US Graduate Research Articles

Exploring clinician perspectives of systems-based practice: A physician training challenge.

Systems-based practice (SBP) has been a competency in US graduate medical education for over 20 years, but it is not well implemented. SBP is loosely defined as physician's responsiveness to the larger system of healthcare. The aim of this study was to describe healthcare professionals' perspectives regarding: (1) their knowledge and beliefs about SBP and (2) their beliefs regarding factors in clinical learning environments (CLE) that facilitate or hinder operationalisation and learning of SBP. Semi-structured interviews were conducted between November 2020 and April 2021 with 42 individuals from four health systems. Participants were healthcare professionals involved in graduate medical education, including physicians and interprofessional clinicians (e.g., nursing staff). Interviews were transcribed and coded using a social constructivist, codebook thematic analysis approach and themes were agreed upon through discussion amongst the research team. Five themes were constructed: (1) SBP remains a challenge to define, (2) SBP may be intuitively understood, particularly when framed at the microsystem level, (3) SBP aligns with the Health Systems Science framework, (4) SBP learning must be intentionally integrated into the CLE, through training such as onboarding and (5) multidisciplinary settings and work processes are critical to engage in SBP. Workload compression is a barrier to SBP implementation. Healthcare professionals highlighted that current CLEs are not designed to prioritise SBP. Graduate medical education programmes may benefit from focusing systems content at the microsystem level and purposefully integrating onboarding procedures, clinical settings and rotations specifically designed to teach SBP into their residencies.

Greener pastures: why Indian international students leave the US labor market

ABSTRACT This paper revisits conventional wisdom on US degree premiums for immigrant workers and shows that, despite the benefits of a US degree, migration policies and substandard labor conditions contribute to international student motivations to return home. Using two original datasets, I find that about a third of Indian-born US graduates leave the US, seeking employment opportunities abroad and a respite from US work visa restrictions. I draw on 105 in-depth interviews and 7,177 employment histories constructed from LinkedIn, and the analysis demonstrates the use of digital data to shed new light on under-studied patterns of return migration in institutional perspective. I find that US work visas are related to the underemployment of immigrant workers, and gaps in visa availability are associated with US labor market departure for Indian international students. At the same time, foreign employers reward skills and credentials developed in the US, and the results suggest that US degrees carry a higher premium in foreign labor markets. The paper emphasizes the role of institutions in the skilled migration system and identifies disjunctures in US migration policy. I identify opportunities for policy reform to improve immigrant labor conditions and increase the retention of US-educated migrants in the US labor market.

Predictors for success and failure in international medical graduates: a systematic review of observational studies

BackgroundInternational Medical Graduates (IMG) are an essential part of the international physician workforce, and exploring the predictors of success and failure for IMGs could help inform international and national physician labour workforce selection and planning. The objective of this study was to explore predictors for success for selection of IMGs into high stakes postgraduate training positions and practice and not necessarily for informing IMGs.MethodsWe searched 11 databases, including Medline, Embase and LILACS, from inception to February 2022 for studies that explored the predictors of success and failure in IMGs. We reported baseline probability, effect size in relative risk (RR), odds ratio (OR) or hazard ratio (HR) and absolute probability change for success and failure across six groups of outcomes, including success in qualifying exams, or certificate exams, successful matching into residency, retention in practice, disciplinary actions, and outcomes of IMG clinical practice.ResultsTwenty-five studies (375,549 participants) reported the association of 93 predictors of success and failure for IMGs. Female sex, English fluency, graduation recency, higher scores in USMLE step 2 and participation in a skill assessment program were associated with success in qualifying exams. Female sex, English fluency, previous internship and results of qualifying exams were associated with success in certification exams. Retention to work in Canada was associated with several factors, including male sex, graduating within the past five years, and completing residency over fellowships. In the UK, IMGs and candidates who attempted PLAB part 1, ≥ 4 times vs. first attempters, and candidates who attempted PLAB part 2, ≥ 3 times vs. first attempters were more likely to be censured in future practice. Patients treated by IMGs had significantly lower mortalities than those treated by US graduates, and patients of IMGs had lower mortalities [OR: 0.82 (95% CI: 0.62, 0.99)] than patients of US citizens who trained abroad.ConclusionsThis study informed factors associated with the success and failure of IMGs and is the first systematic review on this topic, which can inform IMG selection and future studies.Systematic review registrationPROSPERO: CRD42021252678.

