Medicine Fellowship Programs Research Articles

A longitudinal blended learning curriculum for bedside ultrasound education in pulmonary and critical care fellowship

BackgroundThere exists no standardized longitudinal curriculum for teaching bedside ultrasonography (US) in Pulmonary and Critical Care Medicine (PCCM) fellowship programs. Given the importance of mastering bedside US in clinical practice, we developed an integrated year-long US curriculum for first-year PCCM fellows.Methods11 first-year PCCM fellows completed the entire seven-step Blended Learning Curriculum. We provide results from an evaluation of Step I, the initial training course. Evaluation included a 17-question multiple-choice knowledge test and a hands-on skill exam delivered pre-, immediately post-, and 6 months post-course. Performance on these same evaluation measures was compared between learners who completed a traditionally designed curriculum, which contained a formal in-person didactic course, and learners who completed a blended learning curriculum covering the same learning objectives.ResultsAll learners showed a significant improvement immediately after the course in both knowledge (p = 0.007) and skills (p = 0.004) with adequate retention of both knowledge and skills after 6 months. Scores on a multiple-choice knowledge test increased from a median (interquartile range [IQR]) of 24% (15–41%) pre-course to a median of 71% (59–82%) post-course, while scores on a hands-on skill exam increased from a median of 16% (7–45%) pre-course to a median of 87% (74–94%) post-course. There was no difference in learning or retention between those who learned via the blended learning model as compared with a more traditional model. Learners agreed the course was well-designed, with relevant learning topics, sufficient time to learn, and fair evaluation modalities. The blended learning model required 15 fewer faculty-hours than the traditional learning model.DiscussionA blended learning model for bedside US education implemented at a single PCCM fellowship performs comparably to a traditional model for both acquisition and retention of knowledge and skills. The incorporation of asynchronous learning mitigates the barrier of insufficient time and quantity of US skilled teaching faculty that many PCCM fellowships face and provides flexibility to both instructors and learners.

Assessing Program Culture in Virtual Fellowship Interviews: Insights From Pulmonary and Critical Care Fellows.

Virtual interviewing for fellowship training programs has been widely adopted since the COVID-19 pandemic. However, whether fellowship candidates can adequately evaluate training program culture through virtual interviews is unclear. Our aim was to explore how pulmonary and critical care fellows ascertained program culture during virtual and in-person fellowship program recruitment interviews, with the overall goal of improving our virtual recruiting interview processes. Exploratory semi-structured one-on-one interviews (study-interviews) following a constructivist approach were done during the fall of 2022 with a convenience sample of current fellows within the pulmonary critical care medicine fellowship program in an urban tertiary care hospital. Questions probed fellows' perspectives on program culture, what features of program culture they valued, and how they evaluated program culture during their initial fellowship interviews (recruitment-interviews). Study-interviews were framed to explore four deductive themes, and transcripts were analyzed with inductive thematic analysis. Of the 11 fellows interviewed, two had completed in-person and nine had completed virtual recruitment-interviews. There was an overall favorable perception of program culture during all recruitment-interviews, regardless of format. Elements of program culture that fellows valued included training program quality, an academic focus, complexity in cases, workplace diversity, a positive socioemotional environment, and a collaborative/supportive working/learning environment. This study suggests that important elements of program culture can be evaluated by fellowship candidates through virtual interviews when applicants are allowed ample opportunity for high-quality interactions with faculty and current trainees.

Can We Improve Geriatrics Recruitment? An Analysis of U.S. Geriatrics Fellowship Programs on X.

The COVID-19 pandemic accelerated the shift from in-person to virtual recruitment, prompting residency and fellowship programs to adopt innovative strategies, such as leveraging social media platforms to attract applicants and enhance visibility. Our aim was to identify and describe the presence of U.S. geriatric medicine fellowship programs on X. We identified all U.S. geriatric medicine fellowship programs using FREIDA, and then located their X accounts through a stepwise process. Data were collected on account creation, number of followers, posts, and activity level, with an analysis of the last 100 posts from the most active accounts. Descriptive statistics were used to analyze the data. Among the 147 geriatric medicine fellowship programs identified, 38 (25.9%) had an X account. The majority of accounts were created after the start of the pandemic, reflecting likely the adaptation to virtual recruitment processes. Only a few accounts generated the majority of posts and followers. The accounts primarily posted or reposted educational content, research highlights, and promotional material. The use of X by geriatric medicine programs is still significantly underutilized, with only one-fourth of them having an account. Half of the accounts were created after the COVID-19 pandemic began. Programs should focus on building a robust social media presence to increase their visibility, especially as virtual interviews have become a permanent part of recruitment.

