Early environmental field research career exploration: An analysis of impacts on precollege apprentices

Research apprenticeships offer opportunities for deep understanding of scientific practice, transparency about research careers, and possible transformational effects on precollege youth. We examined two consecutive field-based environmental biology apprenticeship programs designed to deliver realistic career exploration and connections to research scientists. The Shaw Institute for Field Training (SIFT) program combines introductory field-skills training with research assistance opportunities, and the subsequent Tyson Environmental Research Fellowships (TERF) program provides immersive internships on university field station–based research teams. In a longitudinal mixed-methods study grounded in social cognitive career theory, changes in youth perspectives were measured during program progression from 10th grade through college, evaluating the efficacy of encouraging career path entry. Results indicate SIFT provided self-knowledge and career perspectives more aligned with reality. During SIFT, differences were found between SIFT-only participants compared with those who progressed to TERF. Transition from educational activities to fieldwork with scientists was a pivotal moment at which data showed decreased or increased interest and confidence. Continuation to TERF provided deeper relationships with role models who gave essential early-career support. Our study indicates the two-stage apprenticeship structure influenced persistence in pursuit of an environmental research career pathway. Recommendations for other precollege environmental career–exploration programs are presented

Exploring reasons for MD-PhD trainees\u27 experiences of impostor phenomenon

BACKGROUND: Acceptance into U.S. MD-PhD dual-degree programs is highly competitive, and the lengthy training program requires transitioning between multiple phases (pre-clinical-, PhD-research-, and clinical-training phases), which can be stressful. Challenges faced during MD-PhD training could exacerbate self-doubt and anxiety. Impostor phenomenon is the experience of feeling like a fraud, with some high-achieving, competent individuals attributing their successes to luck or other factors rather than their own ability and hard work. To our knowledge, impostor phenomenon among MD-PhD trainees has not been described. This study examined impostor phenomenon experiences during MD-PhD training and reasons trainees attributed to these feelings. METHODS: Individuals in science and medicine fields participated in an online survey that included the 20-item Clance Impostor Phenomenon Scale (CIPS); higher scores (range 20-100) indicate more frequent impostor phenomenon. Some respondents who reported experiencing impostor phenomenon also voluntarily completed a semi-structured interview, sharing experiences during training that contributed to feelings of impostor phenomenon. Interview transcripts were coded and analysed using the constant comparative method and analytic induction to identify themes. RESULTS: Of 959 survey respondents (students and professionals in science and medicine), 13 MD-PhD students and residents completed the survey, nine of whom (five male, four female; four white, five other race-ethnicity) also completed an interview. These participants experienced moderate-to-intense scores on the CIPS (range: 46-96). Four themes emerged from the interview narratives that described participants\u27 experiences of IP: professional identity formation, fear of evaluation, minority status, and, program-transition experiences. All reported struggling to develop a physician-scientist identity and lacking a sense of belonging in medicine or research. CONCLUSIONS: Impostor experiences that MD-PhD participants attributed to bias and micro-aggressions in social interactions with peers, faculty, and patients challenged their professional identity formation as physician-scientists. It is important to further examine how MD-PhD-program structures, cultures, and social interactions can lead to feelings of alienation and experiences of impostor phenomenon, particularly for students from diverse and underrepresented populations in medicine

An assessment of residents’ and fellows’ personal finance literacy: An unmet medical education need

