Residency Directors Research Articles

Postinterview Communication in Orthopaedic Surgery Residency Interviews: A Survey of Match Applicants.

Background:To maintain the integrity of the match, postinterview communication (PIC) from programs to applicants is monitored and discouraged. The most recent report on the prevalence of PIC in orthopaedics found that 64% of surveyed applicants in 2014 and 2015 had received some form of PIC during their match cycle. In July 2019, the American Orthopaedic Association’s Council of Orthopaedic Residency Directors (AOA/CORD) released a guideline recommending the elimination of all PIC in any form. The goal of this follow-up study was to determine the current prevalence of PIC with orthopaedic surgery applicants and assess the perspectives of medical students who recently applied for orthopaedic surgery residency positions.Methods:A 35-question survey was e-mailed to all orthopaedic surgery residency applicants of 4 geographically diverse residency programs in postmatch March 2020. The survey was open for 1 month, and the responses were reported using descriptive statistics.Results:Of the 229 respondents (21% response rate), 91 (39.7%) received PIC during the 2019 to 2020 residency match cycle. The program director was most commonly identified (80.2%) as the person who communicated with the applicants. At the interview day, 198 respondents (86.5%) were told that programs would not be contacting the applicants with PIC. However, over a quarter of respondents (25.3%) who received PIC answered that those programs contacted applicants after announcing they would not. Nearly half of the respondents (48.5%) agreed or strongly agreed that PIC causes added stress on applicants, and over half (52.9%) agreed or strongly agreed that all programs should stop participating in any form of PIC.Conclusions:Although the prevalence of PIC seems to have decreased since the 2014 and 2015 match, there is still room for improvement toward eliminating PIC. The AOA/CORD position statement from July 2019 should be disseminated to all members of the residency selection team to ensure consistency from all programs. The primary limitation of this study was the 21% response rate.Level of Evidence:Level IV (survey study)

Faculty Recruitment, Retention, and Representation in Leadership: An Evidence-Based Guide to Best Practices for Diversity, Equity, and Inclusion from the Council of Residency Directors in Emergency Medicine.

Improving the recruitment, retention, and leadership advancement of faculty who are under-represented in medicine is a priority at many academic institutions to ensure excellence in patient care, research, and health equity. Here we provide a critical review of the literature and offer evidence-based guidelines for faculty recruitment, retention, and representation in leadership. Recommendations for recruitment include targeted recruitment to expand the candidate pool with diverse candidates, holistic review of applications, and incentivizing stakeholders for success with diversity efforts. Retention efforts should establish a culture of inclusivity, promote faculty development, and evaluate for biases in the promotion and tenure process. We believe this guide will be valuable for all leaders and faculty members seeking to advance diversity, equity, and inclusion in their institutions.

Miriam: Friend, Mentor, Scholar, and Teacher

MiriamFriend, Mentor, Scholar, and Teacher Sarita Rai (bio) I met Miriam at the University of Hawai‘i at Mānoa in 1995 when she was appointed as the faculty resident director for the London study abroad program. Later, when she was the honors director in 1998, we collaborated to implement a joint student recruitment program to persuade Hawai‘i high school seniors (public and private) to attend UH Mānoa and to make it their “choice” university. This way, as freshmen they could take specialized classes in the honors program and also go abroad. I write about her personal statement for the London resident directorship because it resonates with the same type of mentorship and friendship she gave me. She states, “a semester abroad will be successful if its participants ‘take part in’ and are ‘engaged in’ all things the program can offer. But it will be an experience that participants will cherish for the rest of their lives, if ‘cooperating’ and ‘lending a hand’ lead them to form a learning and experiential community that involves partnership.” Within this partnership she saw herself as “cooperating, lending a hand, and engaging” her students so they would excel in learning and experiencing their term abroad. To demonstrate the outcome, I take the liberty of quoting some of her students’ writings. These are samples of tributes to Miriam Fuchs: “thanks for being such a great teacher . . . my writing has improved,” “you opened my eyes to literature in a whole new way,” and “dear Dr. Fuchs, I will always remember my time in London. You are an inseparable part of that memory. You gave us all guidance and support, asking nothing in return. Thank you.” This was the nature of her mentorship that I experienced as well, and I cherish her role in my life. She asked for nothing in return. Somehow, we transitioned from the beginnings of a professional relationship to one of deep and enduring friendship. She was a mentor to me in every step of my life. Miriam insisted on reviewing my promotion application dossier, and acquired a deep knowledge and understanding of the study abroad programs and my job responsibilities. She would always remark that I “had the worst job as a faculty member of the University of Hawai‘i.” On another note, with her urging, we embarked on a journey to coedit Study Abroad: Traditions and New Directions (2019). When she had writer’s block she would have tantrums, and I would just sit, listen, and watch her. This is why she would always call me an “easy friend.” I, on the [End Page 151] other hand, would stop working on the book for long periods of time—and she would guilt me into going back to the project. She was resilient and never gave up on me. Together we wrote and published, and we complemented one another in the relationship that formed. She would listen to one of my ideas and go off on a tangent that had no bearing on the original thought. She spent a great deal of time reading on study abroad topics and somehow had the patience in writing and rewriting, over and over again, till the piece was just perfect. As a political scientist, I had radical views and opinions, but she had the wisdom to know that to get published I needed to be neutral and noncontroversial. She, of course, was correct, so I always agreed with her in the end. I had said “let’s have lunch,” and never followed up. Three months later, I found out that she had her cancer surgery and treatment, and I had missed it all. It taught me to never put off anything if you want to do something. I still hear her saying, “I don’t want to talk about it,” when she didn’t want to update me about her health. We also ignored each other and hardly talked on the phone when in Hawai‘i. She knew she could count on me, so she never worried when I was not traveling. However, she would worry and stress whenever I was out of the country, and even made sure that we talked...

