Objectives: With an ever-expanding medical knowledge base and requirements for clinical training, medical schools struggle to incorporate subspecialty education, such as otolaryngology (OTO), into curricula. This study aims to assess the current state of OTO education, and evaluate factors contributing to the extent of OTO teaching in United States (U.S.) medical schools. Methods: A 48-question survey evaluated the extent and practices of OTO teaching. The survey was distributed by email to all 155 LCME accredited U.S. allopathic medical schools in 2020 and 2021. Results: Sixty-eight unique responses were received (43.9% of U.S. allopathic medical schools). 36.8% (n = 25) of schools reported having formal expectations of OTO knowledge in their core curriculum. Only 1 school (1.5%) had a required OTO rotation; the majority of schools offered an optional third or fourth year clerkship rotation (76.5% and 95.6%, respectively). Schools with residency programs and who employ their faculty through an OTO or surgery department were more likely to have otolaryngologists teach basic science lectures and the Head & Neck exam, offer an optional third year rotation, and have formal expectations of rotating students. Conclusions: Medical schools with residency programs and who employ their faculty through an OTO or surgery department have more robust OTO curricula. Despite the ubiquity of OTO presentations across specialties, incorporation of OTO knowledge in U.S. medical school curricula remains variable, and at times limited.
Interruptions are germane to inpatient medical practice but carry the consequences of reduced error prevention, psychological stress, and impaired knowledge consolidation among trainees. In this mixed methods study, we captured 172 task changes via time-motion observations of four residents on a general neurology service and completed semi-structured interviews with the same group. Twenty-five percent of task changes were due to interruptions, the majority via pager communications, and only 2% required urgent clinical attention. Residents reported frustration towards inefficient aspects of the pager system. Given the high rates of interruptions identified, we propose mitigating strategies such as triaging communications by urgency.
Background: Cosmetic approaches to midface aging are complex and vary in their treatment methodology. The nature of cosmetic surgery limits clinical trial data, forcing surgeons to rely on small studies and professional preferences when choosing an approach. Our study aimed to quantitatively assess national trends in midface rejuvenation practices. Methods: We conducted a cross-sectional study consisting of a survey administered through the American Academy of Facial Plastic and Reconstructive Surgery and the American Society of Plastic Surgeons listservs. To evaluate trends, techniques were grouped into 2 categories: minimally invasive (injectable fillers, fat transfer, fat repositioning) or invasive (deep plane facelift, subperiosteal lift, malar/cheek alloplastic implant, bone grafting/bone advancement). Results: Two hundred thirty-two survey responses were received. Of the total respondents, 46.52% were certified by the American Board of Facial Plastic and Reconstructive Surgery, and 48.26% were certified by the American Board of Plastic Surgery. Minimally invasive techniques were far more preferred (66.67%) over invasive (33.33%) techniques, with injectable fillers as the most common technique (34.88%), followed by fat transfer (20.93%). Deep plane facelift was preferred over subperiosteal lift (18.60% vs 7.91%, respectively). Surgeons board certified by the American Board of Facial Plastic and Reconstructive Surgery were more inclined to perform invasive techniques over those board certified by the American Board of Plastic Surgery ( P = 0.0427). Conclusion: This study quantitatively assessed national trends in cosmetic approaches to midface aging. Our data suggest that trends among surgeons across the United States have shifted toward favoring minimally invasive techniques over more invasive approaches.
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