Large Medical School Research Articles

Pilot qualitative exploration of the impact of community asset mapping within the undergraduate psychiatry curriculum at an Irish medical school

IntroductionProviding an effective response to global health disparities requires that future doctors are better prepared to embrace a public health ethos. Asset-based approaches see people and communities as coproducers of...

A matter of choice: a cross-sectional study examining the impact of the overturning of Roe v Wade on U.S. medical students’ perceptions and career decisions

Background In June 2022, the Dobbs decision by the U.S. Supreme Court overturned federal abortion protections. In states with restrictive abortion laws such as Indiana, which also has the country’s largest medical school and the third worst maternal mortality rate, the impact of this ruling may be huge on the medical field. The purpose of this study was to analyze perceptions of medical students in Indiana in their third and fourth years of education after the Dobbs decision to assess if the state’s current abortion restrictions impact their career choice. Methods Between December 2022 and March 2023, an anonymous survey was carried out at Indiana University School of Medicine, which included questions about personal beliefs on abortion and the current abortion laws in Indiana, as well as priorities when choosing residency training and practice locations. Results Our survey found that four-fifths of medical students in Indiana disagreed with the Dobbs decision. While most students (71.4%) had not considered state abortion laws when selecting a medical school, since the Dobbs decision, 66.3% of third-year and 40.3% of fourth-year students indicated that they would take abortion laws into account when choosing a residency program. 47.5% of female students stated that they will be seeking residency in a state where abortion is legal and 55.3% of single students were more likely to leave Indiana to practice medicine. Conclusion Our research suggests that physicians who are more liberal in their views on abortion may now be much less likely to practice in conservative states which will compound the healthcare outcomes secondary to the Dobbs decision. We emphasize the role that abortion laws have in shaping the landscape of healthcare workforce and the need for a more nuanced understanding of how societal structures impact women's reproductive decisions and career paths in medicine.

Perspectives of educators and students on the efficacy of online teaching and learning strategies employed during COVID-19 in a health sciences institution.

Healthcare education encountered unprecedented challenges during the COVID-19 pandemic, but the necessary responses have also provided learning opportunities for the future. We aimed to evaluate the impact of COVID-19 on teaching and learning strategies and the perceptions of clinical educators and health sciences students on novel methods to improve online student engagement in Ireland's largest medical school. Two separate online surveys designed to gain insights into the perceived efficacy of online teaching strategies were distributed to clinical educators and health sciences students (medical and pharmacy) over 7months via email. A total of 86.4% of educators responded that rapport was more difficult to build online, and 90.5% reported less engagement from students online. The most popular methods that improved student engagement included using polls, a chat box function for questions, small group discussions and having student cameras turned on. Amongst educators surveyed, 81.8% felt a training course focused on teaching strategies at the start of every academic year would be beneficial. From the students' perspective, no difference was noted between the medicine and the pharmacy students. Seventy-five percent reported using quizzes/polls, and 63% reported using game-based platforms as techniques to improve online learning. Sixty-two percent of students described it as a positive outcome of learning during the pandemic. Any pandemic poses unique challenges to the delivery of healthcare education. These surveys report educators' and students' views on online teaching and learning strategies, highlighting novel mechanisms to improve student engagement and ultimately impact on graduate outcomes.

Feasibility of a cinematic-virtual reality training program about opioid use disorder for osteopathic medical students: a single-arm pre-post study.

