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"Olaf, Mark"
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In Ramallah, running
In Ramallah, Running represents Guy Mannes-Abbott's uniquely personal encounter with Palestine, interweaving short, poetic texts with exploratory essays. International artists and prominent writers have been invited to respond both directly and indirectly to the texts with newly commissioned works.
Book
Mastoiditis with concomitant Lemierre's syndrome
Otalgia with mastoiditis is an infrequently encountered complication of acute otitis media (Pfaff and Moore, 2018). Even more rare is the development of infected jugular venous thrombosis, Lemierre's disease. We present a case of a six year-old girl with otalgia for over two months who presented to our Emergency Department (ED) with clinical mastoiditis, confirmed on CT scan, as well as an incidental diagnosis of complete thrombosis of the internal jugular (IJ) vein, Lemierre's syndrome. The true prevalence of Lemierre's from mastoiditis is difficult to discern. This clinical case highlights the importance of the consideration of these pathologies by the emergency physician.
Journal Article
Practical Tips for Undergraduate Medical Education Advisors in Residency Application Signaling
Objectives
The residency application process has become increasingly complex for medical students and advisors to navigate. Program signaling was piloted to improve applicants’ abilities to obtain interview offers at programs they were strongly interested in. The initial positive results led to expansion of signaling to additional specialties over the next two application cycles. Despite the benefits of program signaling, the variation in signaling practices among specialties has presented challenges for both advisors and students when determining how to best allocate signals. The aim of this study is to identify students’ perceptions of the signaling process, how this may impact outcomes, and to guide future educational programming.
Methods
This is an exploratory original survey study of students in a US allopathic medical school applying in ERAS for the 2023 residency cycle. The survey was developed to determine students’ understanding of how programs would use signals in the application process and assess strategies students used to allocate signals. We compared program signals to student interview offers and match outcomes using descriptive statistics.
Results
57 of 96 eligible students completed the survey. 51% signaled a range of programs based on their perceived competitiveness for the program while 40% signaled programs of interest regardless of perceived competitiveness. 53% of students thought sending a signal would increase their chance of an interview, while 42% were unsure how the signal would be used by residency programs. Students received interviews at 49% of the programs signaled, which increased to 56.5% when specialties offering more than 7 signals were excluded. 35% of students matched at a signaled program.
Conclusions
Students’ perceptions and strategies related to the signaling process are varied and may impact interview offers. Advisors should monitor and review internal institutional trends to help inform future educational programming to optimize signal allocation for their students.
Journal Article
Analysis of Anonymous Student Narratives About Experiences with Emergency Medicine Residency Programs
Academic emergency medicine (EM) communities have viewed anonymous online communities (AOC) such as Reddit or specialty-specific \"applicant spreadsheets\" as poor advising resources. Despite this, robust EM AOCs exist, with large user bases and heavy readership. Insights about applicants' authentic experiences can be critical for applicants and program leadership decision-making. To date, there are no EM studies to qualitatively assess EM AOC narratives during the application cycle. Our goal was to perform a qualitative analysis of students' EM program experiences through a publicly available AOC.
This was a qualitative analysis of a publicly available, time-stamped, user-locked AOC dataset: \"Official 2020-2021 Emergency Medicine Applicant Spreadsheet.\" We extracted and then de-identified all data from selected sub-sheets entitled \"Virtual Interview Impressions\" and \"Rotation Impressions.\" Four investigators used constant comparative method to analyze the data inductively, and they subsequently met to generate common themes discussed by students. Preliminary thematic analysis was conducted on a random sample of 37/183 (20%) independent narratives to create the initial codebook. This was used and updated iteratively to analyze the entire narrative set consisting of 841 discrete statements. Finally, two unique codes were created to distinguish whether the identified sub-themes, or program attributes, were likely \"modifiable\" or \"non-modifiable.\"
We identified six major themes: living and working conditions; interpersonal relationships; learning experiences, postgraduate readiness, and online/virtual supplements. Common sub-themes included patient population (13%); resident personality (7%); program leadership personality (7%); relationship with faculty/leadership (6%); geography (4%); practice setting (4%); program reputation (4%), and postgraduate year-3 experiences (4%). Modifiable sub-themes outnumbered non-modifiable sub-themes, 60.7% to 39.3%.
In this analysis of selected medical students' narratives in an AOC, the majority of identified themes represented topics that may serve as external feedback for EM residency programs and their clerkships. Selective use of AOCs may set a precedent for future program assessments by applicants and inform program leadership of important programmatic elements in the eyes of applicants. It elucidates important themes in their interactions or learning experiences with programs and creates opportunities for learner-centric program improvement.
Journal Article
Program Signaling in Emergency Medicine: The 2022–2023 Program Director Experience
Introduction: Program signaling (PS), which enables residency applicants to signal their preference for a specific program, was introduced in emergency medicine (EM) in the 2022–2023 residency application cycle. In this study we evaluated EM program directors’ (PD) utilization of PS in application review and ranking. This study also explores the relationship between program characteristics and number of signals received as well as the relative importance and utilization of signals related to the number of signals received. Methods: This is an institutional review board-approved, cross-sectional study of PDs at Accreditation Council for Graduate Medical Education-accredited EM residency programs. We used descriptive statistics to describe the characteristics of residency programs and practices around PS. Measures of central tendency and dispersion summarized continuous variables. We used chi-square analysis or the Fisher exact test for comparisons between groups for categorical variables. Comparisons for continuous variables were made using the t-test for independent samples or analysis of variance. Results: The response rate was 41% (n = 113/277 EM programs). Most programs participated in PS(n = 261/277 EM programs, 94.2%). Mean number of signals received was 60 (range 2–203). Signals received varied based on program characteristics including geographic location and program type, duration, environment, and longevity. Most used PS in holistic review (52.2%), but other uses varied by proportion of applications that were signaled. The importance of PS in application review (mean 2.9; 1–5scale,1= not important, 5 = extremely important) and rank list preparation (2.1) was relatively low compared to other application elements such as standardized letters of evaluation (4.97 for review, 4.90 for ranking). Conclusion: The study provides insights into PS utilization in EM’s inaugural year. We have identified patterns of signal use based on program characteristics and number of signals received that can inform signal allocation and utilization on an individual applicant and program level. A more nuanced understanding of signal use can provide valuable insight as the specialty of EM grapples with fluctuations in its applicant numbers and shifting demographics of its applicant pool.
Journal Article
Addressing Challenges in Obtaining Emergency Medicine Away Rotations and Standardized Letters of Evaluation Due to COVID-19 Pandemic
The Council of Residency Directors in Emergency Medicine (CORD) Advising Students Committee in Emergency Medicine (ASC-EM) anticipates institutional and regional variability in both the spread and response to COVID-19. Travel restrictions and host institution rotation closures will impact the number of emergency medicine (EM) rotations EM-bound medical students can complete in an unprecedented manner. They may prevent students from completing any away rotations this academic cycle, challenging the students’ ability to obtain EM Standardized Letters of Evaluation (SLOEs). EM’s emphasis on residency group SLOEs over other letter types creates an undue burden on these vulnerable students and makes the application process intrinsically inequitable. This inequity warrants a reevaluation of the current application practice. This article outlines ASC-EM's proposed recommendations for all stakeholders, including EM program leadership, medical schools, and EM-bound medical students, to consider for the upcoming EM application cycle.
Journal Article