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Agrawal S, Patell R, Dodge LE, Pegher JW, Coleman RL, Waterhouse DM, Roberts DA, Rangachari D. Defining the Educational Needs for a Community-Based Hematology/Oncology Career: A National Needs Assessment. JCO Oncol Pract 2024; 20:861-868. [PMID: 38330269 DOI: 10.1200/op.23.00698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/06/2023] [Accepted: 01/05/2024] [Indexed: 02/10/2024] Open
Abstract
PURPOSE Little is known about the specific needs during training for hematology/oncology providers practicing in community-based settings. We conducted a national survey of hematologists/oncologists employed in community or academic-community hybrid settings to delineate their educational needs. METHODS An electronic questionnaire was developed and distributed nationally through professional organizations. We primarily assessed whether survey participants received any specific training during fellowship for community-based practice. Participants were also surveyed regarding training experiences that might have affected their preparation. Relative risk (RR) and 95% CI were calculated using modified Poisson regression to identify factors associated with receiving training specifically for community-based settings. RESULTS Of 125 participants from across 25 states, 63% were male and 58% identified as White. Less than half (41.6%, binomial 95% CI, 32.8 to 50.7) received any training in a community-based setting. Participants identified rotations in community settings (47%), direct mentorship from community-based physicians (40%), and longitudinal clinic in a community setting (36%) as experiences that would have been valuable. Specific curricula of interest included medical operations and administration (63%), health policy (35%), and quality improvement (27%). Respondents in clinical practice for <10 years were more likely to have received any training specifically for a community-based career (RR, 2.13 [95% CI, 1.18 to 3.86]). CONCLUSION Our study demonstrates substantial unmet needs as they relate to deliberately training fellows destined for community-based careers. Prospective design of clinical training and curricula emphasizing longitudinal exposures to and key aspects of health care delivery in the community setting are paramount to achieving optimal goal-concordant hematology/oncology training during fellowship.
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Affiliation(s)
- Shubham Agrawal
- Department of Internal Medicine, Mercy Catholic Medical Center, Darby, PA
| | - Rushad Patell
- Division of Hematology and Hematologic Malignancies, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Laura E Dodge
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | | | | | | | | | - Deepa Rangachari
- Dvision of Medical Oncology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
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Griggio TB, de Camargo PSF, Costa ML, Luz AG. Professional activity and experience after a residency training program in ObGyn: A 10-year analysis. Int J Gynaecol Obstet 2024. [PMID: 38769696 DOI: 10.1002/ijgo.15586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 04/16/2024] [Accepted: 04/22/2024] [Indexed: 05/22/2024]
Abstract
OBJECTIVE To describe the profile and professional trajectory of the obstetrics and gynecology (ObGyn) graduates over the past decade, at a referral university hospital. METHODS A cross-sectional study was conducted, utilizing a survey that targeted graduates of the ObGyn residency program from the last decade, asking about demographics, medical undergraduate, residency details, post-residency trajectory, satisfaction levels, and social media usage. A descriptive analysis was performed. Comparative analyses, including gender-based differences, were assessed using chi-squared or Fisher exact tests (P < 0.05). RESULTS Among 126 graduates, 84 agreed to participate (66.67%), predominantly comprising females with an average age of 33 years. Most identified themselves as white. The majority had pursued their undergraduate studies at the same institution (78.6%) and subsequently acquired specialized titles in ObGyn from the national society. Most of them were employed in both public and private sectors (71.08%). Male graduates held the majority of medical shifts in obstetrics. A significant gender-based salary discrepancy was noted, favoring males. More than half of the professionals utilized social media for work-related purposes. Many expressed the necessity for supplementary education beyond public health, particularly career management. CONCLUSION The findings highlight a predominance of female and white individuals among the graduates. Overall, graduates expressed contentment with their education and professional engagements. A gender-based income disparity was identified, favoring male graduates. Studies like this can provide insights for improving medical residency education.
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Affiliation(s)
- Thauane Batalhoto Griggio
- Faculdade de Ciências Médicas, Universidade Estadual de Campinas (FCM Unicamp), Campinas, SP, Brazil
| | | | - Maria Laura Costa
- Departamento de Tocoginecologia, CAISM, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Adriana Gomes Luz
- Departamento de Tocoginecologia, CAISM, Universidade Estadual de Campinas, Campinas, SP, Brazil
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Silvestre J, Aakhus E, Weldeslase TA, DeLisser HM. A 15-Year Analysis of Supply and Demand for Hematology and Oncology Training in the United States. JCO Oncol Pract 2024; 20:717-724. [PMID: 38285966 DOI: 10.1200/op.23.00531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/14/2023] [Accepted: 12/19/2023] [Indexed: 01/31/2024] Open
Abstract
PURPOSE There is a paucity of research on the supply of the hematology and oncology workforce despite projected shortages in the United States Over the past 15 years of the hematology and oncology match (HOM), we hypothesized that there would be more growth in the number of training positions relative to applicants, higher match rates for US allopathic graduates relative to non-US allopathic graduates, and fewer applicants matching at their top fellowship choices. METHODS This was a national, retrospective cohort study of all applicants in the HOM (2009-2023). Match rates and applicant-to-training position ratios were calculated and compared over time with Pearson tests. RESULTS Growth in the number of annual training positions (426-708; 66% increase) exceeded growth in the number of interested applicants (706-945; 34% increase; P < .001). Annual applicant-to-training position ratios decreased from 1.7 to 1.3 (r = -0.813; P < .001). Match rates increased over the study period for both US allopathic graduates (79%-88%; r = 0.761; P = .001) and non-US allopathic graduates (45%-63%; r = 0.801; P < .001). During each year, match rates for US allopathic graduates exceeded those for non-US allopathic graduates (P < .001). From 2018 to 2023, US allopathic graduates (83%) had higher match rates than US osteopathic graduates (60%) and international medical graduates (50%; P < .001). The percentage of applicants that matched at one of their top three fellowship choices increased from 53% to 60% (r = 0.480; P = .070). Fewer available annual training positions went unfilled over the study period (3%-0.3%; r = - 0.870; P < .001). CONCLUSION Match rates have increased in the HOM but remain competitive especially for non-US allopathic graduates. Future investigation is needed to understand disparities in match outcomes by additional applicant and fellowship program characteristics. Ongoing surveillance of HOM outcomes remains critical given the projected shortages in the US hematology and oncology workforce.
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Affiliation(s)
| | - Erin Aakhus
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | | | - Horace M DeLisser
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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Lewis AR, Choong GM, Cathcart-Rake E, Florez N, Durani U, Yadav S, Fuentes H, Sorensen K, Childs DS, Saliba A, Paludo J, Hobday TJ. Preparing Hematology/Oncology Fellows for Success: Implementing an Annual Career Development and Research Retreat. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2024; 39:58-64. [PMID: 37848596 DOI: 10.1007/s13187-023-02375-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/01/2023] [Indexed: 10/19/2023]
Abstract
Multiple factors, including job satisfaction, personality traits, and training experiences, influence the career trajectory of hematology/oncology fellows. In an effort to expose hematology/oncology fellows to (1) the various careers in oncology, (2) a diverse group of speakers for future mentorship, and (3) research opportunities, and grant writing experience, we established an annual career development and research retreat. During the retreat, we engaged speakers who covered a range of career trajectories, including academic, private practice, industry, government, and administrative paths. We introduced clinicians and researchers with a track record of providing top-notch mentorship to fellows with aligning interests and detailed research opportunities and grant writing. The sessions were led by senior fellows, and we adopted an in-person and virtual hybrid model to allow speakers from various institutions to participate. Feedback from participants, as gathered through surveys, indicated positive responses: all respondents reported that this retreat was "extremely" or "very helpful," and a majority expressed their intent to pursue academic careers. The curriculum and structure of this retreat may help to inform the development of fellowship career development and research retreats at other institutions.
