Medical School Location Research Articles

Usage and perception of electronic medical records (EMR) among medical students in southwestern Nigeria

BackgroundThe transformational potential of electronic medical records (EMRs) in global healthcare is evident, but their adoption in low- and middle-income countries, including Nigeria, remains low.ObjectiveThis study aimed to understand the perceptions of southwestern Nigerian medical students toward EMRs given the limited literature on this topic.MethodsA descriptive, cross-sectional online survey was conducted among 412 medical students from four institutions in southwestern Nigeria. Data on the students' demographics, exposure to, and perspectives on EMR was collected. Data was analyzed using R Version 3.6.1.ResultsMajority (79%) of respondents were in their clinical years. We found that 68.4% of the respondents had good perception (scores ≥ 16) about EMRs while 31.6% were deemed as having fair level of perception (scores < 16). Interestingly, 54.9% had never used an electronic medical record (EMR). Although 46.4% felt very comfortable with EMRs' postgraduation use, 16% felt very uncomfortable. Notably, 94.5% believed that health technology solutions could enhance Nigerian health outcomes. Furthermore, 81.8% felt that their medical education would benefit from greater EMR exposure, while 80.9% believed that EMRs are essential for adequate patient care. Males exhibited significantly more EMR experience and more positive attitudes toward EMRs. However, there was no significant association between the level of study, location of medical school, and respondents' experience or perceptions of EMRs.ConclusionMore than half of students surveyed reported that they have never used EMRs. Despite this, many students felt comfortable with the idea of using EMRs in their future practice. Observed gender differences in EMR use and attitudes highlight the need for targeted strategies to prepare all students, regardless of gender, for the digital transition in healthcare.

Biostatistics deserts and scholarly productivity among US medical schools

The teaching and practice of biostatistics are essential to medical education, but access to biostatistical expertise is limited at many medical schools. Medical schools in rural and historically underserved areas may be doubly disadvantaged in accessing biostatistics expertise by their lack of financial resources and a lack of local programmes training future generations of biostatisticians. Using public data on US medical schools and biostatistics PhD programmes, we identified medical schools operating in ‘biostatistics deserts’ (institutions without an affiliated or colocated PhD programme in biostatistics) and correlated each medical school's location in a biostatistics desert with scholarly productivity, operationalized as the annual number of scholarly publications. Among 126 MD‐granting medical schools in our analysis, 46% were located in a biostatistics desert and had a median of 590 publications/year, compared to 993 for medical schools with a colocated PhD programme and 1,369 with an affiliated programme. On multivariable analysis, the presence of a Biostatistics, Epidemiology, and Research Design (BERD) programme, but not affiliation or colocation with a biostatistics PhD program, was associated with higher scholarly productivity. Structured biostatistics services, such as BERD programmes, may represent the best opportunity for medical schools to leverage the local biostatistics workforce to support scholarly publication.

Exploring Medical Students’ Perceptions of Peer-to-Peer Interactions Related to Applying to a Surgical Residency

The objectives were to (1) identify themes related to competitive peer-to-peer interactions elicited from the lived experiences of undergraduate medical students, and (2) understand how these experiences influenced medical students' choices related to surgical residency programs. A qualitative descriptive methodology, with purposive and maximal variation sampling (e.g., selection based on medical school location; gender), was adopted for this study. Temerty Faculty of Medicine, University of Toronto. Participants were 15 undergraduate medical students from 4 medical schools in Ontario, Canada, who agreed to an individual semi-structured interview by Zoom or telephone. Peer-to-peer interactions influence students' perception of self and identity formation related to surgical specialty decision-making and interest. These interactions were shown to hold greater value, specifically for information gathering. Identity formation, related to pursuing a surgical residency, was influenced by the attitudes and perceptions of competition with peers throughout medical school. Cultures of competition were seen to dictate peer-to-peer interactions and their associated value, with their perception and experience differing between medical schools. Peer-to-peer interactions and a culture of competition have inherent roles in the residency decision-making process. We observed that student background and pre-formed relationships influenced how students perceived and responded to competition. Addressing the culture of competitiveness associated with peer-to-peer interactions along with considering student background and pre-existing relationships may provide insight into how medical educators can tailor learning experiences that limit the detrimental effects of hidden curriculum influences.

