THE UICC FELLOWSHIPS

The UICC offers long, medium, and short-term fellowships to appropriately qualified in-vestigators and specialists in the field of cancer research and clinical management worldwide:ELEANOR ROOSEVELT INTERNATIONAL CANCER RESEARCH FELLOWSHIPS (fundedby the American Cancer Society): 15 to 20 grants are available annually to recognized senior investigators who have beenactively engaged in cancer research for at least five years. The grants contribute to the traveland cost of living expenses of the Fellow and a maximum of three dependents for a period of

Multimodality Imaging Training for General and Advanced Cardiology Fellowships

With the growth in multimodality imaging technology,there is heightened interest in advanced imaging training within the cardiology fellow community.The ideal training models for multimodality imaging remain to be determined and there are uncertainties about the manpower needs for cardiologists with advanced multimodality imaging expertise.This commentary discusses several areas pertaining to training of cardiology fellows in multimodality imaging.

Trends in leadership at orthopaedic surgery sports medicine fellowships

BACKGROUND Fellowship directors(FDs)in sports medicine influence the future of trainees in the field of orthopaedics.Understanding the characteristics these leaders share must be brought into focus.For all current sports medicine FDs,our group analyzed their demographic background,institutional training,and academic experience.AIM To serve as a framework for those aspiring to achieve this position in orthopaedics and also identify opportunities to improve the position.METHODS Fellowship programs were identified using both the American Orthopaedic Society for Sports Medicine and the Arthroscopy Association of North America Sports Medicine Fellowship Directories.The demographic and educational background data for each FD was gathered via author review of current curriculum vitae(CVs).Any information that was unavailable on CV review was gathered from institutional biographies,Scopus Web of Science,and emailed questionnaires.To ensure the collection of as many data points as possible,fellowship program coordinators,orthopaedic department offices and FDs were directly contacted via phone if there was no response via email.Demographic information of interest included:Age,gender,ethnicity,residency/fellowship training,residency/fellowship graduation year,year hired by current institution,time since training completion until FD appointment,length in FD role,status as a team physician and H-index.RESULTS Information was gathered for 82 FDs.Of these,97.5%(n=80)of the leadership were male;84.15%(n=69)were Caucasian,7.32%(n=6)were Asian-American,2.44%(n=2)were Hispanic and 2.44%(n=2)were African American,and 3.66%(n=3)were of another race or ethnicity.The mean age of current FDs was 56 years old(±9.00 years),and the mean Scopus H-index was 23.49(±16.57).The mean calendar years for completion of residency and fellowship training were 1996(±15 years)and 1997(±9.51 years),respectively.The time since fellowship training completion until FD appointment was 9.77 years.17.07%(n=14)of FDs currently work at the same institution where they completed residency training;21.95%(n=18)of FDs work at the same institution where they completed fellowship training;and 6.10%(n=5)work at the same institution where they completed both residency and fellowship training.Additionally,69.5%(n=57)are also team physicians at the professional and/or collegiate level.Of those that were found to currently serve as team physicians,56.14%(n=32)of them worked with professional sports teams,29.82%(n=17)with collegiate sports teams,and 14.04%(n=8)with both professional and collegiate sports teams.Seven residency programs produced the greatest number of future FDs,included programs produced at least three future FDs.Seven fellowship programs produced the greatest number of future FDs,included programs produced at least four future FDs.Eight FDs(9.75%)completed two fellowships and three FDs(3.66%)finished three fellowships.Three FDs(3.66%)did not graduate from any fellowship training program.The Scopus H-indices for FDs are displayed as ranges that include 1 to 15(31.71%,n=26),15 to 30(34.15%,n=28),30 to 45(20.73%,n=17),45 to 60(6.10%,n=5)and 60 to 80(3.66%,n=3).Specifically,the most impactful FD in research currently has a Scopus H-index value of 79.By comparison,the tenth most impactful FD in research had a Scopus H-index value of 43(accessed December 1,2019).CONCLUSION This study provides an overview of current sports medicine FDs within the United States and functions as a guide to direct initiatives to achieve diversity equality.

