What’s New and In the Queue for Academic Medicine

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What’s New: A Preview of the May Issue

The May 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:

Role Modeling and Regional Health Care Intensity: U.S. Medical Student Attitudes Toward and Experiences With Cost-Conscious Care
Leep Hunderfund and colleagues found that medical students endorsed barriers to cost-conscious care and reported encountering conflicting physician role-modeling behaviors. Students in higher-health-care-intensity regions reported observing significantly fewer cost-conscious role-modeling behaviors. A blog post related to this article is available.

Building a Global, Online Community of Practice: The OPENPediatrics World Shared Practices Video Series
Wolbrink and colleagues, each month, the OPENPediatrics World Shared Practices video series releases a 30–45 minute video featuring an expert in pediatric critical care medicine, interspersed with questions for the audience. Viewers contribute to the community discussion by leaving comments that display alongside the video.

Making Management Skills a Core Component of Medical Education
Management skills are largely undeveloped in medical education. To address this, Myers and Pronovost argue that medical schools should partner with organizational scholars to offer a “Management 101” course in the medical curriculum.

Assessment for Systems Learning: A Holistic Assessment Framework to Support Decision-Making Across the Medical Education Continuum
Bowe and Armstrong propose three levels of systems-based assessment of medical education: assessment of individual component performance, for improvement in system performance, and to prepare the system for future change.

The Development of an Indigenous Health Curriculum for Medical Students
Lewis and Prunuske describe efforts at the University of Minnesota Medical School, Duluth campus, to develop an Indigenous health curriculum using collaborative and decolonizing methods to gather ideas and opinions from multiple stakeholders. A blog post providing an update on the program is available.

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

Rethinking the Match: A Proposal for Modern Match-Making
Alan Dow, MD, MSHA, Chris Ray, and Steven Bishop

Abstract

Since the 1950s, the National Resident Matching Program, or “the Match,” has governed the placement of medical students into residencies. The Match was created to protect students in an era when residency positions outnumbered applicants and hospitals pressured students early in their academic careers to commit to a residency position. Now, however, applicants outnumber positions, applicants are applying to increasing numbers of programs, and the costs of the Match for applicants and programs are high. Meanwhile, medical education is evolving toward a competency based approach, a U.S. physician shortage is predicted, and some researchers describe a “July effect”–worse clinical outcomes correlated with the mass entry of new residents.

Against this background, the authors argue for adopting a more modern, free-market approach to residency match-making that might better suit the needs of applicants, programs, and the public. They propose allowing students, who have been identified by their medical schools as having achieved graduation-level competency, to apply to residency programs at any point during the year. Residency programs would set their own application timetables and extend offers in an ongoing fashion. Students, counseled by their schools, would accept or decline offers as desired. The authors argue this approach would better support competency-based education while allowing applicants and programs more choice regarding how they engage and adapt within the selection process. The approach’s staggered start times for new residents might attenuate the July effect and improve outcomes for patients. Medical students might also enter and thereby complete residency earlier, increasing the physician workforce.

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