Motivational Interviewing Education in North American Family Medicine Clerkships: A CERA Study.

Many health conditions are preventable or modifiable through behavioral changes. Motivational interviewing (MI) is an evidence-based communication technique that explores a patient's reasons for behavioral changes. This study assesses the current landscape of MI training in North American Family Medicine (FM) clerkships. We analyzed data gathered as part of the 2022 Council of Academic Family Medicine's Educational Research Alliance (CERA) survey of FM clerkship directors (CDs). The survey was distributed via email invitation to 159 US and Canadian FM CDs in June 2022. Of the 94 responses received, 61% indicated that MI training is provided in their FM clerkship. Medical school type, class size, and location were associated with MI training priority, offerings, and duration in the clerkship, respectively. CD experience correlated with MI training duration; student MI skill training level was associated with MI training duration and priority; the rigor of student MI skills evaluation was correlated with MI teaching methods and training duration; self-reported student MI competency was associated with the length of time students spent with FM community preceptors as well as MI training priority and teaching methods; and several items emerged as predictors of student, CD, and FM faculty MI training expansion. Opportunities exist to enhance the volume, content, and rigor of MI training in North American FM clerkships as well as to improve self-reported student MI competency within those clerkships.

Bibliometric Analysis of International Medical Graduates and Professorship Promotion in Neurosurgery

International medical graduates (IMGs) comprise ∼25% of physicians in the United States. Differences in promotion rates from assistant to associate to full professorship based on medical school location have been understudied. We aim to stratify odds of professional advancement by 3 categories: IMG with U.S. residency, IMG with international residency, and U.S. medical with U.S. residency training. We created and queried a database after exclusions of 1334 neurosurgeons including multiple demographic factors: academic productivity and promotion rates. Stratified logistic regression modeled odds of promotion including the variables: decades out of training, Scopus h-index, gender, and training location. Odds ratios (ORs) and 95% confidence intervals (CIs) for each variable were calculated. Significant predictors of increased associate versus assistant professorship included decades out of training (OR= 2.519 [95% CI: 2.07-3.093], P < 0.0001) and Scopus h-index (OR= 1.085 [95% CI: 1.064-1.108], P < 0.0001) while international medical school with U.S. residency (OR= 0.471 [95% CI: 0.231-0.914], P= 0.0352) was associated with decreased promotion. Significant predictors of associate versus full professorship were decades out of training (OR= 2.781 [95% CI: 2.268-3.444], P < 0.0001) and Scopus h-index (OR= 1.064 [95% CI: 1.049-1.080], P < 0.0001). Attending medical school or residency internationally was not associated with odds of full professorship. Time out of residency and Scopus h-index were associated with higher academic rank regardless of career level. Attending medical school internationally with U.S. residency was associated with lower odds of associate professorship promotion over 10 years. There was no relationship between IMG and full professorship promotion. IMGs who attended residency internationally did not have lower promotion rates. These findings suggest it may be harder for IMGs to earn promotion from assistant to associate professor in neurosurgery.

(059) Comfort With Sexual Health Literacy Assessed in Urology Resident Physicians

