The HIV epidemic and training in internal medicine: challenges and recommendations

Article Abstract:

Acquired immunodeficiency syndrome (AIDS) is a disease compromising the ability to fight off disease. How the AIDS epidemic is affecting medical education has not been studied. Training programs in internal medicine are faced with some new issues concerning the AIDS epidemic. Medical personnel are rightfully concerned about contracting the disease while caring for infected patients. This is the first time in many years that healthcare professionals have been at increased risk while caring for patients. There is some concern that one effect of the epidemic will be reduced educational experience of medical students with caring for similar patients. The high numbers of AIDS patients at hospitals serving medical schools may discourage prospective medical students from applying. There are many prejudices against caring for AIDS patients. Because the disease is not curable, the caretakers often feel frustrated and anxious; additional anxiety can arise from caring for homosexuals and drug addicts. Individuals being trained are faced with new ethical issues and responsibilities. On the other hand, caring for AIDS patients can help restore the wounded physician-patient relationship, and can contribute to experience with technological approaches and in collaborating with other healthcare professionals. The special challenge of caring for AIDS patients must be dealt with by the medical community and efforts should be made to reduce the associated stress, frustration and discouragement experienced in medical training programs.

author: Sande, Merle A., Cooke, Molly
Evaluation, Beliefs, opinions and attitudes, Ethical aspects, Study and teaching, Internal medicine, AIDS phobia

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Sexual harassment in medical training

Article Abstract:

The incidence of sexual harassment among medical students and residents appears to be high and may create an environment that is hostile to learning and working. Sexual harassment can be non-physical or physical and includes behavior such as offensive comments or displays, unwanted attention, offensive body language and sexual bribery. Altogether, 43% of 82 medical residents surveyed had been sexually harassed. Among the 33 women, almost 75% reported being sexually harassed, and many were harassed more than once. Eleven of the 49 men reported being sexually harassed. Unlike the women, men were more likely to have been harassed during residency than during medical school. Only two women and none of the men reported an episode of sexual harassment to an authority. Among the women, 77% said they did not report harassment because they did not think they would be helped, whereas 82% of the men said they did not report harassment because they had resolved the problem without outside help.

author: Sande, Merle A., Bindman, Andrew B., Haber, Richard J., Komaromy, Miriam
Surveys, Sexual harassment, Residents (Medicine)

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American medical education 100 years after the Flexner report

Article Abstract:

Medical education has been criticized from the early 1900s to the present, for emphasizing scientific knowledge over biologic understanding, critical reasoning, practical skill, development of character, compassion and integrity. Increasing emphasis is placed on evidence-based practice, system approaches and quality improvement. Advances in these areas require the ability to integrate scientific discoveries and context-specific experimentation for continuous improvement of the processes of medical practice.

author: Ludmerer, Kenneth M., Cooke, Molly, Irby, David M., Sullivan, William
Forecasts, trends, outlooks, Product quality, Personnel administration, New England States, Methods, Medicine, Forecasts and trends, Training, Quality management, Market trend/market analysis, Medical practice

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subjects list: Medical students, Medical education
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