What’s New and In the Queue for Academic Medicine

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What’s New: A Preview of the January Issue
The January 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:

A Plea to Reassess the Role of United States Medical Licensing Examination Step 1 Scores in Residency Selection
Prober and colleagues strongly recommend a move away from using test scores alone in screening applicants and towards a more holistic evaluation of future health care providers. A blog post to this article written by a resident is available.

Addressing the “Global Health Tax” and “Wild Cards”: Practical Challenges to Building Academic Careers in Global Health
Emphasizing financial, personal, professional, and logistical challenges that young “expat” global health physicians in academic institutions face, Palazuelos and Dhillon discuss ways to support these career paths and propose possible solutions.

What’s in It for Me? Maintenance of Certification as an Incentive for Faculty Supervision of Resident Quality Improvement Projects
Rosenbluth and colleagues describe a maintenance of certification portfolio program designed to more actively engage faculty who were supervising residents’ quality improvement projects and provide them incentives for doing so.

The Variables That Lead to Severe Action Decisions by the Liaison Committee on Medical Education
Hunt and colleagues found noncompliance with two accreditation standards was strongly associated with severe action decisions: lack of evidence of comparability across instructional sites and the absence of strong central management of the curriculum.

The “Pillars” of Curriculum Reform
Pock and colleagues describe four key elements of the Carnegie Foundations’ report on medical education reform: (1) standardization and individualization, (2) integration, (3) inquiry and innovation, and (4) professional identity.

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

Unprofessional Behaviors Among Tomorrow’s Physicians: Review of the Literature With a Focus on Risk Factors, Temporal Trends, and Future Directions
Kyle M. Fargen, MD, MPH, Brian C. Drolet, MD, and Ingrid Philibert, PhD, MBA


Recent reports have identified concerning patterns of unprofessional behavior by resident physicians. Despite this publicity, the prevalence and impact of these behaviors is not well described. To date, there have been few published studies that review and analyze the various studies on this topic.

A literature review was performed looking for all published reports on academic dishonesty among U.S. medical school students or resident physicians. The search included all articles published in English and referenced in the PubMed database between January 1980 and May 2014.

A total of 53 publications met criteria for inclusion in the study. The data suggest that plagiarism, cheating on examinations, and listing fraudulent publications on residency/fellowship applications were reported in 5-15% of the student and resident populations that were studied. Other behaviors, such as inaccurately reporting a medical examination during rounds or falsifying duty hours, appear to be even more common (40-50% of students and residents).

“Unprofessional behavior” lacks a unified definition. The data on the prevalence of unprofessional behavior in medical students and residents are limited. Unprofessional behaviors are common and appear to be occurring in various demographic groups within the medical trainee population. The relationship between unprofessional behaviors in training and future disciplinary action is poorly understood. Going forward, it is critical that the incidence, motivations, and relevance of these behaviors be more carefully studied. Unprofessional behavior should be clearly defined and instruments for its study should be created and validated so that behaviors may be evaluated scientifically.

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