Gender differences in career and practice patterns of PGD-trained dentists. (65/1094)

This study compares differences by gender in the practice patterns and professional activities of general dentists, specialists, and dentists with Advanced Education in General Dentistry (AEGD) or General Practice Residency (GPR) training. The UCLA School of Dentistry surveyed a random sample of 6,725 dentists graduating from dental school in 1989, 1993, and 1997 as part of an evaluation of the impact of federal funding on postgraduate general dentist (PGD) programs. The survey asked about current practice, services referred and provided, and professional activities. Of the 2,029 dentists (30 percent) who responded, 49 percent were general dentists with no specialty training; 7 percent had AEGD training; 20 percent had GPR training; and 24 percent had specialty training. General dentists were more likely to be in private practice (p < 0.05). AEGDs, specialists, and females were more likely to report faculty positions as a secondary occupation. General dentists were more likely to be practice owners than AEGD- or GPR-trained dentists. The mean number of patients seen was highest for specialists. Females reported fewer patients than males, and this difference was significant for GPR-trained dentists. With respect to services, GPR-trained dentists reported significantly more biopsy procedures, conscious sedation, periodontal surgery, and implants than general dentists. AEGD-trained dentists reported more conscious sedation than general dentists. GPR dentists were more likely to volunteer time than general dentists without specialty training. PGD training appears to result in different types of employment and specific practice patterns that strengthen primary care dentistry. We further conclude that there are gender differences in the types of practice, patients seen, and services provided. These findings occur in addition to training differences.  (+info)

Goals, costs, and outcomes of a predoctoral student research program. (66/1094)

The aims of this work were to describe the goals and costs of a predoctoral student research program and compare the career choice and school donations of dental alumni who received student research experience to those without the experience. The identity of participants in the student research program was obtained from college records, and outcomes data on the student researchers from the years 1991 to 1994 were obtained with a telephone survey. Survey responses were compared to recent alumni surveys of the classes of 1992 and 1994, mathematically corrected to provide an estimate for non-research participants. A student research program that involves about one-fourth of the class currently costs in excess of $100,000. However, the benefits were found to be considerable. Compared to the class as a whole, after seven to ten years student researchers were 3.5 times more likely to complete specialty training, nearly five times more likely to become full-time faculty members, and 32 percent more likely to be donors.  (+info)

The future supply of family physicians: implications for rural America. (67/1094)

Throughout the past century rural health care has been dependent upon general practitioners (GPs) and their successors, family physicians (FPs). Only FPs and GPs have practiced in rural areas in proportion to the population, then and now. As specialization occurred, numbers of GPs declined and physician shortages developed in rural areas. The creation of family practice residencies in the 1970s halted this decline, but rural shortages persist today. During the 1990s the number of allopathic and osteopathic FP residency graduates rose 54 percent. At the same time, the percentage of women enrolled in these residencies increased to 46 percent, and women have been less likely than men to select rural practice. We project that if current numbers of graduates continue, the nonmetropolitan FP/GP-to-population ratio will increase 17 percent by the year 2020. However, today, medical students' interest in primary care residencies (including family practice) is declining precipitously. If numbers of FP graduates return to 1993 levels, the density of FPs in rural America and in the nation as a whole will decline after 2010.  (+info)

Variation in predictors of primary care career choice by year and stage of training. (68/1094)

CONTEXT: It is not known whether factors associated with primary care career choice affect trainees differently at different times or stages of medical education. OBJECTIVE: To examine how role models, encouragement, and personal characteristics affect career choice at different stages (medical school vs residency) and periods (1994 vs 1997) of training. DESIGN: A split-panel design with 2 cross-sectional telephone surveys and a panel survey in 1994 and 1997. PARTICIPANTS: A national probability sample of fourth-year students (307 in 1994, 219 in 1997), 645 second-year residents in 1994, and 494 third-year residents in 1997. Of the fourth-year students interviewed in 1994, 241 (78.5%) were re-interviewed as third-year residents in 1997. MAIN OUTCOME MEASURE: Primary care (general internal medicine, general pediatrics, or family medicine) career choice. RESULTS: Having a primary care role model was a stronger predictor of primary care career choice for residents (odds ratio [OR], 18.0; 95% confidence interval [95% CI], 11.2 to 28.8 in 1994; OR, 43.7; 95% CI, 24.4 to 78.3 in 1997) than for students (OR, 6.5; 95% CI, 4.3 to 10.2; no variation by year). Likewise, peer encouragement was more predictive for residents (OR, 5.4; 95% CI, 3.3 to 8.9 in 1994; OR, 16.6; 95% CI; 9.7 to 28.4 in 1997) than for students (OR, 2.1; 95% CI, 1.3 to 3.2; no variation by year). Orientation to the emotional aspects of care was consistently associated with primary care career choice across stages and years of training. CONCLUSIONS: The effect of peer encouragement and role models on career choice differed for students and residents and, in the case of residents, by year of training, suggesting that interventions to increase the primary care workforce should be tailored to stage of training.  (+info)

Models to increase enrollment of minority females in science-based careers. (69/1094)

