The 2003 Survey of Academic Medical Center Psychologists: Implications and Outlook

This paper offers commentaries on Pate and Kohout’s (2005) report of data from the 1997 and 2003 surveys of psychologists in medical school settings. The commentaries reflect upon the significance of the survey findings and implications for psychology’s role in medical school and academic health science settings. Though the response rate to the survey was disappointing, the data indicate that psychologists are moving up in academic rank, and have made substantial gains in salary. The data also indicate that among psychologists who are medical staff members, who constitute half the 2003 sample, an increasing proportion are functioning autonomously as reflected in gains in the percentage having admitting privileges, staff voting privileges, and authority to write orders. Research continues to be a major focus for psychologists in academic medical centers. Overall, the findings indicate that psychologists can have productive, satisfying careers in medical school/academic health center settings—though there is one troubling sign, a sizeable drop in the number of positions being created for younger, more recently trained psychologists. Methodological enhancements are described that could improve the quality, scope, and usefulness of data from future studies, both for understanding long-term trends and for conducting salary negotiations. High quality data provide a solid foundation for advocating for psychologists’ full participation in the life of medical schools and academic health centers.     

Gender Differences in Employment and Salaries of Psychologists Within Medical School Settings

A survey of 3,894 psychologists employed within medical schools and academic health centers was conducted in 1997 by the Research Office of the American Psychological Association (APA) in collaboration with the Association of Medical School Psychologists (AMSP). This survey, published as the 1997 Employment Characteristics and Salaries of Medical School Psychologists, included inquiries about various aspects of employment (e.g., academic rank, tenure status, employment activities, appointment characteristics, department affiliations, demographic characteristics) and earnings. Employment characteristics and salary information were compared by gender. The findings indicated that men had more favorable employment circumstances and higher base salaries than their female counterparts. These differences existed across all academic ranks and were found at each level of experience. This article discusses these findings and their implications.     

Role of Psychologists in Academic Medicine

With an interdisciplinary approach to understanding human psychosocial development and behavior, psychologists in academic medical settings have much to offer in the areas of administration, research, teaching, and service, including in the realm of organizational systems and behavior within medical schools. In these ways, psychologists can play a large role in the fulfillment of the mission of academic medicine and enhance psychology’s stature in the medical school organization. Two case studies are presented that exemplify the varied roles and responsibilities of psychologists in a medical school. To be successful within medical schools, the following generalizable principles are offered: (1) “add value” to the medical school by demonstrating the diverse and relatively unique abilities of psychologists; (2) be flexible and adaptive to the different requirements of medical academic settings; (3) make a concerted effort to work well with medical students, residents, and physicians who may not be well-versed in certain aspects such as rigorous research methodology and statistics; and (4) find a “good match” between one’s strengths, the needs of the medical setting, and the attributes of the M.D. leader. With such an approach, remarkable accomplishments can be made.     

医学专业精神及医疗保密：美国历史及现状中的冲突

讨论卫生部门宣传和加强强制汇报的法律的努力、强制性汇报的规定与医学专业精神及个人自主性之间的冲突、私人医生避免遵守这些规则的策略、病人和倡议者设法避免强制性登记和检测的策略,以及医生/病人和公共卫生官员达成的妥协。最后对公共卫生政策提出建议,认识到强制性汇报存在的问题和卫生政策透明度的重要性。     

Health Care Reform and Psychologists in Medical Schools: Stress, Challenge, and Change

Psychologists from 45 academic health science centers throughout the United States and Canada gathered at Georgetown University for a national conference November 2–5, 1995 organized by the Association of Medical School Psychologists. This paper introduces the proceedings of that conference described in the next four articles in this issue of the Journal of Clinical Psychology in Medical Settings[Volume 4, number 1]. Papers prepared by the working groups focus upon clinical services, education and training, research, and governance and administration within the academic medical setting.     

A History of the Association of Medical School Psychologists

While psychologists have been active faculty members in medical schools for over 85 years, they lacked organization on the national level until 1981. This history traces the background of psychology's involvement in medical schools, landmark events that affected the discipline, and progress since formal organization has occurred. Office of the Senior Vice President and Provost     

中美两国医疗救助模式比较分析

医疗救助作为保障贫困人群健康权的最后一道防线,在世界各国均备受关注.各国因国情的不同,医疗救助模式也大有不同.为进一步完善我国医疗救助制度,从救助对象的选择、救助项目、筹资及运作方式几个方面对中美两国医疗救助进行了比较分析.发现中美两国的医疗救助在救助对象的选择、救助项目、筹资及运作方式方面有所不同,而这些不同给我国医疗救助制度、模式乃至理念带来很多可借鉴之处,推动我国进一步完善医疗救助制度.     

