US Allopathic Medical Schools Research Articles

Sex, Race, and Ethnic Diversity of the Emerging US Orthopaedic Sports Medicine Workforce is Limited

The purpose of this study was to analyze the demographics and trends of orthopaedic surgeons entering the US orthopaedic sports medicine workforce over the past decade. This was a cross-sectional study of allopathic medical students, orthopaedic surgery residents, and orthopaedic sports medicine fellows in the US (2013-2022) leveraging data from the Accreditation Council for Graduate Medical Education and American Medical Association. Disparities in demographic representation between orthopaedic sports medicine fellows and the 2020 US population census were quantified with participation-to-prevalence ratios (PPRs). A PPR between 0.8-1.2 was classified as equivalent representation and a PPR<0.8 was classified as under-representation, relative to the US population. The representation of female, Hispanic, Black, and Asian trainees decreased at each stage of the training pipeline to orthopaedic sports medicine fellowship training. In contrast, the representation of White trainees increased at each stage of the training pipeline. Over the study period, there were modest increases in female (9.9% to 12.6%) and Hispanic (1.2% to 1.7%) trainee representation in orthopaedic sports medicine. In contrast, Asian (16.6% to 5.6%) and Black (5.1% to 1.9%) trainee representation decreased. Relative to the US population, female (PPR=0.22), Black (PPR=0.30), Hispanic (PPR=0.19), Native Hawaiian/Pacific Islander (PPR=0.01), and Native American/Alaskan Native (PPR=0.00) trainees were underrepresented. In contrast, male (PPR=1.79), Asian (PPR=1.96), and White (PPR=1.36) trainees were overrepresented in orthopaedic sports medicine. There is limited diversity in the emerging orthopaedic sports medicine workforce relative to the US population. Improvements in the representation of female, Black, and Hispanic trainees in orthopaedic sports medicine has been marginal relative to trends observed at US allopathic medical schools. Promoting diversity and inclusion in the orthopaedic sports medicine workforce can create more surgical provider options for diverse patient populations in the US.

How Does Lacking a Home Program Impact Otolaryngology Applicants?

To compare otolaryngology interview and match outcomes between applicants with and without home residency programs. Otolaryngology applicants from US allopathic medical schools during the 2019-2023 cycles who responded to the Texas Seeking Transparency in Application to Residency (STAR) survey were identified. Students were stratified based upon whether their medical school had an affiliated otolaryngology residency program. The primary outcomes were number of interviews and match rate. Wilcoxon-rank sum and χ2 testing was used to assess associations between home program status and interview and match outcomes. Of the 633 fourth-year medical students applying to otolaryngology during the 2019-2023 application cycles, 89 had no home program (NHP) and 544 had a home program (HP). Applicants with NHP completed significantly more away rotations than applicants with a HP (2.2 vs. 1.5; p < 0.01). There was no difference in mean number of applications submitted between applicants with NHP and applicants with a HP. However, applicants with a HP received a significantly greater number of interviews (14.7 vs. 11.8; p < 0.01), attended more interviews (12.4 vs. 11.3; p = 0.02), attended a lower percentage of their offered interviews (84.4% vs. 95.8%), and had a higher match rate (81.8% vs. 70.8%; p = 0.02) than applicants with NHP. Applicants with NHP interviewed at (1.9 vs. 1.3; p < 0.01) and matched at (33.7% vs. 23.9%; p = 0.048) significantly more away rotation institutions than applicants with a HP. Applicants with NHP received fewer interviews and had lower match rates. Away rotations may be especially important for applicants with NHP. NA Laryngoscope, 134:4494-4500, 2024.

