Publications by authors named "Arthur Rubenstein"

22 Publications

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How Academic Medical Centers Can Navigate the Pandemic and its Aftermath: Solutions for Three Major Issues.

Acad Med 2021 May 11. Epub 2021 May 11.

B.F. Godley is Adjunct Professor, Ophthalmology and Visual Sciences, University of Texas, Medical Branch. T.J. Lawley is William P. Timmie Professor of Dermatology and Former Dean at Emory School of Medicine. A. Rubenstein is Professor in the Department of Medicine and the Division of Endocrinology and Former Dean and Executive Vice President at the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania. P.A. Pizzo is the David and Susan Heckerman Professor of Pediatrics and of Microbiology and Immunology at Stanford and Former Dean, School of Medicine and Founding Director of the Stanford Distinguished Careers Institute, Stanford University; ORCID: https://orcid.org/0000-0002-1000-6516.

The COVID-19 crisis has seriously affected academic medical centers (AMCs) on multiple levels. Combined with many trends that were already under way pre-pandemic, the current situation has generated significant disruption and underscored the need for change within and across AMCs. In this article, the authors explore some of the major issues and propose actionable solutions in 3 areas of concentration. First, the impact on medical students is considered, particularly the tradeoffs associated with online learning and the need to place greater pedagogical emphasis on virtual care delivery and other skills that will be increasingly in demand. Solutions described include greater utilization of technology, building more public health knowledge into the curriculum, and partnering with a wide range of academic disciplines. Second, leadership recruiting, vital to long-term success for AMCs, has been complicated by the crisis. Pressures discussed include adapting to the dynamics of competitive physician labor markets as well as attracting candidates with the skill sets to meet the requirements of a shifting AMC leadership landscape. Solutions proposed in this domain include making search processes more focused and streamlined, prioritizing creativity and flexibility as core management capabilities to be sought, and enhancing efforts with assistance from outside advisors. Finally, attention is devoted to the severe financial impact wrought by the pandemic, creating challenges whose resolution is central to planning future AMC directions. Specific challenges include recovery of lost clinical revenue and cash flow, determining how to deal with research funding, and the precarious economic balancing act engendered by the need to continue distance education. A full embrace of telehealth, collaborative policy-making among the many AMC constituencies, and committing fully to being in the vanguard of the transition to value-based care form the solution set offered.
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http://dx.doi.org/10.1097/ACM.0000000000004155DOI Listing
May 2021

ACCELERATE: A Patient-Powered Natural History Study Design Enabling Clinical and Therapeutic Discoveries in a Rare Disorder.

Cell Rep Med 2020 Dec 22;1(9):100158. Epub 2020 Dec 22.

Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY 10065, USA.

Geographically dispersed patients, inconsistent treatment tracking, and limited infrastructure slow research for many orphan diseases. We assess the feasibility of a patient-powered study design to overcome these challenges for Castleman disease, a rare hematologic disorder. Here, we report initial results from the ACCELERATE natural history registry. ACCELERATE includes a traditional physician-reported arm and a patient-powered arm, which enables patients to directly contribute medical data and biospecimens. This study design enables successful enrollment, with the 5-year minimum enrollment goal being met in 2 years. A median of 683 clinical, laboratory, and imaging data elements are captured per patient in the patient-powered arm compared with 37 in the physician-reported arm. These data reveal subgrouping characteristics, identify off-label treatments, support treatment guidelines, and are used in 17 clinical and translational studies. This feasibility study demonstrates that the direct-to-patient design is effective for collecting natural history data and biospecimens, tracking therapies, and providing critical research infrastructure.
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http://dx.doi.org/10.1016/j.xcrm.2020.100158DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7762771PMC
December 2020

Identifying and targeting pathogenic PI3K/AKT/mTOR signaling in IL-6-blockade-refractory idiopathic multicentric Castleman disease.

J Clin Invest 2019 08 13;129(10):4451-4463. Epub 2019 Aug 13.

Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.

Background: Idiopathic multicentric Castleman disease (iMCD) is a hematologic illness involving cytokine-induced lymphoproliferation, systemic inflammation, cytopenias, and life-threatening multi-organ dysfunction. The molecular underpinnings of interleukin-6(IL-6)-blockade refractory patients remain unknown; no targeted therapies exist. In this study, we searched for therapeutic targets in IL-6-blockade refractory iMCD patients with the thrombocytopenia, anasarca, fever/elevated C-reactive protein, reticulin myelofibrosis, renal dysfunction, organomegaly (TAFRO) clinical subtype.

