Psychiatric emergencies are acute disturbances in thought, behavior, mood, or social relationship that require immediate intervention as defined by the patient, family, or social unit to save the patient and/or others from imminent danger. Ensuring the safety of the patient, surrounding persons, and the medical team is the first step of evaluation. Treatment focuses on stabilization of the patient, then on specific symptoms and ultimately the cause of symptoms. There are important legal considerations, particularly regarding involuntary admissions. It is important to debrief with the patient, surrounding family, and the health care team to ensure a continued therapeutic alliance and the emotional health of all involved.
This bibliometric analysis seeks to explore how the COVID-19 pandemic impacted submission rates to Annals of Family Medicine by gender. Women represented 46.3% of all manuscript submissions included in our study (n = 1,964/4,238), spanning from January 1, 2015 to July 15, 2020. The overall volume of submissions increased during COVID-19 in comparison to pre-pandemic months; however, this increase was not evenly distributed among men and women (122% increase vs 101% increase, respectively). In the early months of the pandemic, 244 submissions were authored by men (58.5%), and 173 submissions were authored by women (41.5%). The gap in women's submission rates is troubling, as it suggests they may be at greater risk of falling behind male colleagues during and beyond the COVID-19 pandemic.
This cross-sectional study examines the prevalence of women authors in 5 prominent family medicine journals.
Background As the Accreditation Council for Graduate Medical Education (ACGME) began to ask programs to report their efforts surrounding diversity, equity, and inclusion (DEI), program directors felt ill prepared to evaluate their programs and measure change. Objective To develop a tool that would allow graduate medical education (GME) programs to evaluate the current state of DEI within their residencies, identify areas of need, and track progress; to evaluate feasibility of using this assessment method within family medicine training programs; and to analyze and report pilot data from implementation of these milestones within family medicine residency programs. Methods The Association of Family Medicine Residency Directors (AFMRD) Diversity and Health Equity (DHE) Task Force developed a tool for program DEI evaluation modeled after the ACGME Milestones. These milestones focus on DEI assessment in 5 key domains: Institution, Curriculum, Evaluation, Resident Personnel, and Faculty Personnel. After finalizing a draft, a pilot implementation of the milestones was conducted by a convenience sample of 10 AFMRD DHE Task Force members for their own programs. Results Scores varied widely across surveyed programs for all milestones. Highest average scores were seen for the Curriculum milestone (2.65) and the lowest for the Faculty Personnel milestone (2.0). Milestone assessments were completed within 10 to 40 minutes using various methods. Conclusions The AFMRD DEI Milestones were developed for program assessment, goal setting, and tracking of progress related to DEI within residency programs. The pilot implementation showed these milestones were easily used by family medicine faculty members in diverse settings.
Family physicians have the privilege of caring for patients throughout their lifespan and witness the impact all facets of life have on the health of individuals and the health of communities. The importance of engaging the community in the success of population-based initiatives to drive social change has been proven repeatedly and family medicine residencies should include community as the fifth “C.” At a minimum, this includes incorporating the following three recommendations: (1) define community on initial accreditation, at self-study, and whenever major community changes occur; (2) utilize a community needs assessment as part of goal setting of activities with Annual Action Plan; and (3) evaluate residents and faculty on understanding of and cooperation with community needs. We must highlight engagement with the community as a central aspect of family medicine so that all programs focus on this important aspect of our work.
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