Abstract Introduction Despite the importance of sexual health, physicians may not be adequately equipped to diagnose and treat sexual dysfunction. Topics related to healthy sexual function (pleasure, masturbation, communication, sex toys/tools, and anal sex practices) are largely omitted from medical education. It is vital that urologists are trained to ask detailed questions about sexual health, counsel on healthy sexual habits, and identify and treat sexual dysfunction. Objective To determine the level of comfort among urology residents in taking a comprehensive sexual health history, identifying sexual dysfunction, and treating patients of various gender identities and sexual orientations. Methods An anonymous electronic survey was distributed to current urology residents in the United States. The survey contained five demographics questions and twenty-three questions tied to sexual health competencies. Participants were asked to provide their education year, current age, medical school location, residency location, and estimated hours of sexual health education during training (excluding STI/STD content). Survey questions targeted previously established sexual education competency domains. Results A total of 52 urology residents participated in the study. Participant post-graduate years ranged from 1-6. 61.5% of participants stated they received only 0-3 hours of formal sex education during medical school and 46.3% reported having any formal sex education during urology residency. 80% of participants felt comfortable asking patients about self-erogenous stimulation, but only 27% of responders felt comfortable answering questions about anal stimulation devices, and 35% of responders felt comfortable answering questions about vaginal stimulation devices. Greater than 94% of residents feel “very comfortable” or “somewhat comfortable” with describing male sexual dysfunction and performing physical exam for a man with sexual dysfunction, but only 59% felt the same towards female sexual dysfunction. When describing medicines used for sexual function, 100% of residents are comfortable doing so for men, but only 63% are comfortable doing the same for women. When counseling transgender males or females on sexual practice/therapies/surgeries, only 29% of residents felt comfortable. Conclusions There are knowledge gaps in sexual medicine literacy confidence among urology residents surveyed. Lack of a comprehensive sexual health education curriculum during medical training may be affecting patient care. Women and sexual and gender minority (LGBTQ) patients may be at higher risk of being treated by a urologist without comfort in managing their sexual health. Sexual health education optimization during urology residency has the potential to promote improved understanding of the sexual health of women and sexual and gender minorities and improve the evaluation and management of sexual dysfunction in general. Disclosure No

(373) Sexual Health Literacy Confidence Among Urology Resident Physicians

Abstract Introduction Despite the importance of sexual health, physicians may not be adequately equipped to diagnose and treat sexual dysfunction. Topics related to healthy sexual function (pleasure, masturbation, communication, sex toys/tools, and anal sex practices) are largely omitted from medical education. It is vital that urologists are trained to ask detailed questions about sexual health, counsel on healthy sexual habits, and identify and treat sexual dysfunction. Objective To determine the level of comfort among urology residents in taking a comprehensive sexual health history, identifying sexual dysfunction, and treating patients of various gender identities and sexual orientations. Methods An anonymous electronic survey was distributed to current urology residents in the United States. The survey contained five demographics questions and twenty-three questions tied to sexual health competencies. Participants were asked to provide their education year, current age, medical school location, residency location, and estimated hours of sexual health education during training (excluding STI/STD content). Survey questions targeted previously established sexual education competency domains. Results A total of 52 urology residents participated in the study. Participant post-graduate years ranged from 1-6. 61.5% of participants stated they received only 0-3 hours of formal sex education during medical school and 46.3% reported having any formal sex education during urology residency. 80% of participants felt comfortable asking patients about self-erogenous stimulation, but only 27% of responders felt comfortable answering questions about anal stimulation devices, and 35% of responders felt comfortable answering questions about vaginal stimulation devices. Greater than 94% of residents feel “very comfortable” or “somewhat comfortable” with describing male sexual dysfunction and performing physical exam for a man with sexual dysfunction, but only 59% felt the same towards female sexual dysfunction. When describing medicines used for sexual function, 100% of residents are comfortable doing so for men, but only 63% are comfortable doing the same for women. When counseling transgender males or females on sexual practice/therapies/surgeries, only 29% of residents felt comfortable. Conclusions There are knowledge gaps in sexual medicine literacy confidence among urology residents surveyed. Lack of a comprehensive sexual health education curriculum during medical training may be affecting patient care. Women and sexual and gender minority (LGBTQ) patients may be at higher risk of being treated by a urologist without comfort in managing their sexual health. Sexual health education optimization during urology residency has the potential to promote improved understanding of the sexual health of women and sexual and gender minorities and improve the evaluation and management of sexual dysfunction in general. Disclosure No

Correlation between USMLE Step scores, personal attributes and RITE exam performance among neurology residents at an academic center. (S13.003)

