American Medical Students Research Articles

International study of medical school learning environments and their relationship with student well-being and empathy.

To assess whether favourable perceptions of the learning environment (LE) were associated with better quality of life, less burnout and more empathy across three undergraduate medical education programmes in Israel, Malaysia and China. Cross-sectional surveys were administered at the end of the 2013-2014 academic year at three medical schools: Technion American Medical Students Program (TAMS) in Israel, Perdana University-Royal College of Surgeons in Ireland School of Medicine (PURCSI) in Malaysia and Peking Union Medical College (PUMC) in China. LE perceptions were assessed using the Johns Hopkins Learning Environment Scale (JHLES). Well-being was assessed using validated items for quality of life and the depersonalisation and emotional exhaustion domains of burnout. The 20-item Jefferson Empathy Scale assessed empathy. Statistical analyses included bivariate regressions and multivariate regressions that adjusted for gender, school, class year and perceived academic rank. Overall, 400/622 (64.3%) students responded, with the following rates by site: TAMS 92/121 (76.0%), PURCSI 160/198 (80.1%) and PUMC 148/303 (48.8%). In multivariate models, favourable overall LE perceptions were associated with higher odds of good quality of life (odds ratio [OR], 3.2; 95% confidence interval [CI], 1.8-5.8; p < 0.001) and lower odds of emotional exhaustion (OR, 0.34; 95% CI, 0.24-0.50; p < 0.001) and depersonaliation (OR, 0.30; 95% CI, 0.24-0.37; p = 0.001). 'Community of Peers', one of seven factors in the JHLES, was the only one to be independently associated with better quality of life and less emotional exhaustion and depersonalisation. After adjusting for covariates, there was not a statistically significant association between overall LE and empathy (OR, 1.4; 95% CI, 0.91-2.2; p = 0.12). Students' LE perceptions are closely associated with their well-being, and fostering peer community may hold promise for enhancing quality of life and protecting against burnout. Across these three settings, LE and empathy were not closely related, suggesting that any influence of learning environment on empathy would be modest.

Impostor syndrome and burnout among American medical students: a pilot study.

ObjectivesTo describe levels of burnout and impostor syndrome (IS) in medical students, and to recognize demographic differences in those experiencing burnout and IS. MethodsResearch participants included 2,612 medical students who entered Jefferson Medical College between 2002 and 2012. This sample was divided into two groups: Matriculants between 2002 and 2007 (n=1,380) and between 2008 and 2012 (n=1,232). Data for 2002-2007 matriculants were subjected to EFA (principal component factor extraction), and data for matriculants of 2008-2012 were used for CFA (structural equation modeling, and root mean square error for approximation).ResultsOne hundred and thirty-eight students completed the questionnaire. Female gender was significantly associated with IS (χ2(3)=10.6, p=0.004) with more than double the percentage of females displaying IS than their male counterparts (49.4% of females versus 23.7% of males). IS was significantly associated with the burnout components of exhaustion (χ2 (2)=5.9, p=0.045), cynicism (χ2(2)=9.4, p=0.004), emotional exhaustion (χ2(2)=8.0, p=0.018), and depersonalization (χ2 (2)=10.3, p=0.006). The fourth year of medical school was significantly associated with IS (χ2(3)=10.5, p=0.015).ConclusionsAlmost a quarter of male medical students and nearly half of female students experience IS and IS was found to be significantly associated with burnout indices. Given the high psychological morbidity of these conditions, this association cannot be ignored. It behooves us to reconsider facets of medical education (i.e. shame-based learning and overall teaching style) and optimize the medical learning environment.

