Medicine Residents Research Articles

2092313 Attitudes Towards the Appropriateness of Including Of Ultrasound-Guided Nerve and Musculoskeletal Procedures in The Scope Of Physical Medicine And Rehabilitation Residency Education

2092313 Attitudes Towards the Appropriateness of Including Of Ultrasound-Guided Nerve and Musculoskeletal Procedures in The Scope Of Physical Medicine And Rehabilitation Residency Education

A time-efficient web-based teaching tool to improve medical knowledge and decrease ABIM failure rate in select residents

AimThe American Board of Internal Medicine (ABIM) exam's pass rate is considered a quality measure of a residency program, yet few interventions have shown benefit in reducing the failure rate. We developed a web-based Directed Reading (DR) program with an aim to increase medical knowledge and reduce ABIM exam failure rate.MethodsInternal medicine residents at our academic medical center with In-Training Examination (ITE) scores ≤35th percentile from 2007 to 2013 were enrolled in DR. The program matches residents to reading assignments based on their own ITE-failed educational objectives and provides direct electronic feedback from their teaching physicians. ABIM exam pass rates were analyzed across various groups between 2002 and 2013 to examine the effect of the DR program on residents with ITE scores ≤35 percentile pre- (2002–2006) and post-intervention (2007–2013). A time commitment survey was also given to physicians and DR residents at the end of the study.ResultsResidents who never scored ≤35 percentile on ITE were the most likely to pass the ABIM exam on first attempt regardless of time period. For those who ever scored ≤35 percentile on ITE, 91.9% of residents who participated in DR passed the ABIM exam on first attempt vs 85.2% of their counterparts pre-intervention (p<0.001). This showed an improvement in ABIM exam pass rate for this subset of residents after introduction of the DR program. The time survey showed that faculty used an average of 40±18 min per week to participate in DR and residents required an average of 25 min to search/read about the objective and 20 min to write a response.ConclusionsAlthough residents who ever scored ≤35 percentile on ITE were more likely to fail ABIM exam on first attempt, those who participated in the DR program were less likely to fail than the historical control counterparts. The web-based teaching method required little time commitment by faculty.

Professor Hernán Alessandri, M.D.: his legacy for the new generations of physicians

Professor Alessandri died in 1980. We started our residency in Internal Medicine about 30 years later. Considering the profound changes our society has witnessed, including medical practice, I would like to approach the meaning of his work for our generation. It is not the Father's figure nor his Aura what inspires us today. Neither is his personality nor his shape. His universality comes from his transcendent image as a teacher. Today's teachers live rough times, their social status has changed, their professional requirements have grown exponentially, they have to adapt to social phenomena like the Internet and multiculturalism. Being a teacher nowadays demands to be a multifaceted expert. Things have changed since Professor Alessandri made rounds with his patients. But a deeper look allows us to understand that everything returns to where it started: professional deontology of the teacher, never fading but transcendent. We know that Doctor Alessandri had the natural gift to keep faithful to that code with consistency and perseverance. He excelled with integrity in every aspect including professional betterment, constructive work for his institution, collegiality, a warm relationship with students and a model of social values. Beyond virtues and personal defects he will keep on being the mould in which present teachers should be formed, engraved in their souls and in the subconscious of students that seek to learn.

