Academic Medicine最新文献

{"title":"Commentary on \"Discharged into Clouds\".","authors":"Woods Nash, Nick Almeida","doi":"10.1097/01.ACM.0001168120.63862.57","DOIUrl":"10.1097/01.ACM.0001168120.63862.57","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":"100 10","pages":"1151"},"PeriodicalIF":5.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preparing to Thrive: Supporting Learners With Disabilities Through the Undergraduate-to-Graduate Medical Education Transition.","authors":"Zoie C Sheets, Maureen Fausone, Anne Messman, Pilar Ortega, Jessica Ramsay, Megan Creasman, Nalinda Charnsangavej","doi":"10.1097/ACM.0000000000006136","DOIUrl":"10.1097/ACM.0000000000006136","url":null,"abstract":"<p><strong>Abstract: </strong>The transition from undergraduate to graduate medical education is a complex time that may be impacted by bias, limited resources, and inadequate standardization and information sharing. For learners with disabilities, there may be additional barriers including disability-specific bias, limited guidance on obtaining needed accommodations, and misunderstanding regarding the requirements and benefits of matching and retaining a disabled learner. The authors, through our personal and professional experience, identify four key areas to further support disabled learners in the residency transition process. These include: (1) disability disclosure, (2) selecting a specialty, (3) selecting a program, and (4) requesting and utilizing accommodations in graduate medical education. Strategies recommended can help both undergraduate and graduate medical programs intentionally support these learners and increase the prevalence and success of disabled learners across the medical education continuum.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"S161-S165"},"PeriodicalIF":5.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Intersection of Disability, Race, Ethnicity, and Financial Background on Food Insecurity Among Medical Students.","authors":"Mytien Nguyen, Bassel M Shanab, Pavan Khosla, Dowin Boatright, Sarwat I Chaudhry, Eric J Brandt, Nour M Hammad, Karri L Grob, Morgan Brinker, Caden Cannon, Katherine Cermack, Maha Fathali, John W R Kincaid, Yuxing Emily Ma, Yuu Ohno, Aishwarya Pradeep, Anitza Quintero, Neelufar Raja, Brendan L Rooney, Sasha Stogniy, Kiara K Smith, George Sun, Jahnavi Sunkara, Belinda Tang, Gabriella VanAken Rubick, JiCi Wang, Sanaea Z Bhagwagar, Nathan Luzum, Frank Liu, John S Francis, Lisa M Meeks, Cindy W Leung","doi":"10.1097/ACM.0000000000006156","DOIUrl":"10.1097/ACM.0000000000006156","url":null,"abstract":"<p><strong>Purpose: </strong>Food insecurity is negatively associated with college students' well-being and academic performance. Little is known about the prevalence of food insecurity among medical students. This study examined variations in food insecurity among medical students at 15 schools, analyzing differences by disability status, race, ethnicity, and financial background.</p><p><strong>Method: </strong>Between March-October 2024, 1,659 students across 15 MD-granting medical schools completed an online survey. Over the past 12 months, food insecurity was assessed using the 10-item U.S. Household Food Security Survey Module. Additional survey measures included age, gender identity, race, ethnicity, Pell Grant recipient status, disability status, and graduation year. Poisson regression models were utilized to estimate the relative risk of food insecurity based on self-reported disability, race, ethnicity, and financial background and their intersections.</p><p><strong>Results: </strong>In the analytic sample, a higher proportion of students with disability (33.7% vs 21.8%, P <.001), from low-income backgrounds (34.9% vs 20.3%, P <.001), and those underrepresented in medicine (URiM) reported food insecurity (37.6% vs 19.7%, P <.001). Across intersectional groups, URiM low-income students with disability have the highest rate of food insecurity (62.5% vs 16.8% for nondisabled non-URiM non-low-income peers, P <.001). In the fully adjusted model, compared to nondisabled non-URiM non-low-income students, non-URiM and URiM low-income students with disability (non-URiM aRR: 2.44, 95% CI: 1.72-3.48; URiM aRR: 3.52, 95% CI: 2.79-4.45) had a higher relative risk of food insecurity.