Prevalence of Disability and Use of Accommodation Among US Allopathic Medical School Students Before and During the COVID-19 Pandemic.

This survey study assesses self-disclosures of disability, disability types, and accommodation needs reported by US allopathic medical schools in 2021 vs 2015 and 2019.

Is online learning during the COVID-19 pandemic associated with increased burnout in medical learners?: A medical school's experience.

INTRODUCTION: The COVID-19 pandemic necessitated a shift to virtual curriculum delivery at Canadian medical schools. At the NOSM University, some learners transitioned to entirely online learning, while others continued in-person, in-clinic learning. This study aimed to show that medical learners who transitioned to exclusively online learning exhibited higher levels of burnout compared to their peers who continued in-person, clinical learning. Analysis of factors that protect against burnout including resilience, mindfulness, and self-compassion exhibited by online and in-person learners at NOSM University during this curriculum shift were also explored. METHODS: As part of a pilot wellness initiative, a cross-sectional online survey-based study of learner wellness was conducted at NOSM University during the 2020-2021 academic year. Seventy-four learners responded. The survey utilized the Maslach Burnout Inventory, the Brief Resilience Scale, Cognitive and Affective Mindfulness Scale-Revised, and the Self-Compassion Scale-Short Form. T-tests were utilized to compare these parameters in those who studied exclusively online and those who continued learning in-person in a clinical setting. RESULTS: Medical learners who engaged in online learning exhibited significantly higher levels of burnout when compared with learners who continued in-person learning in a clinical setting, despite scoring equally on protective factors such as resilience, mindfulness, and self-compassion. CONCLUSION: The results discussed in this paper suggest that the increased time spent in a virtual learning environment during the COVID-19 pandemic might be associated with burnout among exclusively online learners, as compared to learners who were educated in clinical, in-person settings. Further inquiry should investigate causality and any protective factors that could mitigate negative effects of the virtual learning environment.

Experience Sharing: Final Year MBBS Journey.

Studying medicine is tough. The saying: It is hard to enter medical school but easier later is a myth. All the semesters and years have their trials and tribulations but the final year is known among students to be a terror. Here we share our experience of the final year hoping it could give insight to the medical students about what to expect in the ultimate year and prepare themselves mentally as well as academically beforehand.

Medical Students' Perspectives on Opportunities to Engage in the Clinical Care of COVID-19 Patients during the Pandemic.

OBJECTIVES: Recent disease modeling suggests that pandemics are likely to increase in frequency and severity. As such, medical educators must learn from their experiences with coronavirus disease 2019 (COVID-19) to develop systematic strategies for ensuring that medical students receive hands-on training in the management of emerging diseases. Here, we outline the process by which the Florida International University Herbert Wertheim College of Medicine developed and updated guidelines for student participation in the care of patients with COVID-19 and report on students' experiences. METHODS: During the 2020-2021 academic year, Florida International University Herbert Wertheim College of Medicine students were not permitted to care for patients with COVID-19; however, academic year 2021-2022 guidelines did permit fourth-year students on subinternships or Emergency Medicine rotations to voluntarily care for patients with COVID-19. At the end of the 2021-2022 academic year, students completed an anonymous survey about their experience caring for patients with COVID-19. Likert-type and multiple-choice questions were analyzed using descriptive statistics and the short-answer responses were analyzed qualitatively. RESULTS: One hundred two students (84%) responded to the survey. Sixty-four percent of respondents opted to provide care for patients with COVID-19. Most students (63%) cared for patients with COVID-19 during their required Emergency Medicine Selective. Twenty-eight percent of students wished they had more COVID-19 patient care opportunities, and 29% did not feel prepared to care for patients with COVID-19 on their first day of residency. CONCLUSIONS: Many graduating students felt unprepared to care for patients with COVID-19 during residency and many wished they had had more opportunities to care for patients with COVID-19 during medical school. Curricular policies must evolve to allow students to gain competency in the care of patients with COVID-19 so that they are prepared for day one of residency.

Sabbaticals in US Medical Schools.

