Journal of graduate medical education最新文献

{"title":"The Hidden Work of the Note: What Ambient Scribes Ask Us to Decide.","authors":"Carl Preiksaitis","doi":"10.4300/JGME-D-26-00855.1","DOIUrl":"10.4300/JGME-D-26-00855.1","url":null,"abstract":"","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"18 5","pages":"525-528"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sacred Frustration.","authors":"Erin E Finn","doi":"10.4300/JGME-D-26-00196.1","DOIUrl":"https://doi.org/10.4300/JGME-D-26-00196.1","url":null,"abstract":"","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"18 5","pages":"613"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Grey Anatomy of Workplace Mistreatment.","authors":"Michael Soh, Binbin Zheng, Anthony R Artino, TingLan Ma, Jerri Curtis, Steven J Durning, Ting Dong","doi":"10.4300/JGME-D-26-00091.1","DOIUrl":"10.4300/JGME-D-26-00091.1","url":null,"abstract":"<p><strong>Background: </strong>Workplace mistreatment in graduate medical education is typically measured using instruments with validity evidence, yet these tools may inadequately capture context-dependent experiences that vary by frequency, source, and setting.</p><p><strong>Objective: </strong>To examine response frequency distributions from 2 mistreatment instruments used with residents and fellows whereby ambiguous (\"grey\") experiences appeared distinct from explicit mistreatment, and to assess the differential associations of each with resident well-being and burnout.</p><p><strong>Methods: </strong>Using data collected in 2024 from the Workplace Psychologically Violent Behaviors scale (WPVB; 12 items) and Negative Acts Questionnaire (6 items) on 266 of 675 residents and fellows (39.4% response rate) at a large Northeast sponsoring institution, we conducted an exploratory factor analysis to examine the underlying structure of WPVB responses. Grey items were defined as those whose interpretation depends heavily on frequency, source, and context; explicit items represented overt behaviors regardless of context. We compared well-being and burnout across residents grouped by grey item frequency, using a modified Medical Student Well-Being Index and a single-item burnout measure.</p><p><strong>Results: </strong>Two factors emerged from the exploratory factor analysis, accounting for 55.2% of the variance: 9 grey items (eg, having your performance evaluated negatively) in the first factor and 3 explicit items (eg, been humiliated or ridiculed) in the second. Grey item frequency was associated with well-being (<i>r</i>=0.59; 95% CI, 0.48-0.68) and burnout (<i>r</i>=0.54; 95% CI, 0.42-0.64).</p><p><strong>Conclusions: </strong>Grey mistreatment experiences-ambiguous in isolation but potentially harmful when repeated frequently-were more strongly associated with resident well-being and burnout than explicit mistreatment.</p>","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"18 5","pages":"605-609"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When Matching Is Not Enough: Administrative Attrition Among International Medical Graduates.","authors":"Mutaz Kassas","doi":"10.4300/JGME-D-26-00537.1","DOIUrl":"10.4300/JGME-D-26-00537.1","url":null,"abstract":"","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"18 5","pages":"540-542"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trustworthiness in the Future: The Enduring Principles, Values, and Virtues of Professionalism in Medicine.","authors":"Thomas J Nasca, Charles W Thomas","doi":"10.4300/JGME-D-26-00899.1","DOIUrl":"10.4300/JGME-D-26-00899.1","url":null,"abstract":"","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"18 5","pages":"616-620"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Family Medicine Milestone Ratings With Early-Career Patient Retention: A US National Insurance Claims Study.","authors":"Kenji Yamazaki, Lorenzo Pence, Sean O Hogan","doi":"10.4300/JGME-D-25-00838.1","DOIUrl":"10.4300/JGME-D-25-00838.1","url":null,"abstract":"<p><strong>Background: </strong>US family medicine (FM) residency training emphasizes the development of patient-physician relationships, which are associated with patient satisfaction, improved health outcomes, cost containment, and retention. It is important to examine whether this emphasis translates into observable performance during physicians' early years of independent practice.</p><p><strong>Objective: </strong>To assess the association between residency Milestone ratings related to patient-physician relationships and patient retention in early clinical practice.</p><p><strong>Methods: </strong>We analyzed data from 2375 FM residents across 435 programs who completed training in June 2016, linked to 416 249 patients in a commercial health insurance claims dataset. The dataset included patients seen for evaluation and management services and chronic disease visits within 2 years after resident graduation. Subject matter experts identified, a priori, Milestone subcompetencies relevant to patient-physician relationships and retention. A logistic regression model was used to evaluate the association between composite Milestone ratings and patient retention.</p><p><strong>Results: </strong>After adjusting for each patient's total visit count to any primary care physician, FM graduates with higher Milestone ratings than their program peers were associated with greater patient retention (OR, 1.19; 95% CI, 1.16-1.22). This association was stronger among graduates from programs with higher composite program-level Milestone performance (OR, 1.30; 95% CI, 1.26-1.35).</p><p><strong>Conclusions: </strong>Higher ratings in patient-physician relationship subcompetencies were associated with increased patient retention among early-career FM physicians, with stronger associations in programs with higher program mean ratings.