Medical School Deans Research Articles

Arts-Related Activities Across U.S. Medical Schools: A Follow-Up Study

Background: The authors' 2001 survey of the variety of arts-related activities incorporated by U.S. medical schools revealed expansion far beyond the literary arts introduced three decades ago.Purpose: A 2002 survey of all U.S. medical schools was designed to assess student involvement in arts-related activities in greater depth.Methods: Questionnaires were mailed in summer 2002 to all U.S. medical school deans asking about characteristics of arts-related activities, degree and nature of student participation, and if specific outcomes are assessed.Results: The 65% response rate indicates that over half of U.S. medical schools involve the arts in learning activities. Most include literature, visual arts, performing arts, and/or music. Active participation exceeds passive. Electives typically involve 15-18 students. School-based funding predominates. Assessment for increased well-being, clinical skills, and humanism is rare.Conclusions: Utilization of the arts serves four major functions: (a) enhancement of student well-being, (b) improvement of clinical skills, (c) promotion of humanism, and (d) employment by students as a teaching tool.

Coalition of American societies for anatomy

On 17 October 2003, there was a historic meeting in Washington, D.C. Representatives from the American Association of Anatomists (AAA; Robert McCuskey, President; Kathy Svoboda, President-Elect; and Andrea Pendleton, Executive Director), American Association of Clinical Anatomists (AACA; Daniel Graney, Past-President; Arthur Dalley, Past-President; and Todd R. Olson, Treasurer), Association of Anatomy, Cell Biology, and Neurobiology Chairpersons (AACBNC; James West, President-Elect; and Stephen Carmichael, Past-President), and the Human Anatomy and Physiology Society (HAPS; Phil Tate, President; Sandra Lewis, President-Elect; and Gail Jenkins, Treasurer) gathered in a roundtable discussion hosted by Donald Jenkins of the National Library of Medicine. The meeting was the initiative of Bob McCuskey and enthusiastically endorsed by the representatives of the above-named organizations. The goal was to seek common ground on challenges and opportunities presented to the modern anatomist in the United States and Canada. The discussions were amicable and far-reaching. There was widespread concern about the source of future teachers of anatomy. Whereas the participants unanimously agreed that a shortfall is predictable, it is imperative to involve the lead administrators at the involved academic institutions (i.e., medical school deans). Bob McCuskey will organize leaders of the involved organizations, as well as a leader from the Council of Deans (a subgroup of the Association of American Medical Colleges), to draft a “white paper” on the importance of anatomy in health education, the shortage of anatomy educators, and the need to train qualified educators for the future. The use of donated human bodies for the purpose of education was another topic of discussion. It was agreed that recognition and appreciation of this precious resource is a preeminent concern to all anatomists. Also, public displays of human material need to conform to local laws and the sensibilities of the general community must be considered. Representatives from each of the societies will work together to address common concerns about donated material. Don Jenkins moderated the discussion in such a way that each participant had the opportunity to express his or her opinions fully, and each topic was thoroughly covered before moving onto another. Topics were as diverse as forming a coalition of health professionals who constitute the “end users” of anatomy education, to the future of virtual microscopy (the use of computers rather than microscopes) in histology courses. Each participant had ample opportunity to hear the opinions of others and to be heard. Mutual respect among the participants was abundant. Although historical differences among some of the organizations were reviewed, it was obvious that we are entering a new era of cooperation among anatomists. Several joint projects are already in place and more will be organized in the near future. As testament to this newly forged alliance, the AAA, AACA, and HAPS agreed to form an umbrella organization that will provide a forum for discussion and subsequently coordination of the common causes of anatomical organizations in the United States and Canada. This organization will be known as the Coalition of American Societies for Anatomy (CASA; a homey acronym, to be sure). We are predicting success for this newly formed coalition.

AOA/AOS. The future of academic orthopaedics.

At the Annual Meeting of the American Orthopaedic Association (AOA) in June 2003, the Executive Committee of the Academic Orthopaedic Society (AOS) met and voted to formally dissolve the AOS at the end of this fiscal year. This decision came at a time when program directors face substantial changes. These changes, mandated by the Accreditation Council for Graduate Medical Education (ACGME), specified resident work-hour requirements, as well as resident evaluations based upon performance in the six core competencies. Traditionally, these topics would consume much of the Annual Fall Meeting of the AOS. In the organization's early years, these mandates would have been subjected to the scrutiny of a midyear Delphi panel. Chairpersons and program directors would have had an opportunity to carefully review these required changes, reach a consensus, and, hopefully, come to an agreement with regard to the best method of implementation. In fact, chairpersons and program directors in all specialties have felt the need for frequent collaboration and, as such, virtually every specialty has an association of program directors and, in turn, a national association of program directors. The history of this organization in orthopaedics is as follows: The Association of Orthopaedic Chairmen (AOC) was originally founded in 1971 under the leadership of Kay Clawson, MD, and Fred Reynolds, MD. The purpose was to discuss issues that were not currently addressed by the AOA, the American Academy of Orthopaedic Surgeons (AAOS), or the American Board of Orthopaedic Surgery. These issues included the recruitment of new faculty members, development of an orthopaedic residency curriculum, and providing orthopaedic instruction in undergraduate medical education. The founders recognized the necessity to speak in a unified voice to medical school deans with regard to the problems confronting academic departments and/or divisions of orthopaedic surgery. The organization began with fifty-six members and, by 1990, …

