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Medical Specialties (medical + specialty)

Distribution by Scientific Domains

Medical Sciences	95%

Selected Abstracts

Quality of poisoning management advice in the Monthly Index of Medical Specialties Annual

EMERGENCY MEDICINE AUSTRALASIA, Issue 5-6 2005
James Mallows
Abstract Background:, The Monthly Index of Medical Specialties (MIMS) contains Therapeutic Goods Administration-approved product information supplied by manufacturers. It is widely used by health-care professionals but is not specifically designed as a toxicology reference. Objectives:, To determine how widespread the use of MIMS is as a toxicology reference. To evaluate the quality of poisoning management advice it contains. Methods:, First, a survey of 500 consecutive calls to the NSW Poison Information Centre (PIC) was undertaken asking health-care workers which toxicology references were consulted prior to calling and which references they would use if the PIC were not available. Second, a consensus opinion for poisoning management was obtained, for 25 medications which are either commonly involved in poisoning or potentially life-threatening in overdose, by review of 5 current toxicology references for contraindicated treatments, ineffective treatments and specific recommended treatments and antidotes. MIMS poisoning management advice was then compared with this toxicology consensus opinion. Results:, In total, 276 doctors and 222 nurses were surveyed. Prior to calling the PIC 22.8% of doctors and 6.8% of nurses consulted MIMS. In total, 25.7% of doctors and 39.6% nurses stated they would use the MIMS for poisoning management advice if the PIC were not available. For the 25 drugs assessed, 14 contained inaccurate poisoning management: 1 recommended ineffective treatments and 14 omitted specific treatments or antidotes. Conclusion:, The MIMS is often used as a toxicology reference by physicians prior to calling the PIC. It contains a number of significant inaccuracies pertaining to management of poisonings and should not be used as a primary reference for poisoning advice. [source]

Defining characteristics of educational competencies

MEDICAL EDUCATION, Issue 3 2008
Mark A Albanese
Context, Doctor competencies have become an increasing focus of medical education at all levels. However, confusion exists regarding what constitutes a competency versus a goal, objective or outcome. Objectives, This article attempts to identify the characteristics that define a competency and proposes criteria that can be applied to distinguish between competencies, goals, objectives and outcomes. Methods, We provide a brief overview of the history of competencies and compare competencies identified by international medical education organisations (CanMEDS 2005, Institute for International Medical Education, Dundee Outcome Model, Accreditation Council for Graduate Medical Education/American Board of Medical Specialties). Based upon this review and comparisons, as well as on definitions of competencies from the literature and theoretical and conceptual analyses of the underpinnings of competencies, the authors develop criteria that can serve to distinguish competencies from goals, objectives and outcomes. Results, We propose 5 criteria which can be used to define a competency: it focuses on the performance of the end-product or goal-state of instruction; it reflects expectations that are external to the immediate instructional programme; it is expressible in terms of measurable behaviour; it uses a standard for judging competence that is not dependent upon the performance of other learners, and it informs learners, as well as other stakeholders, about what is expected of them. Conclusions, Competency-based medical education is likely to be here for the foreseeable future. Whether or not these 5 criteria, or some variation of them, become the ultimate defining criteria for what constitutes a competency, they represent an essential step towards clearing the confusion that reigns. [source]

American board of medical specialties and repositioning for excellence in lifelong learning: Maintenance of certification

THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS, Issue 3 2005
FACS President, Stephen H. Miller MD
Abstract The board certification movement was founded out of a concern for the quality of care, and today, more than 85% of all physicians licensed to practice medicine in the United States have been certified by an American Board of Medical Specialties (ABMS) member board. There is increasing evidence of a need for continuous monitoring and promotion of quality as well as for assessment and documentation that certified medical specialists are keeping up-to-date so that their continuing competence can be documented. To help, the ABMS established a program called Maintenance of Certification, a system that includes periodic examination of knowledge and the comprehensive evaluation of practice. Maintenance of Certification includes 4 major components: professional standing, including an unrestricted license to practice medicine; lifelong learning and self-assessment; demonstrated cognitive expertise; and practice performance assessment. The efforts of the Conjoint Committee on Continuing Medical Education press continuing medical education providers to facilitate self-directed learning and directed self-learning while driving lifelong learning and assessment into the clinical practices of all physicians who seek to continuously upgrade their knowledge, skills, and behaviors to provide quality medical care. [source]

