Journal of graduate medical education最新文献

{"title":"Community-Based Training and Impact on Care of Socially Disadvantaged Populations.","authors":"Freesia Quezada, Peter Manfredonia, Trenten L Fenster, Michael Topmiller, Yalda Jabbarpour, Jeongyoung Park","doi":"10.4300/JGME-D-25-00680.1","DOIUrl":"https://doi.org/10.4300/JGME-D-25-00680.1","url":null,"abstract":"<p><strong>Background: </strong>Community-based training is crucial for the equitable development of the physician workforce and influences the practice location of new physicians. However, little is known about the distribution of the physicians trained in community-based settings across areas of varying social risks.</p><p><strong>Objective: </strong>To examine the association between community-based training of family physicians and subsequent practice comprising socially disadvantaged populations.</p><p><strong>Methods: </strong>Using the 2017-2022 American Board of Family Medicine Initial Certification Questionnaires and the 2024 American Medical Association Physician Masterfile, we performed a multivariate logistic regression analysis to assess the association between community-based training-applying a broad definition (training outside of large academic centers) and a narrow definition (training specifically in Teaching Health Centers [THCs] or rural/Rural Training Tracks [RTTs])-and subsequent practice location in communities with high health-related social needs.</p><p><strong>Results: </strong>Among the 15 851 family physicians, 5717 (36.1%) trained outside a hospital or large academic center (broad), whereas only 1419 (9%) trained in THCs or rural/RTTs (narrow). Family physicians from a narrowly defined community-based training had higher odds of practicing in socially disadvantaged communities (Social Deprivation Index≥median) compared to their counterparts (OR, 1.224; 95% CI, 1.097-1.366; <i>P</i><.001). No significant association was found in the model using the broad definition of community-based training. Male, non-White, Hispanic, and international medical graduates were statistically positively associated with practicing in areas with high health-related social needs.</p><p><strong>Conclusions: </strong>This study shows that family physicians who trained in THCs or rural/RTTs are significantly more likely to be practicing in areas with high social needs than those who did not.</p>","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"18 4","pages":"424-431"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763865","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":"Associations Between Medical School Metrics and Early Pediatric Resident Milestones.","authors":"Veronica M Gonzalez, Raymond Parlar-Chun, Gary Beck Dallaghan, Kristel Montano, Nicholas Kuzma, Sheela Lahoti, Alan Schwartz","doi":"10.4300/JGME-D-25-01139.1","DOIUrl":"10.4300/JGME-D-25-01139.1","url":null,"abstract":"<p><strong>Background: </strong>Residency programs utilize holistic review processes to identify applicants prepared for early clinical responsibility, yet limited evidence links undergraduate medical education (UME) metrics with Accreditation Council for Graduate Medical Education (ACGME) Milestone-based performance.</p><p><strong>Objective: </strong>To determine which UME factors are associated with early pediatric residency performance as measured by the ACGME Milestones.</p><p><strong>Methods: </strong>This multi-institutional, retrospective cohort study included medical students who graduated and completed at least one year of residency in categorical pediatrics between 2014 and 2018. We collected United States Medical Licensing Examination Step 1 and Step 2 Clinical Knowledge scores, overall pediatric clinical performance assessment scores, other required clerkship grades, National Board of Medical Examiners (NBME) Pediatrics Subject Examination scores, leadership roles, research/scholarly activity, and honorary society membership. The primary outcomes were ACGME midyear Milestone data for postgraduate year 1 residents. Linear mixed models with random and fixed effects were used for data analysis.</p><p><strong>Results: </strong>Of 451 eligible graduates from 5 participating sites, 414 (91.8%) were included in the analysis, with Milestone data available for 228 (55.1%). The NBME Examination score was the only covariate associated with all 6 Core Competency Milestones (<i>B</i>=0.03; 95% CI, 0.00-0.06; <i>P</i><.05). Earning an honors or high pass during the pediatrics clerkship was associated with Milestone performance in 2 competencies-Professionalism and Patient Care (<i>B</i>=1.10-1.18; 95% CI, 0.36-1.92; <i>P</i><.05).</p><p><strong>Conclusions: </strong>Pediatric NBME scores and clinical performance grades were associated with either all or select midyear Milestone competencies in the first year of pediatrics residency.</p>","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"18 4","pages":"439-447"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761773","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":"Navigating the Tension Between Learner Autonomy and Patient Safety in Procedural Education.","authors":"Melissa Nadler, Kevin Fung Cai, Rafael Ortega","doi":"10.4300/JGME-D-26-00062.1","DOIUrl":"https://doi.org/10.4300/JGME-D-26-00062.1","url":null,"abstract":"<p><p>Visual Abstract.