The Current State of Medical Psychology in Iran

This paper reviews medical psychology in Iran and describes the two major professional associations representing the profession. The unique role of religion in Iran is stressed, and limitations of the current health care system are described. The paper also addresses human resource issues and the educational requirements for the practice of psychology in Iran.     

Partnerships with Psychiatry and Other Clinical Disciplines: A Key to Psychology's Success in U.S. Medical Schools

This paper describes the growth of psychology in medical schools and the distribution of psychologists across medical school departments. The Association of American Medical Colleges (AAMC) and American Psychological Association (APA) use different data collection approaches that reflect their different missions. AAMC focuses solely on medical school faculty, whereas APA tries to reach all psychologists working in academic health centers (AHCs). The number of psychologists in medical school settings has increased, largely due to their research expertise; but psychologists also contribute through teaching and clinical service. Psychologists hold appointments in wide variety of medical school departments, which has been a key factor in their success. Through partnership and interdisciplinary collaboration with a wide range of academic physicians, psychologists have gained increased support, become valued members of the AHC and medical school communities, and can rise to leadership positions in medical schools.     

医学专业精神及医疗保密:美国历史及现状中的冲突

讨论卫生部门宣传和加强强制汇报的法律的努力、强制性汇报的规定与医学专业精神及个人自主性之间的冲突、私人医生避免遵守这些规则的策略、病人和倡议者设法避免强制性登记和检测的策略,以及医生/病人和公共卫生官员达成的妥协.最后对公共卫生政策提出建议,认识到强制性汇报存在的问题和卫生政策透明度的重要性.     

Racial Differences in Perceptions of Starting Salaries: How Failing to Discriminate Can Perpetuate Discrimination

Despite recent findings suggesting the presence of racial differences in the perception of starting salaries, researchers have yet to empirically investigate this possibility. Consequently, this study examined the interactive effects of race, ethnic identity, and starting salaries on the salary perceptions of 342 undergraduates. Hispanic, Asian American, and White participants exhibited positive effects of salary whereas Black respondents failed to discriminate between the different salaries. However, a three-way interaction involving ethnic identity, race, and salary revealed a more complex pattern of responses for Black participants: Higher ethnic identifiers responded similarly to Hispanic, White, and Asian Americans. The implications of these results regarding the perpetuation of racial wage inequity are discussed.     

Health Psychology in Catalonia in 2000: Current View and Future Perspective

This report describes the current status of health psychology in the nation of Catalonia (Spain). Emphasis is placed upon autonomy and self-governance, which have progressively influenced the structure and functioning of the health care system and the professional colleges. The current university educational model of training and practice in health psychology is reviewed. The most important characteristics of professional psychologists are presented. A critical view of health psychology research in medical settings and future perspectives of health psychology in Catalonia are also discussed.     

中美医疗损害责任制度改革之比较研究

医疗损害责任已成为现代社会普遍的医疗法律问题。中美两国医疗损害责任制度改革正朝着相反的方向发展。诉讼机制在美国医疗损害责任中的作用由强变弱,医疗诉讼起诉由易变难,医疗损害赔偿由不限制到相对限制,行政管理式的医疗过错责任制度由无到逐渐提议。我国医疗损害责任制度改革恰恰相反,即诉讼制度的作用由弱变强、医疗损害起诉由难到易,医疗损害赔偿由相对限制到不限制、行政管理式的医疗过错责任制度从有到无。我国医疗损害责任制度的改革趋势值得反思。建议借鉴美国医疗损害责任制度改革的经验。     

美国CS考试中SP对完善我国医师资格实践技能考试的启示

当前,标准化病人（SP）在国内数十所医学高等院校和医疗机构得到了较为成熟的研究和开发,但在医师执业资格实践技能（CS）考试方面的运用和研究尚未起步,本文在比较中美医考实践技能考试特点的基础上,肯定美国医师执业资格考试（USMLE）运用SP在医学人文性和公平性等方面所彰显的独特优势,并指出我国现行的医师资格实践技能考试存在的不足,结合相关文献和笔者在国家医学考试中心工作和学习经历,借鉴美国CS考试中SP的经验,提出完善对我国医师医学人文素养考查的方式方法和提高考查方式的灵活性、渗透性等建议.     