Surgical and non-surgical education practices in female pelvic medicine and reconstructive surgery fellowships within the United States

Data are scarce regarding surgical and non-surgical education in accredited Female Pelvic Medicine and Reconstructive Surgery (FPMRS) fellowships in theUnited States. We compared surgical and non-surgical and education among training programs and expected surgical comfort level with pelvic reconstructive procedures from the perspective of the fellow and program director. An online survey was distributed to program directors and fellows from the 39 accredited FPMRS fellowships at the time (2010). Domains evaluated in the survey were academic education requirements;surgical approaches to prolapse and to incontinence;other surgical procedures;and research and publication expectations. In total, forty fellows from 21 programs and directors from 27 programs. The most common surgical procedures performed for apical, anterior, and posterior prolapse were uterosacral ligament suspension, native tissue anterior colporrhaphy, and posterior colporrhaphy, respectively. Differences in perceived surgical comfort level were seen for coccygeus suspension, graftreinforced posterior colporrhaphy, rectus fascial sling, urethral bulking agent, cystoscopic ureteral stent placement and bowel repair. A greater proportion of program directors reported that fellows would be comfortable performing these procedures upon graduation than the proportion reported by the fellows themselves. Differences exist in FPMRS training nationwide, however, responding fellows appeared to be trained in multiple approaches to prolapse repair. Differences were seen in surgical comfort level as perceived by fellows and program directors.

Limb Lengthening and Reconstruction Society orthopedic surgeons in the United States:An analysis of geographical distribution,academic,leadership,and demographic characteristics

BACKGROUND The Limb Lengthening and Reconstruction Society(LLRS)is a premier orthopedic specialty organization that promotes limb reconstruction for all ages.LLRS membership characteristics,however,are poorly reported.This study delineates orthopedic surgeon LLRS members’demographic traits,academic achievement,leadership attainment,and geographical distribution across the United States.AIM To inform aspiring orthopedic professionals,as well as to promote growth and diversity in both the LLRS organization and overarching field.METHODS This cross-sectional study examined United States LLRS members’academic,leadership,demographic,and geographical attributes.After reviewing the 2023 LLRS member directory,Google search results were matched to the listings and appended to the compiled data.Sex and ethnicity were evaluated visually utilizing retrieved images.The Hirsch index(H-index)of academic activity,residency and fellowship training,other graduate degrees,leadership positions,practice type(academic or non-academic),and spoken languages were categorized.LLRS members per state and capita determined geographic distribution.The Mann Whitney U test was applied to compare H-index between males and females,as well as to assess member differences pertaining to affiliation with academic vs non-academic practice facilities.RESULTS The study included 101 orthopedic surgeons,78(77.23%)Caucasian and 23(22.77%)non-Caucasian,79(78.22%)male and 22(21.78%)female.Surgeons with DO degrees comprised only 3.96%(4)of the cohort,while the vast majority held MDs[96.04%(97)].Mean H-index was 10.55,with male surgeons having a significantly higher score(P=0.002).Most orthopedic surgeons(88.12%,)practiced in academic centers.Of those professionals who occupied leadership positions,14%were women,while 86%were men.Additionally,19(37.25%)United States regions and the District of Columbia lacked an LLRS-member orthopedic surgeon.Total per capita rate across the United States was 0.30 LLRS orthopedic surgeons per 1 million people.CONCLUSION Over 21%of LLRS members are women,surpassing prior benchmarks noted in orthopedic faculty reporting.LLRS members’high research productivity scores imply field dedication that can refine expertise in the limb lengthening and reconstruction space.Gender disparities in leadership remain,however,necessitating greater equity efforts.A low rate of LLRS representation per capita must be addressed geographically as well,to affect improvements in regional care access.This study can serve to support aspiring orthopedic professionals,inform diversity,leadership,and field advancement strategies,and maintain the continued goal of enhanced patient care worldwide.

