Journal of general internal medicine
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Well-defined, systematic, and transparent processes to identify health research gaps, needs, and priorities are vital to ensuring that available funds target areas with the greatest potential for impact. ⋯ To ensure optimal targeting of funds to meet the greatest areas of need and maximize outcomes, a much more robust evidence base is needed to ascertain the effectiveness of methods used to identify research gaps, needs, and priorities.
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With rising applications to internal medicine programs and pending changes in United States Medical Licensing Examination Step 1 score reporting, program directors desire transparent data for comparing applicants. The Department of Medicine Letters of Recommendation (DOM LORs) are frequently used to assess applicants and have the potential to provide clearly defined data on performance including stratification of a medical school class. Despite published guidelines on the expected content of the DOM LOR, these LORs do not always meet that need. ⋯ Adherence to published guidelines for DOM LORs varies but is generally low. For program directors desiring transparent data to use in application review, clearly defined data on student performance, stratification groupings, and common language across schools could improve the utility of DOM LORs.
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The COVID-19 pandemic plunged hospital systems into resource-deprived conditions unprecedented since the 1918 flu pandemic. It brought forward concerns around ethical management of scarcity, racism and distributive justice, cross-disciplinary collaboration, provider wellness, and other difficult themes. ⋯ Support for global health educational activities is a valuable component of medical training, as they build skills and perspectives that are critical to responding to a pandemic or other health system cataclysm. We frame our argument as consideration of three questions that required rapid, effective responses in our home institutions during the pandemic: How can our health system function with new limitations on essential resources? How do we work at high intensity and volume, on a new disease, within new and evolving systems, while still providing high-quality, patient-centered care? And, how do we help personnel manage an unprecedented level of morbidity and mortality, disproportionately affecting the poor and marginalized, including moral difficulties of perceived care rationing?