Which U.S. medical graduates plan to become specialty-board certified? Analysis of the 1997-2004 national association of American Medical Colleges Graduation Questionnaire database.

BACKGROUND: Predictors of U.S. allopathic medical-school graduates' board-certification plans have not been characterized. METHOD: Using multivariable logistic regression, graduates' responses to 11 questions on the 1997-2004 Association of American Medical Colleges Graduation Questionnaire were analyzed to identify independent predictors of plans for specialty-board certification. RESULTS: The proportion of 108,408 graduates planning specialty-board certification decreased from 97.3% in 1997 to 88.4% in 2004. Among 101,805 (93.9%) graduates with complete data, graduates who were Hispanic, rated their clinical clerkships, quality of medical education, and confidence in clinical skills more highly, had any debt, and planned "University-faculty" careers were more likely to plan becoming board certified. Females, Asians/Pacific Islanders, and graduates who planned to practice in underserved areas, planned "other" nonclinical-practice careers, and graduated with MD/other (non-PhD) degrees were less likely to plan becoming board certified. CONCLUSION: Specialty-board certification does not appear to be among the professional goals for a growing proportion of U.S. medical graduates.

How perceived risk and personal and clinical experience affect medical students' decisions to seek treatment for major depression.

PURPOSE: To examine the role of perceived risk, and personal and clinical experience in medical students' treatment seeking behavior for major depression. METHOD: In 2003, a questionnaire was administered to 173 first-year and 164 fourth-year medical students at Northwestern University's Feinberg School of Medicine to assess students' perception of risk for major depression in the general population and personal and clinical experience with major depression. Treatment-seeking behavior was examined using a hypothetical scenario. Data analysis used analysis of variance and regression models. RESULTS: A total of 157 (91%) first-year and 108 (66%) fourth-year students completed the questionnaire. The majority overestimated the risk for major depression in the general population (p <.001), although respondents were more accurate for risk in the medical student population. The significant predictors for willingness to diagnose depression in the scenario were: risk perception (beta =.176, p <.01), clinical experience (beta =.173, p <.01) and personal treatment for major depression (beta =.188, p <.01). Significant predictors for willingness to refer to a professional were personal treatment (beta =.136, p <.05) and having a close friend treated for major depression (beta =.176, p <.01). CONCLUSIONS: Students' hesitation to seek treatment may be explained by the overestimation of risk, which has been shown to cause increased anxiety and avoidance of health seeking behavior. Interestingly, personal experience was found to be a significant predictor of treatment seeking behavior. This information can be used in preparing health risk communication messages for medical students.

An interviewing course for a psychiatry clerkship.

OBJECTIVE: Taking a psychiatric history is a key educational objective in the psychiatry clerkship. Medical students arrive on psychiatry clerkships unprepared for the unique challenges of psychiatric interviewing. This paper describes an interviewing course for psychiatry clerks that combines practice, observation, and feedback in a small group setting. METHODS: A quasi-experimental cohort design with medical student self-ratings as the dependent variable. RESULTS: Students' self-perceived skill in interviewing and differential diagnosis improved more than students who did not have the interviewing course. Students' self-perceived skills also correlated significantly with the number of times they observed interviews. CONCLUSION: Clerkship directors in psychiatry should provide students with opportunities to practice interviewing skills, observe interviews, and receive feedback.