Opioid use disorder (OUD) has a considerable morbidity and mortality in the United States. Healthcare providers are key points of contact for those with OUD; however, some providers may hold stigma toward OUD. Stigma toward OUD can lead to lower quality of care and more negative health outcomes. Thus, new trainings designed to reduce stigma toward OUD while increasing empathy are critical. We created a web-based cinematic virtual reality (cine-VR) training program on OUD for osteopathic medical students. The aim of this pilot study was to assess changes in stigma toward OUD and empathy before and after the online cine-VR training program on OUD. We employed a single-arm, pre- and posttest pilot study to assess changes in stigma toward OUD and empathy. Osteopathic medical students from one large medical school in the Midwest with three campuses were invited to participate in the online cine-VR training. Participants completed two surveys before and after the cine-VR training. We performed paired t tests to examine changes in stigma toward OUD and empathy scores before and after the cine-VR OUD training program. A total of 48 participants completed the training. We observed a decrease in stigma toward OUD posttraining (t=4.402, p<0.001); this change had a Cohen's d of 0.64, indicating a medium effect. We also observed an increase in participants' empathy scores posttraining (t=-2.376, p=0.023), with a Cohen's d of 0.40 signifying a small effect. Findings from this pilot study suggest that the online cine-VR training may reduce stigma toward OUD while increasing empathy. Future research employing a randomized controlled trial design with a larger, more diverse sample and a proper attention control condition is needed to confirm the effectiveness of the online cine-VR training. If confirmed, this cine-VR training may be an accessible approach to educating osteopathic medical students about OUD.

Value of Gold and Silver Signals and their Correlation with Step Scores on OBGYN Interview Offers

Competition for residency positions has led to application inflation. In the 2022-23 cycle, 16 residency specialties allowed applications to be submitted with a virtual “token” - signaling a preferred interest in a program. OBGYN was the only program using a two-tiered system that allowed applicants to assign signals using “gold” to indicate highest interest and “silver” indicating very high interest. We examined the impact of the tiered signals on interview offer trends of senior students pursuing OBGYN at a large allopathic medical school and if the interview rate was correlated with their USMLE step scores. A cross-sectional, anonymous survey included the number of interviews obtained from applications submitted using gold signals (3), silver signals (15), and no signal (no cap). Fifteen students identified as participating in the OBGYN match with 100% participation, ten of whom were from regional campuses (67%). The mean interview rate differed based on signaling, showing increased likelihood of interview offers based on signal type. Step 1 and step 2 quartile rank were not associated with signal interview rate. This study supports the use of tiered signals as a method for students to express an interest in specific programs and have it recognized by programs in extending interview offers. The authors have no conflicts of interest to disclose. This study was IRB exempt.

The Military Health History: An Educational Initiative to Improve Veteran Healthcare.

As a result of the nature of military service, veterans are a unique patient population with many special health considerations. For various reasons, measures are often not taken by clinicians to address such special considerations. This results in a healthcare disparity for veterans first described by Dr. Jeffrey Brown in 2012. To address this disparity, we introduced "the military health history" to third-year medical students at a large medical school in the southeastern United States. Our objective was to assess the effectiveness of this educational intervention and determine its potential role in creating a future in which veteran healthcare is of the highest quality. This study was approved as a quality assurance/quality improvement project by both Louisiana State University Health Science Center and Southeast Louisiana Veteran Healthcare System IRB offices. A short lecture outlining the components of the military health history was presented to 186 third-year medical students. The students were given the opportunity to answer five survey questions before and after the lecture. These questions assessed the students' current confidence performing a military health history, perceived importance of doing so, and likelihood of future implementation. To determine useful retention of the lecture material, the post-lecture survey was readministered to the same population sample 6 months after the lecture. A series of repeated measures analyses of variance were conducted to examine changes in mean levels of confidence, importance, and likelihood of ascertaining military history during a patient encounter at pre- and post-presentation as well as at the 6 month follow-up. Results revealed a significant effect of time on importance, Wilks' Lambda = 0.74, F (2, 87) = 15.41, P < 0.001; confidence, Wilks' Lambda = 0.61, F (2, 87) = 27.58, P < 0.001; and likelihood of ascertaining a military history during a future patient encounter, Wilks' Lambda = 0.46, F (2, 88) = 50.58, P < 0.001. Results are demonstrated in detail in Table I of the manuscript. The lecture resulted in a statistically significant increase over 6 months in both the likelihood and confidence parameters. The team believes that this result indicates that the students demonstrated useful retention of the lecture material. Our hope is that these students continue to employ the military health history throughout their years of clinical work. In the future, we plan to survey veterans immediately following Veterans Health Administration clinic visits with members of our study population to assess the patient's perceived benefit of the military health history. The team will continue to investigate ways in which military health curricula can be implemented in undergraduate medical education.

