Medical Education Office Research Articles

Evaluating equity, diversity, and inclusion in Canadian Postgraduate Medical Education: A cross-sectional analysis of online content.

Medical graduates applying to Residency through the Canadian Resident Matching System (CaRMS) utilize the internet to gather information on programs and their overarching Postgraduate Medical Education (PGME) Office. This study aims to evaluate how PGME websites across Canada convey their commitment to equity, diversity, and inclusion (EDI) through their website features. Cross-sectional analysis of the 17 Canadian PGME websites against 20 EDI criteria based on contemporary literature, across five domains: leadership and governance, recruitment, accommodations, community engagement, and pathways to entry. Non-parametric testing was conducted to explore the relationship between EDI performance and municipal population diversity and geographic region. The evaluation of PGME websites, policies, reports, and plans revealed a mean score of 8.65/20 (SD = 3.00), with scores ranging from a minimum of 4/20 to a maximum of 13/20, indicating variability in EDI representation. Specifically, the domain of leadership and governance demonstrated the highest mean proportion of completed criteria (51%), while community engagement had the lowest (24%). Notably, 9 out of 17 PGME websites (53%) met at least 10 EDI criteria. Analysis by geographic region demonstrates significant mean differences (p = 0.02), with Ontario (10.50, SD = 2.17) and Western Provinces (11.00, SD = 0.00) scoring notably higher than Quebec (4.50, SD = 0.58), the Prairies (8.50, SD = 2.12), and the Atlantic region (8.00, SD = 2.83). The assessment of Canadian PGME websites reveals varying levels of commitment to EDI. While many programs exhibit strong EDI representation in mission statements, access to mental health services, and anti-discrimination policies, there are notable gaps in leadership messaging, diverse interview panels, family-friendly policies, and deliberate recruitment of underrepresented groups. Regional differences highlight the need for sharing best practices to promote inclusivity across the country. Improving EDI efforts on PGME websites can promote the recruitment and retention of a diverse resident population.

Where Do We Go From Here? An Inventory of Publicly Available Data About Educator Academies, Medical Education Departments, and Offices of Medical Education.

With the recent widespread growth and interest among medical educators, analysis of how departments of medical education are structured and their intersection with existing structures within the same institution, such as an office of medical education and/or academy of educators, is warranted. Based on a review of the literature, the authors determined there was a need for an inventory of what medical schools have to offer their faculty, whether it be an office, an academy, or a department. This project sought to inventory the current structures of medical education departments, offices, and academies at U.S. medical schools to explore reporting structure, functions, and characteristics of these entities. Data were extracted from A Snapshot of Medical Student Education in the United States and Canada: Reports From 145 Schools, published in 2020 in the journal Academic Medicine , for each reporting institution. This led to exploration of medical school websites to catalogue institutional structures. Data collected in this inventory demonstrate the range of structures used by medical schools to offer faculty support for their work as teachers and educational researchers. The hypothesis was that departments of medical education would be the least prevalent structures identified in U.S. medical schools, which was indeed a finding. Although the search yielded considerable data for the inventory, there is a dearth of published literature describing current models and characteristics of these different entities. Significant difficulties were encountered locating information clearly delineating roles and responsibilities of each entity on many medical schools' public-facing web pages. Findings are significant because they underscore the challenges medical education leaders have in obtaining information to research, compare, select, and design the administrative model(s) best suited to support faculty educators at their institution. Future work should include creating a detailed catalogue with descriptive information supplied by schools.

Medical students' perspectives on a longitudinal wellness curriculum: a qualitative investigation.