</p>","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"18 4","pages":"391-393"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762189","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":"To the Editor: Making Clinical Reasoning Visible During Resident Use of Artificial Intelligence.","authors":"Rajkumar Kundavaram, Bhavna Dhingra","doi":"10.4300/JGME-D-26-00408.1","DOIUrl":"https://doi.org/10.4300/JGME-D-26-00408.1","url":null,"abstract":"","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"18 4","pages":"505-506"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762584","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":"Crossing the In-Between.","authors":"Mohammed Ayyad","doi":"10.4300/JGME-D-26-00288.1","DOIUrl":"https://doi.org/10.4300/JGME-D-26-00288.1","url":null,"abstract":"","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"18 4","pages":"499-500"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763123","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":"Training Surgeons to Take the Me Out of Team.","authors":"AlleaBelle Bradshaw, Ahmet Kilic","doi":"10.4300/JGME-D-26-00190.1","DOIUrl":"https://doi.org/10.4300/JGME-D-26-00190.1","url":null,"abstract":"","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"18 4","pages":"399-401"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763228","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":"What the Eye Is For.","authors":"Henry Bair","doi":"10.4300/JGME-D-26-00256.1","DOIUrl":"https://doi.org/10.4300/JGME-D-26-00256.1","url":null,"abstract":"","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"18 4","pages":"501-502"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763237","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":"Leveraging Large Language Models to Summarize Data and Free-Text Comments From Resident Assessments.","authors":"Carisa M Cooney, Rebecca Slattery, Damon S Cooney, Scott D Lifchez, Julie E Park","doi":"10.4300/JGME-D-25-01049.1","DOIUrl":"https://doi.org/10.4300/JGME-D-25-01049.1","url":null,"abstract":"<p><strong>Background: </strong>Summarizing resident assessments for Clinical Competency Committee or mentoring meetings is challenging. This especially applies to raters' free-text comments, which often provide valuable feedback.</p><p><strong>Objective: </strong>To assess feasibility and accuracy of using a large language model (LLM) to label free-text comments as \"Strengths\" or \"Areas for Improvement\" from end-of-rotation assessments of residents.</p><p><strong>Methods: </strong>We performed a mixed-methods study of residents' end-of-rotation assessments completed between July 1, 2024 and June 30, 2025. Following data de-identification, we used a private (paid) LLM account (ChatGPT-4o) to compile numerical and label free-text (\"Strengths,\" \"Areas for Improvement\") feedback. We assessed feasibility using time spent de-identifying data, time for LLMs to return labeled free-text comments, and LLM recall (ability to accurately extract/label free-text feedback). We performed 2 confirmatory trials (free LLMs: MS CoPilot, ChatGPT-4) to ascertain reproducibility. Two subject matter experts labeled free-text comments to determine LLM labeling accuracy. The study was performed in 2025.</p><p><strong>Results: </strong>Our dataset represented 277 individual assessments for 25 unique residents. Feasibility data demonstrated data de-identification time of ∼60 minutes and LLM processing/labeling times of <7 minutes per LLM. All LLMs consistently compiled all free-text entries, accurately labeling 59.7% of free-text comments. Human analysis of comments (476) identified 388 (81.5%) \"Strengths\" and 88 (18.5%) \"Areas for Improvement.\" Of these, LLM recall was 67.8% for \"Strengths\" and 23.9% for \"Areas for Improvement.\"</p><p><strong>Conclusions: </strong>We designed prompts that feasibly labeled end-of-rotation assessment free-text comments across 3 LLMs with recall for \"Strengths\" 2.5 times higher than recall for \"Areas for Improvement.\"</p>","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"18 4","pages":"477-482"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765299","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":"To the Editor: In Response to \"We Co-Created This Mess\": A Couples Counselor's Thoughts.","authors":"Sandrijn M van Schaik","doi":"10.4300/JGME-D-26-00446.1","DOIUrl":"https://doi.org/10.4300/JGME-D-26-00446.1","url":null,"abstract":"","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"18 4","pages":"503"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759266","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":"Attention, Engagement, and Retention Walk Into a Noon Conference: Using Humor to Improve Resident Education.","authors":"Barat S Venkataramany","doi":"10.4300/JGME-D-26-00105.1","DOIUrl":"https://doi.org/10.4300/JGME-D-26-00105.1","url":null,"abstract":"","PeriodicalId":37886,"journal":{"name":"Journal of graduate medical education","volume":"18 4","pages":"394-398"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148766199","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}