Enrollment of African-American females in academic pathways that lead to science based-careers may be limited by gender discrepancies in standardized test scores, academic preparation, selecting "college-prep" course work in the high school curriculum, and lack of mentors or role models. Barriers related to teacher characteristics are: (a) lack of self-confidence, (b) learning environment, (c) teacher behavior, (d) lack of female role models, and (e) failure to see the relevance between the classes and a female's expected role in life. Other limiting factors include differences in access to educational resources, differences in economic status, differences in interest or choice, cultural barriers, and lack of encouragement. Confidence building models that improve enrollment of minority females in science-based careers include equitable teaching instruction, inquiry-based pedagogy, and cooperative learning. Practices that correlate with achievement and success include challenging curricula, a nurturing learning environment, high expectations, community service, research experiences, and mentoring relationships.  (+info)

What do they contribute? Family medicine residents who practise in cities. (70/1094)

OBJECTIVE: To determine how a cohort of family practice residents graduating between 1990 and 1997 was serving the needs of urban populations in British Columbia. DESIGN: Survey using mailed questionnaire. SETTING: British Columbia. PARTICIPANTS: All graduates of the British Columbia family practice residency program between 1990 and 1997. MAIN OUTCOME MEASURES: Graduates who were currently practising as family physicians and providing medical care to urban and inner-city populations of more than 100 000, sex, practice profiles, and a comparison with Janus Project data for British Columbia. RESULTS: Of 287 graduates surveyed, 206 responded (71.8%). Less than half (86) identified themselves as practising in urban settings; 61 of those were practising as family physicians. These physicians offered a range of primary care services; many offered inpatient and obstetric care. In addition, many were offering care to disadvantaged inner-city populations with unique and challenging medical problems. CONCLUSION: Recent graduates in family medicine practising in urban and inner-city areas are offering full-service primary care and are not abandoning it for more episodic high-volume medical practice.  (+info)

The experience of native peer facilitators in the campaign against type 2 diabetes. (71/1094)

CONTEXT: The use of peer facilitators in health programs has great potential. One important application is prevention and control of type 2 diabetes among American Indians. PURPOSE: To explore the experience of American Indian facilitators in a culturally appropriate intervention (Talking Circles) on 2 Northern Plains reservations. The Talking Circles offered a forum for educational dialogue on diabetes risk factors and the management of type 2 diabetes. METHODS: Phenomenology, a qualitative research approach, was used to answer the research question: "What did Native Talking Circle facilitators experience?" Participants were 4 lay health workers from the intervention reservations who had been trained to present a diabetes curriculum while coordinating and guiding the group discussion. During open-ended, taped interviews, the facilitators shared their experiences conducting the Talking Circles. Analysis categorized the experiences into common themes to explain the phenomena and cultural construction of oral discussions (Talking Circles) of diabetes. FINDINGS: Themes included the concept of "a calling" to do the work, which included a self-growth process, a blending of 2 worldviews as a diabetes intervention strategy, the importance of translating educational materials in a liaison role, and commitment to tribal people and communities. CONCLUSIONS: The experience of the facilitators was positive because they were knowledgeable about American Indian culture and worldview and were trained in both Talking Circle facilitation and type 2 diabetes.  (+info)

Characteristics of international medical graduates who applied to the CaRMS 2002 match. (72/1094)

BACKGROUND: International medical graduates are an important component of the Canadian physician workforce. For most international medical graduates, the principal route to obtaining a residency position in Canada is to apply through the second iteration of the Canadian Resident Matching Service (CaRMS) match. In order to help inform the work toward integrating unlicensed international medical graduates into Canada's health professional workforce, our objectives were to describe the demographic and educational characteristics of international medical graduate CaRMS applicants and identify their preferred clinical disciplines and practice locations. METHODS: A 37-item Web-based questionnaire survey was offered to all 659 international medical graduate second-iteration CaRMS 2002 applicants. We collected data on their demographic and educational background and preferred clinical discipline and practice location. Up to 2 follow-up email reminders were sent to nonrespondents. RESULTS: The survey response rate was 70.3% (463/659). Of the respondents, 71.9% had obtained their medical degree in Asia, the Middle East or Eastern Europe: 36.5% had graduated with a medical degree since 1994, and 17.3% since 1997. Most respondents (74.3%) were aged between 30 and 44 years. More than half (54.6%) had completed their medical education in English. Most (69.3%) had done postgraduate training outside Canada. Before coming to Canada, 42.8% had practised medicine for 1-5 years and 45.6% had practised for 6-20 years. The top 5 choices of clinical discipline in Canada were family medicine/general practice (45.6%), internal medicine (14.9%), surgery (7.3%), obstetrics/gynecology (6.7%) and pediatrics (4.8%). Of those who resided in the 4 Western provinces or Nova Scotia, between 76.8% and 86.7% preferred to stay in their own province, and 60%, 51.4% and 37% of those who resided in Newfoundland, Ontario or Quebec respectively preferred to practise in their own province. INTERPRETATION: Second-iteration international medical graduate CaRMS applicants are a heterogeneous group of physicians, some with substantial medical training and experience and others at an earlier stage of their medical career.  (+info)