Examining the Role of Physician Characteristics in Web-Based Verified Primary Care Physician Reviews: Observational Study.

Doctor review websites have become increasingly popular as a source of information for patients looking to select a primary care provider. Zocdoc is one such platform that allows patients to not only rate and review their experiences with doctors but also directly schedule appointments. This study examines how several physician characteristics including gender, age, race, languages spoken in a physician's office, education, and facial attractiveness impact the average numerical rating of primary care doctors on Zocdoc. The aim of this study was to investigate the association between physician characteristics and patient satisfaction ratings on Zocdoc. A data set of 1455 primary care doctor profiles across 30 cities was scraped from Zocdoc. The profiles contained information on the physician's gender, education, and languages spoken in their office. Age, facial attractiveness, and race were imputed from profile pictures using commercial facial analysis software. Each doctor profile listed an average overall satisfaction rating, bedside manner rating, and wait time rating from verified patients. Descriptive statistics, the Wilcoxon rank sum test, and multivariate logistic regression were used to analyze the data. The average overall rating on Zocdoc was highly positive, with older age, lower facial attractiveness, foreign degrees, allopathic degrees, and speaking more languages negatively associated with the average rating. However, the effect sizes of these factors were relatively small. For example, graduates of Latin American medical schools had a mean overall rating of 4.63 compared to a 4.77 rating for US graduates (P<.001), a difference roughly equivalent to a 2.8% decrease in appointments. On multivariate analysis, being Asian and having a doctor of osteopathic medicine degree were positively associated with higher overall ratings, while attending a South Asian medical school and speaking more European and Middle Eastern languages in the office were negatively associated with higher overall ratings. Overall, the findings suggest that age, facial attractiveness, education, and multilingualism do have some impact on web-based doctor reviews, but the numerical effect is small. Notably, bias may play out in many forms. For example, a physician's appearance or accent may impact a patient's trust, confidence, or satisfaction with their physician, which could in turn influence their take-up of preventative services and lead to either better or worse health outcomes. The study highlights the need for further research in how physician characteristics influence patient ratings of care.

OBGYN Specialty Qualifying Exam Score Improvement from 2018-2023

Background: All US graduate OBGYN candidates must pass a Specialty Qualifying Exam, also known as the written board exam, before being able to take the Specialty Certifiying Exam, also known as the oral board exam. There has been emphasis on appropriate preparation. Introduction: This study’s aim was to review the Specialty Qualifying Exam results from graduating residents between the years 2018 and 2023. There has been a notable change through an improved didactic schedule. This included incorporating a question bank and test preparation throughout the year. Methods: The passage rate per graduating class year for Corewell Health East- Dearborn was compared in three-year windows. We compared the passage rate of 2018 to 2020 to the passage rate of 2021 to 2023. Study Design: The didactic schedule emphasized areas of weakness identified in the prior year, a gamified question bank, and test preparation was initiated at the beginning of the academic year. Residents were also given a personal analysis with areas of improvement from prior years and a faculty liaison. Results: From 2018 to 2020, the three-trend noted overall 73.7% passage rate, with an 83.3% first time passage rate and a 57.1% repeat test passage rate. Compared to the three-year trend from 2021 to 2023 resulting in a 100% overall passage rate, 100% first time passage rate and 100% repeat test passage rate. Discussion: Over six years, our residency didactic schedule and learning environment was revamped by our residents and faculty, and as a result, there has been improvement in the Specialty Qualifying Exam by our graduating residents. We have maintained our commitment to recruit residents with diverse backgrounds who have come from US MD, US DO and foreign medical schools. Conclusion: The improvement in scores will continue to guide future changes in our didactic schedule.

