Obstetrics and gynecology clerkship for males and females: similar curriculum, different outcomes?

OBJECTIVE

To determine if performance differences exist between male and female students on a 6-week obstetrics and gynecology (Ob/Gyn) clerkship and to evaluate potential variables that might underlie any observed variations.

STUDY DESIGN

Final clerkship grades and component scores (clinical evaluations, objective structured clinical examination [OSCE], oral examination, and National Board of Medical Examiners [NBME] subject examination) from July 2007 to June 2010 were matched by student and analyzed by gender. Basic science grade point average (GPA) and initial United States Medical Licensing Exam (USMLE) Step 1 scores were used to establish students' baseline medical knowledge. On a post-clerkship questionnaire, a subset of students reported the numbers of procedures they performed during the clerkship; students also completed online pre- and post-clerkship questionnaires reflecting their self-assessed confidence in women's health clinical skills.

RESULTS

Scores were analyzed for 136 women and 220 men. Final clerkship grades were significantly higher for females than for males (89.05 vs. 87.34, p=0.0004, η(2)=0.08). Specifically, females outscored males on the OSCE, oral, and NBME subject examination portions of the clerkship but not clinical evaluations. Males reported completing fewer breast examinations (p=0.001, η(2)=0.14). Pre-clerkship, males were significantly less confident than females in women's health clinical skills (p<0.01) but reached similar levels upon completion of the clerkship. No gender differences were detected for basic science GPA and USMLE Step 1 scores.

CONCLUSION

Student gender is associated with final grades on an Ob/Gyn clerkship. Further research regarding these differences should be explored.

A required third-year medical student palliative care curriculum impacts knowledge and attitudes

BACKGROUND

Despite broad support for palliative and end-of-life care training in medical schools, required clinical palliative care and end-of-life experiences are rare. In this study, we assess the impact of a required palliative care educational intervention on medical students' palliative care pain knowledge and end-of-life attitudes.

METHODS

In this wait-list control crossover design, third-year medical students from two sequential classes (n=157) completed a palliative care workshop at the beginning of a required year-long course. Students then completed a patient experience, online pain management module, and reflective essay in either the first or second half of the course. Fifteen validated multiple choice palliative care pain management items and the Thanatophobia Scale (7 items) were administered to measure knowledge and attitudes for all students at baseline, 5.5 months, and 11 months. Multivariate repeated measures ANOVA was used to determine differences between groups and across time.

RESULTS

Analysis found statistically significant increases in knowledge and improvements in attitudes (p<0.001) across the time points as well as a statistically significant interaction effect between time and groups (p=0.006). These changes correspond to specific curricular intervention components in which attitudinal improvements are seen after the workshop, and knowledge increases are seen after the patient experience, online pain module, and reflective essay.

CONCLUSION

A modest, required palliative care curriculum can yield improvements in medical student knowledge and attitudes. However, expansion of the experiential component and palliative care skills training and assessment are needed for students to have more meaningful outcomes and to ultimately contribute to better patient outcomes.

Meeting the family: promoting humanism in gross anatomy

BACKGROUND

Human dissection commonly occurs early in the undergraduate medical school curriculum, thus presenting an immediate opportunity for educators to teach and encourage humanistic qualities of respect, empathy, and compassion.

PURPOSE

The purpose of this study was to measure the impact of the Donor Luncheon, a unique program in which medical students meet the families of the anatomical donor prior to dissection in the anatomy course at the University of Oklahoma College of Medicine.

METHODS

Students were randomized into groups of 8 to attend the luncheon and either met with family of the donor or attended the luncheon with no donor family present. A questionnaire measured students' attitudes at 2 weeks, 6 weeks, and at the conclusion of the anatomy course.

RESULTS

Factor analysis revealed 5 scales. Analysis revealed statistically significant differences across time for Donor as Person, Dissection Process, and Donor as Patient and statistically significant differences between groups for Donor as Person and Donor as Patient.

CONCLUSIONS

These results suggest that this program can provide students with the opportunity to maintain more humanistic attitudes at the beginning of their medical education career.

