United States Medical Schools Research Articles

Development and Effectiveness of a Rater Training Curriculum for Evaluating Student Medical Spanish Oral Proficiency Using the Physician Oral Language Observation Matrix

To improve language-concordant, equitable healthcare for Spanish speakers, many United States medical schools offer medical Spanish education. However, there is no clinically contextualized, standardized approach to medical student language assessment. This article reports on the development and effectiveness of a training curriculum to prepare raters to use a new rubric, the Physician Oral Language Observation Matrix (POLOM), to reliably rate medical student Spanish oral proficiency after observing videorecorded encounters between students and standardized patients. Curriculum effectiveness was primarily evaluated by examining each rater trainee’s level of agreement with expert consensus POLOM ratings (i.e., inter-rater reliability as measured by the generalizability theory dependability coefficient). Out of the study’s nine rater trainees, who were from either medical or linguistic professional backgrounds, five proceeded to the calibration phase, and four attained the reliability threshold required for calibration. The paper concludes that this rater training curriculum can successfully train raters to use the POLOM reliably when evaluating medical student Spanish oral proficiency during videorecorded healthcare encounters. To allow for improved assessment of student language skills prior to use in patient care, future efforts should focus on POLOM validity assessment and larger scale rater recruitment, training, calibration, and maintenance.

A Call for Diversity: Women, Professional Development, and Work Experience in Cardiothoracic Anesthesiology

DESPITE THE ACHIEVEMENT of parity in medical school matriculation decades ago, 1 Association of American Medical Colleges. AAMC chart 5: Graduates of US medical schools by sex, academic years 1980-1981 through 2018-2019. Available at: https://www.aamc.org/media/9631/download?attachment. Accessed December 10, 2020. Google Scholar female physicians across specialties continue to face barriers in their professional development. Women in cardiothoracic anesthesiology (CTA) are a growing and increasingly vocal minority in a medical subspecialty that has been dominated by men throughout history. Approximately 36% of United States medical school faculty anesthesiologists are women, 2 Association of American Medical Colleges. AAMC table 13: US medical school faculty by gender, rank, and department, 2019. Available at: https://www.aamc.org/media/8441/download?attachment. Accessed September 27, 2022. Google Scholar and women account for 29% of cardiothoracic anesthesiologists. 3 Capdeville M. If all the world's a stage, then where's our microphone?. J Cardiothor Vasc Anes. 2020; 34: 1810-1814 Abstract Full Text Full Text PDF PubMed Scopus (0) Google Scholar These latter women face unique challenges in the often-stressful and dynamic environment of the cardiothoracic operating room. These challenges have led to the formation of organizations whose mission is to provide support and guidance in the professional lives of female cardiac anesthesiologists.

Characteristics of International Rotations for Undergraduate Medical Education at United States Medical Schools: A National Study.

Medical education is criticized that it does not prepare students to serve in an increasingly globalized society. Evidence that global educational experiences can alleviate these concerns have contributed to the rise in international medical education experiences. This study explores surrounding characteristics and institutional support for international rotations across medical schools in the US. The authors conducted a sequential mixed methods exploratory national survey of international rotation coordinators at 185 US medical schools and 15 semi-structured interviews in fall 2018. Quantitative data were analyzed with descriptive statistics and qualitative data were coded and analyzed using interpretive description to identify themes across data. There were 57 responses to the survey for an overall response rate of 31%, with 77% percent of respondents (n = 44) indicating that their medical school offered international rotations. Fifteen individuals representing 13 medical schools were identified as interviewees for the second stage of the study. International rotation coordinators described components of international rotations, including partnerships with host communities, use of third-party organizations, and supporting administrative and academic structures. Although international rotations are common in medical education, they are not positioned as core academic programming within medical schools. This leads to challenges in planning, implementation, and evaluation, and immense variation in rotation components across medical programs. Future research should explore best practices for pre-departure preparation, post-travel debriefing, and evaluation of student activity as well as impact on the host site. Additional research should include exploration of unique benefits of international versus domestic sites, and aspects of sustainable partnerships between medical schools and host communities.

