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We conclude that required structured didactic and experiential palliative care during the clinical clerkship year of medical student education shows significant and largely sustained effects indicating students are better prepared than a national sample of residents and attending physicians.

Two hundred fifty patients were entered into a multicenter trial to evaluate the efficacy and toxicity of orally administered acyclovir for treatment of recurrent genital herpes. The

Dissection of conventionally embalmed cadavers exposes students, staff, and faculty to formaldehyde, a probable carcinogen. Therefore, prudent practices should seek to minimize formaldehyde exposure. In this study, we evaluated two commercially available chemicals, InfuTrace and Perfect Solution, for their effectiveness in reducing ambient formaldehyde levels. Four cadavers embalmed conventionally with formaldehyde and/or with the above agents were compared for their formaldehyde levels under conditions that strictly controlled for air circulation and for locations and methods of testing, and during activities that simulated student dissecting. For InfuTrace, one cadaver was reinfused with InfuTrace after initial standard perfusion with formaldehyde; a second cadaver had InfuTrace injected into the thoracic and abdominal body cavities after formaldehyde perfusion. For Perfect Solution, the product was used for embalming a third cadaver in lieu of formaldehyde. For a control, a fourth cadaver was embalmed with the standard formaldehyde solution. Testing of personal and ambient room air samples and of fluid obtained from the cadavers was performed and analyzed in a blinded fashion. Results indicated that both Perfect Solution, substituted for standard formaldehyde embalming, and InfuTrace infused through the vasculature after formaldehyde embalming, resulted in lower concentrations of formaldehyde than embalming with formaldehyde solution alone or in combination with body cavity injection of InfuTrace. These differences in formaldehyde concentrations are consistent across measuring methods, for example, of room air, of breathing zone air during cadaver handling and dissection, and of liquid samples obtained from the cadavers. Perfect Solution yielded suboptimum fixation and a different texture, color, and smell than the formaldehyde treatments.

BackgroundTo assess the impact of a change in preclerkship grading system from Honors/Pass/Fail (H/P/F) to Pass/Fail (P/F) on University of California, San Diego (UCSD) medical students’ academic performance.MethodsAcademic performance of students in the classes of 2011 and 2012 (constant-grading classes) were collected and compared with performance of students in the class of 2013 (grading-change class) because the grading policy at UCSD SOM was changed for the class of 2013, from H/P/F during the first year (MS1) to P/F during the second year (MS2). For all students, data consisted of test scores from required preclinical courses from MS1 and MS2 years, and USMLE Step 1 scores. Linear regression analysis controlled for other factors that could be predictive of student performance (i.e., MCAT scores, undergraduate GPA, age, gender, etc.) in order to isolate the effect of the changed grading policy on academic performance. The change in grading policy in the MS2 year only, without any corresponding changes to the medical curriculum, presents a unique natural experiment with which to cleanly evaluate the effect of P/F grading on performance outcomes.ResultsAfter controlling for other factors, the grading policy change to P/F grading in the MS2 year had a negative impact on second-year grades relative to first-year grades (the constant-grading classes performed 1.65% points lower during their MS2 year compared to the MS1 year versus 3.25% points lower for the grading-change class, p < 0.0001), but had no observable impact on USMLE Step 1 scores.ConclusionsA change in grading from H/P/F grading to P/F grading was associated with decreased performance on preclinical examinations but no decrease in performance on the USMLE Step 1 examination. These results are discussed in the broader context of the multitude of factors that should be considered in assessing the merits of various grading systems, and ultimately the authors recommend the continuation of pass-fail grading at UCSD School of Medicine.