In the 2020-2021 academic year, more than 40 000 medical students and physicians will apply for residency positions in the United States. Yet due to the effects of the novel coronavirus disease 2019 (COVID-19) pandemic, the experience will be distinctly different for applicants and programs than in previous years. How will the residency application process be affected by COVID-19? While the pandemic will stress the residency selection process, it will also provide the opportunity for change and systemic improvements.Even before COVID-19, calls to reform the residency selection process were becoming more frequent. 1,2 Many issues are related to the increasing number of programs to which applicants apply. In 2019-2020, applicants from US medical schools applied to an average of 65 programs, and international medical graduates (IMGs) applied to an average of 137 programs. 3 This number of applications likely does not improve match rates and imposes a substantial cost on applicants and a potentially unmanageable load on program directors.
BackgroundThe COVID-19 pandemic impacted many aspects of normal operations in academic medicine. While effective leadership is always important, the intensity and urgency of COVID-19 challenged academic medicine leaders to find new ways to lead their institutions and manage their own experiences of the pandemic.MethodsSixteen physician leaders from Michigan Medicine took part in semistructured interviews during April and May 2020. Participants were asked open-ended questions about the attributes and techniques that were important to effectively lead during a crisis. The authors analysed the interviews using thematic analysis.ResultsParticipants described three overarching themes of leadership during the COVID-19 pandemic: (1) bringing together a diverse team with clear, shared goals; (2) using a range of strategies to tend to their teams’—as well as their own—well-being; and (3) engaging in leadership reasoning as a way of learning from others and reflecting on their own actions to inform their future leadership practice.ConclusionThe results of this study reveal several salient themes of crisis leadership during the COVID-19 pandemic. The findings also highlight the role of leadership reasoning, a reflective practice employed by leaders to understand and improve their leadership skills. This finding presents leadership skill development as part of lifelong learning in medicine. Findings may be incorporated into best practices and preparations to inform future healthcare leaders.
Cholesteryl ester transfer protein (CETP) mediates the transfer of HDL cholesteryl esters for triglyceride (TG) in VLDL/LDL. CETP inhibition, with anacetrapib, increases HDL-cholesterol, reduces LDL-cholesterol, and lowers TG levels. This study describes the mechanisms responsible for TG lowering by examining the kinetics of VLDL-TG, apoC-II, apoC-III, and apoE. Mildly hypercholesterolemic subjects were randomized to either placebo (N = 10) or atorvastatin 20 mg/qd (N = 29) for 4 weeks (period 1) followed by 8 weeks of anacetrapib, 100 mg/qd (period 2). Following each period, subjects underwent stable isotope metabolic studies to determine the fractional catabolic rates (FCRs) and production rates (PRs) of VLDL-TG and plasma apoC-II, apoC-III, and apoE. Anacetrapib reduced the VLDL-TG pool on a statin background due to an increased VLDL-TG FCR (29%; P = 0.002). Despite an increased VLDL-TG FCR following anacetrapib monotherapy (41%; P = 0.11), the VLDL-TG pool was unchanged due to an increase in the VLDL-TG PR (39%; P = 0.014). apoC-II, apoC-III, and apoE pool sizes increased following anacetrapib; however, the mechanisms responsible for these changes differed by treatment group. Anacetrapib increased the VLDL-TG FCR by enhancing the lipolytic potential of VLDL, which lowered the VLDL-TG pool on atorvastatin background. There was no change in the VLDL-TG pool in subjects treated with anacetrapib monotherapy due to an accompanying increase in the VLDL-TG PR.
The 2019 novel coronavirus (COVID-19) pandemic has led to dramatic changes in the 2020 residency application cycle, including halting away rotations and delaying the application timeline. These stressors are laid on top of a resident selection process already under duress with exploding application and interview numbers—the latter likely to be exacerbated with the widespread shift to virtual interviewing. Leveraging their trainee perspective, the authors propose enforcing a cap on the number of interviews that applicants may attend through a novel interview ticket system (ITS). Specialties electing to participate in the ITS would select an evidence-based, specialty-specific interview cap. Applicants would then receive unique electronic tickets—equal in number to the cap—that would be given to participating programs at the time of an interview, when the tickets would be marked as used. The system would be self-enforcing and would ensure each interview represents genuine interest between applicant and program, while potentially increasing the number of interviews—and thus match rate—for less competitive applicants. Limitations of the ITS and alternative approaches for interview capping, including an honor code system, are also discussed. Finally, in the context of capped interview numbers, the authors emphasize the need for transparent preinterview data from programs to inform applicants and their advisors on which interviews to attend, learning from prior experiences and studies on virtual interviewing, adherence to best practices for interviewing, and careful consideration of how virtual interviews may shift inequities in the resident selection process.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.