Diversity, Equity, and Inclusion Content on Ophthalmology Fellowship Webpages.

This quality improvement study characterizes diversity, equity, and inclusion content on ophthalmology fellowship program websites.

Analyzing diversity, equity, and inclusion content on dermatology fellowship program websites.

Diversity, Equity, and Inclusion (DEI) initiatives have garnered increasing attention within medical education as there have been increased efforts to diversify the physician workforce among medical students, residents, fellows, and attendings. One way in which programs can improve their DEI initiatives and attract a more diverse pool of applicants is through DEI content on their graduate medical education websites. Prior studies characterizing the content and prevalence of DEI material on residency webpages have shown that dermatology residencies have relatively low levels of DEI content on their websites in which almost ¾ of all programs having no DEI content. Little is known, however, if similar findings are to be expected for the three main dermatology subspecialty fellowship program webpages: Dermatopathology, Pediatric Dermatology, and Micrographic Surgery and Dermatology Oncology. Fellowship programs were identified using the Accreditation Council for Graduate Medical Education's online database of fellowship programs. Programs were evaluated on a standardized scoring system for five equally weighted criteria: fellowship-specific DEI webpage, DEI commitment statement, DEI initiatives (summer research opportunities for under-represented minorities, DEI council, etc.), link to the institution's DEI homepage, and information about bias training. The mean score among all programs was 12.5. Pediatric dermatology ranked the highest among all specialties, while Mohs ranked the lowest. A link to the institution's DEI homepage was the most prevalent factor accounting for 42.1% of all programs collected, whereas information about bias training and fellowship-associated DEI webpage were the least prevalent. The results of this study reveal an overall lack of DEI content across all dermatology subspecialties' webpages and represent an actionable area of improvement for fellowship directors to increase their DEI efforts to attract a diverse pool of applicants to their program.

Ansa Pancreatica: A Rare Culprit in Recurrent Acute Pancreatitis.

Ansa pancreatica is a rare anatomical variation of the pancreatic duct system, characterized by a reversed S-shaped loop that connects the main pancreatic duct to the minor papilla. Its clinical significance, particularly with recurrent acute pancreatitis, has been a subject of interest, but remains poorly understood due to the rarity of reported cases. We report the case of a 34-year-old female with a history of multiple episodes of acute pancreatitis, diagnosed with ansa pancreatica using magnetic resonance cholangiopancreatography (MRCP). The patient presented with severe epigastric pain radiating to the back, accompanied by vomiting and nausea. Laboratory findings revealed elevated serum amylase and lipase levels. MRCP imaging identified the ansa pancreatica, showing a distinct looping ductal variant terminating near the minor papilla. The patient underwent successful endoscopic treatment with significant improvement in symptoms and no recurrence of pancreatitis at follow-up. In this case, the presence of ansa pancreatica underscores the variant's potential role in predisposing individuals to recurrent episodes of acute pancreatitis. The literature review highlights the anatomical description of ansa pancreatica and its speculated pathophysiological mechanism leading to pancreatitis, primarily due to impaired pancreatic juice drainage. Despite its rarity, recognizing ansa pancreatica is crucial for the appropriate management of idiopathic recurrent pancreatitis, especially in cases where conventional causes are absent. This case report and literature review emphasize the importance of considering ansa pancreatica in the differential diagnosis of recurrent acute pancreatitis. Further research is needed to elucidate the exact mechanism by which this anatomical variant contributes to pancreatitis and to explore potential therapeutic interventions. Awareness and early detection of ansa pancreatica can lead to targeted treatments, reducing the morbidity associated with recurrent pancreatitis episodes.

Future Implications of Artificial Intelligence in Medical Education.

Artificial intelligence has experienced explosive growth in the past year that will have implications in all aspects of our lives, including medicine. In order to train a physician workforce that understands these new advancements, medical educators must take steps now to ensure that physicians are adequately trained in medical school, residency, and fellowship programs to become proficient in the usage of artificial intelligence in medical practice. This manuscript discusses the various considerations that leadership within medical training programs should be mindful of when deciding how to best integrate artificial intelligence into their curricula.

Characterizing the initial effects of the single accreditation system merge on the ophthalmology residency match.