The cost of virtual interviews; more than just the money

PurposeThe COVID-19 pandemic resulted in travel restrictions to limit virus transmission, altering the residency interview process across the country. While the transition to virtual interviews has the potential benefit of convenience and cost savings, concerns remain about the impact on applicants’ ability to distinguish programs. We sought to understand individual applicant motivations when presented with the opportunity to interview in-person or virtually and the associated costs.MethodsAn anonymous, voluntary, mixed-methods survey was distributed to all US allopathic medical school general surgery applicants who applied to our program in the 2023 cycle. The primary outcome was identifying factors that impacted the decision to interview either in-person or virtually. Secondary outcomes included costs associated with the entire interview process, including travel for away rotations, in-person interviews, and program second looks.Results155 (21.3%) applicants completed the survey. The average number of interviews completed was 14.2 ± 6.25. Females completed more interviews than males (14.9, 12.6, p = 0.047). Respondents accepted a mean of 89% of virtual interviews offered. 73% of applicants selected to complete at least one interview in-person. Top reasons for electing in-person interviews were to gain a stronger impression of the program (64%), make a greater impression of the program (50%), and strength of interest in the program (64%). Top factors for choosing virtual interviews were decreased costs (64%), less travel time (53%), and the ability to complete more interviews (53%). 58% of applicants planned to visit at least one program in-person post-interview. The mean total cost of interviews was $122 for virtual and $358 for in-person. Travel for a “second look” visit cost $279. 53% of respondents completed an away rotation, spending an average of $1688 per away rotation.ConclusionWhen presented with the option, applicants chose to interview in-person because of a mutual feeling of portraying and receiving a stronger impression. Candidates chose virtual due to cost reduction and the ability to complete more interviews. The financial savings of virtual interviews should be examined in the context of increased applications, increased interviews, post-interview travel or "second look" experiences, and costs associated with away rotations. Future work is needed to elucidate the role of in-person contact or away rotations on the likelihood of an applicant to interview and match in a largely virtual interview era.

Disability's absence from admissions nondiscrimination and recruitment initiatives in Top-Tier US allopathic medical schools

BackgroundDiversity in medical school students is essential to ensure that future physicians can care for a range of patients from different backgrounds. However, disability is often overlooked and there are potential examples of discrimination in US medical schools. ObjectiveTo determine if students with disabilities are included in online recruitment, diversity equity and inclusion (DEI), or nondiscrimination materials for US allopathic medical schools. MethodsIn this descriptive study, the authors reviewed publicly available data from websites of the top ranked 51 US allopathic medical schools to assess inclusion of disability in recruitment efforts or antidiscrimination statements. ResultsThe results showed that just under one third of these schools (31 %) mention disability within their DEI or published recruitment efforts. Most commonly (27.5 %), disability is mentioned in a general diversity statement. ConclusionsThese findings suggest that there is a need for greater inclusion of disability in US medical schools' recruitment efforts. This is essential to ensure that people with disabilities are not discriminated against in medical school applications and is one of many factors that will contribute to future physicians being prepared to care for patients with disabilities.

An Update on the Independent Plastic Surgery Match (2019-2022): Trends, Predictors, and Program Leaders' Perspectives.

A previous study by the authors noted a decline in independent plastic surgery residency programs and rising applicant participation. This study provides updates on match trends and influential predictors, and gathers program leaders' views on the future of the independent track. Match data (2019-2022) were obtained from the San Francisco match after American Council of Educators in Plastic Surgery approval. Variables influencing match success were analyzed, and program leaders were surveyed about desirable applicant traits and program trajectories. From 2019 to 2022, 243 of 428 applicants matched. Programs and positions declined by 10% and 9.5%, respectively. Applicants rose to 42.3%, but match rates fell from 82% to 56%. Osteopathic graduates doubled, whereas international graduates increased to 53.8%. Successful matches were associated with US allopathic medical school graduates, university-affiliated general surgery residencies, eight or more interviews, United States Medical Licensing Examination scores greater than 230, and high post graduate year (PGY)1-3 American Board of Surgery In-service Training Examination scores (PGY1-64.7%, PGY2-61.2%, PGY3-60.7%; P < 0.05). Of surveyed programs, 55.6% aimed to continue running the independent track in the next year. Conversely, 7.4% planned to discontinue in the next year, 22.2% within 2-5 years, 7.4% within the next decade, and 7.4% were unsure. Although support for the independent plastic surgery track remains, program participation diminishes as applicant interest increases, intensifying match challenges. Increasing number of interviews improves match potential. Program leaders display varied commitments, with looming plans for some programs to discontinue offering this track. Applicant evaluation pivots on strong recommendations, research, and test scores.

