Fourth-year Medical Students Research Articles

Evaluation of factors that impact medical student consideration of a career in otolaryngology.

To identify differences in timing of exposure and demographic characteristics between medical students who did and did not consider Otolaryngology as a career choice. This cross-sectional study involved developing and distributing a survey by an interdisciplinary team to assess exposure to Otolaryngology and individual consideration of pursuing Otolaryngology. The survey was administered electronically to third- and fourth-year medical students at a single medical school, with a small monetary incentive for completion. Descriptive statistics, Fisher's exact tests, and logistic regression models were used for analysis. A total of 172 survey responses were collected out of 374 third- and fourth-year medical students (46%). A total of 74 (43.0%) respondents considered Otolaryngology during medical school. Exposure to Otolaryngology prior to medical school was significantly associated with choosing Otolaryngology (71.4%) compared to those who lacked exposure (28.6%) (p = .048). There was no significant gender difference among students who considered Otolaryngology (p = .537). However, our results showed significant differences between those who considered Otolaryngology by race (p = .003). Black/African American (OR = 0.11, 95% CI 0.01-0.99; p = .049) and Hispanic or Latino (OR = 0.14, 95% CI 0.03-0.65; p = .012) were less likely to consider Otolaryngology when compared to those identifying as White when adjusted for exposure prior to medical school. Our results showed that early exposure and demographic background impact a student's decision to consider Otolaryngology as a career. These findings highlight the need for robust recruitment initiatives. Avenues like pipeline and mentorship programs are recommended to recruit and attract diverse applicants to Otolaryngology. 3.

Implementing a Novel “Frontiers in Neoplasia” Curriculum to Engage Fourth-Year Medical Students in Evidence-Based, Multidisciplinary Oncology Care

Implementing a Novel “Frontiers in Neoplasia” Curriculum to Engage Fourth-Year Medical Students in Evidence-Based, Multidisciplinary Oncology Care

Experiences of Simulated Phone Death Notification.

Physicians perform many difficult skills, but notifying loved ones about the death of a family member is a particularly challenging skill that requires specific training. Descriptions of such training are lacking in the literature. We developed a formative standardised patient encounter on death notification over the telephone for fourth-year medical students and evaluated their qualitative perspectives, including emotional safety. Embedded within a fourth-year advanced communication skills workshop in 2019, a case was introduced to practice telephone death notification. Students had a preparatory didactic lesson, received formative peer feedback, and participated in faculty-led debriefs. Eighty-eight medical students at one medical school in the United States participated in debriefing sessions after a communication skills workshop during the fourth-year capstone course. The debriefing sessions were audio-recorded and transcribed. Fifty-seven of those students completed postsession surveys. Transcripts and surveys were qualitatively analysed using content analysis to code responses, extract salient categories, and distil into themes. Three general themes emerged: communication challenges, emotional responses, and appreciation for the experience. Communication challenges included using language about death, experiences of silence, complications of distance and driving, and communication by phone. Students described the case as "challenging," "uncomfortable," "intense," and "emotional." Despite these strong feelings, students expressed appreciation for the experience, noting appropriateness of the preparation and debrief, a sense of safety, and realistic encounters. Telephone death notification training was a valued, realistic, and emotionally safe experience. Students felt appropriately challenged, but adequately supported. These skills can be included in formative communication skills curricula.

Effectiveness of a Collaborative, Virtual Outreach Curriculum for 4th-Year EM-bound Students at a Medical School Affiliated with a Historically Black College and University

