Undergraduate and postgraduate orthodontics in Australia.
Undergraduate orthodontic education in Australian university dental schools reflects a strong British influence. The Australian Dental Council is now responsible for undergraduate course accreditation and the development of a more distinctly Australian model might be expected, although not in isolation from the traditional British and American influences. Postgraduate specialty training has been more directly influenced by the North American dental schools, and specialist registers in the states and territories reflect that influence. The Australian Dental Council will commence accreditation of postgraduate specialty courses in 1999. (+info)
American Board of Radiology computer test center.
In 1997, the American Board of Radiology (ABR) determined to develop a computer-based examination and to create a test center for administration of computer-based examinations. In implementation of its plan, the Board has developed a flexible examination platform, well-adapted to the graphics needs of an image-based examination, and at the same time, compatible with test centers being developed by other medical specialty boards in terms of hardware, software, and candidate surroundings. A test center for secure proctored examination of up to 33 candidates has been created at the Board's headquarters in Tucson, AZ. The decision of the ABR to employ computer-based testing as a part of its recertification process represents an important step of significance to the entire field of radiology, embracing methods that are rapidly becoming integral to the practice of radiology in the acquisition, display, and management of diagnostic imaging information. (+info)
The impact of globalization on public health: implications for the UK Faculty of Public Health Medicine.
BACKGROUND: There has been substantial discussion of globalization in the scholarly and popular press yet limited attention so far among public health professionals. This is so despite the many potential impacts of globalization on public health. Defining public health broadly, as focused on the collective health of populations requiring a range of intersectoral activities, globalization can be seen to have particular relevance. Globalization, in turn, can be defined as a process that is changing the nature of human interaction across a wide range of spheres and along at least three dimensions. Understanding public health and globalization in these ways suggests the urgent need for research to better understand the linkages between the two, and effective policy responses by a range of public health institutions, including the UK Faculty of Public Health Medicine. METHODS: The paper is based on a review of secondary literature on globalization that led to the development of a conceptual framework for understanding potential impacts on the determinants of health and public health. The paper then discusses major areas of public health in relation to these potential impacts. It concludes with recommendations on how the UK Faculty of Public Health Medicine might contribute to addressing these impacts through its various activities. RESULTS: Although there is growing attention to the importance of globalization to public health, there has been limited research and policy development in the United Kingdom. The UK Faculty of Public Health Medicine needs to play an active role in bringing relevant issues to the attention of policy makers, and encourage its members to take up research, teaching and policy initiatives. CONCLUSIONS: The potential impacts of globalization support a broader understanding and practice of public health that embraces a wide range of health determinants. (+info)
The effects of competency requirements in Part II MFPHM submission--a study of the abstracts of successful reports.
BACKGROUND: The objectives of this study are to explore the effects of the new 1996 guidance requiring explicit demonstration of competencies on the nature of successful MFPHM Part II reports, how successful candidates claimed competency areas in their two reports and the effects of the subject areas of the report on the specific competencies claimed. METHODS: The abstracts of candidates who passed the examination from January 1996 to January 1999 were studied. Information was extracted on candidate's region, year of the abstract, examination guidance, subject area, methods and data used, format of the abstract, and level (e.g. national, regional, etc.) for which the work was performed. RESULTS: Compared with reports submitted under the 1992 guidance, those submitted under the 1996 guidance were more likely to have a structured abstract, and to employ descriptive epidemiological methods and routine data, and were less likely to be case-control or retrospective studies. There were no other significant differences in the level for which the work was performed, the subject area, or the methods and data used. Thirty-nine per cent of candidates under the 1996 guidance claimed at least one identical competency area in both reports, most frequently for health needs assessment and literature review. Each of the four competencies was demonstrated by a significant proportion of reports in each subject areas. CONCLUSIONS: The new examination guidance had only minor effects on the nature of successful Part II reports. Candidates used different strategies for claiming competencies, apparently at the choice of individual trainees and trainers. The competency requirements did not appear to limit the range of work performed. (+info)
Procedural experience and comfort level in internal medicine trainees.
BACKGROUND: The American Board of Internal Medicine (ABIM) has recommended a specific number of procedures be done as a minimum standard for ensuring competence in various medical procedures. These minimum standards were determined by consensus of an expert panel and may not reflect actual procedural comfort or competence. OBJECTIVE: To estimate the minimum number of selected procedures at which a majority of internal medicine trainees become comfortable performing that procedure. DESIGN: Cross-sectional, self-administered survey. SETTING: A military-based, a community-based, and 2 university-based programs. PARTICIPANTS: Two hundred thirty-two internal medicine residents. MEASUREMENTS: Survey questions included number of specific procedures performed, comfort level with performing specific procedures, and whether respondents desired further training in specific procedures. The comfort threshold for a given procedure was defined as the number of procedures at which two thirds or more of the respondents reported being comfortable or very comfortable performing that procedure. RESULTS: For three of seven procedures selected, residents were comfortable performing the procedure at or below the number recommended by the ABIM as a minimum requirement. However, residents needed more procedures than recommended by the ABIM to feel comfortable with central venous line placement, knee joint aspiration, lumbar puncture, and thoracentesis. Using multivariate logistic regression analysis, variables independently associated with greater comfort performing selected procedures included increased number performed, more years of training, male gender, career goals, and for skin biopsy, training in the community-based program. Except for skin biopsy, comfort level was independent of training site. A significant number of advanced-year house officers in some programs had little experience in performing selected common ambulatory procedures. CONCLUSION: Minimum standards for certifying internal medicine residents may need to be reexamined in light of house officer comfort level performing selected procedures. (+info)
Chairpersons of pathology in the United States. Benchmarks for academic publications and professional credentials.