A national survey of medical education fellowships

PURPOSE

The purpose of our study was to determine the prevalence, focus, time commitment, graduation requirements and programme evaluation methods of medical education fellowships throughout the United States. Medical education fellowships are defined as a single cohort of medical teaching faculty who participate in an extended faculty development programme.

METHODS

A 26-item online questionnaire was distributed to all US medical schools (n=127) in 2005 and 2006. The questionnaire asked each school if it had a medical education fellowship and the characteristics of the fellowship programme.

RESULTS

Almost half (n=55) of the participating schools (n=120, response rate 94.5 %) reported having fellowships. Duration (10-584 hours) and length (<1 month-48 months) varied; most focused on teaching skills, scholarly dissemination and curriculum design, and required the completion of a scholarly project. A majority collected participant satisfaction; few used other programme evaluation strategies.

CONCLUSIONS

The number of medical education fellowships increased rapidly during the 1990s and 2000s. Across the US, programmes are similar in participant characteristics and curricular focus but unique in completion requirements. Fellowships collect limited programme evaluation data, indicating a need for better outcome data. These results provide benchmark data for those implementing or revising existing medical education fellowships.

Decoding the learning environment of medical education: a hidden curriculum perspective for faculty development

Medical student literature has broadly established the importance of differentiating between formal-explicit and hidden-tacit dimensions of the physician education process. The hidden curriculum refers to cultural mores that are transmitted, but not openly acknowledged, through formal and informal educational endeavors. The authors extend the concept of the hidden curriculum from students to faculty, and in so doing, they frame the acquisition by faculty of knowledge, skills, and values as a more global process of identity formation. This process includes a subset of formal, formative activities labeled "faculty development programs" that target specific faculty skills such as teaching effectiveness or leadership; however, it also includes informal, tacit messages that faculty absorb. As faculty members are socialized into faculty life, they often encounter conflicting messages about their role. In this article, the authors examine how faculty development programs have functioned as a source of conflict, and they ask how these programs might be retooled to assist faculty in understanding the tacit institutional culture shaping effective socialization and in managing the inconsistencies that so often dominate faculty life.

Following the clues: teaching medical students to explore patients' contexts

OBJECTIVE

Physicians often overlook important contextual clues that patients give during an encounter. The objective of our study was to increase medical students' knowledge and skills in identifying contextual issues.

METHODS

Six consecutive learning experiences, including a standardized patient (SP) encounter and activities designed to trigger reflection, were implemented within a first-year Introduction to Clinical Medicine course. Evaluation of the intervention was measured through self-confidence, attitudes, SP history checklist, and student and small group facilitator evaluations.

RESULTS

Standardized patient encounters, coupled with activities designed to trigger reflection, can help students identify patients' contextual clues. Students' confidence in eliciting patient clues significantly increased after the intervention. Our results suggest that some contextual clues were more difficult for students to elicit.

CONCLUSION

Multi-faceted approaches that include activities to trigger reflection are effective in teaching students to recognize and respond to contextual clues, however, more research is needed.

PRACTICE IMPLICATIONS

While students elicited most clues in this study, they struggled with identifying some clues. These results suggest the need for additional research and educational development in this area.

Ideals, activities, dissonance, and processing: a conceptual model to guide educators' efforts to stimulate student reflection

PURPOSE

Medical schools are increasingly incorporating opportunities for reflection into their curricula. However, little is known about the cognitive and/or emotional processes that occur when learners participate in activities designed to promote reflection. The purpose of this study was to identify and elucidate those processes.

METHOD

In 2008, the authors analyzed qualitative data from focus groups that were originally conducted to evaluate an educational activity designed to promote reflection. These data afforded the opportunity to explore the processes of reflection in detail. Transcripts (94 pages, single-spaced) from four focus groups were analyzed using a narrative framework. The authors spent approximately 40 hours in group and 240 hours in individual coding activities.

RESULTS

The authors developed a conceptual model of five major elements in students' reflective processes: the educational activity, the presence or absence of cognitive or emotional dissonance, and two methods of processing dissonance (preservation or reconciliation). The model also incorporates the relationship between the student's internal ideal of what a doctor is or does and the student's perception of the teacher's ideal of what a doctor is or does. The model further identifies points at which educators may be able to influence the processes of reflection and the development of professional ideals.

