Band 109, Heft 6

Context: Several studies have shown that the personality types of medical and dental students affect performance on aptitude and achievement examinations. However, such studies are lacking in osteopathic medical literature. Objective: To determine if personality type is associated with performance on aptitude and achievement tests taken by osteopathic medical students. Methods: The Myers-Briggs Type Indicator (MBTI) was used to determine the mental-function pairs—sensing-thinking, intuition-thinking, sensing-feeling, or intuition-feeling—of osteopathic medical students at Midwestern University/Chicago College of Osteopathic Medicine in Downers Grove, Ill. Results were analyzed with participants' scores on the Medical College Admissions Test and the Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) Level 1. Results: A total of 295 osteopathic medical students completed the MBTI, but 32 (11%) were excluded because they did not meet the study criteria. Among the remaining 263 participants, no personality types were associated with high or low scores on the Medical College Admissions Test ( P =.229). However, participants in the intuition-feeling group had statistically significant lower scores on COMLEX-USA Level 1 ( P =.002). Conclusion: The differences in scores obtained on COMLEX-USA Level 1 were statistically significant when students were identified by personality type. This finding suggests that using the MBTI during training could enhance learning and improve academic performance in osteopathic medical schools.

Currently, close to 50% of osteopathic medical graduates receive residency training from programs accredited by the Accreditation Council for Graduate Medical Education (ACGME) rather than those approved by the American Osteopathic Association (AOA). As a result, leaders within the osteopathic medical profession have expressed ongoing concerns about the viability of the profession's distinct osteopathic identity. Using a one-page, 12-item survey, the authors queried ACGME-trained family practice residents (N=1354) regarding their interest in formal membership, continuing medical education activities, and specialty board certification options within the osteopathic medical profession. Four hundred twenty-six completed surveys were returned and usable for analysis for an overall response rate of 31.4%. A majority of survey participants indicated an interest “in continuing [their] osteopathic skills and training during residency” (376 [88.5%]), membership in osteopathic organizations and participating in continuing medical education programs (325 [77.2%]), and completing the American Osteopathic Board of Family Physicians certification examination (267 [63.7%]). Unfortunately, actual involvement may be limited by lack of communication or understanding, as in the case of lack of awareness regarding eligibility criteria for AOA board certification (311 [74.2%]). A variety of recommendations are offered to osteopathic organizations to improve involvement in and commitment to the profession among ACGME-trained DOs.

Although it has long been known that fasting or the consumption of certain foods can trigger headaches, abdominal and total body obesity have only recently been linked to migraine. Several adipocytokines appear to play an integral role in feeding and obesity—and have also been linked to pain. Among these proteins are adiponectin and leptin. The author reviews the regulation of adipose tissue and feeding and provides an in-depth examination of adiponectin and leptin and their association with migraine.

Context : Relatively few osteopathic physicians (DOs) practice in the deep central southern geographic region as compared to other parts of the United States. Objective : To assess the potential effects of underrepresentation on the perception of osteopathic medicine among allopathic physicians (MDs) in this geographic region. Methods : A 20-item, Likert scale survey was designed to evaluate participant perceptions of the osteopathic medical profession. The instrument was mailed to 468 MDs who reside and practice in the deep central southern region of the United States. Results : One hundred seven individuals completed the survey for a response rate of 22.9%. Although the majority of respondents (71 [66.3%]) recognized the distinctiveness of the osteopathic medical profession, they were not necessarily able to articulate these differences clearly through their responses to other survey items. In addition, survey participants expressed was a belief that residency training programs accredited by the Accreditation Council for Graduate Medical Education were more beneficial to osteopathic medical graduates than those approved by the American Osteopathic Association (94 [87.8%]). Finally, there was a perception that research efforts supporting “the scientific basis of osteopathic medicine” were inadequate (53 [49.5%]). The one demographic factor that had a statistically significant ( P <.001) positive impact on perceptions of osteopathic medicine among these MDs was previous contact with DOs. Conclusion : Underrepresentation of DOs in the deep central southern region of the United States appears to have an impact on the perception of osteopathic medicine among MDs insofar as direct or indirect contact with osteopathic physicians led to improved perceptions among this cohort.

Methotrexate sodium use in the management of various immunologic disorders has increased—as have the number of reported adverse effects associated with this therapy. While methotrexate has helped combat various autoimmune and cancerous disorders, the paradoxical risk of causing an often fatal malignancy may still occur as a result of the drug's effect on suppressing immune function. We present a case of methotrexate-induced Hodgkin disease in a 48-year-old man with a history of systemic lupus erythematosus (SLE). Discontinuation of methotrexate facilitated Hodgkin disease reversal. In addition, we review other lymphoproliferative hematologic malignancies caused by methotrexate.