Square pegs in round holes: How do pediatric emergency medicine fellowship program directors fit graduates of emergency medicine residencies into their programs?

Pediatric emergency medicine (PEM) fellowship directors can interview candidates from either pediatric or EM residency programs. Currently, most candidates are pediatricians; however, because emergency physicians have attributes that could benefit PEM, our goal was to investigate facilitators and barriers to training more of them to become PEM physicians. We surveyed U.S. PEM fellowship program directors (PDs) about their program's recruitment practices: Do they recruit only pediatricians or mostly pediatricians with an occasional emergency physician or do they actively recruit both? We solicited volunteers from each recruitment group for interviews. These were recorded, transcribed, and thematically coded using summative content analysis. Comments were cataloged into themes that were philosophical or logistic in nature and those that might facilitate (drivers) or serve as barriers (restrainers) to the inclusion of emergency physicians in PEM. We received 50 of 86 (58%) survey responses, 29 (34%) of whom volunteered for interviews. The 17 volunteers we selected for interviews generated 13 themes that fell into the four major theme categories: four philosophical drivers, three logistic drivers, two philosophical restrainers, and four logistic restrainers. Program groups differed with regard to the inclusion of emergency physicians. Most limiting were the impact of variable program length and the implicit belief that pediatricians are best suited to treat children. Most beneficial is the recognized value of EM graduates to the field of PEM. While PDs acknowledged a growing need for PEM physicians, particularly in community hospitals, and that emergency physicians would contribute to PEM, they also identified the logistical burden of including them in programs primarily designed for pediatricians. This burden involves maintaining separate curricula for EM graduates and finding emergency physician faculty to serve as mentors. PDs also expressed a desire for resources to guide the integration of more emergency physicians into their programs.

Academic Productivity at Orthopaedic Surgery Sports Medicine Fellowship Programs in the United States Has a Weak Positive Correlation With Nonresearch Lifetime Industry Earnings

PurposeTo characterize the relationship between academic productivity, as defined by H-index, and industry payments for fellowship-trained sports medicine surgeons in faculty positions at sports medicine fellowships. MethodsThe American Orthopaedic Society for Sports Medicine (AOSSM) fellowship directory was used to create a comprehensive list of all fellowship programs nationwide. Fellowship websites were then reviewed to generate a list of the teaching faculty associated with each program. Total non-research life-time earnings was obtained from the Centers for Medicare and Medicaid Services website. Academic productivity of each fellowship faculty was assessed via H-index. Frequency counts and other descriptive statistic measures were used to describe the data for this study. Correlation was performed for continuous data using Spearman’s rho. Results90 orthopedic surgery sports medicine fellowships were identified with a combined total of 574 orthopedic surgery sports medicine fellowship faculty. There was a weak positive correlation between individual physician H-index and individual physician life-time earnings at orthopedic surgery sports medicine fellowships (p<0.001; Spearman’s rho = 0.329). There was a statistically significant difference between individual faculty H-index by quartile and individual faculty life-time earnings (test statistic: 47.3; p<0.001). There was no significant regional difference in payments but there is remarkable heterogeneity in the distribution of payments to individual physicians, with the top 10% of physicians receiving over 80% of industry dollars. ConclusionThere is a positive correlation between academic productivity and industry payments at both the individual and institutional level in orthopedic sports medicine departments, although this relationship was greater at the fellowship level. Furthermore, the majority of non-research industry funding goes to a minority of physicians. Clinical RelevanceEvaluating the impact that non-research industry payments have on a sports medicine orthopedic surgeon's research productivity can offer valuable insights into the relationship between industry compensation and scholarly output in this field.

Evolving Regional Anesthesiology and Acute Pain Medicine fellowship application process: a program director survey

Background and objectivesMost Regional Anesthesiology and Acute Pain Medicine (RAAPM) fellowship programs transitioned to virtual interviews in 2020 because of the COVID-19 pandemic. Then, the RAAPM fellowship match started in...

