What Keeps Medical Educators Awake at Night  

This question was the basis for a session at the annual meeting of the Association of American Medical Colleges in November 2013. Before any presentation or discussion, the very first activity for session participants was to put their answer to this question on an index card. Take a moment to write down your answer to this question... commit your problem/concern/fear/question to paper. If you can't decide, don't worry: some conference participants completed multiple index cards. Take the next step; submit your reply anonymously using this link. In the next newsletter we will provide an update of what is keeping CHM awake at night.

At the conference session all of the index cards were collected and while the discussion was underway, the cards were collated by themes. I realize that there are many ways to group these types of responses, but what group of concerns that keep medical educators awake at night do you think emerged as the largest category?

The session participants generated a list of over 100 issues in response to the question of what keeps them up at night, and the largest group of concerns focused on faculty. Faculty's concerns about themselves ranged from balancing to competing work demands to the struggles of work-life balance. They cited concerns related to mentoring, the morale of colleagues and buy-in for medical education as recurring themes. A number of them also wondered where the next generation of medical educators would come from.

Sleepless nights related to curriculum and curriculum change was the second largest group of concerns. "What should we be teaching," "are we creating good students or good doctors," and "are we preparing our students for health care models of the future" were common concerns expressed in this category.

Medical students were the focus of the third largest category of concerns for insomniacs. "How to address issues related to professional behavior", "identifying and supporting struggling students," "engaging students in their education", and "supporting medical students to make sounds career choices" were among the many ideas written by the participants. Of course there were other groupings related to technology, administration and leadership, and scholarship that concerned session participants.

The session provided participants with relief that they were not alone with their fears and in fact many were energized to learn that they individually or institutionally were not unique in the problems that they faced. Look back at your answer to the question. It is very likely that someone else shares sleepless nights for the same reason: the complete list generated by the conference participants can be downloaded here. This list, although generated informally, suggests many avenues for scholarship in terms of developing best practice models, empirical studies, resource sharing and collaboration. Perhaps John Lennon was right, "Who's to say that dreams and nightmares aren't as real as the here and now?" Not too late to add your dreams and nightmares to the CHM list using this link.

Associate Professor and Director
Office of Medical Education Research and Development
College of Human Medicine  

More information and articles available at: http://libraries.rbhs.rutgers.edu/rwjlbweb/drmerlistnew.html    

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Serving the People: Outcomes of the U.P. Rural Physician Program  

The Upper Peninsula is a primarily rural and medically underserved region of Michigan that makes up 29% of the state's land area and is home to 3% of the state's population. In 1974, CHM began the Rural Physician Program (RPP) as a specialized a rural training option, with a goal of increasing the number of rural primary care physicians and physicians that specifically serve rural Upper Peninsula communities.

As CHM has expanded the class size, explored new certificate options and works towards developing a new curriculum, the time was right to document the success of the RPP. Using data from the AMA Masterfile for CHM graduates, the rates of primary care specialty choice, rural practice location, and Michigan residence for RPP-trained physicians were compared to CHM graduates who did not participate in the program. In Phase 1 of the project, outcomes were reviewed for graduates from 1996 to 2006, the most recent decade of graduates for which practice data are available.

RPP graduates (56%) were more likely than other CHM graduates (42%) to choose Family Medicine, Pediatrics and Internal Medicine as practice specialties, and CHM overall exceeds graduates nationally (32%) in this regard. RPP graduates were more likely than other CHM graduates to practice in rural communities (42% vs 13%) and to practice in Michigan (55% vs 40%). Non-RPP CHM graduates are representative of national trends in terms of rural and in-state practice. It is important to keep in mind that RPP participation is optional and interested students must apply to the program before matriculation.  

Similarly, the RPP selection process identifies students interested in a rural lifestyle, and they are likely over-represented among RPP graduates compared to CHM graduates overall. Despite these limitations, this sample of recent graduates suggests that the RPP is successful in encouraging students to practice primary care in rural Michigan settings. 

In this issue of VitalSigns we continue a series of articles highlighting items from CHM Educator, OMERAD's website collection of teaching resources. 

An interactive gallery featuring examples of CHM blended and online learning projects by B-CLR.

CHM Educator

A website with Information to help you teach, whether in a classroom or in a clinic.

DR-ED 

A medical education listserv maintained by OMERAD.

Medical Education Online (MEO)  

Peer-reviewed international open access journal for disseminating information on the education and training of physicians and other health care professionals.

Vital Signs Newsletter Archive

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Medical Education Scholarship Group

Meets first Wednesday of each month in room A116 East Fee Hall from 1:30 pm-3:00 pm.For questions about this group contact Dr. Brian Mavis:[email protected]

OMERAD Technology Center (OTC)  

John Williamson ([email protected])