Academic productivity correlates with industry earnings in foot and ankle fellowship programs in the United States:A retrospective analysis

BACKGROUND The study investigates the connection between academic productivity and industry earnings in foot and ankle orthopedic surgery fellowships.Utilizing metrics like the H-index and Open Payments Database(OPD)data,it addresses a gap in understanding the relationship between scholarly achievements and financial outcomes,providing a basis for further exploration in this specialized medical field.AIM To elucidate the trends between academic productivity and industry earnings across foot and ankle orthopedic surgery fellowship programs in the United States.METHODS This study is a retrospective analysis of the relationship between academic productivity and industry earnings of foot and ankle orthopedic surgery fellowships at an individual faculty and fellowship level.Academic productivity was defined via H-index and recorded from the Scopus website.Industry earnings were recorded from the OPD.RESULTS Forty-eight foot and ankle orthopedic surgery fellowships(100%of fellowships)in the United States with a combined total of 165 physicians(95.9%of physicians)were included.Mean individual physician(n=165)total life-time earnings reported on the OPD website was United States Dollar(USD)451430.30±1851084.89(range:USD 25.16-21269249.85;median:USD 27839.80).Mean physician(n=165)H-index as reported on Scopus is 14.24±12.39(range:0-63;median:11).There was a significant but weak correlation between individual physician H-index and individual physician total life-time earnings(P<0.001;Spearman’s rho=0.334)and a significant and moderate positive correlation between combined fellowship H-index and total life-time earnings per fellowship(P=0.004,Spearman’s rho=0.409).CONCLUSION There is a significant and positive correlation between academic productivity and industry earnings at foot and ankle orthopedic surgery fellowships in the United States.This observation is true on an individual physician level as well as on a fellowship level.

听力学课程设置的思考与体会

首都医科大学开办的听力学教育课程通过对教学形式与内容的不断摸索,具备了多样性特色,培养了学生多方面能力。

美国企业博士后职业选择与发展研究——以IBM公司Goldstine Fellowship项目为例

IBM的企业博士后Goldstine Fellowship项目坚持高标准、国际化的生源质量,注重博士后在基础科学与理论前沿方面的培养,使博士后职业发展呈现学术性、多元化、高水平的特性。Goldstine Fellowship博士后的职业成长分为萌芽期、培育期、成长期、成熟期和稳定期5个阶段,在职称晋升、论文发表体现了优于同龄人的能力与水平,呈现常态化的提升模式。

APPLIED MATHEMATICS AND MECHANICS

A number of (1) Ph.D. graduate research fellowships, (2) postdoctoral fellowships, and (3) undergraduate research fellowships are available immediately in the area of neutron-diffraction materials research. Candidates with strong backgrounds in Materials Science, Metallurgy (including Processing, and Mechanical/Physical Behavior), Computational Materials Science, Mechanical/Civil Engineering, Physics, Computer Science and Engineering, or a related field are encouraged to apply. The research activities will focus on the subjects of (1) in-situ neutron-diffraction characterization of mechanical behavior (plasticity, twinning, fatigue, and creep deformation) of advanced ma-

Stricter national standards are required for credentialing of endoscopic-retrograde-cholangiopan-creatography in the United States

