Helping patients receive medical benefits. Collaboration between hospitals and legal services assists providers and low-income Kansans.

In Kansas, legal services lawyers have teamed up with Catholic healthcare administrators to help uninsured and underinsured hospital patients receive healthcare benefits from programs for which they may be eligible. The project--Hospital Patient Assistance Program--provides comprehensive assistance in establishing a patient's eligibility for medical benefits. Hospital participation in the program is simple. When business office or admissions staff discover that a self-pay patient has been registered with the program, they refer the patient to Kansas Legal Services; Inc. (KLS). KLS staff members try to determine if the patient is eligible for benefits from any of a number of programs, including Medicaid, Medicare, and Crime Victims Assistance. If KLS finds no programs for which the patient is eligible, it does not accept the case and notifies the hospital. Hospitals participating in the program have found that many accounts they previously wrote off as not collectible can be paid. Since the program began in 1990, participating hospitals have realized almost $8 million in payments from various benefit sources.

Use of free time in the third and fourth years of a flexible curriculum.

In 1988, the author surveyed senior students on their use of the six months of free time in the junior-senior biennial at the University of Minnesota Medical School-Minneapolis. The students were asked both to provide detailed reports on their free-time activities and to rank the three activities they considered to be most helpful to their professional development. Of 274 seniors, 191 (70%) responded. The students had used a majority of their free time for pursuits related to education and advancement of their careers. Approximately one-third of the time had been used for vacations. The activities the students viewed as most helpful included research, interviewing for residency positions, vacation, study elsewhere, and preparation for the National Board of Medical Examiners Part II examination. The author suggests that when free time is made available in a flexible curriculum, students use it to advantage in an educationally responsible manner.

Influences of marital status and parental status on the professional choices of physicians about to enter practice.

The trend toward increasing numbers of working women may alter the ways both men and women physicians structure their professional lives. The 1987 graduates of residency and fellowship programs at the University of Minnesota Medical School--Minneapolis were surveyed in June 1987 about professional plans and factors that led to their decisions. The women expected that their spouses would contribute half of their family's income, whereas the men expected that they would be largely responsible for their family's income. The married women with children planned on working fewer hours than did other physicians. Family structure may play an important role in preventing the convergence of men and women physicians' personal incomes or working hours.

The use of Part I National Board scores in the selection of residents in ophthalmology and otolaryngology.

A survey of ophthalmology and otolaryngology residency program directors was conducted to determine the extent to which National Board of Medical Examiners (NBME) Part I scores are used in selection of residents in these highly competitive specialty fields. Results from 218 completed questionnaires representing nearly 90% of all US ophthalmology and otolaryngology/head and neck surgery programs were analyzed. More than three fourths indicated that Part I NBME scores were used in selecting residents; more than half of the programs used these scores as a means to determine whom to interview. The direct use of NBME scores in the residency application process is widespread; however, such use of NBME scores is not consistent with the purposes of the National Board. The preeminent role of the faculty in the evaluation of medical students and in the assessment of their clinical competence needs emphasis.