Background: Diversity within the physician workforce is associated with improved clinical outcomes and patient satisfaction. Despite this, the US physician workforce, particularly in emergency medicine (EM), remains relatively homogeneous. Of all Black medical school students in the US, 14% attend the four Historically Black Colleges and Universities (HBCU) that have a medical school. Unfortunately, none of these schools are affiliated with an academic EM program. Because of this, there is less professional mentorship focused on obtaining a career in EM and potentially less formal curricula for senior medical students doing their home sub-internship in EM. Objectives: Our objective was to fill the gap left by the absence of an academic EM department at Howard University College of Medicine (HUCOM) by creating a collaborative educational experience for fourth-year medical students during their home EM sub-internship. The curricular objectives were to teach core principles of EM, build relationships with students, and prepare them for pursuing EM residency training. Curricular Design: Four EM academic departments collaborated to create and implement a virtual curriculum using the six-step approach to curricular development. Impact/Effectiveness: After completion of the course, five students (100%) reported strongly agreeing with the following statements. These sessions 1) helped me learn the approach to core EM topics more than I would have been able to do on my own; 2) helped me learn key skills for excelling in an EM rotation more than I would have been able to do on my own; and 3) allowed me to connect with faculty and resident mentors to learn more about the field of EM. Of these five students, 80% and 20% reported strongly agreeing and agreeing, respectively, that these sessions helped them learn about the process of applying to and selecting an EM residency program.

Comparing the Effectiveness of Online and Face-to-Face Teaching for Medical Students in Shared Decision-Making Communication Skills Training.

Shared decision-making (SDM) is crucial in healthcare to facilitate effective communication between providers and patients, aiding in making optimal medical decisions. Communication skills training (CST) can improve physicians' ability in SDM. However, SDM CST for medical students in Taiwan is scarce, and research comparing online versus in-person CST outcomes is lacking. This study aims to assess the effectiveness of online versus face-to-face SDM CST on medical students' decision-making proficiency and communication skills over time. This study employs a retrospective quasi-experimental design, analyzing 323 questionnaires from the CST training database. Participants (fourth-year medical students) were divided into two groups: face-to-face CST (n = 160) and online CST (n = 163). Assessments were conducted before (T0) and immediately after (T1) CST. Paired t-tests and generalized estimating equations were used to evaluate within-group and between-group differences in SDM decision-making proficiency and communication skills. In the within-group comparison, both groups showed a significant improvement in SDM decision-making proficiency and communication skills. For SDM decision-making proficiency, the face-to-face group demonstrated a large effect (t = 12.9, p < 0.001, d = 0.87), and the online group achieved a moderate effect (t = 8.98, p < 0.001, d = 0.64). In terms of communication skills, both groups reached a moderate effect (face-to-face, t = 9.77, p < 0.001, d = 0.67; online, t = 8.00, p < 0.001, d = 0.54). No significant differences were found between groups in SDM decision-making proficiency and communication skills. This study has demonstrated that both online and face-to-face SDM CST effectively enhance the SDM decision-making proficiency and communication skills of medical students. The effectiveness of online CST is on par with face-to-face CST. It is recommended to use online CST when face-to-face classes are not feasible, especially during epidemics or budget constraints. Future research should explore the long-term impacts of these CST methods on students' skills, considering additional follow-up time points.

Perspectives of female medical students and physicians on professional development in Japan

Introduction: Female physicians often interrupt their careers due to fulfilling family caregiving roles, with childbirth and child-rearing being significant reasons for temporary leave or resignation. The employment rate of female physicians in Japan shows an M-shaped curve, with a low proportion in leadership positions. Female medical students also have anxiety about balancing family and career. While support systems are recognized as necessary, female physicians' experiences and career development perceptions are underexplored. Therefore, this study investigates their career aspirations and challenges. Methods: This study conducted semi-structured interviews with eight fourth-year Japanese female medical students and nine Japanese female physicians with over nine years of clinical experience. Interview data were analyzed using thematic analysis. Results: Four main themes related to professional life emerged: work environment, marriage and childbirth, continuation of work, and career development approach. Female students expressed concerns about inadequate support systems and balancing career and family. Female physicians, even with support, worried about burdening colleagues, and experienced gender bias. Both groups cited advanced maternal age as a concern and recognized career development barriers due to part-time work after childbirth. Female students desired to maintain work, while physicians struggled to regain skills and knowledge after extended leave. Conclusions: Female students harbor anxieties about balancing work and family. Integrating learning opportunities about female physicians' experiences into early stages of education is crucial. Establishing communities of practice for career development can address these issues—involving both male and female students and physicians. This study highlights the need for support systems and role models to enhance the career fulfillment of female medical students and physicians in Japan.