<h3>Objective:</h3> We aimed to investigate the correlation between USMLE scores and personal attributes with Residency in-training exam (RITE) performance among residents at our academic neurology residency training program. <h3>Background:</h3> Studies assessing medical and surgical residents’ performance during training and its relation to USMLE Step scores have found differing correlations among different medical specialties. This correlation has never been studied among neurology residents. <h3>Design/Methods:</h3> Data on 51 neurology residents at Medical University of South Carolina between 2005 and 2020 was analyzed. Resident personal attributes included were gender, age at residency enrollment, medical school location, awards/honor degrees during medical school, presence of advanced degree/completion of another residency program, number of peer reviewed publications, and years from medical school graduation. Correlation analysis was conducted between Step 1 and Step 2 CK scores with RITE Exam scores, respectively. Repeated measures ANOVA was utilized to examine differences in mean RITE scores of residents with/without above personal attributes. <h3>Results:</h3> Mean age at residency enrollment was 30.92 years(25 – 48). 68.6% residents were males and 50.9% were IMGs. Statistically significant strong positive correlations were found between Step 1 and RITE scores (PGY-2 r = 0.6, PGY-4 r = 0.69, p&lt;0.01). Weaker but statistically significant positive correlations were found between Step 2 CK and RITE scores (PGY-2 r= 0.56, PGY-4 r = 0.52, p&lt;0.01). Mean PGY-2 RITE score for IMGs was higher than US graduates (p&lt;0.05). Residents with ≥6 publications, and those with honors/award during medical school had higher RITE scores compared to those without. There was no significant difference in RITE scores of males and females, those with and without advanced degrees and those with and without gap years between medical school and residency. <h3>Conclusions:</h3> USMLE Step 1 and Step 2 CK scores, medical school location, awards/honor degrees during medical school, and ≥6 publications correlate with higher RITE scores among neurology residents. <b>Disclosure:</b> Mrs. Al Issa has nothing to disclose. Dr. Kohli has nothing to disclose. Dr. Banerjee has nothing to disclose.

Analysis of Current Neurological Surgery Residents and Prior Medical Education: Do Medical School Attributes Matter?

With the recent changes to the U.S. Medical Licensing Examination grading system, an understanding of the factors that influence the neurological surgery residency match process is crucial for residency directors. The aim of the present retrospective study was to explore the associations of medical school location, ranking, private school status, size, and presence of an American Association of Neurological Surgeons (AANS) chapter or neurological surgery interest group (NSIG) with the neurosurgery match outcomes. An enrollment list of all accredited U.S. neurosurgery residency programs was compiled on June 28, 2021. For the included residents, the residency program, degree, and previously attended medical school were retrieved. The geographic location, ranking, private school status, and size were collected for the residency programs and medical schools attended by the residents at each program. A total of 1437 residents from 101 neurosurgery residency programs (89%) were included. Graduates from the top 25 medical schools were more likely to match into their home residency programs (P < 0.001) and highly ranked residency programs (P < 0.001). Students from larger medical schools were also more likely to match into larger (P < 0.001) and highly ranked (P < 0.001) programs than were applicants from smaller schools. Students from medical schools with an AANS chapter or NSIG were also more likely to match into top ranked programs (P < 0.001 for both). Medical students from the top 25 medical schools, private medical schools, medical schools with an AANS chapter, and medical schools with an NSIG were more likely to match into a prestigious residency program. These findings suggest that underlying biases might be present for program directors to consider in the resident selection process.

Trends in NIH Funding to Medical Schools in 2011 and 2020.

To examine trends in National Institutes of Health (NIH) funding to U.S. medical schools and their academic departments and the amount of awards provided by each of the NIH institutes. All data on NIH awards to U.S. medical schools from 2000 to 2020 are publicly available and were obtained from the NIH Research Portfolio Online Reporting Tools and Blue Ridge Institute for Medical Research. These data include the value and number of awards to each medical school, medical school department, medical school location, principal investigator, and the NIH awarding institute. Trends in the inflation-adjusted awards from 2011 to 2020 were calculated and a comparison of the awards made in 2011 and 2020 was performed. The total NIH budget increased by 16.1% from 2011 to 2020. The allocation of NIH funds to medical schools increased 26.3% ($13.7 billion to $17.3 billion) during this interval. In 2020, 29.3% of all medical school NIH funds were allocated to departments of internal medicine/medicine. Psychiatry was the second ranking department, which was followed, in order, by pediatrics, neurology, and microbiology/immunology/virology. The National Cancer Institute, National Institute of Allergy and Infectious Diseases, and National Heart, Lung, and Blood Institute were the top medical school funding institutes in 2011 and 2020. Medical schools as a group continue to receive the greatest percentage of NIH funding. Funding to clinical science departments increased by a larger percentage than that to basic science departments (35.3% vs 10.9%, respectively) over the 2011-2020 interval. Funding for clinical science departments is increasing at a faster rate than that of basic science departments. However, that so much investigation in basic science and clinical science departments is performed by personnel with a PhD degree indicates the goals and methods of the basic and clinical sciences may not be so different.