CONCLUSIONS

Students' cognitive and emotional processes have important effects on the success of educational activities intended to stimulate reflection. Although additional research is needed, this model-which incorporates ideals, activities, dissonance, and processing-can guide educators as they plan and implement such activities.

Medical students' perceptions of their teachers' and their own cultural competency: implications for education

BACKGROUND

Enhancing the cultural competency of students is emerging as a key issue in medical education; however, students may perceive that they are more able to function within cross-cultural situations than their teachers, reducing the effectiveness of cultural competency educational efforts.

OBJECTIVE

The purpose of our study was to compare medical students' perceptions of their residents, attendings, and their own cultural competency.

DESIGN

Cross-sectional study.

MAIN MEASURES

A questionnaire containing previously validated instruments was administered to end-of-third-year medical students at four institutions throughout the US. Repeated measures multivariate analysis was used to determine differences in student ratings.

PARTICIPANTS

Three hundred fifty-eight medical students from four schools participated, for an overall response rate of 65%.

RESULTS

Analysis indicated overall statistically significant differences in students' ratings (p < 0.001, eta(2) = 0.33). Students rated their own cultural competency as statistically significantly higher than their residents, but similar to their attendings. For reference, students rated the patient care competency of themselves, their residents, and their attendings; they rated their attendings' skills as statistically significantly higher than residents, and residents as statistically significantly higher than themselves. There were differences between cultural competency and patient care ratings.

CONCLUSIONS

Our results indicate that students perceive the cultural competency of their attendings and residents to be the same or lower than themselves. These findings indicate that this is an important area for future research and curricular reform, considering the vital role that attendings and residents play in the education of medical students.

The prevalence and practice of academies of medical educators: a survey of U.S. medical schools

PURPOSE

Academies of medical educators can be defined as formal organizations of academic teaching faculty recognized for excellence in their contributions to their school's education mission and who, as a group, serve specific needs of the institution. The authors studied the characteristics of academies, including the processes for admission, selection, and retention of academy members; the types of faculty who are academy members; program goals; benefits offered by academies to the individual and to the institution; funding sources and amounts; and the rapid increase in academies since 2003.

METHOD

In 2008, the authors sent an online questionnaire to 127 U.S. medical schools. Responses were analyzed using descriptive statistics. To determine differences between groups, multivariate analysis of variance was performed. Correlation analysis (Pearson r) was used to identify association between variables. Effect size was determined using eta squared (eta2).

RESULTS

Thirty-six of the 122 responding schools (96% response rate) reported having academies; 21 schools had initiated academies since 2003, and 33 schools were planning or considering academies. There was a statistically significant difference between academies established before 2004 and in 2004 regarding benefits offered to individuals, membership terms and maintenance requirements, and goals.

CONCLUSIONS

Rogers' theory of the diffusion of innovation may explain the recent spread of academies. When beginning or reexamining existing academy programs, institutions should consider goals, application process, benefits offered to members as well as the institution, expendable resources, and means of support, because the final product depends on the choices made at the beginning.

Blood glutathione peroxidase-1 mRNA levels can be used as molecular biomarkers to determine dietary selenium requirements in rats