Methods: We analyzed tissues and blood samples from three IL-6-blockade refractory iMCD-TAFRO patients. Cytokine panels, quantitative serum proteomics, flow cytometry of PBMCs, and pathway analyses were employed to identify novel therapeutic targets. To confirm elevated mTOR signaling, a candidate therapeutic target from the above assays, immunohistochemistry was performed for phosphorylated S6, a read-out of mTOR activation, in three iMCD lymph node tissue samples and controls. Proteomic, immunophenotypic, and clinical response assessments were performed to quantify the effects of administration of the mTOR inhibitor, sirolimus.

Results: Studies of three IL-6-blockade refractory iMCD cases revealed increased CD8+ T cell activation, VEGF-A, and PI3K/Akt/mTOR pathway activity. Administration of sirolimus significantly attenuated CD8+ T cell activation and decreased VEGF-A levels. Sirolimus induced clinical benefit responses in all three patients with durable and ongoing remissions of 66, 19, and 19 months.

Conclusion: This precision medicine approach identifies PI3K/Akt/mTOR signaling as the first pharmacologically-targetable pathogenic process in IL-6-blockade refractory iMCD. Prospective evaluation of sirolimus in treatment-refractory iMCD is planned (NCT03933904).

Funding: Castleman's Awareness & Research Effort/Castleman Disease Collaborative Network, Penn Center for Precision Medicine, University Research Foundation, Intramural NIH funding, and National Heart Lung and Blood Institute.
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http://dx.doi.org/10.1172/JCI126091DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6763254PMC
August 2019

A Randomized Controlled Trial to Improve the Success of Women Assistant Professors.

J Womens Health (Larchmt) 2017 05 28;26(5):571-579. Epub 2017 Feb 28.

9 Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania.

Background: Given the persistent disparity in the advancement of women compared with men faculty in academic medicine, it is critical to develop effective interventions to enhance women's careers. We carried out a cluster-randomized, multifaceted intervention to improve the success of women assistant professors at a research-intensive medical school.

Materials And Methods: Twenty-seven departments/divisions were randomly assigned to intervention or control groups. The three-tiered intervention included components that were aimed at (1) the professional development of women assistant professors, (2) changes at the department/division level through faculty-led task forces, and (3) engagement of institutional leaders. Generalized linear models were used to test associations between assignment and outcomes, adjusting for correlations induced by the clustered design.

Results: Academic productivity and work self-efficacy improved significantly over the 3-year trial in both intervention and control groups, but the improvements did not differ between the groups. Average hours worked per week declined significantly more for faculty in the intervention group as compared with the control group (-3.82 vs. -1.39 hours, respectively, p = 0.006). The PhD faculty in the intervention group published significantly more than PhD controls; however, no differences were observed between MDs in the intervention group and MDs in the control group.

Conclusions: Significant improvements in academic productivity and work self-efficacy occurred in both intervention and control groups, potentially due to school-wide intervention effects. A greater decline in work hours in the intervention group despite similar increases in academic productivity may reflect learning to "work smarter" or reveal efficiencies brought about as a result of the multifaceted intervention. The intervention appeared to benefit the academic productivity of faculty with PhDs, but not MDs, suggesting that interventions should be more intense or tailored to specific faculty groups.
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http://dx.doi.org/10.1089/jwh.2016.6025DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5446599PMC
May 2017

Idiopathic multicentric Castleman's disease: a systematic literature review.

Lancet Haematol 2016 Apr 17;3(4):e163-75. Epub 2016 Mar 17.

Orphan Disease Center, Perelman School of Medicine, University of Pennsylvania, Translational Research Laboratory, Philadelphia, PA, USA; Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Electronic address:

Background: Multicentric Castleman's disease describes a group of poorly understood lymphoproliferative disorders driven by proinflammatory hypercytokinaemia. Patients have heterogeneous clinical features, characteristic lymph node histopathology, and often deadly multiple organ dysfunction. Human herpesvirus 8 (HHV8) causes multicentric Castleman's disease in immunosuppressed patients. The cause of HHV8-negative multicentric Castleman's disease is idiopathic; such cases are called idiopathic multicentric Castleman's disease. An absence of centralised information about idiopathic multicentric Castleman's disease represents a major challenge for clinicians and researchers. We aimed to characterise clinical features of, treatments for, and outcomes of idiopathic multicentric Castleman's disease.