Personal Therapy and Self-Care in the Making of Psychologists

Abstract

Psychologists are skilled in assessing, researching, and treating patients’ distress, but frequently experience difficulty in applying these talents to themselves. The authors offer 13 research-supported and theoretically neutral self-care strategies catered to psychologists and those in training: valuing the person of the psychologist, refocusing on the rewards, recognizing the hazards, minding the body, nurturing relationships, setting boundaries, restructuring cognitions, sustaining healthy escapes, maintaining mindfulness, creating a flourishing environment, cultivating spirituality and mission, fostering creativity and growth, and profiting from personal therapy. The latter deserves special emphasis in the making of health care psychologists. These strategies are recommended both during training and throughout the career span. Recommendations are offered for enhancing and publicizing systems of self-care throughout the profession.     

The Impact of Gender on Productivity and Satisfaction Among Medical School Psychologists

The impact of gender on productivity and satisfaction was examined among a random sample of 293 psychologists employed as faculty members in medical schools. Forty-one percent of the respondents were female. Males were older than females, had worked in a medical school longer, had higher academic ranks, held more administrative positions, were more likely to be tenured, and earned higher salaries. When years of employment as a psychologist were statistically controlled, there were no gender differences in productivity, as measured by publications, presentations, and grant awards; however, gender differences in salary remained. Females were less satisfied than males with regard to salary, promotion opportunities, and overall respect. Results are discussed within the context of the changing gender composition within psychology and the changing demands within the health care system.     

The United States Cover-up of Japanese Wartime Medical Atrocities: Complicity Committed in the National Interest and Two Proposals for Contemporary Action

To monopolize the scientific data gained by Japanese physicians and researchers from vivisections and other barbarous experiments performed on living humans in biological warfare programs such as Unit 731, immediately after the war the United States (US) government secretly granted those involved immunity from war crimes prosecution, withdrew vital information from the International Military Tribunal for the Far East, and publicly denounced otherwise irrefutable evidence from other sources such as the Russian Khabarovsk trial. Acting in “the national interest” and for the security of the US, authorities in the US tramped justice and morality, and engaged in what the English common law tradition clearly defines as “complicity after the fact.” To repair this historical injustice, the US government should issue an official apology and offer appropriate compensation for having covered up Japanese medical war crimes for six decades. To help prevent similar acts of aiding principal offender(s) in the future, international declarations or codes of human rights and medical ethics should include a clause banning any kind of complicity in any unethical medicine—whether before or after the fact—by any state or group for whatever reasons.     

台湾中山医学大学医学人文教育特色与反思

台湾中山医学大学教育的宗旨是以医学暨人文发展为导向,致力建构一个崇尚人文价值与尊重生命、医学人文兼容并蓄的医学大学,强调“先学做人,再学当医师”.开设的医学人文课程非常有医学针对性,按核心能力要求整合医学人文核心课程,分为文化与社会、人际关系与沟通、医学伦理/法律三个主轴,贯穿于1年级～6年级的学习中,而且与专业课程学习紧密相联,教学方式多元、务实和潜移默化.其教育模式无疑为我国的医学人文教育改革带来全新的视野.     

Social Capital and Employment Outcomes of Zimbabwean Immigrants in the United States

Understanding of cultural and contextual factors that may influence settlement is vital for successful immigrant integration. This study explored the effect of social capital on employment outcomes of Zimbabwean immigrants (N?=?103) in the USA using a triangulation mixed methods design. Participants completed a survey that assessed their social capital and employment outcomes. Twelve participants were selected from those who had completed the survey to participate in in-depth interviews that asked about their life experiences. The results of a multiple logistic regression analysis identified network diversity as a significant inverse predictor of underemployment (p?=?0.04) controlling for educational attainment. Qualitative results elaborated on how social capital contributed to or minimized underemployment. Implications for practice are also suggested.     

美国的医学人文教育:历史与理论

大体上考察了美国医学人文教育的发展情况.首先,对医学人文研究加入到美国医学教育计划中的原因与方式进行考察.其次,对美国医学人文运动的历史进行考察,决定医学人文的诞生的原因,并讨论医学人文领域中的学者是如何定义"医学人文"的.最后,从理论视角对医学人文的目的与教育方法进行分析.