Transcript (mRNA) levels are increasingly being used in medicine as molecular biomarkers for disease and disease risk, including use of whole blood as a target tissue for analysis. Development of blood molecular biomarkers for nutritional status, too, has potential application that parallels opportunities in medicine, including providing solid data for individualized nutrition. We previously reported that blood glutathione peroxidase-1 (Gpx1) mRNA was expressed at levels comparable to major tissues in rats and humans. To determine the efficacy of using blood Gpx1 mRNA to assess selenium (Se) status and requirements, we fed graded levels of Se (0-0.3 microg Se/g as selenite) to weanling male rats. Se status was determined by liver Se concentration and selenoenzyme activity, and selenoprotein mRNA abundance in liver and blood was determined by ribonuclease protection analysis. Liver Se and plasma glutathione peroxidase-3 and liver Gpx1 activities indicated that minimal Se requirements were at 0.08 microg Se/g diet. When total RNA was isolated from whole blood, Gpx1 mRNA in Se-deficient rats decreased to 10% of levels in Se-adequate (0.2 microg Se/g diet) rats. With Se supplementation, blood Gpx1 mRNA levels increased sigmoidally to a plateau with a minimum Se requirement of 0.08 microg Se/g diet, whereas glutathione peroxidase-4 mRNA levels were unaffected. Similarly, Gpx1 mRNA in RNA isolated from fractionated red blood cells decreased in Se-deficient rats to 23% of Se-adequate levels, with a minimum Se requirement of 0.09 microg Se/g diet. Additional studies showed that the preponderance of whole blood Gpx1 mRNA arises from erythroid cells, most likely reticulocytes and young erythrocytes. In summary, whole blood selenoprotein mRNA levels can be used as molecular biomarkers for assessing Se requirements, illustrating that whole blood has potential as a target tissue in development of molecular biomarkers for use in nutrition as well as in medicine.

Evaluating the quality of learning-team processes in medical education: development and validation of a new measure

BACKGROUND

Measurement of the quality of team processes in medical education, particularly in classroom-based teaching settings, has been limited by a lack of measurement instruments. Therefore, the purpose of this study was to develop and test an instrument to measure the quality of team interactions.

METHOD

The authors created 30 items and reduced these to 18 items using factor analysis. They distributed the scale to 309 second-year medical students (RR = 95%) in a course that used teams and measured internal consistency, validity, and differences in scores between teams.

RESULTS

Cronbach's alpha for the scale was 0.97. Team ratings were variable, with a mean score of 95.7 (SD 8.5) out of 108. Team Performance Scale (TPS) scores correlated inversely with the spread of peer evaluation scores (r = -0.38, P = .003). Differences between teams were statistically significant (P < .001, eta = 0.33).

CONCLUSIONS

The TPS was short, had evidence of reliability and validity, and exhibited the capacity to distinguish between teams. This instrument can provide a measure of the quality of team interactions. More work is needed to provide further evidence of validity and generalizability.

Evaluating the quality of learning-team processes in medical education: development and validation of a new measure

BACKGROUND

Measurement of the quality of team processes in medical education, particularly in classroom-based teaching settings, has been limited by a lack of measurement instruments. Therefore, the purpose of this study was to develop and test an instrument to measure the quality of team interactions.

METHOD

The authors created 30 items and reduced these to 18 items using factor analysis. They distributed the scale to 309 second-year medical students (RR = 95%) in a course that used teams and measured internal consistency, validity, and differences in scores between teams.

RESULTS

Cronbach's alpha for the scale was 0.97. Team ratings were variable, with a mean score of 95.7 (SD 8.5) out of 108. Team Performance Scale (TPS) scores correlated inversely with the spread of peer evaluation scores (r = -0.38, P = .003). Differences between teams were statistically significant (P < .001, eta = 0.33).

CONCLUSIONS

The TPS was short, had evidence of reliability and validity, and exhibited the capacity to distinguish between teams. This instrument can provide a measure of the quality of team interactions. More work is needed to provide further evidence of validity and generalizability.

Exploring the learning curve in medical education: using self-assessment as a measure of learning

BACKGROUND

Learning is a complex process that follows predictable patterns. The authors explored whether students' self-assessment of competencies could be used as a measure of learning within medical school.

METHOD

Medical students (all grade levels) rated their achievement of competencies at the beginning and end of an academic year. Repeated-measures ANOVA and [eta]2 were used to determine differences.

RESULTS

Five hundred thirty-three students participated (response rate = 79.3%). Self-assessment ratings between four grade levels were significant (P < .001, [eta]2 = 0.33), with the steepest difference between MS2 and MS3; professionalism ratings remained relatively stable. The largest percent increase within an academic year occurred between MS1 and MS2, with little increase within MS3 and MS4.

CONCLUSIONS

Medical students' self-assessment ratings of competencies indicated differences between grade levels and during an academic year, following a sigmoidal curve. These results have implications for medical education and indicate the need to develop longitudinal measures to track changes in learning.

