Twelve Tips to Promote Gender Equity in International Academic Medicine

10.1080/0142159X.2017.1388503Medical Teacher940962-96

"I find it quite a privilege to be involved in their lives": A multinational qualitative study of program directors' perspectives on their relationships with residents

Teaching and Learning in Medicine345473-48

Promotion of academic hospitalists : room for improvement

Introduction: Academic hospitalist medicine has grown rapidly and often focuses on clinical rather than academic productivity. Hospitalist faculty may face challenges achieving academic promotion. Materials and Methods: Academic hospitalist program leaders at hospitals associated with American Association of Medical Colleges (AAMC) were surveyed. Domains included leader, faculty, and program characteristics as well as promotion and faculty development. Results: 146 programs were identified, 11 were excluded; 78 responded (58%) reporting on 3294 faculty. Faculty: Most identified hospital medicine as a career. Promotion: 21% of institutions reported a single promotion track. Among institutions with multiple tracks (79%) faculty were reported to be on the following tracks: educator (48%), clinical (47%), and research (3.3%). Most academic hospitalists were reported to be instructor/assistant professors (70%) and a median of 1.5% were professors. Publications were required for promotion in the majority of institutions regardless of track. 61% of programs had 10 percent protected time or less; 21% had none. Conclusion: Academic hospitalists have to balance clinical duties, teaching, and scholarship. Despite a majority being on a promotion track and a majority needing to produce scholarship, most had little to no protected time. Compared to data from the AAMC, Academic Hospitalists were at lower rank than Department of Medicine peers. Academic hospitalist leaders reported barriers to promotion including lack of expertise and mentorship (74%) and/or insufficient time for research (58%). Taken together, this may limit the ability of academic hospitalists to achieve academic promotion.Carrie Herzke, Amanda Bertram, Ariella Stein, Hsin-Chieh Yeh, and Joseph Cofrancesco, Jr. (Department of Medicine, Johns Hopkins University)Includes bibliographical reference

Twelve tips for developing and running a successful women?s group in international academic medicine

10.1080/0142159X.2018.1521954Medical Teacher41111239-124

Effect of the 2011 vs 2003 duty hour regulation-compliant models on sleep duration, trainee education, and continuity of patient care among internal medicine house staff: a randomized trial

On July 1, 2011, the Accreditation Council for Graduate Medical Education implemented further restrictions of its 2003 regulations on duty hours and supervision. It remains unclear if the 2003 regulations improved trainee well-being or patient safety. To determine the effects of the 2011 Accreditation Council for Graduate Medical Education duty hour regulations compared with the 2003 regulations concerning sleep duration, trainee education, continuity of patient care, and perceived quality of care among internal medicine trainees. Crossover study design in an academic research setting. Medical house staff. General medical teams were randomly assigned using a sealed-envelope draw to an experimental model or a control model. We randomly assigned 4 medical house staff teams (43 interns) using a 3-month crossover design to a 2003-compliant model of every fourth night overnight call (control) with 30-hour duty limits or to one of two 2011-compliant models of every fifth night overnight call (Q5) or a night float schedule (NF), both with 16-hour duty limits. We measured sleep duration using actigraphy and used admission volumes, educational opportunities, the number of handoffs, and satisfaction surveys to assess trainee education, continuity of patient care, and perceived quality of care. RESULTS The study included 560 control, 420 Q5, and 140 NF days that interns worked and 834 hospital admissions. Compared with controls, interns on NF slept longer during the on call period (mean, 5.1 vs 8.3 hours; P = .003), and interns on Q5 slept longer during the postcall period (mean, 7.5 vs 10.2 hours; P = .05). However, both the Q5 and NF models increased handoffs, decreased availability for teaching conferences, and reduced intern presence during daytime work hours. Residents and nurses in both experimental models perceived reduced quality of care, so much so with NF that it was terminated early. Compared with a 2003-compliant model, two 2011 duty hour regulation-compliant models were associated with increased sleep duration during the on-call period and with deteriorations in educational opportunities, continuity of patient care, and perceived quality of care

Provider and Practice Characteristics Associated with Use of Rapid HIV Testing by General Internists

Background. Rapid HIV testing could increase routine HIV testing. Most previous studies of rapid testing were conducted in acute care settings, and few described the primary care providers’ perspective. Objective – To identify characteristics of general internal medicine physicians with access to rapid HIV testing, and to determine whether such access is associated with differences in HIV-testing practices or perceived HIV-testing barriers. Design – Web-based cross-sectional survey conducted in 2009. Participants - 406 physician members of the Society of General Internal Medicine who supervise residents or provide care in outpatient settings. Main measures. Surveys assessed provider and practice characteristics, HIV-testing types, HIV-testing behavior, and potential barriers to HIV testing. Results. Among respondents, 15% had access to rapid HIV testing. In multivariable analysis, physicians were more likely to report access to rapid testing if they were non-white (OR 0.45, 95% CI 0.22, 0.91), had more years since completing training (OR 1.06, 95% CI 1.02, 1.10), practiced in the Northeastern US (OR 2.35; 95% CI 1.28, 4.32), or if their practice included a higher percentage of uninsured patients (OR 1.03; 95% CI 1.01, 1.04). Internists with access to rapid testing reported fewer barriers to HIV testing. More respondents with rapid than standard testing reported at least 25% of their patients received HIV testing (51% versus 35%, p =.02). However, access to rapid HIV testing was not significantly associated with the estimated proportion of patients receiving HIV testing within the previous 30 days (7.24% vs. 4.58%, p=.06). Conclusion. Relatively few internists have access to rapid HIV testing in outpatient settings, with greater availability of rapid testing in community-based clinics and in the Northeastern U.S. Future research may determine whether access to rapid testing in primary care settings will impact routinizing HIV testing