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Medical Graduates (medical + graduate)

Distribution by Scientific Domains

Medical Sciences	100%

Kinds of Medical Graduates

international medical graduate

Selected Abstracts

Do International Medical Graduates (IMGs) "Fill the Gap" in Rural Primary Care in the United States?

THE JOURNAL OF RURAL HEALTH, Issue 2 2009
A National Study
ABSTRACT:,Context: The contribution that international medical graduates (IMGs) make to reducing the rural-urban maldistribution of physicians in the United States is unclear. Quantifying the extent of such "gap filling" has significant implications for planning IMG workforce needs as well as other state and federal initiatives to increase the numbers of rural providers. Purpose: To compare the practice location of IMGs and US medical graduates (USMGs) practicing in primary care specialties. Methods: We used the 2002 AMA physician file to determine the practice location of all 205,063 primary care physicians in the United States. Practice locations were linked to the Rural-Urban Commuting Areas, and aggregated into urban, large rural, small rural, and isolated small rural areas. We determined the difference between the percentage of IMGs and percentage of USMGs in each type of geographic area. This was repeated for each Census Division and state. Findings: One quarter (24.8% or 50,804) of primary care physicians in the United States are IMGs. IMGs are significantly more likely to be female (31.9% vs 29.9%, P < .0001), older (mean ages 49.7 and 47.1 year, P < .0001), and less likely to practice family medicine (19.0% vs 38%, P < .0001) than USMGs. We found only two Census Divisions in which IMGs were relatively more likely than USMGs to practice in rural areas (East South Central and West North Central). However, we found 18 states in which IMGs were more likely, and 16 in which they were less likely to practice in rural areas than USMGs. Conclusions: IMGs fill gaps in the primary care workforce in many rural areas, but this varies widely between states. Policies aimed to redress the rural-urban physician maldistribution in the United States should take into account the vital role of IMGs. [source]

Inaccuracies on Applications for Emergency Medicine Residency Training

ACADEMIC EMERGENCY MEDICINE, Issue 9 2004
Martha S. Roellig MD
Abstract Objectives: Studies have shown erroneous claims of authorship by medical students applying for residency. Authors have hypothesized that investigation of advanced degrees, Alpha Omega Alpha (AOA) status, and peer-reviewed publications all show important rates of inaccuracy. Methods:A retrospective review of all applicants offered an interview for the authors' emergency medicine (EM) residency (entering class of 2002), excluding foreign medical graduates and current residents, was conducted. After verifying peer-reviewed publications by MEDLINE search and journal review, errors were tabulated as follows: reference not found, not referenced as an abstract, incorrect author list, or clerical error. AOA status was verified by the AOA organization. Advanced degrees were verified by the awarding institutions. Results: Of 194 applications screened (58.3% of applications), 21 (10.8%) were excluded (9 foreign medical graduates, 12 current residents). Multiple inaccuracies on a single application were counted separately. Of the 173 remaining applications, 23 (13.3%; 95% confidence interval [95% CI] = 8.8% to 19.5%) had at least one misrepresentation and seven of 173 (4.0%; 95% CI = 1.8% to 8.5%) had two or more. Authorship of at least one peer-reviewed article was claimed by 47 of 173 (27.2%), with ten of 47 (21.3%; 95% CI = 11.2% to 36.1%) having one inaccuracy and six of 47 (12.8%, 95% CI = 5.3% to 26.4%) having two or more. AOA membership was claimed by 14 applicants (8.1%), but five claims (35.7%, 95% CI = 14.0% to 64.4%) were inaccurate. Advanced degrees were claimed by 15 (8.7%); four (26.7%, 95% CI = 8.9% to 55.2%) were in error. Conclusions: Applications for EM residency contain frequent inaccuracies in publications listed, AOA status, and advanced degrees. Careful review of applications is necessary to ensure appropriate credit is given for claims of these types. [source]

The capacity of Australian ED to absorb the projected increase in intern numbers

EMERGENCY MEDICINE AUSTRALASIA, Issue 2 2010
Anthony Chong
Abstract As a reaction to the medical workforce shortage in Australia, a large expansion of undergraduate medical education has occurred through the provision of funding of additional medical student places. As a consequence, the number of medical graduates is anticipated to increase by as much as 90% with a peak in numbers anticipated in 2012. With ED already under pressure, this increase has serious implications for ED, particularly the delivery of intern and student teaching. This integrated review describes potential challenges that might arise from the predicted increase in intern numbers working in ED. A structured literature search was conducted from which 44 directly relevant articles were identified. We discuss the possible impact of an increased number of medical graduates on emergency medical staff, education, supervision and feedback to interns, and given the potential impacts on the education of junior doctors; we review the purpose and implementation of the Australian Curriculum framework for Junior Doctors in relation to their learning requirements. Although there is consensus by most postgraduate bodies that the core emergency term in emergency medicine should be retained, the impact of increased intern numbers might dramatically affect the clinical experiences, supervision and educational resources in the ED. This might necessitate cultural changes in medical education and ED function. [source]