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Affiliation(s)
- Akeem R Lewis
- Division of Oncology, Department of Oncology, Mayo Clinic, 200 First St SW, Rochester, MN, USA.
| | - Grace M Choong
- Division of Oncology, Department of Oncology, Mayo Clinic, 200 First St SW, Rochester, MN, USA
| | - Elizabeth Cathcart-Rake
- Division of Oncology, Department of Oncology, Mayo Clinic, 200 First St SW, Rochester, MN, USA
| | - Narjust Florez
- Dana Farber Cancer Institute, Harvard School of Medicine, Boston, MA, USA
| | - Urshila Durani
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Siddhartha Yadav
- Division of Oncology, Department of Oncology, Mayo Clinic, 200 First St SW, Rochester, MN, USA
| | - Harry Fuentes
- Division of Oncology, Department of Oncology, Mayo Clinic, 200 First St SW, Rochester, MN, USA
| | - Karl Sorensen
- Providence Cancer Specialist-Montana, Missoula, MT, USA
| | - Daniel S Childs
- Division of Oncology, Department of Oncology, Mayo Clinic, 200 First St SW, Rochester, MN, USA
| | - Antoine Saliba
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Jonas Paludo
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Timothy J Hobday
- Division of Oncology, Department of Oncology, Mayo Clinic, 200 First St SW, Rochester, MN, USA
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Khoury EG, Lynch-Kelly K, Fulton-Ward T, Heritage S, Devasar A, Jones CM. Online Oncology Careers Events to Attract the Future Oncology Medical Workforce: An Exemplar Event and Review of the Literature. Clin Oncol (R Coll Radiol) 2024; 36:e51-e60. [PMID: 37932187 DOI: 10.1016/j.clon.2023.10.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 09/18/2023] [Accepted: 10/19/2023] [Indexed: 11/08/2023]
Abstract
AIMS There are too few oncologists to meet the increasing burden imposed by the rising incidence of cancer. This results from issues with the retention of established oncologists and longstanding challenges to the recruitment of adequate numbers of trainees. To counter this, the British Oncology Network for Undergraduate Societies (BONUS) devised an online oncology careers event for medical students and junior doctors who are yet to select a specialty. MATERIALS AND METHODS An online careers event was devised with a focus on oncology practice and related subspecialties, as well as research. Event attendees were asked to respond to piloted pre- and post-event surveys. Knowledge and attitudes towards a career in oncology were evaluated using Likert scale and multiple-choice questions. A systematic literature search was carried out to contextualise these data. RESULTS Of the 73 attendees, 44 (60%) participants completed both the pre- and post-event surveys; 79.5% of attendees believed that information on a career in oncology is lacking in medical training. This viewpoint was supported by the systematic review, which highlighted a need for relevant focussed interventions targeted at medical students and fledgling doctors. The education event led to an increase in the median reported understanding of the oncology career pathway from 6.0 to 8.0 (P < 0.05 and P < 0.001), as well as the likelihood of pursuing a career in oncology (8.0-9.0; P < 0.05). It was also associated with a proportional increase in medical and surgical oncology interest, albeit with a fall in interest in clinical and interventional oncology as well as academia. CONCLUSION A targeted online careers event increases knowledge of and interest in a career in oncology, albeit predominantly for medical and surgical subspecialties. Broader initiatives based on our model should be developed and careers in academia as well as clinical and interventional oncology emphasised.
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Affiliation(s)
- E G Khoury
- Cancer Academic Sciences Unit, University Hospital Southampton, Southampton, UK
| | | | - T Fulton-Ward
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - S Heritage
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - A Devasar
- Edinburgh Medical School, The University of Edinburgh, Edinburgh, UK
| | - C M Jones
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; Department of Oncology, University of Cambridge, Cambridge, UK.
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Barbosa ACN, Duarte BKL, De Paula EV. Career paths and workforce diversity in hematology: A cross-sectional study of a 35-year alumni cohort from an academic residency program in Brazil. Hematol Transfus Cell Ther 2023; 45 Suppl 2:S76-S84. [PMID: 35400622 PMCID: PMC10433302 DOI: 10.1016/j.htct.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 01/06/2022] [Accepted: 02/13/2022] [Indexed: 10/18/2022] Open
Abstract
INTRODUCTION Although not mandatory, medical residency has become a sine qua non condition for practicing in most medical specialties in Brazil. Residency programs are hosted mainly by university accredited academic centers and hospitals in the national public healthcare system, under guidance and accreditation by a national commission. Despite the importance of these programs for the development of the hematology workforce, few studies have addressed their characteristics and impact on society. METHODS We performed a comprehensive cross-sectional survey of a 35-year alumni cohort from a hematology academic residency program in Brazil. RESULTS In total, 86/98 (87.8%) responded to the survey. The mean age at residency completion was 28.5 years, 60.5% of the alumni were women and sixty-four (74.4%) self-declared their skin color as white. Higher rates of parental education attainment and low rates of trainee financial dependence were observed and these patterns were stable over time. While the proportion of trainees from other states increased steadily, the number of hematologists practicing in other states remained stable. Approximately half of the alumni worked both in the private and public sectors, mainly in malignant hematology and in outpatient clinics. Twenty-five percent of the alumni reported prior leadership and teaching positions, mainly as directors of transfusion services. CONCLUSION Our results provide data that can be potentially useful for policymakers and curricular development in the planning of strategies concerning the future workforce of hematologists.
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Affiliation(s)
- Ayla Cristina Nóbrega Barbosa
- Faculdade de Ciências Médicas, Universidade Estadual de Campinas, (FCM Unicamp), Campinas, SP, Brazil; Universidade Federal de Campina Grande (UFCG), Campina Grande, PB, Brazil.
| | - Bruno Kosa Lino Duarte
- Faculdade de Ciências Médicas, Universidade Estadual de Campinas, (FCM Unicamp), Campinas, SP, Brazil; Hemocentro de Campinas, Universidade Estadual de Campinas, (Hemocentro Unicamp), Campinas, SP, Brazil
| | - Erich Vinicius De Paula
- Faculdade de Ciências Médicas, Universidade Estadual de Campinas, (FCM Unicamp), Campinas, SP, Brazil; Hemocentro de Campinas, Universidade Estadual de Campinas, (Hemocentro Unicamp), Campinas, SP, Brazil
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Pritzl SL, Lang LM, Osman F, Parkes A. Standardizing Research Training: a Pilot Curriculum Within a Hematology/Oncology Fellowship Program. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:713-717. [PMID: 35614174 DOI: 10.1007/s13187-022-02181-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/15/2022] [Indexed: 05/20/2023]
Abstract
While scholarly activity is recognized as critical in cancer education, there is an outstanding need for methods to define research learning competencies and tools for formal research productivity and competency assessment. We piloted and studied a novel educational initiative within the University of Wisconsin Hematology/Oncology fellowship program, establishing a professional learning community (PLC) of research mentors and developing a formative evaluation tool, a research portfolio. We developed a PLC engaged in reflective conversations about intended learning outcomes and effective instructional strategies. Subsequently, a research portfolio was piloted with four first-year Hematology/Oncology fellows at the start of the 2020 academic year in which trainees document, critically evaluate, and reflect upon the knowledge, skills, confidence, and productivity acquired during research training. We employed surveys to evaluate the initiative. Seven Hematology/Oncology fellows (7/12, 58%) completed pre-intervention and six-month interim evaluation surveys, with 43% (3/7) identifying an increased confidence in quality of research training strategies following the pilot initiation. All four first-year fellows that piloted the research portfolio (4/4, 100%) completed interim evaluation surveys that demonstrated benefits of the research portfolio including self-reflection and goal setting. Research portfolio scoring correlated with other markers of academic success, suggesting its potential to predict research success. Our data suggest that bringing together a community of research mentors to generate shared learning goals and develop the framework for a formative evaluation portfolio may meet critical needs research training needs in cancer education. Given promising results, we aim to create a new educational tool for research training.
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Affiliation(s)
- Stephanie L Pritzl
- Department of Medicine, Division of Hematology, Medical Oncology, and Palliative Care, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA.
| | - Laura M Lang
- Department of Educational Leadership and Policy Analysis, University of Wisconsin, Madison, WI, USA
| | - Fauzia Osman
- Department of Medicine, Division of Hematology, Medical Oncology, and Palliative Care, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Amanda Parkes
- Department of Medicine, Division of Hematology, Medical Oncology, and Palliative Care, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
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Martinez DAS, Quilez-Cutillas A, Jimenez-Labaig P, Sesma A, Tarazona N, Pacheco-Barcia V, Obispo B, Paez D, Quintanar T, Sanchez-Canovas M, Montes AF, Felip E, Rodriguez-Lescure A, Elez E. Current professional standing of young medical oncologists in Spain: a nationwide survey by the Spanish Society of Medical Oncology + MIR section. Clin Transl Oncol 2023; 25:796-802. [PMID: 36418642 PMCID: PMC9685015 DOI: 10.1007/s12094-022-02989-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 10/18/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND There is a lack of knowledge about the career paths and employment situation of young medical oncologists. The aim of our study was to evaluate the current professional standing of these professionals in Spain. METHODS The Spanish Society of Medical Oncology + MIR section conducted a national online survey in May 2021 of young medical oncology consultants (< 6 years of expertise) and final year medical oncology residents. RESULTS A total of 162 responses were eligible for analysis and included participants from 16 autonomous communities; 64% were women, 80% were consultants, and 20% were residents. More than half of the participants performed routine healthcare activity and only 7% research activity. Almost three quarters (73%) were subspecialized in a main area of interest and almost half of these chose this area because it was the only option available after residency. Half of the respondents (51%) considered working abroad and 81% believed the professional standing in Spain was worse than in other countries. After finishing their residency, only 22 were offered a job at their training hospital. Just 16% of participants had a permanent employment contract and 87% were concerned (score of ≥ 5 on a scale of 1-10) about their job stability. In addition, one quarter of the participants in our study showed an interest in increasing their research activity. CONCLUSIONS The choice of subspecialty in medical oncology may depend on job opportunities after residency rather than personal interest. The abundance of temporary contracts may have influenced the job stability concerns observed. Future mentoring strategies should engage in building a long-term career path for young medical oncologists.
