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Summary: Obesity is the most common chronic condition in the United States (US), yet primary care physicians face barriers in providing obesity treatment. This study examines the prevalence of American Board of Obesity Medicine (ABOM) certified obesity specialists on the faculty of US Family Medicine residency training programmes, the preparedness of graduating resident physicians to treat obesity, and residency training programme director preferences for supporting faculty development to improve residency education in obesity management. This cross‐sectional on‐line survey of programme directors addressed the number of ABOM‐certified faculty, perceived graduate preparedness to treat obesity, and priorities to improve faculty expertise and obesity curriculum. Of 672 eligible programme directors, 298 (44%) responded to our survey. Most programmes (76%) had no ABOM‐certified faculty. The proportion of programme directors assessing their graduates as prepared to care for patients with obesity has significantly decreased in the last 5 years (2018: 74%, 2022: 58%, p =.016). Residents in programmes with ABOM‐certified faculty member were more likely to be assessed as very prepared to provide medical care (18% vs. 7.8% p =.047). A majority (54%) of programme directors identified limited faculty training and expertise as the biggest faculty and resident‐level barrier to quality obesity care. This study demonstrates an important trend towards increasing ABOM‐certification among Family Medicine residency programme faculty and an urgent need to prioritise faculty development to improve faculty expertise and resident training to address the obesity epidemic. [ABSTRACT FROM AUTHOR]

Previous studies of pediatric residents have identified educational gaps in caring for children with medical complexity. Training opportunities in complex care vary across residency programs. Defining core curricular topics in complex care is a priority in medical education. To identify core topics to include in a standard complex care curriculum for pediatric residents. An initial topic list was generated through literature review and proceedings of national meetings. Expert panelists were identified based on experience in complex care and residency education. A modified Delphi method was used to determine group consensus by asking participants to rate the importance of complex care curricular topics for pediatric residents. Consensus was defined as >70% of experts identifying a topic as essential. There was a predetermined maximum of 3 iterative, electronic survey rounds, with feedback provided to participants between each round. Sixteen experts participated. Response rate was 100% for all rounds. Experts were from the United States (44%) and Canada (56%); most were affiliated with an academic medical center (96%) involved in both inpatient and outpatient care (69%). Eleven topics were identified as essential across 3 rounds: feeding difficulties, pain/irritability, transition, feeding tube management, difficult discussions, team management/care coordination, dysmotility, aspiration, safety/emergency planning, neuromuscular/skeletal issues, and advocacy. Essential topics were organized according to the International Classification of Functioning, Disability and Health. Eleven curricular priorities in complex care were identified across multiple domains of the International Classification of Functioning, Disability and Health framework, serving as a guide for standardized curriculum development for future pediatricians. [ABSTRACT FROM AUTHOR]

Orthopaedic surgery has not experienced the same increase in diversity as other surgical subspecialties over time. Professional orthopaedic societies across the nation, including the American Academy of Orthopaedic Surgeons, are now making sincere efforts to improve diversity, equity, and inclusion (DEI) within the field. Several national groups provide funding to support DEI -related research as well as scholarships to national meetings. Others are more focused on mentorship and mitigation of residency attrition amongst underrepresented minorities (URMs). Individual residency programs, including the Department of Orthopaedics at Brown University, are engaging in community outreach to attract more diverse candidates to orthopaedics and providing away rotation scholarship support for medical students that identify as female or URMs. These local and national efforts will hopefully lead to a more inclusive environment for all trainees and practitioners within orthopaedics and ultimately improved orthopaedic care for all patients.

