News

Caruso-Brown to Present “Creating Diverse, Equitable and Inclusive Content in Health in Medical Education”

The IAMSE 2021 Spring webinar series will explore strategies for inclusive teaching. Recognizing that unconscious bias is a crucial and contributory step in this endeavor, this series will begin by exploring how to recognize unconscious bias and create diverse, inclusive and equitable content for both the basic science curriculum and the clinical learning environment. The first session in the series will feature Amy Caruso-Brown from Upstate Medical University (NY, USA).

Amy Caruso-Brown

Creating Diverse, Equitable and Inclusive Content in Health in Medical Education 
Presenter: Amy Caruso-Brown MD, MSc, MSCS
Session: March 4, 2021 at 12pm Eastern Time

Bias, shame, stereotype and stigma are pervasive in healthcare, with detrimental effects on the learning environment, student and faculty retention, and the health of our patients and communities. How can educators learn to create diverse, equitable, inclusive content? In this webinar, Dr. Caruso Brown will provide a concrete framework for educators, exploring examples of how to effectively address racism and other forms of bias and structural oppression in medical science education.

We Can’t Wait to See You at #IAMSE21!

June 2021 is just around the corner and the preparations for the next IAMSE annual meeting are at full speed. Attendee registration opened in January and we are already off to a strong start! I would like to again remind you about the opportunity to participate in supporting the International Association of Medical Science Educators at our 2021 Meeting. http://www.iamseconference.org

I have included a copy of our exhibitor brochure for your review. Download Here

The 2021 Annual IAMSE Meeting will be held virtually from June 12-17, 2021. At the meeting faculty, staff and students from around the world who are interested in medical science education join together in faculty development and networking opportunities. Sessions on curriculum development, assessment and simulation are among the common topics available at the annual meetings.

I look forward to working with you to make this educational event successful for all involved and hope to see you in June!

Sincerely,

Julie K. Hewett, CMP, CAE
IAMSE Association Manager

Check Out Our 2021 Events of Interest Schedule

Each year we eagerly await the announcement of educational and professional meetings and events all over the world and, as soon as that information is available, we add it to our Events of Interest Schedule.

While most in-person events have gone virtual, they are joined by the increasing number of standalone seminars, webinars, open discussion calls and online courses and series! Visit our page for more information on these upcoming events and many more:

Don’t miss upcoming events, planned virtually and in person throughout the year. If you would like us to add an event that you think your colleagues may enjoy, send the info to support@iamse.org.

Reminder* Elise Lovell to Present FREE Bonus Webinar – February 25

Based on the enthusiastic response to the Winter IAMSE Series entitled “USMLE STEP-1 is Going to Pass/Fail: Now What Do We Do?,” IAMSE is excited to add a special follow up session on February 25th at 12:00 pm on an update from the important work of the UGRC. The session will be presented by one of the UGRC Co-Chairs: Elise Lovell, an emergency medicine physician and the prior chair of the Organization of Program Directors’ Associations (OPDA).

Registration is limited to the first 1000 participants!

We encourage you to join us for this free session but please note that we can only host the first 1000 participants. The archive of the recorded session will be made freely available on our website after the broadcast.

The Coalition for Physician Accountability: UME-GME Review Committee

Presenter: Elise Lovell, MD
Session: February 25, 2021 at 12pm Eastern Time

Learner Objectives:
At the end of this session, attendees will be able to:
Describe the history and background leading to the creation of the UME-GME Review Committee (UGRC)
Identify the goals, work process, and timeline of the UGRC


More information on the Winter 2021 Webcast Audio Seminar Series, including information on how to register for access to the archives, can be found by clicking the button below.

#IAMSE21 Welcomes Stewart Mennin as Plenary Speaker

The 2021 IAMSE meeting offers many opportunities for faculty development and networking and brings medical sciences and medical education across the continuum together. This year’s main topic is Global Perspectives on Health Sciences Education. The final of four keynote speakers is Stewart Mennin from Human Systems Dynamics Institute, Brazil.