Residents-as-teachers programs in psychiatry: a systematic review

OBJECTIVES

Because psychiatry residents have important roles as teachers and significant opportunities to contribute to medical student education, we set out to: identify all randomized control trials (RCT) for residents' teaching skills programs in psychiatry and to identify the efficacy of those interventions for improving teaching skills; identify the strengths and weaknesses of the available studies across medical disciplines; and identify currently available methods for enhancing residents' teaching skills for residents training in psychiatry.

METHODS

The published English-language literature was searched using PubMed, Social Sciences Index, and PsycINFO databases, with key search words including: residents, teaching skills, residents as teachers, psychiatry, and assessments. Both RCT and controlled, nonrandomized trials of residents' teaching programs directed to enhance residents' teaching skills were selected and critically appraised.

RESULTS

Of 13 trials identified and reviewed, most included residents in internal medicine. Only one included psychiatry residents and assessed their ability to teach interviewing skills to medical students. Along with other studies, this study demonstrated improvement in residents' teaching skills. Overall, interventions and outcome measures were heterogeneous while the quality of methodologies varied. Five studies were of higher quality, representing examples of quality educational research. Several described group differences, blinding, good follow-up, and use of valid, reliable tools.

CONCLUSIONS

Only one trial exists that incorporated psychiatry residents. Significant opportunity to advance educational research in this field exists. Psychiatry residency program directors should incorporate high-quality methodologies and can benefit from the findings of trials in other disciplines.

Factors influencing implementation of team-based learning in health sciences education

BACKGROUND

Limited studies have looked at factors that lead to successful implementation of team-based learning (TBL). The purpose of this study was to identify contextual factors associated with implementation of TBL with a larger pool of individuals.

METHOD

The authors administered a questionnaire who had implemented TBL via the Web to participants who attended TBL workshops; 297 of 594 responded. We used the constant comparative method to analyze responses.

RESULTS

Analysis revealed five factors important to successful implementation of TBL: buy-in, expertise, resources, time, and course characteristics, with 60%, 38%, 37%, 36%, and 16% of respondents identifying each factor, respectively.

CONCLUSIONS

When health science faculty and administrators implement TBL or other educational innovations, they must have buy-in, ensure adequate time and resources, develop needed expertise, and determine best fit within a course. Although these results are specific to TBL, they are consistent with models of dissemination and have implications for other educational innovations.

Team-based learning at ten medical schools: two years later

PURPOSE

In 2003, we described initial use of team-based learning (TBL) at 10 medical schools. The purpose of the present study was to review progress and understand factors affecting the use of TBL at these schools during the subsequent 2 years.

METHODS

Representatives from 10 schools evaluated in 2003 were again evaluated in 2005. They were interviewed by members of the Team Based Learning Collaborative using a semistructured interview process. Data were analysed by 2 researchers using the constant comparative method and were triangulated through sharing results with other interviewers at regular intervals to verify conclusions and form consensus.

RESULTS

TBL continued to be used in all but 1 school. At the 9 remaining schools, TBL was added to 18 courses, continued to be used in 19 and was discontinued in 13 courses. At some schools, it was discontinued in single courses in lieu of new, longitudinal integration courses in which TBL was a main instructional strategy. Faculty, student, course and institutional factors were associated with changes in TBL use.

CONCLUSION

Faculty, administration/curriculum, students and characteristics of specific courses influence ongoing utilisation of TBL. Those who desire to implement TBL would do well to take these factors into account as they plan implementation efforts at their schools.

Integrative clinical experience: an innovative program to prepare for internship

BACKGROUND

Interns experience tremendous challenges on the transition from student to new physician. There is limited literature describing curriculum that enhances medical students' preparation for internship.

DESCRIPTION

To prepare graduating medical students at our institution for the new responsibilities and stressors that they will face as interns, an elective course, Integrative Clinical Experience, was implemented. Over a 2-week period, participating medical students rotate through 1 to 3-hr modules that cover four major domains: managing acutely ill patients, teaching, communicating, and coping with stressors.

EVALUATION

Participants evaluated the course qualitatively and quantitatively through verbal and written feedback. Students found the course useful and educationally valuable. They also had a statistically significant increase in perceived preparedness for internship upon completion of the course.