I’m in! So why don’t I fit in? A cross-sectional exploration of imposterism within medical school cohorts

Background: Transitioning within medical school to new duties, roles and challenges represents a significant change in responsibility. Medical students may experience the imposter phenomenon, fearing exposure as a “fraud”. Identifying when imposterism could peak during training, the student’s historical social determinants and personal history that can lead to the overall imposter syndrome is very important, because during medical school, student wellness and professional identity typically decrease. This study aims to characterize the imposter phenomenon in medical students at a single institution as they transition from one academic year to the next. Methods: This study is a cross-sectional observational design. We constructed a 30-item survey using the Clance Imposterism Scale and selected demographic characteristics. Indicators of interest include: environment of upbringing, education, socioeconomic status, and race/ethnicity. We analyzed the data using Pearson’s Chi Square and Fisher Exact tests, and a two-tailed Type I error of less than 5% to assess statistical significance. Results: Out of 387 students, we received 89 responses, resulting in a 23% response rate. Fourth-year medical students reported experiencing feelings of imposterism more frequently or intensely than students in the first three years. Females had frequent/intense levels of imposterism more than males or non conforming individuals. More than 75% of individuals raised in rural areas experienced frequent to intense imposterism compared to those raised in suburban or urban environments. Completing an undergraduate degree with dedicated mentoring from physicians did not ameliorate feelings of not belonging. Conclusion: We characterized medical students by cohort to identify points of intervention. Our findings highlight the importance of addressing the imposter phenomenon, especially in environments like medical school, where the expectations to excel are intense. Recognizing that certain groups, such as females, underrepresented minorities, and first-generation college students, may be more susceptible to these feelings of inadequacy is an important step toward providing support and resources tailored to meet their needs.

Development and Implementation of a Pediatric Pulmonary-Focused Active Learning Curriculum.

During the pediatric pulmonary rotation, trainees reported that while the clinical experience was robust, they desired more structured didactic sessions. Self-paced online modules can be an alternative but equally effective teaching tool. Multiple studies demonstrate the benefits of e-learning in medical education. Four interactive, case-based, e-learning modules on asthma, chronic cough, tracheostomy, and obstructive sleep apnea were created and piloted to pediatric residents and medical students in the pediatric pulmonology elective at the University of California, San Francisco and Oakland campus. Modules incorporated videos with experts, images, and multiple-choice questions to enhance learning. The modules were distributed via email on their first day of the rotation and were completed virtually by the trainees during their rotation. Progress was evaluated from December 2021 to July 2022 using pre- and postcourse questions assessing knowledge acquisition and decision-making skills. A total of 22 participants took part in the elective and completed the modules to varying degrees. This group included six fourth-year medical students and three first-year, five second-year, and eight third-year pediatric residents. Data showed an improvement in posttest scores across all four modules, ranging from 9% to 21%, with a large improvement in the obstructive sleep apnea module and a small improvement in the chronic cough module. Trainees reported that the modules supplemented and increased their knowledge base. Knowledge about managing common pulmonary conditions is critical for general pediatricians. Self-paced online modules are well accepted by trainees and are effective in improving knowledge and medical decision-making.

Medical students' knowledge, attitude, and practice regarding hepatitis B and C virus infections in Jordan: A cross-sectional study.

We aimed to assess the levels of hepatitis B and C knowledge, attitudes, and practices among medical students in Jordan. A survey included participation from medical students across all faculties in Jordan, from 2022 to 2023. The data were analyzed with The R Statistical Software (v4.1.2; R Core Team 2022) using descriptive statistics, and multivariate regression analyses. A p ≤ 0.05 was considered statistically significant. In this study of 2602 participants, the average age was 21.4, with 52.6% females. Most were fourth-year medical students (19.1%), and 52.3% were in clinical years. The mean knowledge score was 14 (SD ± 2.5) out of 20, categorized as high at 58.84%, and low at 41.16%. The mean practice score was 4.89 (SD ± 1.1) out of 7, with good practice in 65%, and low in 35%. The mean attitude score was 1.6 (SD ± 3.1), categorized as low in 81.7%, and high in 18.3%,. High levels of KAP were associated with gender, year of study, and university. Male respondents had lower knowledge (OR: 0.73; p: 0.001; 95% CI: -0.50 to -0.13), and students in the first to fifth years scored lower than sixth-year students. There were moderate positive associations between knowledge and attitude (r: 0.33, p < 0.001), and weak positive associations between knowledge and practice (r: 0.17, p < 0.001), and attitude and practice (r: 0.133, p < 0.001). In conclusion, the participants revealed high adherence to some practices and intermediate knowledge levels. Gender, academic year, and university affiliation emerged as significant factors, highlighting the necessity for tailored interventions.