Stewart Mennin

Ten Global Challenges in Medical Education: Lessons from the field
Presenter: 
Stewart Mennin – Human Systems Dynamics Institute, Brazil
Plenary Address: Thursday, June 17, 2021, 10:00 AM – 11:15 AM EDT  

Medical Education varies from school to school, from institution to institution, and from culture to culture.  At the same time,  there are similarities among global challenges that stand out regardless of scale, the specificity of local context and point of view.  Ten of the most pressing issues and challenges that inform our present work and future directions are highlighted and discussed.

For more information on Dr. Mennin and to register for the 25th Annual IAMSE Meeting, please visit www.IAMSEconference.org.

A Review from Medical Science Educator from Dr. Dani McBeth

This month the IAMSE Publications Committee review is taken from the article titled This Isn’t Being a Doctor.”—Qualitative Inquiry into the Existential Dimensions of Medical Student Burnout, published online in Medical Science Educator, (July 2020) by Ye Kyung Song.

In a recent issue of Medical Science Educator I was drawn to an article about medical student burnout. The article, “This Isn’t Being a Doctor.”—Qualitative Inquiry into the Existential Dimensions of Medical Student Burnout, provides a unique method and perspective in trying to learn more about this critically important issue. In the current environment affected by a pandemic and the demonstrations demanding a reckoning for racial injustice sweeping the US, this article takes on an even greater importance. 

Dr. Ye Kyung Song brings a unique perspective to this matter as a young physician who writes that she experienced burnout during her medical training. She adequately explains in the article text how she designed her study to mitigate any bias of her own experience clouding the results. Another unique aspect of this study is using a qualitative analysis of social media posts by medical students on the sub-Reddit forum – /r/medicalschool as the basis for the study. This is a common forum for students to anonymously post their perspectives. Many in medical education express concern about the “advice” that medical students may find in this forum. However, in this study it seems a reasonable place to find honest, evocative feelings expressed by medical students on this important issue. Even with the limitation that it is only the voices of those who choose to use this forum that are heard, the results offer a look into the feelings being expressed by current and recent medical students. As with much qualitative research, the richness of the data as seen through the direct comments in the posts and comments to those posts allows one to hear those voices and feel empathy for what those posting are feeling.

Searching the archives of /r/medicalschool posts for those using the word burnout or similar words, 352 posts were identified spanning the years 2009-2018. Using an inductive approach three themes emerged to account for burnout in medical students. These included meaninglessness, groundlessness, and existential isolation. In all these areas, analyses of initial posts and comments by readers clearly indicate that it is direct experiences within the learning environment that contribute to the feelings of burnout across the span of all 4 years of medical school. These stressors can include financial instability, feelings of being trapped in completing training after taking on significant debt, pressure to perform well in the preclinical years and especially on Step 1 as influencing the rest of their lives, perceived subjective grading in clerkship experiences and the pressures of performing well in clerkship while preparing for Step 2 examinations and applying for residency. While some have theorized that medical student burnout is due to an inability to confront suffering, death, and their own mortality during medical training, Dr. Song’s research suggests otherwise. She rightfully points out that burnout begins for many students in the preclinical years well before students confront such issues on a regular basis.

Directly addressing root causes of burnout as a systemic issue in the learning environment will not be easy. It does seem that it is an issue that the medical education community must confront. The end result would be graduating kind, caring, virtuous physicians that is part of why so many of us entered medical education. It is our way to do our part to better society. 

Dani McBeth, PhD
Associate Dean for Student Affairs
CUNY School of Medicine
Member, IAMSE Publications Committee

#IAMSE21 Welcomes Atsusi Hirumi to Discuss Instructional Design & Technology

The 2021 IAMSE meeting offers many opportunities for faculty development and networking and brings medical sciences and medical education across the continuum together. This year’s main topic is Global Perspectives on Health Sciences Education. The third of our keynote speakers is Atsusi Hirumi from the University of Central Florida in Orlando, FL, USA.

