Category Archives: medical education

Checklist – Year 3

Last week we reviewed a checklist for 4th year medical students.  Now let’s take a look at what you have to do the year before.  The AMA recommends:

  • Find residency programs that fit your specialty interests and needs.
  • Organize the key elements of your application.
  • Contact the National Board of Medical Examiners to schedule your United States Medical Licensing Exam (USMLE) Step 2 exams.
  • Familiarize yourself with the Association of American Medical Colleges’ Electronic Residency Application Service (ERAS).
  • Build your clinical and research skills.

Read details on each step from the AMA Wire.

 

Medical Student Checklist

Many medical students will soon be wrapping up their 3rd year.  What do you need to do to prepare for the 4th?

After three years of arduous studying, exams and clinical rotations, you’re finally in the home-stretch to completing your undergraduate medical training and transitioning to the next phase of your career in residency.

AMA has developed a 4th year student checklist.  As you apply to programs this year, keep these tasks top of mind to reduce stress and ensure you have an effective residency application process:

  • May-June: Obtain your token for the Electronic Residency Application Service (ERAS)
  • June-July: If you’re an osteopathic applicant, register for the AOA Intern/Resident Registration Program
  • July-August: Use these months to prepare supplemental application materials
  • September: Select and apply to programs accredited by the Accreditation Council for Graduate Medical Education (ACGME)
  • October-January: Schedule and travel to interviews
  • February: AOA Intern/Resident Registration Program match results will be available
  • March: NRMP main residency Match results are announced

The next year will fly fast – make sure you’re ready to soar!

Registration Now Open!

Registration for the Rural Residents Research Symposium is now open!

Scheduled for April 22nd at the Slemp Center of UVA Wise; this is a day for residents to present original research (not case studies) regarding topics of interest to rural primary care docs and their peers.

Slots at the Rural Residents Research Symposium are 30-45 minutes long; anyone interested in presenting must meet the criteria of rural focus and should apply through their residency coordinator.

A limit of two applications per residency program will be accepted with a total of 10 presentations.  The top two presentations will be invited to speak at the 2016 Head for the Hills event in October.

Click here to register.  For questions, contact GMEC Director Wendy Welch at wow6n@uvawise.edu

 

Urban Choosing Rural

A recent study noted that having a rural origin is a primary factor in medical students choosing to practice in rural areas.  The study decided to turn that information around and ask what influences urban students to also choose rural.

“Determinants of an urban origin student choosing rural practice” used a scoping review of the literature, in contrast to a traditional systematic review.  Out of these 17 studies, the following four factors that suggest why urban-origin medical students may choose rural practice were generated:

  • geographic diffusion of physicians in response to economic forces such as debt repayment and financial incentives
  • scope of practice and personal satisfaction
  • undergraduate and postgraduate rural training
  • premedical school mindset to practice rurally

The study concluded:

Urban-origin students may choose rural practice because of market forces as well as financial incentives. The participation in undergraduate and postgraduate rural training is reported to positively alter the attitude of urban-origin students. A small subset of these students has a predetermined mindset to practice rurally at the time of matriculation.

Obstacles for choosing a rural carrier include, but are not limited to lack of job and education opportunities for spouses/partners, lack of recreational and educational opportunities for children, and obscure opportunities for continuing medical education.

 

 

Remote Residency?

Last week we asked if skipping residency was the solution to addressing the doctor shortage in rural communities.  And if skipping residency wasn’t the answer; what is?

A recently published study proposed that maybe tele-residency is part of the solution.  “The feasibility and acceptability of administering a telemedicine objective structured clinical exam as a solution for providing equivalent education to remote and rural learners” reviewed remote residencies from both the fiscal and student acceptability aspects.  The study introduction notes:

 Although many medical schools incorporate distance learning into their curricula, assessing students at a distance can be challenging. While some assessments are relatively simple to administer to remote students, other assessments, such as objective structured clinical exams (OSCEs) are not.

Students were assigned mock patients in rural areas which the student would examine via telemedicine (teleOSCE).  In addition to demonstrating clinical competency, the student also had to show “understanding of the geographic and socioeconomic realities of rural patients: learners must incorporate rural circumstances into the plan of care.”

TeleOSCE  was determined to be both fiscally feasible and valuable to the students.  It also served to:

expose students to telemedicine visits as a new model of rural care, while simultaneously increasing awareness of common issues in rural population health.

So it is affordable, and the students like it – but does make up for not having residents physically present in rural communities?

 

Can We Skip Residency?