Resident individual interactive instruction preferences and activities

Objective: The ACGME permits Individual Interactive Instruction (III) to fulfill twenty percent of emergency medicine (EM) residents’ total education requirement. It is not known what type of curriculum or III activities residents prefer, or which forms of III activities they choose to utilize. We sought to evaluate resident preferences between the three different curricula used from 2011 and 2014 in the State University of New York (SUNY) Downstate EM program: one without III, one with III and compulsory activities, and one with III and no compulsory activities. We hypothesized that residents prefer an III curriculum without compulsory activities, and prefer online activities versus in-person activities. Methods: In this observational, cross-sectional study at a large, urban, EM program, residents were sampled using a structured questionnaire that collected data on III curriculum preferences and III activity preferences. All matriculating trainees were eligible for inclusion. Residents graded each curriculum and activity on Likert scales. III activity logs were retrieved from an online repository. Descriptive analyses were performed for the study population. Significant differences in performed III activities were assessed based on year of training using one-way analysis-of-variance models with Bonferroni corrections. Results: A convenience sample of 56 (69%) residents was obtained. Residents preferred a curriculum with III (83.9%) more frequently than one without III (8.9%). The curriculum without III was more frequently disliked (75%) compared to the curriculum with III (3.6%). Additionally, residents prefer an III curriculum without compulsory activities (75%) compared to one with compulsory activities (7.1%). With regard to types of III, 48.2% prefer online activities compared to 10.7% prefer in-person activities. The most frequently preferred activities were Evidence Based Medicine (EBM) reviews, Simulation, and Journal Club. Board review was the least liked III activity with 44.7% disliking the modality. Residents participated most frequently in the two online III opportunities despite the Online Literature Module (OLM) activity being less well liked than other, in-person options. No significant differences in performed III activities were found based on year of training. Conclusions: Residents prefer an III curriculum without compulsory III assignments. Importantly, residents most often complete online activities, even if they are less well-liked than in-person activities. This data provides needed information on resident preferences on incorporating III into the EM curriculum and can guide other residencies in determining their III structure and activities.

Professionalization of anesthesiologists and critical care specialists in humanitarian action: a nationwide poll among italian residents.

Over the last decades, humanitarian crises have seen a sharp upward trend. Regrettably, physicians involved in humanitarian action have often demonstrated incomplete preparation for these compelling events which have proved to be quite different from their daily work. Responders to these crises have included an unpredictable mix of beginner-level, mid-level, and expert-level providers. The quality of care has varied considerably. The international humanitarian community, in responding to international calls for improved accountability, transparency, coordination, and a registry of professionalized international responders, has recently launched a call for further professionalization within the humanitarian assistance sector, especially among academic-affiliated education and training programs. As anesthetists have been involved traditionally in medical relief operations, and recent disasters have seen a massive engagement of young physicians, the authors conducted, as a first step, a poll among residents in Anesthesia and Critical Care Medicine in Italy to evaluate their interest in participating in competency-based humanitarian assistance education and in training incorporated early in residencies. The Directors of all the 39 accredited anesthesia/critical care training programs in Italy were contacted and asked to submit a questionnaire to their residents regarding the objectives of the poll study. After acceptance to participate, residents were enrolled and asked to complete a web-based poll. A total of 29 (74%) of the initial training programs participated in the poll. Out of the 1,362 questionnaires mailed to residents, 924 (68%) were fully completed and returned. Only 63(6.8%) of the respondents voiced prior participation in humanitarian missions, but up to 690 (74.7%) stated they were interested in participating in future humanitarian deployments during their residency that carried over into their professional careers. Countrywide, 896 (97%) favored prior preparation for residents before participating in humanitarian missions, while the need for a specific, formal, professionalization process of the entire humanitarian aid sector was supported by 889 (96.2%). In Italy, the majority of anesthesia/critical care residents, through a formal poll study, affirmed interest in participating in humanitarian assistance missions and believe that further professionalization within the humanitarian aid sector is required. These results have implications for residency training programs worldwide.