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Affiliation(s)
- Domingo Antonio Sanchez Martinez
- grid.411372.20000 0001 0534 3000Department of Medical Oncology, IMIB, Virgen de La Arrixaca University Hospital, Murcia, Región de Murcia Spain
| | - Aliica Quilez-Cutillas
- Department of Medical Oncology, Can Misses Hospital, Área de Salud de Ibiza y Formentera (ASEF), Ibiza, Illes Balears Spain
| | - Pablo Jimenez-Labaig
- grid.411232.70000 0004 1767 5135Department of Medical Oncology, Cruces University Hospital, Barakaldo, Bizkaia Spain
| | - Andrea Sesma
- grid.411050.10000 0004 1767 4212Department of Medical Oncology, Lozano Blesa University Clinical Hospital, Zaragossa, Aragón Spain
| | - Noelia Tarazona
- grid.429003.c0000 0004 7413 8491Department of Medical Oncology, INCLIVA Biomedical Research Institute, Comunitat Valenciana, Spain ,grid.510933.d0000 0004 8339 0058Instituto de Salud Carlos III, CIBERONC, Madrid, Spain
| | - Vilma Pacheco-Barcia
- grid.411171.30000 0004 0425 3881Department of Medical Oncology, Torrejón University Hospital, Madrid, Spain
| | - Berta Obispo
- grid.414761.1Department of Medical Oncology, Infanta Leonor University Hospital, Madrid, Spain
| | - David Paez
- grid.410458.c0000 0000 9635 9413Department of Medical Oncology, Santa Creu i Sant Pau University Hospital, Barcelona, Catalunya Spain
| | - Teresa Quintanar
- grid.411089.50000 0004 1768 5165Department of Medical Oncology, Elche University General Hospital, Elche, Comunitat Valenciana Spain
| | - Manuel Sanchez-Canovas
- grid.411089.50000 0004 1768 5165Department of Hematology and Medical Oncology, Morales Meseguer University General Hospital, Murcia, Región de Murcia Spain
| | - Ana Fernandez Montes
- grid.418883.e0000 0000 9242 242XDepartment of Medical Oncology, University Hospital Complex of Ourense (CHUO), Ourense, Galicia Spain
| | - Enriqueta Felip
- grid.411083.f0000 0001 0675 8654Vall d’Hebron Institute of Oncology (VHIO), Medical Oncology Department, Vall d’Hebron University Hospital, Univesitat Autònoma de Barcelona (UAB), 119-129, 08035 Barcelona, Catalunya Spain
| | - Alvaro Rodriguez-Lescure
- grid.411089.50000 0004 1768 5165Department of Medical Oncology, Elche University General Hospital, Elche, Comunitat Valenciana Spain
| | - Elena Elez
- Vall d'Hebron Institute of Oncology (VHIO), Medical Oncology Department, Vall d'Hebron University Hospital, Univesitat Autònoma de Barcelona (UAB), 119-129, 08035, Barcelona, Catalunya, Spain.
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Roberts DA, Faig J, Bodio-Downey K, Shpilsky J, Leahy K, Wischhusen J, Giordano S, Acharya U, Drews R, Dougherty D, Lathan C, Rangachari D. Training Hematologists/Oncologists for the Academic-Community Hybrid: Creating a Fellowship Framework for the Future. JCO Oncol Pract 2022:OP2200671. [DOI: 10.1200/op.22.00671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
PURPOSE: Conventional hematology/oncology fellowship training is designed to foster careers in academic practice through intensive exposure to clinical and laboratory research. Even so, a notable proportion of graduating fellows opt to pursue a clinically focused career outside the realm of academic medicine. Given the corresponding shortage of oncologists in nonurban and rural settings, improving the representation of hematologists/oncologists in the community setting is a national priority. METHODS: We reviewed current national challenges and changing models of cancer care delivery in the context of the traditional academic training model along with trends in practice patterns for recent hematology/oncology graduates. We defined the Academic-Community hybrid (ACH) and how it supports the evolution in contemporary models of cancer care. We then drew on the authors’ experiences to formulate an innovative goal-concordant training paradigm for fellows seeking careers in the ACH model. RESULTS: The ACH hematology/oncology fellowship training pathway emphasizes and optimizes professional development domains including clinical care, patient safety and quality improvement, business and operations, cancer care equity and community access, healthy policy and alignment with professional organizations, and medical education. CONCLUSION: This novel hematology/oncology training model provides a paradigm for optimizing preparedness for practice in an increasingly complex cancer care delivery environment while addressing workforce shortages and health disparities.
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Affiliation(s)
- Daniel A. Roberts
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Jennifer Faig
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | | | - Jason Shpilsky
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
| | - Kathleen Leahy
- Lank Cancer Center at Beth Israel Lahey Hospital—Needham, Needham, MA
| | | | - Sara Giordano
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Utkarsh Acharya
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
- Brigham and Women's Hospital, Boston, MA
| | - Reed Drews
- Harvard Medical School, Boston, MA
- Beth Israel Deaconess Medical Center, Boston, MA
| | - David Dougherty
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
| | - Christopher Lathan
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
| | - Deepa Rangachari
- Harvard Medical School, Boston, MA
- Beth Israel Deaconess Medical Center, Boston, MA
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Ben-David K, Lin JJ, Ferrara JLM, Gabrilove JL. Tisch Cancer Institute Scholars Program: Mentored Cancer Research Training Pipeline for Medical Students. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:1166-1171. [PMID: 33410115 PMCID: PMC7787701 DOI: 10.1007/s13187-020-01934-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/27/2020] [Indexed: 06/01/2023]
Abstract
Cancer research has led to unprecedented advances in treatment in recent decades. Physician-scientists have played a crucial role in these advances given their unique perspective at the intersection between basic research and clinical care, though their representation in cancer research has been in progressive decline. Cancer research programs that feature strong mentorship at the medical student level are associated with increased likelihood of alumni choosing a cancer research career path. In an effort to increase the cancer research medical student training pipeline, senior research faculty from the Tisch Cancer Institute (TCI) at the Icahn School of Medicine at Mount Sinai (ISMMS) developed the TCI Scholars Program, a rigorous mentored research training program funding medical students' summer research. This program is currently in its third year and has garnered significant interest among mentors and students alike from all four TCI Cancer Center Support Grant (CCSG)-funded research programs. Herein, we describe the development, implementation, evaluation, and major outcomes of this program.
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Affiliation(s)
- Kaitlyn Ben-David
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Jenny J Lin
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - James L M Ferrara
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Janice L Gabrilove
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Beck Dallaghan GL, Coe CL, Wright ST, Jordan SG. Mentoring Medical Education Research: Guidelines from a Narrative Review. MEDICAL SCIENCE EDUCATOR 2022; 32:723-731. [PMID: 35818612 PMCID: PMC9270543 DOI: 10.1007/s40670-022-01565-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/05/2022] [Indexed: 06/03/2023]
Abstract
Mentorship is critical to develop research scholars. Current literature provides mentorship guidance for biomedical research; however, mentorship for educational research is scarce. We explored literature to offer evidence-based guidance for medical education research mentors. A librarian searched peer-reviewed literature from 2001 to 2021 to identify guidelines for research mentors. Thirty-five articles were included in this narrative review. Our results identified attributes of mentors, overlapping roles, and barriers and benefits of mentoring. The structures and processes related to mentoring are reviewed and applicability to medical education research mentorship is summarized. Supplementary Information The online version contains supplementary material available at 10.1007/s40670-022-01565-2.
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Affiliation(s)
- Gary L. Beck Dallaghan
- Office of Medical Education, University of North Carolina School of Medicine, 108 Taylor Hall, CB 7321, Chapel Hill, NC 27599 USA
| | - Catherine L. Coe
- Department of Family Medicine, University of North Carolina School of Medicine, Chapel Hill, NC USA
| | - Sarah Towner Wright
- Health Sciences Library, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Sheryl G. Jordan
- Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, NC USA
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12
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Baugh AD, Baugh RF. How Financial Aid Policy Shortchanges American Healthcare. TEACHING AND LEARNING IN MEDICINE 2022; 34:322-328. [PMID: 34672908 DOI: 10.1080/10401334.2021.1977135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 08/17/2021] [Indexed: 06/13/2023]
Abstract
Issue: Medical school debt is increasing. This trend may reduce access to medical school at a time of historic recognition of the need for greater openness and diversity in medical education by disadvantaging candidates who are underrepresented in medicine. The effects of high education-related debt for medical school needs greater consideration. Evidence: The implementation staircase model is employed as lens for understanding the impact of debt on trainees who are underrepresented in medicine and the healthcare system overall. Higher debt burdens are associated with worse mental health outcomes and increased odds of attrition in medical school. Trainees cite debt as a concern in considering primary care careers. Those with greater debt are less likely to pursue or remain in academic careers. Implications: The current financial aid system's reliance on high debt burden undermines goals to improve the representation of underrepresented candidates in primary care and academic medicine. Alternative models requiring less debt could facilitate the creation of a more diverse workforce in healthcare.