A study of smoking and smoking cessation on the curricula of UK medical schools

Objectives: To identify current practice in teaching on smoking and smoking cessation in UK medical schools, and establish whether newly qualified UK doctors feel prepared to deliver smoking cessation interventions....

Cardiology's workforce shortage: implications for patient care and research.

The common wisdom at the end of the 20th century was that the United States was training too many specialists, including cardiologists.1 By 2001, however, there was increasing evidence that the supply of cardiologists was not meeting the growing demand. That year, as president-elect of the American College of Cardiology (ACC), I appointed a task force to evaluate cardiology workforce. The task force undertook a 2-year process of literature review, hypothesis generation, research design, data acquisition, and analysis. This intense effort included a Bethesda Conference at which consensus was achieved on a report that will be published in the Journal of the American College of Cardiology . Based on various types of information and data, the ACC task force concluded that the United States is facing a shortage of cardiologists. This will reduce access to specialty care of proven benefit and will undermine our nation’s vital cardiovascular research effort. The Bethesda Conference report includes 8 working group documents that recommend several short- and intermediate-term strategies to help narrow the growing demand-supply gap for cardiologists (see Table 1). Some recommendations can be implemented at a local practice or institution level. Others will require a series of complex and coordinated actions at a national level. Hopefully, the report will catalyze actions by academic medical centers, regulatory organizations, federal policymakers, professional societies, and others that influence the output of cardiovascular specialists. View this table: TABLE 1. Working Groups of the ACC Task Force on Workforce Several things continue to drive demand for cardiologists. Elsewhere, I have argued that various scientific, social, and demographic “demand catalysts” outweigh factors that might decrease demand for cardiologists during the next decade2 (see Table 2). Although the relative influence of each demand factor will change over time, one thing is certain: the cardiovascular disease burden in the United States …

Is a Third Year Clerkship in Emergency Medicine Correlated With a Career Choice in Emergency Medicine?

Background: The factors medical students use to choose emergency medicine (EM) as a career path have not been well studied. The role of a 3rd year clerkship in EM in a student's choice of EM residency is not known. Purpose: The purpose of this survey was to determine whether a 3rd year clerkship in EM is correlated with a student's choosing EM as a career choice, as evidenced by the number of students who apply for or matching in EM in medical schools in the United States. Methods: The deans of American medical schools were surveyed by mail, using a seven-part questionnaire inquiring as to type of exposure, number of students, length of the exposure, number of students applying for and matching in EM in the past 3 years. The data was analyzed using SPSS software. Results: The survey was returned by 71 of the 125 medical schools (56.8 percent) in the country. The average class size was 129.9 students. Over one half of the medical schools (58.8 percent) provided EM exposure in the 3rd year; in 38.7 percent it was a required clerkship. The number of students applying for or matching in EM was not correlated with a required or elective rotation in EM, departmental status, percentage of board certified emergency physicians, emergency department volume, or a residency training program in EM (p >. 05). Conclusions: This study did not demonstrate a correlation of a 3rd year rotation in EM with the number of students applying or matching in EM.

Perceptions of medical school deans and state medical society executives about physician supply.

Physician shortages are appearing, yet controversy about their significance and uncertainty about their remedy exist. To sample the perceptions of medical school deans and state medical society executives about the adequacy of physician supply, to determine the perceived impact of any shortages on medical schools, and to assess the capacity of medical schools to expand. Medical school deans in the United States and Puerto Rico were surveyed by means of a structured questionnaire, and officials of US state medical societies were queried by means of open-ended telephone interviews. Information was obtained from 58% of medical school deans and 86% of state medical society executives. Reported perceptions of shortages or surpluses of physicians by specialty and plans to increase medical school class size. Approximately 85% of both deans and medical society respondents perceived shortages of physicians, usually in multiple specialties, while 10% perceived surpluses, usually coexisting with shortages. Among deans reporting shortages, 83% described a negative impact on their schools. Recent or planned increases in class size were reported by 27% of deans and expansion capacity by another 34%, but 7% noted recent decreases in class size. Applied generally, these changes in class size could yield 7.6% additional matriculants annually. Physician shortages are prevalent and they are negatively affecting medical schools. Little capacity exists to alleviate these shortages through class size expansion.

