Explore the vast range of titles available.

Background The U.S. News & World Report has used the Doximity social networking site to determine rankings for 27 medical specialties, which influence medical students' choices. Despite concerns about the validity of these rankings, few studies have explored whether Doximity rankings correlate with program characteristics. We aim to determine associations between Doximity internal medicine reputation rank and publicly available program characteristics. Methods We performed a cross-sectional study of the 566 internal medicine residencies with a Doximity reputation rank from 2020. Doximity rankings were linked with publicly available sources, including the American Medical Association’s FREIDA, the American Board of Internal Medicine, the Accreditation Council for Graduate Medical Education, the Centers for Medicare and Medicaid Services Quality System, and U.S. News Best Hospitals Ranking. Variables included resident demographics, faculty characteristics, and program features. Statistical analyses involved univariable and multivariable linear regression. Results In multivariable analysis (parameter estimate ± standard error), higher ABIM pass rates (-1.30 ± 0.41), higher physician faculty-to-resident ratios (-14.10 ± 4.45), older programs (-1.07 ± 0.25), availability of research rotations (-38.56 ± 16.23), and larger program sizes (-1.09 ± 0.16) were associated with better Doximity ranks. Conversely, a higher percentage of international medical graduates (1.07 ± 0.19) and Doctors of Osteopathy (1.12 ± 0.27) were linked to lower rankings. Variables had an adjusted R2 of 0.53. Conclusions Doximity rankings were positively associated with publicly available characteristics of residency programs including higher ABIM pass rates, lower physician faculty-to-resident ratio, older program age, availability of a research rotation, and larger program size. Doximity rankings were negatively associated with a higher percentage of IMG and DO residents. These findings suggest that while Doximity rankings may be influenced by larger program sizes and higher self-reporting rates, they may also reflect meaningful indicators of program quality. The findings highlight the importance of research productivity and faculty ratios in enhancing program reputation and underscore potential disadvantages for community-based programs.

The body and mind are instruments that, through the senses, provide a gateway to conscious experience. One could reduce the totality of human existence to the body and mind alone, yet superficial appearances can be misleading. According to the yogic system, humans are comprised progressively subtle sheaths or koshas, ranging from the physical to the mind, energy, intellect, and bliss body. Furthermore, harnessing the intellect brings a level of control over energy, thoughts, behaviors, and quality of life. This understanding reorients the traditional, allopathic approach, which tends to emphasize the physical body in terms of anatomy, physiology, and clinical pathology. Recognizing deeper layers of self reminds physicians to see patients more holistically, while empowering patients to have greater authority over their own health outcomes.

Background Continuing medical education (CME) often uses passive educational models including lectures. However, numerous studies have questioned the effectiveness of these less engaging educational strategies. Studies outside of CME suggest that engaged learning is associated with improved educational outcomes. However, measuring participants’ engagement can be challenging. We developed and determined the validity evidence for a novel instrument to assess learner engagement in CME. Methods We conducted a cross-sectional validation study at a large, didactic-style CME conference. Content validity evidence was established through review of literature and previously published engagement scales and conceptual frameworks on engagement, along with an iterative process involving experts in the field, to develop an eight-item Learner Engagement Instrument (LEI). Response process validity was established by vetting LEI items on item clarity and perceived meaning prior to implementation, as well as using a well-developed online platform with clear instructions. Internal structure validity evidence was based on factor analysis and calculating internal consistency reliability. Relations to other variables validity evidence was determined by examining associations between LEI and previously validated CME Teaching Effectiveness (CMETE) instrument scores. Following each presentation, all participants were invited to complete the LEI and the CMETE. Results 51 out of 206 participants completed the LEI and CMETE (response rate 25%) Correlations between the LEI and the CMETE overall scores were strong (r = 0.80). Internal consistency reliability for the LEI was excellent (Cronbach’s alpha = 0.96). To support validity to internal structure, a factor analysis was performed and revealed a two dimensional instrument consisting of internal and external engagement domains. The internal consistency reliabilities were 0.96 for the internal engagement domain and 0.95 for the external engagement domain. Conclusion Engagement, as measured by the LEI, is strongly related to teaching effectiveness. The LEI is supported by robust validity evidence including content, response process, internal structure, and relations to other variables. Given the relationship between learner engagement and teaching effectiveness, identifying more engaging and interactive methods for teaching in CME is recommended.