(127) INFERTILITY FELLOWSHIP WEBSITE ANALYSIS: THERE IS ROOM FOR IMPROVEMENT

Abstract Introduction In order for both programs to select the best fitting applicant and the applicant to find the best fitting program, both parties need to be transparent with each other. Currently, applicants that apply for andrology fellowships can investigate programs on the web but the information available to them is inconsistent, lacking, and possibly even inaccurate. To date, there have yet to be any formal studies that assess Infertility and Sexual Medicine Fellowships on this subject. Objective This project aims to identify gaps in basic information provided on these fellowship websites, thus thwarting potential applicants from reaching informed decisions regarding their advanced training. Methods Utilizing publicly available lists of Infertility and Sexual Medicine fellowship programs from the American Urological Association (AUA) website, The Society for Male Reproduction and Urology (SMRU) website, and Sexual Medicine Society of North America (SMSNA) website, we documented each of the advertised programs. All program websites were accessed on the same day (6/6/2024) to reduce variability as websites may update over time. Any program with an active fellowship website was included and had to be a clinical fellowship geared toward training graduates of urology training programs. The analysis did not include any programs geared toward primary care providers, programs that were research-based only, or did not have an active website. Included programs were assessed on the transparency of their respective websites. A number of factors were assessed including participation in the infertility match, inclusion of rotations schedules, expected length of the fellowship, and estimated number of procedures to be completed by end of the fellowship. Results A total of 25 programs were included in the analysis. We found that the majority of programs included information on research opportunities (92.6 %) and included current faculty profiles (96.3%). 77.8% of programs included information on potential procedures that a fellow may participate in during the course of their fellowship but only 14.8% of programs included information regarding fellow case logs including the number of completed procedures during the fellowship. The majority of programs lacked information regarding DEI (18.5%), wellness initiatives (3.7%), call responsibilities (18.5%), and salary/benefits (7.4%). Additionally, of those participating in the AUA Andrology fellowship match (n = 17), only 17.6% had mention of the match application on their website (n = 3). Conclusions Our data suggests a significant lack of standardization among fellowship websites as well as major gaps in data that are pertinent to applicants, such as comprehensive procedure logs. If the priorities of the program do not align with those of the applicant, and vice versa, the successful outcome of both parties will be compromised. Our study demonstrates that the current state of fellowship websites could be improved and that this would likely better serve both applicant and program. Disclosure No.

Pediatric Hospital Medicine Fellows' Perspectives on Autonomy Through Time.

Promoting autonomy is at the core of fellowship education. Pediatric hospital medicine (PHM) fellowship programs are relatively new, and many supervising physicians are not trained on how to promote fellow autonomy. Moreover, no studies have explored fellows' perception of autonomy throughout training. To fill this gap, we explored PHM fellows' perceptions of autonomy throughout training. PHM fellows starting fellowship in July 2021 were recruited to participate in a longitudinal qualitative study. Using self-determination theory as a sensitizing framework, the authors conducted semistructured interviews with 14 fellows throughout fellowship. Incoming data were iteratively analyzed, and codes were created from patterns in the data. Coded data were clustered into themes. Four themes developed: (1) at the beginning of fellowship, fellows valued direct observation and close supervision from their attending. (2) Initially, fellows felt pressured to make the identical clinical decision as their attending, but over the course of training, they realized their autonomous decisions could coexist with different decisions from their attending physicians. (3) At first, fellows desired attending presence to support and guide their decision making. Over time, fellows desired a coach who could provide valuable formative feedback. (4) Because of the hierarchical nature of medicine, conversations between fellows and attending physicians about autonomy were challenging to initiate. Fellows' perceptions of autonomy change throughout fellowship, which should be taken into consideration as provisions of autonomy evolve through training. Our findings can inform PHM fellowship curricula and professional development around the promotion of autonomy in fellowship.

American Board of Emergency Medicine Report on Residency and Fellowship Training Information (2023-2024)

The American Board of Emergency Medicine gathers extensive background information on Accreditation Council of Graduate Medical Education-accredited emergency medicine residency and fellowship programs as well as the residents and fellows training in those programs. We present the 2024 annual report on the status of physicians training in ACGME-accredited emergency medicine training programs in the United States.

