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BackgroundIn the rapidly changing landscape of undergraduate medical education (UME), the roles and responsibilities of clerkship directors (CDs) are not clear.ObjectiveTo describe the current roles and responsibilities of Internal Medicine CDs.DesignNational annual Clerkship Directors in Internal Medicine (CDIM) cross-sectional survey.ParticipantsOne hundred twenty-nine clerkship directors at all Liaison Committee on Medical Education accredited US medical schools with CDIM membership as of September 1, 2017.Main measuresResponsibilities of core CDs, including oversight of other faculty, and resources available to CDs including financial support and dedicated time.Key resultThe survey response rate was 83% (107/129). Ninety-four percent of the respondents oversaw the core clerkship inpatient experience, while 47.7% (n = 51) and 5.6% (n = 6) oversaw the outpatient and longitudinal integrated clerkships respectively. In addition to oversight, CDs were responsible for curriculum development, evaluation and grades, remediation, scheduling, student mentoring, and faculty development. Less than one-third of CDs (n = 33) received the recommended 0.5 full-time equivalent (FTE) support for their roles, and 15% (n = 16) had less than 20% FTE support. An average 0.41 FTE (SD .2) was spent in clinical work and 0.20 FTE (SD .21) in administrative duties. Eighty-three percent worked with other faculty who assisted in the oversight of departmental UME experiences, with FTE support varying by role and institution. Thirty-five percent of CDs (n = 38) had a dedicated budget for managing their clerkship.ConclusionsThe responsibilities of CDs have increased in both number and complexity since the dissemination of previous guidelines for expectations of and for CDs in 2003. However, resources available to them have not substantially changed.

Purpose: Increasing challenges in recruiting and retaining community‐based teaching physicians (e.g., community preceptors) call for a better understanding of motivators and barriers community preceptors perceive in their teaching role. Given the importance of medical school partnerships with community‐based sites for student training, it is essential to understand the perspectives of community preceptors as teaching physicians in a context away from the medical school, such as rural, and the factors affecting their career choice to engage in teaching while practising medicine. Methods: We conducted semi‐structured interviews with rural community preceptors and used open coding to conceptualise data and axial coding to connect codes into categories. We used the socio‐cognitive career theory framework to organise categories into themes. Results: Eleven rural community preceptors from two medical schools participated. Specialties included family medicine, internal medicine and paediatrics; clinical practice and teaching experience ranged from 3–36 and 2–29 years, respectively. Readiness for teaching ('self‐efficacy') was pivotal in community preceptors' decision to teach and derived largely from vicarious learning from teaching attendings in medical school or residency; social persuasion and encouragement from clinical partners; and their accomplishments as practising physicians. However, limited faculty development, incomplete knowledge of expectations, disengagement from the medical school and lack of current mentors hindered their self‐confidence. Teaching fulfilled their aspirations ('outcome expectations') to give back to the profession, but they felt undervalued and disconnected from other clinician educators. Teaching increased job satisfaction, but clinical workload, and financial impact impeded their goals for achieving excellence ('performance'). Conclusions: Self‐efficacy was a pivotal motivator in rural community preceptors' decision to teach. Role models from early training inspired them to teach. Internal awards sustained teaching efforts. Future research should explore structural barriers influencing rural community preceptors' teaching experiences to better support their career choice to become medical educators. Understanding rural community preceptors' motivations and barriers in teaching medical students is crucial for training. This study explores the role of self‐efficacy, giving back to the profession, and disengagement from medical schools. #MedEd #RuralHealth [ABSTRACT FROM AUTHOR]