Endoscopic-retrograde-cholangiopancreatography(ERCP) is now a vital modality with primarily therapeutic and occasionally solely diagnostic utility for numerous biliary/pancreatic disorders. It has a significantly steeper learning curve than that for other standard gastrointestinal(GI) endoscopies, such as esophagogastroduodenoscopy or colonoscopy, due to greater technical difficulty and higher risk of complications. Yet, GI fellows have limited exposure to ERCP during standard-three-year-GI-fellowships because ERCP is much less frequently performed than esophagogastroduodenoscopy/colonoscopy. This led to adding an optional year of training in therapeutic endoscopy. Yet many graduates from standard three-year-fellowships without advanced training intensely pursue independent/unsupervised ERCP privileges despite inadequate numbers of performed ERCPs and unacceptably low rates of successful selective cannulation of desired(biliary or pancreatic) duct. Hospital credentialing committees have traditionally performed ERCP credentialing, but this practice has led to widespread flouting of recommended guidelines(e.g., planned privileging of applicant with 20% successful cannulation rate, or after performing only 7 ERCPs);and intense politicking of committee members by applicants, their practice groups, and potential competitors. Consequently, some gastroenterologists upon completing standard fellowships train and learn ERCP 'on the job' during independent/unsupervised practice, which can result in bad outcomes: high rates of failed bile duct cannulation. This severe clinical problem is indicated by publication of ≥ 12 ERCP competency studies/guidelines during last 5 years. However, lack of mandatory, quantitative, ERCP credentialing criteria has permitted neglect of recommended guidelines. This work comprehensively reviews literature on ERCP credentialing;reviews rationales for proposed guidelines;reports problems with current system;and proposes novel criteria for competency. This work advocates for mandatory, national, written,minimum, quantitative, standards, including cognitive skills(possibly assessed by a nationwide examination), and technical skills, assessed by number performed(≥ 200-250 ERCPs), types of ERCPs, success rate(approximately ≥ 90%cannulation of desired duct), and letters of recommendation by program director/ERCP mentor. Mandatory criteria should ideally not be monitored by a hospital committee subjected to intense politicking by applicants, their employers, and sometimes even competitors, but an independent national entity,like the National Board of Medical Examiners/American Board of Internal Medicine.

Evolution of gastroenterology training

There have been rapid developments in gastroenterology(GE)over the last decade.Up until the late 1980s,GE-training was incorporated in Internal Medicine training.The introduction of endoscopy has necessitated the need for additional training.Around the world different national boards have developed their own curricula which will be discussed in this paper. Emphasis will be placed on the curriculum recently introduced in The Netherlands.The internal medicine component has become a two-year requirement (Common Trunk)and the duration of training in GE has been extended to four years.Because of the growing complexity of GE,there are now four subspecialties:Interventional Endoscopy,Neuromotility, Oncology and Hepatology that trainees can choose from.These subspecialties each have predefined specific requirements.The World Gastroenterology Organization has drawn up a standard curriculum which can be of help to the boards in different countries. The curriculum emphasizes the knowledge and skill components.The curriculum also defines the training recommendations,the requirements of training facilities and competence evaluation of fellows and facilities,while less is said about research,finance and the number of gastroenterologists required.In the coming decades the curriculum will need to be revised continuously.Personalization of the curriculum will be the next challenge for the years to come.

Disruptive behavior in the workplace: Challenges for gastroenterology fellows

To assess first-year gastroenterology fellows’ ability to address difficult interpersonal situations in the workplace using objective structured clinical examinations (OSCE).METHODSTwo OSCEs (“distracted care team” and “frazzled intern”) were created to assess response to disruptive behavior. In case 1, a fellow used a colonoscopy simulator while interacting with a standardized patient (SP), nurse, and attending physician all played by actors. The nurse and attending were instructed to display specific disruptive behavior and disregard the fellow unless requested to stop the disruptive behavior and focus on the patient and procedure. In case 2, the fellow was to calm an intern managing a patient with massive gastrointestinal bleeding. The objective in both scenarios was to assess the fellows’ ability to perform their duties while managing the disruptive behavior displayed by the actor. The SPs used checklists to rate fellows’ performances. The fellows completed a self-assessment survey.RESULTSTwelve fellows from four gastrointestinal fellowship training programs participated in the OSCE. In the “distracted care team” case, one-third of the fellows interrupted the conflict and refocused attention to the patient. Half of the fellows were able to display professionalism despite the heated discussion nearby. Fellows scored lowest in the interprofessionalism portion of post-OSCE surveys, measuring their ability to handle the conflict. In the “frazzled intern” case, 68% of fellows were able to establish a calm and professional relationship with the SP. Despite this success, only half of the fellows were successfully communicate a plan to the SP and only a third scored “well done” in a domain that focused on allowing the intern to think through the case with the fellow’s guidance.CONCLUSIONFellows must receive training on how to approach disruptive behavior. OSCEs are a tool that can assess fellow skills and set a culture for open discussion.