Clinical Practice Guideline Development in Pediatric Emergency Medicine Departments Across the United States: A Cross-sectional Study.

This cross-sectional study aimed to assess the process of clinical practice guideline (CPG) development in pediatric emergency medicine departments (PEDs) across the United States, with a focus on identifying areas for improvement to enhance the quality of CPGs. An electronic survey was distributed to PEDs with pediatric emergency medicine fellowship programs. Respondents were asked about their CPG development processes (ie, guideline committee composition, consideration of conflicts of interest, grading recommendations, guideline training opportunities) based on the Appraisal of Guidelines, Research, and Evaluation (AGREE II) tool as well as implementation and monitoring. Univariate analysis was used to assess associations between the number of AGREE II elements adhered to and annual patient volume. Of the 84 PEDs surveyed, 44 (52.4%) responded, representing institutions from 28 states. Most PEDs (97.7%, n = 43) reported developing their own guidelines, citing the need to improve care quality and standardize patient care as primary reasons. Although most guideline committees included multidisciplinary team members (74.4%, n = 32), routine patient involvement in committees was rare (11.6%, n = 5), and barriers such as time and resource constraints hindered their inclusion. Formal training for committee members in guideline development was uncommon (18.6%, n = 8). There was an association between higher annual patient volume and the number of AGREE II elements adhered to (P = 0.03). Few PEDs considered potential conflicts of interest among committee members (13.6%, n = 6). Over half of surveyed PEDs (54.5%, n = 24) lacked a systematic approach to grading recommendations. Educational materials and workshops were the most common guideline implementation strategies. Our findings highlight need for improvement in the CPG development process in PEDs. Including patients in committees, providing formal training for committee members, and adopting a rigorous approach to grading recommendations are crucial steps toward enhancing guideline quality. Emphasizing these improvements has the potential to improve the quality of CPGs for pediatric emergency care.

An evaluation of physical medicine and rehabilitation accredited sports medicine fellowship websites.

Due to the virtual format of fellowship applications, prospective physical medicine and rehabilitation (PM&R) sports medicine fellowship applicants commonly rely upon fellowship website content to make decisions about applications. Studies have shown that information available to fellowship applicants on program websites is inadequate, and there is no standard for important components of sports medicine fellowship websites. To determine what sports medicine fellowship program features PM&R residents, fellows, and attending physicians consider the most important to be listed on fellowship websites, as well as to assess the scope of information available on fellowship websites. We developed a 30-item list of criteria that fell into categories of general information, fellowship education, recruitment, experience, and academic research. Survey participants were asked to rank the importance of those various items. We then assessed the 21 PM&R accredited sports medicine fellowship websites for the presence of these criteria. Ninety-six survey respondents composed of PM&R residents, current sports medicine fellows, and attendings. Not applicable. Not applicable. Items ranked as most important were those in the categories of general information, fellowship experience, and fellowship recruitment. The most valued items were program location, program coordinator contact information, program length, specific requirements for applying, number of positions, types of procedures taught, and specific sites covered. Academic research items were ranked as least important. Survey respondents identified many fellowship website items as important factors when applying to programs. Many of these items were not listed on fellowship websites, suggesting that adding these criteria to fellowship sites might benefit applicants. Our findings can be used to develop standardized criteria for important components of sports medicine fellowship websites to improve the application and recruitment process.

Social Care Education and Training Among US Pediatric Emergency Medicine Fellowship Programs.

The aim of the study is to assess the association of social determinants of health (SDOH) education and social needs training on pediatric emergency medicine (PEM) physician perception and practices of social care. Data were derived from the 2021 National Social Care Practices Survey of PEM program directors (PDs) and fellows. Ordinal and binary logistic regression modeling were completed for educational/training factors and social care perspective and practice outcomes. A national sample of 44 PDs (49% response rate) and 109 fellows (28%) participated. A minority of fellows received SDOH education and social needs training during fellowship. Fellows and PDs with SDOH education had a 3.1 odds (95% confidence interval CI, 1.4-6.9) of screening for social needs, with 4.4 odds among fellows (95% CI, 1.2-20.7). Those with social needs training were more comfortable assessing social risk, with 2.4 odds overall (95% CI, 1.2-4.7) and 3.1 odds among fellows (95% CI, 1.4-6.7). They also had 2.4 odds overall (95% CI, 1.1-4.9) of screening for social needs, with a 2.9 odds among fellows (95% CI, 1.3-6.8). Social care education and training appear to be associated with comfort assessing social risk and social needs screening tendency among both PEM PDs and fellows. Key areas for educational interventions are identified among PEM fellows, who are uniquely positioned as clinical leaders and patient advocates.