(073) WOMEN'S SEXUAL DYSFUNCTION TRAINING MODULE INCREASES SCREENING COMFORT

Abstract Introduction Sexual dysfunction in women affects approximately 40% of patients, however, many providers fail to screen for it. The continual lack of screening presents limited opportunities for healthcare trainees to observe, learn and master this skill. Approximately half of medical students feel inadequately prepared to discuss these diagnoses with patients. For this reason, experts advocated a multidisciplinary, longitudinal sexual health education approach to address the exposure of women’s sexual health in the clinical setting. In order to address this issue, our institution created a module focusing on sexual dysfunction in women to educate healthcare students on screening, assessment and baseline treatment for the most common dysfunction, hypoactive sexual desire disorder or decreased libido. This module was created by a gynecologist and reviewed by professors in the psychology department and graduate nursing school. Additionally, it was approved by the medical school for use. It simulates a clinical rotation to emphasize screening for sexual dysfunction in women and baseline evaluation of decreased libido using a biopsychosocial model. Objective The primary aim of this study is to evaluate changes in students’ comfort level who screen for women’s sexual dysfunctions after completion of the Female Sexual Dysfunction Module. Additionally, we aim to assess the over baseline level of comfort in screening and determine if knowledge about when to screen is gained through the module. Methods This study was IRB approved. US medical students and graduate nursing students were approached via email to complete demographic information, a pre-survey, module, and post-survey. In the redcap survey, participants were asked to identify scenarios appropriate to broach the subject of a patient's sexual functioning. Additionally, they were asked to rate their comfort level asking patients about sexual desire, dyspareunia, and anorgasmia as well as general knowledge-based questions about sexual dysfunction in women. Results This study surveyed 425 medical students and nursing students from over 70 institutions across the US. Compared to their pre-module response, more respondents felt it was appropriate to query patients about their sexual functioning following the module (all p &amp;lt; .05). Respondents were also far more comfortable asking patients about their sexual health after the module compared to pre-module responses (all p &amp;lt; .05). Compared to their pre-module response, more respondents correctly identified the components of the linear female sexual response cycle created by Masters and Johnson (24.8% versus 61.6%; p &amp;lt; .001), and more respondents identified the components of the Plisst screening model (6.3% versus 53.7%; p &amp;lt; .001). Conclusions This nationwide study demonstrates our module provides statistical improvement in students’ comfort level when screening for female sexual dysfunction. It agrees with previous studies in terms of healthcare trainees’ overall lower baseline aptitude with this diagnosis and shows that this module statistically increases knowledge These results support using interactive modules in healthcare training curricula in order to standardize training. It can be especially helpful for schools where clinical exposure to this diagnosis is sparse. To further elucidate the most efficacious method of teaching, this study recommends future directions to assess the various models of sexual medicine education. Disclosure No.

Geographic Proximity of Medical Students to PM&R Residency Programs Is Associated With Increased Match Rates Into PM&R.

Despite the growing popularity of physical medicine and rehabilitation as a specialty among medical students, meaningful experiences and mentorship can be challenging to obtain and may significantly vary depending on opportunities available to interact with physiatrists. This study explores the association between the geographic proximity of physical medicine and rehabilitation residency programs to medical schools and the match rate of medical students into physical medicine and rehabilitation from 2019 to 2021. Data on US medical schools, graduates, and physical medicine and rehabilitation residency programs were collected from publicly available sources, and a sample of 1193 physical medicine and rehabilitation residents from US medical schools was analyzed using a one-sample proportion test. The proportion of physical medicine and rehabilitation residents originating from medical schools with physical medicine and rehabilitation residency programs in the same metropolitan area was significantly greater than the corresponding proportion of expected residents based on medical school graduates, even when controlling for medical school affiliations with physical medicine and rehabilitation residency programs. These findings suggest that exposure and opportunities provided by physical medicine and rehabilitation residency programs may influence nearby medical students and that expanding residency programs into geographic regions without existing physical medicine and rehabilitation programs may foster interest and promote growth in the field of physiatry.