Rise of Medical Specialization and Organizations Affecting Otolaryngology

THE LARYNGOSCOPE, Issue 7 2001
Jerome C. Goldstein MD
Abstract As we enter the third millennium, there are in the United States 24 medical specialties recognized by the American Board of Medical Specialties. The majority of the members of each of these specialties have their education, training, and knowledge "certified" by an examining board unique to their specialty. One hundred years ago virtually none of the foregoing existed. At the turn of the 20th century, nearly all physicians practiced all of medicine. How and why did this evolution occur and what controls evolved to contain this? The goal of this presentation is to review the rise of medical specialties and the board examination system and describe some of the many organizations, often known by acronyms, which deal with this now complex architecture. [source]

Supply and Demand of Board-certified Emergency Physicians by U.S. State, 2005

ACADEMIC EMERGENCY MEDICINE, Issue 10 2009
Ashley F. Sullivan MS
Abstract Objectives:, The objective was to estimate the emergency medicine (EM) board-certified emergency physician (EP) workforce supply and demand by U.S. state. Methods:, The 2005 National Emergency Department Inventories-USA provided annual visit volumes for U.S. emergency departments (EDs). We estimated full-time equivalent (FTE) EP demand at each ED by dividing the actual number of visits by the estimated average EP visit volume (3,548 visits/year) and then summing FTEs by state. Our model assumed that at least one EP should be present 24/7 in each ED. The number of EM board-certified EPs per state was provided by the American Board of Medical Specialties (American Board of Emergency Medicine, American Board of Pediatrics) and the American Osteopathic Board of Emergency Medicine. We used U.S. Census Bureau civilian population estimates to calculate EP population density by state. Results:, The supply of EM board-certified EPs was 58% of required FTEs to staff all EDs nationally and ranged from 10% in South Dakota to 104% in Hawai'i (i.e., there were more EPs than the estimated need). Texas and Florida had the largest absolute shortages of EM board-certified EPs (2,069 and 1,146, respectively). The number of EM board-certified EPs per 100,000 U.S. civilian population ranged from 3.6 in South Dakota to 13.8 in Washington, DC. States with a higher population density of EM board-certified EPs had higher percent high school graduates and a lower percent rural population and whites. Conclusions:, The supply and demand of EM board-certified EPs varies by state. Only one state had an adequate supply of EM board-certified EPs to fully staff its EDs. [source]

Introductory Remarks by the President of the American Board of Medical Specialties

ACADEMIC EMERGENCY MEDICINE, Issue 11 2008
Kevin B. Weiss
No abstract is available for this article. [source]

Decision Factors and the Recognition of Medical Specialty in Patients Receiving Cosmetic Laser and Intense Pulsed Light Treatment

DERMATOLOGIC SURGERY, Issue 12 2007
TIEN-YI TZUNG MD
BACKGROUND In addition to dermatologists and plastic surgeons, physicians of other medical specialties also provide cosmetic laser and light treatment. OBJECTIVE This study aimed to determine the major decision factors in patients who received cosmetic laser or intense pulsed light treatment and how they perceived different medical specialties in providing such services. METHODS The method of factor analysis was adopted to extract the common characteristics (major decision factors) from a list of 17 items patients would regard as important when they planned to receive laser and intense pulsed light treatment. In addition, the level of recognition of different medical specialties in cosmetic patients was indirectly forecast using an analytic hierarchy process. RESULTS Medical competence (0.3296) was the most important decision factor, followed by recommendation (0.2198), friendliness (0.1350), cost (0.1307), complete service (0.0984), and the physical attributes of the physician (0.0865). Dermatologists and plastic surgeons outscored cosmetic practitioners in five factors except for cost, in which the plastic surgeons were weakest. CONCLUSION Medical competence and recommendation are the core issues for cosmetic patients. Dermatologists and plastic surgeons gain better overall recognition than physicians of other medical specialties in cosmetic patients. [source]

Pain Medicine: A Medical Specialty?