Purpose: This study sought to assess interest in global surgery rotations among current United States (US)-based oral and maxillofacial surgery (OMS) residents., Methods: An anonymous 23-question survey was distributed to 633 current OMS residents in the US to examine resident interest in global surgery rotations during residency. The primary outcome variable was resident interest in participating in global OMS rotations during residency training, whereas the primary predictor variable was the presence of residency faculty involved in global OMS work. Descriptive statistics were calculated for all study variables and univariate/multivariate logistic regression analyses were conducted to identify predictors of interest in global OMS rotations., Results: A total of 120 residents with an average age of 30.4 ± 3.2 years responded to the survey. At present, 22 (18.5%) residents stated that their residency programs offer some sort of global OMS rotation and 21 (95.5%) of these claimed they were willing to participate in global OMS rotations at their residency program. Out of the residents who stated their program did not offer a global OMS rotation, 86 (87.8%) respondents stated they would be interested in adding a dedicated global OMS rotation to their residency curriculum. The presence of OMS residency faculty involved in global OMS work (p = 0.030) and a resident's willingness to dedicate vacation time to participate in a global surgery rotation (p = 0.005) were associated with increased interest in a global surgery rotation., Conclusion: The majority of respondents would welcome a dedicated global OMS rotation during their residency training., (© 2023 American Dental Education Association.)

Background: Interest in global health during postgraduate residency training is increasing across medical specialties, and multiple disciplines have categorized global health training opportunities in their arena. No such cataloging exists for anesthesiology residency programs. The aim of this study was to assess and characterize global health opportunities and the attitudes of program directors (PDs) in U.S. anesthesiology residency programs towards this training. Methods: A cross-sectional 20-question survey on global health opportunities was distributed to 128 ACGME accredited anesthesiology residency program directors via email between October 2015 and January 2016. Descriptive statistics and exploratory inferential analyses were applied. Maximal nonresponse selection bias was estimated. Results: The overall response rate was 44%. Of those who responded, 61% reported that their residency program had a global health elective, with a maximal bias estimate of 6.5%. 45% of program directors with no global health elective reported wanting to offer one. 77% of electives have articulated educational goals, but there is substantial heterogeneity in curricula offered. Program director attitudes regarding the value of global health programs differed significantly between those with and without existing programs. Conclusions: The proportion of U.S. anesthesiology residency programs offering global health electives is similar to that in other medical specialties. There is inconsistency in program structure, goals, curriculum, and funding. Attitudes of program directors differ between programs with and without electives, which may reflect bidirectional influence to be investigated further. Further studies are needed to codify curricula, assess effectiveness, and validate methodologies. [ABSTRACT FROM AUTHOR]

Purpose: Residency programs must ensure resident competence for independent practice. The coronavirus disease-19 (COVID-19) pandemic disrupted health care delivery, impacting pediatric residencies. This study examines the impact on pediatric resident education., Methods: The authors conducted a mixed methods national survey of pediatric residency program directors (PDs) from May 2020 to July 2020. Data analysis included descriptive statistics, chi-square, and Wilcoxon rank sum tests. Multivariable modeling identified factors associated with resident preparation for more senior roles. Thematic analysis was performed on open-ended questions about PD COVID-19 pandemic recommendations to peers, Accreditation Council for Graduate Medical Education and American Board of Pediatrics., Results: Response rate was 55% (110/199). PDs reported the COVID-19 pandemic negatively affected inpatient (n = 86, 78.2%), and outpatient education (n = 104, 94.5%), procedural competence (n = 64; 58.2%), and resident preparation for more senior roles (n = 50, 45.5%). In bivariate analyses, increasingly negative impacts on inpatient and outpatient education were associated with an increasingly negative impact on resident preparation for more senior roles (P = .03, P = .008), these relationships held true in multivariable analysis. Qualitative analysis identified 4 themes from PD recommendations: 1) Clear communication from governing bodies and other leaders; 2) Flexibility within programs and from governing bodies; 3) Clinical exposure is key for competency development; 4) Online platforms are important for education, communication, and support., Conclusions: The COVID-19 pandemic negatively impacted inpatient and outpatient education. When these were more negatively impacted, resident preparation for more senior roles was worse, highlighting the importance of competency based medical education to tailor experiences ensuring each resident is competent for independent practice., (Copyright © 2022 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.)