Background Internal medicine (IM) residents face significant challenges when pursing subspecialty fellowships. This study determined the factors that differentiate IM residents entering pulmonary and critical care medicine (PCCM) fellowships from those pursuing other careers. Methods We completed a retrospective study of 12 classes of IM residents at a single institution completing residency between 2010 and 2021. Data included pre-residency characteristics, global residency performance, and PCCM-specific experiences. Logistic regression models examined associations between these variables and the primary outcome of matching into a PCCM fellowship within one year of completing IM residency. Results Among 522 residents, 10.3% matched into PCCM. Completing a pulmonary elective significantly increased the odds of matching into PCCM (OR 7.78, 99% CI 3.10–19.53, p  < 0.0001). Residents who match into PCCM were more likely to have < 3 publications than 3 + (OR 3.51 (1.20–10.25), p  = 0.003).” A stated intent to enter PCCM was positively associated with matching into PCCM in the univariable, but not the multivariable, model. Conclusions Matriculating into PCCM fellowship was significantly associated with completing a pulmonary elective during residency. PCCM-bound residents were less likely to achieve high numbers of publications, suggesting these residents’ preferences for clinical learning and practice over scholarship. This study provides insights into characteristics of residents who match into PCCM and guides mentors as they counsel residents considering PCCM.

Nearly 30% of patients with COVID-19 infection develop post-COVID Syndrome. Knowledge of post-COVID Syndrome is evolving, creating the need for adaptable curricula. Flipped classrooms (FC) are flexible and dynamic with demonstrated utility in continuing medical education (CME), yet there has been no research on application of FCs, or comparisons between livestream and in-person learning, in post-COVID CME. We implemented a novel post-COVID curriculum using FCs for in-person and livestream participants at four Mayo Clinic CME conferences. Outcomes were validated measures of knowledge; perceptions of FCs and CME teacher effectiveness; and learner engagement. Pre-conferences surveys were a post-COVID knowledge test and the Flipped Classroom Perception Inventory (FCPI). Post-conference surveys were a post-COVID knowledge test, the FCPI, the CME Teaching Effectiveness Instrument (CMETE), and the Learner Engagement Inventory (LEI). Pre-post knowledge and FCPI scores were analyzed using linear mixed models. CMETE and LEI were compared for in-person versus livestream participants using the Wilcoxon rank-sum test. Overall, 59 participants completed the pre-test, and 72 participants completed the post-test, surveys. Participants were predominantly female (58%), were in nonacademic group practices (65%), and lacked prior experience with flipped classrooms (83%). Following the presentations, participants showed significant improvements in post-COVID knowledge (47% correct precourse to 54% correct postcourse, -value = 0.004), and a trend toward improved FCPI scores. Teaching effectiveness, learner engagement, and pre-post change in COVID knowledge did not differ significantly between participants of in-person versus livestream sessions. This post-COVID FC curriculum was feasible and associated with improved knowledge scores among a diverse population of physician learners in CME, without any apparent compromise in learner engagement, or in perceptions of teaching effectiveness and FCs, among livestream versus in-person participants.