Cardiovascular News

Cardiovascular News

Nature Cures: The History of Alternative Medicine in America (review)

The enormous expansion of interest in and usage of alternative medicine by the American public in the last couple of decades is provided in Nature Cures with a brilliant historical background that unifies the role of unorthodoxy through the nation's past. Anyone concerned with health—from the undergraduate pre-med student to the medical school dean, as well as the curious patient—will be fascinated and enlightened by James C. Whorton's deeply researched, lively, and persuasive account. Apt quotations from the sources are especially well chosen.

Impact Factor: Myths and Realities

The Impact Factor was originally devised as an index of the quality of scientific journals and has since obtained mythical proportions. Authors select journals to which they submit their work on the basis of that journal’s Impact Factor. Medical school deans and administrators have adopted the Impact Factor as a means of judging the quality of the academic efforts of individual faculty, as well as the aggregate academic productivity of medical school departments. Departmental budgets have been based on the Impact Factor. There are serious questions as to the validity of using the Impact Factor for these purposes.

Case Western Reserve University Names Ralph Horwitz New Vice President for Medical Affairs, Medical School Dean, and Director of Case Research Institute

Case Western Reserve University Names Ralph Horwitz New Vice President for Medical Affairs, Medical School Dean, and Director of Case Research Institute

Case Western Reserve University Names Ralph Horwitz New Vice President for Medical Affairs, Medical School Dean, and Director of Case Research Institute

Case Western Reserve University Names Ralph Horwitz New Vice President for Medical Affairs, Medical School Dean, and Director of Case Research Institute

Clinical pharmacology and therapeutics into the future.

Clinical pharmacology sits at the interface between basic pharmacology and the effective drug treatment of human disease. Because of the dominance of pharmacotherapy in modern therapeutics, clinical pharmacology has become indispensable for the development of new treatments as well as for the proper understanding and practice of contemporary medicine. Clinical pharmacologists have not only been strikingly successful in advancing therapeutic knowledge but, especially in the UK, they have also developed a broader leadership role in the provision of health services. Nevertheless, there remain areas of activity where the influence of the discipline has been less impressive, and where there are real opportunities for the future of the subject.

The ordinariness of teaching

This issue of the journal presents papers covering aspects of student learning and the teaching experience. All of us are interested in how our students are progressing and in what they think about the educational activities we provide for them, but how often do we really know what our students are thinking? A Letter to the Editor starts the proceedings: Bridgens, now a qualified doctor, writes with feeling about some of his experiences as a student, decrying teachers and educationalists for the gloss we put on our practice when the reality, at least for some students some of the time, is a far remove from the theory. His main complaint focuses on the practical delivery of clinical teaching, pointing out both its regular failure to occur and its haphazard nature, resulting in feelings of depression and demotivation amongst students. He resolved to do better as a teacher himself when qualified and writes that teaching must become recognised as an essential and important part of a doctor's duty and not just seen as an afterthought. He recognises that protected time is required to ensure this and to make sure that teaching brings life to the ordinariness of everyday clinical practice rather than be seen as an extra duty.1 In reply, Sam Leinster, Dean of a new medical school in England draws on the results of the inspections of all medical schools in England during the period 1998–2000 by the Quality Assurance Agency. Those inspections rigorously examined how teaching was delivered at each school. Of all the criteria examined, Quality Management and Enhancement was the commonest area of weakness with very few schools achieving full marks for the provision of suitable systems to monitor quality of teaching. Whilst the responsibility for the delivery of teaching rests clearly with the teacher, both Bridgens and Leinster point out the problems faced in trying to achieve quality in a system that is under pressure. One part of the solution is to ensure that teaching becomes a fixed part of the service contract for clinicians. Leinster recognises that this will not work for all, with ‘pressed men’ less likely to achieve good results than those with interest and ability in teaching. Another part of the change process includes improving monitoring and management systems within the teaching environment, with the routine collection of student views a central part of the data set. Collecting data is not sufficient in itself and management systems that allow rapid action and feedback to students and teachers are essential to ensure that the teaching ‘system’ learns from its mistakes and continues to grow.2 Why does this matter? Well, for many of us our choice of career within medicine was based on positive experiences we had as students during our clinical attachments. These experiences may have been with a particular patient or groups of patients, with an aspect of technology, the intellectual challenge offered by a certain discipline or, and I think quite commonly, by the influence of a particular role model clinician or teacher. Fortunately, the experiences described by Bridgens are balanced by some at the other end of the scale, and this month McParland and her colleagues in London describe the effects of a psychiatric attachment on how students viewed a potential career in psychiatry.3 They asked students from both a problem based and a traditional curriculum about their career intentions and their attitudes to psychiatry before and after an eight week clinical rotation. They found that specific experiences during the attachment significantly influenced the development of positive attitudes towards a career in the specialty – amongst these positive experiences were receiving encouragement from consultant teachers and being directly involved in patient care. What can we learn from this debate? Medical students, like all other human beings respond warmly to positive stimuli, and react to negative environments by withdrawal and adopting defensive attitudes. It is the teacher's responsibility to establish a learning environment that encourages learning, and planned, structured learning activities and teaching are key components of this environment whatever educational philosophy underpins the curriculum in vogue. There is no place for the haphazard, the unprepared or the absent teacher in contemporary medical education. But just like medical students, medical teachers too need a positive working environment in which to flourish and use their skills to the full. Who is responsible for ensuring this?