A Survey of Residency Directors in Academic Trauma Centers for Policies on Airway Management in the Trauma Ward

A Survey of Residency Directors in Academic Trauma Centers for Policies on Airway Management in the Trauma Ward

How Did Coronavirus-19 Impact the Expenses for Medical Students Applying to an Orthopaedic Surgery Residency in 2020 to 2021?

Orthopaedic surgery is one of the most competitive specialties for residency applicants. For the 2021 residency match, the coronavirus-19 pandemic introduced complexity for programs and applicants because away rotations were limited and in-person interviews were cancelled. This may have changed the landscape in terms of expenses for candidates in important ways, but this topic has been insufficiently studied. Given that in 2021, students did not attend away rotations and all interviews were held virtually, we asked (1) What were the financial savings associated with this change? (2) Was medical school geographic region associated with differences in expenses when applying to residency? A retrospective, cross-sectional analysis of the 2020 and 2021 Texas Seeking Transparency in Application to Residency Dashboard database was performed. The data were derived from an online survey of a nationwide pool of applicants from 87% (123 of 141) of US allopathic medical schools upon conclusion of the match. The response percentage was 29% (521 of 1794). We believe this nationwide dataset represents the largest and most current data for this applicant group. Responses from applicants applying to orthopaedic surgery residency in the year before the COVID-19 pandemic application changes (2020) and during COVID-19 (2021) were queried and compared. After the orthopaedic surgery match, the database was evaluated for individual (application costs, away rotation expenses, and interview expenses) and total expenses for medical school seniors applying to orthopaedic surgery residency. Applicant characteristics were compared between application cycles. The 2020 to 2021 Texas Seeking Transparency in Application to Residency Dashboard database had 521 responses (n = 263 in 2020 and n = 258 in 2021) from applicants applying to orthopaedic surgery residency. Demographic and applicant characteristics were comparable between application cycles. Median expenses are reported with percentile distributions and geographic comparisons. A Mann-Whitney U test or Kruskal-Wallis H test was used to determine whether there were statistically significant differences in expenses between years and between medical school regions at a p value threshold of < 0.05. For all applicants, the median total expenses (USD 7250 versus USD 2250), application costs (USD 2250 versus USD 1750), away rotation expenses (USD 2750 versus USD 250), and interview expenses (USD 2250 versus USD 75) declined in 2021 compared with 2020 (all p < 0.001). The median total savings in expenses for all applicants in 2021 compared with 2020 was USD 5000. In 2021, median total expenses were lower in all geographic regions with the greatest savings from applicants in the West (USD 6000); in addition, the difference in median total expenses between the geographic region with the highest total expenses and the lowest total expenses was lower in the pandemic year than it was in the year prior (USD 1000 versus USD 1500; p < 0.001). In 2021, there were differences in total expenses between the Northeast (USD 1750), West (USD 1750), and Central (USD 2750) regions (p < 0.001). From 2020 to 2021, only application fees from Northeast applicants differed (USD 2250 versus USD 1250; p < 0.001). In 2020, interview expenses were not different between all regions (USD 2250 Northeast and West versus USD 2750 Central and South; p = 0.19); similarly in 2021, interview expenses were similar between all regions (USD 75 versus USD 75; p = 0.82). Finally, in 2020, Northeast (USD 3250) and Western (USD 3250) applicants spent more for away rotations than Southern (USD 2750) and Central (USD 2250) applicants (p = 0.01). In 2021, applicants from schools in the South (USD 250) and Central (USD 250) regions spent more than their counterparts (USD 0; p = 0.028). In the COVID-19 application cycle, the median expenditures of orthopaedic residency candidates were USD 5000 lower than they were in the previous year; the difference can be attributed to the use of virtual interviews and the lack of away rotations. There are geographic implications, with applicants from Western United States medical schools potentially saving the most. Despite the financial savings during the 2021 match, further study related to the long-term success of the current application process (both for applicants and programs) is needed. The recommendation in May 2020 by the AOA Council of Orthopaedic Residency Directors (CORD) to limit the number of applications submitted by candidates with USMLE Step 1 scores greater than 235 did not result in any considerable decline in applications submitted or expenses. A better understanding of how differences in these expenses may influence our specialty's ability to attract socioeconomically diverse candidates would be important, and we need to explore perceived and actual financial obstacles to obtaining this diversity in the application process. Finally, avenues should be explored by program directors and chairpersons to reduce the expenses of the traditional application process while maintaining recruitment of top candidates. Level IV, economic analysis.

