Academic medicine : journal of the Association of American Medical Colleges
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This study examined the concurrent validity of the Objective Structured Assessment of Technical Skill (OSATS), a new test of technical skill for general surgery residents. ⋯ Scores on the OSATS accurately reflect the independent opinions of faculty regarding the technical skills of senior residents, suggesting that it is a valid measure of technical skill for these individuals. The scores did not, however, reproduce faculty rankings of the junior residents. Whether this was a failing of the OSATS or the faculty rankings requires further study.
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One of the most difficult problems in twentieth-century medical education has been finding ways to successfully integrate the basic and applied sciences into the medical curriculum. Not only have medical students regarded basic sciences such as physics and biochemistry with distaste, but these subjects traditionally have been taught by pure scientists with little interest in the needs of medical students. In this paper, the author reviews the history of physics teaching at the Queen's University Faculty of Medicine in Canada, placing particular emphasis on the work of J. ⋯ Robertson (1885-1958), professor of physics. Although physics no longer has the relevance to general medical training that it once had a study of Robertson's ideas and methods provides insight into the process of integrating basic science into medical training. Robertson's success in the endeavor was based largely on two factors his "sympathetic understanding" of the needs of medical students and his innovative combination of basic and applied science in one course--factors that are as important to medical teaching today as they were 50 years ago.
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Comparative Study
On rising medical student debt: in for a penny, in for a pound.
Using national databases of the Association of American Medical Colleges, the authors have examined reasons for the rising indebtedness of U. S. medical students, looking across the past decade at the influence of tuition and fees (tuition-fees) alone and the total costs of attending school, the effects of the changing demographics of medical school enrollments and lengthened graduation times, the relationship between the availability of school-funded scholarships and the amount of student loan disbursements, the pattern of student financial aid, and the reliance on borrowing to cover the costs of medical education. In constant dollars, the average indebtedness of students graduating from public schools increased 59.2% between 1985 and 1995, and that for graduates of private schools increased 64.2%. ⋯ In parallel, entering medical students have declared their intentions to rely more heavily on loans as a means of financing. These findings, although based on national data and trends, provide a framework for exploration of the factors affecting educational costs and financing at individual medical schools. The importance of doing so is mounting, as students may be throwing caution to the winds in the more favorable climate for borrowing, ignoring indicators of changing practice opportunities and incomes ahead.
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Historical Article
Reengineering academic medical centers: reengineering academic values?
Academic medicine is entering an era of profound, unsettling change resulting not simply from the drastic transformation of the health care marketplace but more fundamentally from the chronic, growing gap between academic medicine's seemingly insatiable demand for total resources and the supply of resources that society is willing to provide. To examine this problem, the author reviews the major factors that have shaped the development of academic medical centers (AMCs) since World War II and are now the roots of their vulnerability. The first was the major federal investment in university-based programs of science research and education that began in the 1940s; the second was the enactment in the 1960s of the Medicare/Medicaid legislation that established federal responsibility for the support of graduate medical education. ⋯ Of particular concern are the fate of the clinical investigator and the future of clinical research. The author concludes with a list of four feasible strategic options for AMCs (e.g., "build one's own system") and an extensive list of what he believes AMCs will do to respond to the stresses now upon them (e.g., capitalize on unique strengths rather than trying to compete in all areas). He concludes that it will take courage for AMCs to preserve their core values in the new era, but that this can be done if AMCs craft new adaptive structures that are better attuned to the new environment and not wedded to one that is vanishing.