Gamified versus non-gamified online educational modules for teaching clinical laboratory medicine to first-year medical students at a large allopathic medical school in the United States

BackgroundMedical educators seek innovative ways to engage learners efficiently and effectively. Gamification has been explored as one way to accomplish this feat; however, questions remain about which contexts gamification would be most useful. Time constraints and student interest present major barriers for teaching laboratory medicine to students. This study aims to compare two versions of an interactive online module, one gamified and one not, for teaching laboratory medicine concepts to pre-clinical medical students.MethodsFirst-year medical students reviewed either a gamified or non-gamified version of an interactive online module in preparation for an in-person flipped classroom session on Laboratory Medicine. Learning theory guided the design of the modules and both contained identical content, objectives, and structure. The “gamified” module included the additional elements of personalization, progress meters, points, badges, and story/role play. After reviewing the module, students completed an anonymous knowledge check and optional survey.ResultsOne hundred seventy-one students completed the post module knowledge check as assigned (82 gamified, 89 non-gamified). Knowledge check scores were higher for the students who reviewed the gamified module (p < 0.02), corresponding to an effect size of 0.4 for the gamified module. Eighty-one students completed optional post-module surveys (46 gamified, 35 non-gamified). Instructional efficiency was calculated using task difficulty questions and knowledge check scores, and the resulting instructional efficiency was higher for the gamified module. There was no significant difference in the student-reported time required to complete the modules. Additionally, both versions of the module were well received and led to positive ratings related to motivation and confidence. Finally, examination of open-ended survey results suggested that the addition of game elements added value to the gamified module and enhanced engagement and enjoyment.ConclusionsIn this setting, the addition of gamification to an interactive online module enhanced learning outcome, instructional efficiency, student engagement and enjoyment. These results should inspire further exploration of gamification for teaching Laboratory Medicine concepts to pre-clinical medical students.

Leaders' Perspectives on Resources for Academic Success: Defining Clinical Effort, Academic Time, and Faculty Support.

For academic promotion, clinical faculty are expected to excel in clinical care, teaching, and scholarship. Ensuring adequate protected time and resources to engage in scholarly work in the face of competing clinical responsibilities is critical. The authors examined academic leaders' perspectives across affiliate hospitals of a large medical school regarding the definition of clinical full-time effort and academic time, best practices to enable academic success, and barriers to faculty advancement. Open-ended, semistructured, individual interviews were conducted with a purposive sample of clinical department and division heads. Interview data were examined to illuminate the range and commonalities in practices and to identify successful approaches. Interviews were conducted with 17 academic leaders across 6 affiliate hospitals. There was considerable variability in clinical full-time effort definition. "Academic time," more accurately characterized as "nonclinical time," was typically 1 day a week for nonshift specialties and mostly used for administrative work or completing clinical documentation. Certain departments were more explicit in designating and protecting time for academic pursuits; some had invested resources in intensive programs for academic advancement with built-in expectations for accountability. The impact of documentation burden was considerable in certain departments. Marked variability exists in time allocations for clinical and academic work, as well as in resources for academic success. This supports the potential value of establishing standards for defining and protecting academic time, motivating clinical faculty to engage in academic work, and building accountability expectations. Sharing best practices and setting standards may enhance academic advancement. Strategies to reduce documentation burden may enhance wellness.

