Identifying inaccuracies on emergency medicine residency applications.
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BACKGROUND: Previous trials have showed a 10-30% rate of inaccuracies on applications to individual residency programs. No studies have attempted to corroborate this on a national level. Attempts by residency programs to diminish the frequency of inaccuracies on applications have not been reported. We seek to clarify the national incidence of inaccuracies on applications to emergency medicine residency programs. METHODS: This is a multi-center, single-blinded, randomized, cohort study of all applicants from LCME accredited schools to involved EM residency programs. Applications were randomly selected to investigate claims of AOA election, advanced degrees and publications. Errors were reported to applicants' deans and the NRMP. RESULTS: Nine residencies reviewed 493 applications (28.6% of all applicants who applied to any EM program). 56 applications (11.4%, 95%CI 8.6-14.2%) contained at least one error. Excluding "benign" errors, 9.8% (95% CI 7.2-12.4%), contained at least one error. 41% (95% CI 35.0-47.0%) of all publications contained an error. All AOA membership claims were verified, but 13.7% (95%CI 4.4-23.1%) of claimed advanced degrees were inaccurate. Inter-rater reliability of evaluations was good. Investigators were reluctant to notify applicants' dean's offices and the NRMP. CONCLUSION: This is the largest study to date of accuracy on application for residency and the first such multi-centered trial. High rates of incorrect data were found on applications. This data will serve as a baseline for future years of the project, with emphasis on reporting inaccuracies and warning applicants of the project's goals. (+info)
Mistreatment of university students most common during medical studies.
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BACKGROUND: This study concerns the occurrence of various forms of mistreatment by staff and fellow students experienced by students in the Faculty of Medicine and the other four faculties of the University of Oulu, Finland. METHODS: A questionnaire with 51 questions on various forms of physical and psychological mistreatment was distributed to 665 students (451 females) after lectures or examinations and filled in and returned. The results were analysed by gender and faculty. The differences between the males and females were assessed statistically using a test for the equality of two proportions. An exact two-sided P value was calculated using a mid-P approach to Fisher's exact test (the null hypothesis being that there is no difference between the two proportions). RESULTS: About half of the students answering the questionnaire had experienced some form of mistreatment by staff during their university studies, most commonly humiliation and contempt (40%), negative or disparaging remarks (34%), yelling and shouting (23%), sexual harassment and other forms of gender-based mistreatment (17%) and tasks assigned as punishment (13%). The students in the Faculty of Medicine reported every form of mistreatment more commonly than those in the Faculties of Humanities, Education, Science and Technology. Experiences of mistreatment varied, but clear messages regarding its patterns were to be found in each faculty. Female students reported more instances of mistreatment than males and were more disturbed by them. Professors, lecturers and other staff in particular mistreated female students more than they mistreated males. About half of the respondents reported some form of mistreatment by their fellow students. CONCLUSION: Students in the Faculty of Medicine reported the greatest amount of mistreatment. If a faculty mistreats its students, its success in the main tasks of universities, research, teaching and learning, will be threatened. The results challenge university teachers, especially in faculties of medicine, to evaluate their ability to create a safe environment conducive to learning. (+info)
Sexual contact in the doctor-patient relationship in The Netherlands.
(19/86)
OBJECTIVE: To obtain data on sexual contact between doctors and their patients. DESIGN: Anonymous questionnaire with 17 items sent to all working gynaecologists (n = 595) and all ear, nose, and throat specialists (n = 380) in the Netherlands. RESULTS: Response rate was 74%; a total 64 doctors gave a reason for not completing the questionnaire. 201 (59%) male gynaecologists and 128 (56%) male ear nose, and throat specialists indicated that sexual feelings are acceptable in the doctor-patient relationship; 286 (85%) and 186 (81%), respectively, had felt sexually attracted to a patient at some time, as had 14 (27%) female gynaecologists. More than half (59%) of the doctors who indicated that sexual feelings are unacceptable in the doctor-patient relationship had experienced these feelings, and 91% of this group had a negative attitude towards these feelings. 4% of respondents in each group had had actual sexual contact with patients. Most gynaecologists were in favour of having more attention paid to sexual problems during training; having their professional society take an official viewpoint; subsequent public support of this viewpoint; and taking on an impartial counsellor for the patients as well as the doctors. CONCLUSION: Sexuality exists in the doctor-patient relationship. Gynaecologists have a higher risk of having sexual contact with their patients than do ear, nose, and throat specialists but compensate for this greater risk by a higher state of recognition and acknowledgement. (+info)
The threat to scientific integrity in environmental and occupational medicine.
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Over the last century, environmental and occupational medicine has played a significant role in the protection and improvement of public health. However, scientific integrity in this field has been increasingly threatened by pressure from some industries and governments. For example, it has been reported that the tobacco industry manipulated eminent scientists to legitimise their industrial positions, irresponsibly distorted risk and deliberately subverted scientific processes, and influenced many organisations in receipt of tobacco funding. Many environmental whistleblowers were sued and encountered numerous personal attacks. In some countries, scientific findings have been suppressed and distorted, and scientific advisory committees manipulated for political purposes by government agencies. How to respond to these threats is an important challenge for environmental and occupational medicine professionals and their societies. The authors recommend that professional organisations adopt a code of ethics that requires openness from public health professionals; that they not undertake research or use data where they do not have freedom to publish their results if these data have public health implications; that they disclose all possible conflicts; that the veracity of their research results should not be compromised; and that their research independence be protected through professional and legal support. The authors furthermore recommend that research funding for public health not be directly from the industry to the researcher. An independent, intermediate funding scheme should be established to ensure that there is no pressure to analyse data and publish results in bad faith. Such a funding system should also provide equal competition for funds and selection of the best proposals according to standard scientific criteria. (+info)
Disciplinary action by medical boards and prior behavior in medical school.