Case Western Reserve University Names Ralph Horwitz New Vice President for Medical Affairs, Medical School Dean, and Director of Case Research Institute

Case Western Reserve University Names Ralph Horwitz New Vice President for Medical Affairs, Medical School Dean, and Director of Case Research Institute

Development criteria for academic leadership in anesthesiology: have they changed?

T he issues facing chairs of academic anesthesiology departments have changed quite dramatically over the past decade (1,2). The rapidly changing health care environment has placed academic anesthesiology departments at significant financial risk and dramatically impacted the recruitment of residents and faculty (1–3). Chairs of academic anesthesia departments have thus been faced with unprecedented challenges over the last decade that have forced increased dependence on clinical productivity from faculty (2,3). The impact of this increased pressure on the ability of academic physicians to pursue their primary missions of teaching, research, and academic career development is not well documented. We surveyed chairs of American academic anesthesiology departments and deans of American medical schools to evaluate the impact of the last decade on the selection criteria for academic chairs of anesthesiology. Traditional criteria, such as teaching experience and peer-reviewed research, as well as potential new criteria, such as formal business education, were evaluated. We also inquired about the availability of nonclinical time for potential chairs to pursue academic goals. The purpose of this study was to determine if the criteria for chairmanship of American academic anesthesiology departments have changed in light of the evolving health care environment.

Development Criteria for Academic Leadership in Anesthesiology: Have They Changed?

Development Criteria for Academic Leadership in Anesthesiology: Have They Changed?

La Francophonie médicale

Medicine has always been and remains the most solid base of the French-speaking world which was born in Africa and Indochina with the admirable action of "colonial" military physicians, the implantation of the Pasteur Institutes and the emergence of resulting overseas medical schools. Obviously, we are referring to the French-speaking medical world. Since the first International Conference of the Deans of French-Speaking Medical Schools in Abidjan in 1981, today medical schools from 40 French-speaking countries participate. The conference undertakes co-operative medical school initiatives in a multi-lateral spirit, comprised by concrete, practical actions to assist universities in developing countries strive for excellence. These actions, which are conducted with the help of both institutional (AUF, MAE, WHO, UNESCO) and private partners mainly concentrate on promoting medical education of medicine, the evaluation of medical schools, the development of scientific and technical information and training teachers in the methodology of scientific clinical research and in public health. For the future, the Conference has three important objectives, to assist in training researchers and consequently in the development of research centres in emerging countries, to promote continuing medical education in rural areas far from medical schools by taking advantage of modern computer technology, and finally to open horizons toward other communities which speak other languages, and first of all, towards non French-speaking countries who live in a French-speaking environment.

Medical Education and The Arts: A Survey of U.S. Medical Schools

Background: Although the literary arts initiated the movement to include the humanities in medical education, little is known about the incorporation of other art forms. Purpose: A study was designed to determine the variety of arts-related activities in U.S. medical schools. Methods: Questionnaires were mailed twice to each of the U.S. medical school deans requesting information about arts-related required and elective courses, extracurricular activities, course and activity titles, and funding sources. Results: Of 100 respondents (78%), 21 offer arts-related required courses, 42 offer electives, and 89 offer extracurricular activities. School-based funds were listed in 67 schools and endowments in 13. Conclusion: Exposure to a variety of the arts is commonplace in U.S. medical schools. Almost half the schools involve the arts in the curriculum and over two thirds support arts-related extracurricular programs. Further investigation is necessary to determine the numbers of students involved, degree of involvement, and the impact on learning and practice.

The Missing Links Between the Veterinary and Medical Fields in Saudi Arabia

The Missing Links Between the Veterinary and Medical Fields in Saudi Arabia