Adjectives in the Summary Paragraph of the MSPE: Are They Telling Us Something?

Rationale and ObjectivesMany US medical schools do not provide a summative, comparative assessment of students (class rank), instead utilizing descriptive adjectives in the summary paragraph of the Medical Student Performance Evaluation (MSPE). The objective of this study was to determine whether those adjectives correlate with student performance. Materials and MethodsApplications from all US allopathic medical schools received by a single diagnostic radiology program in the 2023-24 cycle were reviewed. The final adjectives from schools that rank students were coded as positive, negative, or neutral. For students from non-ranking schools, descriptive adjectives from the MSPE summary paragraphs were extracted and categorized based on the final adjective coding schema along with a library of commonly used positive adjectives. The frequency of adjectives was correlated with applicant academic and demographic factors using multivariable logistic regression. ResultsApplications from 97% (147/151) of US allopathic medical schools were received. 60.5% (89/147) of schools rank their students with 27.9% (41/147) using a final adjective coded to performance tier. Of the 58 non-ranking schools, 56.9% (33/58) used descriptive adjectives in the MSPE’s summary paragraph. There was no association with academic performance metrics and either generally positive adjectives or coded descriptive adjectives. There was a greater association with positive descriptive adjectives for non-white applicants (p=0.011) and generally positive adjectives for higher ranked schools (p=0.004). ConclusionUndefined descriptive adjectives in the MSPE’s summary paragraph, when benchmarked to final adjectives, do not correlate with academic performance, and may instead be used for student advocacy by medical school deans.

Experiences of Leaders in Diversity, Equity, and Inclusion in US Academic Health Centers

The murder of George Floyd in 2020 spurred an outpouring of calls for racial justice in the United States, including within academic medicine. In response, academic health centers announced new antiracism initiatives and expanded their administrative positions related to diversity, equity, and/or inclusion (DEI). To understand the experiences of DEI leaders at US allopathic medical schools and academic health centers, ie, the structure of their role, official and unofficial responsibilities, access to resources, institutional support, and challenges. This qualitative study used key informant interviews with participants who held formal DEI positions in their school of medicine, health system, or department. Interviews were conducted from December 2020 to September 2021. Transcripts were coded using a phenomenographic approach, with iterative concurrent analysis to identify thematic categories across participants. Data were analyzed from January to December 2021. Formal DEI role. Questions elicited reflection on the responsibilities of the role and the strengths and challenges of the unit or office. A total of 32 participants (18 of 30 [56%] cisgender women; 16 [50%] Black or African American, 6 [19%] Latinx or Hispanic, and 8 [25%] White) from 27 institutions with a mean (range) of 14 (3-43) years of experience in medical education were interviewed. More than half held a dean position (17 [53%]), and multiple participants held 2 or more titled DEI roles (4 [13%]). Two-thirds self-identified as underrepresented in medicine (20 [63%]) and one-third as first generation to attend college (11 [34%]). Key themes reflected ongoing challenges for DEI leaders, including (1) variability in roles, responsibilities, and access to resources, both across participants and institutions as well as within the same position over time; (2) mismatch between institutional investments and directives, including insufficient authority, support staff, and/or funding, and reduced efficacy due to lack of integration with other units within the school or health system; (3) lack of evidence-based practices, theories of change, or standards to guide their work; and (4) work experiences that drive and exhaust leaders. Multiple participants described burnout due to increasing demands that are not met with equivalent increase in institutional support. In this qualitative study, DEI leaders described multiple institutional challenges to their work. To effectively address stated goals of DEI, medical schools and academic centers need to provide leaders with concomitant resources and authority that facilitate change. Institutions need to acknowledge and implement strategies that integrate across units, beyond one leader and office. Policymakers, including professional organizations and accrediting bodies, should provide guidance, accountability mechanisms, and support for research to identify and disseminate evidence for best practices. Creating statements and positions, without mechanisms for change, perpetuates stagnation and injustice.