Evaluation of Maternal-Fetal Medicine Fellowship Program Websites.

Introduction Due to the COVID-19 pandemic,the American Association of Medical Colleges (AAMC) recommended that all interviews for residencies and fellowships be conducted in a virtual format. As of March 2024, the Society of Maternal-Fetal Medicine (SMFM) continues to request that all fellowship interviews occur virtually. Without in-person interviews, prospective Maternal-Fetal Medicine (MFM) fellowship applicants must largely rely on program websites to gain insight into each program's offerings, culture, and application requirements. The purpose of this study was to evaluate the content of American College of Graduate Medical Education (ACGME)-accredited Maternal-Fetal Medicine (MFM) fellowship program websites and assess if regional differences exist among website content. Methods All ACGME-accredited MFM fellowship programwebsites were assessed for 21 defined criteria as of March 2024 and further compared by geographic regions (Midwest, Northeast, South, and West). Analyses were completed using chi-squared univariate tests, with a p < 0.05. Results Of the 108 accredited MFM fellowship programs, 106 programs had a dedicated website (98.15%). Most MFM programs (over 80%) included contact information (102/106), program director name (98/106), faculty names (95/106), application requirements (92/106), current fellow names (91/106), and the program coordinator name (89/106) on their website. Less programs (less than 30%) included diversity, equity, inclusion (DEI) content (28/106), interview dates (28/106), and current fellow research projects or publications (27/106). Western programs were less likely to include the program coordinator's name (12/18 (67%), p = 0.046), but more likely to include DEI content (10/18 (56%), p = 0.005). Northeastern programs were less likely to include their application requirements (24/32 (75%), p = 0.049) and less likely to include pictures of their current fellows (20/32 (63%), p = 0.045). Southern programs were more likely to include the yearly rotation schedule (19/32 (59%), p = 0.040). Midwestern programs were more likely to include information on fellowship benefits or salary (15/24 (63%), p = 0.046). Conclusion This study demonstrated that the content available on MFM fellowship websites varies greatly between programs and geographic regions. Efforts should be made by MFM training institutions to enhance website DEI content, curriculum information, recent fellow publications, and information on program alumni. A detailed and well-structured website may helpapplicants compare individual programs more equitablyin the age of virtual interviewing.

Workforce and Employment Status of Sleep Medicine Graduates in Iran

&#x0D; &#x0D; &#x0D; &#x0D; Background and Objective: Sleep medicine is a multidisciplinary specialty that focuses on diagnosing and treating sleep disorders. Sleep medicine fellowship programs in Iran commenced in 2012 at Tehran University of Medical Sciences, Tehran, Iran. This study aimed to investigate the human resources and employment status of sleep medicine fellowship graduates in Iran.&#x0D; Materials and Methods: This study was a descriptive cross-sectional study conducted in Iran in 2022 using conven- ience sampling and included 41 sleep medicine fellows in Iran. Data collection tools included a demographic question- naire and a researcher-made survey. Data were analyzed using the SPSS software.&#x0D; Results: Out of 57 sleep medicine fellows, 41 individuals with an average age of 44.95 ± 7.57 years participated in the study. Only 12% of the fellows were satisfied with their income, and all participants expressed dissatisfaction with their insurance coverage. 92% considered the existence of a national guideline for sleep medicine to be crucial, while 66.7% felt the curriculum of medical sleep medicine had some deficiencies.&#x0D; Conclusion: Lack of a suitable national guideline for treating and preventing sleep disorders, lack of insurance coverage for tests and respiratory assist devices, and high costs of establishing and equipping specialized sleep clinics are major challenges recognized by sleep medicine fellows. Additionally, due to the low priority given to these diseases by authorities and the inappropriate distribution of sleep medicine specialists in the country, access to appropriate treatment for sleep disorders is only feasible in giant cities.&#x0D; &#x0D; &#x0D; &#x0D;

The current state of training in pain medicine fellowships: An Association of Pain Program Directors (APPD) survey of program directors.