Screening for Sexual Dysfunction by Medical Students

IntroductionDespite the widespread effects of sexual dysfunction on health, sexual problems are not routinely addressed by physicians. Attitudes toward sexual dysfunction screening have not yet been evaluated in medical students. AimTo evaluate the frequency of screening for sexual dysfunction by medical students, their attitudes toward screening, and factors that influence whether medical students discuss sexual problems with patients. MethodsA cross-sectional study was conducted by online questionnaire. Participants were U.S. medical student members of the American Medical Student Association. Main Outcome MeasuresDemographic information, frequency of screening for sexual problems at annual examinations, importance of screening, and screening practices of role models were assessed. ResultsIn total 369 participants completed demographic information and additional questions (mean age = 26.5 ± 4.3 years, range = 21–52). Most students believed it was important to screen for sexual dysfunction (mean = 7.8 ± 2.0); however, 16.1% never screened patients. Importance and frequency of screening were correlated with how often the student's role model screened (r = 0.400, P < .001; r = 0.582, P < .001, respectively). Other significant relationships with screening importance were students interested in obstetrics and gynecology or urology (t = −2.166, P = .031), students earlier in their training (F = 3.608, P = .014), those who had observed a preceptor screen a patient (t = −2.298, P = .022), and those screened by their own clinician (t = −2.446, P = .015). Students reported increased screening frequency if they had observed any preceptor screen a patient (t = −7.678, P < .001), believed that their medical school curriculum provided enough training in screening techniques (t = −3.281, P = .001), and had themselves been screened by a clinician (t = −4.557, P < .001). There were no differences by age, sex, or religion. ConclusionMedical students do not routinely screen patients for sexual dysfunction despite believing it is in the physician's scope of practice. These results highlight the importance of role modeling and curriculum in increasing screening practices.

Near-peer teaching between Haitian and American medical students: a longitudinal evaluation of an emergency response curriculum

Welcome to Annals of Global Health,Annals of Global Health is a peer-reviewed, fully open access, online journal dedicated to publishing high quality articles dedicated to all aspects of global health. The journal's mission is to advance global health, promote research, and foster the prevention and treatment of disease worldwide. Its goals are to improve the health and well-being of all people, advance health equity, and promote wise stewardship of the earth's environment. The latest journal impact factor is 3.64.Annals of Global Health is supported by the Program for Global Public Health and the Common Good at Boston College. It was founded in 1934 by the Icahn School of Medicine at Mount Sinai as the Mount Sinai Journal of Medicine. It is a partner journal of the Consortium of Universities for Global Health. Authors of articles accepted for publication in Annals of Global Health will be asked to pay an Article Publication Charge (APC) to cover publication costs. This charge can normally be sourced from your funder or institution. We are committed to supporting authors from all countries to publish their work in Annals of Global Health regardless of national income level, and to achieve this goal, we waive the Article Publication Charge for manuscripts where all authors are from low-income or lower-middle-income countries (as defined by the World Bank). From time to time, Annals of Global Health publishes Special Collections, a series of articles organized around a common theme in global health. Recent Special Collections have included “Strengthening Women’s Leadership in Global Health”, “Decolonizing Global Health Education”, and “Capacity Building for Global Health Leadership Training”. Global health workers interested in developing a Special Collection are strongly encouraged to contact the Managing Editor in advance to discuss the project.

The updated AMSA scorecard of conflict-of-interest policies: a survey of U.S. medical schools.

