Overview of Rheumatology and Rheumatic Conditions
Ted Mikuls, Amy Cannella, Gerald Moore, James O'Dell, Alan Erikson, Geoffrey Thiele in Rheumatology, 2013
RHEUMATOLOGY AND RHEUMATIC CONDITIONS – OVERVIEW Rheumatology is an internal medicine and pediatric subspecialty focused on the diagnosis and management of diseases affecting primarily the joints and surrounding soft tissues. Rheumatic conditions are composed of arthritis and its allied connective tissue diseases. The term ‘arthritis’ is derived from the Greek ‘arthro’ (meaning joint) and ‘-itis’ (meaning inflam mation). There are currently more than 100 discrete forms of arthritis recognized, the most common being osteoarthritis (OA). Arthritis is often categorized by its distribution (monoarticular vs. polyarticular); its association with detectable autoantibody (seropositive vs. seronegative); or the degree of underlying inflammation involved (inflammatory vs. noninflammatory. (The latter is a misnomer since nearly all forms of arthritis are characterized by at least low-grade inflammation).
One size does not fit all
Allan Peterkin, Alan Bleakley in Staying Human During the Foundation Programme and Beyond, 2017
This chapter considers issues of gender, ethnicity, sexual orientation and religious beliefs — all of which can have an impact on the learning experiences of Foundation doctors. Worldwide, women tend to choose particular specialties: internal medicine, paediatrics, obstetrics, gynaecology, family practice and psychiatry. Studies worldwide have shown that in postgraduate education and training women tend to work more hours, experience more stress, and report more personal, emotional and relationship problems than do their male counterparts. Trainees with a visible impairment may have to work harder to establish credibility with patients and to deal repeatedly with social awkwardness in patients and colleagues in a way that sometimes wears down a successful coping style. As patient-centred and team-based collaborative practices become the norm, the medical landscape will surely change, perhaps shaped by a new didactic metaphor of collaboration and holism within an ecological feminism.
Primary Health Care in the US
John Fry, Donald Light, Jonathan Rodnick, Peter Orton in Reviving Primary Care, 2018
This chapter concentrates on the organization and practice economic arrangements of family physicians, as being the most parallel to general practice in the UK. If 'primary care' only means the care received from the health professional first contacted, then 'primary care' is alive and well in the US, although it is frequently done by subspecialists. Many specialties lobbied to be designated as primary care and therefore eligible for the federal largess, including family practice, general internal medicine and general pediatrics. The significant income disparities between physicians working in urban and rural areas will have to be addressed in order to even out physician geographic distribution, as the US is not likely to require physicians to practice in certain regions. Most US primary care physicians take care of hospitalized patients, which is not true of British general practitioners.
Positioning Medical Students for the Geriatric Imperative: Using Geriatrics to Effectively Teach Medicine
Published in Gerontology & Geriatrics Education, 2013
Annie Nguyen, Elizabeth Duthie, Kathryn Denson, Jose Franco, Edmund Duthie
Medical schools must consider innovative ways to ensure that graduates are prepared to care for the aging population. One way is to offer a geriatrics clerkship as an option for the fulfillment of a medical school's internal medicine rotation requirement. The authors' purpose was to evaluate the geriatrics clerkship's impact on internal medicine knowledge and medical student attitudes toward older adults. Mean National Board of Medical Examiners (NBME) internal medicine subject exam scores from geriatrics and internal medicine students who matriculated from 2005 to 2011 were compared using student's t-tests. Academic performance was controlled for using the United States Medical Licensing Exam Step 1 exam scores. Focus groups were conducted to explore student attitudes. Geriatrics students performed just as well on the NBME exam as their internal medicine colleagues, but reported greater comfort with elder care. Geriatrics students also reported more positive attitudes toward older adults. Completing an internal medicine requirement using a geriatrics clerkship is an innovation for medical school curriculum structure.
Incorporating the Fourth Year of Medical School into an Internal Medicine Residency: Effect of an Accelerated Program on Performance Outcomes and Career Choice
Published in Teaching and Learning in Medicine, 2004
Louise L. Chang, Martha S. Grayson, Patricia A. Patrick, Steven L. Sivak
Background: To counter declining student interest in general internal medicine, New York Medical College and Saint Vincent's Catholic Medical Centers of New York implemented an experimental accelerated internal medicine curriculum that was provisionally approved by the American Board of Internal Medicine. Description: This accelerated program allowed selected 4th-year medical students to obtain credit for their 1st year of an internal medicine residency while completing requirements for the MD degree. Evaluation: Career and performance outcomes for trainees in the accelerated and traditional internal medicine residency programs were compared for 6 classes of graduates. There were no statistically significant differences between the 2 groups in mean scores on the Intern Clinical Evaluation Exercise, standardized in-service exam, monthly attending evaluations, or in Board pass rates. However, graduates of the accelerated program were more likely to be in general internal medicine practice on completion of residency. Conclusions: The accelerated program successfully increased the number of trainees entering generalist practice a year earlier, and maintained academic standards.
Postgraduate internal medicine residents’ roles at patient discharge – do their perceived roles and perceptions by other health care providers correlate?
Published in Journal of Interprofessional Care, 2014
Sharon Elizabeth Card, Heather A. Ward, Dylan Chipperfield, M. Suzanne Sheppard
Knowing one’s own role is a key collaboration competency for postgraduate trainees in the Canadian competency framework (CanMEDS®). To explore methods to teach collaborative competency to internal medicine postgraduate trainees, baseline role knowledge of the trainees was explored. The perceptions of roles (self and others) at patient discharge from an acute care internal medicine teaching unit amongst 69 participants, 34 physicians (25 internal medicine postgraduate trainees and 9 faculty physicians) and 35 health care professionals from different professions were assessed using an adapted previously validated survey (Jenkins et al., 2001). Internal medicine postgraduate trainees agreed on 8/13 (62%) discharge roles, but for 5/13 (38%), there was a substantial disagreement. Other professions had similar lack of clarity about the postgraduate internal medicine residents’ roles at discharge. The lack of interprofessional and intraprofessional clarity about roles needs to be explored to develop methods to enhance collaborative competence in internal medicine postgraduate trainees.
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