Medical School Deans Research Articles

Books: Making a Medic: the Ultimate Guide to Medical School: Love the Fluff.

David Brill Scion Publishing Ltd , 2019 , PB, 320 pp, £15.99 , 978-1911510444 I remember how bemused I felt, reading two very different books in preparation for medical school. One was a dry, daunting manual written by a medical school dean, and the other was Doctor in the House , Richard Gordon’s whimsical novel about the jolly japes of a 1950s medical student. Fortunately, today’s eager medical students can turn to Making a Medic — an infinitely more reliable, accessible, and up-to-date guide. …

Leadership Development for Future Medical School Deans: Outcomes of the AAMC Council of Deans Fellowship Program.

To determine the outcomes of the Association of American Medical Colleges (AAMC) Council of Deans (COD) Fellowship Program with respect to participants' achieving the goals of becoming a medical school dean and developing leadership skills, and to ascertain fellows' views about the program's value, beneficial aspects, and areas for improvement. The 37 COD fellows from 2002 to 2016 were invited to participate in a 2017 survey addressing demographics, training, current leadership position, and value of the program. The survey also included 3 open-ended questions. A 2018 web-based search was conducted to determine fellows' senior leadership roles since their program participation. The survey response rate was 73% (27/37). The majority of respondents were male (82%, 22), aged 51-70 (89%, 25), and white (82%, 22). The top 5 medical specialties reported were internal medicine, pediatrics, anesthesiology, psychiatry, and surgery. Most respondents (63%, 17) reported having a graduate degree. All reported being in leadership positions in academia and/or health care. The web-based search found that 27% (10/37) of the fellows became medical school deans (average tenure 5.6 years); 2 fellows became deans of other types of schools. Overall, survey respondents perceived the program as valuable. Respondents identified shadowing a dean mentor, attending COD meetings, and attending the AAMC Executive Development Seminar for Deans as the most valuable program components. The majority (88%, 23/26) indicated their fellow experience persuaded them to pursue being a dean; 2 (8%) indicated it did not. Respondents identified 4 key opportunities for program improvement: more sponsorship by deans, development of a learning community, enhanced mentoring, and coaching. The COD Fellowship Program appears to be successful in preparing senior faculty to become deans and assume other senior leadership roles in academia and/or health care. Fellows' feedback will be used to inform future revisions to the program.

Low priority of obesity education leads to lack of medical students\u2019 preparedness to effectively treat patients with obesity: results from the U.S. medical school obesity education curriculum benchmark study

BackgroundPhysicians are currently unprepared to treat patients with obesity, which is of great concern given the obesity epidemic in the United States. This study sought to evaluate the current status of obesity education among U.S. medical schools, benchmarking the degree to which medical school curricula address competencies proposed by the Obesity Medicine Education Collaborative (OMEC).MethodsInvitations to complete an online survey were sent via postal mail to 141 U.S. medical schools compiled from Association of American Medical Colleges. Medical school deans and curriculum staff knowledgeable about their medical school curriculum completed online surveys in the summer of 2018. Descriptive analyses were performed.ResultsForty of 141 medical schools responded (28.4%) and completed the survey. Only 10.0% of respondents believe their students were “very prepared” to manage patients with obesity and one-third reported that their medical school had no obesity education program in place and no plans to develop one. Half of the medical schools surveyed reported that expanding obesity education was a low priority or not a priority. An average of 10 h was reported as dedicated to obesity education, but less than 40% of schools reported that any obesity-related topic was well covered (i.e., to a “great extent”). Medical students received an adequate education (defined as covered to at least “some extent”) on the topics of biology, physiology, epidemiology of obesity, obesity-related comorbidities, and evidence-based behavior change models to assess patient readiness for counseling (range: 79.5 to 94.9%). However, in approximately 30% of the schools surveyed, there was little or no education in nutrition and behavioral obesity interventions, on appropriate communication with patients with obesity, or pharmacotherapy. Lack of room in the curriculum was reported as the greatest barrier to incorporating obesity education.ConclusionsCurrently, U.S. medical schools are not adequately preparing their students to manage patients with obesity. Despite the obesity epidemic and high cost burden, medical schools are not prioritizing obesity in their curricula.