Perceptions of the Universal Interview Offer Day in the Orthopaedic Surgery Residency Interview Process.

The American Orthopaedic Association's Council of Orthopaedic Residency Directors recommended implementing a universal offer day (UOD) in the 2020 residency match. Although this decision was an attempt to benefit applicants, it is important to assess how this endeavor was perceived. Questionnaires for applicants and program directors asked about the perception of the UOD and the experience with it. Responses were included from 383 applicants (43% response rate) and 84 program directors (45% response rate). Applicant Survey: Most of the students (81.5%) were worried or very worried about the interview offer process. Most of the applicants (64.0%) stated that the UOD decreased their stress. The majority (93.2%) indicated that they would like to see the UOD continue in future years. Program Director Survey: Most of the program directors (83.1%) mentioned that they would like to see the UOD continued, and 86.8% indicated that they would participate in a similar process if implemented in future cycles. Benefits of a standardized interview offer date include decreased stress and fewer clinical interruptions. Advantages can also extend to scheduling conflicts and over-interviewing. These favorable results, along with positive experiences from other specialties implementing a UOD, encourage the continued use of this approach for offering interviews. N/A. N/A.

How real is a virtual interview? Perspectives of orthopaedic surgery residency directors.

As a result of COVID-19 pandemic, the 2021 US residency MATCH was devoid of the traditional in-person interviews. Herein, we assess the impact of Virtual Interviews (VIs) on resident selection, from the perspectives of Orthopedic Surgery (OS) Program Directors (PDs). A 14-item survey was sent to PDs of ACGME-accredited OS residencies. Questions were designed to assess the pros, cons, and robustness of VIs compared to their antecedent in-person format. Forty-seven PDs responded to our survey. VIs antagonized PDs' ability to assess applicants' fit to program (76.6%), commitment to specialty (64%), and interpersonal skills (68.1%). This led to heavier dependence upon applicants' portfolios (64%). Almost all respondents (97.9%) found VIs to be more cost-efficient, saving a median of $3000 in interview-related expenses. Overall, only 8.5% of PDs were willing to conduct exclusive VIs in future cycles, compared to the majority in favor of dual formats (51.5%) or exclusive in-person interviews (40.4%). VIs have been an overall success, making most PDs opt for dual interview formats in future cycles. How this technology is further implemented in the future remains to be seen.

Announcements

Announcements

Physician-Perceived Barriers to Treating Opioid Use Disorder in the Emergency Department.