Abstract A83: Diversity by race, Hispanic ethnicity, and sex of the United States medical oncology physician workforce

Abstract Background/Purpose: Diversification of the oncology physician workforce has been identified as a means to address cancer disparities and serve the impending needs of newly insured patients following the Affordable Care Act, yet limited data exist regarding the current status of its diversity. The specific aim of this study was to assess the demographic diversity of the US Medical Oncology (MO) physician workforce by race, Hispanic ethnicity, and sex, with particular attention to the fellow trainee level. Materials and Methods: Publicly available American Medical Association, American Association of Medical Colleges, Accreditation Council for Graduate Medical Education, and US Census registries were used to assess differences for 2010 amongst MO academic faculty, Hematology and Oncology fellows and Oncology fellows combined into a single category as “MO” fellows, Internal Medicine (IM) residents, and the US population, and 2008 Oncology practicing physicians – the most recent year available for this group – by using binomial tests; adjusting for multiple comparisons among different groups, differences with P&amp;lt;0.001 were considered significant. To assess significant changes over time in percentages by different race, ethnicity, and sex for all reported academic yrs 1986 – 2011, the slope and associated 95% confidence intervals for each group were estimated using a linear regression model with yr as the independent variable. Results: Within the MO physician workforce, females and traditionally underrepresented minorities in medicine (URM) – Blacks, Hispanics, American Indians, Alaska Natives, Native Hawaiian, and Pacific Islanders (AI/AN/NH/PI) – are underrepresented as practicing physicians (38.1% and 7.8%, respectively), faculty (22.4%, 5.7%), and fellows (45.0%, 10.9%), compared to the US population (50.8%, 30.0%), (Ps&amp;lt;0.001). As faculty, females (22.4% vs. 38.1%, respectively), Blacks (1.8% vs. 3.5%), and AI/AN/NH/PI (0 vs. 0.2%) were underrepresented compared to practicing physicians (Ps&amp;lt;0.001). As fellows, females (45.0%) and Hispanics (7.5%) were increased compared to both faculty and practicing physicians (Ps&amp;lt;0.001); for Black fellows (3.1%) there were no differences compared to faculty or practicing physicians. When comparing MO fellows to IM residents, there were no differences for AI/AN/NH/PI (0.3% vs. 0.6%, P=0.137), Hispanics (7.5% vs. 8.7%, P=0.139), and females (45.0% vs. 44.7%, P=0.853); Blacks were underrepresented as fellows (3.1%) compared to IM residents (5.6%), P&amp;lt;0.001. Over the past 26 yrs of available data, female representation as fellows has increased significantly at 1.001% per yr (95%CI: 0.867, 1.137; P&amp;lt;0.001). Meanwhile, there has been no significant change in representation of individual URM groups over the past 17 yrs available: AI/AN/NH/PI -0.018% (95%CI: -0.132, 0.096; P=0.726), Blacks -0.063% (95%CI: -0.153, 0.028; P=0.165), Hispanics 0.063% (95%CI: -0.032, 0.158; P=0.178). Conclusions: Females and URM are underrepresented in the MO physician workforce relative to the US population. Female representation as fellows has increased significantly over the past quarter century at 1% per annum and is increased relative to practicing physicians and academic faculty, indicating historical gains. Meanwhile, there are no significant increases in URM groups over the past 17 yrs, suggesting that racial and ethnic diversity are not increasing. Furthermore, for Blacks alone, representation as fellows is decreased compared to IM residents, suggesting a greater disparity in Blacks entering MO training. Given existing cancer disparities and an increasingly diverse society, future research and training efforts should address increasing trainee diversity. Note: The author block has been changed and no longer matches the print Proceedings. Citation Format: Ramon Burgos, Christina H. Chapman, Wei-Ting Hwang, Stefan Both, Charles R. Thomas, Jr., Curtiland Deville. Diversity by race, Hispanic ethnicity, and sex of the United States medical oncology physician workforce. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr A83. doi:10.1158/1538-7755.DISP13-A83