Gender and Geographic Trends Amongst Foot &amp; Ankle Surgeons: Where are We and Where Do We Need to Improve?

Category: Other Introduction/Purpose: Clinical and elective experiences as well as the guidance of mentors are all critical factors in the pursuance of orthopedic residencies and fellowships. Women have historically been underrepresented in orthopedics. Some propose that the root cause lies in the lack of availability in the aforementioned factors. Previous studies demonstrated geographic differences in sex representation in orthopedic residency programs. Studies over geographic distributions of orthopedic foot and ankle (OFA) surgeons showed high variation in geographic density of OFA surgeons throughout the U.S. This study seeks to determine both the gender and geographic distributions of OFA surgeons as well as to determine geographic patterns between their training locations and current practices. Methods: AOFAS data regarding fellowship completion from 1988 through 2021 was analyzed with regards to gender and fellowship location. Internet searches were performed for all those identified within the database for their medical school, residency, and current practice location. This biographical data was obtained from their front-facing biographical webpage or hospital affiliation. States were placed into regions and subsequent divisions as defined according to the US Census Bureau definition: Northeast (New England and Middle Atlantic), Midwest (East North Central and West North Central), South (South Atlantic, East South Central, and West South Central) and West (Mountain and Pacific). Results: 1,088 OFA surgeons were analyzed. 168 (15.3%) were female and 922 (84.7%) were male. Female-held OFA fellowship positions increased over time, currently sitting at 13 (22% of all fellowship positions), with a maximum of 15 (25%) in 2017. Geographically, the Pacific had most females (n=26, 15.6% of females), while East South Central had least (n=10, 6.0%). The South Atlantic had most males (n=193, 20.9% of males) while East South Central had least (n=59, 5.3%). The region with the most OFA surgeons in total was the South Atlantic (n=218, 20.0% of the total) whereas the regions with the least were East South Central and New England (n=59, 5.4% in each). Conclusion: Although the amount of female OFA surgeons has increased, the numbers are still low. Geographically, the East South Central division of the U.S consistently had the least number of OFA surgeons whereas the South Atlantic division had the highest.

Family Medicine Residencies: How Rural Training Exposure in GME Is Associated With Subsequent Rural Practice.

Rural US populations face a chronic shortage of physicians and an increasing gap in life expectancy compared to urban US populations, creating a need to understand how to increase residency graduates' desire to practice in such areas. This study quantifies associations between the amount of rural training during family medicine (FM) residencies and subsequent rural work. American Medical Association (AMA) Masterfile, AMA graduate medical education (GME) supplement, American Board of Family Medicine certification, Accreditation Council for Graduate Medical Education (ACGME), and Centers for Medicare and Medicaid Services hospital costs data were merged and analyzed. Multiple logistic regression measured associations between rural training and rural or urban practice in 2018 by all 12 162 clinically active physicians who completed a US FM residency accredited by the ACGME between 2008 and 2012. Analyses adjusted for key potential confounders (age, sex, program size, region, and medical school location and type) and clustering by resident program. Most (91%, 11 011 of 12 162) residents had no rural training. A minority (14%, 1721 of 12 162) practiced in a rural location in 2018. Residents with no rural training comprised 80% (1373 of 1721) of those in rural practice in 2018. Spending more than half of residency training months in rural areas was associated with substantially increased odds of rural practice (OR 5.3-6.3). Only 4% (424 of 12 162) of residents spent more than half their training in rural locations, and only 5% (26 of 436) of FM training programs had residents training mostly in rural settings or community-based clinics. There is a linear gradient between increasing levels of rural exposure in FM GME and subsequent rural work.