BACKGROUND: Sabbaticals are an important feature of academia for faculty and their institutions. Whereas sabbaticals are common in institutions of higher learning, little is known about their role and utilization in US medical schools. This perspective piece examining sabbaticals in medical school faculty was undertaken at a time that well-being of health professionals was increasingly being recognized as a workforce health priority. METHODS: We surveyed associate deans at US medical schools in 2021 about faculty who had taken sabbaticals within the past 3 years, the parameters of the sabbaticals, and institutional policies and respondents' predictions of future sabbatical use. RESULTS: A total of 53% of respondents reported any faculty had taken sabbaticals in the past 3 years (M = 6.27; Median = 3; range = 1-60). Institutions rated enhancing research as the most important objective, while recognizing other benefits. Sabbaticals were more commonly taken by male, white, senior faculty PhDs. Details about sabbaticals, including eligibility, expectations, length, financial support, and benefits were reviewed. Most (54.8%) respondents expected no change in the number of faculty seeking sabbaticals. Nearly all anticipated the COVID-19 pandemic would not affect sabbatical policies. CONCLUSION: In contrast to other institutions of higher learning, sabbatical-taking by medical school faculty is rare. We explore factors that may contribute to this phenomenon (eg, the tripartite mission, faculty clinical responsibilities, culture of medicine, and student debt). Despite financial and other barriers, a closer look at the benefits of sabbaticals is warranted as a mechanism that may support faculty well-being, retention, and mental health.

Challenges in Use of Practice-based Research Networks for a Medical Device Trial to Detect SARS-CoV-2.

INTRODUCTION/OBJECTIVES: Primary care practice-based research networks (PBRNs) participated in a point of care (POC) device study funded by by the National Institutes of Health and led by the University of Massachusetts Chan Medical School (UMass) to speed the development, validation, and commercialization of POC tests to detect SARS-CoV-2. The purposes of this study were to describe the characteristics of participating PBRNs and their respective collaborators in this device trial and describe complications challenging its execution. METHODS: Semi-structured interviews were conducted with lead personnel from participating PBRNs and UMass. RESULTS: Four PBRNs and UMass were invited to participate and 3 PBRNs and UMass participated. This device trial recruited 321 subjects in 6 months; 65 subjects from PBRNs. Each PBRN and the academic medical center site enrolled and recruited subjects differently. Main challenges identified were having adequate clinic personnel to enroll and aid in consent and questionnaire completion, frequently changing inclusion/exclusion criteria, use of the digital electronic data collection platform, and having access to a -80°C freezer to store supplies. DISCUSSION: This trial involved numerous researchers, primary care clinic leaders and staff, and academic center sponsored program staff and attorneys resulting in a resource-intensive endeavor to enroll 65 subjects in the real-world clinical setting of primary care PBRNs with the academic medical center enrolling the rest. Multiple obstacles to standing up the study were encountered by the PBRNS. CONCLUSIONS: Primary care PBRNs rely largely on the goodwill established between academic health centers and participating practices. For future investigations involving device studies, collaborating PBRN leaders should assess whether recruitment criteria may change, obtain detailed lists of equipment needed, and/or know if the study is likely to be halted suddenly to appropriately prepare their member practices.

Breaking Bad News: Integrating the Spikes Model into Medical School Curriculum.

INTRODUCTION: Breaking bad news to patients is a daunting yet inevitable task for most physicians. When done poorly, physicians can cause further pain to the patients while creating great distress for themselves; therefore, it is important medical students learn effective and compassionate techniques. The SPIKES model was created as a guiding framework for providers to use when breaking bad news. The objective of this project was to create a sustainable method to integrate use of the SPIKES model for giving bad news to patients into the curriculum for the University of South Dakota Sanford School of Medicine (SSOM). METHODS: The changes to the curriculum occurred in three phases - one for each Pillar of the University of South Dakota SSOM's curriculum. The first session was a lecture format introducing and defining the SPIKES model for the first-year students. The second lesson was both didactic and interactive, as students were able to practice the SPIKES model through role-playing with colleagues. Prior to COVID, the final lesson was planned to be a standardized patient encounter for the graduating students; however, this lesson ended up in a virtual lecture format. A pre- and post-survey was given for each lesson to determine the usefulness of the SPIKES model in preparing students for handling these challenging conversations. RESULTS: 197 students completed the pre-test survey, and 157 students completed the post-test survey. Overall, a statistically significant improvement was found in students' self-reported confidence, preparedness, and comfort. When the data was broken down based upon year of training, not all cohorts had statistically significant improvement in all three categories. CONCLUSIONS: The SPIKES model serves as a good framework for students to use and tailor to the specific patient encounters. It was evident these lessons greatly improved the student's confidence, comfort, and plan of action. The next step would be to study whether improvement is noted from a patient's perspective and what mode of instruction was most effective.

