Erin M. Bonura

Factors Influencing Internal Medicine Resident Choice of Infectious Diseases or Other Specialties: A National Cross-sectional Study

BACKGROUND Only 49% of infectious diseases (ID) fellowship programs were filled in 2015 through the national match, but little is known about internal medicine (IM) resident perceptions of ID and factors related to IM resident career choice. METHODS We conducted 25 interviews and disseminated a Web-based survey to graduating IM residents in the United States utilizing a 2-stage sampling strategy. Participants were categorized into 3 groups based on interest in ID: (1) applied/intended to apply to ID; (2) interested in ID but did not apply; (3) never interested in ID. We conducted all analysis using poststratification adjustment weights with survey data analysis procedures. RESULTS Of the 590 participants, 42 (7%) selected category 1, 188 (32%) category 2, and 360 (61%) category 3. Most (65%) developed an interest in their ultimate career before residency. Of those interested in ID, >52% rated their ID medical school curriculum as very good and influential on their interest in ID. Ninety-one percent of category 2 participants felt mentorship was influential on career choice, although 43% identified an ID mentor. Category 2 chose salary as the most dissuading factor and the most likely intervention to increase ID interest. CONCLUSIONS In this nationally representative sample of graduating IM residents, most develop an interest in their ultimate career before residency. Factors influencing this decision reside in both medical school and residency, which is consistent with career decision-making constructs. By identifying career determining factors and understanding how they fit into medical training frameworks, we can develop targeted initiatives to reinvigorate interest in ID.

Coaching: a new model for academic and career achievement

Background Individualized education is emerging as an innovative model for physician training. This requires faculty coaching to guide learners’ achievements in academic performance, competency development, and career progression. In addition, coaching can foster self-reflection and self-monitoring using a data-guided approach to support lifelong learning. Context Coaching differs from mentoring or advising, and its application in medical education is novel. Because of this, definitions of the concept and the constructs of coaching as applied to medical education are needed to accurately assess the coaching relationship and coaching processes. These can then be linked to learner outcomes to inform how coaching serves as a modifier of academic and competency achievement and career satisfaction. Innovation We developed definitions and constructs for academic coaching in medical education based on review of existing education and non-education coaching literature. These constructs focus on 1) establishing relationship principles, 2) conducting learner assessments, 3) developing and implementing an action plan, and 4) assessing results and revising plans accordingly. Implication Coaching is emerging as an important construct in the context of medical education. This article lays the vital groundwork needed for evaluation of coaching programs aimed at producing outstanding physicians.

Case Report: Conjunctival Infestation with Thelazia gulosa: A Novel Agent of Human Thelaziasis in the United States

We report a case of thelaziasis in a 26-year-old female, acquired in Oregon. A total of 14 worms were removed from the patients left eye and were morphologically identified as being Thelazia gulosa. Until now, only two species of Thelazia have been implicated in causing human disease, Thelazia callipaeda in Asia and Europe and occasional reports of Thelazia californiensis from the United States of America. Here, we describe a third, previously unreported parasite of humans, T. gulosa (the cattle eyeworm) as an agent of human thelaziasis and the first reported case of human thelaziasis in North America in over two decades.

Increasing Subspecialization in the Field of Infectious Diseases: Evaluating Challenges and Strategies to Move Forward

In the preceding article, Moore et al detailed the internal medicine National Residency Matching Program match trends and workforce challenges. The declining interest in infectious diseases (ID) subspecialization has left many in the field concerned for the sustainability of the discipline and its ability to meet the service needs of the public. Despite these trends, the opportunities in ID are broader than they have ever been. New epidemics continue to occur, placing ID issues on the world stage. The United Nations recently held a high-level meeting to address the crisis of antimicrobial resistance. Human immunodeficiency (HIV) infection, tuberculosis, and hepatitis C continue to affect millions of people around the globe. It is important that we as ID subspecialists learn how best to share the many exciting aspects of our field with trainees to foster the next generation of ID physicians. In this article, we will explore the challenges to and potential strategies for increasing interest in ID careers.