ObjectivesEmergency departments serve a wide variety of racial, ethnic, socioeconomic, and gender backgrounds. It is currently unknown what characteristics of students who express interest in emergency medicine (EM) are associated with a simultaneous desire to work in medically underserved areas. We hypothesize that those who are underrepresented in medicine, are female, learn another language, and have more student debt will be more likely to practice in a medically underserved area.MethodsData from the National Board of Medical Examiners, Association of American Medical Colleges (AAMC) Student Record System, and the AAMC Graduation Questionnaire were collected on a national cohort of 92,013 U.S. medical students who matriculated from 2007 through 2012. Extracted variables included planned practice area, intention to practice in underserved areas, race/ethnicity, sex, medical school experiences, age at matriculation, debt at graduation, and first‐attempt USMLE Step 1 score.ResultsEM‐intending students who identified as female, non‐Hispanic Black/African American, or Latinx/Hispanic; had a larger debt at graduation; had experiences with health education in the community; had global health experience; and had learned more than one language were more likely to report an intention to practice in underserved areas.ConclusionWith the increasing importance of physician diversity to match those of the community being served, this study identifies factors associated with a desire of EM students to work in underserved areas. Medical schools and EM residencies may wish to consider these factors in their admissions process.
Background Despite the 2013 United States Preventive Services Task Force (USPSTF) recommendations, Hepatitis C (HCV) screening rates among patients born between 1945-1965 has remained below 25% (MacLean, 2018). At our outpatient academic suburban primary care practice in Albany County, NY, our hepatitis C baseline prior to interventions was 31.75%. In collaboration with Project FOCUS through Gilead, our practice attempted to increase screening rates among this birth cohort. Methods We performed a retrospective chart review on patients eligible for HCV screening with birth years 1945-1965 at the time of their visit at the Albany Med Internal Medicine/Pediatrics practice. We report monthly HCV screening from January 2018 to April 2020. In addition, we determined whether HCV screening rates differed by race, gender, ethnicity, private vs public insurance, and risk stratification or RAF (standard vs. high-risk patient). Results The chance that a test conducted for eligible patients increased from 29.9% (pre-intervention) to 58.76% in 2019 (post-intervention). From June 2019- December 2019, the testing rates were consistently above the 2019 average (Figure 1). There were no significant differences in HCV screening due to gender, race, ethnicity, or type of insurance (Table 1). Figure 1. Hepatitis C Screening Rates at an Outpatient Medicine/Pediatrics Practice 2018-2020 Table 1. Demographics - Hepatitis C Screening Rates Conclusion In this outpatient Med/Peds practice, hepatitis C screening rates increased dramatically after incorporation of an EMR prompt, as well as nursing-generated orders for patients due for screening. There was no statistical difference in screening based on race, ethnicity, gender, or insurance type. Of note, high-risk patients were more likely to be screened, perhaps as they receive more case management services and are more likely to be in the office, increasing the opportunities for screening. The next step would be to adapt these interventions to screening all patients age 18-79, as per the updated 2020 USPSTF guidelines. Disclosures Danielle P. Wales, MD, MPH, Gilead (Grant/Research Support) Abigale Eichelman, MA, Gilead FOCUS Foundation (Other Financial or Material Support, Employee of Albany Medical Center with Salary Support on Grant) Ashar Ata, MD, MPH, PHD, GILEAD FOCUS Foundation (Grant/Research Support) Michael Waxman, MD, MPH, Gilead FOCUS Foundation (Grant/Research Support)
To characterize and study the impact of moderate-to-severe atopic dermatitis (AD) on the adult treated population in Portugal. Methods: Crosssectional study conducted in Portuguese community pharmacies. Eligible participants were recruited by pharmacists based on their AD medication, between February and March 2018. A self-administered questionnaire was used to collected data on patients' demographics, medical care, level of embarrassment and absenteeism related to AD. The analysis was based on descriptive statistics and multiple regression models. These were used to study the predictors of embarrassment and systemic treatment. Results: A total of 622 eligible patients were recruited in 57 pharmacies. Mean patients' age was 46.8 years, 55.1% were women and 66.2% were employed. Many (43.1%) reported having felt little embarrassment in the previous week due to AD but 40.2% felt a lot or very much embarrassed. AD was most frequently treated by combined topic and systemic therapy (56.4%), 58.5% were followed by a dermatologist, and 52.8% were followed in a public setting. Only 4.1% of patients had been hospitalized in the previous 12 months. About 18% of patients missed work due to AD, and among those the mean number of days absent in the previous 6 months was 4.8. The results from the regression model showed that being followed by a dermatologist, consulting more than one specialist and having a prior hospitalization were predictors of a higher level of embarrassment. Patients followed by a dermatologist and patients hospitalized in the last 12 months had higher odds of being treated with systemic therapy. Conclusions: Results show that AD impacts patients' life. Most patients reported some level of embarrassment and some reported that AD had an impact on their work life. The study also gives some insights on the predictors of AD medication and the level of embarrassment experienced by patients.
Introduction Previous publications have assessed the diversity among medical students, residents, faculty, and department leaders in surgery and medicine overall. We aim to evaluate the diversity among medical school deans in the United States. We quantify and compare the representation of women and underrepresented minority surgeon and non-surgeons. Methods 151 allopathic medical schools were included. Data regarding demographics, education, training, and previous leadership position were collected from institutional websites, online resources, and July 2021 Association of American Medical Colleges Council of Deans. Demographics for surgeon and non-surgeon were compared using chi square and logistic regression with 5% significance interval. Results 21.9% (n = 33) of all medical school deans were surgeons. 21.2% (n = 7) were women, which was not significantly different from non-surgeons (22%, P = .92). All the women surgeons were non-Hispanic white, similar to all deans ( P = .83). 78.8% (n = 26) of all surgeon deans were non-Hispanic White compared to 84.7% (n = 100) overall ( P = .28). There were 13 Black deans, four of whom were surgeons, and only one Hispanic dean, who was not a surgeon. Surgeons were more likely to be fellows of their professional society ( P = .012). Conclusion The demographic diversity of surgeon and non-surgeon US medical school deans is not significantly different. The deficiencies in leadership diversity in medicine persists among medical school deans. There remains substantial room to improve the representation of women and underrepresented minorities as deans.
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