Factors affecting the recruitment of new obstetrician-gynecologists in Japan: A report of the MIRAI Committee of the Japanese Society of Obstetrics and Gynecology.

There is a chronic shortage of obstetrician-gynecologists in Japan. To increase the number of obstetrician-gynecologists, it is crucial to increase the number of residents being recruited. The purpose of this study was to identify the factors that led students and interns to specialize in obstetrics and gynecology through a questionnaire survey. We sent a questionnaire to the obstetrics and gynecology departments of all the medical schools in Japan (N=81) and collected data about the institutional background, including the location, total number of obstetrician-gynecologists employed, and number of newly joined obstetrics-gynecology residents and resigned obstetrician-gynecologists and the educational and recruitment activities for medical students and interns. The net balance (increased or decreased) over the fiscal years 2013-2015 was considered a surrogate marker for the number of newly joined obstetrics-gynecology residents. We used binomial logistic regression analysis to determine the factors related to a positive net balance of obstetrician-gynecologists. We obtained responses from 59 (72.8%) medical schools. Medical students who observed deliveries were more likely to become obstetrician-gynecologists than those who did not (95% confidence interval: 1.000-1.045, p=0.052). Medical school location (rural or urban), providing medical students with preparatory lectures for national board examinations, and providing interns with experience as the first assistant during surgery were not associated with an increase in the number of newly joined obstetrician-gynecologists. The experience of observing deliveries may encourage medical students to become obstetrician-gynecologists.

COMLEX-USA and USMLE for Osteopathic Medical Students: Should We Duplicate, Divide, or Unify?

COMLEX-USA and USMLE for Osteopathic Medical Students: Should We Duplicate, Divide, or Unify?

Assessing the Impact of the COVID-19 Pandemic on Geographic Residency Placement Relative to Medical School Location.

The 2020-2021 residency application cycle was altered to reduce COVID-19 transmission, with moves to all virtual interviews and no away rotations for medical students. These changes may have affected how students ranked residency programs, such as choosing programs near their medical schools. To determine if a larger percentage of medical students matched to residency programs in the same state as their medical schools in 2021 vs 2018-2020. We searched the webpages or emailed student affairs deans of the 155 Liaison Committee on Medical Education accredited MD programs to attain medical school match lists. Differences in the percentage of students matching to residency programs in the same US state as their medical schools in 2021 vs 2018-2020 were compared using chi-square tests. We recorded 36 021 of 79 406 (45%) National Resident Matching Program, 759 of 1720 (44%) ophthalmology, and 586 urology MD residency matches between 2018 and 2021. The percentage of students matching to residency programs in the same state as their medical schools was 35.9% in 2021 versus 34.3% in 2018-2020 (P=.005). Students were more likely to match to programs in the same state as their medical schools in 2021 if they attended a public medical school (40.3% vs 38.5%, P=.009) or applied into specialties where ≥50% of students traditionally perform away rotations (32.2% vs 30.2%, P=.031). There was a small difference in the percentage of medical students matching to residency programs in the same state as their medical schools in 2021 vs 2018-2020.

Gender and Geographic Trends Amongst Foot &amp; Ankle Surgeons: Where Are We and Where Do We Need to Improve?