Abstract: Background: Abortion is one of the most common health services utilized by women in the USA. Training new providers is an important factor in ensuring an adequate supply of clinicians to provide comprehensive reproductive health services. Study Design: Data came from a mailed survey of obstetrician/gynecologists who completed residency in 2007. Results: Participation in first-trimester procedures training was lower than that in second-trimester procedures training. Notably, residents reported less exposure to medication abortion than nearly all other abortion procedures; only 41% of survey participants reported having received training in mifepristone/misoprostol. Significantly more respondents who trained in programs with routine training participated in first-trimester procedures, specifically medication abortion, manual vacuum aspiration and electric vacuum aspiration, compared to those who attended programs with elective training. Discussion: As the vast majority of abortions in the USA occur during the first trimester, exposure to the full array of common first-trimester abortion procedures, including both medication abortion and aspiration abortion procedures, warrants attention. These findings suggest that residency education guidelines may need to be revised to ensure adequate training in medication abortion. [Copyright &y& Elsevier]

Background: The care of patients with HIV is increasingly focused on outpatient chronic disease management. It is not known to what extent internal medicine residents in the US are currently being trained in or encouraged to provide primary care for this population of patients.Objective: To survey internal medicine residency program directors about their attitudes regarding training in outpatient HIV care and current program practices.Design: Program directors were surveyed first by email. Non-responding programs were mailed up to two copies of the survey.Subjects: All internal medicine residency program directors in the US.Main Measures: Program director attitudes and residency descriptions.Key Results: Of the 372 program directors surveyed, 230 responded (61.8 %). Forty-two percent of program directors agreed that it is important to train residents to be primary care providers for patients with HIV. Teaching outpatient-based HIV curricula was a priority for 45.1%, and 56.5% reported that exposing residents to outpatient HIV clinical care was a high priority. Only 46.5% of programs offer a dedicated rotation in outpatient HIV care, and 50.5% of programs have curricula in place to teach about outpatient HIV care. Only 18.8% of program directors believed their graduates had the skills to be primary providers for patients with HIV, and 70.6% reported that residents interested in providing care for patients with HIV pursued ID fellowships. The strongest reasons cited for limited HIV training during residency were beliefs that patients with HIV prefer to be seen and receive better care in ID clinics compared to general medicine clinics.Conclusions: With a looming HIV workforce shortage, we believe that internal medicine programs should create educational experiences that will provide their residents with the skills and knowledge necessary to meet the healthcare needs of this population. [ABSTRACT FROM AUTHOR]

Introduction: Most residents have limited education or exposure to health policy during residency.Aims: We developed a course to (1) educate residents on health policy topics applicable to daily physician practice; (2) expose residents to health policy careers through visits with policy makers and analysts; (3) promote personal engagement in health policy.Setting: Residents registered for a 3-week elective offered twice annually through the George Washington University Department of Health Policy.Program Description: The course format includes: daily required readings and small-group seminars with policy experts, interactive on-site visits with policy makers, and final team presentations to senior faculty on topical health policy issues.Program Evaluation: One hundred thirty residents from 14 specialties have completed the course to date. Seventy completed our post-course survey. Most participants [59 (84%)] felt the course was very or extremely helpful. Participant self-ratings increased from pre- to post-course in overall knowledge of health policy [2 (3%) good or excellent before, 58 (83%) after], likelihood of teaching policy concepts to peers [20 (25%) vs. 62 (86%)], and likelihood of pursuing further health policy training [28 (37%) vs. 56 (82%)].Conclusions: This 3-week elective in health policy improves self-reported knowledge and interest in health policy research, advocacy, and teaching. [ABSTRACT FROM AUTHOR]

The article offers information on the Healthcare Matrix which was developed at Vanderbilt University Medical Center. The Matrix assesses the care of patients using the Accreditation Council for Graduate Medical Education (ACGME) competencies and the Institute of Medicine (IOM) Aims for Improvement. Interns and medical students can fulfill specific ACGME core competencies by participating in the quality improvement process.

Experts acknowledge the unmet need for all physicians to have basic knowledge of aging and competency in geriatric care given the context of population aging. The University of South Carolina (USC) School of Medicine implemented a highly successful program of aging-oriented undergraduate medical training, including a geriatrics vertical curriculum and its senior mentor program—a required, 4-year experience matching students with older community volunteers, referred to herein as the integrated vertical curriculum in geriatrics (IVC). In earlier work, it was established that IVC graduating classes were significantly more likely to report exposure to and coverage of various geriatrics topics than prior USC classes or other U.S. medical graduates. Here the results of a follow-up survey of USC graduating classes before and after exposure to the IVC and contemporaneous Medical University of South Carolina (MUSC) graduates after two to three years of residency (before the initiation of a senior mentor program at MUSC) is reported. Of 403 graduates, 227 returned questionnaires (response rate 56%). Significantly more IVC (2004) than pre-IVC (2003) and 2003 and 2004 MUSC graduates rated themselves fairly or very well prepared by their undergraduate education to treat older adults seen in residency (95% vs 77% and 52%; P<.001). Implications of this and other findings are discussed. [ABSTRACT FROM AUTHOR]