PAIN PRACTICE, Issue 1 2004
DABPM, Miles Day MD
First page of article [source]

Decision Factors and the Recognition of Medical Specialty in Patients Receiving Cosmetic Laser and Intense Pulsed Light Treatment

Full Scope of Effect of Facial Lipoatrophy: A Framework of Disease Understanding

DERMATOLOGIC SURGERY, Issue 8 2006
BENJAMIN ASCHER MD
BACKGROUND Facial lipoatrophy has been observed to occur in a variety of patient populations, with inherited or acquired disease, or even in aging patients as a natural progression of tissue change over time. There is currently no framework from which physicians of all medical specialties can communally discuss the manifestations, diagnoses, and management of facial lipoatrophy. OBJECTIVE The aim of this assembly was to derive a definition of facial lipoatrophy capable of being applied to all patient populations and develop an accompanying grading system. RESULTS The final consensus of the Facial Lipoatrophy Panel encompasses both aging and disease states: "Loss of facial fat due to aging, trauma or disease, manifested by flattening or indentation of normally convex contours." The proposed grading scale includes five gradations (Grades 1,5; 5 being the most severe), and the face is assessed according to three criteria: contour, bony prominence, and visibility of musculature. CONCLUSION Categorizing the presentation of facial lipoatrophy is subjective and qualitative, and will need to be validated with objective measures. Furthermore, during the assembly, several topics were exposed that warrant further research, including the physiology of volume loss, age and lipoatrophy, and human immunodeficiency virus and lipoatrophy. [source]

Why should addiction medicine be an attractive field for young physicians?

ADDICTION, Issue 2 2009
Michael Soyka
ABSTRACT Aims The clinical practice and science of addiction are increasingly active fields, which are attracting professionals from diverse disciplines such as psychology and neurobiology. Our scientific knowledge of the pathophysiology of addiction is rapidly growing, along with the variety of effective treatments available to clinicians. Yet, we believe that the medical specialties of addiction medicine/psychiatry are not attracting the interest and enthusiasm of young physicians. What can be done? Methods We offer the opinions of two experience addiction psychiatrists. Results In the US, there has been a decline in the number of psychiatrists seeking training or board certification in addiction psychiatry; about one-third of graduates with such training are not practicing in an addiction psychiatry setting. There is widespread neglect of addiction medicine/psychiatry among the medical profession, academia and national health authorities. This neglect is unfortunate, given the enormous societal costs of addiction (3,5% of the gross domestic product in some developed countries), the substantial unmet need for addiction treatment, and the highly favourable benefit to cost yield (at least 7:1) from treatment. Conclusions We believe that addiction medicine/psychiatry can be made more attractive for young physicians. Helpful steps include widening acceptance as a medical specialty or subspecialty, reducing the social stigma against people with substance use disorders, expanding insurance coverage and increasing the low rates of reimbursement for physicians. These steps would be easier to take with broader societal (and political) recognition of substance use disorders as a major cause of premature death, morbidity and economic burden. [source]

Women in Academic Emergency Medicine

ACADEMIC EMERGENCY MEDICINE, Issue 9 2000
Rita K. Cydulka MD
Abstract. Objective: To evaluate the achievement gof women in academic emergency medicine (EM) relative to men. Methods: This study was a cross-sectional mail survey of all emergency physicians who were employed at three-fourths full-time equivalent or greater at the 105 EM residency programs in the United States from August 1997 to December 1997. The following information was obtained: demographics, training and practice issues, roles and responsibilities in academic EM, percentage of time spent per week in clinical practice, teaching, administrative and research activities, academic productivity, and funding. Results: Of the 1,575 self-administered questionnaires distributed by the office of the chairs, 1,197 (76%) were returned. Two hundred seventy-four (23%) of the respondents were women, and 923 (77%) were men. There was a significant difference noted between men and women in all demographic categories. The numbers of respondents who were nonwhite were extremely small in the sample and, therefore, the authors are hesitant to draw any conclusions based on race/ethnicity. There was no difference in training in EM between men and women (82% vs 82%, p = 0.288), but a significantly higher proportion of male respondents were board-certified in EM (84% vs 76%, p < 0.002). Women in academic EM were less likely to hold major leadership positions, spent a greater percentage of time in clinical and teaching activities, published less in peer-reviewed journals, and were less likely to achieve senior academic rank in their medical schools. Conclusions: These findings mirror those of most medical specialties: academic achievement of women in academic EM lags behind that of men. The paucity of minority physicians in academic EM didn't permit analysis of their academic achievements. [source]