</p>","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"18 5","pages":"597-604"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lessons for Medical Educators From an AI Breakthrough in Mathematics.","authors":"Jenny X Chen","doi":"10.4300/JGME-D-26-00568.1","DOIUrl":"10.4300/JGME-D-26-00568.1","url":null,"abstract":"","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"18 5","pages":"543-545"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased Prevalence of Large Language Model-Associated Language in US Residency Application Personal Statements.","authors":"Darrow Traylor, Andrea Carlson, Ravi Chacko, Elise Lovell, Bethany J Slater, Brandyn Mason, Kent Nelson, Kevin Loughry, Ryan McKillip","doi":"10.4300/JGME-D-26-00014.1","DOIUrl":"10.4300/JGME-D-26-00014.1","url":null,"abstract":"<p><strong>Background: </strong>Residency leaders increasingly rely on personal statements to assess applicant communication skills and individuality. Personal statements written by large language models (LLMs) have been rated more readable but more generic than applicant-written ones, yet the prevalence of LLM use and its effect on applicant writing remain unknown.</p><p><strong>Objective: </strong>To measure the prevalence of LLM-associated language in personal statements from the 2017 through 2024 application cycles and assess associated changes in applicant writing.</p><p><strong>Methods: </strong>This retrospective descriptive study analyzed personal statements submitted to the internal medicine, family medicine, pediatrics, emergency medicine, and general surgery residencies of a US academic medical center for the 2017 through 2024 application cycles. Using one-sample <i>t</i> tests, prevalence in 2024 of 27 LLM-associated words and 12 control words, identified in prior research, was compared to 2017-2023, the period before widespread LLM release. Secondary outcomes assessing writing characteristics reflective of communication skills and individuality included linguistic complexity (Flesch Reading Ease, word count), lexical diversity (type-token ratio), personalization (first- and third-person pronoun frequency), and topic entropy.</p><p><strong>Results: </strong>Among 62 132 statements (55 199 from 2017-2023, 6933 from 2024), LLM-associated word prevalence increased from 27.9% (SD, 1.05%) pre-2024 to 45.6% in 2024 (<i>P</i><.001). Average length decreased from 717.2 (SD, 13.6) words to 676.6 (<i>P</i><.001), while the type-token ratio increased from 0.49 (SD, 0.006) to 0.51 (<i>P</i><.001). Approximately 3 fewer first-person pronouns were used per statement (<i>P</i><.001). Topic entropy remained stable.</p><p><strong>Conclusions: </strong>LLM-associated language increased 17.7% in 2024, corresponding to approximately 1 in 6 additional personal statements, while writing characteristics reflective of communication skills and individuality changed modestly.</p>","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"18 5","pages":"588-596"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Community-Based Health Care Disparities Curriculum: Perceptions From Multispecialty Residents, Community Partners, and Program Directors.","authors":"Jessica L De Santis, Anne L Castro, Christopher Simenz, Stacy L Fairbanks, Michael Malinowski, M Tracy Zundel, David Nelson","doi":"10.4300/JGME-D-25-00912.1","DOIUrl":"10.4300/JGME-D-25-00912.1","url":null,"abstract":"<p><strong>Background: </strong>Graduate medical education (GME) focuses predominantly on clinical practice, and some specialties lack effective models for in-depth health care disparities (HCD) education, even though it is required.</p><p><strong>Objective: </strong>We describe the perspectives and feasibility data of residents, program directors, and community partners across multiple specialties at the Medical College of Wisconsin regarding a community-based HCD curriculum that integrates community outreach with discussion-based educational sessions.</p><p><strong>Methods: </strong>In academic years 2022-2023 and 2023-2024, first-year residents from 5 and 8 specialties participated in 2 half-day community outreach sessions and 3 half-day educational sessions. Residents (n=99), program directors (n=16), and community partners (n=5) were surveyed for perceptions of and satisfaction with the curriculum. Resident responses to survey questions were aggregated into topic areas. Faculty time, community partner donations, speaker fees, and average cost per resident for food and transportation were calculated for feasibility.</p><p><strong>Results: </strong>Residents (99 of 129, 77%) reported overall satisfaction with educational sessions (median, 8; IQR, 6-10; 66% survey participation) and outreach experiences (median, 10; IQR, 8-10; 68% survey participation). Program directors (16 of 16, 100% survey participation; median, 9; IQR, 7-10) and community partners (5 of 5, 100% survey participation; median, 10; IQR, 10-10) reported overall satisfaction with the curriculum. Program directors reported satisfaction with logistics (median, 8; IQR, 7-9) and community partners with hosting residents (median, 10; IQR, 10-10). Costs averaged $9 per resident per educational session, and $38 per resident per outreach experience. Faculty time commitment averaged 32 hours per academic year.</p><p><strong>Conclusions: </strong>This study demonstrates that integrating community engagement into HCD education in residency is feasible and well-received by residents, program leadership, and community partners.</p>","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"18 5","pages":"563-573"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing Unexpected Residency Vacancies Outside the Match.","authors":"Matthew R Meunier, Christopher L Boswell, Katherine M Schupack, Cesar A Gonzalez","doi":"10.4300/JGME-D-26-00319.1","DOIUrl":"10.4300/JGME-D-26-00319.1","url":null,"abstract":"","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"18 5","pages":"532-535"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}