Graduate education and government policy in times of crisis: a case study of the United States during the COVID-19 pandemic

PurposeThe purpose of this paper is to understand US federal government policy during the early stages of the COVID-19 pandemic and the connections to graduate education. Using the multiple streams framework, the paper outlines these actions through various streams (problems, policy and political) and perspectives (defining problems, articulating options and mobilizing responses).Design/methodology/approachThe primary sources of data collected for this study were US federal government policies from March 2020 through May 2021. Policies were examined through introduction, implementation and alteration (when possible) within the specific time period of the study. The policies outlined in this paper were connected to the US Department of Education, and to a lesser extent, the National Institutes of Health, the National Science Foundation and other federal agencies. Data analysis was a two-fold process. First, the individual policy was considered as a single case and second, a cross-case comparison occurred across the multiple cases.FindingsAnalysing the study’s data in the problem stream provides a strong indicator of how the pandemic was perceived as a challenge for US graduate education. The pandemic served as a focusing event and illuminated the connections of graduate education to key institutional functions, including research and teaching. Broadly, US federal policy actions in this area focused on giving institutions resources and flexibility to support graduate students and allow them to continue their academic work while also seeding funding and incentives to continue the movement of knowledge, activities and people in the research pipeline. Actions in the policy stream aligned with the decentralized nature of the US higher education system and allowed for choice by academic institutions within the parameters of options.Originality/valueThis paper extends extant literature related to policy-making and graduate education to consider policy-making during a time of crisis. The paper offers methodological and conceptual ideas for consideration in future research.

The Positive Association between Grit and Mental Toughness, Enhanced by a Minimum of 75 Minutes of Moderate-to-Vigorous Physical Activity, among US Students

Drawing from the 2015 Gucciardi et al.’s mental toughness (MT) framework, this study examines the association between grit and MT in US college students, while considering the moderating role of at least 75 min of moderate-to-vigorous physical activity (MVPA) based on recommendations from the American College of Sports Medicine. We administered the Grit-S Scale and the Mental Toughness Index in two samples of a total of 340 US undergraduate student-athletes and graduate students. The Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was employed to ensure internal validity, while statistical procedures including principal component analysis and regression models were utilized to analyze the collected data. A weighted component combining grit and the interaction between MVPA and grit significantly predicted MT, explaining 23% of its variability. Drawing from a specific conceptual framework, this study provides novel insights into the relationship between grit, engagement in at least 75 min of MVPA per week, and MT among US collegiate students. The findings support a positive association between grit, MVPA, and both MT and a specific component of MT, highlighting the significance of these factors in enhancing performance and suggesting potential implications for future research and practical applications in the field.

Measuring novice auditor orientation and its impact on judgment

PurposeThe purpose of this study is to construct and test a new measure of auditor orientation using two audit quality-related tasks.Design/methodology/approachThe sample consists of 66 Dutch and US graduate auditing students. Participants complete two tasks: one involving a lease classification and another, supplemental experiment involving a contingent liability judgment. The purpose is to construct a new measure for rules-based/ principles-based orientation. Rigorous, psychometric testing confirms that parts of tolerance for ambiguity (TOA) and need for cognition (NFC), together, form a new construct the authors identify as auditor orientation. The authors next conduct a main and supplemental experiment with novice auditor participants from both the USA and the Netherlands.FindingsThe authors begin with rigorous, psychometric testing using participants from the USA and the Netherlands. The resulting 10-item scale combines parts of TOA and NFC to reflect auditor orientation. The common themes across scale items are high (low) adaptability to complexity and a substance-over-form (form-over-substance) preference for principles-oriented (PO) (rules-oriented [RO]) auditors. Conducting two experiments, results from two distinct tasks confirm our research question; novice auditors classified as RO (PO) are more (less) likely to recommend a more aggressive/client-favorable disclosure judgment.Originality/valueAuditor orientation (i.e. rules or principles) has a significant impact on the application of rules-based or principles-based standards. How the standards are applied, therefore, influences auditor decision-making and thus audit quality. However, there is a paucity of auditor orientation research to date, including a validated measure. The study contributes a new measure for future research in the related accounting standards and audit quality literatures, while also identifying a potentially important construct in auditor training.