There is growing concern about the mental health status of medical students. Medical students are at a higher risk for depression, anxiety, and burnout than non-medical students. The Undergraduate Medical Education (UGME) Office of Medical Learner Affairs at McGill University developed a Longitudinal Wellness Curriculum (LWC) to foster medical students' well-being, self-care, and adaptability. We conducted a qualitative descriptive study to explore students' experiences with the LWC. We conducted three semi-structured focus groups involving a total of 11 medical students. We used thematic framework analysis for data analysis. We found four main themes related to participants' engagement with the curriculum: 1) diverse perceptions on curriculum relevance and helpfulness; 2) the benefits of experiential sessions, role model speakers, and supportive staff; 3) insights on student-friendly curriculum scheduling; and 4) the importance of wellness education and systemic interventions in medical education. Most participants found the curriculum valuable and supported its integration into the academic curriculum. Experiential and active learning, diverse approaches to wellness, small group sessions, role modeling, and student-centered approaches were preferred methods. Inconvenient curriculum scheduling and skepticism over system-level support were seen as barriers to curriculum engagement and uptake. The findings of our study contribute to the development and implementation of wellness curriculum efforts in medical education.

The Potential of Real-Time Behavior and Well-Being Assessments to Improve Medical Student Wellness.

Medical students experience psychological distress more frequently than age-matched peers. Tracking medical student well-being has typically been limited to once- or twice-per-year questionnaires. Ongoing, real-time assessment of student behavior and well-being could facilitate individualized, timely interventions. Faculty at the University of Vermont, in conjunction with the Larner College of Medicine Office of Medical Education, developed a novel smartphone app in 2021 called WE MD to track and support medical student wellness. The app included the following features: (1) nightly surveys assessing wellness-related behaviors (e.g., social interaction, sleep, exercise) and outcomes (i.e., mood, focus, stress, overall well-being); (2) health reports that enabled users to graph various combinations of their own behaviors and outcomes, allowing them to visualize trends and understand possible correlations between behaviors and outcomes; (3) a resource library with articles and educational videos related to specific wellness behaviors or outcomes; and (4) research-based "insights" or brief tips intended to promote healthy habits. Participants also received virtual "coins" for interacting with the app that could be exchanged for various items in an online store. The WE MD program enrolled a substantial portion of the medical school population (43%); most of the students used the app on a regular basis. Students found the app to be acceptable and appreciated many features and also provided feedback on how to improve the app. Information from the nightly survey data converged with established measures but also identified variability over time in wellness behaviors and outcomes. Data from the WE MD program suggest that app-based daily tracking of wellness behaviors and outcomes is a feasible, promising approach to promote student wellness and identify real-time patterns and risk periods for medical students. The app will be revised based on student feedback and adapted for use by students, residents, and faculty.

Structure and Funding of Clinical Informatics Fellowships: A National Survey of Program Directors.

In 2011, the American Board of Medical Specialties established clinical informatics (CI) as a subspecialty in medicine, jointly administered by the American Board of Pathology and the American Board of Preventive Medicine. Subsequently, many institutions created CI fellowship training programs to meet the growing need for informaticists. Although many programs share similar features, there is considerable variation in program funding and administrative structures. The aim of our study was to characterize CI fellowship program features, including governance structures, funding sources, and expenses. We created a cross-sectional online REDCap survey with 44 items requesting information on program administration, fellows, administrative support, funding sources, and expenses. We surveyed program directors of programs accredited by the Accreditation Council for Graduate Medical Education between 2014 and 2021. We invited 54 program directors, of which 41 (76%) completed the survey. The average administrative support received was $27,732/year. Most programs (85.4%) were accredited to have two or more fellows per year. Programs were administratively housed under six departments: Internal Medicine (17; 41.5%), Pediatrics (7; 17.1%), Pathology (6; 14.6%), Family Medicine (6; 14.6%), Emergency Medicine (4; 9.8%), and Anesthesiology (1; 2.4%). Funding sources for CI fellowship program directors included: hospital or health systems (28.3%), clinical departments (28.3%), graduate medical education office (13.2%), biomedical informatics department (9.4%), hospital information technology (9.4%), research and grants (7.5%), and other sources (3.8%) that included philanthropy and external entities. CI fellowships have been established in leading academic and community health care systems across the country. Due to their unique training requirements, these programs require significant resources for education, administration, and recruitment. There continues to be considerable heterogeneity in funding models between programs. Our survey findings reinforce the need for reformed federal funding models for informatics practice and training.

