The Carbon Footprint of Residency Interview Travel

ABSTRACT Background Over the last decade, medical student residency applicants have shown a substantial increase in the number of interviews attended, which is associated with a significant increase in travel. The carbon footprint associated with residency interviews has not been well documented prior to this investigation, and is a critical issue related to climate health. Objective The purpose of this study is to document the carbon footprint associated with travel to residency interviews of the applicants from a single institution. Methods Graduating medical students from the University of Michigan Medical School were surveyed in 2020 to gather information regarding travel related to residency interviews. A validated carbon emissions calculator was used to determine the associated carbon footprint. Results Response rate was 103 of 174 (59%). Average interviews per student across all specialties was 14.39 interviews per student. The overall class average for total carbon footprint per student was calculated as 3.07 metric tons CO2, making the class average carbon footprint per interview 0.21 metric tons CO2. If we extrapolate the results of our study to all residents, the resulting CO2 emissions approach 51 665 metric tons CO2 per year, which is equivalent to the amount of CO2 produced by 11 162 passenger cars in 1 year. Conclusions Medical education leaders could help reduce the carbon footprint by encouraging a reduction in number of in-person interviews attended by applicants.

Increasing Medical Student Exposure to Pathology by Creating an Integrated Rotation During Surgery Clerkship

Following a nationwide trend, the University of Michigan Medical School has restructured its curriculum to facilitate integration of basic science curricula and early inclusion of clinical experiences, resulting in a truncation of a 19-month didactic-based preclinical curriculum to 13 months. Because preclinical didactic and lab sessions formed the bulk of pathology contact hours, the curriculum overhaul significantly reduced student exposure to pathologists. This reduction in exposure may decrease student understanding of how pathology integrates into the larger picture of healthcare delivery and could also decrease the pipeline of students interested in pursuing pathology as a career choice. To ameliorate these concerns, a mandatory 1-week rotation through the Pathology Department was integrated into the surgery clerkship. This brief report outlines the process of creating a new, unique pathology rotation for surgery clerkship students that includes observation in autopsy and surgical pathology sign-out, small group sessions focused on foundational concepts in microbiology, chemistry, and transfusion medicine, and access to online case-based modules. Available qualitative student feedback indicates that students appreciate how this rotation granted them a “behind the scenes” look at pathology but also noted that the fast pace of clinical sign-out sessions and length of small group sessions were suboptimal for student learning. This feedback and future survey data will serve as a platform on which curricular improvements can be made to enhance the learning environment for both learners and educators.

A detailed open access model of the PubMed literature

Portfolio analysis is a fundamental practice of organizational leadership and is a necessary precursor of strategic planning. Successful application requires a highly detailed model of research options. We have constructed a model, the first of its kind, that accurately characterizes these options for the biomedical literature. The model comprises over 18 million PubMed documents from 1996–2019. Document relatedness was measured using a hybrid citation analysis + text similarity approach. The resulting 606.6 million document-to-document links were used to create 28,743 document clusters and an associated visual map. Clusters are characterized using metadata (e.g., phrases, MeSH) and over 20 indicators (e.g., funding, patent activity). The map and cluster-level data are embedded in Tableau to provide an interactive model enabling in-depth exploration of a research portfolio. Two example usage cases are provided, one to identify specific research opportunities related to coronavirus, and the second to identify research strengths of a large cohort of African American and Native American researchers at the University of Michigan Medical School.

Medical Student Ophthalmic Knowledge Proficiency after Completing a Clinical Elective or an Online Course

Background As more information is being packed into medical school curricula, mainstream medical topics legitimately receive more attention than specialty topics such as ophthalmology. However, general practitioners, as gatekeepers of specialty care, must attain competency in ophthalmology. We have investigated whether an online ophthalmology course alone would be noninferior to the same online course plus an in-person clinical elective in providing ophthalmic knowledge. Methods Students at the University of Michigan Medical School voluntarily enrolled in one of two groups: an Online Only group requiring satisfactory completion of an online course entitled “The Eyes Have It” (TEHI) or a Clinical + Online group requiring students to complete a 2-week clinical rotation and the TEHI online course. The outcome metric was the score on an independent 50-question written examination of ophthalmic knowledge. Students also completed a survey assessing confidence in managing ophthalmic problems. Results Twenty students in the Clinical + Online group and 59 students in the Online Only group completed the study. The Clinical + Online group slightly outscored the Online Only group (86.3 vs. 83.0%, p = 0.004). When the two outlier questions were removed from the analysis, there was no difference in mean scores between the two groups (85.8 vs. 85.4, p = 0.069). Students in the Clinical + Online group devoted 80 more hours to the experience than did the students in the Online Only group. The number of hours devoted to the course and interest in ophthalmology were weakly correlated with examination performance. After completion of the experiment, there was no difference in student-reported comfort in dealing with ophthalmic problems between the two groups. Conclusion The examination scores of the students who completed the in-person alone were only slightly inferior to those of the students who completed the in-person clinical elective and the online course. These results suggest that an online course alone may provide a satisfactory ophthalmic knowledge base in a more compact timeframe, an alternative that should have appeal to students who do not intend to pursue a career in ophthalmology.

Improving Efficiency in Dental School Clinics by Computerizing a Manual Task

Background: We computerized a formerly manual task of requesting dental faculty to conduct quality checks on student providers during patient encounters. We surveyed student providers who experienced the manual and computerized versions of the faculty request process for one year each. Methods: All surveys were emailed to student providers and there were no reminders or incentives to complete the survey. Simple descriptive data were used to present the results of the study and Institutional Review Board (IRB) approval was provided by the University of Michigan Medical School Committee on Human Research (HUM00131029) on 1 June 2018 Results: The response rate for the survey was 47.1%. A total of 16.1% of student providers reported that the Faculty Request System (FRS) helped them save 1–10 min per clinic session, 22.3% said it saved them 11–20 min, 29.5% said it saved them 21–30 min, 21.4% said it saved 31–40 min, 2.67% said it saved 41–50 min, and 7.14% said it saved more than 50 min per clinic session. Regarding how student providers used the additional time they gained from the FRS, 96.4% said they used some of the time to write up their notes, 88.4% said they used some of the time to discuss treatments with their patients, 83.9% said they engaged in general conversation with their patients, 81.3% said they took care of other patient-related duties, while 1.8% said they had less time available after the implementation of the FRS. Conclusions: The FRS enabled student providers to remain with their patients for almost a full 30 min more (during a 3 h session). This paper describes several benefits experienced by student providers, and the resulting impacts on patient experiences.