The under-representation in medical education of students from lower socio-economic backgrounds is an important social issue. There is currently little evidence about whether changes in admission strategies might increase the diversity of the medical student population. Denmark introduced an 'attribute-based' admission track to make it easier for students who may not be eligible for admission on the 'grade-based' track to be admitted on the basis of attributes other than academic performance. The aim of this research was to examine whether there were significant differences in the social composition of student cohorts admitted via each of the two tracks during the years 2002-2007.
This prospective cohort study included 1074 medical students admitted during 2002-2007 to the University of Southern Denmark medical school. Of these, 454 were admitted by grade-based selection and 620 were selected on attributes other than grades. To explore the social mix of candidates admitted on each of the two tracks, respectively, we obtained information on social indices associated with educational attainment in Denmark (ethnic origin, father's education, mother's education, parenthood, parents living together, parent in receipt of social benefits).
Selection strategy (grade-based or attribute-based) had no statistically significant effect on the social diversity of the medical student population.
The choice of admission criteria may not be very important to widening access and increasing social diversity in medical schools. Attracting a sufficiently diverse applicant pool may represent a better strategy for increasing diversity in the student population.
Comment In: Med Educ. 2013 Jun;47(6):542-423662869
During a 10-year period 1,050 medical students were questioned regarding allergy and allergy-like symptoms and 612 of them underwent skin prick tests with dog, cat, timothy and birch allergens. Symptoms of eczema, asthma or non-infectious rhinitis, past or current, or current reactions to pollen, furred animals, dust, mould or food were reported by 46% of the students. Three per cent reported present eczema of the flexure type and a further 8% reported past symptoms of the same kind. Current contact e zema was reported by 7% and past contact eczema by a further 3%. Daily treatment with ointments was reported by 52% of the students with current flexure eczema and by 17% with current contact eczema. Current asthma was reported by 5% and past asthma by a further 3%. Of those with current asthma, 88% were allergic to pollens and/or furred animals and 57% used anti-asthmatic drugs for at least 2 weeks/year. Current allergic symptoms in the nose and/or eyes were reported by 29% and a further 2% reported past symptoms. Of those with current symptoms 64% were allergic to pollens and/or furred animals, as judged by the history and skin tests. Almost 60% of the students with pollen allergy used anti-allergic drugs for at least 2 weeks/year. Allergy to pollens was reported by 17%, to animals by 12%, to house dust by 10%, to moulds by 2% and to foods by 15%. Allergy reported and confirmed by a prick test was found in 8% against birch, 6% against timothy, 10% against cat and 5% against dog.(ABSTRACT TRUNCATED AT 250 WORDS)
Results of mutual check-ups of 5-year students of therapeutic and medical prophylactic faculties of I. M. Sechenov Moscow Medical Academy in 1991-1994 are analyzed. A total of 584 case histories of students are reviewed. The data demonstrated correlation of many signs in the sample and statistical data of ophthalmological publications on refraction. Conclusions about errors in prescription and use of eyeglasses are made. Violation of visual loading regimen by these students are detected.
BACKGROUND: Mental distress among medical students is often reported. Burnout has not been studied frequently and studies using interviewer-rated diagnoses as outcomes are rarely employed. The objective of this prospective study of medical students was to examine clinically significant psychiatric morbidity and burnout at 3rd year of medical school, considering personality and study conditions measured at 1st year. METHODS: Questionnaires were sent to 127 first year medical students who were then followed-up at 3rd year of medical school. Eighty-one of 3rd year respondents participated in a diagnostic interview. Personality (HP5-i) and Performance-based self-esteem (PBSE-scale) were assessed at first year, Study conditions (HESI), Burnout (OLBI), Depression (MDI) at 1st and 3rd years. Diagnostic interviews (MINI) were used at 3rd year to assess psychiatric morbidity. High and low burnout at 3rd year was defined by cluster analysis. Logistic regressions were used to identify predictors of high burnout and psychiatric morbidity, controlling for gender. RESULTS: 98 (77%) responded on both occasions, 80 (63%) of these were interviewed. High burnout was predicted by Impulsivity trait, Depressive symptoms at 1st year and Financial concerns at 1st year. When controlling for 3rd year study conditions, Impulsivity and concurrent Workload remained. Of the interviewed sample 21 (27%) had a psychiatric diagnosis, 6 of whom had sought help. Unadjusted analyses showed that psychiatric morbidity was predicted by high Performance-based self-esteem, Disengagement and Depression at 1st year, only the later remained significant in the adjusted analysis. CONCLUSION: Psychiatric morbidity is common in medical students but few seek help. Burnout has individual as well as environmental explanations and to avoid it, organisational as well as individual interventions may be needed. Early signs of depressive symptoms in medical students may be important to address. Students should be encouraged to seek help and adequate facilities should be available.