Survey on the Perceptions of Pregnancy and Parenthood in Trainees: Advances, Obstacles, and Growth Opportunities

IntroductionDespite national policy changes, perspective changes on pregnancy and parenting in training are often lacking. We evaluated current viewpoints regarding pregnancy, parenthood, leave needs, and perceptions of support across trainees at our institution. MethodsA cross-sectional survey was sent to all residents and fellows at a tertiary care academic center with >700 trainees. Demographic information, opinions on maternity and paternity leave, and opinions on institutional support and career goals were collected. The survey was sent via the Graduate Medical Education Office listserv -- 66 Accreditation Council for Graduate Medical Education (ACGME) programs and 40 non-ACGME programs. ResultsSeven hundred and forty-seven house officers received the survey with a response rate of 21.9% (n = 164). Of respondents, 81% were residents and 99 respondents were female (representing 31% of female trainees at our institution). Thirty-seven point two percent of respondents reported being parents. Twenty-five point three percent of respondents had been pregnant while a trainee with no statistical difference by specialty type (P = 0.0817). Statistically significant difference was noted in having children based on sex with men becoming parents at twice the rate of women (56% vs 26%, P < 0.001). No difference was noted between specialties on perceived support while pregnant and peripartum. Thirty percent of parent respondents reported thinking about leaving medical training after having children given family stressors. Statistical difference in thoughts of leaving medicine overall between females (46%) and males (17.6%; P = 0.0238). ConclusionsMen and women need support as they navigate becoming parents at a naturally stressful transition period. Females consider leaving medicine at twice the rate of males after becoming parents. Our institution and other ACGME programs need greater transparency and consistent leave practices that reflect changing times.

O.4.4-3 Developing a bespoke undergraduate physical activity course for a Portuguese Medical School - the VANGUARD European Union Erasmus+ project

Abstract Purpose Embedding physical activity in the undergraduate curricula of frontline health professionals is one of the policies recommended by the World Health Organization and the European Commission to promote health-enhancing physical activity (HEPA). The VANGUARD project is supported by the European Union Erasmus+ Programme, and aims to embed physical activity in the undergraduate curricula of healthcare professionals in European countries. Within this project, this work aimed to describe the bespoke development of a physical activity and health course integrated into the undergraduate medical curriculum of a Portuguese Medical School. Project or policy description The School of Medicine and Biomedical Sciences of the University of Porto (ICBAS) was the invited Medical School to implement the VANGUARD project in Portugal - led by the Institute of Public Health of the University of Porto (ISPUP). An auscultation process with the undergraduate medical students was held to evaluate the importance of HEPA in their curriculum and assess the preferred operational characteristics of including a physical activity and health course in the Integrated Master’s degree in Medicine. A course proposal structure was then developed by the VANGUARD project Portuguese team from ISPUP, the Director of the Integrated Master’s degree in Medicine, and the Coordinator of the Medical Education Office of ICBAS, based on the students’ acceptability, the Medical School constraints, and VANGUARD project goals and resources. The course integrates 26 lessons, from physical activity technical terminology, epidemiology and guidelines, going through its relation with noncommunicable diseases (using #MovementForMovement resources), to Portuguese National Health Service brief intervention tools and community-based exercise programs - in a total of 20 hours of contact, including continuous evaluation and final case studies analysis. The course will be offered on an optional basis to 2nd-year medical students, on an online training platform, using a self-paced learning method. After embedding this course in ICBAS, it will be presented to the Council of Portuguese Medical Schools to be scaled up nationally. Conclusions Medical doctors and Medical Schools are key stakeholders in HEPA promotion, especially in the health sector. Successful implementation of HEPA policies requires tailored solutions to organizations and direct involvement of target groups in policy development.

