Academic medicine : journal of the Association of American Medical Colleges
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End-of-life and palliative care (EOL/PC) education is a necessary component of undergraduate medical education. The extent of EOL/PC education in internal medicine (IM) clerkships is unknown. The purpose of this national study was to investigate the presence of formal EOL/PC curricula within IM clerkships; the value placed by IM clerkship directors on this type of curricula; curricular design and implementation strategies; and related barriers and resources. ⋯ Although many IM clerkship directors have implemented formal curricula in EOL/PC, a substantial gap remains between those who have implemented and those who believe it belongs in the clerkship. Time, faculty, cost, and competing demands are the main barriers to implementation.
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Internal medicine residents are required to participate in scholarly activity, but conducting original research during residency is challenging. Following a poor Match at Baystate Medical Center, the authors implemented a resident research program to overcome known barriers to resident research. The multifaceted program addressed the following barriers: lack of interest, lack of time, insufficient technical support, and paucity of mentors. ⋯ The department also saw more original research (29 publications) and resident first authors (12 publications) after program implementation. The percentage of residents accepted into fellowships rose from 33% before program implementation to 49% after (P = .04). This comprehensive resident research program, which focused on evidence-based medicine and was tailored to overcome specific barriers, led to a significant increase in the number of resident Medline publications and improved the reputation of the residency program.
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A major goal of the Medical Education Partnership Initiative (MEPI) is to improve local health systems by strengthening medical education in Sub-Saharan Africa. A new approach to collaboration was intended to overcome the one-sided nature of many partnerships that often provide more rewards to institutions from wealthy countries than to their Sub-Saharan African counterparts. The benefits of this MEPI approach are reflected in at least five positive outcomes. ⋯ And finally, performance metrics for strengthening of health science education in Sub-Saharan Africa have been advanced. Meanwhile, partner medical schools in the United States have witnessed the benefits of collaborating across traditional disciplinary boundaries, such as physicians working within highly functioning community-based health care teams with many of the participating schools in Sub-Saharan Africa. MEPI demonstrates that North-South as well as South-South partnerships, with an explicit focus on improving local health systems through better education, can be designed to empower partners in the South with support from collaborators in the North.
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Medical schools are challenged to realign curricula to address society's needs in a rapidly changing environment, and to support new instruction and assessment methods that require substantial faculty time. ⋯ During academic year 2013-2014, the GHD Path is adding more community-based experiences. The faculty development and support model will be streamlined to decrease resources required for program development while retaining key features of the advising system. Lessons from the GHD Path are central to planning schoolwide reform of instructional methods, faculty advising, and student portfolios. The use of a small-scale program to pilot new ideas to inform longer-term, larger-scale changes at our institution might prove useful to other schools striving to meet societal needs while implementing innovative methods of instruction and assessment.