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Bellevue Hospital, the oldest public hospital in the United States and a lineal descendant of an infirmary for slaves, accepted its first African-American resident, Dr. Ubert Conrad Vincent, in 1918. This occurred at a time when many medical centers were not accepting African-American residents. At the end of WWII, one-third of the accredited medical schools still barred African Americans. However, Bellevue Hospital continued to train African-American residents. Between the 1920s and 1940s four African Americans matriculated at Bellevue Hospital. There were six in the 1950s, four in the 1960s, and 25 in the 1970s. By the 1980s, 40 African Americans matriculated, and between 1990 and 1995, 61 matriculated. Despite its historic first, Bellevue lagged slightly behind the national average. While the number of African-American residents occupying U.S. residency slots increased from 2.8% in 1978 to 6.5% in 1996, African Americans comprised 3.6% of residency slots at Bellevue between 1985-1995. Currently, only 7% of practicing physicians and 5% in faculty positions are latino, African-American, and Native American. Increasing the number of under-represented minority (URM) physicians is important to the United States, as URM physicians are more likely to serve the poor and uninsured, therefore improving the overall healthcare of the underprivileged. A study by the Association of American Medical Colleges indicated that minority medical school graduates were five times more likely to report that they planned to serve minority populations than other graduates. In their position paper, the American College of Physicians expressed the belief that increasing the number of URM physicians will help reduce healthcare disparities that can hurt minority populations and lead to poor health outcomes. The Supreme Court acknowledged the importance of racial diversity by upholding the University of Michigan affirmative action admissions policy in its June 2003 ruling. URM physicians are needed not only to serve minority populations but also to serve as mentors and role models for prospective and current students. The first African-American resident to graduate from the Bellevue Residency Program did indeed treat the underserved, as Dr. Vincent founded the Vincent Sanatorium, dedicated to treating African-American patients, and training African-American nurses and doctors. Over the course of the 20th century, Bellevue Hospital has trained increasing numbers of African-American physicians. It is hoped that, like their predecessor, Dr. Vincent, they will provide care to underserved communities and to the community as a whole, as well as serve as role models for generations to come.

Increasing attention has been focused on developing professionalism in medical school graduates. Unfortunately, the culture of academic medical centers and the behaviors that faculty model are often incongruent with our image of professionalism. The need for improved role modeling, better assessment of student behavior, and focused faculty development is reviewed. We propose that the incentive structure be adjusted to reward professional behavior in both students and faculty. The third-year medicine clerkship provides an ideal opportunity for clinician-educators to play a leading role in evaluating, rewarding, and ultimately fostering professionalism in medical school graduates.

Since the expansion of the European Union on 1 May 2004 the interest in recruiting dentists from outside the UK has intensified. Additionally, the Department of Health's announcement in July about the modernisation of NHS dentistry included the promise to 'recruit 1000 extra NHS dentists by October 2005' and 'speed up the process for overseas dentists to register to work in the UK; adding to this interest. An overview of the different ways in which overseas dentists can be employed is provided below.

[No abstract available]

In order to provide high quality services in reproductive health, training of health professionals is essential. In Turkey, a project for in-service training of medical residents was conducted in 2003 under the aegis of the Human Resources Development Foundation, the Turkish Ministry of Health and UNFPA. The project included a needs assessment, training programme development and evaluation activities. A seven-day course was developed to train institutional trainers in both training skills and reproductive health information. Fourteen experienced master trainers conducted four courses for 67 institutional trainers from 37 hospital departments in four cities, who in turn conducted a three-day programme on reproductive health topics in their respective institutions, using interactive teaching methods. 163 residents from departments of obstetrics and gynaecology, family medicine, urology, public health and paediatrics participated. Over three-quarters of trainers and residents who participated in the programme approved of the content of the courses. A limited number of topics, e.g. sexual health and adolescent reproductive health, were thought to need more attention. Trainers cited improvements in doctor-patient communication and quality of outpatient and in-patient care, and initiation of counselling in their institutions. We conclude that this training programme, attended by trainers and participants from different disciplines and using interactive teaching methods, has been successful as an effective training model for medical residents. The establishment of an ongoing collaboration between the Ministry of Health and other institutions involved in resident training in Turkey is needed to ensure the expansion of this programme to all residents in training. © 2004 Reproductive Health Matters. All rights reserved.