Methods: We did a systematic literature review and searched PubMed, the Cochrane database, and ClinicalTrials.gov from January, 1995, with keywords including "Castleman's disease" and "giant lymph node hyperplasia". Inclusion criteria were pathology-confirmed Castleman's disease in multiple nodes and minimum clinical and treatment information on individual patients. Patients with HHV8 or HIV infection or diseases known to cause Castleman-like histopathology were excluded.

Findings: Our search identified 626 (33%) patients with HHV8-negative multicentric Castleman's disease from 1923 cases of multicentric Castleman's disease. 128 patients with idiopathic multicentric Castleman's disease met all inclusion criteria for the systematic review. Furthermore, aggregated data for 127 patients with idiopathic multicentric Castleman's disease were presented from clinical trials, which were excluded from primary analyses because patient-level data were not available. Clinical features of idiopathic multicentric Castleman's disease included multicentric lymphadenopathy (128/128), anaemia (79/91), elevated C-reactive protein (65/79), hypergammaglobulinaemia (63/82), hypoalbuminaemia (57/63), elevated interleukin 6 (57/63), hepatomegaly or splenomegaly (52/67), fever (33/64), oedema, ascites, anasarca, or a combination (29/37), elevated soluble interleukin 2 receptor (20/21), and elevated VEGF (16/20). First-line treatments for idiopathic multicentric Castleman's disease included corticosteroids (47/128 [37%]), cytotoxic chemotherapy (47/128 [37%]), and anti-interleukin 6 therapy (11/128 [9%]). 49 (42%) of 116 patients failed first-line therapy, 2-year survival was 88% (95% CI 81-95; 114 total patients, 12 events, 36 censored), and 27 (22%) of 121 patients died by the end of their observed follow-up (median 29 months [IQR 12-50]). 24 (19%) of 128 patients with idiopathic multicentric Castleman's disease had a diagnosis of a separate malignant disease, significantly higher than the frequency expected in age-matched controls (6%).

Interpretation: Our systematic review provides comprehensive information about clinical features, treatment, and outcomes of idiopathic multicentric Castleman's disease, which accounts for at least 33% of all cases of multicentric Castleman's disease. Our findings will assist with prompt recognition, diagnostic criteria development, and effective management of the disease.

Funding: None.
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http://dx.doi.org/10.1016/S2352-3026(16)00006-5DOI Listing
April 2016

The collaborative network approach: a new framework to accelerate Castleman's disease and other rare disease research.

Lancet Haematol 2016 Apr 17;3(4):e150-2. Epub 2016 Mar 17.

Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.

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http://dx.doi.org/10.1016/S2352-3026(16)00007-7DOI Listing
April 2016

Clinical decision support improves physician guideline adherence for laboratory monitoring of chronic kidney disease: a matched cohort study.

BMC Nephrol 2015 Oct 15;16:163. Epub 2015 Oct 15.

University of Chicago, Chicago, IL, USA.

Background: Guidelines exist for chronic kidney disease (CKD) but are not well implemented in clinical practice. We evaluated the impact of a guideline-based clinical decision support system (CDSS) on laboratory monitoring and achievement of laboratory targets in stage 3-4 CKD patients.

Methods: We performed a matched cohort study of 12,353 stage 3-4 CKD patients whose physicians opted to receive an automated guideline-based CDSS with CKD-related lab results, and 42,996 matched controls whose physicians did not receive the CDSS. Physicians were from US community-based physician practices utilizing a large, commercial laboratory (LabCorp®). We compared the percentage of laboratory tests obtained within guideline-recommended intervals and the percentage of results within guideline target ranges between CDSS and non-CDSS patients. Laboratory tests analyzed included estimated glomerular filtration rate, plasma parathyroid hormone, serum calcium, phosphorus, 25-hydroxy vitamin D (25-D), total carbon dioxide, transferrin saturation (TSAT), LDL cholesterol (LDL-C), blood hemoglobin, and urine protein measurements.