Capturing the power of academic medicine to enhance health and health care of the elderly in the USA

GERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 1 2004
William R Hazzard
As in Japan, the US population is aging progressively, a trend that will challenge the health-care system to provide for the chronic, multiple and complex needs of its elderly citizens. and as in Japan, the US academic health enterprise has only belatedly mounted a response to that challenge. Herein is reviewed a quarter of a century of the author's personal experience in developing new programs in gerontology and geriatric medicine from a base in the Department of Internal Medicine at three US academic health centers (AHC): The University of Washington (as Division Head), Johns Hopkins University (as Vice-Chair), and Wake Forest University (as Chair). Rather than to build a program from a new department of geriatrics, this strategy was chosen to capture the power and resources of the department of internal medicine, the largest university department, to ,gerontologize' the institution, beginning with general internal medicine and all of the medical subspecialties (the approach also chosen to date at all but a handful of US AHC). The keystone of success at each institution has been careful faculty development through fellowship training in clinical geriatrics, education and research. Over the same interval major national progress has occurred, including expanded research and training at the National Institute on Aging and the Department of Veterans Affairs, and accreditation of more than 100 fellowship programs for training and certification of geriatricians. However, less than 1% of US medical graduates elect to pursue such training. Hence such geriatricians will remain concentrated at AHC, and most future geriatric care in the USA will be provided by a broad array of specialists, who will be educated and trained in geriatrics by these academic geriatricians. [source]

How prepared are medical graduates to begin prescribing?

INTERNAL MEDICINE JOURNAL, Issue 7 2009
P. Pillans
No abstract is available for this article. [source]

Research degrees for medical graduates

INTERNAL MEDICINE JOURNAL, Issue 9 2006
J. McCormack
No abstract is available for this article. [source]

Patient and physician predictors of inappropriate acid-suppressive therapy (AST) use in hospitalized patients,

JOURNAL OF HOSPITAL MEDICINE, Issue 8 2009
Jagdish S. Nachnani MD
Abstract BACKGROUND: The use of acid suppressive therapy (AST) in prevention of stress ulcers has been well defined in critical care patients, though its use has become increasingly common in general medicine patients, with little to no supportive evidence. None of the previous studies has examined the patient and physician characteristics of inappropriate AST initiation and use in hospitalized patients. The aim of our study was to identify: (1) the appropriateness of AST in hospitalized patients and the cost associated with inappropriate use; and (2) patient and physician characteristics predicting inappropriate initiation and use of AST. METHODS: All discharges over a period of 8 consecutive days were selected. RESULTS: There were 207 patients discharged over a period of 8 days. AST was inappropriately initiated in 92 of 133 (69.2%) patients included in our study. On univariate analysis, higher hemoglobin value, postgraduate year 1 (PGY-1) residents, physicians with an MD degree, international medical graduates (IMGs), and internal medicine physicians were more likely to prescribe AST inappropriately. On multivariate analysis, a higher hemoglobin value, PGY-1 residents, and MD physicians were factors associated with inappropriate AST use. The total direct patient cost for this inappropriate use was $8026, with an estimated annual cost of approximately $366,000. CONCLUSIONS: AST was inappropriately initiated in 69.2% of patients with increased direct costs of $8026. Residents in their first year of training as well physicians with a MD degree are more likely to initiate AST inappropriately. Curtailing the inappropriate use of AST therapy may reduce overall costs for the patient and institution. Journal of Hospital Medicine 2009;4:E10,E14. © 2009 Society of Hospital Medicine. [source]