BackgroundBest practices for conflict-of-interest (COI) policies in medical schools have evolved rapidly over the past decade, in part motivated by the American Medical Student Association (AMSA) scorecard that has publicly graded schools since 2007. This report describes the methodological update and impact of revisions to the scorecard in 2014.MethodsThe original AMSA scorecard (used annually from 2008 to 2013) was revised by a work group to improve its methodology and to increase the stringency of its criteria for scoring COI policies. All U.S. medical schools (both allopathic and osteopathic; n = 160) were invited to submit their COI policies to AMSA for scoring with the new scorecard; web site searches were used to acquire policy information for schools that did not submit. The authors developed a codebook and analyzed 14 distinct categories of COI policies, pertaining to activities such as industry-funded gifts, meals, educational events, site access for sales reps, and conflict-of-interest disclosure requirements. The analysis yielded four possible grades for each school: A, B, C, or I (incomplete). The authors compared 2014 grades with 2013 grades, and compared the distribution of grades of schools by type (allopathic vs. osteopathic) and geographical region.ResultsA total of 27 (16.9 %) medical schools scored A grades, indicating that their COI policies were strong, 81 (50.6 %) scored B, 25 (15.6 %) scored C and 26 (16.3 %) policies scored I. As compared to 2013, in 2014 fewer schools qualified for A grades (17.0 % vs. 26.0 %; p = 0.05). The grade distributions of allopathic and osteopathic schools were significantly different (p < 0.0001), with osteopathic schools more likely than allopathic schools to have incomplete policies. There were no significant grade differences by geographical region.ConclusionsThe revised 2014 AMSA scorecard, with its more stringent criteria for evaluating COI policies, assigned fewer As and more Bs and Cs than in years past. This was the first study to identify schools with COI policies stronger than those recommended in 2008 by the Association of American Medical Colleges. Developing more stringent COI policies should be helpful in reducing the influence of pharmaceutical and device industry marketing on both trainees and faculty in American medical schools.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-016-0725-y) contains supplementary material, which is available to authorized users.

The association between Myers-Briggs Type Indicator and Psychiatry as the specialty choice.

ObjectivesThe purpose of this pilot study is to examine the association between Myers-Briggs Type Indicator (MBTI) and prospective psychiatry residents. MethodsForty-six American medical schools were contacted and asked to participate in this study. Data were collected and an aggregated list was compiled that included the following information: date of MBTI administration, academic year, MBTI form/version, residency match information and student demographic information. The data includes 835 American medical students who completed the MBTI survey and matched into a residency training program in the United States. All analyses were performed using R 3.1.2. ResultsThe probability of an introvert matching to a psychiatry residency is no different than that of an extravert (p= 0.30). The probability of an intuitive individual matching to a psychiatry residency is no different than that of a sensing type (p=0.20). The probability of a feeling type matching to a psychiatry residency is no different than that of a thinking type (p= 0.50). The probability of a perceiving type matching to a psychiatry residency is no different than that of a judging type (p= 0.60). ConclusionsFurther analyses may elicit more accurate information regarding the personality profile of prospective psychiatry residents. The improvement in communication, team dynamics, mentor-mentee relationships and reduction in workplace conflicts are possible with the awareness of MBTI personality profiles.

Growing the 'SEAD': Expansion of the Surgical Exploration and Discovery Program

The declining popularity of surgical specialties among North American medical students has been attributed partially to limited early exposure and minimal involvement of surgeons in preclerkship education; in response, the Surgical Exploration and Discovery (SEAD) program was developed at the University of Toronto in 2012. SEAD is a 2-week curriculum that provides first-year medical students comprehensive exposure to surgical specialties through operating room observerships, simulation workshops, and career discussions. This study is the first to examine implementation of the SEAD program at another site. This prospective cohort study evaluated the effectiveness of the SEAD program in improving surgical knowledge and facilitating career decision making when compared with a control group. In all, 18 students participated in the SEAD program, and 18 students from the same class read only the program's instructional manual; both the groups completed multiple-choice tests and questionnaires at baseline and at completion to assess knowledge acquisition and career-related learning. Both the groups significantly improved their surgical knowledge, but there was no difference between groups. SEAD participants made significantly greater progress in refining their career decisions when compared with the control group; all but one SEAD participant either gained interest in or ruled out a surgical specialty as a potential career choice compared with only 10 of the participants reading the manual only. The SEAD program provides a meaningful opportunity for medical students to explore surgical careers during preclerkship and to make better-informed career decisions. This expansion demonstrates that the program can be successfully reproduced at another institution.

Medical Schools' Industry Interaction Policies Not Associated With Trainees' Self-Reported Behavior as Residents: Results of a National Survey.