Variation in medical humanities program mission statements in United States and Canadian Medical Schools

Purpose In 2019, the American Association of Medical Colleges (AAMC) identified the discipline of medical humanities as a priority in medical education. Although medical humanities programs have existed in medical and osteopathic schools in the U.S. and Canada since the late 1960’s, this interdisciplinary field remains difficult to define. We studied the mission statements of medical humanities programs to identify core themes and priorities. Materials and methods We conducted a content analysis of U.S. and Canada medical humanities MD and DO mission statements and associated descriptions (n = 56). We compared themes across programs whose directors had a clinical degree versus a terminal research degree, conducted comparisons between medical humanities programs housed in medical schools ranked in Top 20 U.S. News and World Report for Research or Primary Care, and conducted a word frequency analysis. Results Content analysis revealed five themes: improving patient care, improving the provider experience, generating scholarship, cultivating community relationships, and promoting diversity/sociocultural awareness. 70% of programs emphasized patient care and provider experience. Only 34% included the promotion of diversity/sociocultural awareness as a theme. Word frequency analysis corroborated our findings. Conclusions U.S. and Canada medical humanities programs focus primarily on improving patient care and provider wellness.

Editorial Commentary

No AccessUrology Practicethe Specialty1 Nov 2022Editorial CommentaryThis article comments on the following:Urological Education in United States Medical Schools: Where Are We Now and How Can We Do Better? Daniel Wong and Jason Frankel Daniel WongDaniel Wong *Email address: E-mail Address: [email protected] Department of Urology, Washington University in St. Louis, St. Louis, Missouri *Email address: [email protected] More articles by this author and Jason FrankelJason Frankel Department of Urology, Washington University in St. Louis, St. Louis, Missouri *Email address: [email protected] More articles by this author View All Author Informationhttps://doi.org/10.1097/UPJ.0000000000000336.02AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "Editorial Commentary." Urology Practice, 9(6), pp. 586–587

Initiation of the Virtual Interview: A 5-Y Evaluation of General Surgery Residency Match Results

IntroductionThe virtual residency application season posed numerous challenges for the 2021 residency match process. Many residency programs are exploring relationships between this novel format and the match process. The purpose of this study was to compare one of the largest general surgery residency program's applications and match data from preCOVID years to the 2021 virtual cycle. Materials and methodsA retrospective review was performed of applicants to a single general surgery residency program from 2017 to 2021. The primary outcome was the number of locally matched applicants. The secondary outcomes were the total number of applications, change in applicant demographics, and variability of the geographic spread during this study period. Chi-square tests of independence, Fisher's exact tests, and negative binomial regression were performed. Results6819 applicants were included in the study. In 2021, an increase in applications was observed. The distribution of 2021 applications was statistically different from previous years regarding gender and race (P < 0.0001). The 2021 application cycle had a greater proportion of applicants from the United States (P < 0.0001) and southern US medical schools (P = 0.008). While the 2021 cycle had significantly more interviews (P = 0.013), there were no significant differences in the demographic composition of interviewees. During the 2021 application year, all 11 matches were from southern medical schools and there was a trend to more matched female applicants compared to previous years. ConclusionsDuring the 2021 COVID-19 virtual match cycle, an increase in both the number of applications and number of interviews for general surgery residency was identified. The characteristics of applicants who interviewed and matched were not different when compared to previous years. As virtual interviews may become more commonplace, it is important to assess all factors that may be involved in the dynamic residency application process.

Efficacy of an Introductory Nail Disorder Learning Module to Supplement the Medical School Curriculum: Experience from One United States Medical School

Introduction: Dermatologic and systemic conditions affecting nails are common, but nail pathology education in medical school curricula is limited. We created and evaluated the efficacy of a case-based module on nail pathologies in a medical student cohort from one well-respected US medical school. Methods: We developed a module consisting of five cases: melanonychia, onychomycosis, nail psoriasis, Beau’s lines/onychomadesis, and apparent leukonychia. Participants completed a pre-module questionnaire prior to completing the module and another questionnaire directly following completion. Results: Sixty-two clinical medical students completed the pre-module questionnaire, the module, and the post-module questionnaire. 59.68% of participants reported they had evaluated 1–5 patients with nail findings. However, 43.55% of study participants denied receiving any lectures on nail pathologies in their medical education. On average, the module took 13.73 min to complete. Student-reported confidence in both identifying and treating common nail disorders significantly increased from to pre- to post-module responses for both identification (p < 0.001) and treatment (p < 0.001) of common nail pathologies. Discussion/Conclusion: Nail findings are prevalent in all medical specialties, and improved medical student education on nail pathologies is necessary. Our introductory, case-based module on pathologies is an effective way to improve student confidence in identifying and treating nail disorders.