Development and Maintenance of Cohort Data at Chonnam National University Medical School

The aim of this study was to systematically collect data for evaluating short- and long-term outcomes using Kirkpatrick’s four-level evaluation model, Chonnam National Medical School has established plans for developing and managing a database of student and graduate cohorts. The Education Evaluation Committee, with assistance from the Medical Education Office, manages the development and maintenance of cohort data. Data collection began in the 2022 academic year with first- through fourth-year medical students and graduates of the year 2022. The collected data include sociodemographic characteristics, admission information, psychological test results, academic performance data, extracurricular activity data, scholarship records, national medical licensing exam results, and post-graduation career paths. The Education Evaluation Committee and the Medical Education Office analyze the annually updated student and graduate cohort data and report the results to the dean and relevant committees. These results are used for admissions processes, curriculum improvement, and the development of educational programs. Applicants interested in using the student and graduate cohort data to evaluate the curriculum or conduct academic research must undergo review by the Educational Evaluation Committee before being granted access to the data. It is expected that the collected data from student and graduate cohorts will provide a sound and scientific basis for evaluating short- and long-term achievements based on student, school, and other characteristics, thereby supporting medical education policies, innovation, and implementation.

Identifying Student Mistreatment Through Peer-Facilitated Learning Environment Sessions.

Data from the Association of American Medical Colleges (AAMC) Medical School Graduation Questionnaire (GQ) show persistent high rates of medical student mistreatment, and multiple barriers to student reporting of mistreatment exist. The authors examined whether learning environment sessions (LESs) allow students opportunities to identify and describe patterns of mistreatment missed by other avenues of reporting. Peer-facilitated LESs were instituted in 2018-2019 at Boston University School of Medicine. The LESs were scheduled once during every third-year core clerkship block. Third- and fourth-year students trained as peer-facilitators led discussions of topics relevant to the student clinical experience using a standardized facilitator guide. Minutes, including details of reported events, were completed during the session and visible to all students participating. These minutes were sent to clerkship leadership and the medical education office for action once student grades were submitted. Summative content analysis was conducted on 44 LES minutes from sessions held in January-November 2019. Reported incidents were categorized into broad categories of negative treatment (NT), negative learning environment (NLE), and positive learning environment (PLE). Sixty-three instances of NT were identified. Of these, 37 fit within the scope of the AAMC GQ mistreatment categories. The remaining 26 instances of NT were classified into 7 novel categories of medical student mistreatment. Instances of NLE were most discussed by students and categorized into 5 subthemes. Examples of PLE were categorized into 4 subthemes, which encompassed 11 descriptors of core qualities of an ideal preceptor or educational environment. LESs have aided in identifying and describing new patterns of mistreatment. They fulfill a unique role by allowing students to identify, analyze, and report mistreatment in a facilitated and protected space. Formal evaluations of institutional improvement in the learning environment, reduction in medical student mistreatment, and subsequent improvement in AAMC GQ data are needed.

Developing a dashboard for program evaluation in competency-based training programs: a design-based research project.

BackgroundCanadian specialist residency training programs are implementing a form of competency-based medical education (CBME) that requires the assessment of entrustable professional activities (EPAs). Dashboards could be used to track the completion of EPAs to support program evaluation.MethodsUsing a design-based research process, we identified program evaluation needs related to CBME assessments and designed a dashboard containing elements (data, analytics, and visualizations) meeting these needs. We interviewed leaders from the emergency medicine program and postgraduate medical education office at the University of Saskatchewan. Two investigators thematically analyzed interview transcripts to identify program evaluation needs that were audited by two additional investigators. Identified needs were described using quotes, analytics, and visualizations.ResultsBetween July 1, 2019 and April 6, 2021 we conducted 17 interviews with six participants (two program leaders and four institutional leaders). Four needs emerged as themes: tracking changes in overall assessment metrics, comparing metrics to the assessment plan, evaluating rotation performance, and engagement with the assessment metrics. We addressed these needs by presenting analytics and visualizations within a dashboard.ConclusionsWe identified program evaluation needs related to EPA assessments and designed dashboard elements to meet them. This work will inform the development of other CBME assessment dashboards designed to support program evaluation.