ObjectiveWe aimed to assess physicians’ perceptions of barriers to starting medication-assisted treatment (MAT) in the Emergency Department (ED), views of the utility of MAT, and abilities to link patients with opioid use disorder (OUD) to MAT programs in their respective communities.MethodsThis was a cross-sectional survey study of American emergency medicine (EM) physicians with a self-administered online survey via SurveyMonkey (Survey Monkey, San Mateo, California). The survey was emailed to the Council of Residency Directors in Emergency Medicine (CORD) listserv and HCA Healthcare affiliated EM residency programs’ listservs. Attendings and residents of all post-graduate years participated. Questions assessed perceptions of barriers to starting OUD patients on MAT, knowledge of the X-waiver, and knowledge of MAT details. Statistics were performed with JMP software (SAS Institute Inc., Cary, NC) using the two-tailed Z-test for proportions.ResultsThere were 98 responses, with 33% female, 55% resident physicians, and an overall 17% response rate. Residents were more eager to start OUD patients on MAT (71% vs 52%, p=0.04) than attendings but were less familiar with the X-waiver (38% vs 73%, p=0.001) or where community outpatient MAT facilities were (21% vs 43%, p=0.02).ConclusionBarriers in the ED were identified as a shortage of qualified prescribers, the lengthy X-waiver process, and the poor availability of outpatient MAT resources. EM residents showed more willingness to prescribe MAT but lacked a core understanding of the process. This shows an area of improvement for residency training as well as advocacy among attendings.

American Orthopaedic Association's (AOA) Council of Orthopaedic Residency Directors (CORD) 2020 Summer Conference: Top Abstracts.

In a continuing collaboration between the American Orthopaedic Association's (AOA) Council of Orthopaedic Residency Directors (CORD) and JBJS, the following 10 abstracts highlight the scientific research presented at AOA's virtual annual national meeting held this past June 2020. These abstracts embody CORD's purpose and mission:"The American Orthopaedic Association's Council of Orthopaedic Residency Directors (CORD) program strives to recognize best practices in orthopaedic residency education and fellowship education based on ACGME [Accreditation Council for Graduate Medical Education]-defined essential knowledge and skills in each of the residency education competency areas. CORD provides a forum for academic orthopaedic leaders to exchange ideas, discuss solutions to challenges, and find ways to teach residents in orthopaedic programs effectively." We hope that this education-related research will inspire further inquiry to advance the development of future orthopaedic surgeons.

Traits and Attributes of a Successful Physical Therapy Resident: A Delphi Study

Introduction. Given the limited number of positions in physical therapy (PT) residency programs, it is important to select individuals who are most likely to succeed. The purpose of the study is to obtain consensus from residency program directors regarding 1) the traits and/or characteristics that are likely to result in a successful residency experience, 2) how success in residency education is defined, and 3) what do programs aspire their residency graduates to accomplish professionally. Review of the Literature: Limited evidence exists that explores the qualities, skills, traits, or experiences that contribute to a successful PT resident or whether the current application process is able to identify these traits. Subjects: The residency directors of 246 American Board of Physical Therapy Residency and Fellowship Education-accredited programs were invited via email. One hundred nine (44.67%) residency program directors participated. Methods: Using the Delphi study design, consensus was reached after round 3 of the survey. Results: Five traits/characteristics, 9 characteristics/achievements of a successful residency graduate, and 4 postresidency aspirations reached consensus as “absolutely essential,” and 1 outcome measure reached consensus as “very useful.” Discussion/Conclusion: Residency programs may look to modify 1) their application/selection processes to identify applicants who possess desirable traits/characteristics and 2) their criteria for successful completion. Entry-level PT programs may use this information to guide what skills/traits are needed to prepare graduates for postprofessional experiences.

Diversity and Facing Discrimination in Family Medicine Residencies: A CERA Survey of Program Directors.

Increasing the number of underrepresented minorities in medicine (URM) has the potential to improve access and quality of care and reduce health inequities for diverse populations. Having a diverse workforce in residency programs necessitates structures in place for support, training, and addressing racism and discrimination. This study examines reports of discrimination and training initiatives to increase diversity and address discrimination and unconscious bias in family medicine residency programs nationally. This survey was part of the Council of Academic Family Medicine Educational Research Alliance (CERA) 2018 national survey of family medicine residency program directors. Questions addressed the presence of reported discrimination, residency program training about discrimination and bias, and admissions practices concerning physician workforce diversity. We performed univariate and bivariate analyses on CERA survey response data. We received 272 responses to the diversity survey items within the CERA program director survey from 522 possible residency director respondents, yielding a response rate of 52.1%. The majority of residency programs (78%) offer training for faculty and/or residents in unconscious/implicit bias and systemic/institutional racism. A minority of program directors report discrimination in the residency environment, most often reported by patients (13.2%) and staff (7.2%) and least often by faculty (3.3%), with most common reasons for discrimination noted as language or race/skin color. Most family medicine residency program directors report initiatives to address diversity in the workforce. Research is needed to develop best practices to ensure continued improvement in workforce diversity and racial climate that will enhance the quality of care and access for underserved populations.

