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BackgroundIn the United States, the Accreditation Council of graduate medical education (ACGME) requires all accredited Internal medicine residency training programs to facilitate resident scholarly activities. However, clinical experience and medical education still remain the main focus of graduate medical education in many Internal Medicine (IM) residency-training programs. Left to design the structure, process and outcome evaluation of the ACGME research requirement, residency-training programs are faced with numerous barriers. Many residency programs report having been cited by the ACGME residency review committee in IM for lack of scholarly activity by residents.MethodsWe would like to share our experience at Lincoln Hospital, an affiliate of Weill Medical College Cornell University New York, in designing and implementing a successful structured research curriculum based on ACGME competencies taught during a dedicated "research rotation".ResultsSince the inception of the research rotation in 2004, participation of our residents among scholarly activities has substantially increased. Our residents increasingly believe and appreciate that research is an integral component of residency training and essential for practice of medicine.ConclusionInternal medicine residents' outlook in research can be significantly improved using a research curriculum offered through a structured and dedicated research rotation. This is exemplified by the improvement noted in resident satisfaction, their participation in scholarly activities and resident research outcomes since the inception of the research rotation in our internal medicine training program.

Research using the MEPS Experiences with Cancer Survivorship Supplement can inform efforts by health care policy makers, healthcare systems, providers, and employers to improve the cancer survivorship experience in the USA.

Introduction: There is increasing concern regarding the financial burden of cancer on patients and their families. This study presents nationally representative estimates of annual out-of-pocket (OOP) burden among non-elderly cancer survivors and assesses the association between high OOP burden and access to care and preventive service utilization. Methods: Using the 2008–2012 Medical Expenditure Panel Survey, 4,271 cancer survivors and 96,780 individuals without a history of cancer were identified, all aged 18–64 years. High annual OOP burden was defined as spending > 20% of annual family income on OOP healthcare costs. Associations between high OOP burden and access to care were evaluated with multivariable logistic regression. Analyses were conducted in 2015. Results: Compared with individuals without a cancer history, cancer survivors were more likely to report a high OOP burden (4.3% vs 3.4%, p=0.009) in adjusted analyses. High OOP burden was more common among cancer survivors who were poor (18.4%), with either public insurance (7.9%) or uninsured (5.7%), and not working (10.2%). Among cancer survivors, high OOP burden was associated with being unable to obtain necessary medical care (19.2% vs 12.5%, p=0.002), delaying necessary medical care (21.6% vs 13.8%, p=0.002), and lower breast cancer screening rates among age-appropriate women (63.2% vs 75.9%, p=0.02). Conclusions: High OOP burden is more common among adults with a cancer history than those without a cancer history. High OOP burden was associated with being unable to obtain necessary medical care, delaying necessary medical care, and lower breast cancer screening rates among women.

The objective of this article is to illustrate the usefulness of Medical Expenditure Panel Survey (MEPS) data for examining variations in medical expenditures for people with multiple chronic conditions (MCC). We analyzed 2009 MEPS data to produce estimates of treated prevalence for MCC and associated medical expenditures for adults in the US civilian noninstitutionalized population (sample = 24,870). We also identified the most common dyad and triad combinations of treated conditions. Approximately one-quarter of civilian US adults were treated for MCCs in 2009; 18.3% were treated for 2 to 3 conditions and 7% were treated for 4 or more conditions. The proportion of adults treated for MCC increased with age. White non-Hispanic adults were most likely and Hispanic and Asian adults were least likely to be treated for MCC. Health care expenditures increased as the number of chronic conditions treated increased. Regardless of age or sex, hypertension and hyperlipidemia was the most common dyad among adults treated for MCC; diabetes in conjunction with these 2 conditions was a common triad. MEPS has the capacity to produce national estimates of health care expenditures associated with MCC. MEPS data in conjunction with data from other US Department of Health and Human Services sources provide information that can inform policies addressing the complex issue of MCC.

Purpose: This study estimates the prevalence of depression assessment in adults age 35 and older and how prevalence varies by sociodemographic characteristics and depressive symptoms.Methods: We used a nationally representative survey, the Agency for Healthcare Research and Quality's Medical Expenditure Panel Survey, to evaluate if adults 35؉ were being assessed for depression by their health care providers in 2014 and 2015. Using multivariate logistic regression, we examined the health and sociodemographic characteristics of patients associated with depression assessment.Results: Approximately 50% of US adults aged 35؉ were being assessed for depression (48.6%; 95% CI, 45.5%-51.6%). The following were less likely to be assessed

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