Exams-related stress and the pattern of substance use and misuse among Palestinian medical and health sciences students

Substance use among school students is a public health concern. Exam-related anxiety is one of the main motives for drug use. This research aimed to determine the prevalence and characteristics of psychostimulant and antidepressants use and misuse among medical and health sciences students at two large representative medical schools in West Bank Palestine. The results of a cross-sectional study, that surveyed 984 Palestinian medical and health sciences students revealed how educational experiences and newfound independence affect substance use behaviors among Palestinian medical and health sciences students. In total, 7.7% of the students reported using illicit drugs. Hallucinogens were the most commonly used drugs (2.9%), followed by central nervous system (CNS) stimulants (2.4%) and CNS depressants (1.4%), while 4.4% were using nonprescribed antidepressants, with Fluoxetine being the most used. Most drug users (72.4%) started using before they enrolled in university, and 39.5% did not realize the potential harm of these drugs. Medical students tend to use these substances less frequently than their non-medical peers. The study indicated that exam-related stress was a crucial factor in the prevalence of drug use and misuse. Peer pressure, academic, psychological, and family pressures were other primary reasons behind drug use. The study’s results indicated that the misuse of antidepressant medications and other licit and illicit substances is highly prevalent among Palestinian medical and non-medical students. The results also underscore the importance of raising awareness about drug use and providing students with accurate information about the safe use of these substances.

Impact of the Dobbs v Jackson Women's Health Organization decision on retention of Indiana medical students for residency

As medical students consider residency training programs, access to comprehensive training in abortion care and the legal climate influencing abortion care provision are likely to affect their decision process. This study aimed to determine medical students' desire to stay in a state with an abortion ban for residency. A cross-sectional survey was distributed to all medical students at a large allopathic medical school. Anonymous survey questions investigated the likelihood of seeking residency training in states with abortion restrictions and the likelihood of considering obstetrics and gynecology as a specialty. Qualitative responses were also captured. The survey was distributed to 1424 students, and 473 responses yielded a 33.2% completion rate; 66.8% of students were less likely to pursue residency training in Indiana following a proposed abortion ban. Moreover, 70.0% of students were less likely to pursue residency in a state with abortion restrictions. Approximately half of respondents (52.2%) were less likely to pursue obstetrics and gynecology as a specialty after proposed abortion restrictions. Qualitative remarks encompassed 6 themes: comprehensive health care access, frustration with the political climate, impact on health care providers, relocation, advocacy, and personal beliefs and ethical considerations. Most medical students expressed decreased likelihood of remaining in Indiana or in states with abortion restrictions for residency training. The field of obstetrics and gynecology has been negatively affected, with medical students indicating lower likelihood to pursue obstetrics and gynecology. Regardless of specialty, the physician shortage may be exacerbated in states with abortion restrictions. The overturn of Roe v Wade has the potential for significant effects on medical student plans for residency training location, thereby shaping the future of the physician workforce.

The Importance of Research Experience With a Scoreless Step 1: A Student Survey at a Community-Based Medical School.

As of January 26, 2022, the United States Medical Licensing Examination (USLME) step 1 exam went from a scored test to pass-fail step 1 (PFS1). The authors were interested in surveying medical students at a community-based medical school to observe their perceptions of the importance of student research given this recent change. A Qualtrics survey was disseminated to medical students (years 1-4) via school emails. Data were analyzed using the Mann-Whitney test to assess Likert scale scores, and narrative comments were grouped as qualitative feedback. Survey dissemination and analysis of data were both conducted at a large community-based medical school. The survey sampled 104 students categorized into pre-clerkship (PC) and clerkship (CL) years, with a response rate of 33%. A contradiction was found, as indicated by the higher number (p = 0.047) of clerkship students interested in Primary Care/Family medicine residency compared to pre-clerkship students at 41% and 59%, respectively. Whereas participants who indicated they are interested in pursuing a competitive specialty for residency were 51% of pre-clerkship students over 41% of clerkship students (p = 0.047).Additionally, given the assessment change to pass/fail, students did in fact believe that residencies would now view research as a higher assessed component than before (79% pre-clerkship and 72% clerkship). However, a minority of students said that they increased their research efforts (41% and 47%). Most students supported the research opportunity improvements proposed in our survey. Efforts to make the step 1 exam pass/fail may have alleviated some stress related to performance but may have increased the perception of the importance of other components in a student's residency application. Our survey highlights how medical students at a community-based medical school perceive this change and how it has affected their research efforts.