Pilot study exploring the presence of leadership curricula in undergraduate medical education

IntroductionThe physician’s role in the healthcare delivery system extends beyond patient care to include numerous critical leadership roles in healthcare. In addition to treating patients, physicians manage multidisciplinary teams and...

Medical Student Preferences on Examination Scheduling at a US Allopathic Medical School - Survey Study.

This study at the University of South Carolina School of Medicine Greenville examines medical students' preferences and concerns regarding exam scheduling, focusing on the schedule's impact on student academic performance and well-being. A cross-sectional survey was administered to second, third, and fourth year medical students, receiving a 53% response rate. The survey, consisting of 11 multiple-choice questions and one open-ended question, assessed preferences for exam days, weeks, sequence of different types of exams, and the timing of schedule releases. Evaluation using descriptive statistics and thematic analysis revealed a strong preference for scheduling Biomedical Science (BMS) exams on Fridays, avoiding weeks with holidays, and separating BMS exams from Integrated Practice of Medicine (IPM) assessments. Students reported that concurrent IPM content delivery during BMS exam weeks negatively impacted their academic performance. Additionally, there was a significant demand for early release of exam schedules to better manage work-life balance. These findings highlight the critical role of exam scheduling in influencing medical students' academic success and overall well-being, suggesting the need for early communication of schedules and equitable assessment planning.

Practical Tips for Undergraduate Medical Education Advisors in Residency Application Signaling.

The residency application process has become increasingly complex for medical students and advisors to navigate. Program signaling was piloted to improve applicants' abilities to obtain interview offers at programs they were strongly interested in. The initial positive results led to expansion of signaling to additional specialties over the next two application cycles. Despite the benefits of program signaling, the variation in signaling practices among specialties has presented challenges for both advisors and students when determining how to best allocate signals. The aim of this study is to identify students' perceptions of the signaling process, how this may impact outcomes, and to guide future educational programming. This is an exploratory original survey study of students in a US allopathic medical school applying in ERAS for the 2023 residency cycle. The survey was developed to determine students' understanding of how programs would use signals in the application process and assess strategies students used to allocate signals. We compared program signals to student interview offers and match outcomes using descriptive statistics. 57 of 96 eligible students completed the survey. 51% signaled a range of programs based on their perceived competitiveness for the program while 40% signaled programs of interest regardless of perceived competitiveness. 53% of students thought sending a signal would increase their chance of an interview, while 42% were unsure how the signal would be used by residency programs. Students received interviews at 49% of the programs signaled, which increased to 56.5% when specialties offering more than 7 signals were excluded. 35% of students matched at a signaled program. Students' perceptions and strategies related to the signaling process are varied and may impact interview offers. Advisors should monitor and review internal institutional trends to help inform future educational programming to optimize signal allocation for their students.

A Game-Based Tool for Reducing Jargon Use by Medical Trainees.

Physicians can be unaware that many US adults have intermediate or lower health literacy. Avoiding medical jargon in patient communication can improve poor outcomes associated with lower health literacy, but physicians may struggle to do so as health literacy education is neither standardized nor universal at US allopathic medical schools. As with other skills-based proficiencies in medical education, repeat exposure and active learning help build competency. Medical students developed the Patient Communication Challenge (PCC), an adaptation of the Hasbro game Taboo, to facilitate practice of patient-centered communication skills among medical trainees. Hour-long workshops were held for groups of preclinical medical students. Students watched a communication exemplar video, played the PCC game, and completed a postworkshop survey. To play, two teams competed to earn points by identifying medical concepts as explained by a teammate who described the term without using medical jargon. Evaluations indicated that the game was enjoyable and reinforced didactic concepts through active learning, with self-reported participant satisfaction and competency gain. Overall, 59% of participants (53 of 90) completed postworkshop surveys; 91% (48 of 53) agreed they felt more proficient in avoiding jargon, 94% (50 of 53) would recommend the workshop to a classmate, and 100% (53 of 53) would play again. The PCC can help early medical trainees develop health communication skills through gamification with utilization of adult learning principles and adequate frequency for skill retention. Future applications include longitudinal assessment and expanding to later stages of medical training and other health professions.