International Medical Graduates and the Shortage of US Pathologists: Challenges and Opportunities.

Physician shortages are affecting many communities across the United States and all medical specialties, including pathology. International medical graduates (IMGs) make up a significant proportion of US physicians and graduate medical education (GME) trainees, including pathologists. However, noncitizen IMGs continue to face great challenges in entering the US health care workforce. To show recent and historical data on noncitizen IMGs in pathology GME training and current limitations on them remaining in the US health care workforce. Compared with applicants who do not need a visa, applicants who need a visa to train in the United States have a greatly reduced chance of matching to a residency program. After completion of residency and fellowship, noncitizen IMGs with J-1 visas face the 2-year home country residence requirement unless they obtain a waiver. H-1B visas facilitate the transition to independent practice but have limited availability. Job announcements for pathologists often do not indicate whether J-1 and H-1B visa holders are considered, which makes the job search process difficult for noncitizen IMGs. Academic and nonacademic institutions with departments of pathology should increase awareness of the pathologist shortage in the United States and the rules and regulations that limit hiring of non-US IMGs. Such institutions should also actively educate policymakers to promote durable solutions to these issues. One potential solution to these shortages may be to make it easier for noncitizen IMGs to access GME and join and remain in the US physician workforce.

Differences in support within the social science graduate admissions pipeline

PurposeThe purpose of this paper is to understand demographic group (race, first-generation college graduate, gender, age) differences among perceived family and faculty social and family financial support within the US graduate school admissions pipeline in the social sciences.Design/methodology/approachUsing data from a cross-sectional convenience sample survey (N = 99), this paper looks at ordinal social support variables (faculty member support, family social support and family financial support) by demographic groups. This paper uses a Mann–Whitney U test to compare first-generation status, race and gender and a Kruskal–Wallis H test to compare age groups.FindingsThis paper finds that applicants over 27 years old had significantly less faculty support in the graduate admissions pipeline compared to other age groups; differences in faculty support across race were marginally significant (p = 0.057). Regarding family social support, this paper finds first-generation applicants, male applicants and applicants over 27 years old report lower levels of support. Finally, this paper finds first-generation applicants and applicants over 27 years old report lower levels of familial financial support.Originality/valuePrevious literature on graduate admissions – published in this journal (Pieper and Krsmanovic, 2022) and others – does not consider experiences up to and before applicants hit the “submit” button on graduate applicants, which the authors term the graduate admissions pipeline. Instead, most previous literatures focus on faculty committees and validity of required application materials. Thus, this study begins to answer Posselt and Grodsky’s (2017) call to develop an understanding of applicant experiences and support within the graduate admissions pipeline.

Influential Radiology Figures and Organizations in Social Media

PurposeWith social media becoming a vibrant hub for the radiology community, highlighting expert leaders and trustful conduits of information in the virtual field is proving crucial. The aim of this study was to identify and describe the most prominent and influential figures and organizational accounts to follow in radiology. MethodsInfluence scores for the topic “radiology” on Twitter (now known as X) were computed using the Right Relevance machine learning service. Top influencers were classified according to gender, geography, physician degree, areas of influence, subspecialization, influence score, title, affiliated institution, dual degree, medical school origin, content type, and research activity. Statistical analysis was performed assessing variable correlations. ResultsIn the top quartile of influential figures, 87% were physicians, 60% men, and 93% located in the United States. Prevalent backgrounds included neuroradiology (21%), abdominal imaging (12%), and artificial intelligence (11%). Of the top 100 figures, 81% were US graduates, 97% held medical degrees, and 28% had dual degrees. Fifty-eight percent provided educational content. A majority held leadership positions (58%) and academic professorship titles (70%). The median h index, publication number, and citation number were 14, 49, and 881, respectively. No significant correlation was noted between influence score and academic rank or research output. ConclusionsVirtual presence is becoming integral to health care professions and academic spheres, unfolding great potential for enhancing the sense of belonging, advocacy, recruitment, and fostering new relationships. Having a core of influential leaders and organizations to follow can serve as a resource for the community members and aspiring students building a positive connected basis for radiology’s thriving future.