Results: Physicians who used the CDSS ordered all CKD-relevant testing more in accord with guidelines than those who did not use the system. Odds ratios favoring CDSS ranged from 1.29 (TSAT) to 1.88 (serum phosphorus) [CI, 1.20 to 2.01], p < 0.001 for all tests. The CDSS impact was greater for primary care physicians versus nephrologists. CDSS physicians met guideline targets for LDL-C and 25-D more often, but hemoglobin targets less often, than non-CDSS physicians. Use of CDSS did not impact guideline target achievement for the remaining tests.

Conclusions: Use of an automated laboratory-based CDSS may improve physician adherence to guidelines with respect to timely monitoring of CKD.
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http://dx.doi.org/10.1186/s12882-015-0159-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4608162PMC
October 2015

American medical education at a crossroads.

Sci Transl Med 2015 Apr;7(285):285fs17

University of Pennsylvania Raymond and Ruth Perelman School of Medicine, Philadelphia, PA 19140, USA.

New medical-education models in which research plays a modest role could engender a two-tiered educational system, cause a reduction in the physician-scientist pipeline, and diminish the translation of biomedical advances.
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http://dx.doi.org/10.1126/scitranslmed.aaa2039DOI Listing
April 2015

Donald F. Steiner, MD, 1930-2014: pioneering diabetes researcher.

Diabetologia 2015 Mar;58(3):419-21

Department of Medicine, University of Chicago, 5841 S Maryland Ave, Chicago, IL, 60637, USA,

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http://dx.doi.org/10.1007/s00125-015-3495-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4320298PMC
March 2015

A review of the mental health issues of diabetes conference.

Diabetes Care 2015 Feb;38(2):333-8

Department of Pediatrics, Section of Psychology, Baylor College of Medicine, Houston, TX

Individuals with type 1 diabetes are at increased risk for depression, anxiety disorder, and eating disorder diagnoses. People with type 1 diabetes are also at risk for subclinical levels of diabetes distress and anxiety. These mental/behavioral health comorbidities of diabetes are associated with poor adherence to treatment and poor glycemic control, thus increasing the risk for serious short- and long-term physical complications, which can result in blindness, amputations, stroke, cognitive decline, decreased quality of life, as well as premature death. When mental health comorbidities of diabetes are not diagnosed and treated, the financial cost to society and health care systems is catastrophic, and the human suffering that results is profound. This review summarizes state-of-the-art presentations and working group scholarly reports from the Mental Health Issues of Diabetes Conference (7-8 October 2013, Philadelphia, PA), which included stakeholders from the National Institutes of Health, people living with type 1 diabetes and their families, diabetes consumer advocacy groups, the insurance industry, as well as psychologists, psychiatrists, endocrinologists, and nurse practitioners who are all nationally and internationally recognized experts in type 1 diabetes research and care. At this landmark conference current evidence for the incidence and the consequences of mental health problems in type 1 diabetes was presented, supporting the integration of mental health screening and mental health care into routine diabetes medical care. Future research directions were recommended to establish the efficacy and cost-effectiveness of paradigms of diabetes care in which physical and mental health care are both priorities.
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http://dx.doi.org/10.2337/dc14-1383DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4302262PMC
February 2015

A fortunate life in academic medicine.

J Clin Invest 2012 Nov 1;122(11):4288-92. Epub 2012 Nov 1.

University of Pennsylvania Perelman School of Medicine, TRC 12th Floor, Room 12-122, 3400 Civic Center Boulevard, Building 421, Philadelphia, Pennsylvania 19104-5160, USA.

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http://dx.doi.org/10.1172/JCI66850DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3484475PMC
November 2012

'One Medicine - One Health' at the School of Veterinary Medicine of the University of Pennsylvania - the first 125 years.

Vet Ital 2009 Jan-Mar;45(1):183-94

The Gilbert S. Kahn Dean of Veterinary Medicine, School of Veterinary Medicine, University of Pennsylvania, 110 Rosenthal Building, 3800 Spruce Street, Philadelphia, PA 19104-6044, USA.

The University of Pennsylvania's School of Veterinary Medicine (Penn Vet), in partnership with other veterinary schools and health professions, is positioned well to advance an international 'One Medicine - One Health' initiative. Founded in 1884 by the University's Medical Faculty, the School has been a leader in moulding the education and practice of veterinary medicine in the nation and the world. Successfully integrating biomedical research into all aspects of veterinary medical education, the School has made significant contributions to basic and clinical research by exemplifying 'One Medicine'. In looking to the future, Penn Vet will embrace the broader 'One Health' mission as well.
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October 2012

The changing relationships between academic health centers and their universities: a look at the University of Pennsylvania.