Twenty-five years on: revisiting Bosnia and Herzegovina after implementation of a family medicine development program

BackgroundThe wars that ravaged the former Socialist Federal Republic of Yugoslavia in the 1990’s resulted in the near destruction of the healthcare system, including education of medical students and the training of specialist physicians. In the latter stages of the war, inspired by Family Medicine programs in countries such as Canada, plans to rebuild a new system founded on a strong primary care model emerged. Over the next fifteen years, the Queen’s University Family Medicine Development Program in Bosnia and Herzegovina played an instrumental role in rebuilding the primary care system through educational initiatives at the undergraduate, residency, Masters, PhD, and continuing professional development levels. Changes were supported by new laws and regulations to insure sustainability. This study revisited Bosnia and Herzegovina (B-H) 8-years after the end of the program to explore the impact of initiatives through understanding the perspectives and experiences of individuals at all levels of the primary care system from students, deans of medical schools, Family Medicine residents, practicing physicians, Health Center Directors and Association Leaders.MethodsQualitative exploratory design using purposeful sampling. Semi-structured interviews and focus groups with key informants were conducted in English or with an interpreter as needed and audiotaped. Transcripts and field notes were analyzed using an interpretative phenomenological approach to identify major themes and subthemes.ResultsOverall, 118 participants were interviewed. Three major themes and 9 subthemes were identified including (1) The Development of Family Medicine Education, (subthemes: establishment of departments of family medicine, undergraduate medical curriculum change), (2) Family Medicine as a Discipline (Family Medicine specialization, academic development, and Family Medicine Associations), and (3) Health Care System Issues (continuity of care, comprehensiveness of care, practice organization and health human resources).ConclusionsDespite the impact of years of war and the challenges of a complex and unstable postwar environment, initiatives introduced by the Queen’s Program succeeded in establishing sustainable changes, allowing Family Medicine in B-H to continue to adapt without abandoning its strong foundations. Despite the success of the program, the undervaluing of Primary Care from a human resource and health finance perspective presents ongoing threats to the system.

A Medical School Dean's Guide to Orienting Educational Leaders on Roles, Responsibilities, and Resources.

Continuing professional development of physicians often revolves around clinical activities. Accordingly, there is a lack of intentional development and support of medical education leaders despite such individuals having critical influence over key organizational functions. Unequivocally, educational leaders have complex and dynamic jobs that require clear delineation of roles, responsibilities, and resources available to successfully train the next generation of health professionals. Although there is guidance on how to longitudinally onboard medical education leaders, there is little information on how to effectively orient such leaders on the functional nature of their jobs. Baylor College of Medicine's medical school dean developed and delivered a 2-day orientation program to educational leaders to clarify roles, responsibilities, and resources. Postevaluation surveys aimed to identify key session content that would be frequently used by educational leaders to oversee key aspects of medical education. The purpose of this article is to outline the structure and content of an orientation program designed for medical education leaders, and share postevaluation data to identify which sessions were most used in practice. Other deans are encouraged to take ownership over the professional development of their educational leaders and delivering similar programming.

National survey on telemedicine education and training among medical students and residents in France