Chairpersons of pathology often are viewed as departmental role models in academic medical centers. To objectify this view, we undertook a systematic survey of publication records and professional certification among 126 chairpersons in the United States. The median of the total number of scientific publications by the cohort was 105 since graduation from medical school, and the median yearly number of peer-reviewed papers was 3.34 per person (mean, 4.25). A random 10% of the study population was analyzed further with reference to the percentage of publications that reflected basic science research; 41% of the total literature contributions of this subgroup fit that description, and only 38% of the chairpersons in the subgroup had 80% or more non-service-related publications. Of all chairpersons, 85% had obtained primary board certification in anatomic pathology, clinical pathology, or both, and 25% of the group had earned at least 1 subspecialty board certificate in addition. These numbers reflect an evolution in the professional backgrounds of chairpersons of pathology such that demands for academic scholarship and proficiency in hospital practice and management seem to pertain to that group. (+info)
Physician credentials and practices associated with childhood immunization rates: private practice pediatricians serving poor children in New York City.
Private practice physicians in New York City's poorest neighborhoods are typically foreign trained, have generally substandard clinical practices, and have been accused of rushing Medicaid patients through to turn a profit. However, they also represent a sizable share of physician capacity in medically underserved neighborhoods. This article documents the level of credentials, systems, and immunization-related procedures among these physicians. Furthermore, it assesses the relationship between such characteristics and childhood immunization rates. The analysis utilizes a cross-sectional comparison of immunization rates in 60 private practices that submitted 2,500 or more Medicaid claims for children. Immunization data were gathered from medical records for 2,948 randomly selected children under 3 years of age. Half of sampled physicians were board certified (55%), and half were accepted by the Medicaid Preferred Physicians and Children (PPAC) program (51.7%). Of physicians, 43% saw patients only on a walk-in basis, while only 17% scheduled the next appointment while the patient was still in the office. There were 75% of the physicians who reported usually immunizing at acute care visits. Immunization rates were higher among PPAC physicians compared to others (41% vs. 29% up to date for diphtheria and tetanus toxoids and pertussis [DTP]/Haemophilus influenzae type b [Hib], polio, and measles-mumps-rubella [MMR], P = .01), and board-certified physicians showed a trend toward better immunization rates (39% vs. 30%, P =.07). Physicians who reported usually immunizing at acute care visits also had higher rates than those who did not (38% vs. 27%, P = .05). Scheduling a date and time for the next immunization showed a trend toward association with immunization coverage (37% vs. 28%, P= .10). Private practice physicians who provide high volumes of care reimbursed by Medicaid have improved their credentials and affiliations over time, thereby expanding reimbursement options. Credentials and affiliations were at least as effective in distinguishing relatively high- and low-performing physicians, as were immunization-related practices, suggesting that they are useful markers for higher quality care. The relative success of the PPAC program should inform efforts to improve the capacity and quality of primary care for vulnerable children. Appointment and reminder systems that effectively manage the flow of children back into the office for immunizations and the vigilant use of acute care visits for immunizations go hand in hand. Opportunity exists for payers and plans to encourage and support these actions. (+info)
Calibration of medium-resolution monochrome cathode ray tube displays for the purpose of board examinations.
This report discusses calibration and set-up procedures for medium-resolution monochrome cathode ray tubes (CRTs) taken in preparation of the oral portion of the board examination of the American Board of Radiology (ABR). The board examinations took place in more than 100 rooms of a hotel. There was one display-station (a computer and the associated CRT display) in each of the hotel rooms used for the examinations. The examinations covered the radiologic specialties cardiopulmonary, musculoskeletal, gastrointestinal, vascular, pediatric, and genitourinary. The software used for set-up and calibration was the VeriLUM 4.0 package from Image Smiths in Germantown, MD. The set-up included setting minimum luminance and maximum luminance, as well as positioning of the CRT in each examination room with respect to reflections of roomlights. The calibration for the grey scale rendition was done meeting the Digital Imaging and communication in Medicine (DICOM) 14 Standard Display Function. We describe these procedures, and present the calibration data in. tables and graphs, listing initial values of minimum luminance, maximum luminance, and grey scale rendition (DICOM 14 standard display function). Changes of these parameters over the duration of the examination were observed and recorded on 11 monitors in a particular room. These changes strongly suggest that all calibrated CRTs be monitored over the duration of the examination. In addition, other CRT performance data affecting image quality such as spatial resolution should be included in set-up and image quality-control procedures. (+info)