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Affiliation(s)
- Aaron D Baugh
- Department of Medicine, University of California San Francisco, California, USA
| | - Reginald F Baugh
- Department of Surgery, University of Toledo College of Medicine, Toledo, Ohio, USA
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Ruddell JH, Tang OY, Persaud B, Eltorai AE, Daniels AH, Ng T. Thoracic surgery program websites: Bridging the content gap for improved applicant recruitment. J Thorac Cardiovasc Surg 2021; 162:724-732. [DOI: 10.1016/j.jtcvs.2020.06.131] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/30/2020] [Accepted: 06/16/2020] [Indexed: 11/17/2022]
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14
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Sampayo EM, Agrawal P, Mittiga MR, Klasner AE, Kim I, Scarfone R, Chang TP. Understanding Graduating Pediatric Emergency Medicine Fellow Priorities for Career Pathways and Faculty Recruitment for Academic or Community Emergency Departments. AEM EDUCATION AND TRAINING 2021; 5:12-18. [PMID: 33521486 PMCID: PMC7821075 DOI: 10.1002/aet2.10445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 03/04/2020] [Accepted: 03/11/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Factors influencing the employment of pediatric emergency medicine (PEM) fellows in a career in academic medicine versus community emergency department (ED) settings have not previously been explored. The purpose of this study was to explore PEM fellows' priorities in selecting jobs and to identify factors that influence their decisions regarding career choices through a multicenter, qualitative approach. We also explored program directors' beliefs about graduates' job selection priorities. METHODS This was a cross-sectional study among a convenience sample of PEM fellows and PEM fellowship program directors and/or associate program directors in the United States. The data were collected in 2017, using a qualitative methodology known as free listing. The fellows and program directors were solicited through the American Academy of Pediatrics Section on Emergency Medicine. Using content analysis, all free-listing responses from participant samples were categorized into 14 distinct groupings. Thematic saturation was achieved, and member checking was performed to ensure trustworthiness. RESULTS A sample of 63 fellows from six geographically diverse programs and 41 program and/or associate program directors were surveyed. Location, schedule/work-life balance and compensation were the most frequently cited factors taken into consideration for employment; these are not specific to PEM as a career choice. Other factors included patient population and ED resources. When deciding between academic and community employment, similar areas for the PEM physician emerged on both sides of the dichotomy: work-life balance, clinical hours, burnout, and acuity/patient complexity. CONCLUSIONS There are universal factors that PEM physicians consider when choosing employment. The information elicited from this exploratory technique can inform content for national survey or other qualitative work to achieve richer descriptions of reported items and dichotomies to guide fellow recruitment and retention strategies.
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Affiliation(s)
| | | | - Matthew R. Mittiga
- University of Colorado School of Medicine/Children's Hospital ColoradoAuroraCO
| | | | - In Kim
- University of Louisville School of MedicineLouisvilleKY
| | - Richard Scarfone
- Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPA
| | - Todd P. Chang
- Children's Hospital Los Angeles/University of Southern CaliforniaLos AngelesCA
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15
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Basu S, Horak R, Pollack MM. The Association of Pediatric Critical Care Medicine Training Programs with Research Publication Productivity and Employment Outcomes of Their Graduates. J Pediatr Intensive Care 2020; 11:138-146. [DOI: 10.1055/s-0040-1721732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 11/04/2020] [Indexed: 10/22/2022] Open
Abstract
AbstractOur objective was to associate characteristics of pediatric critical care medicine (PCCM) fellowship training programs with career outcomes of PCCM physicians, including research publication productivity and employment characteristics. This is a descriptive study using publicly available data from 2557 PCCM physicians from the National Provider Index registry. We analyzed data on a systematic sample of 690 PCCM physicians representing 62 fellowship programs. There was substantial diversity in the characteristics of fellowship training programs in terms of fellowship size, intensive care unit (ICU) bed numbers, age of program, location, research rank of affiliated medical school, and academic metrics based on publication productivity of their graduates standardized over time. The clinical and academic attributes of fellowship training programs were associated with publication success and characteristics of their graduates' employment hospital. Programs with greater publication rate per graduate had more ICU beds and were associated with higher ranked medical schools. At the physician level, training program attributes including larger size, older program, and higher academic metrics were associated with graduates with greater publication productivity. There were varied characteristics of current employment hospitals, with graduates from larger, more academic fellowship training programs more likely to work in larger pediatric intensive care units (24 [interquartile range, IQR: 16–35] vs. 19 [IQR: 12–24] beds; p < 0.001), freestanding children's hospitals (52.6 vs. 26.3%; p < 0.001), hospitals with fellowship programs (57.3 vs. 40.3%; p = 0.01), and higher affiliated medical school research ranks (35.5 [IQR: 14–72] vs. 62 [IQR: 32, unranked]; p < 0.001). Large programs with higher academic metrics train physicians with greater publication success (H index 3 [IQR: 1–7] vs. 2 [IQR: 0–6]; p < 0.001) and greater likelihood of working in large academic centers. These associations may guide prospective trainees as they choose training programs that may foster their career values.
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Affiliation(s)
- Sonali Basu
- Department of Pediatrics, Children's National Hospital and the George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, United States
| | - Robin Horak
- Department of Anesthesia Critical Care, Children's Hospital of Los Angeles and the Keck School of Medicine, Los Angeles, California, United States
| | - Murray M. Pollack
- Department of Pediatrics, Children's National Hospital and the George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, United States
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16
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Trends and factors affecting the US adult hematology workforce: a mixed methods study. Blood Adv 2020; 3:3550-3561. [PMID: 31738829 DOI: 10.1182/bloodadvances.2019000307] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 08/02/2019] [Indexed: 11/20/2022] Open
Abstract
The current demand for adult hematologists in the United States is projected to exceed the existing supply. However, no national study has systematically evaluated factors affecting the adult hematology workforce. In collaboration with the American Society of Hematology (ASH), we performed a mixed methods study consisting of surveys from the annual ASH In-Service Exam for adult hematology/oncology fellows from 2010 to 2016 (8789 participants); interviews with graduating or recently graduated adult hematology/oncology fellows in a single training program (8 participants); and 3 separate focus groups for hematology/oncology fellowship program directors (12 participants), fellows (12 participants), and clinicians (10 participants) at the 2016 ASH annual meeting. In surveys, the majority of fellows favored careers combining hematology and oncology, with more fellows identifying oncology, rather than hematology, as their primary focus. In interviews with advanced-year fellows, mentorship emerged as the single most important career determinant, with mentorship opportunities arising serendipitously, and oncology faculty perceived as having greater availability for mentorship than hematology faculty. In focus group discussions, hematology, particularly benign hematology, was viewed as having poorer income potential, research funding, job availability, and job security than oncology. Focus group participants invariably agreed that the demand for clinical care in hematology, particularly benign hematology, exceeded the current workforce supply. Single-subspecialty fellowship training in hematology and the creation of new clinical care models were offered as potential solutions to these workforce problems. As a next step, ASH is conducting a national, longitudinal study of the adult hematology workforce to improve recruitment and retention in the field.
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Associations between hematology/oncology fellows' training and mentorship experiences and hematology-only career plans. Blood Adv 2020; 3:3278-3286. [PMID: 31698456 DOI: 10.1182/bloodadvances.2019000569] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 08/30/2019] [Indexed: 11/20/2022] Open
Abstract
As the adult hematology and oncology fellowship training pathways have merged in the United States and concerns have arisen about the aging of practicing hematologists, the American Society of Hematology and hematology education leaders are looking to improve their understanding of the factors that contribute to fellows' plans to enter hematology-only careers. With the support of the American Society of Hematology, we collected and analyzed data from a survey of hematology/oncology fellows (n = 626) to examine the relationship between training and mentorship experiences and fellows' plans to enter hematology-only careers. Fellows who planned to enter hematology-only careers were significantly more likely to report having clinical training and mentorship experiences in hematology throughout their training relative to fellows with oncology-only or combined hematology/oncology career plans. After controlling for prior interest in hematology and demographic characteristics, exposure to hematology patients in medical school and fellowship, hematology research experiences, and hematology mentorship (research collaboration and career coaching) were positively and significantly associated with hematology-only career plans. These findings suggest that increasing opportunities for exposure to hematology patients, research opportunities and mentors throughout training could be helpful in building a strong pipeline of potential hematologists.
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18
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Anampa-Guzmán A, Brito-Hijar AD, Gutierrez-Narvaez CA, Molina-Ruiz AR, Simo-Mendoza V, González-Woge M, de la O Murillo A, Leon-Ferre R. American Society of Clinical Oncology-Sponsored Oncology Student Interest Groups in Latin America. JCO Glob Oncol 2020; 6:1439-1445. [PMID: 32997539 PMCID: PMC7531611 DOI: 10.1200/go.20.00363] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2020] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To describe the characteristics of the members of the ASCO-sponsored Oncology Student Interest Groups (OSIGs) in Latin America. METHODS This was a multicenter cross-sectional study. We surveyed 97 OSIG members from three medical schools in Peru and Mexico. We administered a 60-question survey covering topics including personal background, oncology training experience, and professional practice expectations and preferences. RESULTS A little more than one half of the surveyed OSIG members were female. More than one half had a visa to visit the United States and had an advanced level of English. One half of the OSIG members were also ASCO members. Most participants agreed or strongly agreed that participation in their OSIG increased their interest in cancer-related specialties (94%) and provided professional networking opportunities (94%) and that it was accessible to all students (91%). Most participants believed that their OSIG had sufficient resources to carry out its activities. Students were asked to rate their interest when they entered medical school versus at the time of the survey. Most of the members were strongly interested in pursuing surgical oncology. The majority of members were somewhat interested or very interested in palliative care and medical oncology. CONCLUSION To our knowledge, this is the first study that provides data on medical student perceptions of the Latin American OSIGs sponsored by ASCO. Student perceptions of medical oncology and the impact of OSIGs were generally positive. Given the shortages of oncology specialists in Latin American and elsewhere, strategies to engage medical students in the pursuit of cancer-related careers are becoming increasingly essential.