Interspecialty and intraspecialty differences in the management of thyroid nodular disease and cancer

HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 6 2005
FRACS, Jonathan R. Clark MBBS
Abstract Introduction. The management of thyroid cancer includes multiple medical specialties. Physicians from different specialties may vary in opinion regarding the optimal investigation and treatment of patients. Little data exist evaluating the differences within or between various specialties treating thyroid disease. This study aims to examine responses from a variety of specialty physicians closely involved in the medical or surgical management of thyroid disease to provide evidence as to whether any difference exists. Methods. A cross-sectional survey of attendees at the 5th Biennial Course on the Management of Thyroid Nodular Disease and Cancer was conducted using an anonymous electronic touch pad system. Touch pads were given to 213 attendees who were asked to respond to 44 questions. This study analyzes the responses obtained from 19 selected questions (43%) and compares the results between endocrinologists (n = 48), general surgeons (n = 41), otolaryngologists (n = 61), and pathologists (n = 20). Results. Responses were obtained from 69% of endocrinologists, 68% of general surgeons, 72% of otolaryngologists, and 65% of pathologists. Statistically significant interspecialty differences were observed in 12 (63%) of 19 questions. Each question and a summary of responses from all touch pads were recorded. Conclusions. Significant differences in the attitudes toward, and presumably the practice of, managing thyroid nodular disease and cancer exist between specialties. An understanding of these differences is helpful when working as a multidisciplinary team to optimize patient care. © 2005 Wiley Periodicals, Inc. Head Neck27: XXX,XXX, 2005 [source]

Changing roles and challenges faced by women in medical specialties

INTERNAL MEDICINE JOURNAL, Issue 1-2 2002
J. Sewell
No abstract is available for this article. [source]

Pandemic influenza: human rights, ethics and duty to treat

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 1 2010
I. PAHLMAN
The 2009 influenza A/H1N1 pandemic seems to be only moderately severe. In the future, a pandemic influenza with high lethality, such as the Spanish influenza in 1918,1919 or even worse, may emerge. In this kind of scenario, lethality rates ranging roughly from 2% to 30% have been proposed. Legal and ethical issues should be discussed before the incident. This article aims to highlight the legal, ethical and professional aspects that might be relevant to anaesthesiologists in the case of a high-lethality infectious disease such as a severe pandemic influenza. The epidemiology, the role of anaesthesiologists and possible threats to the profession and colleagueship within medical specialties relevant to anaesthesiologists are reviewed. During historical plague epidemics, some doctors have behaved like ,deserters'. However, during the Spanish influenza, physicians remained at their jobs, although many perished. In surveys, more than half of the health-care workers have reported their willingness to work in the case of severe pandemics. Physicians have the same human rights as all citizens: they have to be effectively protected against infectious disease. However, they have a duty to treat. Fair and responsible colleagueship among the diverse medical specialties should be promoted. Until disaster threatens humanity, volunteering to work during a pandemic might be the best way to ensure that physicians and other health-care workers stay at their workplace. Broad discussion in society is needed. [source]

Diode-pumped fiber lasers: A new clinical tool?

