A survey of ethnic and sociocultural issues in medical school education

A survey of 113 medical schools was conducted to determine whether sociocultural issues in the treatment of minority group patients were dealt with in their curricula. The inclusion of factors such as different value systems, attitudes, early experiences, and economic and ethnic backgrounds and their influence upon the delivery of health care services to minority groups was found to be minimal. The variables which appeared to facilitate ethnic and sociocultural courses in medical education are contrasted with those which result in exclusion of this information from the curricula. These findings emphasize the need for a greater commitment to offering such courses.     

The perils of medical education

Medicine and medical education have always faced the uncomfortable necessity of making decisions on the basis of incomplete information. In recent years far more intense social pressures have been added. Some of these are technical and theoretically can be solved logically, for example, equitable financing of medical care and education. However, some of the pressures have their roots in a more general malaise, the loss of philosophical faith and trust in our institutions. The task of the medical educator is to encourage rational changes, but to resist irrational ones. Medicine at its best is in itself for those in this and related professions, at least, a partial response to the abiding human need to feel fulfillment in an altruistic cause.     

The cost of medical education

As the result of another study which identified the indirect costs at a large teaching hospital in which Monash University has established a clinical school, it has been possible to estimate the cost per annum for each medical student. This is the sum of direct university costs ($4,617), Tertiary Education Assistance Scheme ($1,200) and indirect costs ($44)--in aggregate therefore $5,900 (rounded). Thus the cost of the six-year course for each student is approximately $35,500.     

Predictors of careers in academic medicine for graduates of a community-based, primary-care-oriented medical school

OBJECTIVE: To determine whether intraoperative lymphatic mapping with isosulfan blue dye and sentinel lymph node biopsy accurately demonstrates the pathway of regional metastases from mucosal sites in squamous cell carcinoma of the head and neck. DESIGN: A prospective clinical study of intraoperative lymphatic mapping. SETTING: An academic tertiary referral center. PATIENTS: Patients with previously untreated squamous cell carcinoma of the head and neck whose surgical treatment included neck dissection. INTERVENTION: Injection of isosulfan blue dye into the mucosa surrounding squamous cell carcinomas of the upper aerodigestive tract during cervical lymphadenectomy. OUTCOME MEASURES: Correlation of the pathologic findings in the blue sentinel lymph node with those in the remaining cervical lymphatics. RESULTS: No blue-stained cervical lymphatics were identified after injection of the mucosa surrounding the primary squamous cell carcinoma with isosulfan dye. CONCLUSION: The technique of intraoperative lymphatic mapping with isosulfan blue dye requires further study before it can be used for the detection of occult cervical metastases in squamous cell carcinoma of the head and neck.     

Nutrition education in the medical school: factors critical to the development of a successful program

The phagocytosis by mononuclear phagocytes, neutrophils and eosinophils of mast cell granules which are released in the course of anaphylactic reactions was studied in the rat. Degranulation of rat peritoneal mast cells was induced either in vivo or in vitro after passive sensitization with homologous reaginic antiovalbumin serum by challenge with the antigen. The approximate extent of degranulation was assessed by determining histamine release. The anaphylactic reaction was stopped by fixation with glutaraldehyde and the cells were examined by electron microscopy. Phagocytosis was quantified in randomly selected thin section at the magnification of 1,800. Rapid and extensive phagocytosis of mast cell granules was observed both in vivo and in vitro. About one third of the mononuclear phagocytes and between 30 and 53% of the neutrophils present were engaged in phagocytosis and usually contained several mast cell granules. Phagocytosis by eosinophils was less prominent, both with respect to the proportion of phagocytosing cell (10-23%) and to the number of mast cell granules per cell profile. Examination of large numbers of cells indicates that the uptake process is highly efficient since both condensed and already disaggregated granule bodies were seen to adhere to the phagocytes and were taken up rapidly and without the need for opsonization. In the neutrophils, extensive fusion of azurophil granules (as evidenced by peroxidase cytochemistry) with phagosomes containing mast cell granules was observed. Occasionally, mast cell granules were seen within disrupted vacuoles, which could result from the swelling of the granule matrix following engulfment. The result of this study indicate that mononuclear and polymorphonuclear phagocytes have the capacity to scavenge important amounts of mast cell granule products released by anaphylaxis.     

The purposes of psychology curricula in medical education.

Among the general objectives of psychological instruction in medical education are providing sound conceptual backgrounds in general psychology, growth and development, motivation and emotion. A second objective would be "a program of theoretical and practical training in such professional skills as interviewing, observing, gaining and maintaining rapport, interacting in transference relationships… ." The role of the psychologist on a medical school faculty and problems of psychological instruction in graduate medical education are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)