Knowledge, perceptions, interest, and use of integrative medicine among U.S. allopathic medical students

Background: Acceptance, interest, and demand for Complementary Integrative Medicine (CIM) has been steadily growing within the US. Yet despite increased use, patient non-disclosure and physician lack of comfort in discussion is common. Medical students (MS) express interest in CIM. Educational exposure affects attitudes, cultural competence, interprofessional education, knowledge, and clinical skills. A few studies include US MS; however, most studies have been done outside the US. Aims: Our study examined first year US allopathic MS knowledge, perception, and attitudes toward IM for patient care, current personal use, and modalities of interest. Methods: The study was conducted on first year MS from 2020-2022 who participated in a 3-hour IM session within the required Essential Principles of Medicine course at a US allopathic medical school. Five questions were disseminated through Poll Everywhere during a lecture given by an IM board certified physician and students were invited to respond. Questions assessed student definition of IM, perception of patient barriers in discussing IM, perception of physician barriers in discussing IM, personal use, and modalities of interest. Results: MS attitude toward IM was generally positive based on word choice. MS perception of patient barriers in discussing IM focused on emotional factors rather than knowledge and understanding, whereas medical student perception of physician barriers revolved around lack of familiarity, knowledge, and training. Students self-reported physical activity and sleep as the top ranked favorite stress-reducing self-care practice followed by cooking/eating, music, and yoga. Students were most interested in exploring pet therapy, Traditional Chinese Medicine (TCM) and yoga. Conclusions: Further study with the integrative medicine attitude questionnaire (IMAQ) is recommended to determine whether results are generalizable. Integrating IM education and experience into the conventional medical curriculum is of interest to allopathic US MS and may prepare students for optimizing future patient care as well as clinician wellness.

Prevalence of visual art education in medical school curricula: a national survey of US medical schools

ABSTRACT Background: The Association of American Medical Colleges (AAMC) has recommended integrating medically-relevant arts and humanities curricula into medical student education in order promote physician skills development. An analysis of the state of existing visual arts-based medical school pedagogies was conducted to inform future implementation strategies. Methodology: An electronic survey was distributed to representatives of US medical schools to describe the prevalence and characteristics of visual arts-based medical school curricula. Official courses, informal events, cross-registration opportunities, and established art museum partnerships were assessed. Results: Survey response rates were 65% for US allopathic medical schools and 56% for osteopathic medical schools. A majority (79%) of responding institutions incorporate or support medical student art experiences in some format. Thirty-one percent (n = 36) of schools offer stand-alone humanities courses using visual arts. These were primarily allopathic programs (n = 35; 37% of allopathic programs) and only one responding osteopathic program (n = 1; 5% of osteopathic programs). Schools without dedicated courses are less likely to report other curricular and extracurricular visual arts engagement. Most visual art medical courses are offered at medical schools located in the Northeastern United States. Conclusions: Many but not all medical schools are incorporating the visual arts into their medical education curriculum. Opportunities to promote increased uptake, more effective implementation, and collaboration strategies for the AAMC recommendations are proposed.

The Anesthesiology Physician-Scientist Pipeline: Current Status and Recommendations for Future Growth-An Initiative of the Anesthesia Research Council.