Objectives: At the 2005 Annual Meeting of the American Academy of Child and Adolescent Psychiatry (AACAP), the Academy's Workgroup on Research conducted a Research Forum entitled "Increasing Research Literacy Through the Adoption of Evidence-Based Practice (EBP) in Pediatric Psychiatry."Method: Forum participants focused on speeding the adoption of EBP across five areas: EBP as the preferred heuristic for teaching research literacy, use of EBP in training programs, dissemination of EBP in clinical practice, EBP in partnership with industry, and EBP as a framework for developing practice guidelines.Results: EBP provides an easy-to-understand method for accessing and evaluating the research literature and then applying this information to decisions about patient care. Although EBP has been gaining greater visibility in pediatric psychiatry, it is far from the preferred heuristic. To move the field toward fully embracing EBP will require greater understanding of what EBP is (and is not), educating mental health professionals in EBP skills, access to EBP resources, and a commitment to apply EBP to the conceptualization and design of research protocols and practice guidelines.Conclusions: Pediatric psychiatry would benefit from a principled commitment to follow other areas of medicine in adopting EBP. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To study whether and how fear of litigation and defensive medicine are communicated during residency training and to assess whether this affects residents’ attitudes. Methods: Neurology residents in the US (n =25) and, as a control group, Neurology residents training in Germany (n =42) were asked to rate multiple items regarding litigation, defensive strategies and how often these issues are raised by teaching physicians. Statistic analysis was performed using nonparametric tests. Results: Residents in both countries indicated that litigation is an “important problem”, although US residents stated this significantly more often (p <0.001). Initiation of tests motivated mainly by fear of litigation (p =0.004) and explicit teaching of defensive strategies by teaching physicians (p <0.02) were reported more often by US residents. Conclusion: Neurology residents in both the US and Germany perceive a litigational threat, but significantly less so in Germany. This difference may result at least in part from teaching of defensive strategies reported more often in US programs. [Copyright &y& Elsevier]

The Medical College of Wisconsin (MCW) and theWisconsin Geriatric Education Center (WGEC) are committed to developing educational materials for primary care physicians in training. In response to the opportunity created by the Accreditation Council for Graduate Medical Education (ACGME) competency mandate, an MCW-led interdisciplinary working group has developed competency-linked video-based assessment tools for use in primary care residency training programs. Modeled after the Objective Structured Clinical Examinations (OSCE), used as part of the medical licensing examination process, we created geriatric-focused Objective Structured Video Examinations (OSVEs) as a strategy to infuse geriatrics into residency training. Each OSVE tool contains a 1-3 minute video trigger that is associated with a series of multiple choice and/or constructed response questions (e.g., fill in the blank). These questions assess residents' understanding of video-demonstrated ACGME competencies including professionalism, systems-based practice, communication, and practice-based learning. An instructor's guide and scoring key are provided for each tool. Response to the OSVEs has been overwhelmingly enthusiastic including greater than 90% commitment by statewide faculty to use the tools in residency training. [ABSTRACT FROM PUBLISHER]

Introduction: The American Board of Emergency Medicine identifies medical toxicology as an essential curricular element for emergency medicine (EM) residencies; however, access to medical toxicology education varies widely by institution. We hypothesized that EM residents are uncomfortable with core toxicology content and would be interested in  a dedicated toxicology curriculum., Methods: An electronic needs assessment survey developed by experts in EM and medical toxicology was sent to residents and program leadership at nine EM programs participating in the Emergency Medicine Education Research Alliance (EMERA), a geographically diverse sampling of academic EM residency programs. We queried the presence of a current toxicology curriculum, interest in a dedicated toxicology curriculum, and comfort with core toxicology concepts for board examinations and in clinical practice.  RESULTS: A total of 148 residents and 8 faculty leadership completed the survey.  Only 29% of resident respondents felt comfortable with toxicology concepts, and only 66% of respondents reported access to a toxicology curriculum. Of those without a known toxicology curriculum, most were interested in a formal curriculum. Faculty respondents reported 6/8 programs offered a toxicology curriculum. Faculty at the two programs without a formal curriculum expressed interest in a dedicated curriculum., Conclusions: Emergency medicine residents remain uncomfortable with the core toxicology content in clinical practice. The majority of residents without a known toxicology curriculum would be interested in a dedicated toxicology curriculum.