The Central College of Medical Specialities has presented guidelines for modernisation of all postgraduate speciality training programmes. These guidelines include the definition of seven general competency fields, each of them described in more detail with four key competencies. By 2006, all postgraduate speciality training programmes will be based on these competency fields. Furthermore, by then assessment of residents will be focused on the achievement of competence, rather than only on fulfilment of length of specified rotations, numbers of clinical experiences and numbers of performed skills. The application of this competency model emphasises the fact that the education of medical doctors entails more than providing them with the required theoretical and clinical knowledge and skills. © 2004 Van Zuiden Communications B.V. All rights reserved.

Although most needlestick/sharps injuries (NSIs/SIs) research focuses on health care workers (HCWs), students in hospital internships are also at risk. Investigations that examined NSIsS/SIs in student populations generally studied medical rather than nursing students (NSs). In 1999, approximately 17,000 Taiwanese nursing graduates were exposed to the hazard of NSIs/SIs. We examined the frequency and mechanism of NSIs/SIs among vocational school NSs in southern Taiwan. Between July and December of 1999, within 1 week after the NSs completed their internship training, one of the researchers, who was a teacher in this vocational school, asked them to fill out questionnaires. Five hundred twenty-seven of 550 (92.6%) questionnaires were considered valid. Two hundred sixty-four of 527 (50.1%) responders sustained one or more NSIs/SIs. Ninety-six of 527 (18.2%) responders suffered contaminated NSIs/SIs. The average number of NSIs/SIs per student was 8.0 times/year (4.9 times/student/year for NSIs and 3.1 times/student/year for SIs). NSIs/SIs rates for NSs in 10-week and 4-week internships were significantly different (P =. 039): 53.3% versus 43.7%, respectively. The NSIs/SIs frequencies were influenced by length of internship: 7.3 times/student/year in 10-week internship and 11.7 times/student/year in 4-week internship. Logistic regression analysis indicated that length of internship rotation was statistically significant with respect to contaminated NSIs/SIs (OR = 1.682; 95% CI: 1.005-2.81; P =. 048). The NSIs/SIs frequencies of NSs were higher than those for HCWs. We found that frequency of NSIs/SIs for vocational school NSs is above average. Whether the young age of these NSs put them at greater risk for NSIs/SIs warrants further inquiry.

Because workers must be prepared to constantly update their skills and reeducate themselves for new skills, lifelong learning must be a goal for every teacher and student. The curriculum provided during educational experiences should pave the way for attainment of this goal. This is particularly true for deaf and hard of hearing students. School-to-work (STW) has become an umbrella term for activities, experiences and opportunities that prepare students for the world of work, such as youth apprenticeships, mentoring, internships, job shadowing, career exploration, and integration of academic and vocational curriculum. This article provides historical background on STW, laws shaping requirements for STW programs, and research supporting STW components. Recommendations are provided for curricular elements of an STW program, and trends in STW are forecast.

This paper outlines a study designed to validate competencies for dental vocational training (DVT) and general professional training (GPT) in order to ensure their accuracy and acceptability. A highly inclusive approach is described whereby all trainers in Scotland were invited to participate in the exercise. The 168 individuals recruited were drawn from all branches of the dental services and all regions in Scotland. Using online or paper questionnaires, quantitative and qualitative data were collected for each competency statement over 9 months, after which focus groups discussed and decided which changes should be made. A high response rate was observed and from the 160 competencies originally identified, almost half (47.5%) were redrafted as a direct result of the validation process. Sections of the competency document that required most attention are discussed, as are the nature of changes made to the competencies. As a result of this study, a fully validated competency document for DVT and GPT has been produced and will allow a high degree of standardization of training through the provision of essential consistent information to trainers and VDPs.

Certain proposals are difficult to challenge and appear to be beyond debate. The call for improved quality of healthcare is one of these. And certainly, the call for more leaders and more highly skilled leaders in the healthcare industry is another, especially in these times of rapid change, strained resources and concern about quality. Though the goal of preparing more leaders, and in particular preparing more highly skilled leaders, is meritorious, the premises underlying this goal and the methods of achieving it deserve careful examination. This commentary questions the ability to accurately forecast the supply of and demand for leaders in the healthcare industry and examines selected aspects of the 10 principles for leadership development proposed in the lead paper.