LASERS IN SURGERY AND MEDICINE, Issue 3 2002
Stuart D. Jackson PhD
Abstract Background and Objective Diode-pumped fiber lasers are a compact and an efficient source of high power laser radiation. These laser systems have found wide recognition in the area of lasers as a result of these very practical characteristics and are now becoming important tools for a large number of applications. In this review, we outline the basic physics of fiber lasers and illustrate how a number of clinical procedures would benefit from their employment. Study Design/Materials and Methods The pump mechanisms, the relevant pump and laser transitions between the energy levels, and the main properties of the output from fiber lasers will be briefly reviewed. The main types of high power fiber lasers that have been demonstrated will be examined along with some recent medical applications that have used these lasers. We will also provide a general review of some important medical specialties, highlighting why these fields would gain from the introduction of the fiber laser. Results/Conclusion It is established that while the fiber laser is still a new form of laser device and hence not commercially available in a wide sense, a number of important medical procedures will benefit from its general introduction into medicine. With the number of medical and surgical applications requiring high power laser radiation steadily increasing, the demand for more efficient and compact laser systems providing this capacity will grow commensurately. The high power fiber laser is one system that looks like a promising modality to meet this need. Lasers Surg. Med. 30:184-190, 2002. © 2002 Wiley-Liss, Inc. [source]

American board of medical specialties and repositioning for excellence in lifelong learning: Maintenance of certification

Rise of Medical Specialization and Organizations Affecting Otolaryngology

Climate Change and Emergency Medicine: Impacts and Opportunities

ACADEMIC EMERGENCY MEDICINE, Issue 8 2009
Jeremy J. Hess MD
Abstract There is scientific consensus that the climate is changing, that human activity plays a major role, and that the changes will continue through this century. Expert consensus holds that significant health effects are very likely. Public health and health care systems must understand these impacts to properly pursue preparedness and prevention activities. All of medicine will very likely be affected, and certain medical specialties are likely to be more significantly burdened based on their clinical activity, ease of public access, public health roles, and energy use profiles. These specialties have been called on to consider the likely impacts on their patients and practice and to prepare their practitioners. Emergency medicine (EM), with its focus on urgent and emergent ambulatory care, role as a safety-net provider, urban concentration, and broad-based clinical mission, will very likely experience a significant rise in demand for its services over and above current annual increases. Clinically, EM will see amplification of weather-related disease patterns and shifts in disease distribution. In EM's prehospital care and disaster response activities, both emergency medical services (EMS) activity and disaster medical assistance team (DMAT) deployment activities will likely increase. EM's public health roles, including disaster preparedness, emergency department (ED)-based surveillance, and safety-net care, are likely to face increasing demands, along with pressures to improve fuel efficiency and reduce greenhouse gas emissions. Finally, EM's roles in ED and hospital management, particularly related to building and purchasing, are likely to be impacted by efforts to reduce greenhouse gas emissions and enhance energy efficiency. Climate change thus presents multiple clinical and public health challenges to EM, but also creates numerous opportunities for research, education, and leadership on an emerging health issue of global scope. [source]

Work Hours and Caseload as Predictors of Physician Burnout: The Mediating Effects by Perceived Workload and by Autonomy

APPLIED PSYCHOLOGY, Issue 4 2010
Arie Shirom
We tested a model in which perceived workload and autonomy were hypothesised to mediate the effects of work hours and caseload on physician burnout. The study was based on data provided by 890 specialists representing six medical specialties. We used structural equation modeling to test our hypotheses. Controlling for the effects of gender, seniority, and the specialists' academic affiliation, we found that the study data fit the hypothesised model,reflecting these hypotheses,quite well. As expected, workload predicted higher levels of global burnout and physical fatigue, while autonomy predicted lower levels of global burnout. Work hours and caseload predicted global burnout only indirectly, via their effects on either perceived workload or autonomy. These findings suggest that public policies, designed to reduce physician work hours in order to reduce burnout and improve patients' safety, should take into account physician perceived workload and autonomy. Nous avons mis à l'épreuve un modèle centré sur l'hypothèse selon laquelle la charge de travail perçue et l'autonomie régulaient l'impact de la durée du travail médical et administratif sur le burnout des médecins. La recherche a exploité des données fournies par 890 spécialistes relevant de six spécialités médicales. On a fait appel à une modélisation en équations structurales pour valider nos hypothèses. En contrôlant l'action du genre, de l'âge et du type de spécialité, il est apparu que les données correspondaient parfaitement au modèle hypothétique. Comme prévu, la charge de travail prédisait des niveaux plus élevés de burnout global et de fatigue physique, alors que l'autonomie débouchait sur des niveaux plus faibles de burnout global. La durée du travail ne prédisait qu'indirectement le burnout global, par l'entremise des retombées sur la charge de travail perçue et l'autonomie. Ces résultats montrent que la réglementation publique qui envisage de réduire le temps de travail des médecins dans le souci d'atténuer le burnout et d'améliorer la sécurité des malades devrait prendre en considération la charge de travail perçue et l'autonomie des médecins. [source]