Vascular trainee perceptions of diversity, equity, and inclusion within United States vascular surgery training programs

ObjectivesVascular surgery training programs face multiple pressures, including attracting and retaining trainees. Current knowledge of trainees’ views with respect to diversity and equity in vascular training programs is limited. We sought to understand United States vascular surgery trainees’ perceptions and expectations regarding diversity, equity, and inclusion (DEI). MethodsThe Association of Program Directors in Vascular Surgery designed and administered the Annual Training Survey to specifically address DEI and administered it to all trainees (Integrated Residents/Fellows; n = 637) at 122 institutions in August 2020. ResultsOf the 637 vascular trainees, 227 (35%) responded. The respondents included 115 male and 62 female trainees, with 50 not disclosing or not answering the question. The majority of respondents (96.9%) believed their programs incorporated a diverse background of trainees. Of the trainees, 89.8% felt that the faculty were similarly comprised of a diverse background. The majority of respondents (63.6%) felt that their training program was both more diverse and focused on inclusion compared with other training programs at their institution. However, 20% of respondents had experienced discrimination. Seventy-three percent (n = 143) of trainees felt empowered to disagree or engage in a discussion should they observe a faculty member make a disparaging remark about a patient’s background/race/gender, although 27% (n = 35) trainees expressed fear of retaliation as a reason to not engage. Trainees view their program director (82.6%), faculty mentor (60.9%), and Graduate Medical Education office (52.7%) as potential resources for support. Overall, 83.7% (n = 160) of trainees believe that their program has been open to discussion of race relations within the medical community. ConclusionsTrainees are committed to multifaceted diversity and inclusion. The perception of trainees regarding DEI issues within vascular surgery training programs appears to be positive; however, trainees did describe discrimination and gender biases in their institutions. This data has the potential to improve institutional education of faculty and trainees about the multidimensional levels of diversity and increased awareness and incorporation of this philosophy can assist in the recruitment of diverse vascular surgeons.

Implementing Live Virtual Surgery in the COVID Era: Overcoming Medicolegal, Technical, and Educational Hurdles.

Due to current health concerns related to the coronavirus disease of 2019, remote learning has been adopted at every academic level. In congruence with policies drafted by academic surgical societies, a majority of medical schools nationwide have decided against accepting visiting medical students.1,2 As such, there has been an emergence of virtual adaptations of educational sessions and clinical rotations across a variety of medical specialties.3,4 Because surgical education occurs primarily in the operating room, adopting a virtual model for surgical education presents distinct challenges. At the Yale School of Medicine, we designed the first virtual surgical rotation format to center around livestream plastic surgeries across key areas of the specialty.5 Successfully implementing this teaching modality required overcoming medicolegal challenges, the logistical and technical details involved in the creation of this educational modality, and educational hurdles. In coordination with the Yale School of Medicine and the Yale Graduate Medical Education office, the virtual rotation was registered as a formal course for credit through the Association of American Medical College’s Visiting Student Application Service, identical to in-person visiting electives. By formally registering for the virtual rotation through the Visiting Student Application Service, virtual rotators met the same medical malpractice liability coverage and Health Insurance Portability and Accountability Act requirements as in-person rotating subinterns. Many of the participating students used the virtual rotation toward clinical credit for their graduation requirements. In addition, patients completed written consent forms for the hospital and university, giving permission to livestream surgery. (See Document, Supplemental Digital Content 1, which shows the photographic consent form for patients agreeing to participate in the livestream surgery, https://links.lww.com/PRS/E735.) These steps enabled clinical information to be shared freely with students in a remote learning environment. The technical challenges included high-quality visual capture of the surgery, real-time transmission to enrolled students, and real-time interactive communication between students and the surgical team. For image capture, we utilized a high-definition resolution, loupe-mounted camera with two-times and three-times magnification options. Loupe magnification enabled optimal macro image transmission for viewing of detailed surgical anatomy. For more macroscopic surgeries, a nonmagnified camera would be preferable. The high-definition camera captured images onto a computer that livestreamed images to the virtual participants using a Zoom platform (Zoom Video Communications, San Jose, Calif.) with password protection. To enable real-time two-way communication, speakers were strategically placed in the operating room to allow faculty and students to continuously discuss the case (Figs. 1 and 2).Fig. 1.: Setup of the live-stream surgery, with images transmitted to participants via Zoom, with password protection and communication between surgeon and applicants in real time.Fig. 2.: High-definition resolution, loupe-mounted camera was used for the video streaming of the procedures from the surgeon point of view.The virtual surgery curriculum included one live surgery per day spanning the breadth of plastic surgery, which replicated many of the benefits of being physically present in the operating room. Students could view a surgery step by step from the attending’s viewpoint. In addition, a multitude of students can simultaneously participate in the same case, unlike with in-person rotations. Participants were able to reference case-relevant study materials during the operation, which may enhance understanding of the procedure. The development of live virtual surgery poses some initial challenges, but ultimately it can be replicated with ease to create a surgical rotation more authentic to the in-person experience as pandemic restrictions continue. By elucidating the process by which we implemented livestreamed surgeries, other interested institutions will be able to easily traverse the necessary medicolegal and technical aspects of constructing similar models.