The 2020 Evidence-based Promotion Ladder of Academic Plastic Surgery

PURPOSE: Metrics were evaluated between academic plastic surgeons from different tiered training programs to determine promotion predictors within tiers and between tiers for those seeking promotion from assistant, associate, to professors. METHODS: A cross-sectional online review was performed to collect 61 variables from full-time plastic surgeon faculty affiliated with United States residency training programs during the 2020–2021 academic year. Surgeons were stratified into nine cohorts for comparison by professorship (assistant, associate, professor) and Doximity ranked institution program tiers (Tier 1 = T1, Tier 2 = T2, Tier 3 = T3). Univariate, followed by multivariate regressions with reciprocal transformation were performed to determine predictors more likely associated with promotion. RESULTS: Ninety-eight programs included 851 surgeons. T1/T2/T3 surgeons promoted: more years in practice (P = 0.002; P < 0.001; P < 0.001), greater number of last author publications (P < 0.001; P < 0.001; P = 0.007). T1/T3 surgeons promoted: higher h-indexes (P = 0.001; P = 0.002). T1 surgeons promoted: on journal editorial board (P = 0.040). T2 surgeons promoted from assistant to associate: non-White race (P = 0.010). T3 surgeons promoted: residency director (P = 0.009) and greater number of citations (P = 0.026). Promoted from assistant, associate, professor between T3/T2/T1 programs: greater number of last author publications (P = 0.007; P = 0.002; P < 0.001). Promoted from assistant and associate between T3/T2/T1 programs: plastic surgery department (P = 0.002; P < 0.001). Promoted from assistant between programs: attended Top 10 US News medical school (P = 0.012), attended better Doximity ranked research program (P < 0.001), greater number of first author publications (P = 0.017), greater number of citations (P = 0.023). Promoted from associate between programs: attended better Doximity ranked reputation program (P = 0.017), higher h-indexes (P = 0.017). Promoted from professor between programs: received any AAPS award (P = 0.039), greater number of AAPS awards (P = 0.012). CONCLUSION: Promotion predictors provided evidence to synthesize the Promotion Ladder of Academic Plastic Surgery.

The Leadership Landscape: Characteristics of Current Faculty in Leadership Positions in Obstetrics and Gynecology Departments

<h3>Study Objective</h3> To describe the proportion of female faculty in departmental administrative and educational leadership roles in Obstetrics and Gynecology departments. <h3>Design</h3> Cross sectional observational study. <h3>Setting</h3> Accredited Obstetrics & Gynecology residency programs. <h3>Patients or Participants</h3> 288 accredited residency programs were identified from 2019 to 2020 with 1237 individuals in leadership positions. <h3>Interventions</h3> Similar to a 2012-2013 survey by Hofler et al., residency program websites and corresponding fellowships (Maternal Fetal Medicine, Female Pelvic Medicine and Reconstructive Surgery (FPMRS), Reproductive Endocrinology and Infertility (REI), Gynecologic Oncology), departmental, and divisional websites were queried for those in administrative and educational leadership positions. Information regarding gender (as determined by surrogates of name and photographic gender expression), medical and academic degrees, academic rank, and subspecialty certification was abstracted. <h3>Measurements and Main Results</h3> Within administrative leadership roles, women comprised 29% of chairs, 46% of vice chairs, and 47% of division directors; women held significantly fewer chair positions than men (p <.001). In educational leadership, women made up 71% of medical school clerkship directors, 58% of residency directors, and 50% fellowship directors. Women were more likely to hold educational leadership positions (56% vs 40%, p<.001) while men were more likely to hold administrative leadership positions (68% vs 52%, p <.001). There was greatest gender equity within FPMRS and least gender equity in Gynecologic Oncology and REI. Female leaders were more likely to have received additional academic degrees (ex. MBA, MPH) than their male counterparts (19% vs 13%, p=.002). <h3>Conclusion</h3> Women continue to be underrepresented in administrative leadership positions. Compared to 2012-2013, there is only a 9% increase in proportion of women chairing and 10% vice chairing Obstetrics and Gynecology departments; the increase is more substantial in other positions, such as division directors (17%). Our findings demonstrate ongoing gender disparity in the highest levels of departmental leadership and the need to further improve upon diversity and gender equality within leadership roles.