[Practices and challenges of joint education at two medical schools utilizing online pharmacology role-playing].

The pharmacology role-play, in which students impersonate medical personnel and patients to explain illness and drug treatment, is one of the active learning of pharmacology. However, until now, it has been carried out only within one facility, and has not been carried out between different multi-facility facilities with a larger scale. However, the spread of COVID-19 infection in 2020 was a turning point that drastically changed the way of medical school education centered on traditional face-to-face lectures. Above all, remote real-time lessons using Zoom etc. have the advantage that about 300 students can be conducted at multiple facilities without having to gather them in one place at the same time. With the Korona-ka as a strange currency, the infrastructure has been set up to carry out joint education in pharmacological role-playing between different multi-institutions. We are the first in Japan to conduct a pharmacology role-play jointly by Fujita Medical University and Aichi Medical University, so we would like to introduce the contents.

Time of clerkship rotations' interruption during COVID-19 and differences on Progress Test's scores.

OBJECTIVES: The transition from face-to-face to remote teaching is yet to be fully understood. In clinical training, traditional teaching must prevail because it is essential for the acquisition of skills and professionalism. However, the responses of each school to the pandemic and the decision on when to resume clerkship rotations were mixed. In this study, we aimed to analyze whether the time to resume clerkship rotations was associated with the performance of the students by using a multi-institutional Progress Test. METHODS: This is a cross-sectional study conducted at nine different Brazilian medical schools that administer the same annual Progress Test for all students. We included information from 1,470 clerkship medical students and analyzed the time of clinical training interruption as the independent variable and the student's scores as the dependent variable. RESULTS: The comparisons of the students' scores between the schools showed that there are differences; however, they cannot be attributed to the time the clerkship rotations were paused. The correlation between the schools' average scores and the time to resume clerkship rotations was not significant for the fifth year (r= -0.298, p=0.436) and for the sixth year (r= -0.440, p=0.240). By using a cubic regression model, the time to resume clerkship rotations could explain 3.4% of the 5-year students' scores (p<0.001) and 0.9% of the 6-year students, without statistical difference (p=0.085). CONCLUSIONS: The differences between the students' scores cannot be attributed to the time when the schools paused the clerkship rotations.

The Impact of COVID-19 on the Urology Residency Match and Geographic Proximity of Applicants.

OBJECTIVE: To determine the impacts of COVID-19 pandemic-related changes and program-specific characteristics on the geographic diversity of the 2021 and 2022 urology match classes. METHODS: We gathered publicly available information to compare match outcomes in 2021 and 2022 to the previous 5 application cycles (2016-2020). Variables included residency program class size, program and resident AUA section, and program and resident medical school. Univariate comparisons were made with Fisher's t-tests. Odds ratios were calculated following multivariable analysis. RESULTS: Comparing the previous 5 application cycles to the 2 pandemic years individually and together showed no significant changes in home or in-section matches. However, when comparisons were stratified by small (1-2 residents) vs large (3+ residents) programs, a significant increase in at-home and in-section matches was observed for small programs in 2021. Large programs did not experience significant changes in match patterns. Multivariate analysis showed that small programs had significantly lower odds of matching applicants from home institutions and within AUA sections. Additionally, certain AUA sections demonstrated significantly increased likelihood of accepting in-section applicants. CONCLUSION: The changes from in-person to virtual application cycles during the pandemic particularly affected small residency programs in 2021. With easing restrictions and logistical improvements in the 2022 cycle, locoregional match rates partially shifted back to prepandemic patterns, though not completely. Although the pandemic did not affect geographic diversity in urology as much as in other surgical subspecialties, these findings and further study should be considered to optimize upcoming cycles.

Critical Review Two-Years Thereafter of the Effectiveness of the Revolutionary Changes in a Gastroenterology Division at A Medical School Teaching Hospital in Response to the COVID-19 Pandemic: Medical School, Residency, and Gastrointestinal Fellowship Education and Clinical Practice of Gastroenterology Attendings and Gastrointestinal Endoscopy.

