ABSTRACT

Background

Cultural competency training provides participants with knowledge and skills to improve cross-cultural communication and is required for all graduate medical education (GME) training programs.

Objective

The authors sought to determine what cultural competency curricula exist specifically in GME.

Methods

In April 2020, the authors performed a scoping review of the literature using a multidatabase (PubMed, Ovid, MedEdPORTAL) search strategy that included keywords relevant to GME and cultural competency. The authors extracted descriptive data about the structure, implementation, and analysis of cultural competency curricula and analyzed these data for trends.

Results

Sixty-seven articles met criteria for inclusion, of which 61 (91%) were focused exclusively on residents. The most commonly included specialties were psychiatry (n=19, 28.4%), internal medicine (n=16, 23.9%), and pediatrics (n=15, 22.4%). The shortest intervention was a 30-minute online module, while the longest contained didactics, electives, and mentoring programs that spanned the entirety of residency training (4 years). The sample sizes of included studies ranged from 6 to 833 participants. Eight (11.9%) studies utilized OSCEs as assessment tools, while 17 (25.4%) conducted semi-structured interviews or focus groups. Four common themes were unique interventions, retention of learning, trainee evaluation of curricula, and resources required for implementation.

Conclusions

Wide variation exists in the design, implementation, and evaluation of cultural competency curricula for residents and fellows.

ABSTRACT

Background

Under the single GME accreditation system, residency programs receive applicants from MD- and DO-granting medical schools, each of which have their own set of licensing examinations, making concordance studies increasingly relevant. Previous studies comparing Comprehensive Osteopathic Medical Licensing Examination of the United States (COMLEX-USA) and United States Medical Licensing Examination (USMLE) scores have been limited in sample size and examinee composition and have yielded comparisons that may not be generalizable across all applicants. Some osteopathic medical students take USMLE in addition to COMLEX-USA, often at considerable cost and effort, with the aim of making themselves more desirable to potential residency programs. Having more reliable comparisons of COMLEX-USA and USMLE scores would allow program directors to better estimate a score on the alternate examination.

Objective

To derive an accurate concordance between COMLEX-USA and USMLE scores, based on a large sample of osteopathic students who took both examinations.

Methods

Five colleges of osteopathic medicine, representing various regions of the United States, participated in this study. The data included demographics and COMLEX-USA and USMLE scores from September 2015 through August 2020 for students who took both examinations. We derived the concordance between COMLEX-USA and USMLE scores using equipercentile matching.

Results

Comparisons of demographic characteristics showed only minor differences between the sample and the overall population for COMLEX-USA takers, although scores for the study sample were, on average, greater.

Conclusions

A strong association exists between the scores on the COMLEX-USA and USMLE examinations, allowing prediction of performance on USMLE from COMLEX-USA.

ABSTRACT

Background

The COVID-19 pandemic affected graduate medical education (GME) by decreasing elective procedures and disrupting didactic learning activities in 2020. Editorials have hypothesized that resident physicians worked fewer hours, therefore losing valuable experience, but we are not aware of studies that have objectively assessed changes in hours worked.

Objective

This study aims to identify differences secondary to the COVID-19 pandemic in resident work hours across all specialties at 3 geographically dispersed, integrated academic hospitals in a large sponsoring institution.

Methods

We obtained de-identified work hour data from all residency programs at Mayo Clinic in Arizona, Florida, and Minnesota. Resident work hours were compared between 2020 and 2019 from March to May.

Results

Work hours for 1149 and 1118 residents during the pandemic and control periods respectively were compared. Decreases in resident work hours were seen, with the largest decrease demonstrated in April 2020 when 19 of 43 programs demonstrated significantly decreased work hours. Residents worked more hours from home in April 2020 compared to the previous year (Arizona: mean 1 hour in 2019 vs 5.2 hours in 2020, P<.001; Florida: mean 0.7 hour in 2019 vs 6.5 hours in 2020, P<.001; Minnesota: mean 0.8 hour in 2019 vs 10.2 hours in 2020, P<.001).

Conclusions

The COVID-19 pandemic was associated with a decrease in work hours in some, but not all, specialties. The decrease in on-site work was only partially offset by an increased number of hours worked from home.

The Challenge

Health disparities in minoritized populations—African American/Black, Latinx, Indigenous, LGBTQ+, and individuals with disabilities—are well documented. Accrediting organizations and professional societies have recommended diversifying the physician workforce as one way to address these health disparities. Yet responding to these calls, using evidence-based approaches, can be nerve-racking and resource-challenging. Efforts are further complicated by the reality that each training program and community has its own unique diversity profile that must be strategically integrated into plans for increased workforce diversity through recruitment of trainees from underrepresented in medicine (UiM) and LGBTQ+ identity groups, as well as individuals with disabilities.

What Is

The Accreditation Council for Graduate Medical Education (ACGME) is pleased to announce the recipients of the 2022 ACGME Awards, who will be honored during the 2022 Annual Educational Conference, being held virtually March 30–April 1, 2022. Congratulations to all the awardees!

John C. Gienapp Award

Awarded to a notable individual for exemplary contributions to graduate medical education

Kenneth M. Ludmerer, MD, Washington University School of Medicine, St. Louis, Missouri

Barbara Ross-Lee, DO Diversity, Equity, and Inclusion Award

Awarded to ACGME-accredited Sponsoring Institutions and programs, as well as specialty organizations, working to diversify the underrepresented physician workforce and create inclusive workplaces