The limited number and diversity of resident physicians pursuing careers as physician-scientists in medicine has been a concern for many decades. The Anesthesia Research Council aimed to address the status of the anesthesiology physician-scientist pipeline, benchmarked against other medical specialties, and to develop strategic recommendations to sustain and expand the number and diversity of anesthesiology physician-scientists. The working group analyzed data from the Association of American Medical Colleges and the National Resident Matching Program to characterize the diversity and number of research-oriented residents from US and international allopathic medical schools entering 11 medical specialties from 2009 to 2019. Two surveys were developed to assess the research culture of anesthesiology departments. National Institutes of Health (NIH) funding information awarded to anesthesiology physician-scientists and departments was collected from NIH RePORTER and the Blue Ridge Medical Institute. Anesthesiology ranked eighth to tenth place of 11 medical specialties in the percent of "research-oriented" entering residents, defined as those with advanced degrees (Master's or PhDs) in addition to the MD degree or having published at least 3 research publications before residency. Anesthesiology ranked eighth of 11 specialties in the percent of entering residents who were women but ranked fourth of 11 specialties in the percent of entering residents who self-identified as belonging to an underrepresented group in medicine. There has been a 72% increase in both the total NIH funding awarded to anesthesiology departments and the number of NIH K-series mentored training grants (eg, K08 and K23) awarded to anesthesiology physician-scientists between 2015 and 2020. Recommendations for expanding the size and diversity of the anesthesiology physician-scientist pipeline included (1) developing strategies to increase the number of research intensive anesthesiology departments; (2) unifying the diverse programs among academic anesthesiology foundations and societies that seek to grow research in the specialty; (3) adjusting American Society of Anesthesiologists metrics of success to include the number of anesthesiology physician-scientists with extramural research support; (4) increasing the number of mentored awards from Foundation of Anesthesia Education and Research (FAER) and International Anesthesia Research Society (IARS); (5) supporting an organized and concerted effort to inform research-oriented medical students of the diverse research opportunities within anesthesiology should include the specialty being represented at the annual meetings of Medical Scientist Training Program (MSTP) students and the American Physician Scientist Association, as well as in institutional MSTP programs. The medical specialty of anesthesiology is defined by new discoveries and contributions to perioperative medicine which will only be sustained by a robust pipeline of anesthesiology physician-scientists.

Medical Student Mentorship in the COVID-19 Era.

The Covid-19 pandemic led to a reduction of in-person, guided mentorship due to social distancing and an emphasis on virtual meetings. The effect of these changes on medical students' experiences and specialty choice has yet to be studied in a large-scale manner. To determine the perspective of third- and fourth-year medical students regarding the impact of the COVID-19 pandemic on mentorship. The authors distributed a modified Likert scale questionnaire (score: 1-10) to assess responses. Third- and fourth-year medical students at two large US allopathic medical schools. Responses to each survey item were analyzed to characterize the impact of the COVID-19 pandemic on mentorship relationships in medical school. A score of 1-5 was considered "disagree" and a score of 6-10 was considered "agree." A total of 144 responses were collected with a response rate of 16.2%. Overall, 80.6% (n = 116) of respondents agree that the COVID-19 pandemic has had a negative impact on their medical school experience. Nearly half (41.0%, n = 59) expressed concern over the lack of mentorship opportunities, and 66.0% (n = 95) reported that the pandemic has made it more difficult to form or maintain connections with their mentors. Importantly, 43.6% (n = 61) of respondents reported that having close mentoring relationships reduced the impact of the pandemic on their medical training. While many respondents (79.9%, n = 114) did not change career plans due to the pandemic, most students are concerned about evaluating prospective residency programs (88.9%, n = 128). Notably, M3s have much lower confidence than M4s in their ability to choose a specialty (5.9 vs. 8.2, p = 6.43e - 08). This investigation illustrates the concerns that medical students have regarding access to mentorship opportunities due to the COVID-19 pandemic. We hope that these findings encourage medical schools to evaluate and expand their current mentorship programs. The online version contains supplementary material available at 10.1007/s40670-023-01838-4.

Assessing opportunities for formal exposure to clinical neurosurgery within United States allopathic medical education curricula.

