North American Medical Schools Research Articles

1986 Association of residents in radiation oncology survey

Two simultaneous surveys were conducted by the Association of Residents in Radiation Oncology (ARRO). A survey of all residents in Radiation Oncology was conducted to obtain information on trends in residency training. A simultaneous survey of Chief Residents was obtained to determine more specific information on current training programs. Over one-half of residents responded. Eighty-eight percent of respondents were graduates of a North American medical school. Most did at least an internship prior to entering Radiation Oncology and 3 4 of those who did not do a separate internship rotated through other areas at a later time to broaden their knowledge. One-half are Board certified or Board eligible in another specialty or hold a Masters or Ph.D. degree. Three-quarters of all residents had authorship of at least one paper during training and one-half were primary authors. Eighty percent felt adequately prepared for practice after residency. One-half plan at least an initial post-residency affiliation with an academic center. Many were concerned that Radiation Oncologists are not afforded respect equivalent to that of other specialties. Ninety-eight percent favored departmental status for Radiation Oncology. Resident recommendations for improving the image of Radiation Oncology are presented.

Perspectives in the teaching of human genetics.

There is a growing sense of concern among geneticists with regard to the place occupied by their discipline in the curriculum throughout the entire educational system. Surveys of genetics teaching in North American medical schools, especially over the last 30 years, have shown dramatically increasing interest in the subject (Table I). For example, the proportion of schools with formal courses in genetics rose from 8.6% in 1953 (Herndon, 1954) to 74.7% in 1978 (Childs et al., 1981). Similar studies have revealed the importance of genetics in the education of dentists (Sanger, 1980; Farrington et al., 1982), nurses (Brantl and Esslinger, 1962; Feetham, 1984; Mertens et al.,1984; Monsen, 1984), nurse practitioners (J.K. Williams, 1983), and social workers (Mealer et al., 1981; Bishop, 1984). The last decade has even seen the emergence of an entirely new type of genetic practitioner, the genetic counselor or genetic associate (Kenen, 1984; Marks, 1982, 1984; Marks and Richter, 1976).

Straight Interns and Other Psychiatric Residents: A Comparative Study

The issue of the straight internship in psychiatry has not been sufficiently explored experimentally. In order to evaluate the performance of straight interns and residents with prior medical post-graduate training we compared 141 trainees on various measures of performance (intraining evaluations, final year residency examinations, and Royal College of Physicians certification examinations). The three study groups (straight interns, residents graduating from North American medical schools, and graduates of foreign medical schools) showed no difference on five of the six main outcome measures. Straight interns performed significantly better (p<0.05) than either of the two other groups on the final year residency written examination. They also scored significantly higher than the foreign medical graduates on various items of the in-training evaluations. Thus, although the issue of the Straight Internship appears to have been settled by policy adjustments, it still remains open to further examination.

An Australian's impression of biochemistry education in North American Medical Schools

An Australian's impression of biochemistry education in North American Medical Schools

The role of the behavioral sciences in North American medical schools: an overview.

The role of the behavioral sciences in North American medical schools: an overview.

Perspectives of graduates two or five years after graduation from a three-year medical school.

The 1970s have been described as an era of the rise and fall of three-year medical school programs. The present paper describes how graduates of one of the few North American medical schools that has retained its three-year curriculum view the problem-based curriculum and its length. On the whole the graduates of McMaster University School of Medicine were very positive about their undergraduate medical education. Many more of its features were endorsed as strengths than deficiencies. Eighty-two percent of McMaster graduates reported they would enroll in a three-year curriculum if they were entering medical school again, and they said that the advantages of a three-year curriculum outweight its disadvantages. The majority of graduates would return to a problem-based medical curriculum: 58 percent to an unaltered curriculum, 3 percent to one altered slightly, and 8 percent to one spread over four years. Of those that would not return, most chose a somewhat more structured curriculum, while very few chose traditional curricula.

Educators for medical education?

Excerpt To the editor: In his thoughtful analysis of proposed changes in the curricula of North American medical schools (76:487, 1972), Engel asks physicians to pause and reflect whether we may n...

The fate of foreign medical graduates in neurological surgery.