Transition to Medical School: Use of Learning Strategies to Support Self-Regulated Learning in Integrated, Learner-Centered Curricula.

Purpose: Medical education research has demonstrated the importance of supporting students during the transition to medical school, a transition rendered even more complex by many medical schools’ shift toward integrated, learner-centered curricula. 1 Despite prior academic success, many students begin medical school without the learning strategies needed to handle the depth, pace, and structure of the curricula. 2 When students are unable to transition effectively, their academic performance suffers. Self-regulated learning (SRL), a commonly used framework for teaching medical students effective study habits, is a process that students use to acquire academic skills, including setting goals, selecting and developing study strategies, and monitoring effectiveness. 3 Zimmerman proposed 3 phases of SRL: forethought, performance, and self-reflection. 4 While past research shows that successful medical students in a traditional 2 plus 2 curriculum engage in SRL, little is known about which specific strategies first-year medical students use to support SRL when transitioning to an integrated, learner-centered curriculum, and how they employ those strategies. The aim of this study was to document and codify the specific strategies students use in a learner-centered, integrated medical school curriculum to provide a roadmap that future students and educators can use to guide the transition to medical school. Method: Two United States medical schools with integrated, learner-centered curricula collaborated to examine which learning strategies students use to support SRL and how they use them. Thirty-two first-year medical students participated in an interview and were asked to reflect on their approach to SRL at the start and at the end of their first year of medical school. Students were asked to describe what strategies they used to plan (forethought), monitor (performance), and reflect (self-reflection) on their learning. A qualitative analysis of the data was performed using deductive coding that was based on a theoretical framework combining aspects of Zimmerman’s SRL model. Results: The data revealed that most students used a variety of learning strategies during all 3 stages of SRL described by Zimmerman 3 throughout their first year of medical school. Students were able to articulate specific examples of how they used strategies to plan, monitor, and reflect on their learning in an integrated, first-year medical school curriculum. Results indicated that as students progressed through their first year of medical school, they refined their strategy use to better fit the needs of an integrated, learner-centered medical curriculum. Discussion: This work contributes to existing medical education literature by providing concrete examples of strategies that first-year medical students in an integrated, learner-centered curriculum can use when adjusting to medical school. Medical educators recognize that SRL strategies need to be explicitly taught and that the specific SRL strategies used will vary based on the learning environment. The specific strategies, tasks, and behaviors identified in this study represent a bridge between theory and practical steps students can take to engage in SRL. Although students learn about the phases of SRL, they often have difficulty translating each phase into actionable steps as first-year medical students. The specific information provided by this study can aid in diagnosing gaps in learners’ existing processes or serve as concrete suggestions for new strategies, tasks, and behaviors to try when coaching first-year medical students. Significance: This work provides a roadmap of strategies for all stages of SRL that faculty, staff, administrators, and students can use to support learning in first-year, integrated medical school curricula.

A call to action; national survey of teaching radiology curriculum to medical students.

