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Concept: Medical education


Surgical training has always been hard on residents. During my own residency more than 20 years ago, 100-hour workweeks and in-house call every other night were routine. A resident’s life outside the hospital was simply not a priority. Residency may be even harder on patients. A large body of research has linked sleep deprivation in resident physicians to poor performance in neurobehavioral testing and, more alarmingly, to higher rates of attention failure in patient care.(1),(2) Reacting to concerns about both resident well-being and patient safety, the Accreditation Council for Graduate Medical Education (ACGME) implemented duty-hour reforms in 2003 that . . .

Concepts: Medicine, Patient, Hospital, Sleep deprivation, Physician, Medical school, Hospital accreditation, Medical education


Physical activity (PA) is a key component of healthy lifestyle and disease prevention. In contrast, physical inactivity accounts for a significant proportion of premature deaths worldwide. Physicians are in a critical position to help patients develop healthy lifestyles by actively counseling on PA. Sports medicine physicians, with their focus on sports and exercise medicine are uniquely trained to provide such expertise to patients, learners and colleagues. To succeed, physicians need clinical tools and processes that support PA assessment and counseling. Linking patients to community resources, and specifically to health and fitness professionals is a key strategy. Efforts should be made to expand provider education during medical school, residency and fellowship training, and continuing medical education. Lastly, physically active physicians are more likely to counsel patients to be active. A key message for the sports medicine community is the importance of serving as a positive PA role model.

Concepts: Medicine, Obesity, Exercise, Physician, Weight loss, Pediatrics, Medical school, Medical education


Financial relationships between pharmaceutical manufacturers and health care professionals remain controversial. Some interactions, such as those involving research and exchange of expertise, promote the development and study of new drugs; by contrast, payments in the form of meals and continuing medical education (CME) programs have been criticized for being promotional and have been linked to non-evidence-based prescribing practices. The prevalence of these relationships has been estimated from national physician surveys, which found that, across seven specialties, about 83% of physicians received gifts from industry (excluding samples) in 2004. The prevalence has decreased slightly in recent years: a 2009 survey showed . . .

Concepts: Health care, Pharmacology, Medicine, Physician, Medical school, Residency, Medical education, Doctor of Medicine


Death certificates contain critical information for epidemiology, public health research, disease surveillance, and community health programs. In most teaching hospitals, resident physicians complete death certificates. The objective of this study was to examine the experiences and opinions of physician residents in New York City on the accuracy of the cause-of-death reporting system.

Concepts: Medicine, Public health, Epidemiology, Hospital, Demography, Physician, New York City, Medical education


The stigmatization of people with obesity is widespread and causes harm. Weight stigma is often propagated and tolerated in society because of beliefs that stigma and shame will motivate people to lose weight. However, rather than motivating positive change, this stigma contributes to behaviors such as binge eating, social isolation, avoidance of health care services, decreased physical activity, and increased weight gain, which worsen obesity and create additional barriers to healthy behavior change. Furthermore, experiences of weight stigma also dramatically impair quality of life, especially for youth. Health care professionals continue to seek effective strategies and resources to address the obesity epidemic; however, they also frequently exhibit weight bias and stigmatizing behaviors. This policy statement seeks to raise awareness regarding the prevalence and negative effects of weight stigma on pediatric patients and their families and provides 6 clinical practice and 4 advocacy recommendations regarding the role of pediatricians in addressing weight stigma. In summary, these recommendations include improving the clinical setting by modeling best practices for nonbiased behaviors and language; using empathetic and empowering counseling techniques, such as motivational interviewing, and addressing weight stigma and bullying in the clinic visit; advocating for inclusion of training and education about weight stigma in medical schools, residency programs, and continuing medical education programs; and empowering families to be advocates to address weight stigma in the home environment and school setting.

Concepts: Health care, Medicine, Health, Obesity, Physician, Medical school, Motivation, Medical education


BACKGROUND: Resident remediation is required for all residents who do not meet minimum standards in one or more of the Accreditation Council for Graduate Medical Education core competencies. The Council of Residency Directors in Emergency Medicine Remediation Taskforce identified the need for case-based examples of remediation efforts. OBJECTIVES: 1) To describe a complicated resident remediation case and employ consensus panel evaluation of the process. 2) To discuss the available assessment tools (including neuropsychologic/medical testing), due process, documentation, reassessment, and relevant barriers to implementation for this and other resident remediations. DISCUSSION: Details of a remediation case were altered to protect resident confidentiality, and then presented to a multidisciplinary group of program directors. The case details, action plan, and course were submitted and the remediation process, action plan, and course are assessed based on a standardized remediation approach. The resident entered remediation for poor organizational skills and an inability to make or follow through with patient care plans. Opportunities for improvement in the applied remediation process are identified and discussed. Legal concerns and utility of neuropsychological assessment of residents are reviewed. CONCLUSIONS: Remediation requires a complicated and detailed effort. This case demonstrates issues that program directors may face when working with residents and provides suggestions for use of specific remediation tools.

Concepts: Evaluation, Physician, Assessment, Educational psychology, Management, Medical school, Medical education, Resident


Medical students are exposed to high amounts of stress. Stress and poor academic performance can become part of a vicious circle. In order to counteract this circularity, it seems important to better understand the relationship between stress and performance during medical education. The most widespread stress questionnaire designed for use in Medical School is the “Perceived Medical School Stress Instrument” (PMSS). It addresses a wide range of stressors, including workload, competition, social isolation and financial worries. Our aim was to examine the relation between the perceived Medical School stress of undergraduate medical students and academic performance.

Concepts: Observational study, Education, Physician, Cognition, High school, Medical school, Stress, Medical education


Blood pressure (BP) measurement is the most common procedure performed in clinical practice. Accurate BP measurement is critical if patient care is to be delivered with the highest quality, as stressed in published guidelines. Physician training in BP measurement is often limited to a brief demonstration during medical school without retraining in residency, fellowship, or clinical practice to maintain skills. One hundred fifty-nine students from medical schools in 37 states attending the American Medical Association’s House of Delegates Meeting in June 2015 were assessed on an 11-element skillset on BP measurement. Only one student demonstrated proficiency on all 11 skills. The mean number of elements performed properly was 4.1. The findings suggest that changes in medical school curriculum emphasizing BP measurement are needed for medical students to become, and remain, proficient in BP measurement. Measuring BP correctly should be taught and reinforced throughout medical school, residency, and the entire career of clinicians.

Concepts: Medicine, Education, Physician, Pediatrics, Medical school, Internal medicine, Residency, Medical education


Abstract Twitter is a tool for physicians to increase engagement of learners and the public, share scientific information, crowdsource new ideas, conduct, discuss and challenge emerging research, pursue professional development and continuing medical education, expand networks around specialized topics and provide moral support to colleagues. However, new users or skeptics may well be wary of its potential pitfalls. The aims of this commentary are to discuss the potential advantages of the Twitter platform for dialogue among physicians, to explore the barriers to accurate and high-quality healthcare discourse and, finally, to recommend potential safeguards physicians may employ against these threats in order to participate productively.

Concepts: Scientific method, Medicine, Physician, Science, Profession, Medical school, Medical education, Twitter


The transition from medical school to residency is a critical step in the careers of physicians. Because of the standardized application process-wherein schools submit summative Medical Student Performance Evaluations (MSPE’s)-it also represents a unique opportunity to assess the possible prevalence of racial and gender disparities, as shown elsewhere in medicine.

Concepts: Medicine, Evaluation, Physician, Anatomy, Pediatrics, Medical school, Specialty, Medical education