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This Week in JAMA
September 4, 2002

This Week in JAMA

JAMA. 2002;288(9):1045. doi:10.1001/jama.288.9.1045

Medical education

Edited by Stephen J. Lurie, MD, PhD

Certification of International Medical Graduates

International medical graduates are required to obtain Educational Commission for Foreign Medical Graduates (ECFMG) certification to enter an accredited US graduate medical education program. Whelan and colleagues used data from the ECFMG to analyze trends among international medical graduates seeking certification. The annual number of graduates from non-US medical schools pursuing ECFMG certification has decreased since 1998 when a clinical assessment examination was added to the requirements for obtaining ECFMG certification. Performance data on the United States Medical Licensing Examination Step examinations, also required for ECFMG certification, suggest that the quality of applicants has improved.

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Evolution of the Medical College Admission Test

The first Medical College Admission Test (MCAT), designed to evaluate medical school applicants' readiness for medical education, was developed in 1928 in response to a high attrition rate in US medical schools. McGaghie describes the 5 major versions of the MCAT, noting how aptitude for medical education as defined by each version of the test reflects the professional and social values of the time when it was developed.

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Reentry Into Clinical Practice After Extended Leave

Mark and Gupta review factors that may contribute to a health care professional's decision to take an extended leave from clinical practice, discuss challenges associated with reentering clinical practice and programs that assist reentry, and propose recommendations for a national clinical practice reentry program.

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Family Practice in the United States

Family practice was recognized as a specialty in the late 1960s. Graham and colleagues review the development of family practice as a specialty, assess the current status of family practice in the United States, and discuss ongoing challenges faced by family practice today.

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Clinician's corner

Tobacco use is the leading cause of preventable death in the United States, but medical school curricula generally lack adequate training in smoking cessation interventions. In this systematic review of articles on medical school educational methods for tobacco intervention training, Spangler and colleagues found that enhanced teaching methods, such as use of critiqued interaction with standardized and real patients and role playing, were more effective for teaching tobacco intervention than were traditional didactic methods alone.

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Evaluating the Teaching of Evidence-Based Medicine

An increasing number of medical schools and residency programs include curricula for teaching the principles and practice of evidence-based medicine, but the quality of evidence on the effectiveness of methods for teaching evidence-based medicine is poor. Hatala and Guyatt examine limitations of the current literature on evaluation of evidence-based medicine teaching methods and discuss methodologies to improve future research.

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New Standards for Resident Duty Hours

Philibert and coauthors, for the Accreditation Council for Graduate Medical Education Work Group on Resident Duty Hours, discuss the new residency duty-hour standards that will limit duty to 80 hours per week effective July 2003.

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A Piece of My Mind

"As I grew older, moved away from my parents, and began a life of my own, I realized there was something missing—a way of being, and of being present in other people's lives." From "Secondary Consult."

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Contempo Updates

Review of recent evidence on the effectiveness of continuing medical education interventions.

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US Medical Education, 2001-2002

Annual reports describe the status of US medical education programs, students, and faculty, and trends in graduate medical education.

Sleep Loss in Residency: On Call

Veasey and colleagues review the effect of sleep loss on residents' performance and health and countermeasures for sleepiness, including work-hour restriction.

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Winning essays from the annual John Conley Ethics Essay Contest for Medical Students consider ethical issues in the hypothetical case of a young woman from Africa who requests that a US surgeon perform female circumcision on her before she returns to her village, where she would be obligated to undergo the procedure.

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JAMA Patient Page

For your patients: Information about continuing medical education.

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