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Affiliation(s)
- Andrea Anampa-Guzmán
- Faculty of Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
- Sociedad Cientifica de San Fernando, Lima, Peru
| | - Andrea Denise Brito-Hijar
- Faculty of Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
- Sociedad Cientifica de San Fernando, Lima, Peru
| | | | - Anthony Raul Molina-Ruiz
- Faculty of Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
- Sociedad Cientifica de San Fernando, Lima, Peru
| | - Victor Simo-Mendoza
- Faculty of Medicine, Universidad Autónoma de Baja California, Mexicali, Mexico
| | | | | | - Roberto Leon-Ferre
- Division of Medical Oncology, Department of Oncology, Mayo Clinic, Rochester, MN
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LaCasce A, Graff S, Gao J, Close J, Boulmay B. Preparing Fellows for Graduation: Perspectives on Career Guidance. Am Soc Clin Oncol Educ Book 2019; 39:609-614. [PMID: 31099656 DOI: 10.1200/edbk_242603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
At the completion of a hematology/oncology fellowship, trainees are likely to enter into a career differing from the one modeled by the faculty providing mentorship and teaching during training. Fellows benefit from open communication with regard to career goals and opportunities starting early in training. To ensure honesty in the process, program directors must be accepting and supportive of house staff selecting careers different from those of the training environment. Following identification of a long-term career goal, program directors may facilitate a smooth transition to the early career through thoughtful inclusion of alternative experiences and additional mentors. Barriers exist, including funding and limited time in training while completing educational requirements, which may make inclusion of the experiences a challenge.
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Affiliation(s)
- Ann LaCasce
- 1 Dana-Farber/Partners Cancer Care, Boston, MA
| | - Stephanie Graff
- 2 Sarah Cannon Cancer Institute at Menorah Medical Center, Kansas City, MO
| | - Jennifer Gao
- 3 US Food and Drug Administration, Silver Spring, MD
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20
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Ruddell JH, Ahmed SA, Tang OY, Schiffman FJ, Quesenberry MI, Eltorai AEM. Critical Analysis of Hematology and Oncology Fellowship Web Sites in the United States. J Oncol Pract 2019; 15:e439-e446. [PMID: 30964734 DOI: 10.1200/jop.18.00666] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Prospective hematology-oncology fellowship applicants use program Web sites as a critical source of information. The purpose of this study was to evaluate the current content and comprehensiveness of hematology-oncology fellowship Web sites and to identify specific areas for improvement. METHODS This study assessed the presence of 27 commonly evaluated program and application and curriculum and training informational items for Web sites of all accredited hematology-oncology fellowship programs in 2018. The comprehensiveness score was calculated as the number of items present on a fellowship Web site out of 27 and was compared by program region and size using analysis of variance and two-tailed t tests. RESULTS Of the 143 fellowship Web sites evaluated, the mean comprehensiveness score was 39.3% (10.6 ± 3.8 out of 27). Programs contained a mean of 42.1% (5.9 ± 2.3 out of 14) of program and application and 36.2% (4.7 ± 2.1 out of 13) of curriculum and training items. The program and application items most common among Web sites were program coordinator contact and faculty listing (83.2% and 74.1% of Web sites, respectively), whereas social events and salary and benefits were less common (31.5% and 20.3% of Web sites, respectively). Prevalent curriculum and training items were research publications and activity and rotation scheduling (86.0% and 81.1% of Web sites, respectively), whereas board examination pass rates and fellow call duties were uncommon (4.2% and 15.4% of Web sites, respectively). Large programs were associated with greater overall Web site items compared with small programs (43.0% [11.6 ± 4.1 out of 27] v 35.9% [9.7 ± 3.3 out of 27]; P = .003). CONCLUSION Hematology-oncology fellowship Web sites vary considerably in the level and nature of content they contain. Because applicants rely on online information for decision making, more comprehensive online content may promote a better fit between program and applicant. There is room for improvement in hematology-oncology fellowship Web sites, and programs may consider directing resources toward enhancing these Web sites.
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Affiliation(s)
- Jack H Ruddell
- 1 Warren Alpert Medical School of Brown University. Providence, RI
| | - Shaan A Ahmed
- 1 Warren Alpert Medical School of Brown University. Providence, RI
| | - Oliver Y Tang
- 1 Warren Alpert Medical School of Brown University. Providence, RI
| | - Fred J Schiffman
- 1 Warren Alpert Medical School of Brown University. Providence, RI.,2 Lifespan Cancer Institute. Providence, RI
| | - Matthew I Quesenberry
- 1 Warren Alpert Medical School of Brown University. Providence, RI.,2 Lifespan Cancer Institute. Providence, RI
| | - Adam E M Eltorai
- 1 Warren Alpert Medical School of Brown University. Providence, RI
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21
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Yip SM, Loewen SK, Li H, Hao D, Easaw JC. Management of Medical Oncology Services in Canada: Redefined Workload With a Novel Supply-and-Demand Workforce Projection Model. J Oncol Pract 2018; 14:e438-e445. [DOI: 10.1200/jop.18.00114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose: We developed a workforce-planning model to predict Canadian medical oncologist (MO) supply and clinical demand during the next 10 years. Materials and Methods: A forward calculation model was created to forecast the balance of MO supply and demand. MO supply was estimated by using Canadian Institute for Health Information, Canadian Medical Association, and Canadian Post-MD Education Registry data. Care demand was estimated by using data from Canadian Cancer Statistics and Alberta Cancer Registry. The Canadian Royal College MO Committee confirmed its face validity. Results: The MO workforce is expected to grow from 541 staff in 2016 to 830 staff in 2026. During this period, new hires will increase from 39 to 56 per year, and departures will increase from 15 to 24 per year. Although cancer incidence rates will grow from 202,149 to 257,497, a projected increase in MO supply will mean fewer initial consultations, from an average of 168.5 consultations per MO in 2016 to 129.2 consultations per MO in 2026. The initiation of systemic therapy is projected to remain stable at 102.3 new systemic therapy starts per MO per year. Conclusion: We have developed a forward calculation MO workforce model that predicts a growing Canadian MO workforce and redefines MO workload dynamics. MO providers will increasingly support more follow-up care with the initiation of multiple lines of systemic therapy relative to the medical management of patients at the time of initial cancer diagnosis. Workload metrics, including follow-up and new therapy initiation rates, must be measured to appropriately to meet increasingly complex and growing care demands.
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Affiliation(s)
- Steven M. Yip
- Tom Baker Cancer Center, BC Cancer Agency, University of Calgary, Calgary; and Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Shaun K. Loewen
- Tom Baker Cancer Center, BC Cancer Agency, University of Calgary, Calgary; and Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Haocheng Li
- Tom Baker Cancer Center, BC Cancer Agency, University of Calgary, Calgary; and Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Desiree Hao
- Tom Baker Cancer Center, BC Cancer Agency, University of Calgary, Calgary; and Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Jacob C. Easaw
- Tom Baker Cancer Center, BC Cancer Agency, University of Calgary, Calgary; and Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
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Murali K, Banerjee S. Burnout in oncologists is a serious issue: What can we do about it? Cancer Treat Rev 2018; 68:55-61. [DOI: 10.1016/j.ctrv.2018.05.009] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 05/14/2018] [Accepted: 05/15/2018] [Indexed: 11/24/2022]
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Boulmay B, Prowell T, Blaya M, Pietanza MC. No Decision Is Final: Career Planning and Career Transitions. Am Soc Clin Oncol Educ Book 2018; 38:881-886. [PMID: 30231402 DOI: 10.1200/edbk_200983] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Several factors play a role in job selection after completion of a hematology/oncology training program, such as a fellows' overall career goals, expected income potential, and limitations imposed by visa status, among many others. Training programs play an integral role in mentoring trainees in career selection. For many, the first job is often not career-long. In addition to considerations for a fellow considering a first job out of fellowship, physicians will consider a change because of dissatisfaction at one's current position, desire for advancement opportunities, or a desire to work in a different sector. Other factors include non-occupational issues such as career opportunities for a spouse or desire for a different geographic location. Frequent employment changes are common with crossover between academia, clinical practice, industry, or government service. Possessing the skills needed to recognize one's strengths, weaknesses, and goal prioritization can allow for more optimal job selection should a career transition into a different discipline occur. Recognizing opportunities that present themselves and potentially taking advantage of them can lead to professional and personal growth.