Learning Management System (LMS) for Integrating, Monitoring and Evaluating Professional Activities in a Medical Curriculum. The Experience at Humanitas University Medical School

Background: Technology-enabled learning is increasingly important in teaching and learning medicine.At Humanitas University we started using LMS (LMS@Hunimed) also for the organization, management, storage and evaluation of medical education and professionalizing activities.We explored the perceived benefits and practical use of a LMS by The Office of Medical Education in organizing, managing and evaluating professionalizing activities.Summary of the work: An evaluation questionnaire on LMS was submitted to all members of the OME (7 members) and the Student Office (2 members). Furthermore, Humanitas University register’s office provided a quantitative evaluation of the working hours by the members of OME regarding organization, management and assessments of E- Portfolio on LMS compared with Portfolio before LMS.This study involves the testing of all four operational criteria on learning management system:- Effectiveness – The performance in accomplishment of tasks- Learning ability – The degree of learning to accomplish tasks.- Flexibility – The adaptation to variation in tasks and environments.- Attitude – The user satisfaction or suggestions for improvements.We choose to use a System Usability Scale (SUS), a simple, ten-item attitude scale , to provide an assessments of usability. Summary of results: The use of LMS showed improvements in work efficiency through a significant decrease in working hours. Furthermore, a qualitative analysis of the System Usability Scale (SUS) questions showed that teachers felt moreconfident to use LMS in their daily tasks compared to when using a non-digital approach.Conclusions: LMS@Hunimed showed positive results in providing functional direct access to messaging tools for communication and concrete didactic support for students, teachers and collaborators.

A Holistic Approach to Pathology Education During the Coronavirus Disease 2019 (COVID-19) Pandemic

A Holistic Approach to Pathology Education During the Coronavirus Disease 2019 (COVID-19) Pandemic

Narrative Assessment of Medical Students in a Human Structure Course

Formative feedback that provides learners with a description of their strengths and recommendations for improvement plays a central role in medical education as it can promote self-reflection and professional development. Although this form of assessment is more prevalent in clinical education, LCME standards require “ … a narrative description of a medical student's performance, including his or her non-cognitive achievement … whenever teacher-student interaction permits this form of assessment.”1 To provide a narrative assessment (NA) of student performance in a large medical school class is challenging. Here, we present the methodology used in the Human Structure Course at UT Southwestern Medical School. This pre-clerkship course is taught to about 230 students each year and combines Anatomy, Embryology and the basics of Radiology. Prior to the COVID-19 pandemic, the course was dissection-based, but was conducted entirely online in 2020, when the NA procedure was implemented. To emulate the regular dissection experience, small groups of 2-3 students synchronously met in Zoom Breakout Rooms to study a given body region using 3D-Anatomy software together with our own dissection guide and dissection videos. The NA was based on observations faculty members made while joining the small groups in their Breakout Rooms. A rubric with three categories (“Preparation and Knowledge”, “Teamwork”, and “Feedback”) was used to categorize the observed behavior of individual students. To construct the NA, faculty members could choose appropriate comments from provided lists as well as write individual comments on the strengths and areas for improvement for each of the categories. All observations were recorded in a FileMaker application database. The records were then transferred to the Data Mart maintained by the Office of Medical Education, where the observations and comments comprising the NA were converted into cohesive individual reports, which were made available to the students. We aimed at providing six NAs for each student over the course of 11 small-group sessions. To achieve this goal, on average, each faculty member needed to observe and comment on 12-13 students per session. As the students did not spent as much time in their Breakout Room sessions as initially anticipated, faculty members were not always able to observe all students assigned to them during a given session. However, of the 229 students in the class, 58% received all 6 reports, 28% received 5, and 12% received 4 reports. Less than 2% of the students received only 2 or 3 reports. Once the reporting mechanism was fully established, we were able to send the individual reports to the students within 48 hours after the session. In summary, the established procedure allowed us to regularly provide timely narrative feedback to a large class. The greatest limitations were constraints on the time for teacher-student interactions and some inconsistencies in the use of the rubric by faculty. In general, students found the NA helpful, but many requested more individualized comments. In the future, the NA will have to be adapted to a dissection-based course and additional faculty development is desirable. 1Liaison Committee on Medical Education,Standards for Accreditation of Medical Education Programs Leading to the MD Degree.

