Academic medicine : journal of the Association of American Medical Colleges
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The past decade has been turbulent for dental education, marked by debate about the future directions of the curriculum and the profession itself. The bulk of the dental school curriculum is still devoted to tooth restoration or replacement techniques, although the need for these procedures has declined. Some dental educators now advocate an oral physician model as the desired direction for the profession, with expanded training in systemic disease pathophysiology and a practice scope that extends beyond exclusive focus on the teeth and supporting structures. ⋯ Will physicians perceive the new dentist as an encroachment on territory or as a resource to enhance patient care? Within dentistry, the traditions of tooth restoration and prosthodontics shape the profession's culture. Are dental educators ready to reconfigure a curriculum that is deeply intertwined with the professional identity of 150,000 U. S. dentists practicing today? To stimulate thinking about these issues, the authors analyze the responses of dental education to changes in the public's oral health and to calls for curricular reform, propose strategies for modifying the way dentists are prepared for their professional responsibilities, and explore the sociology of change in academic institutions, because elements of dental education targeted for reform are revered components of school culture.
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Legislators are considering the conflicting concerns of consumers, researchers, health care providers, and business in the rapidly developing area of genetics. The Oregon Genetic Privacy Act of 1995 was written to protect the individual's right to genetic privacy by providing legal protection for medical information, tissue samples, and DNA samples. This legislation has had an impact on the academic medical center of Oregon Health Sciences University (OHSU) with its teaching hospital and associated clinics, both in providing medical services and in research. ⋯ It affects both patient care and research. OHSU and other academic medical centers have a mandate to provide leadership in the education of medical students, residents, and physicians about genetic privacy and the issues and areas affected by it. As genetic privacy legislation is developed and enacted at state and federal levels, the needs of individuals must be balanced with the needs of institutions and of research in the larger context of societal needs.
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In 1983, 43% of internal medicine residency program directors had held their positions for less than three years. The purposes of this study were to determine the job turnover rate for internal medicine program directors, and the characteristics of program directors and residency programs that are associated with job turnover. ⋯ Yearly turnover for internal medicine residency program directors is substantial. The four independent predictors of turnover identified in this study should be of interest to institutions recruiting or retaining program directors and to aspiring program directors.