FAIMER Research Scientist Marta van Zanten Publishes Article on Recognition of Accrediting Agencies

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An article about the evaluation and recognition of agencies that accredit medical education programs authored by FAIMER Research Scientist Marta van Zanten was recently published online by the journal Quality in Higher Education. Accreditation provides a level of legitimacy to medical education programs; however, the agencies responsible for accreditation may vary in their scope, governance, and the robustness and transparency of their decision-making processes. To enhance validity and comply with governmental and/or medical professional regulations, some agencies undergo external evaluations of their standards and protocols, a process commonly referred to as recognition. Dr. van Zanten’s article compares six European and United States-based recognition organizations that evaluate agencies that accredit medical education, highlighting similarities and differences in scope, processes, and consequences of review.

The article, titled “Recognition organisations that evaluate agencies accrediting medical education programmes: Quis custodiet ipsos custodes?” was published on August 30, 2017. The first 50 people to access the article will receive a free download of the entire manuscript.

WFME and FAIMER Staff Publish Article about the World Directory of Medical Schools

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An article about the World Directory of Medical Schools, coauthored by FAIMER Research Assistant Sarah Williams Leng and Barbora Hrabalová of the World Federation for Medical Education (WFME), was recently published on the European Consortium for Accreditation’s (ECA) online QAzette. To access the article, click here.

The World Directory of Medical Schools (World Directory) was launched in April 2014 by WFME and FAIMER, as the result of a March 2012 agreement to merge the organizations’ respective directories—FAIMER’s International Medical Education Directory (IMED) and WFME’s Avicenna Directory—to produce a single comprehensive resource on undergraduate medical education worldwide.

The World Directory is freely available at www.wdoms.org. Those interested can search for medical schools listed in the directory. In June 2016, WFME and FAIMER announced the launch of the World Directory Subscription Service. This service allows regulatory authorities, researchers, and other interested subscribers access to download a wealth of information from the World Directory for an annual fee. Available information includes medical schools’ years of operation, academic affiliations, and curriculum details. Data files are available for download in CSV or XML format and are updated daily.

Questions and new listing requests may be sent to the World Directory staff at info@wdoms.org.

FAIMER-Authored Article Is Subject of Recent Key Literature in Medical Education (KeyLIME) Podcast

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An article authored by FAIMER President John Norcini and several other FAIMER staff members was the subject of a recent Key Literature in Medical Education (KeyLIME) podcast by the Royal College of Physicians and Surgeons of Canada. The article, titled “The Relationship Between Licensing Examination Performance and the Outcomes of Care by International Medical School Graduates,” appeared in the August 2014 issue of Academic Medicine. The 20-minute podcast can be accessed on the Royal College of Physicians and Surgeons of Canada website.

FAIMER Fellows Collaborate to Publish New Book on Community Based Education

Posted on Categories FAIMER faculty, Fellows, publicationsTags

cover-cbe-bookFAIMER is proud to announce the publication of a new book on community based education (CBE) authored by Wagdy Talaat, M.D., Ph.D., and Zahra Ladhani, Ph.D., both FAIMER faculty members and Fellows of the 2007 FAIMER Institute. Titled Community Based Education in Health Professions: Global Perspectives, the book was published in January 2014 by the World Health Organization: Regional Office for the Eastern Mediterranean.

To compile experiences of CBE, the authors invited contributions from health professions education institutions in six countries: Bangladesh, Brazil, Egypt, India, Pakistan, and South Africa. The selected institutions were invited to share stories about the implementation of CBE at their schools, to illustrate how different tools and approaches have worked in a variety of local circumstances. By documenting and sharing these varied experiences, the authors hope that their book will help guide and inspire other educators and community workers interested in implementing CBE programs.

The book’s contributors include FAIMER Fellows Valdes Bollela (PHIL 2006) from Brazil, Dina El-Metwally (PHIL 2010) from Egypt, and Ben van Heerden (PHIL 2006) from South Africa. “The publication of this book marks a major collaborative project led by our Fellows,” says Page Morahan, Ph.D., Co-Director of the FAIMER Institute.

To learn more about and/or access the book, click here.