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Affiliation(s)
- Brian Boulmay
- From the Louisiana State University Health Sciences Center, New Orleans, LA; U.S. Food and Drug Administration, Silver Spring, MD, The Sidney Kimmel Cancer Center at Johns Hopkins, Baltimore, MD; Memorial Cancer Institute, Hollywood, FL; Merck & Co., Inc., Rahway, NJ
| | - Tatiana Prowell
- From the Louisiana State University Health Sciences Center, New Orleans, LA; U.S. Food and Drug Administration, Silver Spring, MD, The Sidney Kimmel Cancer Center at Johns Hopkins, Baltimore, MD; Memorial Cancer Institute, Hollywood, FL; Merck & Co., Inc., Rahway, NJ
| | - Marcelo Blaya
- From the Louisiana State University Health Sciences Center, New Orleans, LA; U.S. Food and Drug Administration, Silver Spring, MD, The Sidney Kimmel Cancer Center at Johns Hopkins, Baltimore, MD; Memorial Cancer Institute, Hollywood, FL; Merck & Co., Inc., Rahway, NJ
| | - Maria Catherine Pietanza
- From the Louisiana State University Health Sciences Center, New Orleans, LA; U.S. Food and Drug Administration, Silver Spring, MD, The Sidney Kimmel Cancer Center at Johns Hopkins, Baltimore, MD; Memorial Cancer Institute, Hollywood, FL; Merck & Co., Inc., Rahway, NJ
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Determinants of hematology-oncology trainees' postfellowship career pathways with a focus on nonmalignant hematology. Blood Adv 2018; 2:361-369. [PMID: 29463548 DOI: 10.1182/bloodadvances.2017013722] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 01/04/2018] [Indexed: 02/07/2023] Open
Abstract
Nonmalignant hematologic conditions are extremely prevalent and contribute significantly to the global burden of disease. The US health care system may soon face a shortage of specialists in nonmalignant hematology. We sought to identify factors that lead hematology-oncology fellows to pursue (or not to pursue) careers in nonmalignant hematology. Cross-sectional, web-based survey distributed to 149 graduates of a hematology-oncology fellowship program at a large academic medical center between 1998 and 2016. Eighty-six out of 149 graduates responded (57.7%); most (59 [68.6%]) practice at an academic medical center. Respondents spend a mean of 61% of their time in clinical practice, 23.7% conducting research, 5.2% in education, and 5.2% in administration. Those in clinical practice spend a mean of 52.1% of their time in solid tumor oncology, 37.5% in hematologic malignancies, and 10% in nonmalignant hematology; only 1 spent >50% of time practicing nonmalignant hematology. Factors most significantly affecting choice of patient population included clinical experience during fellowship and intellectual stimulation of the patient population/disease type. Factors that could have most significantly influenced a decision to spend more time in nonmalignant hematology included increased exposure/access to role models and mentors and opportunities for better career growth/advancement. Fellowship graduates spend >50% of their time in clinical practice, but almost none spend a significant amount of time practicing nonmalignant hematology. Given the growing number of patients with nonmalignant hematologic conditions and a possible future provider shortage, medical trainees should be encouraged to pursue careers in nonmalignant hematology.
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25
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Single-board hematology fellowship track: a 10-year institutional experience. Blood 2018; 131:462-464. [PMID: 29229595 DOI: 10.1182/blood-2017-11-816207] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 12/06/2017] [Indexed: 11/20/2022] Open
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26
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Faivre JC, Bibault JE, Bellesoeur A, Salleron J, Wack M, Biau J, Cervellera M, Janoray G, Leroy T, Lescut N, Martin V, Molina S, Pichon B, Teyssier C, Thureau S, Mazeron JJ, Roché H, Culine S. Choosing a career in oncology: results of a nationwide cross-sectional study. BMC MEDICAL EDUCATION 2018; 18:15. [PMID: 29334939 PMCID: PMC5769332 DOI: 10.1186/s12909-018-1117-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Accepted: 01/05/2018] [Indexed: 05/15/2023]
Abstract
BACKGROUND Little information is currently available concerning young medical students desire to pursue a career in oncology, or their career expectations. METHODS This project is a cross-sectional epidemiological study. A voluntary and anonymous questionnaire was distributed to all young oncologists studying in France between the 2nd of October 2013 and the 23rd of February 2014. RESULTS The overall response rate was 75.6%. A total of 505 young oncologists completed the questionnaire. The main determining factors in the decision to practice oncology were the cross-sectional nature of the field (70.8%), the depth and variety of human relations (56.3%) and the multi-disciplinary field of work (50.2%). Most residents would like to complete a rotation outside of their assigned region (59.2%) or abroad (70.2%) in order to acquire additional expertise (67.7%). In addition, most interns would like to undertake a fellowship involving care, teaching and research in order to hone their skills (85.7%) and forge a career in public hospitals (46.4%). Career prospects mainly involve salaried positions in public hospitals. Many young oncologists are concerned about their professional future, due to the shortage of openings (40.8%), the workload (52.8%) and the lack of work-life balance (33.4%). CONCLUSIONS This investigation provides a comprehensive profile of the reasons young oncologists chose to pursue a career in oncology, and their career prospects.
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Affiliation(s)
- J. C. Faivre
- Academic Radiation Oncology & Brachytherapy Department, Lorraine Institute of Cancerology - Alexis-Vautrin Comprehensive Cancer Centre, 6 avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France
- Radiation Oncology Department, University Hospital of Paris (Georges Pompidou European Hospital), 20 rue Leblanc, 75015 Paris, France
- Academic Department of Radiation Therapy & Brachytherapy, Lorraine Institute of Cancerology – Alexis-Vautrin CLCC [Centre de lutte contre le cancer – Cancer Centre] – Unicancer, 6 avenue de Bourgogne –CS 30 519, cedex F-54 511 Vandoeuvre-lès-Nancy, France
| | - J. E. Bibault
- French Society of Young Radiation Oncologists (SFjRO), Centre Antoine-Béclère, 45 rue des Saint Pères, 75005 Paris, France
- Radiation Oncology Department, University Hospital of Paris (Georges Pompidou European Hospital), 20 rue Leblanc, 75015 Paris, France
- Paris Descartes University, 12 rue de l’Ecole de médicine, 75006 Paris, France
| | - A. Bellesoeur
- Medical Oncology Department, University Hospital of Paris (Teaching Hospital Cochin), 27 rue du Faubourg Saint Jacques, 75014 Paris, France
- French Resident’s and Fellow’s Association for Teaching and Research in Oncology (AERIO), 149 avenue du Maine, 75014 Paris, France
| | - J. Salleron
- Biostatistics Department, Lorraine Institute of Cancerology - Alexis-Vautrin Comprehensive Cancer Centre, 6 avenue de Bourgogne, F-54519 Vandœuvre-lès-Nancy, France
| | - M. Wack
- Biostatistics and Epidemiology Department, University Hospital of Nancy, 9 avenue de la Forêt de Haye, 54505 Vandoeuvre-lès-nancy, France
| | - J. Biau
- French Society of Young Radiation Oncologists (SFjRO), Centre Antoine-Béclère, 45 rue des Saint Pères, 75005 Paris, France
- Radiation Oncology Department, Jean-Perrin Comprehensive Cancer Centre, 58 rue Montalembert, 63000 Clermont-Ferrand, France
- University of Auvergne, 28 place Henri Dunant, 63000 Clermont-Ferrand, France
| | - M. Cervellera
- French Society of Young Radiation Oncologists (SFjRO), Centre Antoine-Béclère, 45 rue des Saint Pères, 75005 Paris, France
- Radiation Oncology Department, Jean Godinot Comprehensive Cancer Centre, 1 rue du Général Koenig, 51726 Reims, France
| | - G. Janoray
- French Society of Young Radiation Oncologists (SFjRO), Centre Antoine-Béclère, 45 rue des Saint Pères, 75005 Paris, France
- S. Kaplan Cancer Centre, Radiation Oncology Department, University Hospital of Tours, 2 boulevard Tonnelé, 37000 Tours, France
| | - T. Leroy
- French Society of Young Radiation Oncologists (SFjRO), Centre Antoine-Béclère, 45 rue des Saint Pères, 75005 Paris, France
- Academic Radiation Oncology Department, Oscar Lambret Comprehensive Cancer Centre, 3 rue Frédéric Combemale, 59000 Lille, France
| | - N. Lescut
- French Society of Young Radiation Oncologists (SFjRO), Centre Antoine-Béclère, 45 rue des Saint Pères, 75005 Paris, France
- Radiation Oncology Department, University Hospital of Besançon, 3 boulevard Fleming, 25000 Besançon, France
| | - V. Martin
- French Society of Young Radiation Oncologists (SFjRO), Centre Antoine-Béclère, 45 rue des Saint Pères, 75005 Paris, France
- Radiation Oncology Department, University Hospital of Paris (Kremlin-Bicêtre Hospital), 78 rue du Général Leclerc, 94270 Paris, France
- Paris Sud University, 63 rue Gabriel Péri, 94276 Orsay, France
| | - S. Molina
- French Society of Young Radiation Oncologists (SFjRO), Centre Antoine-Béclère, 45 rue des Saint Pères, 75005 Paris, France