Family Medicine Practice as Learning Environment: A Medical Student Evaluation in Switzerland.

Improving the quality of teaching placements in family medicine practice (FMP) could help to address the shortage of primary care physicians. This study aims to investigate students' evaluations of first-exposure FMP placements, to identify clusters of FMPs that might need to improve their placement quality, and to analyze students' perceptions of the FMP as a learning environment. The design was a cross-sectional survey study, including all fourth-year undergraduate medical students at the University of Zurich, Switzerland, who completed a mandatory placement in FMP during 2019-2022. The placements consisted of individual teaching and training in the same FMP for 8half days within an academic year. The primary outcome was the student Likert scale rating of the 14 key questions as indicators of teaching placement quality. Based on these indicators, cluster analysis was used to identify groups of FMPs with the potential for quality improvement. A framework analysis was used to analyze the students' perceptions. A total of 713 students (response rate 81%) and 249 FMPs (median [interquartile range]: 2 [1,4] students per FMP) were included. Overall, 86% of the students were satisfied with the placement, and 95% reported that the placement gave them realistic insight into FMP work. A cluster of 25 (10%) FMPs that may improve placement quality was identified. Students most liked the opportunity to gain FMP skills, insight into FMP work, and establishment of patient relationships. Our study described students' experiences with FMP and a method for teaching evaluation to identify FMPs that may benefit from interventions to improve their learning environment. This could upgrade the medical education offered and increase the interest in family medicine as a response to the shortage of primary care physicians.

Awareness of Future Participation in Clinical Trials and Clinical Research Among Fourth-Year Medical Students at Hamamatsu University School of Medicine: Analysis Using Text Mining with a Large Language Model

Awareness of Future Participation in Clinical Trials and Clinical Research Among Fourth-Year Medical Students at Hamamatsu University School of Medicine: Analysis Using Text Mining with a Large Language Model

Effect of limiting checklist on the validity of objective structured clinical examination: A comparative validity study

Background The Objective Structured Clinical Examination (OSCE) is a cornerstone of medical education that uses a structured approach to assess clinical skills and competency. A well-designed checklist is essential to enhance the validity of OSCE exams. This study aimed to determine whether a clinically discriminatory checklist (CDC) improves the validity of the OSCE compared with an assessment using the thoroughness checklist (TC), with a particular focus on clinical reasoning. Methods Fourteen OSCE case scenarios with both TC and CDC were developed. Each case was administered to 350–1170 fourth-year medical students in nine medical schools within the Seoul-Gyeonggi-area (Korea) during their OSCEs in 2019 and 2020. We also conducted interstation examinations after standardized patient encounters to assess clinical reasoning ability. The validities of OSCE scores based on the TCs and CDCs were compared. Results The OSCE using a CDC (rather than a TC) enabled better item discrimination but provided a lower internal consistency coefficient and worse standard measurement error. Clinical reasoning scores derived using patient notes were significantly correlated with OSCE scores but varied according to the characteristics of each case, indicating that OSCE scores derived using CDCs did not assess clinical reasoning ability more accurately than OSCE scores obtained using TCs. Conclusions This study found that using a CDC to limit checklist items did not improve OSCE validity and did not reflect clinical reasoning ability. Further development of robust assessment strategies that support and evaluate clinical reasoning abilities is needed.

Impacts of immersive 3D videos on students' surgical learning compared to 2D videos: a randomized controlled trial.