Profound and pervasive GI divisional changes maximized clinical resources devoted to COVID-19-infected patients and minimized risks of transmitting infection. Academic changes degraded by massive cost-cutting while offering institution to about 100 hospital systems and eventually "selling" institution to Spectrum Health, without faculty input.

A Critical Review from the Perspective of 2 Years Thereafter of the Effectiveness of Revolutionary Changes in a Gastroenterology Division at a Medical School Teaching Hospital due to the Coronavirus Disease-2019 Pandemic: Gastrointestinal Physician Clinical Practice and Emotional Stresses, Gastrointestinal Graduate Medical Education, Gastrointestinal Professional Societies, and Pandemic Control.

AIM: Critically review approximately 2 years afterward the effectiveness of revolutionary changes at an academic gastroenterology division from coronavirus disease-2019 (COVID-19) pandemic surge at the metropolitan Detroit epicenter from 0 infected patients on March 9, 2020, to >300 infected patients (one-quarter of) in-hospital census in April 2020 and >200 infected patients in April 2021. SETTING: GI Division, William Beaumont Hospital which had 36 GI clinical faculty who used to perform >23,000 endoscopies annually with a massive plunge in endoscopy volume during the past 2 years; fully accredited GI fellowship since 1973; employs >400 house staff annually since 1995; predominantly voluntary attendings; and primary teaching hospital, Oakland-University-Medical-School. METHODS: Expert opinion, based on: Hospital GI chief >14 years until September 2019; GI fellowship program director, at several hospitals for>20 years; author of 320 publications in peer-reviewed GI journals; and committee-member Food-and-Drug-Administration-GI-Advisory Committee for >5 years. Original study exempted by Hospital Institutional Review Board (IRB), April 14, 2020. IRB approval is not required for the present study because this opinion is based on previously published data. Advantageous changes: Division reorganized patient care to add clinical capacity and minimize risks to staff of contracting COVID-19. Affiliated medical school changes included: changing "live" to virtual lectures, meetings, and conferences. Initially, virtual meetings usually used telephone conferencing which proved cumbersome until meetings were changed to completely computerized virtual meetings using Microsoft Teams or Google Zoom, which performed superbly. Some clinical electives were canceled for medical students and residents because of the need to prioritize car for COVID-19 infection during the pandemic, and medical students graduated on time despite partly missing electives. Division reorganized by changing "live" GI lectures to virtual lectures; by four GI fellows temporarily reassigned as medical attendings supervising COVID-19-infected patients; postponing elective GI endoscopies; and drastically reducing an average number of endoscopies from 100/weekday to a small fraction long-term! GI clinic visits were reduced by half by postponing nonurgent visits, and physical visits were replaced by virtual visits. Economic pandemic impact included a temporary, hospital deficit initially relieved by federal grants and hospital employee terminations. GI program director contacted GI fellows twice weekly to monitor pandemic-induced stress. Applicants for GI fellowship were interviewed virtually. Graduate medical education changes included weekly committee meetings to monitor pandemic-induced changes; program managers working from home; canceling annual ACGME fellowship survey, ACGME site visits, and national GI conventions changed from physical to virtual. Dubious changes: Temporarily mandated intubation of COVID-19-infected patients for EGD; temporarily exempted GI fellows from endoscopy duties during surge; fired highly respected anesthesiology group employed for 20 years during pandemic leading to anesthesiology shortages, and abruptly firing without warning or cause numerous senior respected faculty who greatly contributed to research, academics, and reputation. CONCLUSION: Profound and pervasive GI divisional changes maximized clinical resources devoted to COVID-19-infected patients and minimized risks of transmitting infection. Academic changes were degraded by massive cost-cutting while offering institutions to about 100 hospital systems and eventually "selling" institutions to Spectrum Health, without faculty input.

Supplemental musculoskeletal anatomy education in a shortened medical school curriculum.