CONCLUSIONS

A 2-week, concentrated course is a feasible and effective method for raising students' perceived preparedness for internship.

Making it work: the evolution of a medical educational fellowship program

Longitudinal programs to enhance the educational skills of medical school faculty are present in many medical schools and academic health centers. Multiinstitutional programs are less common. Three health professions schools, Baylor College of Medicine, The University of Texas Medical School at Houston, and The University of Texas Dental Branch have jointly sponsored the Educational Scholars Fellowship Program (ESFP) since 2003. The evolution of this program, from one that addressed the faculty educator development needs of one medical school in the mid-1990s to a more flexible model that includes faculty and fellows from three institutions, reflects the changing needs of faculty as well as those of other health professions schools. The ESFP's strengths lie in the effective use of resources across three schools; the opportunity for an interinstitutional and interdisciplinary collaborative network; the flexibility of the curriculum offerings; and the positive impact on fellows' knowledge, skills and leadership in medical and dental education. The evolution of this program represents a cost-effective and educationally sound response to the changing needs of faculty educators.

The Effect of a Multicomponent Professional Development Training on the Beliefs and Behaviors of Community Health Educators Concerning Food Irradiation

Beliefs have a significant effect on the health behaviors of individuals and educators; however, they can be difficult to change. The purpose of this study was to determine if exposing community health educators, specifically family and consumer sciences county extension educators, to a multicomponentprofessional development training on food irradiation could change their beliefs and behaviors. This study compared the food irradiation beliefs and educational programmingof educators who participated in a professional development training with thosewhodidnot.Results indicatedthat the trainingsignificantlyimproved the foodirradiationbeliefs ofparticipants. In addition, the number of participants who provided food irradiation education significantly improved compared with educators who had not attended the training. These results suggest that this type of professional development training format can significantly affect beliefs and could increase the amount of food irradiation information available to consumers through community health educators.

Determining the food irradiation beliefs of community nutrition educators: do beliefs influence educational outreach?

OBJECTIVE

To develop an instrument to measure the food irradiation beliefs of community nutrition educators and to determine the influence of those beliefs on food irradiation educational outreach.

DESIGN

Survey development, cross-sectional telephone survey.

SETTING

Cooperative Extension Program.

PARTICIPANTS

All Family and Consumer Sciences (FCS) county extension agents serving in the most populated counties in Texas (n = 134, response rate = 99%). These participants may not be representative of all FCS extension agents.

VARIABLES MEASURED

Food irradiation beliefs and educational outreach as well as selected demographic variables.

ANALYSIS

To determine validity and reliability of the instrument, factor analysis and Cronbach's alpha were conducted, respectively. To determine if food irradiation beliefs influenced food irradiation educational outreach, logistic and multiple regression analyses were conducted, with significance set at P < .05.

RESULTS

The instrument had adequate reliability; two belief scales were identified through factor analysis, referred to as Safety Beliefs and Understanding Beliefs. Additionally, regression analysis suggested that educators' beliefs about food irradiation influenced the amount of food irradiation education they provided.

CONCLUSIONS AND IMPLICATIONS

Results suggest that educators' beliefs about the safety and their understanding of food irradiation are predictors of the educational outreach they provide about it, indicating the potential value of professional development regarding food irradiation.

An historical commentary on the physiological effects of music: Tomatis, Mozart and neuropsychology

This article provides an overview of the theoretical underpinnings of the Tomatis Method, along with a commentary on other forms of sound/music training and the need for research. A public debate was sparked over the "Mozart Effect." This debate has turned out to be unfortunate because the real story is being missed. The real story starts with Alfred Tomatis, M.D., scientist and innovator. Dr. Tomatis was the first to develop a technique using modified music to stimulate the rich interconnections between the ear and the nervous system to integrate aspects of human development and behavior. The originating theories behind the Tomatis Method are reviewed to describe the ear's clear connection to the brain and the nervous system. The "neuropsychology of sound training" describes how and what the Tomatis Method effects. Since Dr. Tomatis opened this field in the mid 20th century, no fewer than a dozen offshoot and related systems of training have been developed. Though each new system of treatment makes claims of effectiveness, no research exists to substantiate their claims. Rather, each simplified system bases its "right to exist and advertise" on the claimed relationship to Tomatis and his complex Method. Research is desperately needed in this area. The 50 years of clinical experience and anecdotal evidence amassed by Tomatis show that sound stimulation can provide a valuable remediation and developmental training tool for people of all ages. Offshoot systems have watered down the Tomatis Method without research to guide the decisions of simplifying the techniques and equipment.

