List of Fields | Graduate School

In previous studies, physicians practicing in the areas of obstetrics and gynecology, general practice, psychiatry, and family medicine were more likely to receive disciplinary action, and those practicing in pediatrics and radiology were less likely to be disciplined. The practices of internal medicine, surgery, and anesthesiology were not predictive of disciplinary action. In our study, similar patterns of discipline according to specialty were seen in five of the seven largest specialties (internal medicine, family practice, pediatrics, surgery, and obstetrics and gynecology); these patterns support the generalizability of our findings. In contrast to earlier studies, we did not find male sex to be a risk factor. Our study design precluded a full assessment of age as a risk factor for disciplinary action.

Fields of Study Search | University of Pittsburgh

Principles and applications of polymerase chain reaction in medical diagnostic fields: a review

Fields of Study | Cornell University

3. Veloski JJ, Fields SK, Boex JR, Blank LL. Measuring professionalism: a review of studies with instruments reported in the literature between 1982 and 2002. ;80:-

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We are indebted to Toni Conrad and Bonnie Hellevig for their assistance with data abstraction; to Amanda Gilbert at the Association of American Medical Colleges for providing national mean MCAT scores; to Dr. Rachel Glick for her assistance in the organization of the study; to Drs. Eric Vittinghoff, Michael Shlipak, and Gretchen Guiton for the statistical analyses; and to Drs. Robert Galbraith and Stephen Clyman of the NBME and Dr. James Thompson of the Federation of State Medical Boards for their support.

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What should be done with the findings of this study? Technical standards for admission to medical school and outcome objectives for graduation should be reviewed to make certain they contain explicit language about professional behavior. Standardized instruments should be implemented that assess the personal qualities of medical school applicants and that predict early medical school performance. Professionalism can and must be taught and modeled. Improved systems of evaluation are needed to monitor the development of professional behavior and to document deficiencies. Providing students with feedback that is guided by evidence may motivate and direct remediation strategies, but the best practices for the remediation of deficiencies in professional behavior need development.

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The maintenance of complete student files since 1970 on the part of the three medical schools included in this study afforded a unique opportunity for investigation. Nonetheless, the limitations of this study include its retrospective design and the absence of data, because of incomplete medical school files, for disciplined physicians who graduated before 1970. Also, there may have been additional types of unprofessional behavior in medical school that led to disciplinary action that can best be identified with the use of multidimensional assessments (360-degree multisource feedback — i.e., from peers, patients, and coworkers) of professional competency. The national rate of disciplinary action among the approximately 725,000 physicians practicing in the United States is 0.3 percent. Actions taken by state medical boards may reflect only the most extreme forms of unprofessional behavior. Despite this possibility, our study revealed a strong association between disciplinary action on the part of 40 state medical boards and unprofessional behavior among students.

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In this case–control study, we found that physicians who were disciplined by state medical-licensing boards were three times as likely to have displayed unprofessional behavior in medical school than were control students. This association was observed among graduates of three geographically diverse medical schools, both public and private, and among 40 state licensing boards. Unprofessional behavior as a student was by far the strongest predictor of disciplinary action. Furthermore, the types of unprofessional behavior displayed by students were associated with subsequent disciplinary actions. Among students who were subsequently disciplined, the most irresponsible had a risk of later disciplinary action that was eight times as high as that for control students, and those who were the most resistant to self-improvement had a risk of later discipline that was three times as high as that for controls. Among students who were subsequently disciplined, students with low MCAT scores and those with low grades in the first two years of medical school were also at risk for future disciplinary action, but these were associated with, at most, only one quarter of the risk attributed to unprofessional behavior. Recent objectives for undergraduate and graduate medical education provided by the Association of American Medical Colleges and the Accreditation Council for Graduate Medical Education include professionalism as a core “competency.” Our study provides empirical support for its inclusion and also provides concrete data regarding what is meant by unprofessional behavior.