To address anatomy knowledge gaps exacerbated by the education constraints of a new shortened medical school curriculum and the COVID-19 pandemic, the Orthopedic Surgery Interest Group (OSIG) created a novel hybrid anatomy curriculum for students interested in orthopedic surgery. The main objectives were to determine (1) Does this elective supplement to the curriculum improve students' perceived confidence with regard to orthopedic anatomy? (2) What are the students' preferred formats for receiving this elective supplement to the curriculum? To determine this, we used a prospective study design to determine the impact of the OSIG's student-led hybrid anatomy sessions. A survey with a five-point Likert scale (1) Strongly disagree; (2) Disagree; (3) Neither agree nor disagree; (4) Agree; (5) Strongly agree; was used to quantify responses. Chi-squared tests, Fisher's exact tests and T-tests were used when appropriate. Our results show that participants without prior anatomy experience rated the course higher on average when compared with those with prior anatomy experience (4.27 vs. 3.67, respectively; p = 0.168). Most students (88.2%) prefer for anatomy sessions to be held more frequently and 76.4% enjoyed having virtual components. 82.4% of participants reported that this course improved their self-confidence regarding orthopedic anatomy, and 100% would recommend it to other students. Most students enjoyed the course and reported improved self-perceived anatomy knowledge after participating. Medical schools that have a shortened anatomy curriculum can consider using the present study as a model for an optional musculoskeletal anatomy supplement at their institution.

Initiation of the Virtual Interview: A 5-Y Evaluation of General Surgery Residency Match Results.

INTRODUCTION: The virtual residency application season posed numerous challenges for the 2021 residency match process. Many residency programs are exploring relationships between this novel format and the match process. The purpose of this study was to compare one of the largest general surgery residency program's applications and match data from preCOVID years to the 2021 virtual cycle. MATERIALS AND METHODS: A retrospective review was performed of applicants to a single general surgery residency program from 2017 to 2021. The primary outcome was the number of locally matched applicants. The secondary outcomes were the total number of applications, change in applicant demographics, and variability of the geographic spread during this study period. Chi-square tests of independence, Fisher's exact tests, and negative binomial regression were performed. RESULTS: 6819 applicants were included in the study. In 2021, an increase in applications was observed. The distribution of 2021 applications was statistically different from previous years regarding gender and race (P < 0.0001). The 2021 application cycle had a greater proportion of applicants from the United States (P < 0.0001) and southern US medical schools (P = 0.008). While the 2021 cycle had significantly more interviews (P = 0.013), there were no significant differences in the demographic composition of interviewees. During the 2021 application year, all 11 matches were from southern medical schools and there was a trend to more matched female applicants compared to previous years. CONCLUSIONS: During the 2021 COVID-19 virtual match cycle, an increase in both the number of applications and number of interviews for general surgery residency was identified. The characteristics of applicants who interviewed and matched were not different when compared to previous years. As virtual interviews may become more commonplace, it is important to assess all factors that may be involved in the dynamic residency application process.

COVID-19, Racial Injustice, and Medical Student Engagement With Global Health: A Single-Institution Survey.

INTRODUCTION: United States medical schools continue to respond to student interest in global health (GH) and the evolution of the field through strengthening related curricula. The COVID-19 pandemic and superimposed racial justice movements exposed chasms in the US healthcare system. We sought to explore the possible relationship between the pandemic, US racial justice movements, and medical student interest in GH to inform future academic offerings that best meet student needs. METHODS: A novel, mixed-methods 30-question Qualtrics survey was disseminated twice (May-August 2021) through email and social media to all current students. Data underwent descriptive and thematic analysis. RESULTS: Twenty students who self-identified as interested in GH responded to the survey. Most (N = 13, 65%) were in preclinical training, and half were women (N = 10, 50%). Five (25%) selected GH definitions with paternalistic undertones, 11 (55%) defined GH as noncontingent on geography, and 12 (60%) said the pandemic and US racial justice movement altered their definitions to include themes of equity and racial justice. Eighteen (90%) became interested in GH before medical school through primarily volunteering (N = 8, 40%). Twelve (60%) students plan to incorporate GH into their careers. CONCLUSIONS: Our survey showed most respondents entered medical school with GH interest. Nearly all endorsed a changed perspective since enrollment, with a paradigm shift toward equity and racial justice. Shifts were potentially accelerated by the global pandemic, which uncovered disparities at home and abroad. These results highlight the importance of faculty and curricula that address global needs and how this might critically impact medical students.