Medical students attending schools with policies limiting industry/student interactions report fewer relationships with pharmaceutical representatives. To investigate whether associations between students' medical school policies and their more limited industry interaction behaviors persist into residency. We randomly sampled 1800 third-year residents who graduated from 120 allopathic US-based medical schools, using the American Medical Association Physician Masterfile. We surveyed them in 2011 to determine self-reported behavior and preferences for brand-name prescriptions, and we calculated the strength of their medical schools' industry interaction policies using the 2008 American Medical Student Association and Institute on Medicine as a Profession databases. We used logistic regression to estimate the association between strength of school policies and residents' behaviors with adjustments for class size, postresidency career plan, and concern about medical school debt. We achieved a 44% survey response rate (n = 739). Residents who graduated from schools with restrictive policies were no more or less likely to accept industry gifts or industry-sponsored meals, speak with marketing representative about drug products, attend industry-sponsored lectures, or prefer brand-name medications than residents who graduated from schools with less restrictive policies. Residents who correctly answered evidence-based prescription questions were about 30% less likely to have attended industry-sponsored lectures (OR = 0.72, 95% CI 0.56-0.98). Any effect that medical school industry interaction policies had on insulating students from pharmaceutical marketing did not persist in the behavior of residents in our sample. This suggests that residency training environments are important in influencing behavior.

The Impact of Everyday Discrimination and Racial Identity Centrality on African American Medical Student Well-Being: a Report from the Medical Student CHANGE Study.

Positive psychological well-being is an important predictor of and contributor to medical student success. Previous work showed that first-year African American medical students whose self-concept was highly linked to their race (high racial identity centrality) were at greater risk for poor well-being. The current study extends this work by examining (a) whether the psychological impact of racial discrimination on well-being depends on African American medical students' racial identity centrality and (b) whether this process is explained by how accepted students feel in medical school. This study used baseline data from the Medical Student Cognitive Habits and Growth Evaluation (CHANGE) Study, a large national longitudinal cohort study of 4732 medical students at 49 medical schools in the USA (n=243). Regression analyses were conducted to test whether medical student acceptance mediated an interactive effect of discrimination and racial identity centrality on self-esteem and well-being. Both racial identity centrality and everyday discrimination were associated with negative outcomes for first-year African American medical students. Among participants who experienced higher, but not lower, levels of everyday discrimination, racial identity centrality was associated with negative outcomes. When everyday discrimination was high, but not low, racial identity was negatively related to perceived acceptance in medical school, and this in turn was related to increased negative outcomes. Our results suggest that discrimination may be particularly harmful for African American students who perceive their race to be central to their personal identity. Additionally, our findings speak to the need for institutional change that includes commitment and action towards inclusivity and the elimination of structural racism.

Academic and Post-Graduate Performance of African American Medical Students by Category of Premed Institution: Historically Black vs. Predominantly White Institutions

African American (AA) physicians are more likely to practice primary care and care for underserved populations than majority physicians, yet remain underrep-resented in medicine. Because Historically Black Colleges and Universities (HBCUs) have a legacy of matriculating students with lower standardized test scores, majority medical schools may be reluctant to form pipelines with HBCUs. We compared academic and postgraduate performance of two groups of AA students at The Ohio State University College of Medicine: HBCU versus Predominantly White Institutions (PWI) graduates. We identified 212 AA matriculants between 1992 and 2007. Group 1 (N=39) were HBCU graduates, Group 2 (N=173) were PWI graduates. We compared MCAT scores, medical school, and post-graduate performance. Despite lower average MCAT scores, groups did not differ significantly in terms of graduating, matching into residencies, selecting primary care, or achieving board certification. Majority medical schools should consider forming strong recruitment pipelines with HBCUs.

