Personality type and medical specialty choice.

The July 1999 issue of the Journal of the Louisiana State Medical Society reported results of the Myers-Briggs Type Indicator administered to 1,797 students at Louisiana State University School of Medicine in New Orleans, Louisiana from 1988 through 1998. The current follow-up study has as its subjects 1,262 matriculants who entered the School from 1988 through 1995 and completed their medical undergraduate studies by May 1999. In addition to identification of the graduates' Myers-Briggs type, information on their residency choice was also available. In this study, the authors explore possible association between the graduates' personality type and their chosen career, along with possible type differences of those graduates selecting primary care and those choosing non-primary care specialties.

Why graduates of the LSU School of Medicine, New Orleans choose primary care careers.

In an effort to determine the factors that influence medical students to choose careers in primary care fields, 1994 LSU-New Orleans School of Medicine graduates in residency programs in family medicine, internal medicine, and pediatrics were surveyed. Factors relating to internal influences, such as clerkships or faculty exposure, or external factors, such as a primary care physician role model or national emphasis on primary care, were ranked according to their influence upon the respondents career choice. The more influential factors were clerkships and primary care electives and the national emphasis on primary care. A majority of the respondents indicated plans to practice in Louisiana. Recommendations for increasing primary care interest are proposed.

Psychosocial changes during the first year of medical school.

The goal of this study was to assess psychosocial changes during the first year, on measures thought related to the long-term adjustment of medical students. Measures of self-esteem, health locus of control, hassles, uplifts, mood, and symptoms of stress were administered at the beginning and end of first year to 128 of 181 students. Self-esteem, powerful other locus of control, and uplifts decreased while hassles increased during the year. Positive mood decreased (joy, contentment, vigour, and affection) while negative mood increased (depression and hostility). Hassles at the beginning of the year were positively associated with health outcome at the beginning and end of the year. End-of-the-year first-year students appear to be worse off psychosocially than when they entered. With greater emphasis on health promotion and disease prevention and the adoption of other reforms in medical education, as suggested in the GPEP Report, medical students may learn to cope more effectively with stress as they pursue their medical education.

Perceived mistreatment and attitude change by graduating medical students: a retrospective study.

The goal of this study was to assess types and sources of perceived mistreatment, perceived attitude change, and academic performance of graduating medical students. A total of 87 of 143 (61%) students anonymously completed a mistreatment questionnaire, an attitude questionnaire, and questions about academic performance. The percentage of mistreatment was widespread (98.9%) with psychological mistreatment (shouting and humiliating) by residents/interns being most frequent. Over half of the students perceived sexual harassment, with women reporting greater harassment than men. There was a high incidence of disparaging remarks about doctors and medicine as a profession from a variety of sources. Increased mistreatment was positively associated with a perceived increase in cynicism. The potentially adverse effects of mistreatment on the individual student, the teacher-student relationship, and the doctor-patient relationship are discussed with recommendations for improving medical education.

A retrospective study of attitude change during medical education.

A retrospective attitude questionnaire was administered to 70 of 157 graduating seniors at the end of the medical school year. Students perceived that they became more cynical during medical education. In addition, they perceived that they were more concerned with making money, more concerned for patients, and more helpful. These findings relate to the developmental stressors of medical education as they affect the individual student. Burn-out and impairment are possible consequences; a preventive approach is advocated.

Graduating medical students' ratings of stresses, pleasures, and coping strategies.

The authors' objective in the study reported here was to gather data on the stress and coping of medical students in order to design a health promotion and wellness program. A retrospective questionnaire was completed by 71 of 157 graduating seniors. Examinations, classwork, and financial responsibilities were considered the three most stressful aspects of medical education. The most uplifting items (that is, pleasant, happy, or satisfying experiences) were recreation and social interaction, although good examination performance was rated second highest. Planful problem-solving (that is, deliberate problem-focused efforts to alter a situation) was the most frequently used form of coping, although four of the eight forms of coping assessed were used at least moderately often and all eight were used to some extent.

A survey of health promotion programs in U.S. and Canadian medical schools.

A health promotion and wellness survey questionnaire was sent to all 143 accredited medical schools in the United States, Canada, and Puerto Rico. Of the 120 responding schools, 29 (24.2%) offer health promotion programs and 91 (75.8%) do not; most programs began only recently (average 5.42 years). Nineteen schools plan to begin programs soon. Most emphasized in the programs is physical well-being and least emphasized is spiritual well-being. Over 50% of the schools offer these components: study skills (62.1%), support groups (62.1%), time management (58.6%), aerobics (55.2%), intramural sports (55.2%), and financial planning (51.7%). Most programs are administered by the Dean of Student Affairs, 48.3% have a budget, and 51.7% have an evaluation component. All schools with programs expressed an interest in developing a network to share information. Emphasizing health promotion and disease prevention throughout medical education is important, particularly as an approach to enhancing the doctor-patient relationship.

Substrate metabolism in the isolated perfused dog kidney.

The relationships between substrate utilization and renal work were investigated in an isolated, perfused dog kidney preparation: substrate utilization included free-fatty acid (FFA), glucose, and oxygen, whereas work was assessed by measuring TNa+. The magnitude of TNa+ was varied by altering glomerular filtration rate as a consequence of changing renal blood flow. As the rate of renal blood flow was reduced, both Qo2, and QFFA decreased while Qglucose increased. The reduction in QFFA and Qo2 paralleled the decrease in TNa+. An inverse relationship was noted between QFFA and Qglucose in all experiments. The results suggest that FFA and perhaps glucose may serve as a significant substrate for providing energy for TNA+ in the kidney. Further, since QFFA and Qglucose are inversely related to each other, glucose may substitute for FFA as an energy source at times when QFFA is reduced.