Radiology and medical imaging are important yet often an underrepresented facet of medical education. Notably, there is concern among radiologists that students do not receive enough radiology exposure and that they struggle to interpret image findings on entering residency. Therefore, this survey aims to identify how medical students perceive the radiology curriculum and to determine gaps in delivery. Students were recruited from United States (US) medical schools and given a 21-question survey assessing their perception of the radiology curriculum as well as asking about their confidence levels regarding medical imaging. The inclusion criteria were age >18 and enrolled in US medical school. The surveys were completed in April-July 2020 by students across the US. Objective parameters were measured as percentage correct, while subjective parameters used a 4-point Likert scale. A total of 472 medical students across 31 medical schools completed the surveys with a response rate of 69%. Responses represented all class years within medical schools and showed equal distribution among the future career plans. Students responded that didactic lectures were the most common teaching method and that radiologists were their primary teachers during preclinical education. Students were unfamiliar with the American College of Radiology appropriateness criteria with 65% responding they had never heard of it and 33% reporting that they have heard of it but never used it. In assessing students' perceptions of radiology education, 72% of students responded that they received too little, and 28% of students responded, "Just right." <1% of students responded that there was "Too much" radiology in their curriculum. Radiologists are increasing their educational representation in medical school curricula. Despite this, radiology continues to be under-represented with students desiring more exposure to medical imaging. Integrating the student's perceptions with existing curricula suggests that efforts should focus on increasing awareness of which studies are appropriate and teaching students how to systematically interpret an image.

Intersection of anxiety and negative coping among Asian American medical students.

PurposeAsian Americans comprise 21% of matriculating medical students in the United States but little is known about their mental health. With the growing focus on addressing the mental health of medical students, this systematic, nationwide survey assesses the relationship between anxiety and depression symptoms and coping skills among Asian American medical students.Materials and methodsA survey tool comprised of Patient Health Questionnaire-9, General Anxiety Disorder-7, and questions related to coping were emailed to members of the Asian Pacific American Medical Students Association enrolled in a United States medical school during the 2016–2017 academic year. We evaluated associations between anxiety and coping as well as depression and coping.ResultsA total of 511 Asian American medical students completed the survey. Anxiety symptoms were positively correlated with an increase in negative coping skills. Depressive symptoms were not correlated with an increase in negative coping skills.ConclusionProfessionals and medical schools that aim to improve the mental health of medical students should be aware of the needs of specific populations. Asian American students who experience anxiety were more likely to utilize avoidant or negative coping strategies. In addition, Asian American students who experience depressive symptoms were not more likely to utilize these negative coping strategies. Further research must be done to evaluate the factors that influence the use of negative coping strategies to better address anxiety within the Asian American medical student population.

Editorial Commentary.

No AccessUrology Practicethe Specialty1 Nov 2022Editorial CommentaryThis article comments on the following:Urological Education in United States Medical Schools: Where Are We Now and How Can We Do Better? Daniel Schoenfeld and Gina M. Badalato Daniel SchoenfeldDaniel Schoenfeld New York-Presbyterian Hospital, Columbia University Irving Medical CenterNew York, New York More articles by this author and Gina M. BadalatoGina M. Badalato New York-Presbyterian Hospital, Columbia University Irving Medical CenterNew York, New York More articles by this author View All Author Informationhttps://doi.org/10.1097/UPJ.0000000000000336.01AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "Editorial Commentary." Urology Practice, 9(6), p. 586

Challenges Facing Women in Sexual Medicine

Urology has historically had one of the lowest representations of practicing women physicians, compared to other surgical sub-specialties.1 However, gender demographics in the current urologic workforce are changing. The number of practicing women urologists has increased from <2% in 1980 to >10% in 2020.2,3 Approximately 25% of current Urology residents are women.4 As women now constitute the majority of matriculants to United States medical schools (50.1% in 2019), the proportion of women urology trainees, as well as the proportion of practicing women urologists, is expected to continue to grow.

Urological Education in United States Medical Schools: Where Are We Now and How Can We Do Better?

While urological complaints increase in aging populations and conditions commonly require management by multiple physician specialty types, exposure to formal urological education in United States medical schools is limited and has been decreasing over time. We aim to update the current status of urological education in the United States curriculum and delve further into the subject matter being taught and the type and timing of this education. An 11-question survey was developed to describe the current status of urological education. The survey was distributed using Survey Monkey to the American Urological Association's medical student listserv in November 2021. Descriptive statistics were used to summarize survey findings. Of 879 invitations sent, 173 responded (20%). Most (112/173, 65%) of respondents were in their fourth year. Only 4 (2%) reported that their school had a required clinical urology rotation. Kidney stones (98%) and urinary tract infections (100%) were the most frequent topics taught. The least exposure included infertility (20%), urological emergencies (19%), bladder drainage (17%), and erectile dysfunction (13%). Videos and case vignettes were the preferred learning modalities and the majority (84%) of respondents were familiar with the American Urological Association's medical student curriculum material. The majority of United States medical schools do not have a required clinical urology rotation and some core urological topics are not taught at all. Future incorporation of urological educational material through video and case vignette learning may be the best opportunity to provide exposure to clinical topics that will commonly be encountered regardless of chosen medical discipline.