Unlike other medical specialties, surgery is primarily learned through apprenticeship, by observing surgeons in action during operations. However, the increasing number of medical students and work-hour restrictions limit opportunities for learning in the operating room (OR). These circumstances call for novel technologies, such as immersive video. The objective of this study is to compare knowledge retention, preparedness, and content engagement for surgical learning when watching a surgical video in 3D through a Head-Mounted Display (HMD) versus in 2D video on a conventional screen. This randomized controlled trial includes 231 fourth-year medical students. Participants watched the same 12min surgical video, narrated by an expert, presented either in immersive 3D form through an HMD, or in 2D form through a conventional screen. The students completed three questionnaires (previewing, postviewing, and 1 month later), which included questions on knowledge retention, expected preparedness, content engagement, tool engagement, and self-assessment. Statistical analyses were adjusted by including the confounding factors. Immediately after the video, the 3D immersive video group showed a significantly lower knowledge retention score compared to the classic video group (P<0.01). Nonetheless, the 3D immersive video group demonstrated better-expected preparedness as a future resident (P=0.019), greater satisfaction (P=0.033), better stimulation (P<0.001), higher involvement (P<0.001), and a greater perceived ability to identify anatomical structures (P<0.001). After 1 month, participants in the immersive video group reported feeling more prepared (P=0.016), more self-confident (P=0.020), more at ease (P=0.023), and less overwhelmed (P<0.01) than those in the 2D video group. Our results showed that 3D surgical immersive video vs. 2D surgical video, enhances the sense of stimulation, satisfaction, involvement, and the perception of having better identified anatomical structures. For early medical school students where access to the OR is limited, this tool appears to a significant step forward in surgical pedagogy. However, the precise understanding of its pedagogical value required further investigation and refinement.

Effectiveness of a Novel Global Telemedicine Curriculum for Medical Students.

The University of Pittsburgh School of Medicine collaborated with The Addis Clinic to create a global telemedicine elective for fourth-year medical students during the COVID-19 pandemic. The elective aimed to promote cross-cultural understanding by providing unique, hands-on telemedicine experience. To assess the effectiveness of the telemedicine elective, four of five medical students and 11 of 12 Kenyan clinical officers completed one-on-one interviews and surveys. Students and global health faculty connected virtually with patients and clinical officers from several rural clinics in Kenya during the 4-week elective. Per elective month, participants of the course included two fourth-year medical students and five Kenyan clinical officers. A medical school elective designed in collaboration with The Addis Clinic, using WhatsApp and Telemedicus platform, in which each medical student virtually assisted a team of Kenyan clinical officers with a variety of active patient cases. Qualitative analysis of interviews with medical students and Kenyan clinical officers yielded themes of increased competency with clinical decision-making and culturally appropriate care delivery. Implementation of a unique global telemedicine elective was feasible and well received by both medical students and clinical officers in Kenya. The elective can be implemented at other institutions with faculty experienced in global health who would like to partner with The Addis Clinic.

의과대학생의 자기주도 학습 유형에 따른 학업성취도의 차이

Objectives The purpose of this study was to examine self-directed learning among medical students by type and to investigate whether there are differences in academic achievement based on these types. Methods In order to achieve the research purpose, data were collected from 65 fourth-year medical students enrolled in a professionalism-related course at a medical school in Seoul. Scores on self-directed learning competencies and perceived academic achievement were analyzed using descriptive statistics, frequency analysis, and chi-square tests. Results The findings of the study are as follows: first, among the sub-factors of self-directed learning, cognitive organization was the highest, followed by motivational beliefs. Second, when classifying self-directed learning types based on individual scores, the cognitive type was the highest, followed by the metacognitive type, and then the motivational type. Third, examining differences in academic achievement according to types of self-directed learning among medical students revealed that students with a cognitive self-directed learning type tended to have moderate academic achievement, those with a metacognitive type had higher academic achievement, and those with a motivational type had the lowest academic achievement. Conclusions This study confirmed that metacognition is a significant factor in medical students' learning. The findings of this study are expected to serve as foundational data for improving learning support for medical students in the future.

Recommended Elements of a Musculoskeletal Course for Fourth-Year Medical Students: A Modified Delphi Consensus.