PP-089 METASTASIS OF BREAST CANCER IN BONE MARROW WITH LEUKOERYTHROBLASTIC REACTION: A CASE REPORT

Medicine residency is three to seven years of challenging graduate medical training that puts a lot of mental and physiological burden over the residents. Like other surgical branches, anesthesia and reanimation departments provide 24 h continuous service and the residents are the main providers of this service. The residents are assigned for on-call shifts during their training, as well as working during the regular day shifts. These schedules must address several considerations like preferences of the residents and coverage requirements of two different locations: the intensive care unit (ICU) and the surgery room (SR). In this study we develop a goal programming (GP) model for scheduling the shifts of the residents in the Anesthesia and Reanimation Department of Bezmialem Vakif University Medical School (BUMS). The rules that must be strictly met, like the number of on-duty shifts or preventing block shifts, are formulated as hard constraints. The preferences of the residents like increasing the number of weekends without shifts and assigning duties on the same night to the same social groups are formulated as soft constraints. The penalties for the deviation from the soft constraints are determined by the analytical hierarchy process (AHP). We are able to solve problems of realistic size to optimality in a few seconds. We showed that the proposed formulation, which the department uses currently, has yielded substantial improvements and much better schedules are created with less effort.

In memoriam, Dr. E. Chester Ridgway, 1942-2014.

The Endocrine Society, the world of endocrinology, and the family and innumerable friends and colleagues of Chip Ridgway were immensely saddened to learn of his very untimely death on July 31, 2014. Chip was a graduate of Dartmouth College and an AOA graduate of the University of Colorado School of Medicine, magna cum laude. His internship, medicine residency, and endocrinology fellowship were all at the Massachusetts General Hospital. He served two years in the Navy as Chief of Endocrinology at San Diego prior to returning to Massachusetts General, where he served as Chief of the Thyroid Unit and Associate Professor of Medicine, Harvard Medical School, until 1985. He moved back to the University of Colorado in 1985 to become the Frederic C. Hamilton Professor of Medicine and Division Head of Endocrinology, Metabolism, and Diabetes. Chip received the high honor of Distinguished Professor at the University of Colorado in 2011 and remained at the University until his death. Chip relinquished the role of Division Director in 2007 but continued to serve as interim Chair of Medicine and Executive Vice Chair of Medicine. He has been Senior Associate Dean for Academic Affairs for nearly 20 years. Peer recognition of his stellar career led to early election to membership in the American Society of Clinical Investigation, the Association of American Physicians, and Mastership in the American College of Physicians. Chip generously shared his professional life as a physician-scientist between his associates at the University of Colorado, numerous international colleagues and collaborators, and his two favorite professional societies, the Endocrine Society and the American Thyroid Association (ATA). He served as member and chairman of many committees in both societies and on the Council of the Endocrine Society and on the Executive Board of the ATA. He was elected President of the ATA in 1996–1997 and President of the Endocrine Society in 2003–2004. His welldeserved honors and awards were many, including the Distinguished Service Award, Paul Starr Award, Stanbury Thyroid Pathophysiology Medal, and Lewis Braverman Lectureship Award from the ATA, and the Robert H. Williams Distinguished Leadership Award from the Endocrine Society. Chip founded and directed a “Fellows Day” conference dedicated to thyroid disease at the ATA annual meeting for the past 20 years, touching the careers of over 100 fellows each year. Indeed, his dedication to both education and the growth, development, and mentorship of his fellows and junior colleagues was legend-

A Review of Learner Impact on Faculty Productivity

A Review of Learner Impact on Faculty Productivity

In memoriam, Dr. E. Chester Ridgway, 1942- 2014.