</p><p><strong>Conclusions: </strong>In this study, nearly 1 in 4 medical students were food insecure. URiM, low-income, and students with disabilities reported food insecurity at a significantly higher rate than their peers, with over half of URiM low-income students with disabilities reporting food insecurity. These findings suggest a promising yet underutilized avenue for approaches to enhancing well-being. Proactive efforts should prioritize supporting marginalized students by linking them to nutrition resources and advocating for policies that address their essential needs.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"S113-S118"},"PeriodicalIF":5.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Asynchronous Online Course to Introduce Interprofessional Education to Incoming Health Professions Students.","authors":"Laurel Daniels Abbruzzese, Urmi A Desai, Ashley Kingon, Michelle N Skelton, Phyllis R Simon, Jean N Churchill, Jordana Vanderselt, Letty Moss-Salentijn","doi":"10.1097/ACM.0000000000006121","DOIUrl":"10.1097/ACM.0000000000006121","url":null,"abstract":"<p><strong>Problem: </strong>Interprofessional practice and education (IPE) (educators and learners from ≥2 health professions) can improve patient health outcomes and is required for most health professional program accreditation. Conflicting academic schedules and space limitations are obstacles to implementing interprofessional learning experiences that prepare future clinicians for team-based care.</p><p><strong>Approach: </strong>In February 2019, an asynchronous online course (eCUIMC) was created at Columbia University Irving Medical Center (CUIMC) to equip incoming health professions students to deliver team-based health care and engage in IPE without a shared space and time. eCUIMC oriented first-year students to the IPE core competencies: (1) values and ethics for interprofessional practice, (2) roles and responsibilities, (3) interprofessional communication, and (4) teams and teamwork. Participants were assigned to interprofessional teams of 8 students and 2 faculty. During a 5-day period in fall 2019 and 2020, participants completed interactive activities, performed a clinical case study, facilitated discussions, and completed a self-directed learning activity addressing structural determinants of health. Students completed a pre-post survey of beliefs and attitudes using the 21-item Interprofessional Socialization and Valuing Scale, which uses a 7-point scale to assess the change in interprofessional socialization after interprofessional education, with 1 indicating not at all and 7 indicating to a very great extent.</p><p><strong>Outcomes: </strong>A total of 1,345 participants, representing 10 different health professional programs, completed course evaluations and a pre-post survey of attitudes. Most students found the course engaging, relevant, and manageable, with 1,267 (94%) reporting increased understanding of other health professions. Mean Interprofessional Socialization and Valuing Scale scores increased from 4.5 to 5.8 ( P < .001).</p><p><strong>Next steps: </strong>eCUIMC is a feasible and effective modality for uniting students from different health profession programs where time and space are barriers. eCUIMC is being integrated into the curriculum as an annual requirement for all 10 CUIMC health professions programs.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"1167-1171"},"PeriodicalIF":5.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trust the Process.","authors":"Benjamin W Frush","doi":"10.1097/ACM.0000000000006170","DOIUrl":"10.1097/ACM.0000000000006170","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"1171"},"PeriodicalIF":5.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reflections After Testifying at an Asylum Hearing.","authors":"Juliana E Morris","doi":"10.1097/ACM.0000000000006174","DOIUrl":"10.1097/ACM.0000000000006174","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"1235"},"PeriodicalIF":5.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Private Equity Investment in Health Care With Medical Education Disruptions.","authors":"Kelly J Caverzagie, Amber L Ryan, Sarah E Brotherton, Kevin Heckman, Victoria Stagg Elliott","doi":"10.1097/ACM.0000000000006126","DOIUrl":"10.1097/ACM.0000000000006126","url":null,"abstract":"<p><strong>Abstract: </strong>Private equity investment in health care has increased, attracted by the growing commercialization of this industry sector and the profit possibilities of an aging population, and is consequently affecting medical education and the education of other health care professionals. The goal of private equity-generating profit from financial investment in a relatively short period-is not aligned with the goals of the medical and health care education systems. This lack of