1998-1999 SAEM emergency medicine faculty salary and benefits survey

OBJECTIVES

The Society for Academic Emergency Medicine (SAEM) commissioned an emergency medicine (EM) faculty salary and benefits survey for all 1998 residency review committee (RRC)-EM-accredited programs using the SAEM fourth-generation survey instrument. Responses were collected by SAEM and blinded from the investigators.

METHODS

Blinded program and individual faculty data were entered into a customized version of FileMaker Pro, a relational database program with a built-in statistical package. Salary data were sorted by program region, faculty title, American Board of Emergency Medicine (ABEM) certification, academic rank, years postresidency, program size, and whether data were reported to the American Association of Medical Colleges (AAMC). Demographic data were analyzed with regard to numerous criteria, including department staffing levels, ED volumes, ED length of stay, department income sources, salary incentive components, and specific type and value of fringe benefits offered. Data were compared with those from previous SAEM studies.

RESULTS

Seventy-three of 120 (61%) accredited programs responded, yielding usable data for 70 programs and 965 full-time faculty among the four AAMC regions. Mean salaries were reported as follows: all faculty, $167,478; first-year faculty, $140,616; programs reporting data to the AAMC, $161,794; programs not reporting data to the AAMC, $165,724. Mean salaries as reported by AAMC region: northeast, $167,876; south, $160,586; midwest, $190,957; west, $148,977.

CONCLUSIONS

Reported salaries for full-time EM residency faculty continue to rise. Significant regional differences in salaries have been present in all four SAEM surveys. Nonclinical hours are compensated at approximately one-half the rate paid for clinical hours. The demographic data indicate that EM residency faculty are working at the upper extremes of numbers of patient encounters per physician, patient acuity levels, and department lengths of stay.

1995-1996 SAEM emergency medicine faculty salary/benefits survey

OBJECTIVE

The Society for Academic Emergency Medicine (SAEM) commissioned an emergency medicine (EM) faculty salary and benefit survey for all 1995 Residency Review Committee in Emergency Medicine (RRC-EM)-accredited programs using the SAEM third-generation survey instrument. Responses were collected by SAEM and blinded from the investigators.

POPULATION

Seventy-six of 112 (68%) accredited programs responded, yielding data for 1,032 full-time faculty among the four Association of American Medical Colleges (AAMC) regions.

METHODS

Blinded program and individual faculty data were entered into a customized version of Filemaker Pro, a relational database program with a built-in statistical package. Salary data were sorted by 115 separate criteria such as program regions, faculty title, American Board of Emergency Medicine (ABEM) certification, academic rank, years postresidency, program size, and whether data were reported to AAMC. Demographic data from 132 categories were analyzed and included number of staff and residents per shift, number of intensive care unit (ICU) beds, obstacles to hiring new staff, and specific type and value of fringe benefits offered. Data were compared with those from the 1990 and 1992 SAEM and the 1995-96 AAMC studies.

RESULTS

Mean salaries were reported as follows: all faculty, $158,100; first-year faculty, $131,074; programs reporting data to AAMC, $152,198; programs not reporting data to AAMC, $169,251. Mean salaries as reported by AAMC region: northeast, $155,909; south, $155,403; midwest, $172,260; west, $139,930. Mean salaries as reported by program financial source: community, $175,599; university, $152,878; municipal, $141,566.

CONCLUSIONS

Reported salaries for full-time EM residency faculty continue to rise. Salaries in programs reporting data to the AAMC are considerably lower than those not reporting. The gap between ABEM-certified and non-ABEM-certified faculty continues to widen. Residency-trained faculty are now shown to earn more than non-residency-trained faculty. Significant regional differences in salaries have been present in all three SAEM surveys.