Educational malpractice

Article Abstract:

An important part of the job of university hospitals and medical centers is the teaching of interns and residents. However, teaching is difficult to do well, is time consuming, does not pay very much, and does not advance the careers of those charged with this responsibility. Faculty and staff are concerned with obtaining research grants and treating patients. Interns and residents are simply tossed into the system and expected to perform. There is no reason to think that this system is a particularly effective way of providing young physicians with practical training. However, the system is particularly poor in dealing with anyone who falls just outside the norm. Some interns and residents may become rattled under the pressure; some may take a little longer than usual to understand certain concepts. Such people may earn themselves poor reputations when, in fact, a little more direct observation and teaching may have solved the problem. At the same time, some interns and physicians simply do not have what it takes. Some may lack either the intellectual skills or the proper emotional attitudes to practice clinical medicine; there is rarely any clear-cut protocol for dealing with such problem people. Senior faculty and staff are likely to respond with platitudes rather than actual advice. A curious aspect of medicine is that for many years, students are fed a tremendous amount of knowledge, and their only job has been to digest it. Then, at some point in their careers, they are expected to turn around and teach. There has been no discussion of better teaching methods, or, indeed, of what the actual goals of the teaching process might be. This attitude short-changes the interns and residents who need more than simply to be assigned the scut work which the regular staff finds distasteful. Interns and residents are supposed to receive training in return for their cheap labor. If they do not receive this training, or if they are trained poorly, it is nothing less than educational malpractice. (Consumer Summary produced by Reliance Medical Information, Inc.)

Medical school faculty, Graduate medical education, Medical teaching personnel, Medical education policy, editorial

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Accuracy of death certificate completion: the need for formalized physician training

Article Abstract:

There does not appear to be adequate training in the completion of death certificates. Researchers presented six typical cases of hospital deaths to 35 senior medical students, 12 general internists and 21 internal medicine residents. Participants completed the cause-of-death portion of New York City death certificates, which were then compared with causes determined by an expert in disease classification. On average, the underlying cause of death was determined correctly by about 56% of the medical students, 57% of the internists, and 56% of the residents. Five residents and one internist said they had received written materials on completing death certificates. The primary training of participants in death certification was by word of mouth.

Study and teaching, Death, Nosology, Certification

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Evaluating competence in medical students

Article Abstract:

Different types of evaluations on the performance of medical students is illustrated. Suggestion's reveal that there is no single standard with which one can evaluate medical students.

United States, Management dynamics, Economic aspects, Practice, Medical students

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