Background E-learning—the use of Internet technologies to enhance knowledge and performance—has become a widely accepted instructional approach. Little is known about the current use of e-learning in postgraduate medical education. To determine utilization of e-learning by United States internal medicine residency programs, program director (PD) perceptions of e-learning, and associations between e-learning use and residency program characteristics. Methods We conducted a national survey in collaboration with the Association of Program Directors in Internal Medicine of all United States internal medicine residency programs. Results Of the 368 PDs, 214 (58.2%) completed the e-learning survey. Use of synchronous e-learning at least sometimes, somewhat often, or very often was reported by 85 (39.7%); 153 programs (71.5%) use asynchronous e-learning at least sometimes, somewhat often, or very often. Most programs (168; 79%) do not have a budget to integrate e-learning. Mean (SD) scores for the PD perceptions of e-learning ranged from 3.01 (0.94) to 3.86 (0.72) on a 5-point scale. The odds of synchronous e-learning use were higher in programs with a budget for its implementation (odds ratio, 3.0 [95% CI, 1.04–8.7]; P  = .04). Conclusions Residency programs could be better resourced to integrate e-learning technologies. Asynchronous e-learning was used more than synchronous, which may be to accommodate busy resident schedules and duty-hour restrictions. PD perceptions of e-learning are relatively moderate and future research should determine whether PD reluctance to adopt e-learning is based on unawareness of the evidence, perceptions that e-learning is expensive, or judgments about value versus effectiveness.

ABSTRACT Background Studies reveal that 44.5 % of abstracts presented at national meetings are subsequently published in indexed journals, with lower rates for abstracts of medical education scholarship. Objective We sought to determine whether the quality of medical education abstracts is associated with subsequent publication in indexed journals, and to compare the quality of medical education abstracts presented as scientific abstracts versus innovations in medical education (IME). Design Retrospective cohort study. Participants Medical education abstracts presented at the Society of General Internal Medicine (SGIM) 2009 annual meeting. Main Measures Publication rates were measured using database searches for full-text publications through December 2013. Quality was assessed using the validated Medical Education Research Study Quality Instrument (MERSQI). Key Results Overall, 64 (44 %) medical education abstracts presented at the 2009 SGIM annual meeting were subsequently published in indexed medical journals. The MERSQI demonstrated good inter-rater reliability (intraclass correlation range, 0.77–1.00) for grading the quality of medical education abstracts. MERSQI scores were higher for published versus unpublished abstracts (9.59 vs. 8.81, p  = 0.03). Abstracts with a MERSQI score of 10 or greater were more likely to be published (OR 3.18, 95 % CI 1.47–6.89, p  = 0.003). ). MERSQI scores were higher for scientific versus IME abstracts (9.88 vs. 8.31, p  < 0.001). Publication rates were higher for scientific abstracts (42 [66 %] vs. 37 [46 %], p  = 0.02) and oral presentations (15 [23 %] vs. 6 [8 %], p  = 0.01). Conclusions The publication rate of medical education abstracts presented at the 2009 SGIM annual meeting was similar to reported publication rates for biomedical research abstracts, but higher than publication rates reported for medical education abstracts. MERSQI scores were associated with higher abstract publication rates, suggesting that attention to measures of quality—such as sampling, instrument validity, and data analysis—may improve the likelihood that medical education abstracts will be published.

To determine continuing medical education (CME) course participants' use of social media (SM) and their attitudes about the value of SM for enhancing CME education and to examine associations between participants' characteristics and attitudes toward SM. We conducted a cross-sectional survey and validation study of 539 participants at a Mayo Clinic Internal Medicine CME course in November 2011. The Social Media Use and Perception Instrument (SMUPI) consisted of 10 items (5-point Likert scales) and categorical response options. The main outcome measures were psychometric characteristics of the SMUPI scale, course participants' use of SM, and their attitudes regarding the importance of SM for enhancing CME. Of 539 CME course participants, 327 (61%) responded to the SMUPI survey. Most respondents (291 [89%]) reported using SM, with the most common types being YouTube (189 of the 327 participants [58%]) and Facebook (163 of 327 [50%]). Factor analysis revealed a 2-dimensional assessment of course participants' attitudes. Internal consistency reliability (Cronbach α) was excellent for factor 1 (0.94), factor 2 (0.89), and overall (0.94). The CME course participants' favorable attitudes toward SM were associated with younger age (20-29 years, mean score 3.13; 30-39 years, 3.40; 40-49 years, 3.39; 50-59 years, 3.18; 60-69 years, 2.93; and ≥70 years, 2.92; P=.02), using SM frequently (never, mean score 2.49; less than once monthly, 2.75; once monthly, 3.21; weekly, 3.31; and daily, 3.81; P<.0001), and professional degree (PhD, mean score 3.00; MD, 3.05; DO, 3.35; PA, 3.42; and NP, 3.50; P=.01). We describe the first validated measure of CME course participants' use of and attitudes toward SM. Our results suggest that CME course directors should guide SM strategies toward more youthful, technology-savvy CME participants and that SM will become increasingly worthwhile in CME as younger learners continue to enter the profession.