Category:OtherIntroduction/Purpose:Clinical and elective experiences as well as the guidance of mentors are all critical factors in the pursuance of orthopedic residencies and fellowships. Women have historically been underrepresented in orthopedics. Some propose that the root cause lies in the lack of availability in the aforementioned factors. Previous studies demonstrated geographic differences in sex representation in orthopedic residency programs. Studies over geographic distributions of orthopedic foot and ankle (OFA) surgeons showed high variation in geographic density of OFA surgeons throughout the U.S. This study seeks to determine both the gender and geographic distributions of OFA surgeons as well as to determine geographic patterns between their training locations and current practices.Methods:AOFAS data regarding fellowship completion from 1988 through 2021 was analyzed with regards to gender and fellowship location. Internet searches were performed for all those identified within the database for their medical school, residency, and current practice location. This biographical data was obtained from their front-facing biographical webpage or hospital affiliation. States were placed into regions and subsequent divisions as defined according to the US Census Bureau definition: Northeast (New England and Middle Atlantic), Midwest (East North Central and West North Central), South (South Atlantic, East South Central, and West South Central) and West (Mountain and Pacific).Results:1,088 OFA surgeons were analyzed. 168 (15.3%) were female and 922 (84.7%) were male. Female-held OFA fellowship positions increased over time, currently sitting at 13 (22% of all fellowship positions), with a maximum of 15 (25%) in 2017. Geographically, the Pacific had most females (n=26, 15.6% of females), while East South Central had least (n=10, 6.0%). The South Atlantic had most males (n=193, 20.9% of males) while East South Central had least (n=59, 5.3%). The region with the most OFA surgeons in total was the South Atlantic (n=218, 20.0% of the total) whereas the regions with the least were East South Central and New England (n=59, 5.4% in each).Conclusion:Although the amount of female OFA surgeons has increased, the numbers are still low. Geographically, the East South Central division of the U.S consistently had the least number of OFA surgeons whereas the South Atlantic division had the highest.

The role of medical school prestige and location in neurosurgery residency placement: An analysis of data from 2016 to 2020

ObjectiveThere remains a gap in the literature analyzing how categorical variables may affect the highly competitive neurosurgery residency application process for MD Seniors in the United States. We aimed to improve understanding of the impact of medical school prestige and geographic location on candidacy for neurosurgery residency. MethodsSchools were stratified into high and low prestige cohorts based on the U.S. News and World Report Rankings and by geographic location. Publicly available match data displayed by websites of included medical schools from 2016 to 2020 were examined, and neurosurgery residency placement rates were then compared. Analysis was performed using Fisher’s exact test and chi-square analysis, with a p-value of 0.05. ResultsThere were 6685 total matches in the high-prestige cohort and 12,997 total matches in the low-prestige cohort, with 115 (1.72%) and 113 (0.87%) neurosurgery matches, respectively (OR = 2.00, p < 0.0001). Considering geographic location, there were 5244 total matches in the Midwest, 3456 total matches in the West, 4994 total matches in the South, and 6053 total matches in the Northeast, with 51 (0.97%), 24 (0.69%), 83 (1.66%), and 114 (1.88%) being neurosurgery residency placements, respectively (p < 0.0001). ConclusionsNeurosurgery residency placement may be correlated with attending more prestigious medical schools and those located in the Northeast or South United States. Further elucidation of similar variables may prove to be important as neurosurgery residency becomes more competitive and the evaluation process changes.

The Impact of Virtual Interviews on the Geographic Distribution of Ophthalmology Match Results in the 2020-2021 Cycle.

Background Instead of the traditional in-person interviews, the 2020 to 2021 ophthalmology application cycle was conducted with virtual interviews due to coronavirus disease 2019 (COVID-2019). Little is known about differences between the results of this application cycle with previous years. Objectives The aim of this study was to determine the effect of virtual interviews on the geographic distribution of matched ophthalmology residency applicants. Methods Information was collected on the medical school location and matched residency program location for 2020 to 2021 applicants as well as applicants during the 2016 to 2017, 2017 to 2018, and 2018 to 2019 cycles from publicly available Web sites. Pearson chi-squared tests were conducted to determine whether there was a significant difference in the proportion of applicants matching in the same region, state, and institution as their medical schools in the 2020 to 2021 interview cycle when compared with past cycles. Results Three-hundred seventy-five applicants from 2020 to 2021 and 1,190 applicants from 2016 to 2019 application cycles were analyzed. There was no difference in the type of medical school attended (allopathic vs. osteopathic vs. international medical graduate) ( p = 0.069), the likelihood of attending a residency program in the same region as the home medical school (54% for 2020-2021 vs. 57% for 2016-2019 applicants, p = 0.3), and the likelihood of attending a residency program in the same state as the home medical school (31 vs. 28%, p = 0.2). There was a higher likelihood of applicants during the 2020 to 2021 cycle matching at a residency program affiliated with their home medical school than previous cycles (23 vs. 18%, p = 0.03). Conclusions Virtual interviews did not increase the likelihood of medical students staying in the same region or state as their medical school, while there was a higher likelihood of applicants matching at residency programs at institutions affiliated with their medical schools. A hybrid approach to maintain geographic diversity of applicants' final residency programs involving virtual interviews with the addition of in-person away rotations is suggested.

