ABSTRACT
BACKGROUND: The transition to residency is competitive with more medical students applying for residency positions than slots available, and some will face challenges securing a position in their desired specialty. Our institution created a transitional year (TY) residency program in 2016 to help meet the needs of our medical students who did not initially secure a position in the main residency Match. OBJECTIVE: This report provides a brief overview of the TY program and analysis of the program's value from the inaugural 3 years (2017-2020). METHODS: The TY program is based at a midsized, urban, academic health center and features a tailorable curriculum emphasizing preparation for residents' specialty career plans. We used participatory action research and appreciative inquiry strategies as part of the annual program evaluation to examine TY residents' perceptions of the program's value. Stakeholder perceptions were also elicited from a purposive selection of 4 program directors and 2 key medical school education leaders. RESULTS: Internal evaluations revealed a high rate of resident satisfaction with the TY program and self-reported benefits such as increased confidence, clinical proficiency, and professional enculturation. Stakeholders valued the program as a potential pipeline for increasing physicians in the state and providing valuable direction to students' career trajectories. CONCLUSIONS: Creating a TY residency program to meet the needs of unmatched medical students was feasible to implement, acceptable to residents in meeting their academic and career needs, and provided a sustainable institutional solution with benefits to multiple stakeholders.
Subject(s)
Internship and Residency , Students, Medical , Curriculum , Humans , Personal Satisfaction , Schools, MedicalABSTRACT
RATIONALE: Effective δ(18) O determinations of organic compounds have been made using high-temperature pyrolysis (HTP) units that employ molybdenum (Mo) foil as an oxidation barrier instead of glassy carbon. In this investigation we evaluated the performance of a Mo-lined reactor during δ(18) O determinations from benzoic acid using a standard high-temperature conversion elemental analyser (TC/EA) unit. Our Mo-lined reactor was associated with poor performance statistics. It was hypothesised that this was as a consequence of the partitioning of oxygen within our system. METHODS: In order to test this hypothesis scanning electron microscopy energy-dispersive X-ray spectroscopy (SEM-EDX) and Raman spectroscopy was conducted on two Mo-lined reactors, which had been used for the analysis of benzoic acids. RESULTS: The EDX analysis revealed that the Mo metal, which had become severely pitted and corroded in the region corresponding to the hottest part of the furnace, was associated with Mo-oxide patinas throughout its entire length. CONCLUSIONS: A complex circular reaction between CO, Mo and C is likely to be responsible for the sequestering of a portion of sample oxygen into Mo-oxides, fractionating our sample. Accurate analysis of benzoic acid and other compounds can therefore only be achieved if sample oxygen is quantitatively returned to gaseous CO, preventing the buildup of Mo-oxides within the reactor over time. This is most likely to be achieved if sample gases have a sufficient residence time within the reactive glassy carbon bed, optimising the recovery of sample oxygen. However, such conditions are unlikely to have been met within our standard TC/EA system resulting in poor performance of the Mo-liner compared with other HTP units.
ABSTRACT
A method for the isotope analysis of fluid inclusion water in speleothem calcite is presented. The technique is based on a commercially available continuous-flow pyrolysis furnace (ThermoFinnigan TC-EA). The main adaptation made to the standard TC-EA configuration is the addition of a crusher and cold trap unit, which is connected to the carrier gas inlet at the top of the TC-EA reactor tube. A series of tests conducted with this device shows that: (1) standard waters, injected in the crusher, and passed through a cryogenic trapping routine, yield accurate delta(2)H values; (2) crushed cubes of speleothem calcite from two Peruvian caves with rather dissimilar seepage water delta(2)H values yield fluid inclusion delta(2)H values in good accordance with these drip waters. The clear advantage of this continuous-flow technique for fluid inclusion isotope analysis is that it is relatively quick compared with other techniques. Since the conditions of water sample introduction into the TC-EA are identical for delta(2)H and delta(18)O analysis, we expect that only limited adaptations to the extraction procedure are required to provide delta(18)O analysis of fluid inclusion samples with the same device.
ABSTRACT
Current strategies to protect groundwater sources from microbial contamination (e.g., wellhead protection areas) rely upon natural attenuation of microorganisms between wells or springs and potential sources of contamination and are determined using average (macroscopic) groundwater flow velocities defined by Darcy's Law. However, field studies of sewage contamination and microbial transport using deliberately applied tracers provide evidence of groundwater flow paths that permit the transport of microorganisms by rapid, statistically extreme velocities. These paths can be detected because of (i) the high concentrations of bacteria and viruses that enter near-surface environments in sewage or are deliberately applied as tracers (e.g., bacteriophage); and (ii) low detection limits of these microorganisms in water. Such paths must comprise linked microscopic pathways (sub-paths) that are biased toward high groundwater velocities. In media where microorganisms may be excluded from the matrix (pores and fissures), the disparity between the average linear velocity of groundwater flow and flow velocities transporting released or applied microorganisms is intensified. It is critical to recognise the limited protection afforded by source protection measures that disregard rapid, statistically extreme groundwater velocities transporting pathogenic microorganisms, particularly in areas dependent upon untreated groundwater supplies.