alignment has already disrupted several education programs, most notably the ones at Philadelphia's Hahnemann University Hospital in 2019, and has the potential to disrupt and destabilize many other programs and institutions, even if they do not close. In the long term, this lack of alignment can detract from the primary mission of medical and health care education. Private equity investment may favor specialties that are more lucrative for a health care system, whereas those that are less financially profitable but can have a greater positive impact on the health of society may receive less financial support. Without appropriate laws, regulations, and policies to blunt potential negative impacts, ongoing private equity investment into the health care system could exacerbate the imbalance in the number of physicians trained in various specialties, thus placing a larger strain on the national health care system.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"1120-1126"},"PeriodicalIF":5.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A 10-Year Review of U.S. Medical School Revenue, Fiscal Years 2012 to 2021.","authors":"Alexander G Geboy, Diana Tung, Valerie M Dandar","doi":"10.1097/ACM.0000000000006138","DOIUrl":"10.1097/ACM.0000000000006138","url":null,"abstract":"<p><strong>Purpose: </strong>This study examines how U.S. medical school revenue diversification has changed over time, particularly growth of practice plan, hospital, and research revenue sources, and explores how these revenue changes have occurred alongside changes to the number of full-time faculty, student enrollment, and tuition and fees revenues.</p><p><strong>Method: </strong>Aggregate census data for fiscal years (FYs) 2012 to 2021 are from fully accredited U.S. medical schools and affiliated organizations. Most revenue source data are from December 2022. Tuition and student fees analysis was conducted in June 2023. The numbers of full-time faculty for FY 2012 to FY 2018 are from the Association of American Medical Colleges (AAMC) Faculty Roster and for full-time faculty for FY 2019 onward from the Liaison Committee on Medical Education Annual Medical School Questionnaire Part II. Student enrollment data are from the AAMC Student Records System. Faculty and student enrollment data are from June 2023.</p><p><strong>Results: </strong>Between FY 2012 and FY 2021, total U.S. medical school revenue increased by 48%, from $95.8 billion to $142.0 billion (in constant 2012 dollars). Most (78%) of this growth came from practice plans and hospitals, whereas revenues from federal research grants and contracts saw attenuated growth (12%). The number of full-time clinical faculty increased by 35% compared with a 9% increase in basic science faculty. Total undergraduate medical education student enrollment increased 17%, with average enrollment per school increasing 2%, from 602.6 to 616.3 students.</p><p><strong>Conclusions: </strong>Practice plan and hospital revenue accounted for the largest portion of total U.S. medical school revenue. The number of total full-time clinical faculty increased, potentially reflecting robust clinical service-related medical education activity. Although U.S. medical school revenue has continued to increase despite environmental fluctuations, concern remains that current trends in the diversification of U.S. medical school revenue could hinder education, research, and clinical missions.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"1172-1178"},"PeriodicalIF":5.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Core Competencies for Students Entering Medical School: Reaching Pan-Canadian Consensus for Inclusive and Accessible Medical Education.","authors":"Cheryl L Holmes, Laura Yvonne Bulk, Naomi Lear, Lynn Ashdown, Quinten K Clarke, Laura Farrell, Rachel Giddings, Lisa Graves, Julia Ersilia Hanes, George Kim, Michael Quon, Saleem Razack, Francesco A Rizzuti, Ginger Ruddy, Alex Scott, Erene Stergiopoulos, Lee Toner, Laura Nimmon","doi":"10.1097/ACM.0000000000006132","DOIUrl":"10.1097/ACM.0000000000006132","url":null,"abstract":"<p><strong>Abstract: </strong>A socially accountable physician workforce must include disabled learners and providers. However, current Canadian Technical Standards (TS) for medical school admissions create barriers to their inclusion. These standards overlook advances in assistive technology, universal design, evolving inclusion practices, and legal protections. Replacing the TS required consensus, but traditional methods of achieving consensus on disability inclusion