BackgroundAbstracts accepted at scientific meetings are often not subsequently published. Data on publication rates are largely from subspecialty and surgical studies.ObjectiveThe aims of this study were to 1) determine publication rates of abstracts presented at a general internal medicine meeting; 2) describe research activity among academic general internists; 3) identify factors associated with publication and with the impact factor of the journal of publication; and 4) evaluate for publication bias.DesignRetrospective cohort study.ParticipantsAll scientific abstracts presented at the Society of General Internal Medicine 2009 Annual Meeting.Main MeasuresPublication rates were determined by searching for full-text publications in MEDLINE. Data were abstracted regarding authors’ institution, research topic category, number of study sites, sample size, study design, statistical significance (p value and confidence interval) in abstract and publication, journal of publication, publication date, and journal impact factor.Key ResultsOf the 578 abstracts analyzed, 274 (47.4%) were subsequently published as a full article in a peer-reviewed journal indexed in MEDLINE. In a multivariable model adjusting for institution site, research topic, number of study sites, study design, sample size, and abstract results, publication rates for academic general internists were highest in the areas of medical education (52.5%, OR 5.05, 95% CI 1.57–17.25, reference group Veterans Affairs (VA)-based research, publication rate 36.7%), mental health/substance use (67.7%, OR 4.16, 95% CI 1.39–13.06), and aging/geriatrics/end of life (65.7%, OR 3.31, 95% CI 1.15–9.94, p = 0.01 across topics). Publication rates were higher for multicenter studies than single-institution studies (52.4% vs. 40.4%, OR 1.66, 95% CI 1.10–2.52, p = 0.04 across categories). Randomized controlled trials had higher publication rates than other study designs (66.7% vs. 45.9%, OR 2.72, 95% CI 1.30–5.94, p = 0.03 across study designs). Studies with positive results did not predict higher publication rates than negative studies (OR 0.89, 95% CI 0.6–1.31, p = 0.21).ConclusionsThis study demonstrated that 47.4% of abstracts presented at a general internal medicine national conference were subsequently published in a peer-reviewed journal indexed in MEDLINE.

Background Both research and clinical medicine requires similar attributes of efficiency, diligence and effective teamwork. Furthermore, residents must succeed at scholarship and patient care to be competitive for fellowship training. It is unknown whether research productivity among residents is related to broad measures of clinical achievement. Our goal was to examine associations between the quantity of internal medicine residents’ publications and validated measures of their knowledge, skills and multi-source evaluations of performance. Methods This was a longitudinal study of 308 residents graduating from Mayo Clinic from 2006 to 2012. We identified peer-reviewed articles in Ovid MEDLINE between July of each resident’s match year and the end of their graduation. Outcomes included American Board of Internal Medicine (ABIM) certification examination scores, mini clinical examination (mini-CEX) scores, and validated assessments of clinical performance by resident-peers, faculty and non-physicians. Performance assessments were averaged to form an overall score ranging from 1 to 5. Associations between quantity of resident publications – and ABIM, mini-CEX and performance assessment scores – were determined using multivariate linear regression. Results The residents published 642 papers, of which 443 (69.0 %) were research papers, 198 (30.8 %) were case reports, and 380 (59.2 %) were first-authored. On adjusted analysis, multi-source clinical performance evaluations were significantly associated (beta; 99 % CI; p -value) with the numbers of research articles (0.012; 0.001–0.024; 0.007), and overall publications (0.012; 0.002–0.022; 0.002). Conclusions To our knowledge, this is the first study to demonstrate that scholarly productivity based on journal publication is associated with clinical performance during residency training. Our findings suggest that residents who invest substantial efforts in research are not compromised in their abilities to learn medicine and care for patients.