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BACKGROUND: Evidence supporting professionalism as a critical measure of competence in medical education is limited. In this case-control study, we investigated the association of disciplinary action against practicing physicians with prior unprofessional behavior in medical school. We also examined the specific types of behavior that are most predictive of disciplinary action against practicing physicians with unprofessional behavior in medical school. METHODS: The study included 235 graduates of three medical schools who were disciplined by one of 40 state medical boards between 1990 and 2003 (case physicians). The 469 control physicians were matched with the case physicians according to medical school and graduation year. Predictor variables from medical school included the presence or absence of narratives describing unprofessional behavior, grades, standardized-test scores, and demographic characteristics. Narratives were assigned an overall rating for unprofessional behavior. Those that met the threshold for unprofessional behavior were further classified among eight types of behavior and assigned a severity rating (moderate to severe). RESULTS: Disciplinary action by a medical board was strongly associated with prior unprofessional behavior in medical school (odds ratio, 3.0; 95 percent confidence interval, 1.9 to 4.8), for a population attributable risk of disciplinary action of 26 percent. The types of unprofessional behavior most strongly linked with disciplinary action were severe irresponsibility (odds ratio, 8.5; 95 percent confidence interval, 1.8 to 40.1) and severely diminished capacity for self-improvement (odds ratio, 3.1; 95 percent confidence interval, 1.2 to 8.2). Disciplinary action by a medical board was also associated with low scores on the Medical College Admission Test and poor grades in the first two years of medical school (1 percent and 7 percent population attributable risk, respectively), but the association with these variables was less strong than that with unprofessional behavior. CONCLUSIONS: In this case-control study, disciplinary action among practicing physicians by medical boards was strongly associated with unprofessional behavior in medical school. Students with the strongest association were those who were described as irresponsible or as having diminished ability to improve their behavior. Professionalism should have a central role in medical academics and throughout one's medical career. (+info)
Factors associated with high-severity disciplinary action by a state medical board: a Texas study of medical license revocation.
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CONTEXT: There has been an increase in research evaluating factors associated with disciplinary action of physicians by state medical boards. However, factors related to the severity of disciplinary action are lacking. By investigating these factors while controlling for the type of violation, the authors sought to determine whether physician characteristics influenced the process of disciplinary action by state medical boards. METHODS: Physicians disciplined by the Texas Medical Board between January 1, 1989, and December 31, 1998, were included in this case-controlled study (N=1129). Multivariate logistic regression analysis was used to compute odds ratios (ORs) and 95% confidence intervals (CIs) for factors associated with license revocation, the most severe disciplinary action, compared with all other forms of disciplinary action combined. RESULTS: Anesthesiologists (OR, 2.45; 95% CI, 1.05-5.74), general practitioners (OR, 1.80; 95% CI, 1.01-3.19), and psychiatrists (OR, 2.68; 95% CI, 1.41-5.13), as well as those with multiple disciplinary actions (OR, 1.91; 95% CI, 1.29-2.83) were most susceptible to license revocation. The more years a disciplined physician was in practice, the greater risk he or she had of license revocation (OR, 1.05; 95% CI, 1.04-1.07). CONCLUSIONS: Factors associated with a greater likelihood of license revocation for physicians are: primary medical specialty, number of years in practice, and a history of multiple disciplinary actions. (+info)
Characteristics, prevalence, attitudes, and perceptions of academic dishonesty among pharmacy students.
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OBJECTIVES: To ascertain background factors that influence pharmacy students' willingness to cheat, describe attitudes regarding methods of cheating, assess prevalence of cheating and determine atmospheres that may aid in preventing academic dishonesty. METHODS: Third-professional year PharmD students at 4 institutions participated in a survey administered by a class representative. RESULTS: Of the 296 students who completed survey instruments, 16.3% admitted to cheating during pharmacy school. Approximately 74% admitted that either they or their classmates had worked on an individual assignment with a friend. Students who cheated during high school or in a prepharmacy program were more likely to cheat during pharmacy school (p < 0.0001). Those who possessed a bachelor of science (BS) degree prior to pharmacy school were less likely to cheat (p < 0.0001). CONCLUSIONS: Academic dishonesty is prevalent among pharmacy students. While few respondents directly admitted to cheating, many admitted to activities traditionally defined as dishonest. (+info)
Eponyms and the Nazi era: time to remember and time for change.
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Eponyms are titles of medical disorders named for individuals who originally described the condition. They also help us remember and identify the disorder. Medicine is replete with them, and changing them or eradicating them, for whatever reason, is not simple. But when there is a moral issue involved - for example, research conducted under overwhelming unethical conditions - we believe it wrong to perpetuate and thus "rew ard" the memory of the individual for whom the disorder is named. The name of a syndrome should thus be discontinued if described by an individual whose research used extreme measures or who was involved in atrocities against humanity. Ethical considerations should be introduced into medical nosology just as they exist in patient care and research. This article details a group of notable eponyms, the names of which are associated with overt crimes of the medical community during the Nazi era, and provides alternative medical nomenclature. In addition, examples are provided of eponyms named after Nazi era victims, eponyms of those who protested such injustices, and eponyms of those who had to flee discrimination and death. These should be remembered and even strengthened, as opposed to those of the perpetrators, which should be obliterated. Since the greatest accolade a physician can earn is praise from his colleagues as expressed in an eponym entrenched in one's name, the medical profession should remove any honor given to physicians involved in crimes to humanity. (+info)