Privacy, professionalism and Facebook: a dilemma for young doctors

MEDICAL EDUCATION, Issue 8 2010
Joanna MacDonald
Medical Education 2010: 44: 805,813 Objectives, This study aimed to examine the nature and extent of use of the social networking service Facebook by young medical graduates, and their utilisation of privacy options. Methods, We carried out a cross-sectional survey of the use of Facebook by recent medical graduates, accessing material potentially available to a wider public. Data were then categorised and analysed. Survey subjects were 338 doctors who had graduated from the University of Otago in 2006 and 2007 and were registered with the Medical Council of New Zealand. Main outcome measures were Facebook membership, utilisation of privacy options, and the nature and extent of the material revealed. Results, A total of 220 (65%) graduates had Facebook accounts; 138 (63%) of these had activated their privacy options, restricting their information to ,Friends'. Of the remaining 82 accounts that were more publicly available, 30 (37%) revealed users' sexual orientation, 13 (16%) revealed their religious views, 35 (43%) indicated their relationship status, 38 (46%) showed photographs of the users drinking alcohol, eight (10%) showed images of the users intoxicated and 37 (45%) showed photographs of the users engaged in healthy behaviours. A total of 54 (66%) members had used their accounts within the last week, indicating active use. Conclusions, Young doctors are active members of Facebook. A quarter of the doctors in our survey sample did not use the privacy options, rendering the information they revealed readily available to a wider public. This information, although it included some healthy behaviours, also revealed personal information that might cause distress to patients or alter the professional boundary between patient and practitioner, as well as information that could bring the profession into disrepute (e.g. belonging to groups like ,Perverts united'). Educators and regulators need to consider how best to advise students and doctors on societal changes in the concepts of what is public and what is private. [source]

Exploring barriers to teaching behavioural and social sciences in medical education

MEDICAL EDUCATION, Issue 3 2008
Andrea Litva
Context,Tomorrow's Doctors provides guidance about what is considered core knowledge for medical graduates. One core area of knowledge identified is the individual in society: graduates are required to understand the social and cultural environments in which medicine is practised in the UK. Yet, despite the presence of the behavioural and social sciences (B&SS) in medical curricula in the UK for the past 30 years, barriers to their implementation in medical education remain. Objective, This study sought to discover medical educators' perceptions of the barriers to the implementation of B&SS. Methods, Medical educationalists in all UK medical schools were asked to complete a survey identifying what they felt were the barriers they had experienced to the implementation of B&SS teaching in medical education. Results, A comparison of our findings with the literature revealed that these barriers have not changed since the implementation of B&SS in medical education. Moreover, the barriers remain similar across medical schools with differing ethos and strategies. Conclusions, Various agendas within the hidden curricula create barriers to effective B&SS learning in medical education and thus need further exploration and attention. [source]

Multiple mini-interviews: opinions of candidates and interviewers

MEDICAL EDUCATION, Issue 2 2008
Sarah Humphrey
Objectives, To assess candidates' and interviewers' perceptions of the use of a multiple mini-interview (MMI) for selection of senior house officers (SHOs) to a UK regional paediatric training programme. Methods, Both candidates and interviewers completed anonymous questionnaires (comprising 16 and 25 questions, respectively). Demographic data were recorded for both groups. Data were analysed by frequencies; using Mann,Whitney and Kruskall,Wallis tests for comparisons; and Cronbach's alpha for internal consistency within the data. Results, Both candidates and interviewers were positive about the fairness of the MMI (mean scores of 4.0 and 4.4, respectively). The majority of candidates (83%) had not been to this type of interview before. Gender, age and previous experience of MMIs did not account for differences in candidate responses (P > 0.05). A total of 86% of candidates were international medical graduates who preferred the format more than UK graduates did (P = 0.01). Interviewers were mainly experienced consultants who agreed that the multi-station format was better than the traditional interview (mean score 4.8) and represented a reliable process (mean score 4.4). Interviewers were concerned about the range of competencies covered and the subsequent performance of candidates in post (mean scores 3.6 and 3.2, respectively). Conclusions, Both candidates and interviewers agreed that the MMI format was reliable, fair and asked appropriate, easy-to-understand questions. In high-stakes interviews such as for specialty training in Modernising Medical Careers programmes, it is vital that all concerned have confidence in the selection process. [source]

Relevant behavioural and social science for medical undergraduates: a comparison of specialist and non-specialist educators

MEDICAL EDUCATION, Issue 10 2006
Sarah Peters
Aim, To compare what medical educators who are specialists in the behavioural and social sciences and their non-specialist counterparts consider to be core concepts that medical graduates should understand. Background, Previously perceived as ,nice to know' rather than ,need to know', the General Medical Council (GMC) now places behavioural and social sciences on the same need-to-know basis as clinical and basic sciences. Attempts have been made to identify what components of these topics medical students need to know; however, it remains unknown if decisions over programme content differ depending on whether or not educationalists have specialist knowledge of the behavioural and social sciences. Methods, In a survey of medical educationalists within all UK medical schools, respondents were asked to indicate from a comprehensive list of psychological, sociological and anthropological concepts what they considered a minimally competent graduate should understand. Comparisons were made between the concepts identified by specialist behavioural and social science (BSS) educators and those without such training. Results, Despite different disciplinary backgrounds, non-specialist educators largely concurred with BSS specialist educators in the concepts they considered tomorrow's doctors should know about. However, among BSS specialists there remained disagreement on what BSS content was relevant for graduates. Differences reflect specialist knowledge and recognition of the role of theoretical underpinning of BSS and reveal gaps in non-specialists knowledge. Conclusions, Educationalists with formal training in the full range of behavioural and social sciences should be involved in the development of BSS curriculum content at both national and school levels. [source]