Background Since 2020, virtual interviews have become the typical way in which applicants assess residency programs. It is unknown whether the change from in-person to virtual interviews has been associated with changes in perceptions of the quality of information gathered by prospective applicants. Objective To ascertain perspectives on the satisfaction with, quality of, and accuracy of information gathered by internal medicine (IM) residency applicants from virtual and in-person interviews. Methods Twenty-nine thousand, seven hundred and seventy-six residents from US and Puerto Rico residency programs sitting for the 2022 American College of Physicians Internal Medicine In-Training Examination (IM-ITE) were surveyed. An optional, 5-question survey was administered at the end of the examination. Responses were analyzed based on interview format—virtual (postgraduate year [PGY]-1-2) or in-person (PGY-3)—and PGY. Results Of 29 776, 23 161 residents responded to the survey (77.8% response rate). Regardless of PGY, respondents reported a high degree of satisfaction with the quality of information gathered from their interview day, though there was a statistically significant difference between virtual and in-person [somewhat/very satisfied: In-person 5938 of 7410 (80.1%); 95% CI [79.2, 81.0] vs virtual 12 070 of 15 751 (76.6%); 95% CI [76.0, 77.3]:P<.001]. Residents in all PGYs reported sessions with residents and one-on-one interviews as the most important factors when creating their rank lists. Conclusions We found differences in satisfaction and perceptions of the quality of information gathered between IM residents who participated in virtual and in-person interviews. However, regardless of format, most respondents reported satisfaction with their interview experience. [ABSTRACT FROM AUTHOR]

Introduction: The residency application process is a critical time for medical students. The COVID-19 pandemic prompted changes to the residency recruitment procedures with the conversion of interviews to a virtual format. For medical school advisors guiding students on an all-virtual residency application process brought uncertainty to their advising practices. Thus, this study aimed to identify advising practices during the 2021 virtual application cycle. Methods: We administered an IRB-exempt national survey through the Clerkship Directors in Internal Medicine to 186 internal medicine core/co-/associate/assistant clerkship directors and sub-internship directors representing 140 Liaison Committee on Medical Educationaccredited U.S./U.S.-territory-based medical schools in spring 2021. The 23-question survey was designed and pilot-tested by faculty-educators and leaders with expertise in undergraduate medical education. Data analysis included paired t- and z-tests and thematic analysis of open-ended questions. Results: The institutional response rate was 67% (93/140) and individual rate 55% (103/186). Half of the respondents felt prepared/very prepared (40% and 13% respectively) for their advising roles. Compared to pre-pandemic cycles, respondents advised a typical student in the middle-third of their class at their institution to apply to more residency programs (mean 24 programs vs 20, p < 0.001) and accept more interviews (mean 14 interviews vs 12, p < 0.001). Sixty-three percent (64/101) of respondents spent more time on student advising; 51% (51/101) reported more students asked them for informal advice. Fifty-nine percent (60/101) of respondents reported their advisees were able to assess a residency program 'somewhat well;' 31% (31/101) expressed that residency recruitment should remain entirely virtual in the future. Conclusion: The transition to virtual residency recruitment due to COVID-19 prompted advising practices that may have contributed to application inflation and increased advising workload. Future studies should explore longitudinal outcomes of virtual interviews on student success to guide best practices in how to advise students during residency recruitment. [ABSTRACT FROM AUTHOR]

Background: In the rapidly changing landscape of undergraduate medical education (UME), the roles and responsibilities of clerkship directors (CDs) are not clear.Objective: To describe the current roles and responsibilities of Internal Medicine CDs.Design: National annual Clerkship Directors in Internal Medicine (CDIM) cross-sectional survey.Participants: One hundred twenty-nine clerkship directors at all Liaison Committee on Medical Education accredited US medical schools with CDIM membership as of September 1, 2017.Main Measures: Responsibilities of core CDs, including oversight of other faculty, and resources available to CDs including financial support and dedicated time.Key Result: The survey response rate was 83% (107/129). Ninety-four percent of the respondents oversaw the core clerkship inpatient experience, while 47.7% (n = 51) and 5.6% (n = 6) oversaw the outpatient and longitudinal integrated clerkships respectively. In addition to oversight, CDs were responsible for curriculum development, evaluation and grades, remediation, scheduling, student mentoring, and faculty development. Less than one-third of CDs (n = 33) received the recommended 0.5 full-time equivalent (FTE) support for their roles, and 15% (n = 16) had less than 20% FTE support. An average 0.41 FTE (SD .2) was spent in clinical work and 0.20 FTE (SD .21) in administrative duties. Eighty-three percent worked with other faculty who assisted in the oversight of departmental UME experiences, with FTE support varying by role and institution. Thirty-five percent of CDs (n = 38) had a dedicated budget for managing their clerkship.Conclusions: The responsibilities of CDs have increased in both number and complexity since the dissemination of previous guidelines for expectations of and for CDs in 2003. However, resources available to them have not substantially changed. [ABSTRACT FROM AUTHOR]