The Endocrine Society, the world of endocrinology, and the family and innumerable friends and colleagues of Chip Ridgway were immensely saddened to learn of his very untimely death on July 31, 2014. Chip was a graduate of Dartmouth College and an AOA graduate of the University of Colorado School of Medicine, magna cum laude. His internship, medicine residency, and endocrinology fellowship were all at the Massachusetts General Hospital. He served two years in the Navy as Chief of Endocrinology at San Diego prior to returning to Massachusetts General, where he served as Chief of the Thyroid Unit and Associate Professor of Medicine, Harvard Medical School, until 1985. He moved back to the University of Colorado in 1985 to become the Frederic C. Hamilton Professor of Medicine and Division Head of Endocrinology, Metabolism, and Diabetes. Chip received the high honor of Distinguished Professor at the University of Colorado in 2011 and remained at the University until his death. Chip relinquished the role of Division Director in 2007 but continued to serve as interim Chair of Medicine and Executive Vice Chair of Medicine. He has been Senior Associate Dean for Academic Affairs for nearly 20 years. Peer recognition of his stellar career led to early election to membership in the American Society of Clinical Investigation, the Association of American Physicians, and Mastership in the American College of Physicians. Chip generously shared his professional life as a physician-scientist between his associates at the University of Colorado, numerous international colleagues and collaborators, and his two favorite professional societies, the Endocrine Society and the American Thyroid Association (ATA). He served as member and chairman of many committees in both societies and on the Council of the Endocrine Society and on the Executive Board of the ATA. He was elected President of the ATA in 1996–1997 and President of the Endocrine Society in 2003–2004. His welldeserved honors and awards were many, including the Distinguished Service Award, Paul Starr Award, Stanbury Thyroid Pathophysiology Medal, and Lewis Braverman Lectureship Award from the ATA, and the Robert H. Williams Distinguished Leadership Award from the Endocrine Society. Chip founded and directed a “Fellows Day” conference dedicated to thyroid disease at the ATA annual meeting for the past 20 years, touching the careers of over 100 fellows each year. Indeed, his dedication to both education and the growth, development, and mentorship of his fellows and junior colleagues was legend-

Editorial introductions

Current Opinion in Cardiology was launched in 1985. It is part of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The field of cardiology is divided into 14 sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Section Editors for this issue. SECTION EDITORS Sherif F. NaguehSherif F. NaguehAfter graduating from the Cairo University Faculty of Medicine, Egypt, in 1986, Dr Nagueh emigrated to Houston, Texas, USA. He completed his medicine residency and cardiology fellowship at Baylor College of Medicine, USA. He is currently Professor of Medicine at Weill Medical College of Cornell University, USA; and Medical Director of the Echocardiography Laboratory at the Methodist DeBakey Heart Center in Houston, Texas, USA. Dr Nagueh has received several awards, including the Second Annual Feigenbaum Lecture at the American Society of Echocardiography meeting in 2001. He sits on the Editorial Boards of the Journal of the American College of Cardiology, Circulation, Journal of the American Society of Echocardiography, and Clinical Science; and has served as the Imaging and echocardiography Section Editor for Current Opinion in Cardiology since 2001. Andrew PipeAndrew PipeDr Andrew Pipe graduated from Queen's University, Canada in 1974. He is currently Chief of the Division of Prevention and Rehabilitation at the University of Ottawa Heart Institute, Canada, and is also a Professor in the Faculty of Medicine at the University of Ottawa, Canada. He is currently involved in clinical research assessing new approaches to smoking cessation, strategies designed to facilitate exercise adoption, and novel initiatives to prevent cardiovascular disease. Dr Pipe has addressed audiences in over 30 nations and is frequently consulted on issues related to tobacco use and smoking cessation, physical activity and health, and drug use in sport. Dr Pipe is the recipient of the International Olympic Committee's Award for “Sport, Health and Wellbeing” and honourary degrees from Queen's University (LLD), Brock University (DSc), Canada and the University of Guelph (DSc), Canada. He was the recipient of the Canadian Cardiovascular Society's Dr Harold N. Segall Award for distinguished contributions to the prevention of cardiovascular disease, and was named to the Order of Canada in 2002.

Poster 175 Timeline for Choosing a Fellowship for Physical Medicine and Rehabilitation Residents

Poster 175 Timeline for Choosing a Fellowship for Physical Medicine and Rehabilitation Residents

Do physicians underrecognize obesity?

