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Despite the shortage of physicians in the United States, there is no consensus among medical educators as to how to address the nation's unmet needs. A growing but unfulfilled argument is to revisit the configuration of medical education and the time required to complete medical training. Pilot programs, such as shortened programs or advancement-in-place structures to accelerate the practice capability of trainees, have been attempted. This manuscript addresses underlying economic and human considerations that medical educators must reconcile, drawing on lessons from international educational structures, as we advance toward a system that supports the needs of the communities that our graduates will serve. [ABSTRACT FROM AUTHOR]

Multisystem inflammatory syndrome in children (MIS-C) is a life-threatening sequela of SARS-CoV-2 infection. Limited data are available regarding risk-stratification or long-term outcomes in MIS-C. This study sought to determine associations between serologic markers and severity of illness and understand long-term cardiac outcomes. This series includes 46 cases (mean age 8.1 years; 63.0% male) of MIS-C. Pearson's chi-squared analysis showed an erythrocyte sedimentation rate (ESR) greater than 30 mm/h and 50 mm/h were disproportionately associated with pediatric intensive care unit (PICU) admission (χ2 = 4.44, P =.04) and use of vasopressors (χ2 = 6.06, P =.01), respectively. Ferritin less than 175.6 ng/mL was associated with use of vasopressors (χ2 = 5.28, P =.02). There was a negative correlation between ESR and ejection fraction (EF) (r = -0.39, P =.009). Most patients with abnormal echocardiograms had resolution of abnormalities within 30 days. Therefore, inflammatory markers may be helpful in predicting which patients may require specific interventions or experience cardiac dysfunction, but MIS-C does not appear to be associated with complications at 1 year. [ABSTRACT FROM AUTHOR]