The objective of this study was to evaluate opportunities for early clinical exposure to neurosurgery at US allopathic medical schools and to assess associations between early exposure and recruitment into neurosurgery. The authors conducted a standardized review of online curriculum documentation for all US allopathic medical schools, including descriptive review of opportunities for clinical neurosurgical training among medical students. Chi-square analysis was used to compare baseline characteristics of institutions. Logistic regression was performed to assess factors predictive of early exposure to clinical neurosurgery, defined as completion of a formal rotation at least 6 months prior to Electronic Residency Application Service submission. Among 155 allopathic US medical schools, 143 are fully accredited by the Liaison Committee on Medical Education. Eleven schools have no affiliated hospitals with a neurosurgery practice, and 26 do not have an American Association of Neurological Surgeons (AANS) medical student chapter. Overall, 94 (60.6%) have a traditional preclinical curriculum lasting 21-25 months, 50 (32.3%) offer an intermediate preclinical period of 15-20 months, and 11 (7.1%) report a short preclinical curriculum of 12-14 months. Early formal exposure to clinical neurosurgery was offered by 113 schools (72.9%). Early clinical exposure to neurosurgery was associated with a short (100%) or intermediate (76%) preclinical curriculum, as compared with a traditional curriculum (68.1%; p = 0.066). Early exposure was significantly associated with a shorter preclinical curriculum (OR 0.784, p = 0.005). AANS medical student chapters were present at a high majority of schools with early exposure (OR 4.114, p = 0.006). Medical schools with a higher percentage of graduating medical students matching into neurosurgery were associated with a shorter preclinical curriculum length (β = -0.287, p < 0.001), were more commonly private medical schools (β = 0.338, p < 0.001), and had early clinical exposure to neurosurgery (β = 0.191, p = 0.032). Early exposure to clinical neurosurgery is available at most US allopathic medical schools and is associated with shorter preclinical curricula and institutions with AANS medical student chapters. Medical schools with a higher proportion of medical students entering neurosurgery had a shorter preclinical curriculum length and early clinical exposure to neurosurgery. Further study is recommended to characterize the impact of early exposure on long-term pedagogical outcomes.

Prevalence of Disability and Use of Accommodation Among US Allopathic Medical School Students Before and During the COVID-19 Pandemic

This survey study assesses self-disclosures of disability, disability types, and accommodation needs reported by US allopathic medical schools in 2021 vs 2015 and 2019.

A 5-point framework for students evaluating plastic surgery research fellowship opportunities

An increasing number of medical students pursue research fellowships to enhance their odds of matching into an integrated plastic surgery residency program. 1 Keane C.A. Akhter M.F. Sarac B.A. Janis J.E. Characteristics of Successful Integrated Plastic Surgery Applicants from US Allopathic Medical Schools without a Home Integrated Program. J Surg Educ. 2022; 79: 551-557https://doi.org/10.1016/j.jsurg.2021.11.002 Crossref Scopus (11) Google Scholar , 2 Pathipati A.S. Taleghani N. Research in Medical School: A Survey Evaluating Why Medical Students Take Research Years. Cureus. 2016; 8e741https://doi.org/10.7759/cureus.741 Crossref Google Scholar , 3 Mehta K. Sinno S. Thanik V. Weichman K. Janis J.E. Patel A. Matching into Integrated Plastic Surgery: The Value of Research Fellowships. Plast Reconstr Surg. 2019; 143: 640-645https://doi.org/10.1097/PRS.0000000000005212 Crossref PubMed Scopus (56) Google Scholar The American Council of Academic Plastic Surgeons (ACAPS) Job Board lists research fellowship positions for the following academic year from November to March annually. 4 American Council of Academic Plastic Surgeons . Job Board. Available at 〈https://acaplasticsurgeons.org/jobs/〉. Accessed January 16, 2023 Google Scholar Zimmerman et al. also developed a database of plastic surgery research fellowships and their requirements. 5 Zimmerman C.E. Humphries L.S. Taylor J.A. Equitable Access to Research Opportunities in Plastic Surgery: Development of a Research Fellowship Database. Plast Reconstr Surg. 2021; 148: 1087e-1088ehttps://doi.org/10.1097/PRS.0000000000008535 Crossref Scopus (1) Google Scholar As students select amongst these positions it may be difficult to identify one that matches their goals and interests. The following viewpoint describes a five-part framework of important concerns research year candidates should consider when seeking placement to ensure a high-yielding experience (Figure 1). This framework includes expressing interest to a specific program, attaining funding, maximizing research productivity, creating meaningful mentorship connections and improving skills as a future resident through clinical opportunities.

