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Andrea Silenzi, MD, MPH

Iuris praecepta sunt haec: honeste vivere alterum non laedere, suum cuique tribuere.

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Medical EDUCATION

Docenti e studenti di medicina: nuove regole negli USA per rapporti trasparenti

Nuove linee guida per la trasparenza dei rapporti finanziari tra industria e università e per nuovi modelli di professionalità nell’insegnamento della medicina. Ecco il titolo di un articolo scritto da Anand Reddi, giovane ricercatore dell’University of Colorado School of Medicine, su Jama Pediatrics. «Nel maggio 2011 studenti e docenti della Scuola medica dell’’Università del Colorado (Ucsom) hanno proposto una politica di divulgazione dei conflitti di interessi dei docenti durante le attività di formazione degli studenti. Dopo un anno di dialogo con i docenti, il Senato accademico ha approvato la mozione all’unanimità» spiega Reddi, già vincitore del Thomas Jefferson Award, una delle più alte onorificenze dell’Università del Colorado. In medicina accademica, un principio emergente di professionalità è la gestione trasparente dei rapporti finanziari tra docenti e industria, una collaborazione di vitale importanza per la scoperta e lo sviluppo di nuovi farmaci e dispositivi. Allo stesso tempo, tuttavia, il legame tra industria e accademia non è privo di rischi, data l’associazione significativa tra sponsorizzazione finanziaria e conclusioni pro-industria di medici e scienziati. 

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«La maggior parte delle scuole mediche statunitensi chiedono ai docenti di comunicare i conflitti di interessi prima della pubblicazione di articoli scientifici, ma non ne richiedono la divulgazione agli studenti di medicina durante lezioni, seminari o altri contesti educativi. Così nel giugno 2011 Reddi ha proposto, a nome degli studenti dell’American Medical Association (Ama), una risoluzione che invitava il Comitato di collegamento sull’educazione medica (Lcme) ad adottare nuove normative per incoraggiare i docenti delle scuole mediche nazionali a rivelare i conflitti di interessi durante la formazione medica. «L’assemblea dei delegati dell’Ama ha adottato la risoluzione, trasmettendola per renderla operativa al Lcme, autorità di accreditamento per tutte le scuole mediche statunitensi, nonché punto focale per la creazione di linee guida nazionali per la formazione medica» continua il giovane ricercatore. Il prossimo passo? Per ottenere l’attuazione della risoluzione l’Ama sta lavorando con l’Associazione delle università americane, e ha già trasmesso le nuove regole a ogni scuola di medicina, a ciascun amministratore dei programmi di formazione medica e a tutti gli ospedali universitari degli Stati Uniti.

JAMA PEDIATR. PUBLISHED ONLINE SEPTEMBER 30, 2013.

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How To Apply For USA Residency: Tips For IMGs

1. Apply Early. The early bird catches the worm. Most medical residency programs have limited interview slots. According to FREIDA, on an average a Family Practice Residency Program interviews 50 applicants and an Internal Medicine Residency Program interviews 189 applicants. Normally a program receives applications, reviews them and sends out invitations for interviews. Usually all residency interview slots would be filled up quickly. If you apply after this happens, chances are even if you meet or even exceed the requirements, your application will not be reviewed. So, before 1st September, you should already have finalized the programs you plan to apply. And, you should apply as early as possible in the first week of September itself.

2. (Again) Apply Early. In case you missed the above point or underestimated the importance of applying early, read on. Programs are likely to be flexible in the beginning of the application season. This is the time when they don’t know how the applicant pool is going to be. In fact, most programs in InfoIMG database recommend applying early. If you are already ECFMG certified, not applying early is inexcusable. If you have passing USMLE scores, it becomes even more important that you apply early. As the interview season winds down, the program personnel are sometimes worn out and not that much enthusiastic.
3. Call it evidence-based-application. There is a program that claims to consider all applications including those from IMGs. But, except one, not a single resident in the program’s 30 years history was an IMG. One should rather read it as “IMGs need not apply”. In general, if a program has not had any IMG in last 5 years, chances are IMGs won’t be taken this year too. Whenever available, InfoIMG has collected the “Number to total IMGs” and “Number of PGY-1 IMGs” or “%IMGs” in a program.