Racial and Gender Profile of Public Health Faculty in the United States of America.

IntroductionIn the context of shifting population demographics in the United States (US), a diverse workforce in the discipline of public health can improve outcomes for various populations through the provision of culturally competent public health policies and corresponding research. This study explored the academic, racial, and gender profile of public health faculty in the USA.MethodsIn this retrospective cross-sectional analysis, we analyzed the Association of American Medical Colleges (AAMC) annual report of faculty appointments at US medical schools. Descriptive data analysis was performed for chairperson, full professor, associate professor, assistant professor, instructor, and other positions from 2007 to 2018.ResultsThere was a decrease in appointments at all academic ranks from 2007 to 2018 with an absolute change of −239. Overall, most academic positions were occupied by Whites compared to other races, especially in leadership ranks. However, year-by-year analysis showed a gradual decrease in the number of positions held by Whites. Over the last decade, there was a positive trend with a marginally greater number of minorities appointed at academic ranks, specifically Asians. Similarly, no significant change was seen in appointments for Hispanics. Additionally, females occupied a greater number of new positions as compared to their male counterparts except for the higher academic ranks. The data obtained from the AAMC were voluntarily reported and thus may not provide a complete picture of medical faculty in academic medicine.ConclusionWomen have shown progress in public health faculty positions during our 12-year study period. However, racial and gender incongruity still exists at higher academic ranks and leadership positions. Further research is warranted to explore factors influencing faculty appointment and promotion, and strategies to reduce inequities.

Benefits of implementing student-led review and mock examinations in the medical undergraduate gross anatomy curriculum

Anatomy consists of material that continually defines a student's undergraduate medical curriculum, and thus attaining a solid understanding of it is critical for academic success. Student exposure to anatomy prior to matriculation to the United States (US) medical school is highly variable, with some first introduced to the material in medical school. As a result, students without foundation in anatomy can struggle with adapting to the self-directed learning style that is required to excel with a prosection-based (i.e. hands-off analysis of a cadaver previously dissected by a professional) approach. In this study, second-year US medical students who have previously excelled in the first-year courses at the University of South Florida Morsani College of Medicine (in collaboration with faculty advisors) designed and offered a mock practical examination that mirrors the official practical exam specific to each course: a timed practical examination using dissected human cadavers and radiological imaging to assess anatomical knowledge, followed by a review session. Since the mock practical and review session was designed from a student’s perspective, the material could be tailored to specifically address topics that students historically have struggled with. Students who participated in the mock practical and associated review sessions reported feeling more confident than their peers who did not participate. In addition, they significantly outperformed their peers on the official practical examination, independent of any demographic factors or educational background. This study demonstrates the benefits of incorporating peer-assisted learning (PAL) into the anatomical component of the medical school curriculum.