Abstract Telemedicine was defined in France in 2009 and until 2017 integrated into the official medical school and residency programs. A national survey among medical school deans indicated a lack of implementation of telemedicine education and training despite positive attitudes towards it. In September 2018, teleconsultation started to be reimbursed for all doctors and patients by the National Health Insurance. The objective was to describe the knowledge, attitudes, and practices of medical students and residents in France on telemedicine. A national voluntary online questionnaire-based survey was conducted from December 15th, 2018 to March 3rd, 2019. The survey was shared by the French Society of Telemedicine (SFTelemed), the National Association of French Medical Students (ANEMF), and the National Union of Medical Residents (ISNI). There were 3329 answers, with 67.5% of participants being women and 69.8% being medical students and 30.2% residents. In total, 82.8% declared telemedicine was relevant to improve access to care. 84.8% did not know telemedicine regulations at all. 86.9% declared they knew the definition of teleconsultation and only 40.3% for tele-expertise. 14.4% received telemedicine theoretical education, and 97.9% stated they were not trained enough. 7% practised telemedicine during their medical school education and 30% during residency. Among them 60.2% practiced telemedicine less than 5 occasions. Among those who did not practise telemedicine during their education, 82.6% answered that they would want to practice telemedicine before the end of their studies. Medical students and residents in France have a positive attitude towards telemedicine, however, were limited to its practice. Majority of participants declared they want to be educated and trained for telemedicine during their studies. This is the first national scale study in the world and should be applied in France for other healthcare professionals and other countries. Key messages Telemedicine education and training should be provided to medical students and resident during their curriculum. Medical schools and residency programs need to integrate and apply telemedicine in their programs.

Is Academic Medicine Making Mid-Career Women Physicians Invisible?

In this perspective piece, we describe a multifactorial phenomenon whereby academic women physicians become invisible in the mid-career stage. Barriers, both small and large, cause a cumulative inequity effect, and women may leave academic medicine. Certainly, family and lifestyle choices play a role. And as we describe, so is a situation created where women become discouraged and disillusioned. We describe the growing evidence of subtle disparities, or micro-inequities, that cause women to be less visible and marginalized. Over time, early career women transition to mid-career with an accumulation of these micro-inequities. Women have more difficulty in building their academic portfolios and curriculum vitae-core components of academic promotion. They comprise greater than 50% of the health care workforce; yet, they are underrepresented in top leadership positions. For example, only 22% of full professors, 18% of department chairs, and 17% of medical school deans are women. Macro-inequities, which are observable and measurable, are also well documented. For example, women receive less compensation than men for the same job. We examine the contributing and causative processes and offer suggestions on how to promote equity among highly qualified mid-career women as they graduate from training and move beyond the early career stage.

Resident Mental Health: Time for Action.

Resident Mental Health: Time for Action.

First person profile: Leslie Bernstein, PhD: An epidemiologist known for her groundbreaking discoveries about breast cancer, Dr. Bernstein continues to push the field forward.

First person profile: Leslie Bernstein, PhD: An epidemiologist known for her groundbreaking discoveries about breast cancer, Dr. Bernstein continues to push the field forward.

Cuban medical training for South African students: a mixed methods study

BackgroundAchieving universal health care coverage will require greater investment in primary health care, particularly in rural and underserved populations in low and middle-income countries. South Africa has invested in training black students from disadvantaged backgrounds in Cuba and large numbers of these Cuban-trained students are now returning for final year and internship training in South Africa. There is controversy about the scheme, the quality and relevance of training received and the place of Cuban-trained doctors in the health care system. Exploring the experiences of Cuban- and South African-trained students, recent graduates and medical school faculty may help understand and resolve the current controversy.MethodsUsing a mixed methods approach, in-depth interviews and a focus group discussion were held with deans of medical schools, senior faculty, and Cuban-trained and South African-trained students and recent graduates. An online structured questionnaire, adapted from the USA medical student survey, was developed and administered to Cuban- and South African-trained students and recent graduates.ResultsSouth African students trained in Cuba have had beneficial experiences which orientate them towards primary health care and prevention. Their subsequent training in South Africa is intended to fill skill gaps related to TB, HIV and major trauma. However this training is ad hoc and variable in duration and demoralizing for some students. Cuban-trained students have stronger aspirations than those trained in South Africa to work in rural and underserved communities from which many of them are drawn.ConclusionAttempts to assimilate returning Cuban-trained students will require a reframing of the current negative narrative by focusing on positive aspects of their training, orientation towards primary care and public health, and their aspirations to work in rural and under-served urban areas. Cuban-trained doctors could be part of the solution to South Africa’s health workforce problems.

