Journal of graduate medical education最新文献

Background Female physicians have lower incomes than male physicians. While overall sex-based income disparities are dramatic, compensation differs considerably across specialties. A better understanding of the relationship between anticipated specialty-specific annual incomes and the proportion of females entering that specialty might help residency program directors argue for equity in specialty choice and income for female physicians. Objective We sought to determine the relationship between the percentage of females in the workforce entering a specialty and the average compensation of that specialty in 2023. Methods From a recent JAMA article, we obtained the characteristics and numbers of trainees engaged in 160 specialties or subspecialties within 13 489 graduate medical education programs in 2023; we aggregated those data into 50 specialties for which 2023 average annual self-reported compensation were publicly available from Doximity. We conducted a stepwise linear regression in which the specialty-specific proportion of trainees who were female, US medical school graduates, Canadian, Doctors of Osteopathy, American Indian or Alaska Native, Asian, Black, Hispanic or Latino, Pacific Islander, or White were used to predict the specialty-specific average annual income. We conducted the analysis in 2024. Results Each one percent increase in the specialty-specific percentage of female trainees was associated with a $5,301 decrease in average specialty-specific annual compensation, and each one percent increase in the US medical school graduate percentage was associated with a $3,821 increase. These 2 characteristics accounted for 78% of the adjusted explainable variance in average specialty-specific annual compensation. Conclusions Specialties with higher proportions of female trainees had lower average annual compensation rates.

Background Medical residents rely on mobile digital devices for point-of-care learning and communication. However, most guidance arises from high-income settings with reliable connectivity and clearer governance on the use of digital devices. In low- and middle-income contexts, intermittent access, out-of-pocket costs, and privacy gaps create distinct risks and opportunities. Understanding mobile device use is fundamental for designing curricula and educational policies. Objective To explore how Mexican medical residents perceive and use mobile devices to support their learning during clinical training. Methods An exploratory qualitative study, guided by the framework of self-regulated learning, was performed from February 2023 to January 2024 with 16 residents from 5 medical specialties in Mexico, an upper-middle-income country. Participants were recruited via convenience sampling from university-affiliated academic health centers in Mexico City. Data were collected using a semistructured interview guide and analyzed inductively using thematic analysis with constant comparison and axial coding. Results Thematic analysis of residents' accounts revealed 2 main domains: educational uses of mobile devices; and perceptions and challenges of use, which include professional ambiguity and social regulation, cognitive load and emotional strain, ethical and privacy dilemmas, and infrastructure limitations and digital equity. Mobile devices were considered essential tools for learning and self-directed education, though their use is limited by contextual and institutional constraints. Conclusions Residents reported using mobile digital devices primarily for clinical care information retrieval, procedure review, and self-directed study. Reported constraints included faculty expectations regarding device use, privacy and data-handling concerns, unequal access and costs, infrastructure limitations, and educational tensions in clinical learning environments.

Background Social isolation and loneliness (SIL) are strongly associated with poor health outcomes among older adults; however, graduate medical education often limits dedicated geriatrics clinical training, leaving residents ill-prepared to care for older adults. Engaging residents with older adults in nonclinical environments could change perceptions on SIL and aging and improve care for older adults. Objective To develop and evaluate a social constructivism-based curriculum for interns centered on nonclinical engagement with older adults, aimed at enhancing empathy and understanding of SIL. Methods Twenty-nine internal medicine interns at an academic medical center in Oregon participated in mandatory educational sessions on SIL and completed structured outreach calls to older adults at elevated risk of SIL from 2020 to 2021. On completion of these activities, interns' self-reflection essays about their experiences were analyzed to identify key themes and changes in their perceptions and attitudes. Results Analysis of interns' self-reflection essays yielded 7 major themes, including changes in their understanding of SIL and attitudes toward older adults, often prompted by older adults' resilience and resourceful coping strategies. Other major themes included lessons learned about SIL, factors affecting SIL, and intended changes to future practice. Conclusions By creating opportunities for interns to reflect on biases and engage with the realities of older adults' lives, our curriculum led to a shift in interns' perceptions toward a more thoughtful understanding of aging and SIL and intentions to integrate a more complex understanding of aging and SIL into their future work.