Residents also generally don’t get pay-for-performance bonuses…. When you’re already rotating across different rotations, working hard to relearn different systems/workflows, it’s hard to have the bandwidth to ALSO focus on quality measures that you don’t believe in….

🚨 Hot Off Press.@UCSFDOM Health System Leadership Pathway's work reporting on-the-ground successes and challenges with @DHCS_CA's Enhanced Care Management Program - a novel, statewide endeavor to provide enhanced care to our vulnerable populations. Link:

What do you want to know?.

It’s about damn time. Drugs compose ~10% of our over-inflated healthcare cost. For the sake of our patients, communities, and our national economy, we need to give Medicare a spine to stand up to otherwise predatory drug pricing practices!.

RT @journal_CHEST: INSIDE LOOK 👀 From the upcoming issue (July 8): A retrospective study of 3,999 patients showed similar in-hospital morta….

Lastly, @FreeBeacon writes,."Within three years of Lucero's hiring in 2020, UCLA dropped from 6th to 18th place in U.S. News & World Report's rankings for medical research.". This "rank" is based on NIH research funding, completely unrelated to student academic performance.

In summary, the med school has serious problems, but it's simply hysterical to say it's from diversity picks. When you take away extrinsic motivation to study for one standardized exam, but they still have to take the other exams, this is what you get.

Put everything together, you now have a similarly diverse student body, stressed from COVID, with little extrinsic motivation to thoroughly study content for a standardized, national exam. Fail rates skyrocket when the new curriculum class take their shelves '22-'23

This is a recipe for a rocky road. But the most egregious thing that happened with the new curriculum was not the abridged content, but rather the lack of assessments. While there would be "pitstops" (exams) along the way, you could not fail them. You'd keep advancing. .

I haven't personally experienced this curriculum (though I helped teach the first class going through it). As you can naturally expect, cramming 2 years of content into 1 year is extremely challenging. You either overwhelm students or cut out topics.

People lauded this curriculum. UCLA med students were known nationwide for being very clinically strong. Then, the curriculum changed. Now it's:.1st year pre-clinical .2nd year core clerkship.3rd year Choose your adventure (Masters degree, research, etc.).4th years doing Sub-Is.

#3 The New Curriculum.Until 2021, DGSOM used a "traditional" curriculum. 4 years total. First 2 years pre-clinical, in the classroom or cadaver lab learning anatomy, physiology, pathology. 3rd year doing core rotations (medicine, surgery, neuro, etc.).4th years doing Sub-Is.

The problem though, is that USMLE produce all these exams: Step 1, Step 2, and the shelf exams. And, the information for the next exam builds on the previous exam. ~70% of the Shelf Exam is similar material to Step 1. If you haven't studied for Step 1, you're now in a pinch. .

Now most students are no longer spending long night studying, using $500+ on test prep resources. In some ways this is good. Step 1 was a toxic exam that was effectively an arms race. No one cared about the lecturer's topic unless it was "high-yield" and relevant to Step 1.

As such, students studied their asses off to score as well as they could on this exam. Then, in January 2022, USMLE changed Step 1 from a numeric score to P/F. Suddenly, the extrinsic motivation is not to get 99th percentile, but to pass. What is passing? . 3rd percentile. .

People who did extremely well (90th percentile+) would be well prepared to apply into competitive, lucrative subspecialties (ortho, plastics, ENT). Conversely, if you did poorly on it, the score could jeopardize your chances of getting into a medical residency altogether!.

#2 Step 1 Turning P/F.This played a much bigger factor. For context, the USMLE Step 1 was traditionally THE MOST important exam you would take. Students would grind for 1-2 years to take this 7hr exam and then receive a numeric score. The higher the score, the better.

You might say "COVID is no longer a stressor". I agree with you for the most part. But even years out, it consequently pushed more curriculum online, and has created a culture shift of doing more things virtually rather than in-person.

#1 COVID Pandemic.When the pandemic hit, scores took a hit.No more in-person classes (all Zoom). Some classes are OK virtually. Anatomy is not. You need to see and feel the cadaver. My friends/classmates were also distracted. Parents lost jobs, grandpa died of COVID, etc.

So, what happened? I'd say that there were 3 big things that contributed to the abysmal shelf scores that you see below. They were:.1) COVID-19 Pandemic.2) Step 1 turning into a P/F exam.3) DGSOM's new curriculum.

First, UCLA's med school (DGSOM) has overall been a very diverse class. When I matriculated (2018) there were 4 programs (DGSOM, CDU, PRIME, MSTP) which encompassed our student body. In total, ~25% of our class AT THAT POINT was URiM. There was not some "flood of minorities".