Trends in Racial Diversity among United States Ophthalmology Residents

Underrepresented minority (URM) groups in medicine are defined as racial and ethnic populations in the medical field that are underrepresented relative to their numbers in the general population. 1 Fairless E.A. Nwanyanwu K.H. Forster S.H. Teng C.C. Ophthalmology departments remain among the least diverse clinical departments at United States medical schools. Ophthalmology. 2021; 128: 1129-1134 Abstract Full Text Full Text PDF PubMed Scopus (17) Google Scholar A diverse physician workforce that reflects patient population leads to decreased health care disparities, enhanced access to care, and improved patient outcomes and satisfaction. 2 Olivier M.M.G. Forster S. Carter K.D. et al. Lighting a pathway: the minority ophthalmology mentoring program. Ophthalmology. 2020; 127: 848-851 Abstract Full Text Full Text PDF PubMed Scopus (12) Google Scholar However, the field of ophthalmology has not reflected the racial diversity of the country and URM groups comprise only 7.2% of practicing ophthalmologists in the United States. 3 Xierali I.M. Nivet M.A. Wilson M.R. Current and future status of diversity in ophthalmologist workforce. JAMA Ophthalmol. 2016; 134: 1016-1023 Crossref PubMed Scopus (57) Google Scholar Re: Atkuru et al.: Trends in racial diversity among United States ophthalmology residents (Ophthalmology. 2022;129:957-959)OphthalmologyVol. 129Issue 9PreviewIn their report on the demographic data of United States residents in training across multiple specialties, Atkuru et al1 reveal that ophthalmology had the lowest proportion of residents who were underrepresented in medicine (URM) in the 2019–2020 academic year. We agree with the authors’ assessment that insufficient exposure to ophthalmology during medical training may be a major contributor to the lack of diversity in the field. As specialties compete for limited teaching time within medical school curricula, it seems that ophthalmology is falling behind in the race. Full-Text PDF Racial Diversity among United States Ophthalmology Residents: A Call to ActionOphthalmologyVol. 129Issue 8PreviewThe benefits of a diverse workforce in the medical field are well known and include improved health care outcomes, improved cultural competency, and enhancement of the medical work force dedicated to serving under-resourced areas.1 Despite these well-characterized benefits, the percentage of physicians from underrepresented in medicine (URiM) groups lags well behind the overall population in the United States.1,2 In this issue, Atkuru et al3 (see page 957) used demographic data from the accreditation Council for Graduate Medical Education to compare the proportion of URiM residents between 2011–2012 and 2019–2020. Full-Text PDF

Exposure of 3rd and 4th Medical Students to Pediatric and Adolescent Gynecology - A pilot study

Background: Most United States (US) medical schools allocate 6 weeks of the academic year for clerkships in Obstetrics and Gynecology. This time limitation may prevent students from gaining exposure to many subspecialties in OB/GYN, including Pediatric and Adolescent Gynecology (PAG), which may account for fewer physicians being formally trained in this area. The purpose of this study was to quantify and characterize the level of medical student exposure to PAG.

The Important Factors Applicants Consider When Choosing a Residency: A Survey Study.

While medical school graduates compete to get matched into the best residency programs, programs also compete to attract the best applicants. The applicant's decision to rank their programs of interest is determined by several factors, many of which are not always apparent. This study aimed to evaluate significant factors involved in an applicant's residency program selection. A 12-question survey was sent between June 2020 and September 2020 to all first-year internal medicine residents in the United States (US) through an online national database of residencies using the Survey Monkey platform. We asked them to rank the most significant factors that enticed or deterred them from choosing a specific program. We also compared domestic with international medical graduate (IMG) average ranked responses wherein differences were evaluated using an independent two mean samples t-test. The association between outcomes and predictors was analyzed using Pearson's correlation and chi-square analysis. Out of 9,127 residents, 102 responded to the survey, which equaled a 1.11% response rate. The findings showed that the location, culture, and organization of a program are high-value factors for applicants. Salary, the number of cases seen, and friends near the residency location were not.There are statistically significant differences between graduates of US medical schools and IMG applicants, with the former placing higher importance on the quality of life during residency. Male and female residents also have different priorities with the latter emphasizing program culture and work environment improvement.Residents who chose programs based on academic competitiveness also placed significance on the prestige of the program (r = 0.418, P < .001), program organization/structure (r = 0.3, P = .006), fellowship match rate (r = 0.307, P = .006) and word of mouth (r = 0.520, P < .001). Residents who chose programs based on program culture also put an emphasis on the perceived happiness of the residents (r = 0.450, P = 0.001), and work-life balance (r = 0.359, P = .004). Programs can attract stronger applicants if they emphasize modifiable factors that are important to potential residents.

United States Medical School Academic Faculty Workforce Diversity, Institutional Characteristics, and Geographical Distributions From 2014-2018.

