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Recent accreditation standards have changed for all US and Canadian medical schools and residency programs. Newly mandated knowledge, skills, behavior, and attitudes required of the learner to become a medical professional are permeated with professionalism and associated curricular themes. The art of medicine now emphasizes humanistic skills, ethical precepts, and principle-based values. To this end, this chapter calls for enhanced learner collaboration with educators, as well as a required longitudinal ethics curriculum and medical apprenticeship for all phases of medical education. These efforts can thereby result in greater moral reflection on professionalism and its successful assimilation into clinical practice.

US citizens who attend international medical schools (US IMGs) are more likely to be of Hispanic, Black American, or Asian descent compared to US medical students. As physicians, US IMGs contribute diversity to the health-care workforce; their experiences and perspectives have improved the health outcomes for populations typically underserved. To become a competent medical professional is a challenging experience, especially for IMGs who may have entered medical school with less than optimal academic histories. During this journey, some students develop academic and clinical deficiencies. Addressing these deficits through remediation interventions are critical to the student’s performance as a physician. This study measured the resiliency, self-efficacy, and self-compassion of IMGs who completed remediation while in medical school. Results indicate older students experienced failure more often and were found to have significantly higher levels of self-compassion compared to younger students. Males were assigned significantly more remedial interventions compared to the female participants. Finally, strong positive correlations suggested that the more remediation interventions students were provided, the more likely they were satisfied with their overall remediation experience. These findings indicate that by varying support strategies and encouraging student’s orientation to resiliency, self-efficacy, and self-compassion may assist them in overcoming their deficits.

One of the major challenges in practicing family medicine residents (FMRs) is the choice of an appropriate pattern in training health centers (THCs) to provide high-quality health services to patients. This study aimed to design an efficient residency training model in Iranian healthcare centers.

A four-phase qualitative study with the nominal group technique was carried out in 2018–2019. The required standards of THCs and superior educational practices were initially extracted from the review literature. After collecting and presenting the key findings to the experts' panel, the required training standards and the optimal strategic model to educate FMRs in THCs were prioritized by a nine-point rating system for the well-structured terms of indigenous resources.

Twenty-two educational standards for FMRs in THCs were finalized after reviewing the literature and taking an opinion poll of experts. The highest assessment scores belonged to sufficient numbers of referrals for common health issues and the existence of satisfactory educational and recreational facilities in THCs. The problem-based (PBL), task-based (TBL) and context-based (CBL) learning models were better strategies than guided-discovery learning (GDL) and small group teaching (SGT) ones to train FMRs in THCs. Also, PBL and SGT models were rated as the best and worst advanced medical education methods to empower FMRs.

Due to different resources available in THCs and training centers, different factors and infrastructures should be considered to meet the required standards in building the integrative training model for FMRs in THCs.

The purpose of this paper is to examine the international mobility of physicians by comparing the regulations governing the practice of foreign physicians in the USA and eight other countries.

This is a comparative study of the regulations governing the practice of foreign physicians in eight countries: China, India, the Philippines, the UK, Germany, Denmark, Israel and Australia. Their requirements are then contrasted with the USA’s requirements for foreign physician licensure to evaluate the extent of reciprocity among these countries. We conclude the paper by outlining some recommendations to increase the international mobility of physicians in the future.

The results indicate that licensure for US physicians to practice in the nations above ranges from impossible (India), to difficult (China), to moderately difficult (the UK, Germany and Denmark), to easy and completely reciprocal (Australia, Israel and the Philippines).

The results and recommendations in this study are a valuable starting point for further research and policy changes that will ensure a more reciprocal relationship between the USA and other countries, in terms of opportunities for international medical practice.

The purpose of this paper is to discuss a unique leadership curriculum developed at the University of Florida and its impact on the leadership skills and values of the anesthesiology residents since its conception. The authors instituted a voluntary anesthesiology residency leadership development program at their institution to fill a perceived gap in leadership training. Mounting evidence reveals that strong clinical leadership skills improve outcomes for patients and health-care institutions. Additionally, this growing body of literature indicates that optimal outcomes result from effective team behaviors and skills, which are directed through the requisite clinical leadership. Unfortunately, adding leadership training into the existing medical education curriculum is a formidable challenge regardless of the level of learner.

To evaluate learners, the authors used the Aspiring leaders in Healthcare-Empowering individuals, Achieving excellence, Developing talents instrument, which is a validated and reliable assessment of leadership competency in health-care professionals. In 2017, the authors surveyed the past five graduating classes from the department (classes of 2012-2016), using the two graduating classes before the program’s implementation as a historical control group.

The survey was sent to 96 people, of whom 70 responded (73 per cent). Those participants who usually or always participated in the program responded with higher leadership-readiness skills scores than those who occasionally, rarely or never participated in the program. Notably, those who had participated in another leadership development course at any time had higher skills scores than those who had never participated.

The study’s data provide evidence that residents who either, often or always participated in the leadership development program perceived themselves to be better equipped to become effective health-care leaders as opposed to residents who never, rarely or occasionally participated.

Doctors play a central role in leading improvements to healthcare systems. Leadership knowledge and skills are not inherent, however, and need to be learned. General frameworks for medical leadership guide curriculum development in this area. Explicit discipline-linked competency sets and programmes provide context for learning and likely enhance specialty trainees’ capability for leadership at all levels. The aim of this review was to summarise the scholarly literature available around medical specialty-specific competency-based curricula for leadership in the post-graduate training space.