risk reinforcing ableism in medical education. To address challenges with existing TS, the Association of Faculties of Medicine of Canada (AFMC) formed the \"Re-envisioning TS Working Group,\" using a novel consensus approach grounded in disability inclusion and critical disability discourse. Guided by transparency, accessibility, and respect for disability as diversity, the group prioritized engagement with disabled physicians, educators, scholars, and learners. The WG followed 5 stages: (1) identifying key concepts and reviewing literature on TS reform and ableism; (2) examining relevant legislation and case law; (3) drafting functional Core Competencies; (4) consulting partners across the medical education continuum; and (5) presenting outcomes to the AFMC Board, highlighting a commitment to disability inclusion in undergraduate medical education. The AFMC Board unanimously endorsed the \"Report on Re-Envisioning Technical Standards,\" including the \"Desired Outcomes\" and the \"Core Competencies for Entering Medical Students.\" The AFMC's adoption of functional Core Competencies is a significant step toward inclusion and support for learners with disabilities in Canadian medical education. Medical schools should adopt these competencies, combat ableism, and invest in universal design to promote access. Accommodation support should extend from admission through postgraduate training to independent practice. Finally, efforts to foster an inclusive culture and contribute to a healthy, diverse physician workforce must be evaluated as part of medical schools' social accountability mandate.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"S152-S160"},"PeriodicalIF":5.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Compounded Challenges: The Impact of Race and Disability on Leave of Absence and Time to Graduation During Undergraduate Medical Education.","authors":"William H Eidtson, Mytien Nguyen, Tiffany M Hodgens, Karina Pereira-Lima, Tonya L Fancher, Zoie C Sheets, Lydia Smeltz, Suchita Rastogi, Raymond H Curry, Sharad Jain, Charlene Green, Christina J Grabowski, Rahul Patwari, Jeffrey S LaRochelle, John Francis, Christopher J Moreland, Shami Tarlanov, Catherine Stauffer, Blake Hardin, Leah Tolby, Gabriel Abrams, Christine Low, Rylee Betchkal, Joanna Arnold, Caitlyn Coates, Yoon Soo Park, Lisa M Meeks, Michael H Kim","doi":"10.1097/ACM.0000000000006125","DOIUrl":"10.1097/ACM.0000000000006125","url":null,"abstract":"<p><strong>Purpose: </strong>Medical students with disabilities (MSWD) from racial and ethnic populations that are underrepresented in medicine (URiM) may experience disparate educational paths compared to their peers, including disruption during training. This study examined whether MSWD who are also URiM experienced disproportionate rates of unintended leaves of absence (LOA) or extended time to graduation (TTG) compared to those who are only URiM, only MSWD, or neither.</p><p><strong>Method: </strong>The authors analyzed data from 372 MSWD and 689 matched nondisabled controls across 9 U.S. MD-granting programs. Students were matched by gender, graduation cohort, and Medical College Admission Test scores. MSWD were categorized into cognitive, physical/sensory, and chronic health disabilities, while race/ethnicity was classified as underrepresented in medicine (e.g., American Indian/Alaska Native, Black/African American, Hispanic/Latino, or Native Hawaiian/Pacific Islander), Asian, or White. Likelihood of LOA and extended TTG outcomes were assessed using mixed-effect logistic regression models.</p><p><strong>Results: </strong>MSWD were 2.6 times more likely to take an LOA (25.0% vs 12.6%, P < .001) and 2.6 times more likely to have extended TTG than nondisabled peers (38.6% vs 21.9%, P < .001). URiM students were 1.7 times more likely to take an LOA (22.9% vs 15.3%, P = .01) and 2.1 times more likely to experience extended TTG than White students (36.2% vs 22.5%, P < .001). Adjusted analysis showed URiM MSWD were 5.9 times more likely to take an LOA (40.6% vs 13.4%, P < .001) and 4.9 times more likely to experience extended TTG than nondisabled White peers (56.4% vs 28.7%, P < .001).</p><p><strong>Conclusions: </strong>URiM MSWD faced disproportionately heightened risks for academic disruptions in the form of LOA and extended TTG, underscoring the need for interventions that are more supportive of students with overlapping identities.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"S105-S112"},"PeriodicalIF":5.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}