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Edited by Stephen J. Lurie, MD, PhD
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
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.
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.
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.
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
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.
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
"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."
Review of recent evidence on the effectiveness of continuing medical
Annual reports describe the status of US medical education programs,
students, and faculty, and trends in graduate medical education.
Veasey and colleagues review the effect of sleep loss on residents'
performance and health and countermeasures for sleepiness, including work-hour
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.
For your patients: Information about continuing medical education.
This Week in JAMA. JAMA. 2002;288(9):1045. doi:10.1001/jama.288.9.1045
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