Mount Sinai Offers Fellowship in Transgender Psychiatry

Back to table of contents Previous article Next article Government NewsFull AccessMount Sinai Offers Fellowship in Transgender PsychiatryLinda M. RichmondLinda M. RichmondSearch for more papers by this authorPublished Online:16 Apr 2019https://doi.org/10.1176/appi.pn.2019.4b1AbstractThe one-year fellowship seeks to meet the needs of patients who are transgender.The Icahn School of Medicine at Mount Sinai Health System in New York City has created a one-year fellowship in transgender psychiatry in its Center for Transgender Medicine and Surgery to help meet the growing need for treatment of transgender individuals in the United States.Hansel Arroyo, M.D., says that he finds his work with transgender patients at Mount Sinai to be among the most rewarding of his career. “I wouldn’t change what I do.” Mount Sinai is accepting applications for the fellowship.“The fellowship was launched in 2017 because the visibility of transgender individuals is increasing, yet when they come for medical services, often providers feel they don’t know what to do,” said Hansel Arroyo, M.D., director of psychiatry and behavioral medicine at the Institute for Advanced Medicine and the Center for Transgender Medicine and Surgery and an assistant professor of psychiatry at Icahn School of Medicine at Mount Sinai.One factor leading to the increased demand for transgender care was the May 2014 decision by Medicare to lift its exclusion on coverage for gender-affirming surgeries. “More insurance companies are covering this type of care,” he said. “However there is a big gap in physician training when it comes to meeting the needs of this population. The amount of time dedicated to training around the needs of the LGBTQ population in North America is miniscule and embarrassing at best.”One study found that only about five hours of medical school training on average is spent covering issues related to LGBTQ health, according to an article in the September 7, 2011, JAMA, which summarizes the responses of 132 North American medical school deans. Today the problem persists: only a few U.S. medical schools offer classes, training, mentorship, and research opportunities in LGBTQ-focused health care, such as the University of California, San Francisco, and Vanderbilt University.Along with its offerings of primary care and psychiatric support for individuals who are transgender, the Center for Transgender Medicine and Surgery offers medical approaches—hormones and a range of surgical options—for patients who wish to align their physical appearance with their gender identity, known as gender-affirming care. Since opening its doors three years ago, the center has performed more than 1,000 surgeries and served more than 2,000 transgender patients with primary care or psychiatric support.“While many psychiatric fellows work only in a mental health setting, the transgender fellow works on an interdisciplinary team that spans surgical, primary care, psychiatric, and specialty medical,” Arroyo said.It’s not necessary that a fellow be a member of the LGBTQ community, but only has “a heart to care for transgender and gender-expansive individuals,” Arroyo added. The fellows learn about hormone therapy and gender confirmation surgery and get an understanding of all the services offered at the center, Arroyo said. “It’s a pretty unique opportunity, and when we started this program in 2017-2018, ours was the only fellowship like this out there.”Psychiatrists at the center are involved in presurgical meetings to assess readiness for gender confirmation surgery. They also conduct psychiatric consultations and participate in the mental health education of the surgical and primary care teams. “This is the perfect opportunity for those who want to dedicate part of their career to helping an underserved or minority population, particularly in the transgender community,” Arroyo said.The center currently has two fellows in transgender medicine—one in psychiatry and one in surgery. The psychiatry fellowship is one year, and the next fellow will start training in July.“I find the work I do at the center to be among the most rewarding of my career, and I wouldn’t change what I do,” Arroyo said. “I simply cannot imagine having the drive to wake up in the morning to do anything else other than what I do right now.” ■More information about the transgender fellowship program can be accessed here. “Lesbian, Gay, Bisexual, and Transgender–Related Content in Undergraduate Medical Education“ is available here. ISSUES NewArchived

Choosing the Right Resident: Implications of the New Electronic Emergency Medicine Standardized Letter of Evaluation.