PurposeAcademic healthcare workforce diversity is important in addressing health disparities. Our goal was to evaluate trends and associations in faculty diversity of United States (US) medical schools over a five-year period.MethodsWe analyzed the Association of American Medical Colleges (AAMC) Faculty Roster data of 151 US medical schools from 2014-2018. Outcome faculty variables were female gender, underrepresented in medicine (UiM), age, and professorial representation. Predictor variables included geographical distributions, and institutional characteristics. Statistical analysis included Jonckheere-Terpstra test, ANOVA, and regression analysis.ResultsFemale faculty increased from 37.6% to 40.4% (p<0.001), senior faculty (age >60 years) from 22.6% to 25.9% (p=0.001) while UiM faculty stayed relatively flat from 9.74% to 10.08% (p=0.773). UiM [adjusted odds ratio (aOR) = 0.39, p=0.015], and female faculty (aOR=0.3, p=0.001) had independently significantly decreased associations with professorial representation, while senior faculty had increased associations (aOR=3.82, p<0.001). Significant independent differences occurred in female, UiM, and professorial faculty distributions within US regions; Hispanic faculty were highest in Southwest (6.57%) and lowest in Midwest region (1.59%), while African-American faculty were highest in Southeast (8.15%) but lowest in the West (3.12%). UiM faculty had significantly independent decreased associations with MD/PhD degree (aOR=0.30, p=0.004) and higher US ranking institutions (aOR=0.45, p=0.009).ConclusionsFrom 2014 to 2018, female faculty increased modestly while the UiM faculty trend remained flat. Female and UiM faculty were less represented at the professor level. UiM faculty were less represented in higher-ranking institutions. Geographic location is associated with faculty diversity.

A Ten-Year Analysis of Recent National Institutes of Health Funding for Anesthesiology Research in United States Medical Schools

The characteristics of recent National Institutes of Health (NIH) grant funding to anesthesiology researchers in United States (US) medical schools have not been systematically quantified. NIH funding to cardiac anesthesiologists has also not been estimated. The author conducted an internet-based analysis of NIH awards to anesthesiology researchers from 2011-2020 to identify the types, duration of funding, and amount of grants, and the terminal degree(s), faculty rank, gender, board certification status, and type of appointment of the grant recipients including those with an interest in cardiac anesthesiology. Observational study. Internet analysis. NIH grants recipients. None. NIH grant recipients affiliated with anesthesiology departments were identified from the Blue Ridge Institute for Medical Research website. The number of grants, years of support, and total amount of funding were quantified for research project grants (R series), mentored career development awards (K series), and other grants (U and P series) using NIH Research Portfolio Online Reporting Tools. The terminal degree(s), faculty rank, gender, and type of appointment of grant recipients were identified using department web pages. American Board of Anesthesiology (ABA) certification, National Board of Echocardiography Advanced Perioperative Transesophageal Echocardiography (TEE) certification, and previous or current Foundation for Anesthesia Education and Research (FAER) awards to NIH grant recipients were obtained from each organization's website. A total of 532 researchers received 1250 grants with 3844 cumulative years of funding amounting to $1,676,482,440. R series grants accounted for three-quarters of all funding. PhDs were awarded more than one-half of NIH grants. MDs had lower median numbers of projects, R01 grants, and total R series grants than their colleagues with PhD or MD PhD degrees, but MDs received more K awards. One hundred ninety-eight MD and MD PhD NIH grant recipients were ABA diplomates. These physician-scientists received 26.0% and 53.1% of R and K series grants, respectively. Thirty physician-scientists also held TEE certification; these individuals with an interest in cardiac anesthesiology were awarded 4.8% of all NIH grants. Full Professors were awarded more than three-quarters of R grants and amassed more than $1.3 billion in funding, whereas assistant and associate professors received the majority of K series grants. Male investigators received greater median R grants but fewer median K awards than female researchers. One hundred-fifteen previous or current holders of FAER grants were identified; these individuals earned a total of 240 NIH awards totaling $357.7 million. PhDs, Professors, and male researchers receive the majority of R01 and other R series grants to anesthesiology departments at US medical schools. Physician-scientists, including those interested in cardiac anesthesiology, are awarded a minority of R series grants. FAER continues to provide an important stimulus for subsequent NIH funding of physician-scientists in anesthesiology.