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Preliminary results of a qualitative study of the lived experience of teaching and learning during the Covid-19 pandemic are presented. An instructor, a program director and ve doctoral students in different stages of their coursework and dissertation proposal development, wrote a re ective journal. Participants varied in their levels of familiarity with technology-assisted education, personal backgrounds and circumstances including work, family and caring for sick relatives responsibilities. Participants' journals documenting their reactions, struggles and coping since the abrupt move of the university from face to face to online classes were content analyzed. The analysis was co-conducted by all participants to identify themes and generate understanding of the experience. Two main themes emerged from the analysis: A developmental process of participants' reactions, perceptions and meaning making of the experience and factors that shaped it. Lessons learned are discussed and recommendations for professional education and directions for future research are suggested.

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Disparities in health status between American Indians and other groups in the United States have persisted throughout the 500 years since Europeans arrived in the Americas. Colonists, traders, missionaries, soldiers, physicians, and government officials have struggled to explain these disparities, invoking a wide range of possible causes. American Indians joined these debates, often suggesting different explanations. Europeans and Americans also struggled to respond to the disparities, sometimes working to relieve them, sometimes taking advantage of the ill health of American Indians. Economic and political interests have always affected both explanations of health disparities and responses to them, influencing which explanations were emphasized and which interventions were pursued. Tensions also appear in ongoing debates about the contributions of genetic and socioeconomic forces to the pervasive health disparities. Understanding how these economic and political forces have operated historically can explain both the persistence of the health disparities and the controversies that surround them.

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For the past half century, physicians and clinical researchers have remained confident that randomized controlled trials (RCTs) provide the most rigorous test of preventive, diagnostic, and therapeutic interventions. They are ubiquitously referred to as the "gold standard" of empiric biomedical investigation, to the point where this status is often presented as a self--evident starting point in diagnostic or therapeutic evaluation. However, this status has long been contested, ever more so now with the emergence of "big data," randomized registry trials, and other modes of knowledge production in medicine. In an era of increasing methodological self--reflection, it is useful to step back and examine how and when RCTs became the gold standard and what our aspirations for gold standards reveal about our deeper medical identity.RCTs had a complicated pre--history, entailing attempts to ensure equivalent active and control groups, the occasional blinding of researchers or subjects, and the development of statistical methods of comparison. They took on their recognizably modern form with the British Medical Research Council's landmark 1948 trial of streptomycin for pulmonary tuberculosis. As statisticians and clinical pharmacologists attempted to make sense of the post--Word War II pharmaceutical revolution, the power of RCTs seemed critical. When the 1962 amendments to the Food and Drug Administration mandated proof of efficacy through "well--controlled" studies -namely, RCTs -prior to new drug approval, the United States government set the stage for the avalanche of pharmaceutical trials that followed. In Britain throughout the 1960s and 1970s, Archibald Cochrane advocated for the utility of RCT's to sort therapeutic wheat from chaff. His work set the stage for such worldwide champions of rational therapeutic assessment as Thomas Chalmers, Iain Chalmers, David Sackett, and their colleagues.But when did RCT's become the gold standard? The first instance we have found of the phrase "gold standard" to refer to RCTs came in the pages of the New England Journal of Medicine in December 1982, in an article written by Alvan Feinstein and Ralph Horwitz. This date surprised us (and many of our colleagues) as a very late date for the first usage. Despite extensive searching, we have found no earlier occurrence of "gold standard" in reference to RCTs. We are eager to be proven wrong, but until all textbooks, conference proceedings, journals, and archival collections have been digitized and made full--text searchable, the gold standard of historical research itself remains elusive. Of interest, Feinstein and Horwitz described RCTs not as a gold standard that all research must strive to attain, but as an elusive ideal. Their special article was actually a brief in support of the rigorous conduct of other clinical epidemiological research designs. As they remarked, "epidemiological research has become increasingly important because it offers a substitute for the unattainable scientific gold standard of a randomized experimental t...

Interest in global health (GH) among medical students worldwide is measurably increasing. There is a concomitant emphasis on emphasizing globally-relevant health professions education. Through a structured literature review, expert consensus recommendations, and contact with relevant professional organizations, we review the existing state of GH education in US medical schools for which data were available. Several recommendations from professional societies have been developed, along with a renewed emphasis on competencies in global health. The implementation of these recommendations was not observed as being uniform across medical schools, with variation noted in the presence of global health curricula. Recommendations for including GH in medical education are suggested, as well as ways to formalize GH curricula, while providing flexibility for innovation and adaptation