Choosing the Right Resident: Implications of the New Electronic Emergency Medicine Standardized Letter of Evaluation.

Representation of Women Physician Deans in U.S. Medical Schools.

Background: Among U.S. medical school deans, there is a wide gender gap, most prominent at the highest levels. We aimed to discover how well women physicians were represented within the pool of women deans compared with the pool of men deans. Materials and Methods: A cross-sectional study was performed on 149 allopathic medical schools in the United States. For each school, information was collected on deans' names, titles, genders, and degree(s). Chi-square analyses were performed to determine association between gender and dean ranks. Results: Of the 2559 deans included from 149 medical schools, 1649 (64.4%) were physicians, and of these, women physicians accounted for 634 (38.4%), a significant under-representation (p < 0.00001). In comparison, the 626 nonphysician doctorate-holders of which women accounted for 291 (46.5%, p = 0.061) were equally represented. Of the 284 deans with bachelor's or master's degrees, women accounted for 180 (63.4%), a significant over-representation (p < 0.00001). This difference was most profound at the lower tier (assistant) dean level. A lower tier physician dean was 1.25 times more likely to be a man than a woman, and a higher tier (dean of medical school, senior associate, vice, or associate) physician dean was 1.16 times more likely to be a man. Conclusions: Women physicians were under-represented among medical school deans compared with men. This disparity held among lower tier and higher tier deans.

Fill the gap between traditional and new era: The medical educational reform in Taiwan.

The 7-year medical education program in Taiwan has been established since 1949. More than 60 years later, many medical professionals have observed and voiced its deficiencies following the outbreak of severe acute respiratory syndrome. The deficiencies are three-fold: (1) specialties are excessively institutionalized, (2) students engage in passive learning and memorization, and (3) passing one written national examination serves as the means of granting permanent physician qualification. The situation has aroused concerns and discussions among medical professionals and educators for a new medical education program. Authorized by the Conference of Deans of Medical Schools in Taiwan, Prof. Chyi-Her Lin assembled a team for planning medical curricular reform. Subsequently, Prof. Shan-Chwen Chang organized a task force team which has been monitoring the new 6-year program since 2013. The aims of medical reform by Prof. Lin are (1) to eliminate the specialty training part, (2) to use innovative teaching methods to motivate students to learn proactively, and (3) to implement competency-based medical education. Now, the first class of physicians will enter the workplace in 2019, subject to various clinical challenges.

Incorporating LGBT Health in an Undergraduate Medical Education Curriculum Through the Construct of Social Determinants of Health.

The AAMC has provided a resource to medical schools for implementing curricular change in lesbian, gay, bisexual, and transgender (LGBT) health education. However, studies have identified that many health professionals who do not feel comfortable in their ability to provide quality care for LGBT patients do not perform complete sexual histories routinely and/or harbor bias towards these patients or their sexual practices. This situation underscores the continued need for further education on this topic. Based on a needs assessment survey of medical students and faculty, we developed a 1-hour didactic lecture to provide instruction on how social determinants of health impact the care of LGBT patients. Students were not required to have any prerequisite knowledge for the session. A content expert in LGBT health taught the lecture using Microsoft PowerPoint in a traditional medical school lecture hall. The lecture was given to 180 third-year medical students. A total of 63 students (35%) responded to the retrospective pre- and postlecture survey. After the didactic lecture, students reported a statistically significant change in their knowledge of the lecture objectives. The didactic lecture was able to increase students' knowledge of how social determinants impact the health of LGBT patients. The lecture can be incorporated into a longitudinal curriculum on LGBT health. Additional work and research are needed on increasing comfort in faculty teaching.

A Conceptual Model for Navigating a Career Path in Medical School Leadership.

