented minority students.

Still Marching In A White Coat

White Coat, Clenched Fist, first published in 1976, has now been rededicated by author Fitzhugh Mullan to a new generation of healers, instructing them to question, challenge, and change. It is in this spirit that Mullan, a professor of medicine and health policy at the George Washington University in Washington, D.C., arrived to medicine and continued through his remarkable career. His story, which he originally wrote as a guide for radical health activism and medical education reform, is that of a compassionate young physician deeply concerned about social injustices and a broken health care system. Mullan states that the book’s current edition retains those purposes, with added historical perspective and legacy as grounds for change. The story begins in rural Mississippi, with Mullan, a young white medical student and Civil Rights volunteer, defending a church alongside poor black farmers. After growing dissatisfied with the lack of creativity and humanity in the anatomy lab, and questioning the relevance of the preclinical years of the medical school curriculum, Mullan found in the life in the woods of Mississippi an opportunity “to escape the intellectual and spiritual oppression” for at least one summer. Despite their cultural differences, Mullan was inspired by the people he met in Mississippi and touched by their real-life struggles. There he appreciated the relevance of being a doctor: the poor and disenfranchised could use what he had to offer clinically and politically. Following his summer Civil Rights work, Mullan returned to medical school motivated to confront the medical establishment. His involvement started by supporting a fellow student in his refusal to shave off his beard upon starting clinical rotations as was demanded by the medical school administration; and continued with the formation of the Student Health Organization (SHO). With a focus on community work, critical student publications, and curriculum reform at health professional schools, the SHO brought together likeminded students excited to effect change. During the five-year experience with the SHO, Mullan and others defined their role as physicians as agents of social and political change. However, the organization’s demise was also an early realization that lack of cohesiveness impairs our strength to mobilize such change. In the next few chapters of the book, Mullan discusses his continued efforts to change the health care system, addressing the exploitation of house officers and the use of city hospitals’ patients for the purpose of teaching physicians in training. For his internship site, he chose Jacobi Hospital, a city hospital in the Bronx, New York. Although he appreciated the great learning opportunities and human contact at Jacobi, Mullan became a voice of criticism of the clash between medical schools, which run public hospitals, and the communities, whose residents use those public hospitals. Through the narratives about his time at Jacobi, Mullan describes the irony of using poor public hospitals to train physicians B o o k R e v i e w s

Sexual medicine training: Is a department of sexual medicine feasible?

Sexual medicine physician education and patient care is needed. The establishment of departments of sexual medicine, certified fellowships, and approved residency programs would offer patient care, research, and education. The goal is to establish multidisciplinary departments of sexual medicine. Following the pattern used in sleep medicine, a new multidisciplinary department in sexual medicine would allow for improved diagnosis and treatment of sexual dysfunction and training of residents and fellows. There is a need for departments in the field of sexual medicine, and therefore, they are fiscally viable. However, there is a paucity of research funds. A department would need the support of the medical school or hospital administration. Medical education, basic science, and clinical research can provide improved and more accessible patient care. Departments of sexual medicine are needed to provide the physician education and patient care.

A section devoted to profiles of renowned teachers and to the recognition and accomplishments of physiology teachers within the society

A section devoted to profiles of renowned teachers and to the recognition and accomplishments of physiology teachers within the society

Doctor, Do You Have A Minute? The Dilemma Posed by Physician Interaction with the Pharmaceutical Industry

Doctor, Do You Have A Minute? The Dilemma Posed by Physician Interaction with the Pharmaceutical Industry