A physician's advice is among the strongest predictors of efforts toward weight management made by obese patients, yet only a minority receives such advice. One contributor could be the physician's failure to recognize true obesity. The objectives of this study were to assess physicians' ability to recognize obesity and to identify factors associated with recognition and documentation of obesity. Internal medicine residents and attending physicians at three academic urban primary care clinics and their adult patients participated in a study using recognition and documentation of patient obesity as the main measures. A total of 52 physicians completed weight assessments for 400 patients. The mean patient age was 51 years, 56% were women, 77% were Hispanic, and 67% had one or more obesity-related comorbidity. There were 192 (48%) patients, of whom 66% were correctly identified by physicians as being obese, 86% of those with a body mass index (BMI) ≥ 35, but only 49% of those with a BMI of 30 to 34.9 (P < 0.0001). Fewer obese Hispanic patients were identified than were non-Hispanic patients (62% vs 76%; P = 0.03). No physician characteristics were significantly associated with recognition of obesity. Physicians documented obesity as a problem for 51% of patients. Attending physicians documented obesity more frequently than did residents (64% vs 43%, odds ratio 2.5, 95% confidence interval 1.3-4.6) and normal-weight physicians documented obesity more frequently than overweight physicians (58% vs 41%, odds ratio 2.0, 95% confidence interval 1.0-4.0). Documentation was more common for patients with a BMI ≥ 35 and for non-Hispanics. Documentation was not more common for patients with obesity-related comorbidities. Physicians have difficulty recognizing obesity unless patients' BMI is ≥ 35. Training physicians to recognize true obesity may increase rates of documentation, a first step toward treatment.

Egressos da residência de medicina de família e comunidade em Minas Gerais

Este estudo objetivou investigar alguns aspectos do perfil profissional e a inserção no mercado de trabalho dos egressos médicos da Residência em Medicina de Família e Comunidade (RMFC) no norte de Minas Gerais. Trata-se de um estudo transversal, desenvolvido com aplicação de questionários enviados por meio de correio eletrônico a todos os egressos da RMFC na região nos últimos dez anos. Esses dados foram processados por meio de planilha eletrônica. A validação do questionário on-line foi realizada pelo teste de Kappa. Responderam ao instrumento 42 dos 51 médicos localizados. Verificou-se predominância do sexo masculino, a maioria está na faixa etária entre 30 e 34 anos, residindo e trabalhando na área de formação, na mesma região. O principal vínculo trabalhista é de contrato para prestação de serviço. Os entrevistados que informaram dificuldades no desempenho profissional relataram problemas relacionados à estrutura organizacional da instituição/empresa e necessidade de educação permanente. No mercado de trabalho do egresso da residência em Saúde da Família um dos grandes desafios encontrados é a precarização das relações de trabalho, algumas vezes, dependentes de oscilações políticas locais.

Development of a Global Health Curriculum for Family Medicine Based on ACGME Competencies

Background: With the popularity of global health among medical students and residents, family medicine (FM) residencies are developing pathways in global health. Curriculum based on Accreditation Council for Graduate Medical Education (ACGME) competencies adds rigor to the efforts. Description: We describe the adaptation of a comprehensive pediatric global health curriculum based on ACGME competencies for family medicine. The curriculum maps out goals, objectives, curricular elements, and evaluation modalities for each of the six competencies (medical knowledge, patient care, practice-based learning, professionalism, communication, and systems-based practice). A literature review, followed by an iterative process, guided the expansion of the pediatric curriculum and the prioritization of domains for FM. Input was sought from FM global health faculty at our 8 residencies, affiliated community faculty, and international health experts from across the United States who attended our workshop at a national FM global health meeting. The final product includes comprehensive competency-based curriculum, open-source resources, and evaluation modalities. The goals and objectives pertinent to all FM residents, and those specific to global health pathway residents and fellows, are outlined. Evaluation: The limiting and enabling factors of the curriculum implementation are presented. Conclusions: This global family medicine curriculum has added structure and rigor to our international electives in the department at the University of Minnesota. The competency-based curriculum is in the early stages of implementation and evaluation. It has already strengthened components of the residency learning experience for all residents. A robust evaluation is needed and requires monitoring pathway graduates and their career choices into the future. The curriculum is available for adoption by other FM residencies.