Creating Value: Many Roles of a Centralized Pediatric Fellowship Office.

Pediatric medicine fellowship administration often takes place in individual divisions within a pediatric department, which may result in a lack of coordination and potential inefficiencies. A centralized fellowship office may reduce overlap and streamline shared processes. In this paper, theauthors first share the results of a survey of designated institutional officials of children's hospitals ranked by US News & World Report 2019-2020 (n=83) which asked whether the programs had a centralized fellowship office and included questions about the governance structure, funding sources, and barriers to successful implementation. Of the 50 programs that responded (60.2%), slightly more than half (54%; 27) reported using a centralized pediatric fellowship office. Most were overseen by a combination of the pediatrics department and graduate medical education office. After discussing the survey results, the authors describe their model for a centralized office that administers multiple pediatric medicine fellowship programs at a medium-sized children's hospital. With a focus on recruitment, education, research, wellness, and a personal/professional development curriculum, their office is staffed by a full-time administrative coordinator and a director and can serve as a model for programs looking to implement a centralized fellowship office.

Expanding medical student interaction in neurology with a redesigned student interest group in neurology (sign) chapter

BackgroundStudent Interest Group in Neurology (SIGN) chapters across the medical schools in the United States provide opportunities for medical students to participate in clinical, research, and service activities in neurology. Despite these, applicants for the field of neurology have traditionally been low.MethodsFollowing changes were introduced: an open board style SIGN chapter executive committee with greater active engagement of first and second year students. New activities included journal clubs, hands on workshops, celebration/cause events (example ALS walk). In addition, a free neurology clinic was introduced. Activities were planned in consultation with office of medical education, and were organized during ‘down times’. Data on student enrollment, activities successfully carried out, students interested in neurology residency, number of neurology-related research projects with student involvement were collected prior to changes and compared to values after changes were introduced.ResultsPost intervention, student engagement in neurology activities and projects increased significantly. However, a similar increase in applications to neurology residency was not yet observed.ConclusionsAn open chapter with early engagement and involvement of first and second year medical students, creating a variety of chapter activities with greater hands on involvement, planned in conjunction with office of medical education has reinvigorated our SIGN chapter.

A Trainee-Led Way to Help International Medical Graduates Meet the Challenges of a U.S. Residency.