Does Current Nephrology Fellowship Training Affect Uti-lization of Peritoneal Dialysis in the United States?

Background: The 2010 US Renal Data System annual report revealed that peritoneal dialysis is used by only 7% of end-stage renal disease patients on chronic dialysis vs. hemodialysis which is used by 93% of such patients, despite documented benefits of peritoneal dialysis over hemodialysis in these cases. Purpose: We examined whether education of nephrology fellows contributed to underutilization of peritoneal dialysis in the US. Methods: Self-report questionnaires were administered electronically to nephrology fellowship training program directors, October 2010-March 2011 (55% response). Results: Median number of training faculty and patients/fellow were significantly lower for peritoneal-dialysis vs. hemodialysis training. Hours of didactic teaching for fellows over their 2-year training period were significantly lower for peritoneal dialysis vs. hemodialysis. Peritoneal dialysis training was 20% of total training vs. 80% for hemodialysis. Most program directors (87%) believed lack of trained faculty in peritoneal dialysis and insufficient peritoneal dialysis patient population contributed to inadequate fellows’ peritoneal dialysis training. Conclusions: Findings suggest that current nephrology fellowship training in peritoneal dialysis is inadequate and contributes to its underutilization.

CAS-TWAS President’s Fellowship Programme for PhD Candidates from Developing Countries

Call for ApplicationsIntroduction According to a new agreement between the Chinese Academy of Sciences （CAS） and the academy of sciences for the developing world （TWAS）, up to 140 students/scholars per year from the developing world will be sponsored to travel to China for up to four years of PhD study and research.

Disparities in employment outcomes among critical care graduates with different training backgrounds

Background:We sought to characterize the impact of critical care training pathways on subsequent employment opportunities.Methods:A survey assessing the postfellowship work environment and barriers to employment in a preferred setting was electronically distributed on September 16,2019,to program directors and coordinators at all US adult critical care fellowships with instructions to for-ward it to the prior year’s graduates.Results:Data collection was interrupted by the coronavirus disease 2019 pandemic.Fifty-nine participants were included,reflecting a low rate of return.Most worked in urban areas(76.6%)at academic hospitals(81.7%).Graduates of internal medicine critical care(IMCC)were more likely than pulmonary critical care(PCC)to report their fellowship as a barrier to employment(50%vs 0%;P<0.05).Emergency medicine graduates were more likely than internal medicine to report their residency as a barrier to employment(83.3%vs 4.6%;P<0.05).Inability to find a desired position at an academic center(50%vs 5.9%;P<0.05)and in the preferred metropolitan setting(37.5%vs 0%;P<0.05)were more common among IMCC than PCC.Conclusion:In this survey of critical care graduates,residency in emergency medicine and fellowship in IMCC were associated with in-creased barriers to finding desired employment.

The evolution of integrative medical education: the influence of the University of Arizona Center for Integrative Medicine

The University of Arizona Center for Integrative Medicine （AzCIM） was founded in 1994 with a primary focus of educating physicians in integrative medicine （IM）. Twenty years later, IM has become an internationally recognized movement in medicine. With 40% of United States＇ medical schools having membership in the Academic Consortium for Integrative Medicine and Health it is foreseeable that all medical students and residents will soon receive training in the principles and practices of IM. The AzCIM has the broadest range and depth of IM educational programs and has had a major influence on integrative medical education in the United States. This review describes the fellowship, residency and medical student programs at AzCIM as well as other significant national drivers of IM education; it also points out the challenges faced in developing IM initiatives. The field of IM has matured with new nationa board certification in IM requiring fellowship training. Allied health professional IM educational courses, as well as integrative health coaching, assure that all members of the health care team can receive training. This review describes the evolution of IM education and will be helpful to academic centers, health care institutions, and countries seeking to introduce IM initiatives.