INTRODUCTION: In 2020, the American Osteopathic Association merged its residency programs into one system under the Accreditation Council for Graduate Medical Education (ACGME). The effects of this transition on the ophthalmology match is not fully understood. The purpose of this study is to assess the early impact of the transition to ACGME accreditation on MD, DO, and IMG representation in ophthalmology residency programs. MATERIALS AND METHODS: Information about resident medical degree and resident medical school was gathered from ophthalmology residency program websites from a resident class before and after the Transition. Additionally, the medical degree of residency program directors (PD) was collected to analyze MD vs DO leadership in ophthalmology residency programs and to further stratify resident data to identify any trends in PD preference for different medical graduates. RESULTS: Data was obtained for 915 ophthalmology residents in 110 residency programs that met the study's inclusion criteria. Of these programs, 102 were allopathic with MD leadership, 1 was allopathic with DO leadership, 3 were osteopathic with MD leadership, and 4 were osteopathic with DO leadership. Overall, MD representation increased while DO and IMG representation decreased although not significantly. For both classes analyzed, DO and IMG representation was disproportionately low. DISCUSSION: The transition to ACGME accreditation seems to have primarily harmed DO and IMG applicants in the ophthalmology match while benefitting MDs. Various factors such as loss of protected residency positions for DO applicants and the closure of osteopathic ophthalmology residency programs are likely reasons to blame for this decrease in osteopathic representation.

Integration of Arts and Humanities in Medical Education: a Narrative Review.

This narrative review aims to identify and review the extant literature describing methods and outcomes of embedding the arts and humanities (AH) into medical school curricula. The Association of American Medical Colleges changed the Medical College Admission Test (MCAT) in 2015 to place new emphasis on the role of liberal arts in the process of developing well-rounded physicians. Consequently, medical schools have been implementing more connections to creative writing, literature, theater, movies, music, and the visual arts into their curricula. To review the current literature, we focused on methods medical educators used to embed content related to AH into their curricula to shape and drive associated learning outcomes. We conducted searches in PubMed, CINAHL, PsycINFO, and ERIC for peer-reviewed articles from 2011 to 2020. The authors selected three dyads in medical humanities and reviewed articles independently followed by discussion to identify thematic links to major findings. Out of 261 articles, a total of 177 full-text articles were reviewed with 34 selected for final inclusion. Our review included articles describing curriculum development and delivery in publications from Australia, Canada, India, New Zealand, and the USA. This review showed medical educators are implementing didactic and experiential instructional approaches to embedding the arts, humanities, and social sciences into the medical school classroom. Medical educators' attempts to embed AH into medical school curricula show promising results. Unfortunately, small sample sizes, short-term interventions, and an over-reliance of subjective assessment measures limit our knowledge of the true impact of these interventions. More rigorous assessments of required and longitudinal coursework are necessary to know the true impact of participation in AH coursework for medical students.

Radiological and Embryological Relevance of Persistent Sciatic Arteries: A Rare Presentation.

Persistent sciatic artery (PSA) is an extremely rare condition that is present in around 0.05% of the population and is commonly associated with many complications. The management is conservative or through surgical intervention and depends on the type of complication. The case presented is of a 40-year-old man who complained of persistent pain in the buttock region. On radiology, bilateral PSAs were observed exiting through the infra-pyriformis compartment of the greater sciatic foramen accompanying the sciatic nerve. The femoral artery and the external iliac artery are small in caliber. In this case report, we discuss the underlying embryology that might have led to the persistence of this vessel with illustrations and the abnormal radiological pattern of this anomaly. Increased awareness of PSA can improve patient care and prevent potentially hazardous complications during hip and renal transplant surgery.

Abnormal Anatomical and Radiological Changes in a Rare Presentation of Adult Developmental Dysplasia of the Hip.

Adult presentation of bilateral dysplasia and dislocation is an extremely rare presentation. The management of adult hip dysplasia is to preserve the hip and reduce pain through surgical intervention. Hence, early diagnosis provides more options as the treatment dilemma with the late presentation is very complicated with debatable prognosis. The case presented is a 53-year old woman who complained of persistent pain in the hip region. On radiology, dysplasia and dislocation of both the hip joints were observed along with soft tissue abnormalities around the joint. In this case report, we discuss the underlying pathophysiology that might have led to the abnormal radiological and anatomical changes in the hip region and the possible treatment options in a conservatively managed case of developmental dysplasia of the hip (DDH).

Team Assessment in Laboratory Setting (TAILS): a Novel Approach Using Cadavers to Assess Collaborative Learning in the Gross Anatomy Lab.