A systematic literature search method was applied using the Medline, EMBASE and ERIC (education) online databases. Documents were reviewed for a complete match to the research question. Partial matches to the study topic were noted for comparison.

In this study, 39 articles were retrieved in full text for detailed examination, of which 32 did not comply with the full inclusion criteria. Seven articles defining discipline-linked competencies/curricula specific to medical leadership training were identified. These related to the areas of emergency medicine, general practice, maternal and child health, obstetrics and gynaecology, pathology, radiology and radiation oncology. Leadership interventions were critiqued in relation to key features of their design, development and content, with reference to modern leadership concepts.

There is limited discipline-specific guidance for the learning and teaching of leadership within medical specialty training programmes. The competency sets identified through this review may aid the development of learning interventions and tools for other medical disciplines.

The findings of this study provide a baseline for the further development, implementation and evaluation work required to embed leadership learning across all medical specialty training programmes.

Purpose – Health information technology (HIT) holds promise for improving the quality of health care and reducing health care system inefficiencies. Numerous studies have examined HIT availability, specifically electronic health records (EHRs), and utilization among physicians in individual countries. However, no one has examined EHR use among physicians who train in one country and move to practice in another country. In the United States, physicians who complete medical school outside the country but practice within the United States are commonly referred to as International Medical Graduates (IMGs). IMGs have a growing presence in the United States, yet little is known about the availability and use of HIT among these physicians. The purpose of this study is to explore the availability and use of HIT among IMGs practicing in United States.

Design/methodology/approach – The Health Tracking Physician Survey (2008) was used to examine the relationship between availability and use of HIT and IMG status controlling for several physician and practice characteristics. Our analysis included responses from 4,720 physicians, 20.7% of whom were IMGs.

Findings – Using logistic regression, controlling for physician gender, specialty, years in practice, practice type, ownership status and geographical location, we found IMGs were significantly less likely to have a comprehensive EHR in their practices (OR=0.84; p=0.005). In addition, findings indicate that IMGs are more likely to have and use several so-called first generation HIT capabilities, such as reminders for clinicians about preventive services (OR=1.31; p=0.001) and other needed patient follow-up (OR=1.26; p=0.007).

Originality/value – This study draws attention to the need for further research regarding barriers to HIT adoption and use among IMGs.

The purpose of this paper was to determine the complementarity between the Canadian Medical Education Directions for Specialists (CanMEDS) physician competency and LEADS leadership capability frameworks from three perspectives: epistemological, philosophical and pragmatic. Based on those findings, the authors propose how the frameworks collectively layout pathways of lifelong learning for physician leadership.

Using a qualitative approach combining critical discourse analysis with a modified Delphi, the authors examined “How complementary the CanMEDS and LEADS frameworks are in guiding physician leadership development and practice” with the following sub-questions: What are the similarities and differences between CanMEDS and LEADS from: An epistemological and philosophical perspective? The perspective of guiding physician leadership training and practice? How can CanMEDS and LEADS guide physician leadership development from medical school to retirement?

Similarities and differences exist between the two frameworks from philosophical and epistemological perspectives with significant complementarity. Both frameworks are founded on a caring ethos and value physician leadership – CanMEDS (for physicians) and LEADS (physicians as one of many professions) define leadership similarly. The frameworks share beliefs in the function of leadership, embrace a belief in distributed leadership, and although having some philosophical differences, have a shared purpose (preparing for changing health systems). Practically, the frameworks are mutually supportive, addressing leadership action in different contexts and where there is overlap, complement one another in intent and purpose.

To the best of the authors’ knowledge, this is the first paper to map the CanMEDS (physician competency) and LEADS (leadership capabilities) frameworks. By determining the complementarity between the two, synergies can be used to influence physician leadership capacity needed for today and the future.

Drawing upon the 5% Public-Use Microdata Sample (PUMS) from the 1990 and 2000 Censuses (with comparisons to the 1980 Census through the work of Uhlenberg & Cooney, 1990), this paper examines the changing characteristics of the U.S. young physician labor force (aged 30–49). Currently, over 45% of medical degrees are earned by women, but gendered work-family patterns persist. Measures examined include income, hourly wages, mean work hours, part-time and overtime work, practice setting, marital status, and children. For a sub-sample of physicians married to physicians, I also examine income and work hour differentials. Close attention is paid to whether a marriage premium and/or a motherhood penalty in wages exists and persists over time. Implications of the documented workforce diversity are discussed for organizations within which physicians are employed.

This paper explores student and graduate internships. The roles and motivation of the intern and the academic, employer and professional associations that sponsor internships are considered. An examination of the “Career Starts” Program created by the Public Service Commission of the Province of Nova Scotia, in Canada serves as a case study to consider the application of internships, practical issues and objectives associated with such a program, and the experience of individual interns. This case is interesting, as a “collective agreement” element currently limits intern access to full time employment within the government. The impact of this limitation is contrasted with conventional programs established as a “recruitment pool”. Internships are seen as a critical component of individual development and for succession planning for professional and management staff, as well as development of specialized skills. Internships are seen as providing a bridge between academic preparation, and full participation in work or a professional association that provides benefits to the intern, the academic institutions and employers or professional bodies.