Critical factors in career decision making for women medical graduates

MEDICAL EDUCATION, Issue 4 2003
Joanna Lawrence
Background, Within the next 30 years there will be equal numbers of women and men in the medical workforce. Indications are that women are increasing their participation in specialties other than general practice, although at a slower rate than their participation in the workforce as a whole. To inform those involved in training and employment of medical women, this study investigated the influencing factors in career decision making for female medical graduates. Methods, A total of 305 women medical graduates from the University of Auckland responded to a mail survey (73% response rate) which examined influences on decision making, in both qualitative and quantitative ways, as part of a larger survey. Results, Most women were satisfied with their careers. The principal component analysis of the influencing factors identified four distinct factors important in career choice , interest, flexibility, women friendliness and job security, although the first two of these were rated more highly than the others. Conclusions, Barriers to full participation by medical women in training and employment need to be systematically examined and removed. This is not only to allow women themselves to reach their full potential, but for workforce and socio-economic reasons. Initiatives that allow and value more flexible training and work practices, particularly through the years of child raising, are necessary for women and the health care workforce at large. [source]

Doctors' professional values: results from a cohort study of United Kingdom medical graduates

MEDICAL EDUCATION, Issue 8 2001
Lorelei Cooke
Objectives To examine young doctors' views on a number of professional issues including professional regulation, multidisciplinary teamwork, priority setting, clinical autonomy and private practice. Method Postal survey of 545 doctors who graduated from United Kingdom medical schools in 1995. Results Questionnaires were returned by 95% of the cohort (515/545). On issues of professional regulation, teamwork and clinical autonomy, the majority of doctors held views consistent with current General Medical Council guidance. The majority supported the right of doctors working in the NHS to engage in private practice. Most respondents thought that public expectations of doctors, medicine and the NHS were too high, and that some form of rationing was inevitable. On many issues there was considerable variation in attitudes on the basis of sex and intended branch of medicine. Conclusions The results highlight the heterogeneity of the profession and the influence of specialty and gender on professional values. Doctors' attitudes had also been shaped by broader social changes, especially debates surrounding regulation of the profession, rising public expectations and the need for rationing of NHS care. [source]

Comparison of methods for teaching clinical skills in assessing and managing drug-seeking patients

MEDICAL EDUCATION, Issue 4 2000
Taverner
Aims New medical graduates lack clinical skills in assessing and managing patients seeking drugs of dependence. This study compares the effectiveness of three different clinical skills training methods, with similar content, which were developed to teach these skills to senior medical students. Methods A preliminary survey indicated that common problems seen by primary care practitioners included both new and previously known patients seeking either benzodiazepines or opiates. The common content of the teaching was determined from this survey. A didactic small group tutorial (DT), a video-based tutorial (VBT) using professional actors, and a computer-aided instruction package using digitized video (CAI) were developed with this common content, and trialled with undergraduate medical students over 2 years in a parallel-group design. Outcome was assessed by student feedback, performance on a case-based written examination and by a structured evaluation of interviews with simulated patients requesting drugs. Comparison was also made between methods on the basis of knowledge tests. Results No difference was seen in written examination and simulated patient outcomes between the three groups. However, the VBT was thought by the students to be preferable to other methods. The estimated development costs of CAI were higher, but total costs over a 6-year period were lower than for the DT and VBT. The results suggest that clinical skills can be taught equally effectively through several different methods. Collaboration between institutions in the development of widely applicable CAI tools should be an efficient and economical mode of teaching with a wide range of applications. [source]

