Abstract

Mentorship is critical to the professional success of physicians, physicians-in-training, and junior faculty in academic practice. There are challenges to being a thoughtful and effective mentor and to being an engaged mentee. Many physicians and physicians-in-training cite difficulty finding professional time to dedicate to building their mentoring relationships, particularly given demanding clinical workloads and competing time commitments. Therefore, making the most out of the time in mentoring relationships is key to success. We present a collection of frustrations and good advice that have been passed between mentees and mentors on improving the mentor-mentee relationship. The information was compiled from actual interactions between mentors and mentees, and these “love letters” draw on complex associations, which like any “committed” relationship require constant reevaluation and discussion to bring them to their full potential.

Abstract

We explore the history behind the current structure of graduate medical education funding and the problems with continuing along the current funding path. We then offer suggestions for change that could potentially manage this health care spill. Some of these changes include attracting more students into primary care, aligning federal graduate medical education spending with future workforce needs, and training physicians with skills they will require to practice in systems of the future.

Abstract

Objectives

The purpose of this study is to systematically review the literature on the prevalence of patient assaults against residents in all specialties, and to identify curricula that address this issue.

Methods

The authors searched published English-language literature using PubMed and Scopus databases using key terms including “patient,” “assaults,” “threats,” “violence,” “aggression,” and “residents.” A separate search to identify curricula used the same terms in combination with key words including “curriculum,” “didactics,” and “course.” Bibliographies of studies found by electronic searches were also searched manually.

Results

Fifteen studies met the inclusion criteria. Of these, 7 were conducted on psychiatry residents alone, 6 assessed assaults on residents in nonpsychiatric specialties, and 2 reported cross-specialty data. The prevalence of assaults was defined as the percentage of residents who have experienced at least one assault. The prevalence of physical assaults on residents was 38% in surgery, 26% in emergency medicine, 16% to 40% in internal medicine, 5% to 9% in pediatrics, and 25% to 64% in psychiatry. All studies were cross-sectional; none collected data prospectively. Definitions of assault were heterogeneous or not specified. Few of the assaults were reported to clinical supervisors or training directors, and no programs had a formal reporting process. Approximately 21% to 79% of psychiatry residents and 30% of residents in other specialties had received some training on how to manage violent patients. We found no descriptions of formal curricula for managing the possibility of patient violence against residents or for preparing for the aftermath.

Conclusions

Although the data are limited, assaults by patients are commonly experienced by residents in training. There is a paucity of information and curricula that pertain to reducing the prevalence of these incidents and to addressing potential psychologic consequences, especially in nonpsychiatric specialties.

The European Commission has stated that antimicrobial resistance now takes the lives of approximately 25 000 patients each year throughout the European Union.1

While investing in research will ultimately lead to the discovery of new antimicrobial agents, basic educational groundwork is likely to be just as important.

Prescribing antibiotics inappropriately is the major cause of antibiotic resistance.2

Two years ago, in a 1000-bed North East General Hospital, I audited, with Hospital approval, the application of diagnostic criteria for community-acquired pneumonia (CAP) and acute exacerbation of chronic obstructive pulmonary disease and subsequent compliance with Hospital antimicrobial policy. While 92% of