Graduating Medical Students' Experiences with Away (In-Person and Virtual) Rotations During COVID-19: Analysis of the Association of American Medical Colleges (AAMC) 2021 Graduation Questionnaire (GQ).

OBJECTIVE: The COVID-19 pandemic disrupted students' opportunities for away rotations (ARs). Schools and specialty organizations innovated by supplementing in-person ARs (ipARs) with virtual ARs (vARs). We sought to determine how ipAR and vAR completion varied by intended specialty among 2021 graduates. DESIGN: Using de-identified Association of American Medical Colleges 2021 Graduation Questionnaire (GQ) data, we examined AR completion by specialty and community-based school attendance (among other variables) in univariate analysis and multivariable logistic regression models. SETTING: Students graduating from MD-degree granting U.S. medical schools were invited to complete the 2021 GQ, administered electronically on a confidential basis. PARTICIPANTS: Our study included data for 15,451 GQ respondents (74% of all 2021 graduates). RESULTS: Among GQ respondents, 18% (2,787/15,451) completed ARs: 8% (1,279/15,451) ipAR only, 8% (1,218/15,451) vAR only, and 2% (290/15,541) both. In univariate analysis, specialty and community-based school attendance (each p < 0.001), among other variables, were associated with ipAR and with vAR. In multivariable logistic regression, surgical specialties associated with greater odds of AR completion (vs. general surgery reference) included neurological surgery (ipAR: adjusted odds ratio [AOR]=1.9, 95% confidence interval [CI]=1.1-3.3; vAR AOR=3.1, 95% CI=1.9-4.9), ophthalmology (ipAR: AOR=2.3, 95% CI=1.6-3.3; vAR: AOR=2.5, 95% CI=1.7-3.7), orthopedic surgery (ipAR: AOR=2.5, 95% CI=1.8-3.4; vAR: AOR=12.4, 95%CI=9,2-16.5), otolaryngology (ipAR: AOR=1.8, 95% CI=1.2-2.8; vAR: AOR=4,8, 95% CI=3.4-6.9), plastic surgery (ipAR: AOR=2.1, 95% CI=1.2-3.5; vAR: AOR=13.9, 95% CI=9.3-20.7) and urology (ipAR: AOR=2,1, 95% CI=1.4-3.2; vAR: AOR=11.9, 95% CI=8.4-16.8). Community-based medical school attendance was also associated with greater odds of ipAR (AOR=4.6, 95% CI=3.1-6.7) and vAR (AOR=1.8, 95% CI=1.4-2.3). CONCLUSIONS: The prevalence of AR completion was low. Differences we observed by specialty and medical school type aligned well with recommended circumstances for ipARs for the class of 2021. Substantial specialty-specific differences in vAR completion suggest that various surgical specialties were among the early innovators in this regard.

COVID-19 and Latinx Disparities: Highlighting the Need for Medical Schools to Consider Accepting DACA Recipients.

COVID-19 revealed and magnified the preexisting health inequities faced by many vulnerable groups. The Latinx community is one of these groups and has borne the brunt of disparate rates of infection, hospitalization, and mortality associated with COVID-19. These disparities are rooted in social inequities, such as poverty and lack of access to health care, as well as health inequities associated with disparate disease and condition burdens. Moreover, the lack of an adequate Latinx physician workforce contributes to and exacerbates these inequities. The COVID-19 pandemic has intersected with the U.S. Supreme Court's decision in the Department of Homeland Security v. Regents of the University of California case. The court's decision in this case struck down the attempted ending of the Deferred Action for Childhood Arrivals (DACA) program, although it was settled that the government could end the program if it was done lawfully. Even though this constitutes a win for DACA recipients, the decision is a stopgap as the future of DACA recipients remains vulnerable and subject to other legal challenges and political vagaries. In a time when the need to ameliorate health inequities for the Latinx community is so pronounced, DACA recipient medical trainees could provide much-needed relief. Since the implementation of DACA, some medical schools have decided to accept DACA recipient students, but many do not. This access-limiting practice stymies a group of potential trainees who could help to increase the Latinx physician workforce, as the majority of DACA recipients are Latinx. This article argues that all medical schools should take steps to consider accepting DACA recipient applicants in line with the principles of health equity and suggests 5 recommendations for medical school admissions, support, and advocacy practices.