Workforce diversity in cardiothoracic surgery: An examination of recent demographic changes and the training pathway

IntroductionThe purpose of our study was to examine changes in the demographic makeup of resident physicians in integrated 6-year cardiothoracic surgery and traditional thoracic surgery residency programs from 2013 to 2022 compared with other surgical subspecialties and determine potential leaks in the training pathway. MethodsData from US Graduate Medical Education reports from 2013 to 2022 and medical student enrollment data from the Association of American Medical Colleges were obtained. Average percentages of women and underrepresented minorities were calculated in 2 5-year intervals: 2013 to 2017 and 2018 to 2022. Average percentages of women, Black, and Hispanic medical students and residents were calculated for the 2019 to 2022 period. Pearson χ2 tests were conducted to determine significant differences in proportions of women, Black/African American, and Hispanic trainees across time (α = 0.05). ResultsThoracic surgery and I6 residents saw a significant increase in the proportion of women trainees across the 2 time periods (19.9% (210 out of 1055) to 24.6% (287 out of 1169) (P < .01) and 24.1% (143 out of 592) to 28.9% (330 out of 1142) (P < .05)), respectively. There was no significant change in the proportion of Black and Hispanic trainees in thoracic surgery fellowship or integrated 6-year cardiothoracic residency programs. Hispanic trainees were the only group whose proportion of cardiothoracic surgery trainees was not significantly lower than their medical school proportion. Women and Black trainees had significantly lower proportions of thoracic surgery residents and integrated 6-year cardiothoracic residency program residents than their proportions in medical school (P < .01). ConclusionsCardiothoracic surgery has not significantly increased the number of Black and Hispanic trainees during the past decade. The lower proportion of Blacks and women in thoracic surgery residency and fellowship programs compared with their proportion in medical schools is concerning and is an opportunity for intervention.

EDITORIAL COMMENT

In the realm of surgical training, reliance on operative logs or number of hours worked is simply not adequate to assess and demonstrate competency. Indeed, a recent survey of US graduates of urology residency programs showed a perceived lack of confidence in several procedures that are commonly encountered in a general urologic practice. 1 Okhunov Z. Safiullah S. Patel R. et al. Evaluation of urology residency training and perceived resident abilities in the United States. J Surg Educ. 2019; 76 (Jul–Aug): 936-948 Crossref PubMed Scopus (39) Google Scholar

International Medical Graduates in Radiology Residencies: Demographics, Performance, and Visa Issues

The number of international medical graduates (IMG) in radiology residencies has varied from year to year even as the number of candidates continues to grow. It is unclear from which countries the IMGs are arriving and what visas are being used to accommodate them. We sent a survey to 195 program directors (PD) in diagnostic radiology (DR) inquiring about the number and nationality of IMG residents in their program, their attitudes about IMG candidates, the performance of their IMG trainees, and the visas that are offered. We received responses from 121 of 195 (62.1%) DR programs (121/149=81.2% of actionable emails). 80/121 (66.1%) had at least one IMG in their DR residency program and the countries of origin included India (36), Iran (30), Saudi Arabia (24), Egypt (16), Canada (14), Brazil (14), and Pakistan (9), as the most common. While most programs (76/104, 73.1%) offered J1 visas, 23/99 (23.2%) provided H-1B visas to trainees. IMG DR residents overall performed as well as American graduates, with an equal number of PDs saying IMGs performed better and worse than American graduates. PDs' issues with IMGs centered on visas: (1) expense, (2) lack of familiarity, (3) Educational Commission for Foreign Medical Graduates regulations, and (4) time commitment in submitting paperwork. Most radiology IMG residents originate from India and Middle Eastern countries. Once enrolled, IMG residents perform similarly to US graduates. However, adding IMG candidates to the training program requires overcoming bureaucratic and monetary hurdles around visas. Most DR international medical graduate residents are from India or the Middle East. Although their performance is the same as American graduates in general, PDs note the monetary and bureaucratic hassles accompanying their recruitment.