Global Surgery Fellowship: A model for surgical care and education in resource-poor countries

Background/PurposeSurgical diseases have recently been shown to be a major cause of global morbidity and mortality. Effective methods to decrease the burden of surgical disease and provide care in resource-poor settings are unknown. An opportunity to meet this need exists through collaborative efforts to train local surgeons in specialty care, such as pediatric general surgery. MethodsWe present a novel model for the provision of surgical care and education in a resource-poor setting via a collaborative Global Surgery Fellowship program. Through Partners in Health in Haiti, this program placed a fully trained pediatric surgeon at an established rural hospital, both to temporarily serve that community and to teach local surgeons pediatric surgical care. ResultsThe Global Surgery Fellow performed the cases presented here during his term, between July 2009 and June 2010. A total of 147 operative procedures were performed on 131 patients over the course of 12weeks in Haiti. A total of 134 of the 147 total cases performed (91.2%) were educational cases, in which the Fellow operated with and trained one or more of the following: American medical students, American residents, Haitian residents, or Haitian staff surgeons. ConclusionThe Global Surgery Fellowship model overcomes many of the traditional challenges to providing adequate surgical care in resource-poor countries. Specifically, it meets the challenge of providing a broad educational experience for many levels of local and foreign physicians, while working within an established locally run health care system. We believe that this model is generalizable to many resource-poor hospitals with permanent local staff that are open to collaboration.

Racial Identity and Mental Well-Being: The Experience of African American Medical Students, A Report from the Medical Student CHANGE Study.

Diversification of the physician workforce continues to be a national priority; however, a paucity of knowledge about the medical school experience for African American medical students limits our ability to achieve this goal. Previous studies document that African American medical students are at greater risk for depression and anxiety. This study moves beyond these findings to explore the role of racial identity (the extent to which a person normatively defines her/himself with regard to race) and its relationship to well-being for African American medical students in their first year of training. This study used baseline data from the Medical Student Cognitive Habits and Growth Evaluation (CHANGE) Study; a large national longitudinal cohort study of 4732 medical students at 49 medical schools in the US racial identity for African American students (n = 301) was assessed using the centrality sub-scale of the Multidimensional Inventory of Black Identity. Generalized linear regression models with a Poisson regression family distribution were used to estimate the relative risks of depression, anxiety, and perceived stress. First year African American medical students who had lower levels of racial identity were less likely to experience depressive and anxiety symptoms in their first year of medical school. After controlling for other important social predictors of poor mental health (gender and SES), this finding remained significant. Results increase knowledge about the role of race as a core part of an individual's self-concept. These findings provide new insight into the relationship between racial identity and psychological distress, particularly with respect to a group of high-achieving young adults.

A Systematic Approach to Developing A Global Surgery Elective

Interest in global health has been increasing for years among American residents and medical students. Many residency programs have developed global health tracks or electives in response to this need. Our goal was to create a global surgery elective based on a synergistic partnership between our institution and a hospital in the developing world. We created a business plan and 1-year schedule for researching potential sites and completing a pilot rotation at our selected hospital. We administered a survey to general surgery residents at the University of Cincinnati and visited medical facilities in Sierra Leone, Cameroon, and Malawi. The survey was given to all general surgery residents. A resident and a faculty member executed the fact-finding trip as well as the pilot rotation. Our general surgery residents view an international elective as integral to residency training and would participate in such an elective. After investigating 6 hospitals in sub-Saharan Africa, we conducted a pilot rotation at our selected hospital and gained the necessary information to organize a curriculum. We will begin sending senior residents for 8-week rotations in the coming academic year. By systematically approaching the process of creating a global surgery elective, we were able to gain considerable insight into choosing a location and organizing the elective.

Mental Well-Being in First Year Medical Students: A Comparison by Race and Gender: A Report from the Medical Student CHANGE Study.