Medical Student Mentorship in the COVID-19 Era.

The Covid-19 pandemic led to a reduction of in-person, guided mentorship due to social distancing and an emphasis on virtual meetings. The effect of these changes on medical students' experiences and specialty choice has yet to be studied in a large-scale manner. To determine the perspective of third- and fourth-year medical students regarding the impact of the COVID-19 pandemic on mentorship. The authors distributed a modified Likert scale questionnaire (score: 1-10) to assess responses. Third- and fourth-year medical students at two large US allopathic medical schools. Responses to each survey item were analyzed to characterize the impact of the COVID-19 pandemic on mentorship relationships in medical school. A score of 1-5 was considered "disagree" and a score of 6-10 was considered "agree." A total of 144 responses were collected with a response rate of 16.2%. Overall, 80.6% (n = 116) of respondents agree that the COVID-19 pandemic has had a negative impact on their medical school experience. Nearly half (41.0%, n = 59) expressed concern over the lack of mentorship opportunities, and 66.0% (n = 95) reported that the pandemic has made it more difficult to form or maintain connections with their mentors. Importantly, 43.6% (n = 61) of respondents reported that having close mentoring relationships reduced the impact of the pandemic on their medical training. While many respondents (79.9%, n = 114) did not change career plans due to the pandemic, most students are concerned about evaluating prospective residency programs (88.9%, n = 128). Notably, M3s have much lower confidence than M4s in their ability to choose a specialty (5.9 vs. 8.2, p = 6.43e - 08). This investigation illustrates the concerns that medical students have regarding access to mentorship opportunities due to the COVID-19 pandemic. We hope that these findings encourage medical schools to evaluate and expand their current mentorship programs. The online version contains supplementary material available at 10.1007/s40670-023-01838-4.

Multivariate Modeling of Student Performance on NBME Subject Exams.

Aim This study sought to determine whether it was possible to develop statistical models which could be used to accurately correlate student performance on clinical subject exams based on their National Board of Medical Examiner (NBME) self-assessment performance and other variables, described below, as such tools are not currently available. Methods Students at a large public medical school were provided fee vouchers for NBME self-assessments before clinical subject exams. Multivariate regression models were then developed based on how self-assessment performance correlated to student success on the subsequent subject exam (Medicine, Surgery, Family Medicine, Obstetrics-Gynecology, Pediatrics, and Psychiatry) while controlling for the proximity of the self-assessment to the exam, USMLE Step 1 score, and the academic quarter. Results The variables analyzed satisfied the requirements oflinear regression. The correlation strength of individual variables and overall models varied by discipline and outcome (equated percent correct or percentile, Model R2 Range: 0.1799-0.4915). All models showed statistical significance on the Omnibus F-test (p<0.001). Conclusion The correlation coefficients demonstrate that these models have weak to moderate predictive value, dependent on the clinical subject, in predicting student performance; however, this varies widely based on the subject exam in question. The next step is to utilize these models to identify struggling students to determine if their use reduces failure rates and to further improve model accuracy by controlling for additional variables.

