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Introduction: Lesbian, gay, bisexual, transgender, and queer (LGBTQ) community members experience adverse health outcomes at higher rates than non-LGBTQ individuals. We examined the impact of student demographics as well as gender and sexuality didactic instruction on the attitudes of first-year medical students toward LGBTQ patients., Methods: In January 2017, 255 first-year students at an urban allopathic medical school participated in a gender and sexuality health curriculum. We assessed student attitudes regarding LGBTQ patients using anonymous pre- and postintervention surveys. Each item was measured on a 5-point Likert scale., Results: Of 255 possible respondents, we received 244 responses to the preintervention survey (95.7% response rate) and 253 to the postintervention survey (99.2% response rate). Participants were predominantly white (66.8%), heterosexual (94.7%), and cisgender (100%). Respondents who identified as LGBQ were significantly ( P <.05) more likely than heterosexual students to agree with the following preintervention statements, among others: (1) Discordance between birth sex and gender is a natural human phenomenon, (2) When meeting a patient for the first time, I feel comfortable asking what pronoun they use, (3) I am able to empathize with the life experience of an LGB/T patient, (4) I am motivated to seek out opportunities to learn more about LGBTQ-specific health care issues. Statistically significant changes in attitudes between time points are seen in 4 out of 15 items., Conclusion: A focused gender and sexuality curriculum appears to impact medical student attitudes regarding LGBTQ patients. Furthermore, recruitment of LGBTQ-identifying medical students may translate into improved workforce motivation to provide health care for LGBTQ patients., (© 2019 by the Society of Teachers of Family Medicine.)

Increased emphasis on team care has accelerated interprofessional education (IPE) of health professionals. The health mentors program (HMP) is a required, longitudinal, interprofessional curriculum for all matriculating students from medicine, nursing, occupational therapy, physical therapy, pharmacy, and couple and family therapy. Volunteer lay health mentors serve as educators. Student teams complete four modules over 2 years. A mixed-methods approach has been employed since program inception, evaluating 2911 students enrolled in HMP from 2007 to 2013. Program impact on 577 students enrolled from 2009-2011 is reported. Two interprofessional scales were employed to measure attitudes toward IPE and attitudes toward interprofessional practice. Focus groups and reflection papers provide qualitative data. Students enter professional training with very positive attitudes toward IPE, which are maintained over 2 years. Students demonstrated significantly improved attitudes toward team care, which were not different across programs. Qualitative data suggested limited tolerance for logistic challenges posed by IPE, but strongly support that students achieved the major program goals of understanding the roles of colleagues and understanding the perspective of patients. Ongoing longitudinal evaluation will further elucidate the impact on future practice and patient outcomes.

Background: Clerkship directors (CDs) ensure that medical students achieve the core clinical skills needed to be effective physicians. Recently guidelines for time and support for U.S. CDs have been published by the Alliance for Clinical Education., Purpose: This article reviews 14 published surveys of CDs in seven specialties and assesses CDs' personal characteristics, scholarship, and support for their position., Methods: Investigators reviewed CD surveys conducted over the last 12 years from seven different specialties. Comparisons were made of CDs demographics, departmental and school support, time allotted to the position, and publication rates., Results: Department support was generally good, but school support was often felt to be lacking. The number of publications was relatively low. Time allotted for the position was lower than the 50% recommended in all specialties., Conclusions: Many CDs do not feel adequately supported by time or resources. Future studies need to more closely define what support is needed and what impact CD characteristics, scholarship, and resources have on medical student education.

Background and Objectives: Family medicine faces declining student interest and funding. Predoctoral directors will help lead efforts to overcome these challenges. Academic success will be important for predoctoral directors to be effective leaders in academic health centers. We therefore sought to describe predoctoral directors and factors associated with their academic success., Methods: We carried out a cross-sectional survey of all family medicine predoctoral directors at US allopathic medical schools using a Web-based questionnaire. The response rate was 82%. We measured academic success using a variable combining rank and tenure status. We used bivariate analysis and multiple linear regression analysis to identify factors associated with academic success., Results: The mean age of predoctoral directors is 47, and 45% are women. Forty-two percent are assistant professors, 36% associate professors, 20% full professors, and 33% are on a tenure track. Sixty-four percent of predoctoral programs receive Title VII funding, and 63% of predoctoral directors believe that loss of Title VII funding will adversely affect student education. Factors associated with academic success include years since residency, total publications, years as predoctoral director, male gender, state funding for predoctoral family medicine programs, and participation in an academic fellowship. Involvement in educational research was associated with number of publications., Conclusions: Providing predoctoral directors with the skills and support needed to study their educational undertakings and publish their findings may help them achieve academic success. Medical educators must assess the effects of loss of Title VII funding on predoctoral education while seeking new sources of funding.

Serum iPTH was measured in a large series of normal and osteoporotic women as a function of age, with radioimmunoassays using three antisera: GP-1M, which recognizes primarily a region within the 44--68 amino acid sequence of PTH; CH-12M, which appears to recognize primarily intact hormone; and CH-14M, which recognizes primarily a region within the 1--34 amino acid sequence of PTH. In normal women 20 to 90 years of age, serum iPTH increased significantly with age (p less than 0.001); the proportional increase was greater when measured with antiserum GP-1M (80%) than when measured with antiserum CH-12M (30%), which suggests that the increase in circulating carboxyl fragments of PTH was greater than the increase in circulating intact PTH. In 40 patients with postmenopausal osteoporosis, the mean value for serum iPTH assayed by antiserum GP-1M did not differ significantly from that for age-matched normal women; however, three osteoporotic patients had elevated values and thus appear to represent a separate population. When these subjects were excluded, mean serum iPTH assayed by antiserum GP-1M also was lower than normal (p less than 0.001). The mean value for serum iPTH was lower in osteoporotic patients than in normal subjects when assayed by either antiserum CH-12M (p less than 0.001) or antiserum CH-14M (p less than 0.001). Values for serum phosphate and renal tubular phosphate resorption, both indices of PTH function, were increased (p less than 0.005) in the osteoporotic subjects. Although creatinine clearance decreased with age in both normal and osteoporotic subjects, partial correlations with age held constant showed no relationship between creatinine clearance and serum iPTH. This suggests that a decrease in renal function was not the major factor accounting for the rise in serum iPTH with age. We conclude that serum iPTH increases with aging but that for any given age, it is either normal or low in patients with postmenopausal osteoporosis.