What’s New and In the Queue for Academic Medicine

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What’s New: A Preview of the November Issue
The November issue of Academic Medicine is now available! Read the entire issue online at academicmedicine.org or on your iPad using the Academic Medicine for iPad app. Highlights from the issue include:

Holistic Review in Medical School Admissions and Selection: A Strategic, Mission-Driven Response to Shifting Societal Needs
Conrad and colleagues argue that holistic review is a strategic, mission-driven, evidence-based process that recognizes diversity as critical to excellence, offers a flexible framework for selecting future physicians, and facilitates achieving institutional mission and addressing societal needs.

The Standardized Letter of Evaluation for Postgraduate Training:  A Concept Whose Time Has Come?
Love and colleagues argue that specialty-specific standardized letters of evaluation would increase the likelihood that programs could effectively identify applicants who would not only be a “good fit” for their programs, but also graduate to become successful physicians.

A Hybrid Interview Model for Medical School Interviews: Combining Traditional and Multisampling Formats
Bibler Zaidi and colleagues discuss the University of Michigan Medical School’s implementation of a hybrid interview model with six short-form interviews and two long-form interviews, as well as early reactions to and outcomes of this model. Two blog posts on this article are available here and here.

How Prevalent Are Potentially Illegal Questions During Residency Interviews? A Follow-up Study of Applicants to All Specialties in the National Resident Matching Program
Hern and colleagues found that in 20122013, two-thirds of residency applicants reported being asked potentially illegal questions about gender, age, marital status, parental status, plans for childrearing, ethnicity, religion, or sexual orientation.

Enrollment Management in Medical School Admissions: A Novel Evidence-Based Approach at One Institution
Burkhardt and colleagues compared factors related to enrollment at the University of Michigan versus competing peer institutions. A predictive analytic “dashboard” was created, allowing better management of targeted recruitment and admissions.

What’s In the Queue: A Sneak Peek
Here’s a preview of an upcoming innovation report by Holt and colleagues.

The Addiction Recovery Clinic: A Novel, Primary Care-Based Approach to Teaching Addiction Medicine
Stephen R. Holt, MD, MS, Nora Segar, MD, Dana A. Cavallo, PhD, and Jeanette M. Tetrault, MD

Abstract
Problem
Substance use is highly prevalent in the United States, but little time in the curriculum is devoted to training internal medicine residents in addiction medicine.

Approach
In 2014, the authors developed and launched the Addiction Recovery Clinic (ARC) to address this educational gap while also providing outpatient clinical services to patients with substance use disorders. The ARC is embedded within the residency primary care practice and is staffed by three to four internal medicine residents, two board-certified addiction medicine specialists, one chief resident, and one psychologist. Residents spend one half day per week for four consecutive weeks at the ARC seeing new and returning patients. Services provided include pharmacological and behavioral treatments for opioid, alcohol, and other substance use disorders, with direct referral to local addiction treatment facilities as needed. Visit numbers, a patient satisfaction survey, and an end-of-rotation resident evaluation were used to assess the ARC.

Outcomes
From 2014 to 2015, 611 patient encounters occurred, representing 97 new patients. Sixty-one (63%) patients were seen for opioid use disorders. According to patient satisfaction surveys, 29 (of 31, 94%) patients reported that the ARC probably or definitely helped them to cope with their substance use. Twenty-eight residents completed the end-of-rotation evaluation; all rated the rotation highly.

Next Steps
The ARC offers a unique primary care-based approach to exposing internal medicine residents to the knowledge and skills necessary to diagnose, treat, and prevent unhealthy substance use. Future research will examine other clinical and educational outcomes.

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