In this study, authors sought to characterize race and gender disparities in mental health in a national sample of first year medical students early in their medical school experience. This study used cross-sectional baseline data of Medical Student CHANGES, a large national longitudinal study of a cohort of medical students surveyed in the winter of 2010. Authors ascertained respondents via the American Association of Medical Colleges questionnaire, a third-party vendor-compiled list, and referral sampling. A total of 4732 first year medical students completed the baseline survey; of these, 301 were African American and 2890 were White. Compared to White students and after adjusting for relevant covariates, African American students had a greater risk of being classified as having depressive (relative risk (RR)=1.59 [95 % confidence interval, 1.37-2.40]) and anxiety symptoms (RR=1.66 [1.08-2.71]). Women also had a greater risk of being classified as having depressive (RR=1.36 [1.07-1.63]) and anxiety symptoms (RR-1.95 [1.39-2.84]). At the start of their first year of medical school, African American and female medical students were at a higher risk for depressive symptoms and anxiety than their White and male counterparts, respectively. The findings of this study have practical implications as poor mental and overall health inhibit learning and success in medical school, and physician distress negatively affects quality of clinical care.

Lourdes: A uniquely Catholic approach to medicine.

As an American medical student, I spent the summer break between my first and second year in Lourdes, France, the site where the Immaculate Conception appeared eighteen times to St. Bernadette in 1858 as proclaimed approved by the Catholic Church and whose water is associated with over seven thousand unexplained cures. During this time I volunteered with St. Joseph's Service and Poste Secour, followed several medical teams taking care of large pilgrim groups, and shadowed Dr. Alessandro de Franciscis the president of Le Bureau des Constations Médicales, the office in Lourdes charged with investigating claims of miracles. Through my experiences, I found the mission of medicine in Lourdes to be twofold: to provide the critical care needed to give sick persons the chance to transform their experience of disease through their faith; and secondly, through the efforts of the Medical Bureau, to be an instrument by which we can comprehend the wonders of the work of God. I conclude that this twofold mission should inform the work of every Catholic in health care or research, and Lourdes provides the venue par excellence to cultivate this mission. Lay Summary: Lourdes is a pilgrimage site in southern France that has been associated with medical miracles for the past 150 years. The site is unique in that throughout its history, physicians, of any or no faith, have been invited to participate in the proceedings of the investigations of each claimed cure. The investigations have formalized into a process handled by the Lourdes Medical Bureau and the Lourdes International Medical Association. Travis Dichoso, an American medical student, writes about his experiences as part of this process.

Technical Knowledge, Prosocial Knowledge, and Clinical Performance of Indian Medical Students

We cross‐culturally replicated and extended findings reported by Kell, Motowidlo, Martin, Stotts, and Moreno that technical knowledge and prosocial knowledge have independent effects on performance. In a sample of 196 Indian medical students, we found that prosocial knowledge explains variance in students' clinical performance beyond the variance explained by technical knowledge and technical knowledge explains variance in clinical performance beyond the variance explained by prosocial knowledge. Contrary to findings that American medical students' prosocial inclinations, as reflected in measures of empathy, seem to decline over the course of their medical training (e.g., Hojat, Vergare, Maxwell, Brainard, Herrine, and Isenberg), we found that Indian medical students' prosocial knowledge steadily increased from their third to fifth years of medical study.

Association of medical students' reports of interactions with the pharmaceutical and medical device industries and medical school policies and characteristics: a cross-sectional study.

