Factors affecting residency rank-listing: A Maxdiff survey of graduating Canadian medical students

<p>Abstract</p> <p>Background</p> <p>In Canada, graduating medical students consider many factors, including geographic, social, and academic, when ranking residency programs through the Canadian Residency Matching Service (CaRMS). The relative significance of these factors is poorly studied in Canada. It is also unknown how students differentiate between their top program choices. This survey study addresses the influence of various factors on applicant decision making.</p> <p>Methods</p> <p>Graduating medical students from all six Ontario medical schools were invited to participate in an online survey available for three weeks prior to the CaRMS match day in 2010. Max-Diff discrete choice scaling, multiple choice, and drop-list style questions were employed. The Max-Diff data was analyzed using a scaled simple count method. Data for how students distinguish between top programs was analyzed as percentages. Comparisons were made between male and female applicants as well as between family medicine and specialist applicants; statistical significance was determined by the Mann-Whitney test.</p> <p>Results</p> <p>In total, 339 of 819 (41.4%) eligible students responded. The variety of clinical experiences and resident morale were weighed heavily in choosing a residency program; whereas financial incentives and parental leave attitudes had low influence. Major reasons that applicants selected their first choice program over their second choice included the distance to relatives and desirability of the city. Both genders had similar priorities when selecting programs. Family medicine applicants rated the variety of clinical experiences more importantly; whereas specialty applicants emphasized academic factors more.</p> <p>Conclusions</p> <p>Graduating medical students consider program characteristics such as the variety of clinical experiences and resident morale heavily in terms of overall priority. However, differentiation between their top two choice programs is often dependent on social/geographic factors. The results of this survey will contribute to a better understanding of the CaRMS decision making process for both junior medical students and residency program directors.</p

Resolution, Relief, And Resignation:A Qualitative Study Of Responses To Misfit At Work

Research has portrayed person–environment (PE) fit as a pleasant condition resulting from people being attracted to and selected into compatible work environments; yet, our study reveals that creating and maintaining a sense of fit frequently involves an effortful, dynamic set of strategies. We used a two-phase, qualitative design to allow employees to report how they become aware of and experience misfit, and what they do in response. To address these questions, we conducted interviews with 81 individuals sampled from diverse industries and occupations. Through their descriptions, we identified three broad responses to the experience of misfit: resolution, relief, and resignation. Within these approaches, we identified distinct strategies for responding to misfit. We present a model of how participants used these strategies, often in combination, and develop propositions regarding their effectiveness at reducing strain associated with misfit. These results expand PE fit theory by providing new insight into how individuals experience and react to misfit—portraying them as active, motivated creators of their own fit experience at work

Cortical Modulation of the Transient Visual Response at Thalamic Level: A TMS Study

The transient visual response of feline dorsal lateral geniculate nucleus (dLGN) cells was studied under control conditions and during the application of repetitive transcranial magnetic stimulation at 1 Hz (rTMS@1Hz) on the primary visual cortex (V1). The results show that rTMS@1Hz modulates the firing mode of Y cells, inducing an increase in burst spikes and a decrease in tonic firing. On the other hand, rTMS@1Hz modifies the spatiotemporal characteristics of receptive fields of X cells, inducing a delay and a decrease of the peak response, and a change of the surround/center amplitude ratio of RF profiles. These results indicate that V1 controls the activity of the visual thalamus in a different way in the X and Y pathways, and that this feedback control is consistent with functional roles associated with each cell type

Contemplating workplace change

Drawing on topical life histories of physicians in a particularly volatile public health sector environment, we build theory around the contemplation of workplace change. Overall, our study provides evidence as to why single or multiple independent factors, such as pay or job structure, may fail to predict or explain individual decisions to stay in or change workplaces. Instead, the contemplation process we argue is a complex, evolutionary, and context-dependent one that requires individualized interventions. Our findings reveal the prevalence of episodic context-self fit assessments prompted by triggering stimuli, two mechanisms by which thought processes evolved (reinforcement and recalibration), and four characteristic story lines that explain why the thought processes manifested as they did (exploring opportunities, solving problems, reconciling incongruence, and escaping situations). Based on our findings, we encourage practitioners to regularly engage in story-listening and dialogic conversations to better understand, and potentially affect the evolving socially constructed realities of staff members