Objective: To (1) summarize strategies proposed in the recent otolaryngology-head and neck surgery (OTO-HNS) literature for improving the residency application and selection process, (2) evaluate the effects of recently implemented changes to the OTO-HNS match, and (3) discuss recommendations for future changes to the OTO-HNS residency application and selection process., Data Sources: PubMed, Medline Ovid database, and article reference lists., Review Methods: A structured literature search was performed to identify current English language articles relating to the objectives of this study using the aforementioned data sources, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines. The search was limited to submissions published between January 1, 2015, and January 1, 2020., Conclusions: Numerous proposals have been made for improving the otolaryngology residency application and selection process and addressing the competitive nature of the Match. These proposals include but are not limited to mandating a secondary essay, implementing consortia and early match processes, using a signaling system, conducting regional and web-based interviews, offering early engagement with interest groups, instituting a hard cap on applications, increasing costs of applying, counseling self-restraint to prospective applicants, and creating application filters., Implications for Practice: As the volume of literature surrounding the OTO-HNS Match continues to increase, this review aims to provide a summary of past proposals and serve as a guide for possible future innovations. We propose 3 initiatives that may improve the residency application and selection process for both program and resident, with minimal impact to the current National Resident Matching Program (NRMP) Match structure.

Objectives: The neurosurgery residency match is becoming increasingly competitive, with numerous factors being considered as part of the application. We aim to determine whether USMLE Step 2 scores were a significant predictor of neurosurgery board performance., Patients and Methods: Residents who entered a neurological surgery residency program at a single academic institution during 2000-2017 provided scores for all ABNS attempts, USMLE Step 1 and Step 2 scores. Data were deidentified and analyzed for correlation and regression. Pearson's correlation coefficients were determined., Results: USMLE Step 1, Step 2, and maximum ABNS scores were all normally distributed. Step 1 and Step 2 scores were less variable than ABNS scores. USMLE Step 2 and residents' best ABNS written examination scores were not correlated (Pearson Correlation of 0.228 with a 2-tailed significance of 0.272). No outliers were present. When comparing USMLE Step 2 scores with year in residency at which residents scored over 300 on the ABNS written examination, Pearson correlation was -0.500 (p = .015). A simple linear regression was calculated using Step 2 scores to predict the passing year of ABNS written examination (F(1,14) = 6.984, p = .015, R 2  = 0.25)., Conclusion: Although other studies have found correlations between USMLE Step 2 scores and performance before graduating medical school and during residency for other specialties, this is the first study comparing USMLE Step 2 scores with the ABNS written examination scores of neurosurgical residents. Our data showed that USMLE Step 2 was not a reliable predictor of ABNS written examination scores., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Phenomenon: The American Academy of Pediatrics and Canadian Pediatric Society recommend that pediatricians incorporate literacy promotion during well child care, but literacy promotion education during pediatric training remains understudied. We sought to understand how literacy promotion training is currently implemented in pediatric residency programs from the perspective of program directors. Approach: We conducted semistructured interviews with all 9 residency program directors in 1 state. We analyzed data iteratively coding transcripts using an immersion/crystallization approach to identify themes. Findings: We achieved saturation after 9 interviews with 11 participants. We identified 3 major themes: (a) Residency programs rely on an existing primary-care-based literacy promotion intervention (Reach Out and Read) and the resident continuity clinic for literacy promotion training; (b) program directors encourage early and repeated exposure to facilitate literacy promotion education; and (c) service obligations, content specifications, and pressure on faculty create competing time demands that function as key barriers to literacy promotion training. Insights: Residency program directors used an existing, widely used intervention and the infrastructure provided by continuity clinics to facilitate training on literacy promotion, a relatively new pediatric care standard. Additional work is needed to overcome the barriers identified by program directors.