- Radiation Oncology Department, University Hospital of Poitiers, 2 rue de la Milétrie, 86021 Poitiers, France
| | - B. Pichon
- French Society of Young Radiation Oncologists (SFjRO), Centre Antoine-Béclère, 45 rue des Saint Pères, 75005 Paris, France
- Radiation Oncology Department, René-Gauducheau Comprehensive Cancer Centre, boulevard Jacques Monod, 44805 Nantes, Saint-Herblain France
| | - C. Teyssier
- French Society of Young Radiation Oncologists (SFjRO), Centre Antoine-Béclère, 45 rue des Saint Pères, 75005 Paris, France
- Radiation Oncology Department, University Hospital of Besançon, 3 boulevard Fleming, 25000 Besançon, France
| | - S. Thureau
- Radiation Oncology & Medical Physics Department, Henri-Becquerel Comprehensive Cancer Centre, rue d’Amiens, 76000 Rouen, France
- EA4108 QuantIf Litis, University of Rouen, 22 boulevard Gambetta, 76000 Rouen, France
| | - J. J. Mazeron
- Radiation Oncology Department, University Hospital of Paris (Pitié-Salpétrière Hospital), 83 boulevard de l’hôpital, 75013 Paris, France
- University Pierre et Marie Curie, 4 place Jussieu, 75005 Paris, France
| | - H. Roché
- Oncopole Toulouse, Claudius Regaud Comprehensive Cancer Centre, 1 avenue Irène Joliot-Curie, 31059 Toulouse, France
- University of Toulouse, 37 allée Jules Guesde, 36000 Toulouse, France
| | - S. Culine
- Medical Oncology Department, University Hospital of Paris (Saint-Louis Hospital), 1 avenue Claude Vellefaux, 75010 Paris, France
- Paris Diderot University, 16 rue Huchard, 75018 Paris, France
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The American Society of Hematology Clinical Research Training Institute is associated with high retention in academic hematology. Blood 2016; 128:2881-2885. [PMID: 27784672 DOI: 10.1182/blood-2016-06-724211] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 10/08/2016] [Indexed: 11/20/2022] Open
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Ranieri V, Barratt H, Fulop N, Rees G. Factors that influence career progression among postdoctoral clinical academics: a scoping review of the literature. BMJ Open 2016; 6:e013523. [PMID: 27798036 PMCID: PMC5093673 DOI: 10.1136/bmjopen-2016-013523] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The future of academic medicine is uncertain. Concerns regarding the future availability of qualified and willing trainee clinical academics have been raised worldwide. Of significant concern is our failure to retain postdoctoral trainee clinical academics, who are likely to be our next generation of leaders in scientific discovery. OBJECTIVES To review the literature about factors that may influence postdoctoral career progression in early career clinical academics. DESIGN This study employed a scoping review method. Three reviewers separately assessed whether the articles found fit the inclusion criteria. DATA SOURCES PubMed, Scopus, Web of Science and Google Scholar (1991-2015). ARTICLE SELECTION The review encompassed a broad search of English language studies published anytime up to November 2015. All articles were eligible for inclusion, including research papers employing either quantitative or qualitative methods, as well as editorials and other summary articles. DATA EXTRACTION Data extracted from included publications were charted according to author(s), sample population, study design, key findings, country of origin and year of publication. RESULTS Our review identified 6 key influences: intrinsic motivation, work-life balance, inclusiveness, work environment, mentorship and availability of funding. It also detected significant gaps within the literature about these influences. CONCLUSIONS Three key steps are proposed to help support postdoctoral trainee clinical academics. These focus on ensuring that researchers feel encouraged in their workplace, involved in collaborative dialogue with key stakeholders and able to access reliable information regarding their chosen career pathway. Finally, we highlight recommendations for future research.
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Affiliation(s)
- Veronica Ranieri
- Academic Careers Office, School of Life and Medical Sciences, University College London, London, UK
- Department of Applied Health Research, University College London, London, UK
| | - Helen Barratt
- Department of Applied Health Research, University College London, London, UK
| | - Naomi Fulop
- Health Care Organisation and Management, Department of Applied Health Research, University College London, London, UK
| | - Geraint Rees
- Faculty of Life Sciences, University College London, London, UK
- Department of Cognitive Neurology, University College London, London, UK
- Academic Careers Office, University College London, London, UK
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Variability in structure of university pulmonary/critical care fellowships and retention of fellows in academic medicine. Ann Am Thorac Soc 2016; 12:553-6. [PMID: 25715099 DOI: 10.1513/annalsats.201501-026bc] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Individual fellowship programs are challenged to find a format of training that not only meets the Accreditation Council for Graduate Medical Education requirements, but also grooms fellows to be trusted clinicians, and encourages them to enter academic careers. This study was undertaken as part of an internal effort to evaluate and revise the program structure of the pulmonary/critical care medicine fellowship at the Medical University of South Carolina. Our objectives were to characterize variation in the training structure and specifically research opportunities of university pulmonary/critical care medicine fellowship programs, and to identify factors associated with fellow retention in academic medicine and research. METHODS A 30-item survey was developed through rigorous internal review and was administered via email. Descriptive statistics, Cronbach's alpha, correlations, Wilcoxon sign-rank test, and ANOVA were carried out. RESULTS We had a response rate of 52%. Program directors reported that, within the past 5 years, 38% of their fellows remained in academic medicine and 20% remained in academics with significant research focus. We found a statistically significant association between obtaining a master's degree and remaining in academics (r = 0.559; P < 0.008). The survey also revealed statistically significant relationships between scholarly requirements (grant proposals, peer-reviewed original research projects) and the percent of fellows who graduated and remained in academics. CONCLUSIONS This survey offers some insights that may be useful to fellowship program directors. In particular, advanced education in research and maximizing scholarly activities might be associated with increased academic retention among fellowship trainees.
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Inal C, Yilmaz E, Piperdi B, Perez-Soler R, Cheng H. Emerging treatment for advanced lung cancer withEGFRmutation. Expert Opin Emerg Drugs 2015; 20:597-612. [DOI: 10.1517/14728214.2015.1058778] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Shanafelt TD, Raymond M, Horn L, Moynihan T, Collichio F, Chew H, Kosty MP, Satele D, Sloan J, Gradishar WJ. Oncology fellows’ career plans, expectations, and well-being: do fellows know what they are getting into? J Clin Oncol 2015; 32:2991-7. [PMID: 25049326 DOI: 10.1200/jco.2014.56.2827] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To evaluate the career plans, professional expectations, and well-being of oncology fellows compared with actual experiences of practicing oncologists. METHODS US oncology fellows taking the 2013 Medical Oncology In-Training Examination (MedOnc ITE) were invited to participate in an optional postexamination survey. The survey evaluated fellows’ career plans and professional expectations and measured burnout, quality of life (QOL), fatigue, and satisfaction with work-life balance (WLB) using standardized instruments. Fellows’ professional expectations and well-being were compared with actual experiences of US oncologists assessed simultaneously. RESULTS Of the 1,637 oncology fellows in the United States, 1,373 (83.9%) took the 2013 MedOnc ITE. Among these, 1,345 (97.9%) completed the postexamination survey. The frequency of burnout among fellows decreased from 43.3% in year 1 to 31.7% in year 2 and 28.1% in year 3 (P < .001). Overall, the rate of burnout among fellows and practicing oncologists was similar (34.1% v. 33.7%; P = .86). With respect to other dimensions of well-being, practicing oncologists had lower fatigue (P < .001) and better overall QOL scores (P < .001) than fellows but were less satisfied with WLB (P = .0031) and specialty choice (P < .001). Fellows’ expectations regarding future work hours were 5 to 6 hours per week fewer than oncologists’ actual reported work hours. Levels of burnout (P = .02) and educational debt (P < or =.004) were inversely associated with ITE scores. Fellows with greater educational debt were more likely to pursue private practice and less likely to plan an academic career. CONCLUSION Oncology fellows entering practice trade one set of challenges for another. Unrealized expectations regarding work hours may contribute to future professional dissatisfaction, burnout, and challenges with WLB.