International medical graduates: Learning for practice in Alberta, Canada

THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS, Issue 3 2007
Jocelyn Lockyer PhD
Abstract Introduction: There is little known about the learning that is undertaken by physicians who graduate from a World Health Organization,listed medical school outside Canada and who migrate to Canada to practice. What do physicians learn and what resources do they access in adapting to practice in Alberta, a province of Canada? Methods: Telephone interviews with a theoretical sample of 19 IMG physicians were analyzed using a grounded theory constant comparative approach to develop categories, central themes, and a descriptive model. Results: The physicians described two types of learning: learning associated with studying for Canadian examinations required to remain and practice in the province and learning that was required to succeed at clinical work in a new setting. This second type of learning included regulations and systems, patient expectations, new disease profiles, new medications, new diagnostic procedures, and managing the referral process. The physicians "settled" into their new setting with the help of colleagues; the Internet, personal digital assistants (PDAs), and computers; reading; and continuing medical education programs. Patients both stimulated learning and were a resource for learning. Discussion: Settling into Alberta, Canada, physicians accommodated and adjusted to their settings with learning activities related to the clinical problems and situations that presented themselves. Collegial support in host communities appeared to be a critical dimension in how well physicians adjusted. The results suggest that mentoring programs may be a way of facilitating settlement. [source]

Do International Medical Graduates (IMGs) "Fill the Gap" in Rural Primary Care in the United States?

AL03 ADVERSE EVENTS: OUR RESPONSIBILITY FOR REPORTING, REVIEWING AND RESPONDING

ANZ JOURNAL OF SURGERY, Issue 2009
J. Collins
The sustained production of competent surgeons in sufficient numbers to meet the increasing needs of society commences with recruitment and selection of the most able medical graduates. As the process begins through self-selection, accurate information must be readily available to enable these graduates make an informed judgement on their career choice. Each surgical discipline aspires to use best practice selection in order to identify those who have the potential to acquire the necessary standard of technical and non technical skills and attributes required to practice as a surgeon. A selection system must rank applicants effectively and be reliable, valid, fair, defensible, cost effective and feasible. Best practice selection commences with an analysis of the relevant knowledge, skills, abilities and attitudes associated with successful performance in the particular target job. This information is used to construct a person specification in order to identify selection criteria at a level appropriate for entry to training. Selection methods are then chosen which will best elicit measurable applicant behaviour related to these selection criteria. A number of selection methods are used which include structured references, curriculum vitae and interviews. Other methods available although rarely used include tests of mental ability, aptitude tests and personality inventories. More recently selection or assessment centres (a selection method, not a place) involving a combination of selection techniques such as written exercises, interviews and work simulations have been shown to be highly effective. Eligibility criteria for application (long listing), shortlising for interview, scoring of items within each selection method and overall % weighting for each method are important variables in the selection process. [source]

Cancer curriculum in the Asia,Pacific: Opportunities and challenges in the age of globalization

ASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY, Issue 4 2005
Bogda KOCZWARA
Abstract With the rising incidence and prevalence of cancer in Asia,Pacific, the need for adequate cancer education of medical graduates in the region has become particularly urgent. There are 769 medical schools across the Asia,Pacific region in 33 countries serving over 60% of the world population in very diverse socioeconomic environments. This paper discusses some of the challenges for medical education in the Asia,Pacific in light of increasing globalization of health care, including the need to develop global standards in the area of diverse resources and health care priorities. It also points out emerging opportunities including online learning, telemedicine and collaborative educational initiatives across the region. [source]

Career choices for obstetrics and gynaecology: national surveys of graduates of 1974,2002 from UK medical schools

BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 3 2006
G Turner
Objective, To report the trends in career choices for obstetrics and gynaecology among UK medical graduates. Design, Postal questionnaire surveys of qualifiers from all UK medical schools in nine qualification years since 1974. Setting, United Kingdom. Population, All graduates from UK medical schools in 1974, 1977, 1980, 1983, 1993, 1996, 1999, 2000 and 2002. Methods, Postal questionnaire surveys. Main outcome measures, Career choices for obstetrics and gynaecology and factors influencing career choices for obstetrics and gynaecology. Results, Seventy-four percent (24 623/33 417) and 73% (20 709/28 468) of doctors responded at 1 and 3 years after qualification. Choices for obstetrics and gynaecology fell sharply during the 1990s from 4.2% of 1996 qualifiers to 2.2% of 1999 qualifiers, and rose slightly to 2.8% of 2002 qualifiers. Only 0.8% of male graduates of 2002 chose obstetrics and gynaecology compared with 4.1% of women. Forty-six percent of those who chose obstetrics and gynaecology 1 year after qualification were working in it 10 years after qualifying. Experience of the subject as a student, and the influence of a particular teacher or department, affected long-term career choices more for obstetrics and gynaecology than for other careers. Conclusions, The unwillingness of young doctors to enter obstetrics and gynaecology may be attributable to concerns about workforce planning and career progression problems, rather than any lack of enthusiasm for the specialty. The number of men choosing obstetrics and gynaecology is now very small; the reasons and the future role of men in the specialty need to be debated. [source]