Internship and Residency

Publication Title: 
Academic Psychiatry: The Journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry

OBJECTIVE: As it is increasingly recognized that cultural competence is an essential quality for any practicing psychiatrist, postgraduate psychiatry training programs need to incorporate cultural competence training into their curricula. This article documents the unique approach to resident cultural competence training being developed in the Department of Psychiatry at the University of Toronto, which has the largest residency training program in North America and is situated in an ethnically diverse city and country.

Author(s): 
Fung, Kenneth
Andermann, Lisa
Zaretsky, Ari
Lo, Hung-Tat
Publication Title: 
Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie

The relation between religion and (or) spirituality (RS), and mental health has shown generally positive associations; however, it is a complex and often emotion-laden field of study. We attempt to examine potential mechanisms that have been proposed as mediators for the RS and mental health relation. We also examine more philosophical areas including patient and physician opinions about inclusion of RS in patient care, and ethical issues that may arise.

Author(s): 
Baetz, Marilyn
Toews, John
Publication Title: 
Journal of Dental Education

If it is not a naÔve expectation for dentists who have been beneficiaries of public generosity to share their good fortune with the public that made it possible, there may be a rational basis for enhancing the role of dental education in improving access to oral health care by promoting-but not requiring-a voluntary service commitment after graduation commensurate with the magnitude of the subsidy received.

Author(s): 
Bertolami, Charles N.
Berne, Robert
Publication Title: 
The Journal of Medicine and Philosophy

The author contends that overworking residents cannot be ethically justified. There is evidence that overwork is detrimental both to the resident and to the patient. In addition, the argument that working long hours is essential to maintain medicine's status as a profession is analyzed. The claim cannot be supported by definitions of professionalism. Although Flexner's definition does specify altruism as an essential component, it does not justify long working hours for residents.

Author(s): 
Ritchie, K.
Publication Title: 
The Journal of Medicine and Philosophy
Author(s): 
Boisaubin, E. V.
Publication Title: 
Obstetrics and Gynecology

Access to abortion services in the United States has become increasingly limited because of a decrease in rural hospital providers and a growing shortage of clinicians willing to offer this service. As of 1988, 83% of United States counties had no identified provider. The deficit in numbers of clinicians stems from the current imbalance between incentives and disincentives. The single most powerful incentive appears to be altruism. On the other hand, disincentives include poor pay, frequent harassment, low prestige, suboptimal working conditions, and tedium.

Author(s): 
Grimes, D. A.
Publication Title: 
The Australian and New Zealand Journal of Psychiatry

Successive cohorts of interns assigned to a Sydney teaching hospital since 1987 were interviewed at the beginning and end of their intern year to document factors influencing career choice and psychological morbidity, with comparisons between the graduates of the three NSW medical faculties. Intellectual challenge and altruism were the two most reported motivating factors in choosing Medicine. Many interns expressed regret at their career choice. Apart from anger, self-reported psychological morbidity during internship was low.

Author(s): 
Hume, F.
Wilhelm, K.
Publication Title: 
Academic Medicine: Journal of the Association of American Medical Colleges

PURPOSE: To assess a scale that measures professional attitudes and behaviors associated with the medical education and the residency training environment. METHOD: In 1995-96, the authors surveyed medical students and residents from five institutions in the northeast region of the United States. RESULTS: Of 757 distributed questionnaires, 565 were returned (75% response rate). Of those, 529 (94%) were used in the analysis. The mean score for the retained 12 items was 92.9 (SD, 11.9), with higher scores indicating more positive perceptions.

Author(s): 
Arnold, E. L.
Blank, L. L.
Race, K. E.
Cipparrone, N.
Publication Title: 
Cambridge quarterly of healthcare ethics: CQ: the international journal of healthcare ethics committees

Exploitation of resident physicians still occurs and can result in working conditions so unfavorable that patients are endangered. Because residents are vulnerable to exploitation, and because they are not fully accountable for patient care or for fully developed professionalism until they have completed their training, for just ends it is morally acceptable for residents to strike.

Author(s): 
Braithwaite, S. S.
Publication Title: 
American Journal of Physical Medicine & Rehabilitation

A 12-item questionnaire modeled after the one prepared by the American Board of Internal Medicine dealing with professionalism was distributed to 122 physiatry residents representing six training programs, of whom 59% (72) responded. The mean item score on the survey was 7.7 (SD = 1.0) on a scale from 1 to 10, where 10 represents the highest level of professionalism. The internal reliability of the questionnaire was found to be satisfactory (Cronbach's alpha = 0.75). A factor analysis of the questionnaire items resulted in three factors explaining 64% of the variance.

Author(s): 
DeLisa, J. A.
Foye, P. M.
Jain, S. S.
Kirshblum, S.
Christodoulou, C.

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