F REE migration of professionals, although governments often impose restrictions, is regarded by some as a right rather than a privilege. In any event, movement of intellectuals has had profound beneficial effects in many countries. Interchange of intellectuals between countries of approximately equal development usually represents no loss either way of human capital. However, migration to a highly developed industrial country from a less developed country may represent for the latter country a significant loss in human capital and in financial resources. For example, 300 Latin American physicians enter the United States as immigrants each year; this equals in number the output of three moderate-sized medical schools. Moreover, the immigration of foreign medical graduates from all countries to the United States in 1967 was equal to about one third of the number of graduates of American medical schools. The loss to the less developed country may be disproportionately high because of the relatively small number of educated individuals in that country. The loss of medical graduates from lesser developed countries is particularly onerous for the homeland because of the relatively greater length of training of physicians, the added cost involved, the small reserve of medically trained personnel, and the limited financial capacity to support medical schools. There are significantly increased needs for medical service in this country. The population growth, social pressures demanding medical care as a right, improved financial capacity of many people to finance medical care, insurance plans, and more time-consuming medical procedures are among the most obvious factors. In the year 1966-1967 27% of all hospital internships and 30% of all residencies were filled by foreign medical graduates (hereafter referred to as FMG's). In 1967-1968 the residency percentage rose to 32. This proportion will no doubt increase further because it will be very difficult for the needs of this country to be met through the slow processes of expanding present medical class size and increasing the number of schools. The Educational Council for Foreign Medical Graduates has been established as a quality control mechanism. On the Council sit two representatives each from the American Hospital Association, The American Medical Association, The American Association of Medical Colleges, the Federation of State Medical Examiners, and two members selected from the public at large. The Council is responsible for the administration of the ECFMG examination, which must be passed before an FMG can qualify for an internship and thereby enter the residency training program in any hospital where the FMG carries responsibility for patient care. The standard for the admission of FMG's as a group is significantly lower than the level of accomplishment of North American medical school graduates. There are, of course, great variations among the graduates of foreign medical schools in their ability to pass the ECFMG examination. There is probably a natural selection operative among FMG's that favors elimination of less qualified men from the neurosurgical applicants, but as educators we need to be concerned about the total picture. Two years ago the percentage of FMG's among U.S. neurosurgical trainees was 17%; one year ago it had increased to 21%. This trend may mean, although not necessarily, that the quality of the FMG accepted into neurosurgical programs is also changing. In many of the other specialties the per-

British physicians on medical school faculties in North America.

Data on the movement abroad of British medical graduates have been published by several investigators, notably Seale (1964, 1966), Davison (1962), Last (1963), Whitfield (1963), and Abel-Smith and Gales (1964). Different methods have been used to collect such information, and this has led to problems of validity, though, in spite of past Governmental statements, it appears that medical emigration has been considerable. One weD-designed study estimates that nearly 500 physicians went abroad each year from 1955 to 1960 (Abel-Smith and Gales, 1964), and Seale (1966) indicated that a numerically similar exodus has continued up to 1965. This represents an important loss of educational investment for the United Kingdom, and terms such as brain drain have been used, usually based on isolated and publicized examples. Little attempt, other than that of Abel-Smith and Gales, has been made to evaluate the motives and achievements of physicians who have emigrated, though these matters should be of some interest to those who are responsible for medical administration and education in the United Kingdom. Such facets of medical emigration led to this study of physicians with British medical degrees who are ?on the faculties of North American medical schools. The whole sropic of medical emigration can stir up such emotion that a rational evaluation may not be forthcoming. Nevertheless, it was felt that, apart from documenting numbers, an attempt should be made to obtain a perspective of the personal reasons for making such a major professional move.

A visit to some North American Medical Schools.

Finally, what impressions have I gained from American medicine? I believe there can be no doubt that today they lead the world in scientific medicine. This has developed to such a marked degree that at times there is a danger of drowning the clinical and human aspect with science. However, the Americans themselves are very conscious of this danger, and in fact the care and detail with which they teach clinical medicine seems often superior to our arrangements in Dublin. Of course it is difficult to compare fairly the two situations because of the great difference in the financial resources. American students appear more highly selected, and are undoubtedly more mature, work harder and are more serious. This is largely because they are older and often married. When they enter medical school, the average age is 22. They have left behind 4 years of college life with its social and sporting distractions, and do not expect anything but serious study on entering medical school.

THE PRESIDENT'S PAGE

WITHIN the past few years American medicine has made tremendous strides in prestige and influence. The Academy has contributed its part to this advance. But, progress has not been gained by accident. Behind the scenes in organized medicine are many conscientious and tireless workers who, by their enthusiasm and consecrated effort, are accomplishing the tasks with which they are confronted. Committee members are often unsung heroes in the solution of problems pertaining to the furtherance of more adequate medical care for children. The individual Academy member occasionally forgets how much so many of us owe to so few in the practical application of our ideals. For example, those of you who attended the Annual Meeting at Toronto last fall heard the panel discussion on Pediatric Education; and saw the exhibit, describing some of the aims and objectives of our Committee on Medical Education. Under the inspired leadership of the Chairman, Dr. Lee F. Hill, this group is making progress in attempting to answer some of the questions posed by the Academy Survey of 1946-48. During the current year, continuation of regional conferences throughout the United States and Canada, with emphasis upon the problems of undergraduate education, has resulted in an intelligent exchange of ideas and an opportunity for discussion unparalleled in the history of North American medical schools. The inevitable result of these discussions will be an improvement of standards for medical education. Interpretation and evaluation of new ideas, inclusion of practical and progressive concepts for the betterment of medical school curricula, requires a great deal of time and effort.