Like many rural regions around the world, Northern Ontario has a chronic shortage of doctors. Recognizing that medical graduates who have grown up in a rural area are more likely to practice in the rural setting, the Government of Ontario, Canada, decided in 2001 to establish a new medical school in the region with a social accountability mandate to contribute to improving the health of the people and communities of Northern Ontario. The Northern Ontario School of Medicine (NOSM) is a joint initiative of Laurentian University and Lakehead University, which are located 700 miles apart. This paper outlines the development and implementation of NOSM, Canada's first new medical school in more than 30 years. NOSM is a rural distributed community-based medical school which actively seeks to recruit students into its MD program who come from Northern Ontario or from similar northern, rural, remote, Aboriginal, Francophone backgrounds. The holistic, cohesive curriculum for the MD program relies heavily on electronic communications to support distributed community engaged learning. In the classroom and in clinical settings, students explore cases from the perspective of physicians in Northern Ontario. Clinical education takes place in a wide range of community and health service settings, so that the students experience the diversity of communities and cultures in Northern Ontario. NOSM graduates will be skilled physicians ready and able to undertake postgraduate training anywhere, but with a special affinity for and comfort with pursuing postgraduate training and clinical practice in Northern Ontario.
Over the last 10 years the number of medical students choosing family medicine as a career has steadily declined. Studies have demonstrated that career preference at the time that students begin medical school may be significantly associated with their ultimate career choice. We sought to identify the career preferences students have at entry to medical school and the factors related to family medicine as a first-choice career option.
A questionnaire was administered to students entering medical school programs at the time of entry at the University of Calgary (programs beginning in 2001 and 2002), University of British Columbia (2001 and 2002) and University of Alberta (2002). Students were asked to indicate their top 3 career choices and to rank the importance of 25 variables with respect to their career choice. Factor analysis was performed on the variables. Reliability of the factor scores was estimated using Cronbach's alpha coefficients; biserial correlations between the factors and career choice were also calculated. A logistic regression was performed using career choice (family v. other) as the criterion variable and the factors plus demographic characteristics as predictor variables.
Of 583 students, 519 (89%) completed the questionnaire. Only 20% of the respondents identified family medicine as their first career option, and about half ranked family medicine in their top 3 choices. Factor analysis produced 5 factors (medical lifestyle, societal orientation, prestige, hospital orientation and varied scope of practice) that explained 52% of the variance in responses. The 5 factors demonstrated acceptable internal consistency and correlated in the expected direction with the choice of family medicine. Logistic regression revealed that students who identified family medicine as their first choice tended to be older, to be concerned about medical lifestyle and to have lived in smaller communities at the time of completing high school; they were also less likely to be hospital oriented. Moreover, students who chose family medicine were much more likely to demonstrate a societal orientation and to desire a varied scope of practice.
Several factors appear to drive students toward family medicine, most notably having a societal orientation and a desire for a varied scope of practice. If the factors that influence medical students to choose family medicine can be identified accurately, then it may be possible to use such a model to change medical school admission policies so that the number of students choosing to enter family medicine can be increased.
Cites: Acad Med. 1991 Jan;66(1):44-61985677
Cites: N Engl J Med. 1992 Feb 6;326(6):387-931729622
To determine the changes between 1991 and 1997 in the admission policies of and services offered by U.S. and Canadian medical schools to students with learning disabilities.
Between June 1 and August 31, 1997, the author surveyed 144 medical schools in the United States and Canada regarding their services and programs for learning-disabled medical students. The questionnaire was the same one as used in a 1991 study.
Of the medical schools contacted, 106 responded (one Canadian school sent a letter but did not complete the questionnaire). Ninety-four of 96 U.S. schools and seven of the remaining nine Canadian schools said that they accept students with learning disabilities. All of the respondents that accept such students claimed to make some academic accommodations. Most indicated that they would administer non-standard (e.g., untimed) licensing examinations, and many reported that their affiliated postgraduate medical training programs would also make appropriate accommodations for students with learning disabilities.
When compared with the results from the 1991 survey, the new data suggest that medical schools have improved their services for learning-disabled students in response to the Americans with Disabilities Act.