One of the concerns of those addressing rural workforce issues is residency programs for recent medical school graduates.  Finding a sufficient number of residency slots is always a challenge.  If there aren’t enough in your area, the students could leave the state – or even the country.

Since we know that doctors tend to practice in the same area where they were trained, it’s a constant challenge for those wanting to recruit in rural areas.

But what if we just skipped residency?

A new law in Missouri, Arkansas and Oklahoma offered a first-of-its-kind solution to the physician shortage plaguing thousands of U.S. communities: Medical school graduates could start treating patients immediately, without wading through years of traditional residency programs.

Yet more than 18 months after that first law passed, Missouri regulators are still trying to make it work. And not a single new doctor has gone into practice in any of the three states as a result of the new laws.

Opposition abounds from every side.  Even some rural physicians, who could potentially benefit from the help, don’t like the Missouri law.

Dr. Tammy Hart is the only physician in Missouri’s Mercer Country along the Iowa border. She opens her office at 7 a.m. to walk-in patients with urgent needs and often ends up working on days off. But Hart views the new Missouri law as “a very poor answer” to the physician shortage.

“By no means are you ready to assume being a physician when you graduate from medical school,” she said.

But if skipping residency isn’t the solution; what is?

Anxious Kids

What’s the difference between fear and anxiety?  What level of anxiety in a child is normal? At what stage does it need to be addressed?  When is medication appropriate for a child with anxiety?

C. Allen Musil, Jr., MD’s presentation at Head for the Hills 2015 answered these questions and reviewed risk factors for anxiety disorders, different types of anxiety disorders, treatment approaches and more.

Check out Anxious Kids: A Primary Care Approach by Dr. Musil!

 

Save the Date!

Are you a medical resident?

Are you working in or for rural Southwest Virginia (or surrounding areas)?

Then mark off April 22nd on your calendar and plan to be at the Second Rural Residents Research Symposium!

This is a day for residents to present original research (not case studies) regarding topics of interest to rural primary care docs and their peers.

Slots at the Rural Residents Research Symposium are 30-45 minutes long; anyone interested in presenting must meet the criteria of rural focus and should apply through their residency coordinator.

A limit of two applications per residency program will be accepted with a total of 10 presentations.  The top two presentations will be invited to speak at the 2016 Head for the Hills event in October.

For questions, contact GMEC Director Wendy Welch at wow6n@uvawise.edu

More information coming soon!

 

REVIVE!

Virginia has been severely impacted by opioid abuse, particularly the abuse of prescription drugs. In 2013, 386 individuals died from the abuse of FHMO, an increase of 1,578%, with fentanyl being the primary substance fueling this increase.  In 2013, drug-related deaths happened at a higher per capita level (11.0 deaths per 100,000) than motor vehicle crashes (10.1 per 100,000).

REVIVE! is the Opioid Overdose and Naloxone Education (ONE) program for the Commonwealth of Virginia. REVIVE! provides training to professionals, stakeholders, and others on how to recognize and respond to an opioid overdose emergency with the administration of naloxone (Narcan ®).

At Head for the Hills, Dr. Hughes Melton provided an overview of the REVIVE! program. This allowed the participants to:

  • Understand the REVIVE! program, including lay administration of naloxone, protection from civil liability, and the safe reporting of overdoses law
  • Understand how opioid overdose emergencies happen and how to recognize them
  • Understand how naloxone works
  • Identify risk factors that may make someone more susceptible to an opioid overdose emergency
  • Dispel common myths about how to reverse an opioid overdose
  • Learn how to respond to an opioid overdose emergency with the administration of naloxone

Additional information about REVIVE! and opioid abuse in Virginia can be found on the Virginia Department of Behavioral Health & Developmental Services website.

 

ADHD

Media headlines are full of ADHD information.  Recent examples include:

  • —“Study finds 17% of college students misuse ADHD drugs”
  • —“ADHD Medications Don’t Lead To Drug Or Alcohol Abuse”
  • —“Children with ADHD more likely to have eating disorder”
  • —“Is the Internet giving us all ADHD?”

ADHD

One of the great presentations at Head for the Hills was Dr. Hofford’s Attention-Deficit Hyperactivity Disorder: What’s New and What is Our Data.

This session:

  • —Reviewed the diagnosis of ADHD
  • Reviewed the latest treatment options/algorithms for ADHD
  • —Reviewed recent Virginia Medicaid ADHD data and how do we compare with North Carolina and the United States

We hope you are able to use Dr. Hofford’s information as your starting point for finding solid ADHD references!