4. Programs take IMGs, but most of them are US-IMGs. US citizens and permanent residents (aka, green card holders) who went to medical schools outside the US are called US-IMGs. They do not need H1 or J1 visa to pursue medical residency training in the USA. Most of the US-IMGs go to the Caribbean Medical Schools. In some cases, if you go through program’s website, you might find most of the IMGs are US-IMGs. These programs prefer undergraduate degree from a US university or feel comfortable with Caribbean Medical Schools graduates. If you are a US-IMG, your chances will be better at such programs. On the other side, if you are not a US-IMG, it is best not to have high degree of optimism about those programs. Whenever available, InfoIMG has collected this data too and can use it for your query.

5. Use your green card wisely. Consider this scenario: Program A requires minimum 80 on both the USMLE steps and sponsors H1 and J1 visa. And, Program B also requires minimum 80, but does NOT sponsor H1 and J1 visa. If you have a green card and an exact USMLE scores of 80, where will you apply? Probably both. But, what happens if there are 10 programs like Program A and Program B each? Program A will definitely have a lot many IMGs with 85 or more scores. Why would it take a green card holder then? So, if you have a green card, it makes more sense to apply for programs like B. For a couple of programs it might not matter, but if you have already applied to a lot many places and costs are becoming prohibitive, this will be a nice strategy. We have a list of medical residency programs that say they DO NOT sponsor any visas. InfoIMG can also run a query that gives out programs that do not sponsor visas, with other criteria that you might supply.

6. Persist: In one case, an IMG met all the requirements of a Residency Program. But, did not get an interview invitation or a rejection letter. She kept on calling the program. Eventually, the polite and friendly residency coordinator invited her for interview. So, InfoIMG’s advice is PERSIST till you get rejection letter or hear otherwise. Do not get on the nerves of the Residency Program, but do call sufficiently to let them know you continue to be interested. You can show your goodies (personality, motivation, determination, educational skills, US experience) to the program only if you are interviewed.

7. Make sure your application is complete. If your application is not complete, you are hurting your chances of being offered an interview and perhaps a medical residency position. More so if you are barely meeting the criteria. The average numbers of applications in PGY1 are 314 and 1388 for Family Practice and Internal Medicine respectively. DO NOT EXPECT THE PROGRAM TO CONTACT YOU FOR ANY MISSING DOCUMENTS. They will simply not consider your application. It has happened to quite a few IMGs.

8. H1 visa. It is getting harder to obtain H1 visa. Yet, 2 types of programs are likely to sponsor H1 visas – (a) programs that are unable to attract American Medical Graduates (AMGs) and are seeing a decline in number of applications, and (b) programs that want the best residents, no matter what. Currently Internal Medicine and Family Medicine are out of favor among AMGs and many medical residency programs depend on IMGs. In any case, if you need an H1 visa, most programs require that you pass USMLE Step 3, latest by 31st January. That is just before they submit their rank order list (ROL). However, the earlier you pass USMLE Step 3 and let the program know about it, the better. If you take Step 3 early and unfortunately fail, at least you can take it again. If you wait till the end, you might not be able to take and pass USMLE Step 3 by the time the program submits the ROL.

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Path to United States Practice Is Long Slog to Foreign Doctors

Thousands of foreign-trained immigrant physicians are living in the United States with lifesaving skills that are going unused because they stumbled over one of the many hurdles in the path toward becoming a licensed doctor here.

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The involved testing process and often duplicative training these doctors must go through are intended to make sure they meet this country’s high quality standards, which American medical industry groups say are unmatched elsewhere in the world. Some development experts are also loath to make it too easy for foreign doctors to practice here because of the risk of a “brain drain” abroad.

But many foreign physicians and their advocates argue that the process is unnecessarily restrictive and time-consuming, particularly since America’s need for doctors will expand sharply in a few short months under President Obama’s health care law. They point out that medical services cost far more in the United States than elsewhere in the world, in part because of such restrictions.

The United States already faces a shortage of physicians in many parts of the country, especially in specialties where foreign-trained physicians are most likely to practice, like primary care.

Read more on The New York Times

Ecco come si è ripresa la sanità ad Haiti dopo il terremoto: grazie alla videoconferenza

Ripristinare sia l’infrastruttura fisica che il normale programma educativo delle scuole mediche haitiane e degli ospedali universitari si è subito rivelato necessario per rimettere in piedi il paese dopo il devastante cataclisma. Ed è così che e-learning e videoconferenze si sono rivelate strumento utile.