Study Highlights Contribution of Caribbean-Educated Physicians to U.S. Primary Care Workforce

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The projected shortage of primary care physicians in the United States is well documented, and current trends indicate that the numbers of graduates of U.S. medical schools may not be sufficient to fill these roles. FAIMER Research Scientist Marta van Zanten and FAIMER Associate Vice President for Research and Data Resources John R. Boulet quantify the contribution that graduates of Caribbean medical schools make to the U.S. primary care workforce in their recently published paper:

van Zanten M, Boulet JR. Medical education in the Caribbean: The contribution of Caribbean-educated physicians to the primary care workforce in the United States. Academic Medicine. 2013;88(2):276-81

Findings in the study indicate that graduates of Caribbean medical schools make an important contribution to the U.S. primary care workforce. Specifically, the authors used the American Medical Association Physician Masterfile and ECFMG data to determine the numbers of physicians providing direct patient care. They classified these physicians according to type of medical school from which they graduated, and then calculated frequencies and percentages of self-designated primary care specialties for each physician classification. Results of the study show that graduates of Caribbean medical schools had the highest proportion of physicians practicing primary care, followed by D.O., all other IMGs, and lastly, graduates of U.S. M.D.-granting schools.

FAIMER Faculty Members Tejinder Singh and Anshu Publish Book on Assessment in Medical Education

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FAIMER faculty members Tejinder Singh (Director, CMCL-FAIMER Regional Institute; PHIL 2003; IFME 2006) and Anshu (CMCL 2007, PHIL 2009, IFME 2012) served as co-editors of the book Principles of Assessment in Medical Education, published by Jaypee Brothers in March 2012. The book, a sequel to an earlier book entitled Principles of Medical Education, provides a scientific approach to the assessment of clinical competence, with particular emphasis on the use of assessment to promote learning in Indian medical schools. The book contains a foreword written by Bill Burdick (FAIMER Associate Vice President for Education and Co-Director of the FAIMER Institute), as well as chapters authored by FAIMER President and CEO John Norcini, and FAIMER faculty members B.V. Adkoli, Payal Bansal (PHIL 2007, IFME 2010), Janet Grant, Zahra Ladhani (PHIL 2007), Ciraj Ali Mohammed (CMCL 2008, PHIL 2010), Supten Sarbadhikari (PSG 2007), Avinash Supe (Director, GSMC-FAIMER Regional Institute; PHIL 2002; IFME 2007), Ara Tekian, and Rashmi Vyas (PHIL 2003, IFME 2005).

For more information on Principles of Assessment in Medical Education, visit:http://jaypeebrothers.com/pgDetails.aspx?cat=s&book_id=978-93-5025-885-9#.

FAIMER Fellows Continue to Work on “Really Good Stuff”

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The November 2010 issue of Medical Education contains the latest collection of “Really Good Stuff,” a peer-reviewed compilation of short, structured reports, published semiannually, on new ideas in medical education, including curriculum design, teaching practice, and assessment. Included in the current issue are six reports on the innovation projects of FAIMER Fellows (bold font):

“A Way to Assess Students’ Clinical Reasoning”
Iêda M. B. Aleluia (BRAZ 2009), Paulo M. Carvalho, Jr. (PHIL 2006), Marta S. Menezes (BRAZ 2007)

“Community-based Cervical Cancer Prevention in the Western Amazon”
José O. Ferrari (BRAZ 2009)

“Using Appreciative Inquiry on Learning Styles to Facilitate Student Learning”
Latha Rajendra Kumar (PSG 2009), Thomas V. Chacko (PHIL 2004, IFME 2006)

“Teaching Community-based Palliative Care to Medical Students”
Sairu Philip (PSG 2009), Ayshabeevi Remlabeevi

“Virtual Microscopy as a Teaching Tool Adjuvant to Traditional Microscopy”
Seema Raja (PSG 2009)

“Identification of Social Determinants of Health Components for Teaching: A Pilot Process”
Yegnanarayanaiyer S. Sivan (PSG 2009), Thomas V. Chacko (PHIL 2004, IFME 2006), Pandian Subramaniyan

