Using focus groups to understand causes for morale decline after introducing change in an IM residency program.

Background: Although program evaluation is a core requirement of Internal Medicine residencies, little is reported in the literature regarding resident satisfaction with training. Most program evaluation consists of numerical rating scales from which it is often difficult to pinpoint exact sources of dissatisfaction.

Methods: Our goal in this work is to evaluate the utility of focus group methodology to uncover in detail the reasons for residents' deteriorating morale in an IM residency program, as well as to solicit suggestions for correction.

Decreasing hospitalization and in-hospital mortality related to cholangitis in the United States.

Objectives: The aim of this study was to determine trends in hospitalization rates and in-hospital mortality of cholangitis and also determine predictive factors of in-hospital mortality.

Methods: The Nationwide Inpatient Sample database was utilized for inpatient data analysis from 1988 to 2006. Patients with primary cholangitis International Classification of Diseases, ninth revision, Clinical Modification (ICD-9-CM) discharge diagnosis were included.