A recognized gap exists between primary care physicians' training in musculoskeletal (MSK) medicine and the burden of MSK complaints in primary care. Family medicine interns often lack adequate baseline MSK physical exam skills, which prompted a proposal to introduce a fourth-year preceptorship to reinforce MSK education. The aim of this study was to prioritize the most important elements to include in this new clinical rotation. We employed a three-round, modified Delphi method to derive consensus. Eleven panelists with experience and expertise in MSK training, medical education, or both generated a list of 118 elements. Each panelist then ranked each element by level of importance, and we reviewed the results. The ranking process was repeated two more times with a goal of achieving consensus. Seventy-seven curricular elements (topics, skills, experiences) achieved consensus recommendation by being ranked either "fairly important" or "very important" for inclusion in the curriculum. Twenty-eight items were unanimously ranked "very important," 42 received a mix of "very important" and "fairly important" rankings, and seven received unanimous ranking of "fairly important." Three items were unanimously ranked "neither important nor unimportant." Longitudinal repetition of physical exam skills, reinforcement of relevant anatomy, and incorporation of specific frameworks for approaching MSK care are important components. Physical examination of the shoulder, knee, back, and hip are especially meaningful clinically.

Enhancing medical students’ understanding of end-of-life care ethics and law through video-triggered expert-led debriefing: a two-stage study

BackgroundTaiwan enacted the Hospice Palliative Care Act in 2000 and the Patient Autonomy Act in 2016. However, medical education has emphasized palliative care skills over ethical and legal integration. This study developed a curriculum for pre-clinical students, focusing on applying these issues in end of life care.MethodsThe participants were fourth-year medical students enrolled in a 1-credit medical ethics and law course at a medical school in Taiwan. The study employed a two-stage design, combining quantitative pretests and posttests with qualitative data obtained through the Know-Want-Learn strategy. The curriculum, called the video-triggered expert-led debrief module, included a video scenario on end of life care, insights shared by three interprofessional experts, and students debrief. In 2021, 168 students participated, and a quantitative questionnaire using a pretest-posttest design was applied to assess the curriculum’s impact on students’ knowledge and attitudes toward end of life care. In 2022, 157 students participated, and the survey used open-ended questionnaires (the Know-Want-Learn strategy) to evaluate what students already knew and what they wanted to know before the module, as well as what they had learned afterward.ResultsIn 2021, we collected 166 (98.8%) valid responses in the quantitative questionnaire. Seven of the eight knowledge-based questions and four of the seven learning motivation items showed significant improvement in the posttest (P < 0.05). In 2022, 81 (51.6%) valid responses were obtained from the qualitative questionnaire. Before the module, students’ understanding was superficial and focused on literal meanings. Three themes emerged in what they wanted to know: medical decision-making, ethics and laws, and empathetic communication, with eight subthemes. After the module, three themes and six subthemes were identified in the “what I learned” section. Students reported gaining knowledge related to ethics and laws, and empathetic communication.ConclusionsThe video-triggered expert-led debrief module can effectively teach the application of medical ethics and laws in end of life care. This approach has shown positive results among young medical students. It enhances students’ learning motivation, deepens their understanding of ethics and laws, and empathetic communication. It further encourages them to reflect deeply on the meaning of healthcare.

The Dark Horse: Introducing a Comparative Hematology Course into the Post-Clerkship Phase of Medical School

Introduction: Developing a deep understanding of pathophysiology is integral to training competent physicians. Although the basic sciences are taught primarily in preclinical curriculum, revisiting these concepts during the fourth year of medical school promotes integration into clinical medicine (Spencer et. al, 2008). Immersive comparative physiology courses increase trainee appreciation of physiology and its incorporation into patient care (Herzig et al, 2012). We introduced comparative physiology curriculum during a fourth-year medical student course at University of Texas Southwestern (UTSW) Medical School. Our course aimed to deepen students' understanding of human pathophysiology and its clinical applications by highlighting evolutionarily conserved and adaptive changes among diverse species. Methods: We developed a one-week comparative physiology curriculum to present to fourth-year medical students in April 2024. The curriculum utilized the four stages of Kolb's Experiential Learning Theory through multimodal methodologies, including introductory lectures, case-based learning, laboratory experiments on human and animal blood with integrated case studies and group projects, and evolutionary biology group presentations at the Fort Worth Zoo. The UTSW Institutional Review Board approved the dissemination of pre- and post-course surveys. The surveys incorporated a 7-point Likert scale (1= strongly disagree, 2= disagree, 3= somewhat disagree, 4= neither agree nor disagree, 5= somewhat agree, 6= agree, 7= strongly agree). Anonymous six-digit identifiers tracked changes in individual perceptions. Scores were calculated by summing responses to series of questions evaluating perceptions of construct and knowledge. Paired samples t-tests through Microsoft Excel assessed the significance of differences between pre- and post-course mean perception of construct and confidence in knowledge scores. Results: Fifteen fourth-year medical students enrolled, and 93% completed both surveys. Self-assessed confidence in knowledge significantly increased (p =1.02x10-5) in multiple concepts, including interpretation of the peripheral blood smear and of the complete blood count. In the post-course survey, 79% of respondents agreed or strongly agreed that comparative physiology models should be incorporated into medical education, 79% agreed or strongly agreed that the course increased their interest in hematology, and 100% strongly agreed to recommend the course. Conclusion: Incorporating immersive comparative physiology curriculum into the post-clerkship phase of medical school can enhance understanding of core hematologic physiology principles and promote interest in hematology.