Atsusi Hirumi

Top 10 Ways Instructional Design and Technology May Advance Medical Education
Presenter: 
Atsusi Hirumi – University of Central Florida
Plenary Address: Wednesday, June 16, 2021, 10:00 AM – 11:15 AM EDT  

Along with the continued exponential growth of information and treatment options, healthcare practitioners must now deal with increasing documentation requirements, varying data systems, altering health plans, rising patient expectations, loss of autonomy, and demands to decrease costs while increasing revenue. Add to the complexity, the need to transform coursework and clinical experiences to address the constraints presented by COVID-19 can quickly overwhelm medical educators. Given such prodigious challenges, education specialists with a solid understanding of learning research and theory, instructional design, and emerging technology can play a vital role in designing engaging learning experiences. In this plenary session, Dr. Atsusi “2c” Hirumi will illuminate 10 ways instructional design and technology may advance medical education based on his experience working with professionals in medical, healthcare, aviation, sports, and hospitality industries as well as faculty, staff, and administrators in K12 and higher education across five continents.

For more information on Dr. Hirumi and to register for the 25th Annual IAMSE Meeting, please visit www.IAMSEconference.org.

#IAMSECafe Presents a Follow-up Discussion to “Step 1 is Going P/F: Now What?”

Stay connected with your colleagues around the globe and join us for this week’s IAMSE Cafe round table discussion. Please join our host, Jon Wisco from Boston University School of Medicine as he welcomes IAMSE Winter Webcast Audio Seminar (WAS) 2021 Speaker Doug Gould (Oakland University William Beaumont School of Medicine, USA) and WAS Committee members to continue the discussion started in the Winter series. 
 
Tuesday, February 16, 2021 at 10AM EST – The paradigm shift implications on courses and curricula as a result of moving to pass/fail USMLE Step 1. We will follow up on questions that were raised during the recent Winter WAS series on USMLE Step 1 moving to pass/fail. Whether or not you had the opportunity to view the talks, now you have the opportunity to engage with speakers from the series at the next #IAMSECafe!
 
To join the meeting please click here. The meeting password is IAMSECafe or, if you are calling in from a phone, the numeric password is 778130.
 
Make sure to join us on the first and third Tuesday of each month for more IAMSE Cafe Sessions! Looking for previous sessions? Visit www.IAMSECafe.org for a complete archive of the series. 
 
We look forward to seeing you this week!

IAMSE Winter 2021 WAS Session 5 Highlights

[The following notes were generated by Andrea Belovich, PhD.]

The fifth session of the Winter 2021 IAMSE Web Seminar Series, “USMLE Step-1 is Going to Pass/Fail, Now what do we do?”, was presented on February 4th, 2021 by Drs. John (Jack) Boulet and Robert Cain. Prior to retiring in 2020, Dr. Boulet served as Vice President of Research and Data Resources for the Foundation for Advancement of International Medical Education and Research (FAIMER) and the Educational Commission for Foreign Medical Graduates (ECFMG). Dr. Cain is the President & CEO of the American Association of Colleges of Osteopathic Medicine (AACOM). In this webinar, “USMLE Step 1: Osteopathic and International Perspectives,” the speakers discussed how the USMLE Step 1 shift to pass/fail (P/F) is likely to impact International and Osteopathic medical training programs.

Dr. Boulet began by discussing recent changes to the USMLE Step exam series and how international medical graduates (IMGs) may be impacted. Nearly one-fourth of active physicians and residents in the United States are IMGs, and future IMGs applying to U.S. residency programs may be impacted by the changes to the USMLE Step Exam Series beyond the residency application and ranking process. In order for IMGs to be admitted to residency or fellowship programs accredited by the Accreditation Council for Graduate Medical Education (ACGME), they must first receive ECFMG Certification [1].

Dr. Boulet described the current ECFMG Certification requirements, which include examination in both medical science and clinical skills. Whereas medical science knowledge is assessed by the USMLE Step 1/Step 2 Clinical Knowledge (CK) exams, clinical skills have been assessed using the USMLE Step 2 Clinical Skills (CS) exam before its suspension in early 2020 and recent elimination in January 2021. According to Dr. Boulet, the ECFMG now allows applicants to demonstrate clinical skills through alternative avenues, including having an license to practice medicine in another country or having passed a standardized clinical skills exam for medical licensure. Other avenues include graduating from a medical school that 1) is accredited by an agency recognized by the World Federation for Medical Education, 2) participates in the U.S. Federal Student Loan Program, or 3) issues degree a jointly with U.S. medical school accredited by the Liaison Committee on Medical Education. Finally, without the communication requirements assessed by the USMLE Step 2 CS, IMGs must also pass the Occupational English Test in medicine to receive ECFMG Certification.