Study Finds Non-U.S. Citizen International Medical Graduates Provide Same Quality of Care as Physicians Educated in the United States

Posted on Categories health professions education, publications, researchTags , , , , ,

Internationally trained physicians are key members of the U.S. physician workforce. The United States has not produced enough nationally educated physicians to meet the country’s health care demands for some time, and internationally trained physicians have made up for this shortfall, comprising approximately 25% of the total U.S. physician workforce. Despite a rigorous certification process, questions have persisted concerning the quality of care that these physicians provide. A new study, published in the August issue of Health Affairs and authored by a team led by FAIMER President and CEO John Norcini, examines the performance of internationally trained physicians compared to their U.S. counterparts, and addresses those concerns:

“Evaluating the quality of care provided by graduates of international medical schools” (Health Affairs, 29(8):1461-1468)
John J. Norcini, Ph.D., FAIMER President and CEO
John R. Boulet, Ph.D., FAIMER Associate Vice President for Research and Data Resources
W. Dale Dauphinee, M.D., FAIMER Senior Scholar
Amy Opalek, M.S., FAIMER Data Resource Specialist
Ian D. Krantz, M.D., Member, FAIMER Board of Directors and Chair, Educational Commission for Foreign Medical Graduates Board of Trustees
Suzanne T. Anderson, Trustee-at-Large, Educational Commission for Foreign Medical Graduates Board of Trustees

The study analyzed 244,153 hospitalizations of patients with congestive heart failure or acute heart attack in Pennsylvania from 2003 to 2006. Patients were treated by physicians who specialized in family medicine, internal medicine, or cardiology. Each physician fell into one of three groups: U.S. medical graduates, U.S. citizen international medical graduates, and non-U.S. citizen international medical graduates. The composition of physicians in the study closely matched that of the total U.S. physician workforce: Approximately 75% of the 6,113 doctors were U.S. medical graduates, with the remaining 25% educated abroad. Of the physicians educated abroad, approximately 75% were non-U.S. citizens and 25% were U.S. citizens.

The study examined both mortality rates and hospital lengths-of-stay as indicators of the quality of care that physicians provide. Among the three groups, in-hospital death rates differed significantly. Non-U.S. citizen international graduates were associated with a 16% decrease in mortality relative to U.S. citizen international graduates and a 9% decrease relative to U.S. graduates. Patients of U.S. medical graduates had the shortest hospital lengths-of-stay, while patients of U.S. citizen international graduates had the longest. The length-of-stay of patients of non-U.S. citizen international graduates was only slightly higher than that of U.S. graduates, indicating little practical difference.

These results provide a measure of confidence in the care provided by non-U.S. citizen internationally educated physicians and highlight the important contribution that they make to the U.S. health care system. As Dr. Norcini points out, “It is reassuring to know that patients of these doctors receive the same quality of care that they would receive from a physician trained in the United States.” He adds, “These findings bring attention to foreign-trained doctors and the valuable role they have played in responding to the nation’s physician shortage.”

Still, the findings concerning internationally trained U.S. citizens elicit a moment of pause. Why did these physicians fare less well in the study? The authors speculate that some of them may seek their education abroad because they were unable to enter U.S. medical schools due to lower grades and/or test scores. Alternately, the quality of education provided at some of the schools attended by these physicians may be of a lower standard than at schools attended by physicians in the other two groups. There may be other explanations as well, and additional research is warranted. Regardless, as U.S. medical schools expand enrollment to combat the shortage of home-educated physicians, some of the students who might have otherwise gone abroad may apply to medical schools in the United States. If that happens, U.S. schools will need to maintain high admission standards to ensure the quality of the physician pool. Further compounding the issue is a lack of proportionate growth in graduate training programs to complement the expansion of medical schools. As Dr. Norcini points out, “If this continues, the current physician shortages will persist and the numbers of foreign-trained doctors will likely decrease significantly.”