Medical student perceptions and experiences of incivility: a qualitative study

BackgroundIncivility is rude, dismissive or aggressive behaviour in the workplace. Rates of incivility are increasing in healthcare settings, with minority groups at greatest risk. Medical students are particularly vulnerable to incivility whilst on clinical placements, with detrimental consequences on students’ learning and mental health. Therefore, this study explored the perceptions and experiences of incivility from healthcare workers amongst medical students.MethodsAn online qualitative questionnaire study employing a thematic analysis. Students in years 3–5 or intercalating at a large West Midlands medical school were recruited between May–June 2022. Qualitative free-text questions explored students’ experiences of incivility from healthcare workers over the past 12 months, and actions in response to incivility. Data were analysed using thematic analysis. All researchers agreed thematic saturation was reached at 50 responses, with all year-groups represented.ResultsFive core themes were identified: abuse of hierarchy; exclusion; discrimination; response to incivility; barriers to action. Participants reported a range of uncivil behaviour from staff, including mocking, exclusion and discrimination. Discriminatory incivility targeted students’ protected characteristics, including race, sex, sexual orientation and disability. In response to experiencing or witnessing incivility, participants varied in their preferred mode of action. Many viewed formal escalation to senior staff as favourable action. Meanwhile, other participants would not escalate concerns and instead respond with peer support or allyship. Marked barriers prevented students from challenging or reporting incivility, including a lack of confidence; failures and fears of reporting systems; and perceived severity of abuse.ConclusionOur findings identify the extensive incivility experienced by medical students on clinical placements, which is frequently perpetuated by abusive workplace hierarchy. Whilst students recognise the importance of reporting uncivil behaviours, barriers to reporting include unrecognised incivility, psychological consequences and failed reporting systems. In order to reform toxic educational environments, we recommend medical schools to integrate formal civility training into the curriculum and restructure accessible, supportive reporting systems.

Toward improvement of knowledge of financial conflicts of interest in a large medical school in France.

Conflict of interests (COIs) adversely affect the integrity of science and public health. The role of medical schools in the teaching and management of COIs has been highlighted by the publication of an annual evaluation of American medical schools based on their COIs policies by the American Medical Student Association (AMSA). A deontological charter was adopted by French medical schools in 2018 but its impact on COI comprehension by students and its effects on COI prevention were not evaluated. A 10-item direct survey was conducted among about 1000 students in Paris-Cité University in order to investigate the respect of the charter regarding COIs both in the medical school and in affiliated teaching hospitals. Cumulative results show a satisfying respect of prevention policies regarding COIs in the medical school and hospitals despite the fact that the existence of the charter and its major aspects were insufficiently known. Disclosure of COIs by teachers was insufficient. This first direct study among students shows better results than expected according to current non-academic surveys. Moreover, this study demonstrates the feasibility of this kind of survey whose repetition should be an appropriate tool to improve the implementation of the charter within medical schools and teaching hospitals, in particular mandatory disclosure of COIs by teachers.

Immersive Virtual Reality and Cadaveric Bone are Equally Effective in Skeletal Anatomy Education: A Randomized Crossover Noninferiority Trial

Immersive virtual reality (IVR) technology is transforming medical education. Our aim was to compare the effectiveness of IVR with cadaveric bone models in teaching skeletal anatomy. A randomized crossover noninferiority trial was conducted. Anatomy laboratory of a large medical school. Incoming first-year medical students. Participants were randomized to IVR or cadaveric groups studying upper limb skeletal anatomy, and then were crossed over to use the opposite tool, to study lower limb skeletal anatomy. Participants in both groups completed a pre-and postintervention knowledge test. The primary endpoint of the study was change in performance from the pre-to postintervention knowledge test. Surveys were completed to assess participant's impressions on IVR as an educational tool. Fifty first-year medical students met inclusion criteria and were randomized. Among all students, the average score on the preintervention knowledge test was 14.6% (standard deviation (SD) = 18.2%) and 25.0% (SD = 17%) for upper and lower limbs, respectively. Percentage increase in scores between pre-and postintervention knowledge test, was 15.0% in the upper limb IVR group, and 16.7% for upper limb cadaveric bones (p = 0.286). For the lower limb, score increase was 22.6% in the IVR and 22.5% in the cadaveric bone group (p = 0.936). 79% of participants found that IVR was most valuable for teaching 3-dimensional orientation, anatomical relationships, and key landmarks. Majority of participants were favorable towards combination use of traditional methods and IVR technology for learning skeletal anatomy (LSM>3). In this randomized controlled trial, there was no significant difference in knowledge after using IVR or cadaveric bones for skeletal anatomy education. These findings have further implications for medical schools that face challenges in acquiring human cadavers and cadaveric parts.

