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This Week in JAMA
September 6, 2000

This Week in JAMA

JAMA. 2000;284(9):1061. doi:10.1001/jama.284.9.1061

Concept mapping may be a useful tool to assess the conceptual framework of resident physicians.

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Minorities in US Medical Schools

Despite initiatives to promote racial and ethnic diversity among physicians, minorities continue to be underrepresented among students and faculty in US medical schools. Using data from the Association of American Medical Colleges' Faculty Roster System, Fang and coauthorsArticle found that among medical school faculty members who became assistant or associate professors between 1980 and 1989, minority faculty were less likely than white faculty to be promoted by 1997. In a survey of medical school deans or directors of admissions, Kondo and JuddArticle found that on average there were 4.1 minority members per admission committee, but 11 of the 85 respondent schools had no minority committee members. In a commentary, BergenArticle asserts that US medical schools have a responsibility to create opportunities for qualified minority medical students and faculty.

Tasks Essential to Practice in Managed Care Settings

The specific training necessary to prepare medical residents for clinical practice in managed care settings has not been comprehensively evaluated. Yedidia and colleagues defined 26 clinical tasks as necessary for effective medical practice in managed care settings based on results of a survey of a national sample of 59 residency directors involved in managed care training programs. Residents who participated in these managed care training programs reported more confidence in performing the 26 identified tasks than control residents. National samples of managed care organization medical directors and primary care residency program directors in areas of high managed care penetration rated 65% of the 26 managed care tasks to be important to future practice and agreed on the importance rating of most of the tasks.

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Problems Among Internal Medicine Residents

The American Board of Internal Medicine defines a problem resident as "a trainee who demonstrates a significant enough problem that requires intervention by someone of authority." In this survey of internal medicine residency program directors in the United States, Yao and Wright found that the mean point prevalence of problem residents per program during academic year 1998-1999 was 6.9%, and 94% of programs had problem residents. The most frequently reported difficulties of problem residents were insufficient medical knowledge, poor clinical judgment, and inefficient use of time.

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Medical Education in the United States, 1999-2000

Barzansky and colleaguesArticle describe the faculties, applicants, enrolled students, and curriculum and evaluation at the 125 accredited US medical schools in 1999-2000 and find considerable variation among the schools. In the annual report from the 1999-2000 American Medical Association Annual Survey of Graduate Medical Education Programs, Brotherton and colleaguesArticle note continued growth in the numbers of both resident physicians and graduate medical education programs in the United States.

Trends in Medical School Finances and Faculty Salaries

In this annual review of revenue for the 125 accredited US medical schools, Krakower and colleaguesArticle report that in fiscal year 1998-1999, total revenue increased by 7.4% from the previous year. Most of the $39,761 million total revenue was derived from 3 sources—practice plans, grants and contracts, and hospital support. Studer-Ellis and colleaguesArticle examined trends in medical school faculty salaries during the last decade. Salaries increased between 1988 and 1998 for both clinical and basic science faculty. The annualized salary growth rate for clinical faculty decreased in the period 1988-1993 compared with 1993-1998, but increased for basic science faculty. In an editorial, ReinhardtArticle discusses the increased financial accountability required of academic health centers in today's price-competitive market.

A Piece of My Mind

"My existence is replete with fantastic resources that I use and discard with very little thought. From time to time I simply must pause and take notice." From "After Hours."

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Winning essays from the 2000 John Conley Ethics Contest for Medical Students consider the ethical obligations of the physician when parents of a newborn with trisomy 21 ask that treatment be withheld for an easily repaired but otherwise lethal condition.

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JAMA Patient Page

For your patients: Information about the education and training of physicians.

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