Acad Med 2008 Sep;83(9):861-6

PENN Medicine, and University of Pennsylvania Health System, Philadelphia, Pennsylvania 19104, USA.

After a period of financial losses in the University of Pennsylvania Health System stemming from a combination of internal decision making and negative external market forces, the university set out to make substantial changes in the governance and administrative organization overseeing its health system and medical school. The changes were designed to assure the university and its trustees that financial controls were strengthened and that the missions of research, education, and patient care were balanced. The governance changes included creating a structure whereby a single administrative leader was responsible for all three missions--education, research, and clinical care--and reported directly to the president of the university. Further, existing governing boards responsible for various entities within the school of medicine and health system were disbanded, and a new single board was created to oversee PENN Medicine, the overarching organization established in 2001 and now responsible for oversight of the University of Pennsylvania School of Medicine and the University of Pennsylvania Health System. The realignment initiated by these major changes spawned additional refinements in leadership responsibilities and process controls that, together with the new governance model, are credited with financial recovery and stronger performance in all aspects of the enterprise. These structural changes led to greater emphasis on integrating and coordinating programs to take advantage of PENN Medicine's home in a leading university.
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http://dx.doi.org/10.1097/ACM.0b013e318181f19fDOI Listing
September 2008

Does lowering of blood glucose improve cardiovascular morbidity and mortality?

Clin J Am Soc Nephrol 2008 Jan;3(1):163-7

Section of Endocrinology, Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA.

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http://dx.doi.org/10.2215/CJN.05041107DOI Listing
January 2008

Institutional leadership and faculty response: fostering professionalism at the University of Pennsylvania School of Medicine.

Acad Med 2007 Nov;82(11):1049-56

University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA.

Fostering professionalism requires institutional leadership and faculty buy-in. At the University of Pennsylvania School of Medicine, policies and educational programs were developed to enhance professionalism in three areas: conduct of clinical trials, relations with pharmaceutical manufacturers, and the clinical and teaching environment. Responsible conduct of clinical trials has been addressed with mandatory online education and certification for clinical investigators, but some still fail to recognize conflicts of interest. Activity of pharmaceutical representatives has been strictly regulated, meals and gifts from pharmaceutical companies prohibited, and the role of the pharmaceutical industry in the formulary process and in continuing medical education curtailed. Some faculty members have resented such restrictions, particularly in regard to their opportunity to give paid lectures. Professionalism in the clinical and teaching environment has been addressed with interdisciplinary rounding, experiential learning for medical students and residents in small groups, increased recognition of role models of professionalism, and active management of disruptive physicians. Leadership has been exerted through policy development, open communications, and moral suasion and example. Faculty members have expressed both their support and their reservations. Development of communication strategies continues, including town hall meetings, small groups and critical incident narratives, and individual feedback. The understanding and endorsement of faculty, staff, and trainees are an essential element of the professionalism effort.
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http://dx.doi.org/10.1097/ACM.0b013e31815763d2DOI Listing
November 2007

Clinical revenue investment in biomedical research: lessons from two academic medical centers.

JAMA 2007 Jun;297(22):2521-4

University of Pennsylvania School of Medicine, Philadelphia, USA.

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http://dx.doi.org/10.1001/jama.297.22.2521DOI Listing
June 2007

The Clinical Research Forum and Association of American Physicians disagree with criticism of the NIH Roadmap.

J Clin Invest 2006 Aug;116(8):2058-9

As representatives of 50 leading academic medical centers focusing on clinical research and many of academic medicine's scientific leaders, the Clinical Research Forum and Association of American Physicians disagree with the JCI's recent editorials on the NIH Roadmap, Elias Zerhouni's leadership, and the future directions of biomedical research.
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http://dx.doi.org/10.1172/JCI29557DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1523419PMC
August 2006

Obesity: a modern epidemic.

Trans Am Clin Climatol Assoc 2005 ;116:103-11; discussion 112-3

University of Pennsylvania for the Health System, School of Medicine, 3620 Hamilton Walk, Suite 295, Philadelphia, PA 19104, USA.