Dr. Boulet next discussed how the reporting of USMLE Step 1 scores as P/F is likely to affect IMGs during the residency application process. On average, IMGs have a ~60% match rate with U.S. residencies compared to a >90% for medical graduates trained in the United States. IMGs therefore tend to submit a great number of applications (~150), increasing competition for interviews. Dr. Boulet shared that since IMGs can no longer depend upon a strong numerical USMLE Step 1 scores to stand out from their peers, they must now reconsider how to distinguish themselves during the transition to Graduate Medical Education (GME).

Dr. Boulet suggested that the likely use of the numerically scored Step 2 CK exam to screen residency applications may disadvantage certain IMGs, depending on whether their school’s curriculum that provides early clinical experience or can be altered to do so. Schools may differ in this ability, depending on whether the school uses a 4-year curriculum (such as the Caribbean schools) or a 6-7 year curriculum. Schools with a small minority of graduates who apply to U.S. residencies may also not wish to restructure their curriculum, which could disadvantage their graduates seeking U.S. residency training. Given these concerns, IMGs’ motivation to secure U.S. residency programs may decrease.

In terms of the educational impact of the USMLE Step 1 P/F transition, Dr. Boulet anticipated that students may be less likely to neglecting preclinical coursework in favor of Step 1 preparation. However, the decreased pressure may reduce the perceived value of the basic sciences, which may result in reduced motivation for students to perform as well in the basic sciences. Overall, the lack of pressure to score highly on Step 1 may allow time for a more balanced education, which is expected to positively affect wellness and reduce burnout.

Nevertheless, the question remains in regard to how IMGs will distinguish themselves during the Undergraduate Medical Education (UME) to GME transition. In addition to the increased reliance on Step 2 CK numeric scores, U.S. residency program directors may rely on the international reputation of medical schools, including whether they are ECFMG accredited. Dr. Boulet concluded by emphasizing the need to reevaluate the residency selection process, and highlighted efforts by institutions such as the Coalition for Physician Accountability, the ECFMG, and the National Board of Osteopathic Medical Examiners (NBOME) to make the UME to GME transition more efficient. These efforts include exploring assessment innovations to allow ranking across multiple dimensions needed for success in residency, creating structured holistic reviews of credential portfolios, and developing more holistic metrics such as a “Resident Readiness Index.”

Dr. Cain continued the webinar by sharing the overall organizational impact of the USMLE Step 1 transition to P/F on the osteopathic medicine community, despite the community having its own independent licensing body, the NBOME. Dr. Cain emphasized that osteopathic students and graduates are becoming an increasingly large part of the physician workforce, with 25% of medical students graduating with a Doctor of Osteopathy (DO) degree. Approximately 20% of medical schools offer the DO degree, an 20% of those schools are located in rural and underserved regions. Altogether, this underscores the need for DO graduates to have access to high quality residency training, which is becoming more competitive due to increased volume of applications, including those from IMG and MD graduates. Dr. Cain also expressed concerns that residency programs who have previously accepted DO students may be less likely to do so as a result of the USMLE Step 1 P/F transition, which may result in a loss of DO students in leadership and other prominent positions.

The impact of many residency programs requiring DO students to take the USMLE Step 1 to be considered is associated with significant costs. For students, this cost is felt financially, personally, and relationally, while schools feel the impact of the USMLE Step 1 requirement on their preclinical curricula. These costs raise an ethical question regarding the fairness of requiring students to take two exams, particularly when considering the additional opportunity cost: during the time students must prepare to this extra exam, they must forgo other extracurricular or leadership opportunities.

Dr. Cain then discussed whether it is therefore a benefit or a detriment to require DO students to take the USMLE Step 1 exam, particularly after the transition to P/F occurs. The requirement serves to benefit DO students when a numerical score is provided, as it allows students (particularly high-performing individuals) to distinguish themselves. However, does that benefit change when the Step 1 exam is P/F, if both the COMLEX Level 1 and the USMLE Step 1 test the same material and the COMLEX is also acceptable for medical licensure?