Objectives: This study aimed to assess residents' and fellows' knowledge of finance principles that may affect their personal financial health. Methods: A cross-sectional, anonymous, web-based survey was administered to a convenience sample of residents and fellows at two academic medical centers. Respondents answered 20 questions on personal finance and 28 questions about their own financial planning, attitudes, and debt. Questions regarding satisfaction with one's financial condition and investment-risk tolerance used a 10-point Likert scale (1=lowest, 10=highest). Of 2,010 trainees, 422 (21%) responded (median age 30 years; interquartile range, 28-33). Results: The mean quiz score was 52.0% (SD = 19.1). Of 299 (71%) respondents with student loan debt, 144 (48%) owed over $200,000. Many respondents had other debt, including 86 (21$25,000. Respondents' mean satisfaction with their current personal financial condition was 4.8 (SD = 2.5) and investment-risk tolerance was 5.3 (SD = 2.3). Indebted trainees reported lower satisfaction than trainees without debt (4.4 vs. 6.2, F (1,419) = 41.57, p < .001). Knowledge was moderately correlated with investment-risk tolerance (r=0.41, p < .001), and weakly correlated with satisfaction with financial status (r=0.23, p < .001). Conclusions: Residents and fellows had low financial literacy and investment-risk tolerance, high debt, and deficits in their financial preparedness. Adding personal financial education to the medical education curriculum would benefit trainees. Providing education in areas such as budgeting, estate planning, investment strategies, and retirement planning early in training can offer significant long-term benefits.Open access journalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Participation in college laboratory research apprenticeships among students considering careers in medicine

Objective: We sought to determine the prevalence of college laboratory research apprenticeship (CLRA) participation among students considering medical careers and to examine the relationship between CLRA participation and medical-school acceptance among students who applied to medical school. Methods: We used multivariate logistic regression to identify predictors of: 1) CLRA participation in a national cohort of 2001–2006 Pre-Medical College Admission Test (MCAT) Questionnaire (PMQ) respondents and 2) among those PMQ respondents who subsequently applied to medical school, medical-school acceptance by June 2013, reporting adjusted odds ratios (aOR) and 95% confidence intervals (95% CI). Results: Of 213,497 PMQ respondents in the study sample (81.2% of all 262,813 PMQ respondents in 2001–2006), 72,797 (34.1%) reported CLRA participation. Each of under-represented minorities in medicine (URM) race/ethnicity (vs. white, aOR: 1.04; 95% CI: 1.01–1.06), Asian/Pacific Islander race/ethnicity (vs. white, aOR: 1.20; 95% CI: 1.17–1.22), and high school summer laboratory research apprenticeship (HSLRA) participation (aOR: 3.95; 95% CI: 3.84–4.07) predicted a greater likelihood of CLRA participation. Of the 213,497 PMQ respondents in the study sample, 144,473 (67.7%) had applied to medical school and 87,368 (60.5% of 144,473 medical-school applicants) had been accepted to medical school. Each of female gender (vs. male, aOR: 1.19; 95% CI: 1.16–1.22), URM race/ethnicity (vs. white, aOR: 3.91; 95% CI: 3.75–4.08), HSLRA participation (aOR: 1.11; 95% CI: 1.03–1.19), CLRA participation (aOR: 1.12; 95% CI: 1.09–1.15), college summer academic enrichment program participation (aOR: 1.26; 95% CI: 1.21–1.31), and higher MCAT score (per point increase, aOR: 1.31; 95% CI: 1.30–1.31) predicted a greater likelihood of medical-school acceptance. Conclusions: About one-third of all PMQ respondents had participated in CLRAs prior to taking the MCAT, and such participation was one of the several variables identified that were independently associated with medical-school acceptance

Pathological complete response in breast cancer patients following neoadjuvant chemotherapy at a Comprehensive Cancer Center: The natural history of an elusive prognosticator

Given the prognostic significance of pathological complete response (pCR) to neoadjuvant chemotherapy, we sought to chronicle the clinical course of breast cancer patients whose tumors exhibited pCR at our institution. We retrospectively reviewed 5,533 cancer center patients treated for a first primary breast cancer between March, 1999 and September, 2010 to identify those who received neoadjuvant chemotherapy that resulted in pCR (i.e., no residual invasive malignancy in the breast or axilla). The descriptive statistics of treatments received, recurrence, morbidity and mortality as of October, 2013 were reported. Of the 5,533 patients reviewed, 86 met the inclusion criteria. The mean age at diagnosis was 48 years [standard deviation (SD), 9.4 years] and the mean length of follow-up was 68 months (SD, 27 months). The majority of the patients underwent axillary lymph node dissection (ALND; n=60, 69.8%), received adjuvant radiation therapy (XRT; n=72, 83.7%), had poorly differentiated (grade 3) tumors (n=74, 86.1%) and had pure ductal histology (n=74, 86.1%). A total of 5 patients (5.8%) developed disease recurrence. All the patients who recurred had grade 3 tumors with ductal histology and underwent ALND for known pre-neoadjuvant-treatment lymph node metastases; none received adjuvant chemotherapy. A total of 4 patients (4.7%) succumbed to the disease, 3 due to breast cancer recurrence <18 months following the initial diagnosis. Recurrence following pCR was rare, but when it did occur, time- to-recurrence was short at <18 months. All the patients who recurred and eventually succumbed to breast cancer had axillary metastases at diagnosis, indicating that axillary disease is a major negative prognostic factor in patients who achieve pCR following neoadjuvant chemotherapy