Developing medical professionalism in care of gender nonconforming patients: Reflections of second-year medical students after a curricular experience with gender nonconforming people and allies

Introduction Negative healthcare experiences persist for gender nonconforming individuals. Clinician-related factors, including lack of comfort with gender nonconforming persons and unexamined personal biases, present barriers to equitable and affirming healthcare. We explored the effects of contact with gender nonconforming individuals in preclinical medical education through a structured curricular intervention designed to build medical and humanistic knowledge and stimulate the development of medical professionalism surrounding the care of gender nonconforming individuals. Methods A curricular module (didactic prework, time-synchronous online panel discussion, and post-event written reflection) was implemented in a second-year preclinical course in a large multi-campus Midwestern medical school. The module was based on pedagogical foundations of contact theory and reflective writing. Post-event written reflections were investigated using thematic analysis. Results Analysis of 355 written reflections revealed three major themes (moments of insight, topics of confusion, connections to professional identity formation) and eight sub-themes. The findings demonstrated emerging gender professionalism and the importance of contact in professional development. Discussion Contact with gender nonconforming people and the use of written reflections can encourage self-examination and foster professional identity formation among preclinical medical students. Modeling gender-affirming approaches may help counteract negative cultural messages about gender nonconforming people, aiding development of inclusive future physicians.

Online Medical Education: Utilization of Google Forms for Remote Active Learning Experiences in a Large Medical School Class During the COVID-19 Pandemic.

Remote delivery of preclinical medical scientific curriculum during the COVID pandemic to a large medical school class (n = 429) provided limited options for active learning. We implemented adjunct Google Forms in a first-year medical school class to provide online, active learning with automated feedback and mastery learning approaches.

The implementation of a required book club for medical students and faculty

ABSTRACT More medical schools are incorporating wellness activities and the medical humanities into their curriculum. Finding implementable programming that is feasible and enjoyable is challenging. Both student participants and faculty who might facilitate programs are busy with clinical and educational responsibilities. Book club discussions in general are an activity that bring people together and expose groups to literature. In medical education, informal books clubs have been shown to increase camaraderie and expose participants to topics in medicine that they may not have encountered without the structure of the group assignment. At one large private urban medical school, all fourth year medical students were required to participate in a one-time hour-long book discussion with a faculty member one week before Match Day 2021. This paper describes the implementation of that program and discusses survey results from 179 students who broadly indicated that the books were enjoyable, the discussions were enriching, and that the program should continue for future classes of medical students.

Characterizing physician concerns with publicly supporting abortion at Wisconsin's largest medical school.

To examine factors associated with physicians' level of concern and perceived consequences of publicly supporting abortion at Wisconsin's largest and only publicly funded medical school. We surveyed physicians at the University of Wisconsin School of Medicine and Public Health about their knowledge, attitudes, and referral practices regarding abortion care. Among those who expressed support for abortion (N= 701), we analyzed perceived concerns about making their support public. Nearly a quarter (22%) of respondents felt very or extremely concerned that taking a strong public stance on abortion would alienate patients and 17% felt very or extremely concerned that doing so would alienate coworkers. More than a quarter (27%) felt very or extremely concerned that publicly supporting abortion would lead to harassment or harm. Those with greater concerns about expressing public support for abortion were comparatively less willing to refer for or participate in abortion care themselves. Many physicians supportive of abortion reported concerns over publicizing their support for this common health care service. These concerns may render physicians less likely to refer patients for needed abortion care or weigh in on abortion policy.