Career-Success Scale – A new instrument to assess young physicians' academic career steps

Background: Within the framework of a prospective cohort study of Swiss medical school graduates, a Career-Success Scale (CSS) was constructed in a sample of young physicians choosing different career paths in medicine. Furthermore the influence of personality factors, the participants' personal situation, and career related factors on their career success was investigated. Methods: 406 residents were assessed in terms of career aspired to, and their career progress. The Career-Success Scale, consisting of 7 items, was developed and validated, addressing objective criteria of academic career advancement. The influence of gender and career aspiration was investigated by a two-factorial analysis of variance, the relationships between personality factors, personal situation, career related factors and the Career-Success Scale by a multivariate linear regression analysis. Results: The unidimensional Career-Success Scale has an internal consistency of 0.76. It is significantly correlated at the bivariate level with gender, instrumentality, and all career related factors, particularly with academic career and received mentoring. In multiple regression, only gender, academic career, surgery as chosen specialty, and received mentoring are significant predictors. The highest values were observed in participants aspiring to an academic career, followed by those pursuing a hospital career and those wanting to run a private practice. Independent of the career aspired to, female residents have lower scores than their male colleagues. Conclusion: The Career-Success Scale proved to be a short, reliable and valid instrument to measure career achievements. As mentoring is an independent predictor of career success, mentoring programs could be an important instrument to specifically enhance careers of female physicians in academia

Forearmed and Deceived: Diagnosis?

A 58-year-old male with a four-year history of noninsulin dependent diabetes presented in early January 1999 with a two-week history of progressive right fore arm swelling, pain, and limitation of wrist and elbow movement unassociated with recognized trauma. He had been febrile in the three days before the evaluation, despite having been on an anti-inflammatory medication for approximately one week. Progressive clinical worsening in association with a markedly elevated erythrocyte sedimentation rate prompted referral to an infectious diseases consultant regarding the possibility of osteomyelitis