Background: The COVID-19 pandemic has affected every facet of American health care, including graduate medical education (GME). Prior studies show that COVID-19 resulted in reduced opportunities for elective surgeries, lower patient volumes, altered clinical rotations, increased reliance on telemedicine, and dependence on virtual didactic conferences. These studies, however, focused on individual specialties. Because the Accreditation Council for Graduate Medical Education (ACGME) routinely collects information from all programs it has an obligation to use these data to inform the profession about important trends affecting GME.
Objective: To describe how the pandemic influenced resident training across all specialty programs in areas of clinical experiences, telemedicine, and extended trainings.
Methods: The ACGME validated a questionnaire to supplement the Annual Update reporting requirements of all accredited programs. The questionnaire was tested to ensure easy interpretation of instructions, question wording, response options, and to assess respondent burden. The questionnaire was administered through the Accreditation Data System, which is a password-protected online environment for communication between the ACGME and ACGME-accredited programs.
Results: We received a response rate of 99.6% (11 290 of 12 420). Emergency medicine, family medicine, internal medicine, and obstetrics and gynecology programs experienced the most significant impact. Most programs reported reduced opportunities for in-person didactics and ambulatory continuity rotations. Hospital-based programs on the "frontline" of COVID-19 care relied least on telemedicine. Family medicine and internal medicine programs accounted for the greatest number of extended trainings.
Conclusions: COVID-19 has affected GME training, but its consequences are unevenly distributed across program types and regions of the country.
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http://dx.doi.org/10.4300/JGME-D-22-00351.1 | DOI Listing |
J Surg Educ
January 2025
Washington University of St. Louis, Department of Orthopaedic Surgery, St. Louis, Missouri.
Objective: Orthopedic residents are tasked with rapidly acquiring clinical and surgical skills, especially during their PGY-1 year. However, resource constraints and other factors frequently cause skills training to fall short of established guidelines. We aimed to design and evaluate a cross-institutional, month-long curriculum aimed at pooling resources to optimize training.
View Article and Find Full Text PDFJ Nurs Adm
December 2024
Authors Affiliations: PhD Candidate (Hung) and Professor (Dr Jeng), School of Nursing, Taipei Medical University; Head Nurse (Hung) and Director (Dr Ming), Department of Nursing, Taipei Veterans General Hospital; Adjunct Assistant Professor (Dr Ming), School of Nursing, College of Nursing, National Yang Ming Chiao Tung University, Taipei City; and Professor (Dr Tsao), Nursing Department and Graduate School, National Taipei University of Nursing and Health Sciences, Taiwan.
Objective: The aim of this study was to explore the lived experiences of presenteeism among Taiwanese nursing staffs.
Background: Presenteeism is a subjective and multifaceted experience, but nurses have rarely been invited to provide their own views of presenteeism.
Methods: A qualitative study based on content analysis was conducted.
Proc Natl Acad Sci U S A
January 2025
Department of Chemistry and Biochemistry, The Ohio State University, Columbus, OH 43210.
The homo-dodecameric ring-shaped RNA binding attenuation protein (TRAP) from binds up to twelve tryptophan ligands (Trp) and becomes activated to bind a specific sequence in the 5' leader region of the operon mRNA, thereby downregulating biosynthesis of Trp. Thermodynamic measurements of Trp binding have revealed a range of cooperative behavior for different TRAP variants, even if the averaged apparent affinities for Trp have been found to be similar. Proximity between the ligand binding sites, and the ligand-coupled disorder-to-order transition has implicated nearest-neighbor interactions in cooperativity.
View Article and Find Full Text PDFJ Neurosurg
January 2025
13Department of Neurosurgery, Shimane Prefectural Central Hospital, Shimane, Japan.
Objective: Aneurysmal subarachnoid hemorrhage (SAH) is associated with high morbidity and mortality rates. In particular, functional outcomes of SAH caused by large or giant (≥ 10 mm) ruptured intracranial aneurysms are worsened by high procedure-related complication rates. However, studies describing the risk factors for poor functional outcomes specific to ruptured large/giant aneurysms are sparse.
View Article and Find Full Text PDFJ Occup Environ Med
January 2025
Department of Social Medical Sciences, Graduate School of Medicine, International University of Health and Welfare, Tokyo, Japan.
Objective: Although increasing evidence suggests that depression/distress involves inflammatory processes, its potential sex differences and the temporal directions for this association remain elusive.
Methods: We examined the temporal association between serum inflammatory mediators and depression/distress as measured by the Center for Epidemiologic Studies Depression Scale (CES-D) and the Kessler Psychological Distress Scale (K6), in non-depressed working men and women (n = 61 and 43, respectively) by a 16-month prospective design.
Results: Fully-adjusted partial correlation analyses revealed that in men, a lower IFN-γ predicted subsequent increases in CES-D and K6 scores, while a higher TNF-α predicted increased K6 scores.
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