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This Week in JAMA
September 7, 2005

This Week in JAMA

JAMA. 2005;294(9):999. doi:10.1001/jama.294.9.999
Medical education


Edited by Robert M. Golub, MD

Resident Performance After Night Call

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.

Medical Students and Drug Companies

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.

Internet vs Live CME

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.

Costs and Funding of Education-Related Research

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.

Preparedness in Cross-Cultural Care

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.

US Medical Education, 2004-2005

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.

A Piece of My Mind

“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.”

Reforming GME

Ludmerer and Johns review the history of graduate medical education (GME) and propose strategies to reform and reinvigorate physician training.

Clinician’s corner

Limiting work hours may improve residents’ quality of life, but the effects on residents’ education are unclear.

Promoting Clinician-Educators

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.

JAMA Patient Page

For your patients: Information about standardized patients.