Trends in neurology fellowship training

Aim:Aneed for Neurologists exists in the USA.The majority of Neurology residency graduates go on to additional subspecialty training. Methods: Data from the Accreditation Council for Graduate Medical Education from 2001-2014 and the United Council for Neurologic Subspecialties from was analyzed for trends in the number of Neurology subspecialty training programs and their composition. Results: There has been an overall trend of growth in the number of accredited Neurology subspecialty training programs and fellows. These trends vary between specific subspecialties. Conclusion: The authors provide an overview of the contemporary state of Neurology subspecialty training in the USA. A clearer understanding of subspecialty training allows for anticipation of workforce surpluses and deficits.

The SAFE-T upper endoscopy tool:a web-based application for the point-of-care evaluation of gastroenterology fellow performance in upper endoscopy

Background:Attending assessment is a critical part of endoscopic education for gastroenterology fellows.The aim of this study was to develop and validate a concise,web-based assessment tool to evaluate real-time fellow performance in upper endoscopy.Methods:We developed the Skill Assessment in Fellow Endoscopy Training(SAFE-T)upper endoscopy tool to capture both summative and formative feedback in a concise,five-part questionnaire.The tool mirrors the previously validated SAFE-T colonoscopy tool and is administered electronically via a web-based application.We evaluated the tool in a prospective study of 15 gastroenterology fellows(5 fellows each from Years 1–3 of training)over the 2018–2019 academic year.An independent reviewer evaluated a subset of these procedures and completed both the SAFE-T and Assessment of Competency in Endoscopy(ACE)upper endoscopy forms for reliability testing.Results:Twenty faculty completed 413 SAFE-T evaluations of the 15 fellows in the study.The mean SAFE-T overall score differentiated each sequential fellow year of training,with first-year cases having lower performance than second-year cases(3.31 vs 4.25,P<0.001)and second-year cases having lower performance than third-year cases(4.25 vs 4.56,P<0.001).The mean SAFE-T overall score decreased with increasing case-complexity score,with straightforward compared with average cases(3.98 vs 3.39,P<0.001)and average compared with challenging cases(3.39 vs 2.84,P=0.042).In dual-observed procedures,the SAFE-T tool showed excellent inter-rater reliability with a Kappa agreement statistic of 0.815(P=0.001).The SAFE-T overall score also highly correlated with the ACE upper endoscopy overall hands-on score(r=0.76,P=0.011).Conclusions:We developed and validated the SAFE-T upper endoscopy tool—a concise and web-based means of assessing real-time gastroenterology fellow performance in upper endoscopy.

Effective teaching of endoscopy:a qualitative study of the perceptions of gastroenterology fellows and attending gastroenterologists

Background:There is little information describing the perceptions of gastroenterology fellows and attending gastroenterologists of what constitutes effective teaching of endoscopy.We sought to identify common themes regarding endoscopy training methods and their impact among fellows and attendings.Methods:Focus group exercises and surveys were conducted among fellows,about educational resources,teaching techniques and ways of improving the teaching of endoscopy.The fellows identified the‘best’teachers of endoscopy,who were interviewed regarding their training in endoscopy,their teaching methods,key points of information,and opinions on endoscopy curriculum.Results:Nineteen fellows(68%)had attended the American Society for Gastrointestinal Endoscopy First Year Fellows’Endoscopy course and found it very helpful.Thirteen fellows(46%)had exposure to an endoscopy simulator,but their median duration of use was only 1 hour.Only two out of five fellowship programs used a formal endoscopic skill assessment tool and none of the programs had an endoscopy curriculum of which the fellows were aware.Fellows reported that they learned endoscopy best by performing procedures.They also volunteered that attending gastroenterologists used variable teaching methods,and might benefit from instruction on how to teach endoscopy.Ten attending gastroenterologists(77%)had received training in advanced procedures;none received formal training on teaching endoscopy:they all felt that such training would be beneficial.Conclusions:A standardized endoscopy curriculum may be beneficial to fellows,who prefer to learn endoscopy by performing procedures—but they want explicit and specific instruction.Both those attending and the fellows thought that formal instruction for attending gastroenterologists on how to teach endoscopy would be beneficial,indicating a role for a‘teachthe-teacher’curriculum.