Predictors of pathological complete response to neoadjuvant chemotherapy in stage II and III breast cancer: The impact of chemotherapeutic regimen

In this study, we sought to determine the predictors of pathological complete response (pCR) and compare the chemotherapeutic regimens administered to breast cancer patients with and those without pCR. We retrospectively reviewed the data of 879 patients treated at the Alvin J. Siteman Cancer Center between 2006 and 2010, to identify patients who were diagnosed with primary stage II or III breast cancer and received neoadjuvant chemotherapy. Patients who received only neoadjuvant endocrine therapy were considered to be ineligible. Patient, tumor, and treatment characteristics, including type of chemotherapy, were compared between patients who did and those who did not achieve pCR using Chi-square or Fishers exact tests and multivariate logistic regression analysis. Two-sided P-values of <0.05 were considered significant. Of the 333 patients who met the inclusion criteria, 61 (18.3%) had documented pCR. Compared with patients not achieving pCR, a greater proportion of patients with pCR had stage II disease (80.3 vs. 68%, P=0.057), had poorly differentiated (grade 3) tumors (82 vs. 59.2%, P<0.001), had negative lymph node involvement (41 vs. 34%, P=0.0004) and had tumors that were HER2-amplified (41 vs. 23.5%, P=0.0054). A greater proportion of patients with pCR received taxane-based chemotherapy (23 vs. 12.5%, P=0.016) or trastuzumab in conjunction with chemotherapy (41.0 vs. 16.9%, P<0.001). No patients receiving solely anthracycline-based therapy achieved pCR in our study. Our study demonstrated that, for stage II and III breast cancer, lower stage, negative lymph node involvement and HER2 receptor amplification were each associated with pCR. Taxane therapy and the concurrent use of trastuzumab were also associated with a higher likelihood of pCR

The health and welfare of rural and urban cancer survivors in Missouri

INTRODUCTION: An estimated 2.8 million cancer survivors reside in rural areas in the United States. We compared the risk behaviors, psychosocial factors, health outcomes, quality of life, and follow-up care of rural and urban cancer survivors in Missouri. METHODS: We used 2009–2010 Missouri Behavioral Risk Factor Surveillance System data to examine various health outcomes, behaviors, and psychosocial factors among rural and urban cancer survivors and their respective rural and urban counterparts without a cancer history. Cancer survivors also were asked about receipt of survivorship care plan components. Sociodemographic factors, access to medical care, and chronic conditions were examined as potential explanatory factors for differences among the 4 groups. RESULTS: An estimated 9.4% of rural and 7.9% of urban Missourians aged 18 years or older reported a cancer history. Rural survivors reported the highest rates of poor self-reported health, physical distress, and activity limitation; however differences between rural and urban survivors were attributable largely to sociodemographic differences. Both rural and urban cancer survivors reported more fatigue than their respective counterparts without a cancer history. Rural survivors also were less likely to meet Centers for Disease Control and Prevention recommendations for physical activity than their rural controls. The prevalence of smoking among rural survivors was higher than among urban survivors. Only 62% of rural survivors versus 78% of urban survivors reported receiving advice about cancer follow-up care. CONCLUSION: Rural cancer survivors face many health challenges. Interventions to improve quality of life and health behaviors should be adapted to meet the needs of rural cancer survivors