Objectives: To compare the outcomes of endoscopic versus microscopic tympanoplasty during the initial period of a surgeon adopting the new endoscopic technique and teaching the surgical approach to residents assisting in surgery., Methods: Retrospective medical chart review of 60 consecutive operations for repair of isolated tympanic membrane perforations from 2011 to 2016 performed by a single surgeon assisted by residents in an academic teaching hospital. The outcomes of 20 ears repaired microscopically before the senior author adopted endoscopic ear surgery (Group A) were compared with the outcomes of the first 20 ears that were attempted with endoscopic surgery (Group B) and the next 20 ears performed endoscopically (Group C). Sixty ear operations were performed on 52 patients as 8 patients had bilateral ear surgery., Results: The tympanic membrane closure rate was 80% for Group A, 80% for Group B, and 95% for Group C. Mean air-bone gap improvement was 12.8 dB in Group A, 8.3 dB in Group B, and 12.1 dB in Group C. Mean duration of surgery was 99.2 minutes in Group A, 91.3 minutes in Group B, and 90.5 minutes in Group C. In Group B, 20% of the ears (4/20) were converted to a microscopic approach; in Group C, none required conversion., Conclusions: Maintenance of good outcomes and similar results can be maintained during a surgeon's transition to adopting endoscopic tympanoplasty and teaching it to residents.

Purpose: (1) Evaluate radiology resident perception of emergency radiology (ER). (2) Identify potential barriers to pursuing fellowship training or a career in ER among radiology residents., Materials and Methods: A 9-question digital survey was designed using Qualtrics Experience Management software (Qualtrics Inc., Provo, UT) and distributed to all US radiology residents via a multi-pronged distribution approach., Results: Four hundred fifty-one residents responded out of an estimated national total of 4432 residents (10.2%). Gender proportion was nationally representative (female = 24.5%; p = 0.57), with a slight R1 predominance (p = 0.034). Of the residents, 88.8% were aware that an ER subspecialty exists, 82.0% were aware that ER fellowships exist, but only 51.7% were aware that the American Society of Emergency Radiology (ASER) exists. Nearly a quarter reported no ER division or ER resident rotation. Residents in a program without an ER division or rotation were nearly twice as likely to be unaware of the existence of ER subspecialty, ER fellowships, and ASER compared to others (p = 0.017). The presence of an ER division and rotation significantly increases the knowledge of ASER (65.5% vs. 40.7%, p < 0.001) and increases residents' ratings of their ER training (p < 0.001). The following factors were ranked as the most important for fellowship choice: (1) personal interest, (2) intellectually stimulating, and (3) work hours. When asked if ER had an appealing work schedule, the mean response was 56 out of 100 (0 = disagree, 100 = agree)., Conclusion: US radiology residents with the greatest exposure to ER during residency are more familiar with ER training, ER career opportunities, and ASER and had a more favorable perception of the field. Subspecialty leaders should focus on ER's inherent intellectual appeal and reframe its nontraditional schedule as positive (flexible).

Military neurosurgery has played an integral role in the development and innovation of neurosurgery and neurocritical care in treating battlefield injuries. It is of paramount importance to continue to train and prepare the next generation of military neurosurgeons. For the Army, this is currently primarily achieved through the military neurosurgery residency at the National Capital Consortium and through full-time out-service positions at the Veterans Affairs-Department of Defense partnerships with the University of Florida, the University of Texas-San Antonio, and Baylor University. The authors describe the application process for military neurosurgery residency and highlight the training imparted to residents in a busy academic and level I trauma center at the University of Florida, with a focus on how case variety and volume at this particular civilian-partnered institution produces neurosurgeons who are prepared for the complexities of the battlefield. Further emphasis is also placed on collaboration for research as well as continuing education to maintain the skills of nondeployed neurosurgeons. With ongoing uncertainty regarding future conflict, it is critical to preserve and expand these civilian-military partnerships to maintain a standard level of readiness in order to face the unknown with the confidence befitting a military neurosurgeon.