Team assessment in laboratory setting (TAILS) is a feasible and a novel method of testing the application of anatomical knowledge using the available institutional resources (cadavers) within the anatomy laboratory setting. For preclinical medical students, this method augments clinical authenticity and facilitates collaborative learning.

Folate/Vitamin B12 Supplementation Combats Oxidative Stress-Associated Carcinogenesis in a Rat Model of Colon Cancer.

Folate and vitamin B12 deficiency is associated with depletion of the major intracellular antioxidant glutathione, and oxidative stress is emerging as an etiological mechanism for colon cancer. Azoxymethane (AOM), a potent carcinogen, induces colon cancer in rats by causing pathophysiological changes and oxidative stress. We investigated the synergistic effect of folate and vitamin B12 supplementation against AOM-induced carcinogenesis and oxidative stress in rat colon. Adult male rats were distributed into four groups: 1) Basal diet only; 2) AOM injection (15 mg/kg once per week in weeks 5 and 6); 3) Folate and vitamin B12 supplemented diet; 4) Folate and B12 diet with AOM injection. After 16 weeks, rats were sacrificed, colon tissue dissected, indicators of oxidative stress were measured, and immunohistochemical and ultrastructural changes were evaluated. AOM-injected rats showed oxidative stress, evident by glutathione depletion, oxidation of cellular proteins, and DNA oxidative damage. AOM increased mucosal levels of antiapoptotic and proapoptotic proteins Bcl2 and Bax and caused ultrastructure changes in colonic cell organelles. Folate and vitamin B12 supplementation decreased the level of oxidative stress and ameliorated the cytotoxic effects of AOM. In this in vivo experimental model of colon cancer, folate and vitamin B12 supplementation combats carcinogen-induced oxidative stress.

Metastatic invasive lobular carcinoma of the breast masquerading as a primary renal malignancy.

Breast cancer is known to metastasise to different organs in the body, but an initial presentation of breast cancer with loin pain secondary to a metastatic renal mass is extremely rare. We report a 58-year-old woman who presented with recurrent left loin pain due to a metastatic deposit of invasive lobular carcinoma of the breast. The detection of a renal mass on computed tomography led to the assumption of a renal pelvic malignancy. The diagnostic dilemma posed by the detection of a breast mass during staging and the usefulness of immunohistochemistry in the confirmation of diagnosis are discussed.

Idiopathic Granulomatous Mastitis: Diagnostic strategy and therapeutic implications in Omani patients.

OBJECTIVES: Idiopathic granulomatous mastitis (IGM) is a rare benign disorder of the breast whose aetiology is controversial, and is often misdiagnosed clinically and radiologically as mammary malignancy; as a result, it may be incorrectly treated. Although no standard treatment is available for this chronic disease, surgery with or without corticosteroids has been tried with controversial results. This study discusses the clinical presentation, diagnosis, management, recurrence, and follow-up data of IGM with a review of relevant literature. METHODS: From 2009-2012, the Breast Unit at Sultan Qaboos University Hospital, Oman, conducted a clinical study on 20 patients with breast lumps. Their clinical and radiological examinations were indeterminate, and a diagnosis of granulomatous mastitis was established only by histopathology. RESULTS: The majority of the patients were cases of unknown aetiology, who presented with a unilateral breast mass. A few patients had a mass with an abscess, along with axillary lymphadenopathy. A total of 4 patients were suspected of malignancy using radiology. In all patients, sterilised pus was sent for culture and sensitivity. Microscopy showed the characteristic pattern of granulomatous inflammation. All patients were treated with antibiotics for 6 weeks, and the mean follow-up period was 15 months (11-33 months). All patients had complete remission with no further recurrence. CONCLUSION: This single largest study of cases of IGM in Oman highlights the pitfalls in diagnosing this non-neoplastic disease of unknown aetiology and uncertain pathogenesis. It emphasises IGM's excellent response to antibiotics, which is crucial, as IGM is a disease which is notoriously difficult and controversial to treat.

Implementing a modified team-based learning strategy in the first phase of an outcome-based curriculum--challenges and prospects.

