Surgery training programs in Canada and the United States have recognized the need to modify current models of training and education. The shifting demographic of surgery trainees, lifestyle issues and an increased trend toward subspecialization are the major influences. To guide these important educational initiatives, a contemporary profile of Canadian general surgery residents and their impressions of training in Canada is required.
We developed and distributed a questionnaire to residents in each Canadian general surgery training program, and residents responded during dedicated teaching time.
In all, 186 surveys were returned for analysis (62% response rate). The average age of Canadian general surgery residents is 30 years, 38% are women, 41% are married, 18% have dependants younger than 18 years and 41% plan to add to or start a family during residency. Most (87%) residents plan to pursue postgraduate education. On completion of training, 74% of residents plan to stay in Canada and 49% want to practice in an academic setting. Almost half (42%) of residents identify a poor balance between work and personal life during residency. Forty-seven percent of respondents have appropriate access to mentorship, whereas 37% describe suitable access to career guidance and 40% identify the availability of appropriate social supports. Just over half (54%) believe the stress level during residency is manageable.
This survey provides a profile of contemporary Canadian general surgery residents. Important challenges within the residency system are identified. Program directors and chairs of surgery are encouraged to recognize these challenges and intervene where appropriate.
To describe the administrative functioning of all current Canadian psychiatry residency training programs (RTPs) and to suggest available improvements to existing systems.
We obtained data about the 2004 RTPs by distributing 2 questionnaires to all Canadian psychiatry RTPs.
Residency program committees (RPCs) are mainly consultative and carry only a small amount of the workload of managing a residency program. Program directors (PDs) manage more than 80% of the work and report that the time allowance to perform their duties is suboptimal. PDs remain in office for about 5 years, departing during or at the end of a predetermined second term.
RPCs bear only a small amount of the workload generated by the RTP. We piloted administrative changes that led to more equitable work distribution.
Dr. Allen is clinical professor of family medicine and vice dean for regional affairs, University of Washington School of Medicine, Seattle, Washington. Ms. Ballweg is professor of family medicine and director, MEDEX Northwest Program, University of Washington School of Medicine, Seattle, Washington. Dr. Cosgrove is professor of medicine and vice dean for academic affairs, University of Washington School of Medicine, Seattle, Washington. Ms. Engle is director of operations, Office of Regional Affairs, University of Washington School of Medicine, Seattle, Washington. Dr. Robinson is professor of rehabilitation medicine and vice dean for graduate medical education and clinical affairs, University of Washington School of Medicine, Seattle, Washington. Dr. Rosenblatt is professor and vice chair of family medicine and director, Rural/Underserved Opportunities Program, University of Washington School of Medicine, Seattle, Washington. Ms. Skillman is deputy director, WWAMI Rural Health Research Center and UW Center for Health Workforce Studies, University of Washington School of Medicine, Seattle, Washington. Ms. Wenrich is affiliate assistant professor of biomedical informatics and medical education, University of Washington School of Medicine, and chief of staff, UW Medicine, Seattle, Washington.
The authors examine the potential impact of the Patient Protection and Affordable Care Act (ACA) on a large medical education program in the Northwest United States that builds the primary care workforce for its largely rural region. The 42-year-old Washington, Wyoming, Alaska, Montana, and Idaho (WWAMI) program, hosted by the University of Washington School of Medicine, is one of the nation's most successful models for rural health training. The program has expanded training and retention of primary care health professionals for the region through medical school education, graduate medical education, a physician assistant training program, and support for practicing health professionals.The ACA and resulting accountable care organizations (ACOs) present potential challenges for rural settings and health training programs like WWAMI that focus on building the health workforce for rural and underserved populations. As more Americans acquire health coverage, more health professionals will be needed, especially in primary care. Rural locations may face increased competition for these professionals. Medical schools are expanding their positions to meet the need, but limits on graduate medical education expansion may result in a bottleneck, with insufficient residency positions for graduating students. The development of ACOs may further challenge building a rural workforce by limiting training opportunities for health professionals because of competing demands and concerns about cost, efficiency, and safety associated with training. Medical education programs like WWAMI will need to increase efforts to train primary care physicians and increase their advocacy for student programs and additional graduate medical education for rural constituents.
Leadership courses and multi-source feedback are widely used developmental tools for leaders in health care. On this background we aimed to study the additional effect of a leadership course following a multi-source feedback procedure compared to multi-source feedback alone especially regarding development of leadership skills over time.
Study participants were consultants responsible for postgraduate medical education at clinical departments.
pre-post measures with an intervention and control group. The intervention was participation in a seven-day leadership course. Scores of multi-source feedback from the consultants responsible for education and respondents (heads of department, consultants and doctors in specialist training) were collected before and one year after the intervention and analysed using Mann-Whitney's U-test and Multivariate analysis of variances.
There were no differences in multi-source feedback scores at one year follow up compared to baseline measurements, either in the intervention or in the control group (p = 0.149).
The study indicates that a leadership course following a MSF procedure compared to MSF alone does not improve leadership skills of consultants responsible for education in clinical departments. Developing leadership skills takes time and the time frame of one year might have been too short to show improvement in leadership skills of consultants responsible for education. Further studies are needed to investigate if other combination of initiatives to develop leadership might have more impact in the clinical setting.
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The growing size of the older population challenges not only researchers but also higher education in gerontology. On the basis of an online survey the authors describe the situation of Nordic higher education in gerontology in 2008 and 2009 and also give some good examples of Nordic- and European-level collaboration. The survey results showed that gerontological education was given in every Nordic country, in 31 universities and 60 other higher education institutions. Although separate aging-related courses and modules were relatively numerous, programs for majors were relatively few. Networking in the Nordic region offers a good example on how to further develop higher education in gerontology. Emphasis should be put on strengthening networking on the European and trans-Atlantic levels.