Does Medical School Geography and Ranking Influence Residency Match in Otolaryngology?

To elucidate the associations between geographic locations, rankings, and size/funding of medical schools and residency programs among the current otolaryngology residents. This retrospective cross-sectional study queried otolaryngology residency program websites for relevant publicly accessible information. Location was categorized as Midwest, Northeast, South, and West. Ranking was according to Doximity (residency) and US News and World Report (medical school). Medical school and residency programs were labeled large if they had >704 students or >15 residents, respectively. A total of 1413 residents from 98 (89%) otolaryngology residency programs were included. Residents attending their home medical schools (18%) were equally distributed among regions (P = .845). Residents who attended medical schools in the same US regions (54%) were more likely from top-25 (P = .001) or private (P < .001) medical schools. Southern residents were most likely (64%) and Western residents were least likely (39%) from regional medical schools (P < .001), while residents from Midwest and Northeast had similar rates (54%-55%). The percentage of Midwest residents coming from regional medical schools has decreased from the 2013 to 2014 residency cycle (P = .037). Completing undergraduate school, medical school, and residency in the same region (38%) was also highest in the South (45%) and lowest in the West (25%) (P < .001). Residents at top-ranked residency programs were more likely from top-ranked (P < .001), large (P = .025), and private (P = .018) medical schools. There exist significant associations between otolaryngology residents' medical school location, ranking, size, and funding source and their residency destination. More than half of the current otolaryngology residents attended medical school in the same geographic region, and about one-fifth have attended medical school and residency at the same institution. Future studies are warranted to evaluate how these results change as the match process evolves in the future. N/A.

Medical students' perceptions and motivations during the COVID-19 pandemic.

There has been a rapid increase in the number of cases of COVID-19 in Latin America, Africa, Asia and many countries that have an insufficient number of physicians and other health care personnel, and the need for the inclusion of medical students on health teams is a very important issue. It has been recommended that medical students work as volunteers, undergo appropriate training, not undertake any activity beyond their level of competence, and receive continuous supervision and adequate personal protective equipment. However, the motivation of medical students must be evaluated to make volunteering a more evidence-based initiative. The aim of our study was to evaluate the motivation of medical students to be part of health teams to aid in the COVID-19 pandemic. We developed a questionnaire specifically to evaluate medical students' perceptions about participating in the care of patients with suspected infection with coronavirus during the COVID-19 pandemic. The questionnaire had two parts: a) one part with questions on individual characteristics, year in medical school and geographic location of the medical school and b) a second part with twenty-eight statements assessed on a 5-point Likert scale (totally agree, agree, neither agree nor disagree, disagree and totally disagree). To develop the questionnaire, we performed consensus meetings with a group of faculty and medical students. The questionnaire was sent to student organizations of 257 medical schools in Brazil and answered by 10,433 students. We used multinomial logistic regression models to analyze the data. Statements associated with greater odds ratios for participation of medical students in the COVID-19 pandemic were related to a sense of purpose or duty ("It is the duty of the medical student to put himself or herself at the service of the population in the pandemic"), altruism ("I am willing to take risks by participating in practice in the context of the pandemic"), and perception of good performance and professional identity ("I will be a better health professional for having experienced the pandemic"). Males were more prone than females to believe that only interns should participate in the care of patients with COVID-19 (odds ratio 1.36 [coefficient interval 95%:1.24-1.49]) and that all students should participate (OR 1.68 [CI:1.4-1.91]). Medical students are more motivated by a sense of purpose or duty, altruism, perception of good performance and values of professionalism than by their interest in learning. These results have implications for the development of volunteering programs and the design of health force policies in the present pandemic and in future health emergencies.