BACKGROUND: Team-based learning (TBL) is an innovative form of collaborative learning. The aim of TBL is to create a motivational context in which students become accountable for their learning. AIM: Student attendance at didactic lecture sessions in our school is usually poor. A modified TBL approach in lieu of lectures was undertaken for the first time in a large class (150 students). This communication reports on the challenges of its implementation in our setting and preliminary data on its effects on student performance. METHOD: Using computer-based evaluation followed by an in-class activity, a modified TBL approach was implemented over two semesters during an introductory basic science course. Data on student performance, student motivation and faculty reflection were collected and analysed. RESULTS: This strategy had significantly enhanced students' class attendance. They performed better on the built-in TBL assessment (IRAT) compared to standard in-course tests. Besides content mastery, TBL approach could also instill useful attitudinal outcomes such as self-directed learning. CONCLUSIONS: The TBL strategy is a viable and refreshing alternative to the usual didactic faculty engagement with the teaching process. Students appear to do better in tests built-in within TBL as compared to stand-alone in-course tests.

"Between a Rock and a Hard Place": The discordant views among medical teachers about anatomy content in the undergraduate medical curriculum.

The last two decades of medical education have been marked by a persistent push towards curricular reform. Anatomy as a discipline, the unshakable foundation of medical teaching for hundreds of years, has been at the centre of this development. Although it is widely agreed that for doctors to be competent, they need an adequate knowledge of anatomy underpinning medicine, there is much less agreement over the quantity required, and who should decide and define it. Many clinicians feel medical students are being under-trained in this basic medical science before reaching the clinical stages. Professional accreditation boards advocate the reduction of factual information in undergraduate medical courses. Anatomists complain of a progressive erosion of the time allocated to the subject. Caught in the midst of this controversy is the student of anatomy who is left bewildered and confused about what is required from him to become a safe and competent health professional. The way forward might, first, be for medical schools to facilitate discussions between students, anatomy professors, and clinicians to bring these divergent perspectives into alignment. Second, the anatomists need to re-invent themselves in two principal frameworks: first, to present the subject in the context within which it will be utilised by the student, and second to employ the overwhelming learning tool of today, i.e. technology, in their teaching and assessment of the subject.

Anatomy practical examinations: how does student performance on computerized evaluation compare with the traditional format?

Practical examinations in anatomy are usually conducted on specimens in the anatomy laboratory (referred to here as the "traditional" method). Recently, we have started to administer similar examinations online using the quiz facility in Moodle™. In this study, we compare student scores between two assessment environments viz. online and traditional environments. We hypothesized that regardless of the examination medium (traditional or online) overall student performance would not be significantly different. For the online medium, radiological images, prosected specimens, and short video clips demonstrating muscle action were first acquired from resources used for teaching during anatomy practical classes. These were optimized for online viewing and then uploaded onto Moodle learning management software. With regards to the traditional format, actual specimens were usually laid out in a circular stream. Identification tags were then attached to specific spots on the specimens and questions asked regarding those identified spots. A cohort of students taking practical examinations in six courses was studied. The courses were divided into three pairs with each pair credit-weight matched. Each pair consisted of a course where the practical examination was conducted online and the other in the traditional format. There was no significant difference in the mean scores within each course pair. In addition, a significant positive correlation between score in traditional and online formats was found. We conclude that mean grades in anatomy practical examination conducted either online or in the traditional format were comparable. These findings should reassure teachers intending to use either format for their practical examinations.

Perceptions and Attitudes of Medical Students towards Two Methods of Assessing Practical Anatomy Knowledge.

OBJECTIVES: Traditionally, summative practical examination in anatomy takes the form of 'spotters' consisting of a stream of prosections, radiological images and dissections with pins indicating specific structures. Recently, we have started to administer similar examinations online using the quiz facility in Moodle™ (a free, open-source web application for producing modular internet-based courses) in addition to the traditional format. This paper reports on an investigation into students' perceptions of each assessment environment. METHODS: Over a 3-year period, practical assessment in anatomy was conducted either in traditional format or online via learning management software called Moodle™. All students exposed to the two examination formats at the College of Medicine & Health Sciences, Sultan Qaboos University, Oman, were divided into two categories: junior (Year 3) and senior (Year 4). An evaluation of their perception of both examination formats was conducted using a self-administered questionnaire consisting of restricted and free response items. RESULTS: More than half of all students expressed a clear preference for the online environment and believed it was more exam-friendly. This preference was higher amongst senior students. Compared to females, male students preferred the online environment. Senior students were less likely to study on cadavers when the examination was conducted online. Specimen quality, ability to manage time, and seating arrangements were major advantages identified by students who preferred the online format. CONCLUSION: Computer-based practical examinations in anatomy appeared to be generally popular with our students. The students adopted a different approach to study when the exam was conducted online as compared to the traditional 'steeplechase' format.