To explore this question, Dr. Cain discussed the advantages and disadvantages of associated with the USMLE Step 1 scoring system transition to P/F. Advantages include decreased stress and cost for students, and schools will experience less pressure to “teach to the test.” Furthermore, the reduced pressure to score highly on an assessment designed for allopathic medical education aligns with and supports the development of the osteopathic professional identity. However, disadvantages include concerns regarding reduced transparency surrounding the residency application screening process due to the loss of the numeric Step 1 score and whether program directors will rely upon school reputation or their own familiarity with the individual DO programs. Finally, a greater proportion of DO students pursue clinical clerkship training in non-hospital based settings than MD students, such as ambulatory and physical rehabilitation training, which disadvantages them from scoring as highly on the USMLE Step 2 CK exam.

Dr. Cain next explained the process for DO licensure, underscoring that DO students may achieve licensure either through the NBOME’s COMLEX exams or through the National Board of Medical Examiners’ (NBME) USMLE exams. While DO students are required to pass the COMLEX exams to graduate and most commonly use this pathway to achieve licensure, they are not required to take both COMLEX and USMLE exams. For DO students, this raises the concern that the USMLE exams have been misused in regards to their primary purpose to inform licensure when used as a tool for residency placement, particularly when there are differences in performance compared to allopathic students.

Dr. Cain also provided a more in-depth look at the purpose of the NBOME’s COMLEX exam series, and explained importance to osteopathic medical education. In addition to the biomedical, clinical, and health systems sciences integral to allopathic medical education, a significant component of the osteopathic medical curriculum includes over 200 hours of biomechanical science, complexity science, and osteopathic philosophy. All of these aspects need to be assessed in order to determine knowledge, skill, and behavior of students as they progress through their training. The COMLEX exams are designed to test the osteopathic-specific components at each stage of development, in addition to the biomedical, clinical, and health systems sciences. In all, the COMLEX is not designed as an add-on exam, but is rather embedded throughout the four-year experience.

To conclude the webinar, Dr. Cain emphasized that work is currently being done by the Coalition for Physician Accountability to review the transition from UME to GME, including the development of a more holistic approach to residency recruitment and interviewing. To summarize the general sentiment of the osteopathic community, Dr. Cain stated that the change of the USMLE Step 1 scoring to P/F could have a negative impact on DO students, when there really should be no impact. This highlights a great need for continuing education around the use of the COMLEX exam and understanding the tools for determining residency readiness.

References:

1. About ECFMG Certification. Educational Commission for Foreign Medical Graduates. https://www.ecfmg.org/certification/

Last Call to Submit Manuscripts for the 2021 Special Section

In the last quarter of 2021, Medical Science Educator, the journal of the International Association of Medical Science Educators (IAMSE), will be publishing a special journal section dedicated to the topic of:

Global Perspectives on Health Sciences Education

We welcome contributions in the selected formats of InnovationShort Communication, or descriptive Monograph. Please submit manuscripts through our online submission system that can be found by visiting: www.medicalscienceeducator.org. In your cover letter, please clearly refer to the topic “Global Perspectives on Health Sciences Education” to indicate that you would like to be included in the special section. See our journal website to review the Instructions for Authors.

Manuscripts to be considered for this special section must be submitted by
March 1, 2021.

I look forward to receiving your submissions.

Thank you,
Peter G.M. de Jong, PhD
Editor-in-Chief, Medical Science Educator

#IAMSE21 Welcomes Camille Bentley as Plenary Speaker

The 2021 IAMSE meeting offers many opportunities for faculty development and networking and brings medical sciences and medical education across the continuum together. This year’s main topic is Global Perspectives on Health Sciences Education. The second of our keynote speakers is Camille Bentley from Rocky Vista University in Parker, CO, USA.

Camille Bentley

Training in Medical School with a Focus on Global Health
Presenter:
 Camille Bentley – Rocky Vista University, USA
Plenary Address: Tuesday, June 15, 2021, 10:00 AM – 11:15 AM  EDT

In this age of increased global connectivity, global health education is more important than ever. While numerous residency programs include global programs/activities, fewer are offered during medical school. The Global Medicine Track (GMT) at Rocky Vista University is a 3.5-year formal osteopathic program aimed at training culturally and clinically competent doctors to more effectively serve global and underserved communities, both here and abroad. Major goals include intensive cultural didactic training and clinical exposure.