 06 AGO – Un terremoto devastante come quello di Haiti – con oltre 230.000 vittime – è capace di distruggere tutto. Oltre alle vite delle vittime e delle loro famiglie, alle case e alle auto, distrugge l’impianto stesso della società: l’istruzione non esiste più, così come la sanità: da un giorno all’altro Haiti ha perso la maggior parte delle università intorno alla capitale Port-au-Prince e quattro scuole di medicina sono state interamente distrutte. Il sistema di formazione medica haitiano, nella sua interezza ha dovuto ricostruirsi da zero. E proprio questo è stato lo scopo del progetto Haiti Medical Education (HME). Lo strumento principale per questa rinascita si è rivelato – forse a sorpresa per qualcuno – l’e-learning, ovvero l’insegnamento in videoconferenza.

Leggi tutto su QuotidianoSanità

7 obiettivi per la formazione dei @giovanimedici (e non solo) in Public Health @WRicciardi @muirgray @martinmckee

Spesso per definire la Public Health come materia (intesa come Medicina di Sanità Pubblica) è più facile partire dalla descrizione delle discipline che include: epidemiologia, medicina preventiva, igiene, organizzazione santiaria ecc, o gli obiettivi che si intendono realizzare, come ad esempio la possibilità di studiare / valutare / progettare studi epidemiologici o progettare programmi di prevenzione. Ma tutti sappiamo che in realtà è molto, molto di più di questo. E ‘un mezzo per preparare le persone ad impegnarsi attivamente in un mondo complesso e mutevole in modo da migliorare la salute della popolazione. Quindi, detto questo, che cosa vogliamo, noi che insegnano Public Health, dai giovani medici che scelgono di formarsi ed intraprendere la carriera e la ricerca della sanità pubblica? […]

Libera traduzione dall’inglese dell’incipit di

Seven goals for public health training in the 21st century

Free apps for preclinical medical students

Free apps for preclinical medical students
By: Tom Lewis
Published: 21 August 2012
DOI: 10.1136/sbmj.e5077
Cite this as: Student BMJ 2012;20:e5077

Evernote
Available for: iOS, Android, Blackberry, Web, Windows, Mac
Price: Free
Rating: ****
Dropbox
Available for: iOS, Android, Blackberry, Web, Windows, Mac
Price: Free
Rating: ****
NICE BNF
Available for: iOS and Android
Price: Free
Rating ****
So you have arrived at medical school, signed up to all the societies, bought all your textbooks, and realised that you have to study some science before you get to touch a patient. Some free apps are available that will help you manage your documents and note taking in your preclinical years.

Evernote is the best free note taking app, and great for keeping track of preclinical medical notes and more. It is available on a wide range of devices, and allows you to “capture anything.” You can make and save notes while you’re on the go and add a variety of media, including text, photos, attachments, and audio notes. The strength of Evernote is that it uses cloud storage so you can access notes from anywhere. With Evernote, you can make notes on your lectures using your computer and then access them on your mobile phone. Evernote notes have several advantages over paper notes.

1. You can search them with the function

2. They are stored in a “cloud” so you can’t lose them

3. They can be edited retrospectively and constantly updated

4. You can include media such as photographs, mindmaps, and videos

5. They can be easily shared

6. They can be integrated with study card apps to quickly turn prose notes into flashcards

Dropbox is a file hosting service on the web that uses cloud storage to allow users to store and share files and folders across the internet. Signing up for the basic Dropbox service is free and gives each user two gigabytes of online storage space. The Dropbox downloadable client will create a folder on your computer. Any files placed in this folder will be automatically uploaded to Dropbox’s servers. The folder—and all its contents—can be accessed from a range of platforms including iOS, Android, Windows Phone 7, and Blackberry, as well as via Dropbox.com. Dropbox is a hassle free method of carrying around all your files, which can be downloaded and viewed on a computer or mobile device at any time. It also has a robust mechanism to share files with friends. You can carry around, access, and update all your electronic files with you wherever you go. Using Dropbox and other companion apps such as GoodReader, lectures can be downloaded, annotated, and automatically uploaded, keeping files uncluttered and easy to manage. Dropbox is the easiest way to transfer files between multiple devices.