It has recently become obvious that the prevalence of obesity has been rapidly increasing in the United States, as well as other countries, over the past two decades. This change has involved both sexes, all age ranges and various ethnic groups. The rising prevalence in children and adolescents is of particular concern because of the implications for negative effects on their morbidity and mortality in young adulthood. Obesity is definitely associated with a relative increase in diabetes, cardiovascular disease, various cancers, respiratory disorders in sleep, gallbladder disease and osteoarthritis. It also has negative effects on a variety of other conditions such as pregnancy complications, menstrual disorders, psychological disorders, and urinary stress incontinence. It is an integral component of the metabolic syndrome, which is emerging as a key constellation of risk factors for cardiovascular disease. Dealing with this epidemic will require the mobilization of multiple constituencies and allocation of adequate resources. These approaches should be instituted with urgency.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1473136PMC
May 2006

Rekindling student interest in generalist careers.

Ann Intern Med 2005 Apr;142(8):715-24

Division of General Internal Medicine, New York University School of Medicine, Veterans Affairs New York Harbor Healthcare System, Medical Service (111), 423 East 23rd Street, New York, NY 10010, USA.

Despite changes in the structure of the U.S. health care system, patients continue to need and seek out generalist physicians. However, the proportion of U.S. graduates of medical schools who choose to enter generalist residency training decreased from 50% in 1998 to less than 40% in the 2004 match. Unless we act now to reverse this trend, we may face a shortage of primary care physicians to care for the complex medical needs of an aging population. This article reviews the history of and trends in career choice and proposes 4 evidence-based recommendations to rekindle student interest in generalist careers: 1) We must improve satisfaction and enthusiasm among generalist physician role models. 2) Schools of medicine should redouble their efforts to produce primary care physicians. 3) We must facilitate the pathway from medical school to generalist residency. 4) The U.S. government should increase funding for primary care research and research training. In the absence of a major overhaul of economic incentives in favor of generalist careers, we will need to work at these multiple levels to restore balance to the generalist physician workforce and align with the desires and expectations of patients for continuing healing relationships with generalist physicians.
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http://dx.doi.org/10.7326/0003-4819-142-8-200504190-00040DOI Listing
April 2005

Summary remarks: the implications of professionalism for medical education.

Mt Sinai J Med 2002 Nov;69(6):415-7

University of Pennsylvania, 295 John Morgan Building, 3620 Hamilton Walk, Philadelphia, PA 19104-6055, USA.

Can professionalism be taught and measured? In the medical school environment, particularly with clinical encounters occurring in the first year, a focus on professionalism should begin right away. Attitudes and behavior of the students are strongly influenced during these encounters between physician-mentors, and patients and their families at the bedside or in the clinic. Careful listening and the demonstration of communication skills during these encounters are paramount. Asking questions may be better than telling students what to do. The faculty must provide thoughtful and constructive critiques and must have a mechanism for follow-up. By paying attention to how students really function, we might better teach the precepts of professionalism without adversely affecting their own well being.
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November 2002

Increasing women's leadership in academic medicine: report of the AAMC Project Implementation Committee.

Acad Med 2002 Oct;77(10):1043-61

Women in Medicine, AAMC, Washington, DC 20037, USA.

The AAMC's Increasing Women's Leadership Project Implementation Committee examined four years of data on the advancement of women in academic medicine. With women comprising only 14% of tenured faculty and 12% of full professors, the committee concludes that the progress achieved is inadequate. Because academic medicine needs all the leaders it can develop to address accelerating institutional and societal needs, the waste of most women's potential is of growing importance. Only institutions able to recruit and retain women will be likely to maintain the best housestaff and faculty. The long-term success of academic health centers is thus inextricably linked to the development of women leaders. The committee therefore recommends that medical schools, teaching hospitals, and academic societies (1) emphasize faculty diversity in departmental reviews, evaluating department chairs on their development of women faculty; (2) target women's professional development needs within the context of helping all faculty maximize their faculty appointments, including helping men become more effective mentors of women; (3) assess which institutional practices tend to favor men's over women's professional development, such as defining "academic success" as largely an independent act and rewarding unrestricted availability to work (i.e., neglect of personal life); (4) enhance the effectiveness of search committees to attract women candidates, including assessment of group process and of how candidates' qualifications are defined and evaluated; and (5) financially support institutional Women in Medicine programs and the AAMC Women Liaison Officer and regularly monitor the representation of women at senior ranks.
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http://dx.doi.org/10.1097/00001888-200210000-00023DOI Listing
October 2002