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Deville C, Chapman CH, Burgos R, Hwang WT, Both S, Thomas CR. Diversity by race, Hispanic ethnicity, and sex of the United States medical oncology physician workforce over the past quarter century. J Oncol Pract 2014; 10:e328-34. [PMID: 25052501 DOI: 10.1200/jop.2014.001464] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To assess the medical oncology (MO) physician workforce diversity by race, Hispanic ethnicity, and sex, with attention to trainees. METHODS Public registries were used to assess 2010 differences among MO practicing physicians, academic faculty, and fellows; internal medicine (IM) residents; and the US population, using binomial tests with P < .001 significance adjusting for multiple comparisons. Significant changes in fellow representation from 1986 to 2011 were assessed. RESULTS Female representation as MO fellows (45.0%) was significantly increased compared with faculty (22.4%) and practicing physicians (27.4%); was no different than IM residents (44.7%, P = .853); and increased significantly, by 1.0% per year. Women were significantly underrepresented as practicing physicians, faculty, and fellows compared with the US population (50.8%). Traditionally underrepresented minorities in medicine (URM) were significantly underrepresented as practicing physicians (7.8%), faculty (5.7%), and fellows (10.9%), versus US population (30.0%). Hispanic MO fellows (7.5%) were increased compared with faculty (3.9%) and practicing physicians (4.1%); Black fellows (3.1%) were no different than faculty (1.8%, P = .0283) or practicing physicians (3.5%, P = .443). When comparing MO fellows versus IM residents, there were no differences for American Indians/Alaska Natives/Native Hawaiians/Pacific Islanders (0.3%, 0.6%, respectively, P = .137) and Hispanics (7.5%, 8.7%, P = .139), unlike Blacks (3.1%, 5.6%, P < .001). There has been no significant change in URM representation, with negligible changes every 5 years for American Indians/Alaska Natives/Native Hawaiians/Pacific Islanders (-0.1%), Blacks (-0.3%), and Hispanics (0.3%). CONCLUSIONS Female fellow representation increased 1% per year over the quarter century indicating historical gains, whereas URM diversity remains unchanged. For Blacks alone, representation as MO fellows is decreased compared with IM residents, suggesting greater disparity in MO training.
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Affiliation(s)
- Curtiland Deville
- University of Pennsylvania, Philadelphia, PA; University of Michigan, Ann Arbor, MI; and Knight Cancer Institute, Oregon Health & Science University, Portland, OR
| | - Christina H Chapman
- University of Pennsylvania, Philadelphia, PA; University of Michigan, Ann Arbor, MI; and Knight Cancer Institute, Oregon Health & Science University, Portland, OR
| | - Ramon Burgos
- University of Pennsylvania, Philadelphia, PA; University of Michigan, Ann Arbor, MI; and Knight Cancer Institute, Oregon Health & Science University, Portland, OR
| | - Wei-Ting Hwang
- University of Pennsylvania, Philadelphia, PA; University of Michigan, Ann Arbor, MI; and Knight Cancer Institute, Oregon Health & Science University, Portland, OR
| | - Stefan Both
- University of Pennsylvania, Philadelphia, PA; University of Michigan, Ann Arbor, MI; and Knight Cancer Institute, Oregon Health & Science University, Portland, OR
| | - Charles R Thomas
- University of Pennsylvania, Philadelphia, PA; University of Michigan, Ann Arbor, MI; and Knight Cancer Institute, Oregon Health & Science University, Portland, OR
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Tong CW, Ahmad T, Brittain EL, Bunch TJ, Damp JB, Dardas T, Hijar A, Hill JA, Hilliard AA, Houser SR, Jahangir E, Kates AM, Kim D, Lindman BR, Ryan JJ, Rzeszut AK, Sivaram CA, Valente AM, Freeman AM. Challenges facing early career academic cardiologists. J Am Coll Cardiol 2014; 63:2199-208. [PMID: 24703919 PMCID: PMC4306449 DOI: 10.1016/j.jacc.2014.03.011] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Revised: 03/01/2014] [Accepted: 03/04/2014] [Indexed: 11/26/2022]
Abstract
Early career academic cardiologists currently face unprecedented challenges that threaten a highly valued career path. A team consisting of early career professionals and senior leadership members of American College of Cardiology completed this white paper to inform the cardiovascular medicine profession regarding the plight of early career cardiologists and to suggest possible solutions. This paper includes: 1) definition of categories of early career academic cardiologists; 2) general challenges to all categories and specific challenges to each category; 3) obstacles as identified by a survey of current early career members of the American College of Cardiology; 4) major reasons for the failure of physician-scientists to receive funding from National Institute of Health/National Heart Lung and Blood Institute career development grants; 5) potential solutions; and 6) a call to action with specific recommendations.
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Affiliation(s)
- Carl W Tong
- Department of Medical Physiology and Department of Medicine/Cardiology Division, Texas A&M University Health Science Center-Baylor Scott & White Healthcare, Temple, Texas.
| | - Tariq Ahmad
- Duke University Medical Center, Durham, North Carolina
| | - Evan L Brittain
- Department of Medicine/Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - T Jared Bunch
- Heart Rhythm Program, Intermountain Medical Center, Murray, Utah
| | - Julie B Damp
- Department of Medicine/Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Todd Dardas
- Department of Internal Medicine, University of Washington Medical Center, Seattle, Washington
| | - Amalea Hijar
- Member Strategy and Career Development Department, American College of Cardiology, Washington, DC
| | - Joseph A Hill
- Department of Internal Medicine/Cardiology Division and Harry S. Moss Heart Center, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Anthony A Hilliard
- Department of Medicine/Cardiology Division, Loma Linda University Medical Center, Loma Linda, California
| | - Steven R Houser
- Department of Physiology, Temple University School of Medicine, Philadelphia, Pennsylvania
| | - Eiman Jahangir
- Department of Cardiology, Ochsner Clinical School-the University of Queensland School of Medicine, New Orleans, Louisiana
| | - Andrew M Kates
- Department of Medicine/Cardiology Division, Washington University School of Medicine, St. Louis, Missouri
| | - Darlene Kim
- Department of Medicine/Division of Cardiology, National Jewish Health, Denver, Colorado
| | - Brian R Lindman
- Department of Medicine/Cardiology Division, Washington University School of Medicine, St. Louis, Missouri
| | - John J Ryan
- Department of Medicine/Division of Cardiology, University of Utah Health Care, Salt Lake City, Utah
| | - Anne K Rzeszut
- Member Strategy and Career Development Department, American College of Cardiology, Washington, DC
| | - Chittur A Sivaram
- Department of Medicine/Cardiovascular Section, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma
| | - Anne Marie Valente
- Department of Cardiology, Harvard Medical School, Brigham and Women's Hospital, and Boston Children's Hospital, Boston, Massachusetts
| | - Andrew M Freeman
- Department of Medicine/Division of Cardiology, National Jewish Health, Denver, Colorado
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Daniels VJ, Kassam N. Impact of personal goals on the internal medicine R4 subspecialty match: a Q methodology study. BMC MEDICAL EDUCATION 2013; 13:171. [PMID: 24359484 PMCID: PMC3879426 DOI: 10.1186/1472-6920-13-171] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Accepted: 12/18/2013] [Indexed: 06/03/2023]
Abstract
BACKGROUND There has been a decline in interest in general internal medicine that has resulted in a discrepancy between internal medicine residents' choice in the R4 subspecialty match and societal need. Few studies have focused on the relative importance of personal goals and their impact on residents' choice. The purpose of this study was to assess if internal medicine residents can be grouped based on their personal goals and how each group prioritizes these goals compared to each other. A secondary objective was to explore whether we could predict a resident's desired subspecialty choice based on their constellation of personal goals. METHODS We used Q methodology to examine how postgraduate year 1-3 internal medicine residents could be grouped based on their rankings of 36 statements (derived from our previous qualitative study). Using each groups' defining and distinguishing statements, we predicted their subspecialties of interest. We also collected the residents' first choice in the subspecialty match and used a kappa test to compare our predicted subspecialty group to the residents' self-reported first choice. RESULTS Fifty-nine internal medicine residents at the University of Alberta participated between 2009 and 2010 with 46 Q sorts suitable for analysis. The residents loaded onto four factors (groups) based on how they ranked statements. Our prediction of each groups' desired subspecialties with their defining and/or distinguishing statements are as follows: group 1 - general internal medicine (variety in practice); group 2 - gastroenterology, nephrology, and respirology (higher income); group 3 - cardiology and critical care (procedural, willing to entertain longer training); group 4 - rest of subspecialties (non-procedural, focused practice, and valuing more time for personal life). There was moderate agreement (kappa = 0.57) between our predicted desired subspecialty group and residents' self-reported first choice (p < 0.001). CONCLUSION This study suggests that most residents fall into four groups based on a constellation of personal goals when choosing an internal medicine subspecialty. The key goals that define and/or distinguish between these groups are breadth of practice, lifestyle, desire to do procedures, length of training, and future income potential. Using these groups, we were able to predict residents' first subspecialty group with moderate success.
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Affiliation(s)
- Vijay J Daniels
- Department of Medicine, University of Alberta, Edmonton, Canada
| | - Narmin Kassam
- Department of Medicine, University of Alberta, Edmonton, Canada
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Abstract
This brief report summarizes Dr. Pao's talk at the 54th Annual Meeting of the Thomas L. Petty Aspen Lung Conference, in Aspen, Colorado, on June 11, 2011. In this talk, Dr. Pao discussed three main topics: (1) DETECT (DNA Evaluation of Tumors for Enhanced Cancer Treatment), (2) MyCancerGenome.org (web-based decision support), and (3) DIRECT (DNA-mutation Inventory to Refine and Enhance Cancer Treatment).
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Affiliation(s)
- Ryan D Madanick
- Center for Esophageal Diseases and Swallowing, Division of Gastroenterology & Hepatology, University of North Carolina School of Medicine, Chapel Hill, North Carolina 27599, USA.
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