Professional societies use metrics to evaluate medical schools' policies regarding interactions of students and faculty with the pharmaceutical and medical device industries. We compared these metrics and determined which US medical schools' industry interaction policies were associated with student behaviors. Using survey responses from a national sample of 1,610 US medical students, we compared their reported industry interactions with their schools' American Medical Student Association (AMSA) PharmFree Scorecard and average Institute on Medicine as a Profession (IMAP) Conflicts of Interest Policy Database score. We used hierarchical logistic regression models to determine the association between policies and students' gift acceptance, interactions with marketing representatives, and perceived adequacy of faculty-industry separation. We adjusted for year in training, medical school size, and level of US National Institutes of Health (NIH) funding. We used LASSO regression models to identify specific policies associated with the outcomes. We found that IMAP and AMSA scores had similar median values (1.75 [interquartile range 1.50-2.00] versus 1.77 [1.50-2.18], adjusted to compare scores on the same scale). Scores on AMSA and IMAP shared policy dimensions were not closely correlated (gift policies, r = 0.28, 95% CI 0.11-0.44; marketing representative access policies, r = 0.51, 95% CI 0.36-0.63). Students from schools with the most stringent industry interaction policies were less likely to report receiving gifts (AMSA score, odds ratio [OR]: 0.37, 95% CI 0.19-0.72; IMAP score, OR 0.45, 95% CI 0.19-1.04) and less likely to interact with marketing representatives (AMSA score, OR 0.33, 95% CI 0.15-0.69; IMAP score, OR 0.37, 95% CI 0.14-0.95) than students from schools with the lowest ranked policy scores. The association became nonsignificant when fully adjusted for NIH funding level, whereas adjusting for year of education, size of school, and publicly versus privately funded school did not alter the association. Policies limiting gifts, meals, and speaking bureaus were associated with students reporting having not received gifts and having not interacted with marketing representatives. Policy dimensions reflecting the regulation of industry involvement in educational activities (e.g., continuing medical education, travel compensation, and scholarships) were associated with perceived separation between faculty and industry. The study is limited by potential for recall bias and the cross-sectional nature of the survey, as school curricula and industry interaction policies may have changed since the time of the survey administration and study analysis. As medical schools review policies regulating medical students' industry interactions, limitations on receipt of gifts and meals and participation of faculty in speaking bureaus should be emphasized, and policy makers should pay greater attention to less research-intensive institutions. Please see later in the article for the Editors' Summary.

American Heart Association (AHA) Basic Cardiac Life Support (BCLS) course and introduction to emergency medicine module taught by American medical students to Haitian medical students improves fund of knowledge performance and self-efficacy scores through

American Heart Association (AHA) Basic Cardiac Life Support (BCLS) course and introduction to emergency medicine module taught by American medical students to Haitian medical students improves fund of knowledge performance and self-efficacy scores through

Enhancing diversity in the public health research workforce: the research and mentorship program for future HIV vaccine scientists.

We developed and evaluated a novel National Institutes of Health-sponsored Research and Mentorship Program for African American and Hispanic medical students embedded within the international, multisite HIV Vaccine Trials Network, and explored its impact on scientific knowledge, acquired skills, and future career plans. Scholars conducted social, behavioral, clinical, or laboratory-based research projects with HIV Vaccine Trials Network investigators over 8 to 16 weeks (track 1) or 9 to 12 months (track 2). We conducted an in-depth, mixed-methods evaluation of the first 2 cohorts (2011-2013) to identify program strengths, areas for improvement, and influence on professional development. A pre-post program assessment demonstrated increases in self-reported knowledge, professional skills, and interest in future HIV vaccine research. During in-depth interviews, scholars reported that a supportive, centrally administered program; available funding; and highly involved mentors and staff were keys to the program's early success. A multicomponent, mentored research experience that engages medical students from underrepresented communities and is organized within a clinical trials network may expand the pool of diverse public health scientists. Efforts to sustain scholar interest over time and track career trajectories are warranted.

Levi Myers (1767-1822): An eighteenth century Glasgow medical graduate from South Carolina.

Levi Myers, a native of Georgetown, South Carolina, was the first Jewish medical graduate at the University of Glasgow, obtaining the MD, in 1787. Myers had been registered for studies at the University of Edinburgh for three years, from 1785/1786 to 1787/1788, after some years of training with a physician in Charleston, South Carolina. Recent studies of Jewish life in Edinburgh have revealed the evidence of a settled group of Jewish inhabitants in the city during the last quarter of the eighteenth century, during the time of Myers' sojourn in Edinburgh and thirty years before the formal inauguration of Scotland's first Jewish community. This paper examines the context of Myers' studies in Edinburgh as an American medical student and as a Jew.