Correlation between USMLE Step scores, personal attributes and RITE exam performance among neurology residents at an academic center. (S13.003)

<h3>Objective:</h3> We aimed to investigate the correlation between USMLE scores and personal attributes with Residency in-training exam (RITE) performance among residents at our academic neurology residency training program. <h3>Background:</h3> Studies assessing medical and surgical residents’ performance during training and its relation to USMLE Step scores have found differing correlations among different medical specialties. This correlation has never been studied among neurology residents. <h3>Design/Methods:</h3> Data on 51 neurology residents at Medical University of South Carolina between 2005 and 2020 was analyzed. Resident personal attributes included were gender, age at residency enrollment, medical school location, awards/honor degrees during medical school, presence of advanced degree/completion of another residency program, number of peer reviewed publications, and years from medical school graduation. Correlation analysis was conducted between Step 1 and Step 2 CK scores with RITE Exam scores, respectively. Repeated measures ANOVA was utilized to examine differences in mean RITE scores of residents with/without above personal attributes. <h3>Results:</h3> Mean age at residency enrollment was 30.92 years(25 – 48). 68.6% residents were males and 50.9% were IMGs. Statistically significant strong positive correlations were found between Step 1 and RITE scores (PGY-2 r = 0.6, PGY-4 r = 0.69, p&lt;0.01). Weaker but statistically significant positive correlations were found between Step 2 CK and RITE scores (PGY-2 r= 0.56, PGY-4 r = 0.52, p&lt;0.01). Mean PGY-2 RITE score for IMGs was higher than US graduates (p&lt;0.05). Residents with ≥6 publications, and those with honors/award during medical school had higher RITE scores compared to those without. There was no significant difference in RITE scores of males and females, those with and without advanced degrees and those with and without gap years between medical school and residency. <h3>Conclusions:</h3> USMLE Step 1 and Step 2 CK scores, medical school location, awards/honor degrees during medical school, and ≥6 publications correlate with higher RITE scores among neurology residents. <b>Disclosure:</b> Mrs. Al Issa has nothing to disclose. Dr. Kohli has nothing to disclose. Dr. Banerjee has nothing to disclose.