Resident and program director confidence in resident preparedness for operative vaginal deliveries in Obstetrics and Gynecology Training Programs in the United States

Operative vaginal delivery is used to expedite a safe vaginal delivery in the second stage of labor and is considered an essential part of residency training in obstetrics and gynecology. To assess the self-reported readiness of obstetrics and gynecology residents in the United States to perform vacuum-assisted vaginal delivery and forceps-assisted vaginal delivery compared with the perceptions of program directors. The Council on Resident Education in Obstetrics and Gynecology surveyed the residents in all US training programs about their readiness to perform forceps-assisted and vacuum-assisted deliveries. The program directors were simultaneously surveyed about the readiness of their cohort to perform operative deliveries with and without attending oversight. The primary outcome of the survey was the residents' self-reported confidence in their ability to autonomously and independently perform operative deliveries. Α total of 5084 out of 5514 (92.9%) resident physicians and 241 out of the 292 (83%) residency program directors completed the survey. Eighty-seven percent (95% confidence interval, 84.9-88.9) of the graduating residents reported feeling that they could autonomously perform a vacuum-assisted vaginal delivery, compared with 49.5% (95% confidence interval, 46.6-52.4) for forceps-assisted vaginal delivery (P<.01). Similarly, whereas 95.9% (95% confidence interval, 94.6-97.0) of the residents felt that they could confidently perform an emergency vacuum-assisted vaginal delivery, only 42.3% (95% confidence interval, 39.4-45.2) felt confident performing an emergency forceps-assisted vaginal delivery (P<.01). The residency program directors significantly overestimated their residents' confidence in independently performing an emergency forceps-assisted vaginal delivery or vacuum-assisted vaginal delivery than the residents themselves (54% [95% confidence interval, 47.1-60.5] vs 24% [95% confidence interval, 22.5-24.9] and 98.6% [95% confidence interval, 97.0-100] vs 71.9 [95% confidence interval, 70.6-73.2] respectively P<.01). Trainees in military-based residency programs and those interested in pursuing a career as generalists or maternal-fetal medicine specialists reported significantly higher preparedness to perform a forceps-assisted vaginal delivery. Graduating obstetrics and gynecology residents report feeling less prepared to independently perform a forceps-assisted vaginal delivery than a vacuum-assisted vaginal delivery. The program directors had more confidence in the ability of their residents to perform an operative vaginal delivery than the residents themselves.

Emergency medicine residency programs in Brazil: a national survey

Study objective: To describe the characteristics and curricula of Brazilian Emergency Medicine (EM) residency programs.&#x0D; Methods: This was a national cross-sectional survey conducted between January and May 2021. A survey was distributed to residency directors with queries about the characteristics of their programs. Descriptive analysis was performed stratified by Brazilian regions.&#x0D; Results: There were a total of 35 responses from the 39 (response rate = 89.7%) EM residency training programs in Brazil. Twelve (34.3%) programs were in the South region, 17 (48.6%) in the Southeast, 3 (8.6%) in the Central-West, and 3 (8.6%) in the Northeast. These 35 programs represented a total of 166 residency slots offered per year (median 4, range 2-24). All programs are of 3-year duration. Seventeen programs (48.6%) were officially launched in either 2019 or 2020. The estimated proportion of faculty with prior EM residency or board certification in EM was reported to be less than 20% in 26 of 35 (74.3%) programs. Only 5 rotations were mandatory across all 35 programs, including rotations in the emergency department (ED) intermediate acuity unit (“yellow” room), ED high acuity unit (“red” room), intensive care unit (ICU), obstetrics and gynecology, and trauma. Other rotations were highly heterogeneous across regions.&#x0D; Conclusion: Emergency medicine residency is clearly growing in Brazil, and there is a relatively high level of heterogeneity across programs. There is a clear need for standardization of residency curriculum.

Resource Utilization and Emergency Medicine Advisors' Approach to Video Interview Preparation.