“Neither Side Really Knows… What an Abortion Is Like”: A Qualitative Analysis of Medical Students’ Experiences With Second-Trimester Procedural Abortions

ObjectivesMedical students value abortion education; however, there has been little study regarding participation in second-trimester procedures, which are less common yet receive significant societal attention. We aimed to explore medical students’ perceptions of participation in second-trimester procedural abortions to optimize this educational experience. Study DesignWe conducted qualitative semi-structured interviews with third- and fourth-year medical students who voluntarily participated in second-trimester dilation and evacuation cases. We coded interviews inductively and performed thematic content analysis until thematic saturation was reached. ParticipantsWe interviewed 25 medical students, including 16 third-year and nine fourth-year students. Most participants were female (64%) and white (58%) and had no prior abortion care experience (80%). ResultsFour major themes emerged: 1) students felt unprepared for second-trimester procedural abortions and were unable to find adequate educational resources for preparation; 2) students experienced complex emotional reactions to the procedures, often finding the experience more challenging than expected; 3) students observed implicit expectations and biases in the learning environment; and 4) students highly valued their involvement in abortion procedures, noting that participation was important for their future practice and allowed acquisition of essential clinical skills. ConclusionsMedical students value the educational opportunity to participate in second-trimester procedural abortions; however, most feel unprepared for the technical and emotional aspects, despite utilizing available educational resources. To maximize educational experience and psychological safety, educators should develop specialized training resources. This could strengthen physician knowledge and comfort with abortion care in the future, ultimately improving patient care.

How Does Lacking a Home Program Impact Otolaryngology Applicants?

To compare otolaryngology interview and match outcomes between applicants with and without home residency programs. Otolaryngology applicants from US allopathic medical schools during the 2019-2023 cycles who responded to the Texas Seeking Transparency in Application to Residency (STAR) survey were identified. Students were stratified based upon whether their medical school had an affiliated otolaryngology residency program. The primary outcomes were number of interviews and match rate. Wilcoxon-rank sum and χ2 testing was used to assess associations between home program status and interview and match outcomes. Of the 633 fourth-year medical students applying to otolaryngology during the 2019-2023 application cycles, 89 had no home program (NHP) and 544 had a home program (HP). Applicants with NHP completed significantly more away rotations than applicants with a HP (2.2 vs. 1.5; p < 0.01). There was no difference in mean number of applications submitted between applicants with NHP and applicants with a HP. However, applicants with a HP received a significantly greater number of interviews (14.7 vs. 11.8; p < 0.01), attended more interviews (12.4 vs. 11.3; p = 0.02), attended a lower percentage of their offered interviews (84.4% vs. 95.8%), and had a higher match rate (81.8% vs. 70.8%; p = 0.02) than applicants with NHP. Applicants with NHP interviewed at (1.9 vs. 1.3; p < 0.01) and matched at (33.7% vs. 23.9%; p = 0.048) significantly more away rotation institutions than applicants with a HP. Applicants with NHP received fewer interviews and had lower match rates. Away rotations may be especially important for applicants with NHP. NA Laryngoscope, 134:4494-4500, 2024.