MP25-20 TRENDS IN THE GLOBAL ENDOUROLOGY TRAINING PIPELINE: CONTEMPORARY ANALYSIS OF FELLOWSHIP MATCH OUTCOMES

You have accessJournal of UrologyCME1 Apr 2023MP25-20 TRENDS IN THE GLOBAL ENDOUROLOGY TRAINING PIPELINE: CONTEMPORARY ANALYSIS OF FELLOWSHIP MATCH OUTCOMES Garrett Ungerer, Reza Roshandel, Aaron Potretzke, and Kevin Koo Garrett UngererGarrett Ungerer More articles by this author , Reza RoshandelReza Roshandel More articles by this author , Aaron PotretzkeAaron Potretzke More articles by this author , and Kevin KooKevin Koo More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003253.20AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The proportion of urology residents who choose to pursue fellowship training has steadily increased over the past decade. The Endourological Society fellowship match allocates fellowship positions for advanced endoscopic and minimally invasive surgical training in 83 programs across 5 continents. To understand contemporary trends in the global endourology training pipeline, we aimed to analyze results of the annual endourology fellowship match, conducted by the American Urologic Association. METHODS: We analyzed endourology fellowship match statistics from the AUA for the match years 2014-2023 to characterize trends in application volumes, vacancies, applicants, and successful matches. RESULTS: Over the past 10 years, the number of applicants entering the match increased from 54 to 86. In parallel with this increasing demand in fellowship training, the number if training opportunities has increased from 34 programs offering 36 positions in the 2014 match to 54 programs offering 59 positions in the 2023 match. Despite consistent excess of applicants relative to available positions, an average of 13 positions are unfilled each year (range 8-19) corresponding to 26% of available positions (range 18-43%). Of the potential reasons for this, applicant desirability did not appreciably change: an average of 75% of applicants (range 72%-80%) were ranked by programs each year. Increase in positions and applicants is occurring in parallel. For the prior 10 match cycles, programs received an average of 15 applications (range 14-18) and offered 7 interviews to applicants (range 6-9). Applicants consistently completed an average of 4 interviews (range 3-6). Finally, on average 75% of vacancies were filled by US graduating residents (range 55%-89%), compared to 17% by non-US-trained candidates and 8% by prior US graduates. The number of successful female candidates averaged 5 per year, increasing from 3 women in 2014 to 11 in 2023. CONCLUSIONS: Despite increasing applicant demand and global supply of endourology fellowship positions, only 3 out of 4 applicants are ranked by programs, and a relatively high proportion of vacancies go unfilled each year. Female and non-US-trained candidates remain underrepresented. Strategies to bolster the endourology training pipeline merit increased attention. Source of Funding: none to report © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e350 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Garrett Ungerer More articles by this author Reza Roshandel More articles by this author Aaron Potretzke More articles by this author Kevin Koo More articles by this author Expand All Advertisement PDF downloadLoading ...

Point-of-Care Ultrasound Use in Nephrology: A Survey of Nephrology Program Directors, Fellows, and Fellowship Graduates.

Adoption of point-of-care ultrasound (POCUS) into nephrology practice has been relatively slow. We surveyed US nephrology program directors, their fellows, and graduates from a single training program regarding current/planned POCUS training, clinical use, and barriers to training and use. Anonymous, online survey. All US nephrology program directors (n=151), their fellows (academic year 2021-2022), and 89/90 graduates (1980-2021) of the Walter Reed Nephrology Program. Descriptive. 46% (69/151) of program directors and 33% (118/361) of their fellows responded. Response rate was 62% (55/89) for Walter Reed graduates. 51% of program directors offered POCUS training, most commonly bedside training in non-POCUS oriented rotations (71%), didactic lectures (68%), and simulation (43%). 46% of fellows reported receiving POCUS training, but of these, many reported not being sufficiently trained/not confident in kidney (56%), bladder (50%), and inferior vena cava assessment (46%). Common barriers to training reported by program directors were not enough trained faculty (78%), themselves not being sufficiently trained (55%), and equipment expense (51%). 64% of program directors and 55% of fellows reported<10% of faculty were able to perform POCUS. 64% of fellows reported having too little POCUS training. 72% of program directors and 77% of graduates felt POCUS should be incorporated into the fellowship curriculum. 59% of fellows and 61% of graduates desired hands-on POCUS training rather than didactic lectures or simulation. Loss of respondents as program directors and fellows progressed through the survey. Nephrology program directors, fellows, and graduates surveyed want POCUS training incorporated into the fellowship curriculum. No group felt sufficiently trained to confidently perform POCUS, and the major barrier to training was lack of sufficiently trained faculty. This highlights the need to "train the trainers" before POCUS can be fully integrated into fellowship training and regularly used in nephrology practice.

Rowing Together: Publicly Reported Quality of Care Measures, US Graduate Medical Education Accountability, and Patient Outcomes.

Rowing Together: Publicly Reported Quality of Care Measures, US Graduate Medical Education Accountability, and Patient Outcomes.