The Accreditation Council for Graduate Medical Education (ACGME) approved the first pain medicine fellowship programs over three decades ago, designed around a pharmacological philosophy. Following that, there has been a rise in the transition of pain medicine education toward a multidisciplinary interventional model based on a tremendous surge of contemporaneous literature in these areas. This trend has created variability in clinical experience and education amongst accredited pain medicine programs with minimal literature evaluating the differences and commonalities in education and experience of different pain medicine fellowships through Program Director (PD) experiences. This study aims to gather insight from pain medicine fellowship program directors across the country to assess clinical and interventional training, providing valuable perspectives on the future of pain medicine education. This study involved 56 PDs of ACGME-accredited pain fellowship programs in the United States. The recruitment process included three phases: advanced notification, invitation, and follow-up to maximize response rate. Participants completed a standard online questionnaire, covering various topics such as subcategory fields, online platforms for supplemental education, clinical experience, postgraduate practice success, and training adequacy. Surveys were completed by 39/56 (69%) standing members of the Association of Pain Program Directors (APPD). All PDs allowed fellows to participate in industry-related and professional society-related procedural workshops, with 59% encouraging these workshops. PDs emphasized the importance of integrity, professionalism, and diligence for long-term success. Fifty-four percent of PDs expressed the need for extension of fellowship training to avoid supplemental education by industry or pain/spine societies. This study highlights the challenge of providing adequate training in all Pain Medicine subtopics within a 12-month pain medicine fellowship. PDs suggest the need for additional training for fellows and discuss the importance of curriculum standardization.

Design and Implementation of a Didactic Curriculum in a Large Neonatal-Perinatal Medicine Fellowship Program: A Single-Center Experience.

Although the Accreditation Council for Graduate Medical Education and American Board of Pediatrics (ABP) provide regulations and guidance on fellowship didactic education, each program establishes their own didactic schedules to address these learning needs. Wide variation exists in content, educators, amount of protected educational time, and the format for didactic lectures. This inconsistency can contribute to fellow dissatisfaction, a perceived poor learning experience, and poor attendance. Our objective was to create a Neonatal-Perinatal Medicine (NPM) fellow curriculum based on adult learning theory utilizing fellow input to improve the perceived fellow experience. A needs assessment of current NPM fellows at Cincinnati Children's Hospital was conducted to guide the development of a new curriculum. Fellow perception of educational experience and board preparedness before and after introduction of the new curriculum was collected. Study period was from October 2018 to July 2021. One hundred percent of the fellows responded to the needs assessment survey. A response rate of 100 and 87.5% were noted on mid-curriculum survey and postcurriculum survey, respectively. Key themes identified and incorporated into the curriculum included schedule structure, content, and delivery mode. A new didactic curriculum implementing a consistent schedule of shorter lectures grouped by organ system targeting ABP core content was created. After curriculum implementation, fellows had higher self-perception of board preparedness, and overall improved satisfaction. Our positive experience in implementing this curriculum provides a framework for individual programs to implement similar curricula, and could be utilized to aid in development of national NPM curricula. · Fellowship didactic education varies significantly resulting in learner dissatisfaction and poor attendance.. · Widespread need to restructure didactic curricula exists.. · Our study provides a framework for future curricula..

Resident Education Curriculum in Pediatric and Adolescent Gynecology: The Short Curriculum 4.0

Exposure to pediatric and adolescent gynecology (PAG) varies across residency programs in obstetrics and gynecology, family medicine, and pediatrics, as well as both adolescent medicine and PAG fellowship programs. Nevertheless, these programs are responsible for training residents and fellows and providing opportunities to fulfill PAG learning objectives. To that end, the North American Society for Pediatric and Adolescent Gynecology has taken a leadership role in PAG trainee education by creating and maintaining this Short Curriculum. The curriculum outlines specific learning objectives central to PAG education and lists high-yield, concise resources for learners. This updated curriculum replaces the previous 2021 publication with a new focus toward accessible online content and updated resources.

