Mattes Malcolm D, Ferrari Iii Norman D
Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, USA.
Medical Education, West Virginia University School of Medicine, Morgantown, USA.
Cureus. 2022 Apr 29;14(4):e24583. doi: 10.7759/cureus.24583. eCollection 2022 Apr.
Each year, the United States National Resident Matching Program describes the relative importance of a number of factors in the residency match for each speciality. However, the impact of disciplinary actions taken by a school when a student fails to meet certain expectations is not specifically evaluated but may have a major impact on a physician's future performance.
This study used electronic surveys sent to deans of medical education and residency program directors (PDs) to assess the way disciplinary actions are used at US allopathic medical schools, and the perceived implications of those actions on the residency match.
Thirty-three deans and 158 PDs participated (response rates of 26% and 22%, respectively). The median percentage of students put on probation each year as a function of class size was 3.3% (interquartile range [IQR] 2% to 6%). Three institutions reported putting greater than 10% of their students on probation each year and one institution reported putting 22% of their students on probation each year. A student's risk of failing to match was thought to be very or extremely likely (to deans and PDs, respectively) if there was a history of failed coursework (18.8% and 41.2%, = 0.017), academic probation (34.4% and 67.1%, = 0.009), or professionalism probation (78.1% and 83.9%, = 0.016). The differences between each of the above types of disciplinary action's impact on the likelihood of interviewing ( < 0.001) and risk of failure to match ( < 0.001) were also significant among both groups.
Significant variability exists in the use and reporting of disciplinary actions at US medical schools. A history of these adverse actions, even if successfully remediated, was thought to negatively impact a student's likelihood to interview and match. Greater standardization in the use and reporting of disciplinary actions would be appropriate to ensure equitable treatment of students nationwide.
每年,美国国家住院医师匹配计划都会描述众多因素对各专业住院医师匹配的相对重要性。然而,当学生未达某些期望时学校采取的纪律处分的影响并未得到具体评估,但可能会对医生未来的表现产生重大影响。
本研究通过向医学教育院长和住院医师项目主任(PD)发送电子调查问卷,以评估美国所有opathic医学院使用纪律处分的方式,以及这些处分对住院医师匹配的潜在影响。
33位院长和158位PD参与了调查(回复率分别为26%和22%)。每年因班级规模而被留校察看的学生的中位数百分比为3.3%(四分位间距[IQR]为2%至6%)。有三所机构报告称每年有超过10%的学生被留校察看,一所机构报告称每年有22%的学生被留校察看。如果有课程不及格史(分别为18.8%和41.2%,P = 0.017)、学业留校察看(34.4%和67.1%,P = 0.009)或职业操守留校察看(78.1%和83.9%,P = 0.016),学生未匹配成功的风险被认为非常或极其可能(分别针对院长和PD)。上述每种纪律处分对面试可能性(P < 0.001)和未匹配成功风险(P < 0.001)的影响在两组中也存在显著差异。
美国医学院在纪律处分的使用和报告方面存在显著差异。即使这些不良行为的历史已成功纠正,仍被认为会对学生的面试和匹配可能性产生负面影响。在纪律处分的使用和报告方面进行更大程度的标准化将有助于确保全国范围内学生得到公平对待。