During your preclinical years, you will come across a range of drugs and antibiotics that you have never heard of. The British National Formulary (BNF) apps are electronic versions of the reference book that provides offline access to up to date information on prescribing, dispensing, and administering drugs available on the NHS.

Check out Medscape which was reviewed in June: ideal for new medical students who want a free, comprehensive medical resource on their mobile device. (Anand K. A useful app for general medicine. Student BMJ 2012;20:e3649.)

Tom Lewis, second year medical student and features editor, imedicalapps.com

1University of Warwick, Coventry
Competing interests: None declared.

Provenance and peer review: Not commissioned; not externally peer reviewed.

Junior Medical Leaders – per una nuova formazione in Medicina!

L’adeguata comprensione della cultura manageriale e della leadership risulta ancora, troppo spesso, lontana dal percorso formativo di molti medici. Dura a morire è, infatti, l’errata percezione di molti neolaureati in Medicina e Chirurgia della dicotomia tra l’essere un clinico, focalizzato sul paziente, e l’essere gestore del budget destinato alla copertura dei costi dell’assistenza. Eppure, il solo fatto che il clinico operi in un contesto di risorse definite dovrebbe far capire che egli deve saperle anche amministrare per effettuare scelte non solo efficaci, ma soprattutto efficienti.

La Società Italiana Medici Manager (SIMM), in occasione del V Congresso Nazionale “Sistemi di Cura e Cura dei Sistemi” che si svolgerà a Roma il 14-15 Giugnop.v. ha deciso di dare l’opportunità agli studenti iscritti al Corso di Laurea di Medicina e Chirurgia ed Economia e Gestione delle Aziende e dei Servizi Sanitari dell’Università Cattolica del Sacro Cuore più meritevoli la possibilità di prendere parte ai lavori congressuali e vivere la die giorni fianco a fianco dei medici leader più importanti del panorama nazionale ed internazionale.

 Il programma del Congresso è scaricabile dal sito www.medicimanager.it

 I 7 studenti di Medicina e Chirurgia ed i 5 studenti di Economia più meritevoli – (sulla base del curriculum degli studi ponderato sull’anno di corso) avranno l’iscrizione “giovani” al Congresso di € 50,00 offerta dalla SIMM e riceveranno l’iscrizione gratuita all’Area Giovani  Medici Manager della nostra Società per un anno.

Gli aspiranti dovranno inviare il proprio curriculum in formato europeo (clicca qui) entro l’8 Giugno 2012 alla Segreteria Medici Manager SIMM (e-mail:segreteria@medicimanager.it). Ai vincitori la comunicazione sarà data entro l’11 Giugno.

 In occasione del Convegno sarà assegnato, come ormai di consueto, il premio Medico Manager dell’anno intitolato al Dott. Leonardo La Pietra che quest’anno sarà assegnato al Direttore di Medici con l’Africa Cuamm Don Dante Carraro.

 I lavori congressuali si svolgeranno presso la Sala Congressi dell’hotel “Courtyard by Marriott Rome Central Park” (Via Moscati 7, Trionfale, 00168 Roma).

Yale medical school switching to iPad curriculum, Harvard medical school creating custom apps

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Add Yale’s School of Medicine to the growing list of medical schools that are embracing the iPad as the primary source of medical teaching.

This upcoming year Yale will be giving their medical students, all 520 of them, an iPad 2 with an external wireless keyboard. We’ve covered with great depth the growing list of medical schools using iPads as the main tool for learning — such as Stanford, UC-Irvine, and many more.

“Yale School of Medicine this year will outfit all students with iPads and no longer provide printed course materials. The initiative, born out of a going-green effort, could save the school money in the long run, said Assistant Dean for Curriculum Mike Schwartz.

The school typically spends about $100,000 each year in printing costs for class materials for the first- and second- year students. That doesn’t include the cost of labor, he said.

Schwartz said the iPads will provide professors with new classroom tools, including clearer graphics and the ability to change course materials as often as necessary. “

While Harvard’s School of Medicine isn’t providing a specific tablet or device, they are instead providing supporting apps. They are test piloting apps that medical students can use on the iOS and Android platform — for example — the ability to do patient tracking using your smartphone.

Source: Boston.com

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