EBM curriculum

[albe]

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So I am deciding between two programs on my rank list, and Program A is a more academic program with a dedicated curriculum to teaching EBM and [I assume] incorporating it into daily use while Program B does not seem to mention it. I think Program B has journal clubs, but from what I understand, there is less of a "based on the literature search, we should try ....." on a daily basis.

I just want to see if any residents or fellows can comment on having an Evidence-Based Medicine Curriculum as part of their residency program. Is the culture of your program such that you do a literature search/appraise research studies with most patients you see?

I realize I can always try to teach it to myself and try to incorporate it while a resident, but I just have the feeling that at a time when we are so busy, I may just default to whatever the culture is at the institution I train at during residency. If I go to Program B, would I be taking a hit on my education if EBM is not part of the daily norm at that institution?

 

[albe]

Any thoughts on this?

 

[CrazyPeds527]

At a program that has EBM part of the curriculum, I can comment on this.

You will find that much of pediatric management has no evidence, or scant evidence at best. Nevertheless, programs that emphasize what the literature shows, I believe, set residents up best for the future.

Particularly, teaching residents how to use sites like OMIM, Pubmed and OVID to their advantage, as opposed to the "google search" is a huge advantage so that you can maximize your scholarly output with as little input as possible

We do journal club once/month, have senior rounds where someone presents a journal article on a topic 4-5 times/week, and I believe this has made me a better pediatrician.

Also to keep in mind (this may be difficult to ascertain) a program which discusses evidence within a rounding structure will make residents stronger...

my two cents

 

[TexasRose]

Our program is very pro evidence-based medicine. I like it. But then, I like research and discussions based on measurable outcomes (when available.) Personally, I feel more confident that when I am out in practice I will be able to answer questions for myself with a decent lit review than I would have been in a program that didn't stress learning how to do this.

 

[Stitch]

I also think it's important to have a focus on EBM. You shouldn't be doing things just because 'we've always done it that way,' an attitude you'll see in older physicians who are now out of date. It's important to learn now, so that when you're an attending you can keep learning and reexamining your practice. This type of learning is beyond journal clubs. Always ask 'why are we doing this?' and try to get an answer from people.

One caveat though is that some people become so focused on EBM and asking 'what's the evidence for doing x' that they lose site of actually practicing medicine. It's important to be able to aknowledge that the data for doing x is weak, but it's all we have and that standard of care is x despite this. There is some art to it, and integrating the available science into a coherent practice is part of what you must learn. If that makes any sense.

 

[albe]

Thanks!