IntroductionThe Standardized Video Interview (SVI) was a residency application component introduced by the Association of American Medical Colleges (AAMC) as a supplement to the existing process, which aimed to measure knowledge of professional behaviors and interpersonal skills. Given its novelty in both aim and execution, little advice or experience was available to inform preparation strategies. We sought to perform a cross-sectional analysis to explore advisors’ practices in guiding students’ preparation for the SVI.MethodsAn electronic questionnaire was developed and piloted for flow and usability, then distributed to all members of the Council of Residency Directors in Emergency Medicine (CORD EM), the professional society for emergency medicine educators, via listserv, comprised of 270 residency programs. Questions were both open- and closed-ended and therefore analyzed in a mixed-method fashion. ResultsWe received 56 responses from a listserv representing 270 residency programs. Respondents cited personal experience and consensus opinions from national organizations as the primary sources for their advice. The most common resources offered to students were space for completing the SVI (41%) or technical support for completing the SVI (47%). The time committed to student advising specifically for the SVI ranged from zero to 20 hours. Estimated associated costs of preparation ranged from zero up to $10,000 (time plus resources). Two individuals reported recommending commercial preparation resources to students. ConclusionThe SVI was a novel attempt to augment the resident application process. We found variability in resources and advice offered to students, including broad ranges of time dedicated, the monetary value of resources contributed, and the types of resources utilized. As the global COVID-19 pandemic has inspired a wave of innovation and process changes, we present this data for consideration as a snapshot of the variable responses to a single uniform process change.

The Zipperator! A Novel Model to Simulate Penile Zipper Entrapment.

The Zipperator! A Novel Model to Simulate Penile Zipper Entrapment.

The Impact of Fellowship Training in Academic Plastic Surgery.

The competitive nature of an academic plastic surgery career has contributed to an increase in sub-specialization. The aim of this study is to assess the benefits of subspecialty fellowship training to pursue a career in academic plastic surgery. A cross-sectional study was conducted of all current academic plastic surgeons (APSs) participating in Accreditation Council for Graduate Medical Education-certified residency programs. Online faculty website listings were used to collect their demographics, training and practice characteristics, academic rank and leadership positions, and research productivity. A total of 927 APSs met the inclusion criteria, of which 70.2% had undergone fellowship training, with an overall significant increase in fellowship-trained surgeons within the last 10 years (odds ratio [OR], 1.66; P = 0.0005). Hand training was the most common fellowship (35.6%), followed by craniofacial (32.0%) and microsurgery (28.1%). Fellowship training was more prevalent among younger (48.7 vs 53.5 years, P < 0.0001), White (67.8%), and non-White (77.4%, P = 0.0058) APSs who had received either integrated (67.1%) or independent (81.8%, P < 0.0001) plastic surgery training and are currently working in a department (OR, 1.44; P = 0.028). Fellowship training was shown to influence academic rank (associate professor: OR, 1.68 [P = 0.0073]; full professor: OR, 0.58 [P = 0.0008]), leadership position (fellowship director OR, 10.09; P < 0.0001) and research productivity (publications: 26 vs 16.5; P = 0.0009). In addition, fellowship attainment did not correlate with the size of the employing academic program, population of the city of practice, or being a residency director or chair. The majority of APSs have undergone fellowship training, and there is very strong evidence supporting its impact in current entry and advancement in academic plastic surgery.

A Cross-Sectional Evaluation of the Successful Minority Applicant to Orthopaedic Surgery Residency Programs.

The lack of diversity among orthopaedic health care providers is a pressing matter that must continue to be corrected at all levels. Improving diversity among orthopaedic physicians starts with improving diversity in residency training programs. This study brings light to the demographics and achievements of successful minority applicants, detailing what types of students are successfully matching into orthopaedic surgery. Between June and July 2020, the authors distributed a 12-question, anonymous survey to 53 URM students who successfully matched into orthopaedic surgery residencies for the 2020 application cycle. The survey inquiries about respondent demographics, academic accomplishments, and match process success as well as whether the presence of URM faculty, program director, and chairman influenced how they made their rank list. Overall, 37 students (71%) completed the entire survey. Most students indicated that the presence or absence of URM faculty influenced their rank list (n = 32, 88.9%) and that this distinction was meaningful to their orthopaedic candidacy (n = 28, 87.5%). Less than half of the respondents (n = 16; 44.4%) noted that the presence of a URM residency program director or department chairman influenced their rank list, while 20 (55.6%) noted that it did not. In conclusion, URM applicants with multiple academic achievements can be successful during the orthopaedic match process. Furthermore, the presence of URM faculty is an important factor that URM applicants consider. Residency directors must both identify the competitive URM applicants and strive to recruit more URM faculty when aiming to increase program diversity. Level of Evidence: Level IV.