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This Week in JAMA
JAMA. 2004;292:1007.
MEDICAL EDUCATION
Edited by Catherine D. DeAngelis, MD, MPH
US Medical Education, 2003-2004
Data from annual surveys of undergraduate and graduate medical education programs conducted by the Liaison Committee on Medical Education, the American Medical Association, and the Association of American Medical Colleges are summarized in this issue of JAMA. First, Barzansky and Etzel (SEE ARTICLE) report that in comparison with data from 1993-1994, medical school enrollment is similar while the number of full-time faculty has increased and appointment of a senior administrator with broad responsibilities for medical education is commonplace. In the second article, Brotherton and colleagues (SEE ARTICLE) report trends in residency training and career choices, with a particular focus on women, and programs addressing cultural competence and complementary/alternative medicine.
Specialty Certification and Quality Improvement
Efforts to improve the quality of medical care are often systems-based and few have considered the role of physician certification in quality improvement. Brennan and colleagues review the evidence and theory relating to physician board certification status and measures of physician competence, clinical outcomes, and error prevention and find support for the hypothesis that certification and maintenance of certification will improve quality. They also report results of a national poll assessing public views on physician certification, which found that certification and frequent reevaluation of skills and competencies to maintain certification are highly valued by the public.
(SEE ARTICLE)
Assessing Educational Program Effectiveness
Clinical medicine is becoming increasingly evidence-based, but rigorous and generalizable data to substantiate the effectiveness of medical education programs are limited. Carney and colleagues review the application of standard, population-based epidemiologic research designs to test hypotheses about medical education outcomes. They also outline 3 essential elements—an existing infrastructure, institutional motivation, and a national commitment that includes increased funding—necessary for a strong educational epidemiologic research endeavor.
(SEE ARTICLE)
Detection and Risk of Breast Cancer Recurrence
Studies of prognosis following breast cancer suggest that women whose cancer was found by mammography screening have a better prognosis than women whose tumors were found outside of screening or between mammography screening rounds. However, the mode of detection is not currently a factor in determining the need for systemic adjuvant therapy. Joensuu and colleagues (SEE ARTICLE) examined the risk of recurrence and survival among Finnish women whose breast tumors were detected by mammography screening compared with women whose tumors were found by other methods. They found a significantly increased risk of recurrence in women whose tumors were found other than by mammography screening, and method of detection was found to be an independent predictor of distant disease-free survival and overall survival. In an editorial, (SEE ARTICLE) O'Regan discusses the potential value of these results to identify women who will benefit most from systemic adjuvant therapy.
A Piece of My Mind
"Diseases are easy. Life in a refugee camp is not." From "Clinic."
(SEE ARTICLE)
Liability Issues in GME
On Call: Issues in Graduate Medical Education
Current and emerging professional liability issues relevant to resident and attending physicians and institutions involved in graduate medical education (GME) are reviewed.
(SEE ARTICLE)
Commentary
Education in ambulatory chronic disease management needs emphasis and improvement.
(SEE ARTICLE)
Editorial
The importance of "professors who profess" and the challenges they face are discussed by DeAngelis.
(SEE ARTICLE)
CLINICIAN'S CORNER
Systolic Hypertension
Clinical Review
Clinical management of systolic hypertension in older persons.
(SEE ARTICLE)
JAMA Patient Page
For your patients: Information about academic health centers.
(SEE ARTICLE)
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