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Introduction: Transition from medical school into residency is difficult, particularly for foreign medical graduates (FMGs). Early career mentoring is known to be beneficial. Although mentorship is encouraged, formal programs are seldom in place and are often ineffective. Objective: To study the impact of resident driven mentorship program (Big Sister Big Brother Program) in improving medicine residency experience of new interns. Methods: The study was conducted in the Internal Medicine Residency Program in University of Oklahoma Health Sciences Centre between September 2012 and October 2013. Residents were assigned with incoming interns on 1:1 basis to act as their mentors. Residents were to meet with the interns every month and address their concerns in an informal atmosphere. We developed a 17-item questionnaire to assess participants' perceptions, satisfaction and experience with mentorship. Results: Overall 61% respondents were males and 43% were Caucasian. Majority (61%) were categorical internal medicine and 45% were FMGs. Only 57% interns reported satisfaction with mentorship and 60.5% said the transition was easy with respect to personal life. After introduction of mentorship program, interns reported improvement in ease of transition with respect to personal life (OR 4.5, CI 1.1-18.4), which was more pronounced in FMGs (OR 10.5, CI 1.1-98.9). Intern class also reported improvement in ease of approaching mentor (OR 4.5, CI 1.1-18.1). Conclusion: In traditional faculty driven mentorship, accessibility to faculty is the biggest hindrance. Our study showed resident mentors have a positive impact on quality of life, ease of approaching mentors, and improve comfort level of new interns. This is especially beneficial for FMGs who have to adapt to new culture, and workplace. We have formally incorporated this program into our orientation curriculum. [ABSTRACT FROM AUTHOR]

Background: Resident physicians are frequently uncomfortable ordering enteral nutrition (EN) and are unaware of the variety of formulas and supplements available for different disease processes. Many depend on a clinical dietician to assist with recommending EN formulas and patient energy requirements that may not be readily available on patient admission. This creates a barrier to early initiation of EN and non-compliance with Society of Critical Care Medicine and American Society of Parenteral and Enteral Nutrition clinical guidelines. Objective: Internal medicine resident physicians were provided an iPod with a smart phone/device application (EN application) to assist them in choosing EN formulas for patients during their intensive care unit (ICU) rotation. The primary outcome was improved initiation of EN within 24 hours of admission. Secondary outcomes included the following: time to initiate EN, goal calories reached, infections rates, length of stay, mortality, and concordance with clinical guidelines. Design: The study is a quasi-experimental design to improve delivery of EN at an academic medical center in the medical ICU. Data were collected from a retrospective chart review to evaluate the impact of an EN application to assist resident physicians when ordering EN. Results: Use of the EN application reduced the percent of patients with delayed initiation of EN from 61.2% prior to 37.5% (P <.01). The mean time to initiate EN also improved 44.5 vs 31.9 hours (P <.01). Patients were also more likely to achieve their daily caloric goal (P <.01). Conclusion: The use of an EN application to assist internal medicine residents when ordering EN reduced delays in initiation of EN and improved overall delivery of EN to medical ICU patients. [ABSTRACT FROM AUTHOR]