Improving Foot Examinations in Patients With Diabetes

The purpose of this project was to determine if a Performance-Improvement Continuing Medical Education (PI-CME) project, using the American Medical Association's methodology, would help improve the timeliness and comprehensiveness of foot examinations in patients with diabetes. A PI-CME project was conducted with the Internal Medicine faculty staff physicians (n = 8) and residents (n = 45). Following the 3 steps of PI-CME, participants received baseline reports about their performance defined by the American Diabetes Association's guidelines for foot examinations (stage A). Each group received an educational intervention (stage B) and a reminder tool for use in the practice. Participants received individualized reports about their performance post intervention (stage C) for comparison with preintervention data and reflection on any changes in compliance. In the faculty and resident clinics, the percentage of patients who received an annual foot examination when due increased significantly. Both clinics also showed improvements in the percentage of patients who received all 3 components of the exam, with the greatest improvement in the resident clinic. The PI-CME approach can be successfully used both with faculty staff physicians (who receive CME credits) and residents (who do not receive credits) to improve performance on diabetes quality measures.

Recommendations for Training Psychiatry Residents in Psychosomatic Medicine

The Accreditation Council of Graduate Medical Education (ACGME) mandates that residents in psychiatry training programs learn to provide psychiatric consultation to other medical and surgical services. The ACGME, however, offers little information to instruct academic faculty and institutions to what constitutes a quality educational experience in psychosomatic medicine/consultation-liaison psychiatry for the resident trainee. These recommendations were developed through a collaborative process between educators in C-L psychiatry and members of the Academy of Psychosomatic Medicine's Residency Education Subcommittee. This manuscript provides a broad framework for what constitutes a well-rounded clinical and academic resident rotation on psychiatric consultation-liaison services. A rotation that is viewed positively by residents is important as it likely provides a foundation for a growing interest in Psychosomatic Medicine and the development of future fellows and subspecialty trained physicians.

A Preconference Exchange Experience in Spain

VdGM movement was started in Amsterdam in 2004. It aims to support residents in family medicine or family physicians in fifth year. One of the programmes is Minihippokrates exchange. It aims that visit of a health center and involvement of a conference after this programme. In this article we aimed to write observations in minihippokrates exchange programme in Madrid/ Spain in March 17-21, 2014.

The Vacancies and Preferability of Emergency Medicine Training in Recent Years in Turkey

Objective: Department of Emergency Medicine was founded for the first time in the world in 1970 at Cincinnati University and in Turkey in 1993 at Do- kuz Eylul and Firat Universities. The emergency medicine specialists increased in number rapidly in Turkey by starting-up the training programs in the train- ing and research hospitals of the Health Ministry for the first time in 2006; and participation of the doctors' complete training program for the first time in 2011. We wanted the determine the preferability of the emergency medicine residency program and its completion rate. Material and Methods: The vacancies, preferability rate and completion rate of the residency programs of emergency medicine, family medicine, internal medicine, cardiology and neurosurgery were investigated with this study. The data was derived from the web sites of the Student Selection and Placement Center and the assignment lot lists of the Health Ministry. Results: From 2007 to 2012, 2586 of 2767 emergency medicine vacancies were set. The minimum base -point was 53.03 and the maximum was 55.46 in the examination for specialty training in medicine (TUS). The preferability of emergency medicine was lower than internal medicine and cardiology but similar to neurosurgery and family medicine. The completion of the residency in emergency medicine was 66.1%. Conclusion: In spite of the increase in the number of emergency medicine specialists with the participation of the training and research hospitals, the completion rate of the residency programs were lower than other depart- ments. The completion rates could be increased by improving the job condi- tions of the emergency physicians. (JAEM 2013; 12: 180-4)

The road not taken or how I learned to love the liver: A personal perspective on hepatitis history

The road not taken or how I learned to love the liver: A personal perspective on hepatitis history