Through multiple student and faculty evaluations of the program each semester, the class activities are changed/modified to allow for greater learning and success of the students. The didactic portion has changed to include more pre-reading so that class-time can be more profitably spent in discussion and reflection. Scenarios are presented to small groups on topics ranging from health systems to ethics to disaster medicine and working in low resource communities. Students analyze community needs and programs designed to lessen the burden of disease by eliminating infectious diseases. More hands-on experiences were added and include working with an interpreter, in-flight emergencies, performing laceration repairs in the field, telemedicine and numerous other experiential-learning opportunities.

For more information on Dr. Bentley and to register for the 25th Annual IAMSE Meeting, please visit www.IAMSEconference.org.

Say hello to our featured member Will Brooks

Our association is a robust and diverse set of educators, researchers, medical professionals, volunteers and academics that come from all walks of life and from around the globe. Each month we choose a member to highlight their academic and professional career, and see how they are making the best of their membership in IAMSE. This month’s Featured Member is IAMSE Webcast Audio Seminar Committee Co-Chair, Will Brooks, PhD.

William (Will) Brooks, PhD
Professor, Department of Cell, Developmental & Integrative Biology
The University of Alabama at Birmingham School of Medicine

How long have you been a member of IAMSE?
I became a member of IAMSE in 2013 after joining the faculty at the University of Alabama at Birmingham. A colleague at UAB recommended IAMSE as a great professional society in which to become involved due to its basic science education focus and wonderful membership. She was RIGHT!

Looking at your time with the Association, what have you most enjoyed doing? What are you looking forward to?
I have had the pleasure to serve on the Webcast Audio Seminar Committee since 2018, including a present stint as the committee’s associate chair. This is most definitely the highlight of my IAMSE involvement. Each month I have the pleasure to work collaboratively with amazing people to brainstorm important topics in health sciences education, plan helpful webinars for the membership and abroad, and interact with webinar speakers who are leaders in their fields. It is these thoughtful, intelligent, and humble educators with whom I am able to work that make this committee so exciting to be a part of.

What interesting things are you working on outside the Association right now? Research, presentations, etc.
For the past several years I have been examining the shortage of anatomists. My colleagues and I have been looking at the various ways that anatomists are trained, the declining number of anatomists entering into the workforce, and the growing number of anatomy faculty positions. Our current project, though, is not so much research-focused but rather solutions-focused. We are currently planning a virtual anatomy think-tank symposium in which stakeholders can brainstorm solutions to the shortage of anatomy educators as well as strategies to improve diversity within our anatomy workforce. I am very excited about the potential that this could have on the profession as a whole as we seek to support medical education with more anatomists and more diverse anatomists.

How is the field of anatomy education changed and adapting during the pandemic and beyond? 
Digital anatomy resources have seen increased utilization within education for many years as the technology continues to develop and improve. The pandemic has most definitely increased our reliance upon digital tools as anatomy labs have lain vacant for extended periods of time and social distancing has limited the number of students that labs can accommodate. For me, though, the pandemic has only reinforced the importance of human contact in education. While we can teach anatomy with good outcomes using digital tools alone, the benefits of faculty-student and student-student interaction around an anatomical donor cannot be understated. I would say that the pandemic has introduced us as a collective to new tools for teaching anatomy, but has also demonstrated that there is far more to anatomy education than lists of anatomic structures.

Anything else that you would like to add?
This is an incredibly exciting time to be in medical education. The pandemic has forced a rapid shift in the way that we as basic scientists and medical educators teach and has brought about such incredible innovation. Heightened awareness of issues in diversity and inclusivity has caused everyone to look hard at not only how we can teach students to become better clinicians but also how we as educators can be better. Plus, recent and soon-to-be changes in the USMLE Step examinations will further bring about change in the ways that we teach future physicians. I really can’t think of a more exciting time to be a medical educator! 


Interested in attending one of the upcoming webinars that Will helps develop? Registration is now open for the Spring 2021 Webcast Audio Seminar Series titled, “Strategies for Promoting Inclusivity in Health Sciences Education.” Find more information here.
Sessions begin March 4.