Emergency Medicine Career Choice: A Profile of Factors and Influences from the Association of American Medical Colleges (AAMC) Graduation Questionnaires

ACADEMIC EMERGENCY MEDICINE, Issue 6 2009
Jeremy S. Boyd
Abstract Objectives:, This study sought to account for trends in medical student specialty choice by examining the importance of lifestyle factors. Emergency medicine (EM) is among several medical specialties classified as having a "controllable lifestyle." The primary objective of this study was to determine if medical students choosing careers in EM have a different profile of influences, values, and expectations from students choosing other specialties or specialty groups. Of secondary interest was how much lifestyle influenced students choosing EM compared to students choosing controllable lifestyle (CL) specialties. Methods:, Using data from the 2005 and 2006 Association of American Medical Colleges (AAMC) graduation questionnaire (GQ) supplemental surveys, we grouped responses according to desired specialty choice: EM (n = 963), CL (n = 3,681), primary care (PC; n = 3,191), or surgical specialty (SS; n = 1,694). The survey requires students to rate the influence of nine specific factors in determining their specialty choice: lifestyle, competitiveness, high level of educational debt, mentors and role models, options for fellowship training, salary expectations, length of residency training, family expectations, and medical school career planning activities. Using one-way analysis of variance (ANOVA) and nonparametric statistics, we assessed responses among the four subgroups for differences in the importance attributed to these factors. Results:, A total of 13,440 students completed the two supplemental surveys of the GQ. Of these students, 9,529 identified a specialty choice that fell within one of the four comparison groups and were included in the analysis. Compared to other specialty groups, students choosing EM reported lifestyle and length of residency as strong influences, while attributing less influence to mentors and options for fellowship training. Conclusions:, Students choosing a career in EM have distinctly different priorities and influences than students entering PC and SS. The profile of students who choose EM is very similar to those choosing traditional CL specialties. A more thorough understanding of the values and priorities that shape medical student career selection may allow educators to provide better career counseling. [source]

Why should addiction medicine be an attractive field for young physicians?

EDITORIAL: Addiction medicine: a new medical specialty in a new age of medicine

INTERNAL MEDICINE JOURNAL, Issue 8 2010
Y. Bonomo
No abstract is available for this article. [source]

Review article: Patient-level outcomes: the missing link

NEPHROLOGY, Issue 4 2009
DENISE V O'SHAUGHNESSY
SUMMARY Treatment of chronic kidney disease (CKD) may be life-saving, but can disrupt every aspect of a patient's life and the lives of family members. Many patients with CKD are elderly with significant comorbidities and sometimes therapies to improve survival may be less important than those that improve or maintain quality of life. In this setting, patient-level benefits become particularly important goals of therapy. Randomized controlled trials (RCT) are also essential to justify expensive therapies, such as medications used in the treatment of CKD mineral and bone disorders. Surprisingly, data to support the efficacy of these drugs for patient-level outcomes remains limited. In fact, fewer RCT are conducted in renal medicine than in any other medical specialty and reliance is often placed on association data and the assessment of intermediate and biochemical end-points. While some of these may prove to be valid surrogates for clinically important outcomes, some may not. Inclusion of patient-level outcomes in clinical research provides a missing link that can inform a more comprehensive approach to clinical practice and patient care. Incorporating measures of health-related quality of life into clinical trials can make outcomes more relevant and may be relatively simple. This paper provides examples of reliable, validated instruments to measure health-related quality of life domains and functional status, together with practical instructions for their use. Most could be incorporated into RCT of CKD mineral and bone disorder treatments. Inclusion of outcomes that are perceived by patients to be significant should become standard practice in renal medicine and in clinical renal research. [source]