To the Editor: Transitions during training are stressful for all physicians. This is especially the case for international medical graduates (IMGs) making the transition to a U.S. residency. In addition to the steep learning curve at the outset of residency, these physicians often face being away from their families, having visa-related complications, and experiencing culture shock and racial disparities. The University of Minnesota IMG support group was started in 2019 to build a community for these physicians to connect with others going through similar challenges so they can learn from each other and thrive despite the above stressors. The group was created and executed by residents and fellows across disciplines. As a first step, the group partnered with the graduate medical education (GME) office. That office helped create a list of all the IMGs at the medical school’s residencies and sent an initial email requesting volunteers for a core leadership group. Eleven trainees responded. This core team meets regularly online to discuss initiatives that could be undertaken by the group, and began by conducting informal social gatherings and potlucks. IMG participants reported that these events helped them build connections and better navigate practical aspects of living in the United States. In particular, the events improved their sense of well-being and helped them better cope with stress and adapt more easily to the local culture. In the setting of the COVID-19 pandemic, virtual meetings replaced in-person events. Recently, the group conducted a virtual social event to welcome the incoming IMG trainees to the medical school and university. This event included short talks by IMG panelists on topics they wished they had known about at the beginning of residency, such as culture shock, adapting and thriving in residency, and imposter syndrome. Feedback from new residents indicated that this event helped their anxiety about starting their residencies. Going forward, we hope that this social club of IMGs will grow into a mentoring network among the residencies at the University of Minnesota. Short-term goals are to continue to host social events and to work with the GME office in updating an intern survival handbook for IMGs. The long-term goal is to share the social group model on a national platform with the hope that it is replicated in other residency programs. The GME office continues to support this endeavor by sponsoring some of the events and advertising all the group’s events in the monthly resident–fellow newsletter. Building learner communities from shared experiences has the potential to ease the stressors of medical training. Especially with the challenges our country is facing with the pandemic, it is crucial to enact measures to ensure the well-being of our residents, who are at the front lines of care. These measures are particularly important for IMGs, who are an integral part of the U.S. health care workforce. Residency programs should do all they can to enable these physicians to succeed and achieve their highest potential. Acknowledgments: The authors would like to acknowledge the University of Minnesota Graduate Medical Education Office and Kaz Nelson, MD, associate designated institutional officer, for their continued support.

Office of Medical Education: Opportunities for Trainees to Engage and Lead in Curricular Innovation and Reform.

IntroductionThe AAMC prioritizes promoting a diverse and culturally competent workforce which is thought to have a positive impact on the health of people living in the US. There is a lack of diversity in the current landscape of academic medicine and strategies are needed to effect change. This module introduced undergraduate and graduate medical trainees to leadership skills and opportunities in curriculum innovation and reform by learning about and interacting with the office of medical education (OME) at their institutions.MethodsWe implemented a workshop using small-group case discussions and didactics to help medical students and residents learn how to: (1) describe the structure and functions of an OME, (2) describe leadership competencies associated with various roles within the OME, and (3) identify opportunities for trainees to engage with the OME on curricular innovation and reform, especially advancing diversity and inclusion.ResultsAcross three sites, 45 learners completed partial or full workshop evaluations. Of learners, 22 (49%) were not knowledgeable and 13 (29%) were somewhat knowledgeable in identifying leadership opportunities for trainees to become engaged through the OME. There was a statistically significant increase in confidence after the workshop in “discussing an interdisciplinary approach to the creation of a medical education innovation,” and, “assessing the need for curricula change.” Over 90% of attendees agreed learning objectives were met.DiscussionThis workshop succeeded in promoting awareness of the structure and function of OMEs and confidence in seeking opportunities to become engaged in medical education, especially in advancing diversity and inclusion.

Retrospective analysis of the work of a medical education office

Training of health care students at universities is a great challenge for Medical Education Offices. Our office made clear and explained the teaching-learning process from the perspective of teachers, programs, and students. To report a ten years' analysis of a Medical Education Office (MEO) work, describing the different processes and systematized decisions aimed to improve the quality of the programs and learning results. A 10 years retrospective analysis of the Medical Education Office processes directed to Medicine, Nursing, Physical Therapy, and Nutrition careers of a Faculty of Medicine. Flunks between 2013 and 2017 were compared. A progressive reduction in flunks was observed in the four careers. Specifically, the proportion of flunks in Nutrition decreased from 30 to 9%. When comparing flunks using a Chi-square test of homogeneity in the four careers, a significant decrease in four of six courses was observed. This led to a sustained increase in number of students who completed their career and obtained their title. Specifically, in Medicine there was a 7.5-fold increase in these figures. The Diploma course trained 90% of the teachers in charge of courses of the four careers. The master's degree generated research that allowed to increase the productivity in health sciences education. The Office of Medical Education created knowledge and management models for the education of health sciences students, enhancing the quality of training and learning processes.