CHICAGO—Educational interventions help medical students improve their communication skills, according to an article in the September 3 issue of The Journal of the American Medical Association (JAMA), a theme issue on medical education.

According to background information in the article, despite the acknowledgement that physician-patient communication skills are important, teaching of these communication skills has not been widely incorporated into medical school curricula.

Michael J. Yedidia, Ph.D., of the Wagner Graduate School of Public Service of New York University, and colleagues investigated whether communications training for medical students improved specific aspects of doctor-patient communication known to affect outcomes of care.

The researchers evaluated a communications curriculum instituted in 2000-2001 at 3 medical schools - New York University, University of Massachusetts, and Case Western Reserve University.

The researchers evaluated the communications curriculum at each school based on objective structured clinical examinations (OSCEs, exams, in this case, in which simulated patients assessed students' communications skills). The study included 138 randomly selected medical students in the comparison group, tested at the beginning and end of their third year (1999-2000), and 155 students in the intervention group (received communication curriculum) tested at the beginning and end of their third year (2000-2001).

The researchers found that students who participated in the communications curriculum significantly outperformed students in the comparison group in their overall OSCE scores (65.4 percent vs. 60.4 percent), and in relationship building, organization and time management, negotiation and shared decision making, and patient assessment.

CHICAGO—An increasing number of medical students are basing their choice of specialty on the type of lifestyle associated with each specialty rather than more traditional factors such as pay and prestige, according to an article in the September 3 issue of The Journal of the American Medical Association (JAMA), a theme issue on medical education.

According to background information in the article, lifestyle (including personal time free of practice requirements for leisure, family and hobbies, and control of weekly work hours) has become a factor in students' selection of a medical specialty. Previous studies have found that students were more inclined to select specialties that had fewer work hours per week and had fewer nights on-call.

E. Ray Dorsey, M.D., M.B.A., of the University of Pennsylvania Medical Center, Philadelphia, and colleagues investigated whether and to what degree controllable lifestyle and other specialty-related characteristics are associated with recent (1996-2002) changes in the choice of specialty made by senior medical students in the United States.

The researchers collected data on specialties selected by senior medical students based on results from the National Resident Matching Program, the San Francisco Matching Program, and the American Urological Association Matching Program from 1996 to 2002. The kind of lifestyle associated with each specialty was based on previous research. Specialties were classified as either having a controllable or uncontrollable lifestyle based on pay, work hours and their flexibility and number of years in residency required for each specialty.

Specialties that were associated with a controllable lifestyle were anesthesiology, dermatology, emergency medicine, neurology, ophthalmology, otolaryngology, pathology, psychiatry and radiology. Specialties associated with an uncontrollable lifestyle were family practice, internal medicine, obstetrics and gynecology, orthopedic surgery, pediatrics, surgery and urology.

The researchers found that specialty preferences for U.S. senior medical students changed significantly from 1996 to 2002. Controllable lifestyle issues explained 55 percent of the change in specialty preference within this time period after controlling for income, work hours and years of graduate medical school required for each specialty.

"The increasing preference of U.S. senior medical students for specialties with a controllable lifestyle has significant implications," write the authors. "Chief among them is an alteration in the distribution of U.S. medical graduates and potentially physicians in general by specialty. Family practice and general surgery residency programs, for example, have experienced significantly lower fill rates during the last 6 years, The proportion of positions in family practice filled by U.S. seniors has decreased from 73 percent in 1996 to 47 percent in 2002. For general surgery, the comparable numbers declined from 89 percent to 75 percent during this period. General surgery programs ultimately filled more than 90 percent of their positions in 2002, whereas family practice programs filled only 80 percent of their positions," the researchers write.

CHICAGO—The number of applicants to medical schools declined by 3.5 percent from 2002 to 2001, and is down nearly 22 percent since 1997, according to an article in the September 3 issue of The Journal of the American Medical Association (JAMA), a theme issue on medical education.

Barbara Barzansky, Ph.D., and Sylvia I. Etzel, of the American Medical Association, Chicago, reviewed the status of U.S. medical education in the 2002-2003 academic year, compared with 1997-1998. The source of the data was the Liaison Committee on Medical Education (LCME) Annual Medical School Questionnaire, the Association of American Medical Colleges (AAMC) Databook, and the AAMC Data Warehouse (applicant file). Data evaluated included those on medical school faculty, applicants, and students; curriculum hours devoted to new multidisciplinary or nontraditional subject areas (e.g., cultural diversity, evidence-based medicine, medical ethics, medical informatics); and methods used to evaluate student learning.

The authors found that the number of full-time faculty members in the 126 LCME-accredited medical schools increased by 13.2 percent, from 96,773 in 1997-1998 to 109,526 in 2002-2003. The number of medical school applicants decreased from 43,016 in 1997-1998 to 33,625 in 2002-2003, a decrease of 21.8 percent. The number of medical school enrollees remained virtually unchanged from 1997-1998 (66,748) to 2002-2003 (66,677).

"Interest in medicine as a career, as reflected in the number of applicants to medical school, has continued to decline. However, there are still almost two applicants for every position, and the students who are admitted have comparable academic credentials to those admitted in recent years," the authors write.

"Women constitute less than one-third of full-time medical school faculty members, and individuals from under-represented minority groups (black and Hispanic) together account for about six percent of total faculty. Both women and under-represented minority groups are less represented in the faculty than in the entering medical school class," they add.

MEDICAL STUDENTS WEIGHING QUALITY OF LIFE OVER INCOME WHEN PICKING SPECIALTY—COULD LEAD TO SHORTAGES IN SOME SPECIALTIES