A JAMA THEME ISSUE
Edited by Robert M. Golub, MD
To investigate possible performance deficits resulting from fatigue
after night call, Arnedt and colleaguesArticle administered
neurobehavioral tests to 34 residents following heavy call, light call, and
light call with alcohol ingestion. They found that after a heavy call rotation,
the residents’ performance was comparable with that associated with
a blood alcohol concentration of 0.04% to 0.05%, and the residents demonstrated
limited recognition of their degree of impairment. In an editorial, Dawson
and ZeeArticle discuss work hour restrictions, physician well-being,
and patient safety.
In a survey of third-year medical students, Sierles and colleagues assessed
frequency of exposure to and attitudes toward pharmaceutical company-sponsored
activities or gifts. They found that students had a mean exposure of 1 gift
or sponsored activity per week. Sixty-nine percent did not believe gifts would
influence their practice of medicine, 80.3% believed they were entitled to
the gifts, and 59.6% believed sponsored grand rounds are likely to be biased.
Fordis and colleagues randomly assigned physicians to receive continuing
medical education (CME) in a live small group setting or through an Internet-based
program and then assessed gains in knowledge and change in patient care–related
behaviors. Knowledge gains were similar for both CME formats. Physicians assigned
to Internet-based CME demonstrated more behavioral change consistent with
the CME content.
Reed and colleagues surveyed first authors of recently published medical
education studies to determine the costs of conducting the studies and the
funding source. They found that only 29.6% of the studies were funded. When
funding was obtained—most commonly from private foundations—the
funds were often insufficient to cover the costs of the study.
In a survey of resident physicians about attitudes, educational experiences,
and perceptions of preparedness to provide quality care to diverse patient
populations, Weissman and colleagues found wide agreement that cultural issues
are important. However, many residents reported a lack of instruction or evaluation
in specific areas of cross-cultural care and a significant number responded
they were not prepared to treat patients from other cultures.
Trends in graduate and undergraduate medical education are discussed
in 2 articles in this issue of JAMA. First, Barzansky
and EtzelArticle describe trends in medical school faculty,
applicants and students, student work hours, and other variables related to
the educational experience. In the second article, Brotherton and colleaguesArticle compare trends in primary care specialty training from survey data collected in 1995-1996, 1998-1999, 2001-2002, and 2004-2005 surveys of
allopathic graduate medical education programs.
“What high-powered busy professional—lawyer, banker, architect,
or business exec—has the time, the imaginative wherewithal, or even
the inclination to integrate an appreciation of Bach or O’Keefe amidst
his or her onerous daily tasks.” From “‘The Medical Humanities,’
for Lack of a Better Term.”
Ludmerer and Johns review the history of graduate medical education
(GME) and propose strategies to reform and reinvigorate physician training.
Limiting work hours may improve residents’ quality of life, but
the effects on residents’ education are unclear.
Benefits of separate but equitable tenure-eligible promotion tracks
for clinician-educators and clinician-researchers are discussed.
Reflections on medicine—from rainbows to dark clouds; and on medical
education—from allegory to bull moose.
For your patients: Information about standardized patients.
This Week in JAMA . JAMA. 2005;294(9):999. doi:10.1001/jama.294.9.999