There is a paucity of literature providing guidance to physicians hoping to attain a position as a medical school dean. Realizing this gap, the Society for Academic Emergency Medicine (SAEM) Faculty Development Committee organized an educational session focused on offering faculty guidance for obtaining a position in medical school leadership. The session involved panelists who are nationally known leaders in medical school administration and was successfully presented at the SAEM 2018 annual meeting in Indianapolis, Indiana. Knowledge and perspective gained both during this session and through literature review was analyzed using a conceptual thinking skills framework. This process offered insights that promoted the development of a conceptual model informed by current evidence and expert insight and rooted in educational, economic, and cognitive theory. This model provides a step-by-step guide detailing a process that physicians can use to create a plan for professional development that is informed, thoughtful, and individualized to their own needs to optimize their future chances of advancing to a career in medical school leadership.

Editor’s Recognition Awards

Herbert Y. Kressel, MD, Editor The publication of a major peer-reviewed journal such as Radiology requires substantial time and effort by numerous reviewers. Our skilled and dedicated Editorial Board members are recognized each month on the Radiology masthead. I am pleased to make special note of an additional group of individuals who are recognized for the high quality of their prompt, detailed, and scholarly reviews—the recipients of the 2007 Editor’s Recognition Awards. The awardees were selected by Anthony V. Proto, MD, before he competed his term as editor. Each awardee will receive a certificate and letter of congratulations. If desired by the awardee, the letter will be copied to the recipient’s department chair and, if from an academic center, to the medical school dean to underscore the importance of reviewing as an academic activity. Note that the individuals listed on the 2007 masthead of Radiology were not eligible for these awards.

Who are the right teachers for medical clinical students? Investigating stakeholders' opinions using modified Delphi approach.

PurposeThe purpose of this study was to realize that learning in a clinical setting, the interactions of the students with teachers, learning materials, and learning environments are essential. In clinical education, different groups may play the role of the teacher for medical students. This study was designed to determine the optimal characteristics for medical clinical teachers, their selection criteria, and their responsibilities.MethodsThe modified Delphi technique was used in this study. Participants comprised vice-chancellors of education, deans of medical schools, and deputies of education in medical schools across Iran. This study was conducted in three rounds. In the first round, the participants were selected using purposive sampling, and the data were collected through focus group discussions and analyzed through content analysis. The data collection tool in the second and third rounds involved a questionnaire derived from the first round, and the consensus criterion to accept or reject the questionnaire items was frequency distribution.ResultsThe final number of statements in the first round was 157. The second-round questionnaire was designed in the four sections of teaching team, selection criteria, task description of the teaching team (including faculties, specialist staffs, residents, general practitioners, and health and treatment staff), and incentives separately for the specialist staff, residents, general practitioners, and health and treatment staff. The third-round questionnaire included feedback and items that were not agreed upon in the second round.ConclusionThe results of this study indicated the necessity of forming a teaching team, paying attention to the selection criteria, and planning requirements for assigning responsibilities to the teaching team in accordance with the objectives, programs, and requirements of medical schools, along with using strategies to attract participation and create motivation in the teaching team.

28-7 launches to boost anticancer microRNA

Twentyeight-Seven Therapeutics (28-7) is the latest start-up to launch with the goal of developing drugs that tackle the tricky interface between RNA and proteins. And it has a whopping $65 million in series A financing to do it. The company’s name comes from a protein called Lin28, which binds and blocks the microRNA let-7. In healthy adults, let-7 suppresses genes that can cause cancer if left unchecked. In the past decade, researchers have discovered a loss of let-7 or an uptick in Lin28 in a long list of human cancers. One of those researchers is Harvard Medical School scientist and dean George Daley. In 2016, Daley and three other Harvard scientists—Richard Gregory, Frank Slack, and Piotr Sliz—founded 28-7 to develop small molecules that inhibit Lin28 in cancer cells, thereby boosting levels of let-7. Earlier this month, the company emerged from stealth mode to showcase its ambitions. CEO Kazumo Shiosaki explains

On Becoming a Medical School Dean: Learning a Complex and Complicated Enterprise

On Becoming a Medical School Dean: Learning a Complex and Complicated Enterprise