Evaluation of Faculty Parental Leave Policies at Medical Schools Ranked by US News & World Report in 2020.

Importance: Physician parents, particularly women, are more likely to experience burnout, poor family-career balance, adverse maternal and fetal outcomes, and stigmatization compared with nonparent colleagues. Because many physicians delay child-rearing due to the rigorous demands of medical training, favorable parental leave policies for faculty physicians are crucial to prevent physician workforce attrition. Objective: To evaluate paid and unpaid parental leave policies at medical schools ranked by US News & World Report in 2020 and identify factors associated with leave policies. Design, Setting, and Participants: This cross-sectional national study was performed at US medical schools reviewed from December 1, 2019, through May 31, 2020, and February 1 through March 31, 2021, due to the COVID-19 pandemic. All medical schools ranked by US News & World Report in 2020 were included. Main Outcomes and Measures: The primary outcome was the number of weeks of paid and unpaid leave for birth, nonbirth, adoption, and foster care physician parents. Institutional policies for the number of weeks of leave and requirements to use vacation, sick, or disability leave were characterized. Institutional factors were evaluated for association with the duration of paid parental leave using χ2 tests. Results: Among the 90 ranked medical schools, 87 had available data. Sixty-three medical schools (72.4%) had some paid leave for birth mothers, but only 13 (14.9%) offered 12 weeks of fully paid leave. While 11 medical schools (12.6%) offered 12 weeks of full paid leave for nonbirth parents, 38 (43.7%) had no paid leave for nonbirth parents. Adoptive and foster parents had no paid leave in 35 (40.2%) and 65 (74.7%) medical schools, respectively. Median paid parental leave was 4 (IQR, 0-8) weeks for birth parents, 4 (IQR, 0-6) weeks for adoptive parents, 3 (IQR, 0-6) weeks for nonbirth parents, and 0 (IQR, 0-1) weeks for foster parents. About one-third of medical schools required birth mothers to use vacation (29 [33.3%]), sick leave (31 [35.6%]), or short-term disability (9 [10.3%]). Among institutional characteristics, higher ranking (top vs bottom quartile: 30.4% vs 4.0%; P = .03) and private designation (private vs public, 23.5% vs 9.4%; P < .001) was associated with a higher rate of 12 weeks of paid leave for birth mothers. Conclusions and Relevance: In this cross-sectional national study of medical schools ranked by US News & World Report in 2020, many physician faculty receive no or very limited paid parental leave. The lack of paid parental leave was associated with higher rates of physician burnout and work-life integration dissatisfaction and may further perpetuate sex, racial and ethnic, and socioeconomic disparities in academic medicine.

The educational and psychological impact of the COVID-19 pandemic on medical students: A descriptive survey at the American University of Beirut.

ABSTRACT: The SARS- CoV-2 virus has been a public health crisis since its emergence in 2019. It has affected nearly all aspects of life. Education has been particularly hit, and a lot of effort has been put to implement more and more virtual platforms through online classes, meetings and conferences. Medical education has also been affected, especially because of the need for hands-on education, specifically in the clinical setting of the last 2 years. This had a huge psychological impact on the medical students currently enrolled in medical schools around the globe.In this descriptive study, we sent all medical students at the American University of Beirut Faculty of Medicine (AUBFM) an online anonymous survey by email. The survey started with general questions (age, gender and medical school year), followed by 3 sections that contain questions pertaining to the attitudes of medical students towards clinical rotations and online classes. Data was then analyzed using SPSSv24 and was then reported as percentages.Students were almost equally divided among the medical school classes (Med 1, 2, 3, and 4). The majority of clinical students (Med 3 and Med 4) reported that they feel nervous during their rotations in the hospital. Moreover, they reported that they have increased their use of disinfectants and personal protective equipment since the emergence of the pandemic. Moreover, the majority of medical students reported that they feel more stressed after shifting to online classes. Medical students also reported that they would be willing to go back to on-campus classes.This study aimed at describing the response of medical students at AUBFM to the COVID-19 pandemic in terms of stress. Limited data exists in the literature concerning the psychological impact of the COVID-19 pandemic on medical students in the middle East. Medical students reported that they feel more stressed and nervous during their clinical rotations and after the shift to online education, affecting their academic and social life. Further studies using a larger sample size are needed.