An Elite Privilege: Top-Ranked Medical Schools Provide Fewer Comparative Performance Data on Their Students.

The objective of this study was to determine differences in the reporting of performance data on medical student performance evaluations (MSPEs) by medical school ranking. MSPEs from all US allopathic and osteopathic medical schools received by a single diagnostic radiology residency program during the 2021-2022 application cycle were retrospectively reviewed. Preclinical class and core clerkship grades were categorized as pass/fail or multitiered. Comparative summative assessments provided in the MSPEs were recorded. Medical schools were grouped by their US News & World Report rankings, and the proportion of reported performance metrics for each group was compared. Information from 95% of US allopathic medical schools (148 of 155) and 73% of osteopathic medical schools (27 of 37) was collected, on the basis of 1,046 applications received. For preclinical classes, multitiered grading was reported by no schools ranked in the top 10, 17% of schools ranked 11th to 50th, 52% of schools ranked 51st to 100th, and 59% of unranked schools (P < .001). For core clinical clerkships, multitiered grades were reported by 70% of the top 10 ranked schools, 90% of schools ranked 11th to 50th, 94% of those ranked 51st to 100th, and 94% of unranked schools (P= .0463). Comparative summative assessments were reported by none of the top 10 ranked schools, 56% of schools ranked 11th to 50th, 80% of those ranked 51th to 100th, and 81% of unranked schools (P < .001). Higher ranked medical schools are less likely to provide comparative assessment data on their MSPEs, which may disadvantage students from lower ranked medical schools.

US Medical School Admissions Leaders’ Experiences With Barriers to and Advancements in Diversity, Equity, and Inclusion

Despite decades-long calls for increasing racial and ethnic diversity, the medical profession continues to exclude members of Black or African American, Hispanic or Latinx, and Indigenous groups. To describe US medical school admissions leaders' experiences with barriers to and advances in diversity, equity, and inclusion. This qualitative study involved key-informant interviews of 39 deans and directors of admission from 37 US allopathic medical schools across the range of student body racial and ethnic composition. Interviews were conducted in person and online from October 16, 2019, to March 27, 2020, and analyzed from October 2019 to March 2021. Participant experiences with barriers to and advances in diversity, equity, and inclusion. Among 39 participants from 37 medical schools, admissions experience ranged from 1 to 40 years. Overall, 56.4% of participants identified as women, 10.3% as Asian American, 25.6% as Black or African American, 5.1% as Hispanic or Latinx, and 61.5% as White (participants could report >1 race and/or ethnicity). Participants characterized diversity broadly, with limited attention to racial injustice. Barriers to advancing racial and ethnic diversity included lack of leadership commitment; pressure from faculty and administrators to overemphasize academic scores and school rankings; and political and social influences, such as donors and alumni. Accreditation requirements, holistic review initiatives, and local policy motivated reforms but may also have inadvertently lowered expectations and accountability. Strategies to overcome challenges included narrative change and revision of school leadership structure, admissions goals, practices, and committee membership. In this qualitative study, admissions leaders characterized the ways in which entrenched beliefs, practices, and power structures in medical schools may perpetuate institutional racism, with far-reaching implications for health equity. Participants offered insights on how to remove inequitable structures and implement process changes. Without such action, calls for racial justice will likely remain performative, and racism across health care institutions will continue.