Provider Practice Patterns Regarding Over-The-Counter Continence Devices.

Vaginal inserts and continence devices are recommended as a conservative treatment option for the management of stress urinary incontinence (SUI); however, practice patterns for recommendation and use of such devices are currently unknown. Our objectives were to better understand counseling patterns relating to over-the-counter (OTC) continence devices, to assess perceived barriers to recommending these devices, and to estimate clinician familiarity with three such devices currently available in the USA. In this cross-sectional study, an anonymous electronic survey was distributed to all Accreditation Council for Graduate Medical Education-accredited OB/GYN and Urology residency and Female Pelvic Medicine and Reconstructive Surgery (FPMRS) fellowship programs. A total of 326 survey responses were collected. Multivariate logistic regression was used to assess respondent characteristics associated with recommending OTC continence devices to patients. Sixty-four percent of respondents expressed familiarity with any OTC continence device. Of respondents who reported regular evaluation and treatment of women with SUI (n = 269), 60% reported ever recommending OTC devices for SUI. On multivariate regression, being a trainee and general OB/GYN provider were associated with being less likely to recommend OTC devices for SUI. Of respondents who did not regularly recommend OTC continence devices, reported barriers to doing so included a lack of training with these devices, leading to clinician discomfort (70%) and not remembering OTC devices as an option (15%). Given the low risk associated with patient use of these easily accessible devices, our study highlights barriers to clinician recommendation with the goal of increasing clinician awareness and consideration of OTC continence devices.

Orthopedic Team Surgeons in Major Professional Sports: An Analysis of Affiliation With the Top 10 Sports Medicine Fellowship Programs and Implications for Leadership and Diversity.

This paper examines the correlation between orthopedic team surgeons in major professional sports and their affiliation with the top 10 sports medicine fellowship programs. With a growing trend in post-residency fellowship training, particularly in sports medicine, the study focuses on the implications of fellowship program choice for aspiring major professional sports team physicians. By analyzing data from Major League Baseball (MLB), the National Basketball Association (NBA), the National Football League (NFL), and the National Hockey League (NHL), the research reveals that 61 of 124 (49.19%) team surgeons graduated from the top 10 sports medicine fellowship programs. The results identify a noticeable pipeline effect in professional sports, where teams often hire graduates from a select number of esteemed fellowship programs. The study suggests that choosing a fellowship program from the top 10 list may enhance the prospects of becoming a major league team surgeon. Additionally, our results found a significant gender disparity among team surgeons, with only two (1.6%) of all major professional team physicians being women. Thisemphasizes the imperative for diversity improvement in orthopedic sports medicine. In conclusion, the research underscores the impact of top-tier fellowship programs on professional team surgeons, with implications for aspiring sports medicine physicians and a call for addressing gender disparities.

Integrating Sexual Medicine in Obstetrics and Gynecology Practice: Highlights from The Sexual Medicine Fellowship Program

Background: The health system is least prepared to manage sexual dysfunctions and lacks trainedprofessionals who can adequately assess and manage individuals with sexual dysfunctions because theneed for the service has not been documented. This is because routine data are not collected on sexualdysfunctions. This study aimed to outline the distribution of sexual dysfunctions among patients seekinghealth services in a specialized sexual medicine clinic in Nairobi (Sexology Clinic).Methods: Records of all patients seen at the clinic for 12 months were analyzed. A total of 396 patientfiles were reviewed (362 males and 34 females) using a standard tool. The sociodemographic andmedical details of the patients were analyzed. Data were entered in SPSS and summarized using tablesand figures. Disease associations with sociodemographic characteristics were analyzed. Classification ofsexual disorders was performed using the International Classification of Diseases (ICD)-11.Results: The most prevalent sexual disorders in both genders were sexual arousal disorders (76.4%),sexual desire problems (16.42%), and orgasmic disorders (3.6%). Disease distribution was found to bedependent on patient age and sex. Ethnicity, religion, and profession did not affect disease distribution.Conclusion: The distribution of sexual dysfunctions observed in Nairobi was found to be similar to thoseobserved in other populations.Recommendation: Health promotion and treatment programs for sexual dysfunction should bedeveloped to mirror those in more liberal countries because sexual medicine needs are the same. Thehealth system should collect routine sexual health data to help with future planning.