In addition to its findings concerning the three separate groups of medical graduates, the study also provided insights applicable to the general physician population. The authors found that in-hospital mortality rates and hospital lengths-of-stay increase with the number of years following graduation from medical school, whereas specialty board certification was associated with lower mortality and shorter hospital stays. These findings point to the need for ongoing training and periodic assessment throughout a physician’s career to maintain a high level of competence, an important consideration for all doctors, regardless of where they received their education.

New Textbook on Medical Education

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Presented by the Association for the Study of Medical Education (ASME), Understanding Medical Education: Evidence, Theory and Practice is a new, comprehensive textbook on medical education scheduled to be available from Wiley-Blackwell publishers in August 2010. Edited by Tim Swanwick, Director of Professional Development in the London Deanery, Visiting Fellow at the Institute of Education, and Visiting Professor of Medical Education at the University of Bedfordshire, the book is designed to be an accessible reference for students and practitioners of medical education at all levels: from undergraduates to those pursuing continuing professional development.

Understanding Medical Education includes chapters on teaching and learning, problem-based learning, personal development, e-learning, mentoring, group encounters, simulation, test design, research, assessment, and leadership, among others. Also included are three chapters contributed by FAIMER staff and faculty:

“Principles of Curriculum Design”
Janet Grant (Professor of Education in Medicine at The Open University, FAIMER faculty member)

“Workplace Assessment”
John Norcini (FAIMER President and Chief Executive Officer)

“Structured Assessments of Clinical Competence”
Kathy Boursicot, Trudie Roberts, and Bill Burdick (FAIMER Associate Vice President for Education and Co-Director of the FAIMER Institute)

For more information, including a complete table of contents, please visit http://www.wiley.com/WileyCDA/WileyTitle/productCd-1405196807.html.

Fellows and Faculty Working on Some “Really Good Stuff”

Posted on Categories FAIMER faculty, Fellows, journals, publicationsTags ,

The May 2010 issue of Medical Education contains the latest collection of “Really Good Stuff,” a peer-reviewed compilation of short, structured reports, published semiannually, on new ideas in medical education, including curriculum design, teaching practice, and assessment. Included in the current issue are eight reports on the innovation projects of 2008 FAIMER Institute Fellows. Following are all reports by FAIMER Fellows (bold blue font) and faculty (bold black font):

“Teaching Anatomy with Digital Self-learning Modules”
Ashwini C. Appaji (PSG 2008), Roopa Kulkarni, Anupama Poojar, Kalaivani Vinayagam

“Needs Assessment as a Strategic Planning Tool”
Payal K. Bansal (PHIL 2007), Savita Marathe (GSMC 2008), Prakash M. Shere, Mrudula A. Phadke

“Developing a Web-based Multiple-choice Question Item Bank”
S. Ayhan Çaliskan (PHIL 2008), H. Ibrahim Durak, S Elif Törün, Ö. Sürel Karabilgin

“Epidemiology Training Needs Assessment in Vietnam”
An T. M. Dao (PHIL 2008), Le T. Huong, Huy V. Nguyen, Luu N. Hoat

“Mentored Student Project for Inculcating Research Skills”
Vasudha Devi, Reem R. Abraham (PSG 2007), Sachidananda Adiga, Ramnarayan Komattil

“Optimising Feedback Using the Mini-CEX during the Final Semester Programme”
Sari P. Dewi (PHIL 2008), Tri H. Achmad

“Structuring an Internship Programme for Enhanced Learning”
Harpreet Kapoor (CMCL 2006, PHIL 2008), Ara Tekian, Stewart Mennin

“Student Learning Experiences in a Diversified Academic Environment”
Dianne Manning (PHIL 2008), Danette McKinley, Shalote Chipamaunga

“Utilising Assessment as a Drive for Changing Teaching”
Valéria G. F. Pinheiro, Elcineide S. Castro, Luiz E. A. Troncon

“Academic Counselling for Undergraduate Medical Students of Pharmacology”
Anupama Sukhlecha (CMCL 2008)

“Improving Assessment of Evidence-based Medicine Skills in Medical Students”
John Tumbo (PHIL 2008)

“Using Positive Deviance to Improve Student Performance”
Zareen Zaidi (PHIL 2008), Tara Jaffery (PHIL 2005), Shaheen Moin