JAMA Internal Medicine Blog contributors on what captured their attention this week.
No longer just about the science, undergraduate and graduate medical education must encompass diverse topics such as population health, health care law, safety, informatics, quality, and health care disparities. In a recent JAMA Internal Medicine Special Communication, Dr. Catherine Lucey calls for comprehensive, systems-based medical education to meet these needs, stating “Our failure to translate the biomedical advances of the past century into health care that is consistently of high quality, safe, effective, patient centered, and equitable…is a failure of the medical education enterprise to realize that individual expertise is necessary but no longer sufficient.” Last week, a New York Times opinion article on higher education proposed that top educators be tenured just like successful researchers. These roles could be complementary in undergraduate and graduate medical education, with basic science tenured researchers teaching cutting edge medical science, allowing top clinical educators to focus their efforts exclusively on preparing and mentoring students and residents for complex real-world medical practice.–Ann Sheehy
In this Thursday’s New York Times, Daniel Hernandez, a graduate student in creative writing, published an essay on the experience of volunteering for a 24-hour suicide prevention hotline. The piece is a fascinating look into the complexities of mental health programs and provides a unique window into the mind of a terrified “provider”. –Ned Morris
This BMJ article regarding the efficacy of mammography in preventing breast cancer death among women ages 40-59 is sobering in its findings of no benefit and potential overdiagnosis of up to 1 in 5 of the cancers from the mammography arm. Caveats apply to the findings as usual, including the age of the technology (25 years of follow up means the technology used has to be older). However, as The Incidental Economist blog notes, the objections raised could easily be turned around (25 years of follow up means that any benefit that could appear, should have appeared.) Additional media coverage by the New York Times here notes that Switzerland is considering discontinuing screening mammography completely. JAMA IM recently published a quantitative estimate of the harms and benefits of breast cancer screening with mammography, finding limited benefit for younger women even under the most optimistic scenarios.–Raman Khanna