United States

Background 
Ophthalmology is a highly competitive specialty to match into, yet many medical students have limited exposure to the field. Early exposure and mentorship are essential to introduce students to ophthalmology, better preparing them for residency applications. 
Research on mentorship in ophthalmology for preclinical and clerkship students remains scarce, with no systematic review. Our objective is to conduct a comprehensive review of the critical role of mentorship in medical students&#39; path in ophthalmology. We seek to offer actionable recommendations for medical schools to bridge the divide between preclinical education and clinical exposure to ophthalmology. 
Methods 
Using PRISMA methodology, a literature review was conducted via databases PubMed and Embase. The objective was to identify all published literature on ophthalmology mentorship programs for first through third-year medical students in the United States. 
Inclusion Criteria: 
Intervention: providing mentorship (clinical opportunity, personal mentorship, research exposure, etc.)
Setting: specific to ophthalmology 
Population: First, second, and third-year U.S. medical students 
English language 
Information from chosen articles was summarized into an evidence table. Areas of interest included number of students in the study, year in medical school, intervention type and length, and pre-and post-intervention measurement methods. 
Results 
93 articles were retrieved with 19 duplicates. 74 articles were screened by two independent reviewers. Titles and abstracts were screened, excluding 17 articles. The remaining 57 underwent full-text screening. Seven articles meeting all inclusion criteria were included in this review. Three additional articles were discovered in the references of reviewed articles and were added. 304 subjects were studied, comprising of first, second, and third-year medical students. One study also included four undergraduate students. Seven of ten articles reported significantly increased ophthalmology knowledge. Six of ten articles evaluated the change in student interest in ophthalmology. Five articles reported an interest increase post-intervention, with four articles indicating a statistically significant increase post-intervention. 
Conclusion 
The studies in this review highlight how early exposure to ophthalmology is crucial for enhancing students&#39; skills and knowledge in preparation for elective rotations and residency applications in their fourth year. 
While only four studies showed a significant increase in interest in ophthalmology, this outcome may be influenced by students already interested in ophthalmology being more likely to participate in the offered mentorship and exposure programs. 
Structured programs aimed at providing exposure and mentorship to ophthalmology are invaluable resources for aspiring ophthalmologists. Medical schools can consider adopting similar initiatives to bridge the gap in pre-clinical ophthalmology exposure and knowledge.

AMA Research Challenge 2024 

Medical Student Ophthalmology Mentorship Initiatives in the United States: A Systematic Review​

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AMA Research Challenge 2023

Join the AMA Research Challenge poster symposium and semifinals to explore top research posters, score posters in the semifinals (an AMA member exclusive opportunity) and attend education sessions with experienced physicians to learn tips to advance your research and career. 

Background 
Ophthalmology is a highly competitive specialty to match into, yet many medical students have limited exposure to the field. Early exposure and mentorship are essential to introduce students to ophthalmology, better preparing them for residency applications. 
Research on mentorship in ophthalmology for preclinical and clerkship students remains scarce, with no systematic review. Our objective is to conduct a comprehensive review of the critical role of mentorship in medical students' path in ophthalmology. We seek to offer actionable recommendations for medical schools to bridge the divide between preclinical education and clinical exposure to ophthalmology. 
Methods 
Using PRISMA methodology, a literature review was conducted via databases PubMed and Embase. The objective was to identify all published literature on ophthalmology mentorship programs for first through third-year medical students in the United States. 
Inclusion Criteria: 
Intervention: providing mentorship (clinical opportunity, personal mentorship, research exposure, etc.)
Setting: specific to ophthalmology 
Population: First, second, and third-year U.S. medical students 
English language 
Information from chosen articles was summarized into an evidence table. Areas of interest included number of students in the study, year in medical school, intervention type and length, and pre-and post-intervention measurement methods. 
Results 
93 articles were retrieved with 19 duplicates. 74 articles were screened by two independent reviewers. Titles and abstracts were screened, excluding 17 articles. The remaining 57 underwent full-text screening. Seven articles meeting all inclusion criteria were included in this review. Three additional articles were discovered in the references of reviewed articles and were added. 304 subjects were studied, comprising of first, second, and third-year medical students. One study also included four undergraduate students. Seven of ten articles reported significantly increased ophthalmology knowledge. Six of ten articles evaluated the change in student interest in ophthalmology. Five articles reported an interest increase post-intervention, with four articles indicating a statistically significant increase post-intervention. 
Conclusion 
The studies in this review highlight how early exposure to ophthalmology is crucial for enhancing students' skills and knowledge in preparation for elective rotations and residency applications in their fourth year. 
While only four studies showed a significant increase in interest in ophthalmology, this outcome may be influenced by students already interested in ophthalmology being more likely to participate in the offered mentorship and exposure programs. 
Structured programs aimed at providing exposure and mentorship to ophthalmology are invaluable resources for aspiring ophthalmologists. Medical schools can consider adopting similar initiatives to bridge the gap in pre-clinical ophthalmology exposure and knowledge.

poster

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#### Event Details

The 2024 American Medical Association Research Challenge includes a poster symposium hall and a semifinals hall with the top scored research. **Log in at any time throughout the event to:**

* **View posters and presentations** on a variety of topics and specialties
* **Score posters in the semifinals** to help decide the top five finalists (AMA member exclusive opportunity)
* **Connect with participants** and provide feedback to help advance their research

At the conclusion of this event, the AMA will announce the top five finalists who will advance to the AMA Research Challenge finals, present their research to an elite panel of judges, and compete to win a $10,000 grand prize presented by Laurel Road. 

### Grand Prize Sponsor

AMA would like to thank Laurel Road for sponsoring a $10,000 grand prize for the winner of the AMA Research Challenge. Laurel Road is not involved in winner selection process. The winner will be announced on February 20, 2025 during the AMA Research Challenge finals. Payment of the grand prize will be directly from Laurel Road. See the AMA Research Challenge Official Rules for terms and conditions.

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Join the AMA Research Challenge poster symposium and semifinals to explore top research posters and score posters in the semifinals (an AMA member exclusive opportunity).

Background
Wearable technology has become a rapidly growing consumer market which is expected to double between 2021 and 2026. One popular use for wearables is to track health outcomes. Amid escalating mistrust towards the medical community, this study investigates how varying levels of trust in the healthcare system affect an individual’s decision to track their health with wearables, the frequency of using wearables to track their health, and sharing the data with their providers.

Methods
Data from the 2022 Health Information National Trends Survey (HINTS) 6 was analyzed for trust in the healthcare system, use and sharing of health information from wearable devices, and socio-demographic characteristics (age, gender, income, and race). Level of trust in the healthcare system, the main study predictor, was categorized into four levels: not a lot, a little, somewhat, and a lot. Dependent variables were 1) use of a wearable device to track healthcare information; 2) willingness to share wearable health information with a provider; and 3) frequency of tracking metrics on a wearable over the past month.

Results
Among the 6,118 respondents, 84.8% reported moderate to high levels of trust in the U.S. healthcare system, and 33.2% used wearables in the past year to track their healthcare data. 70.8% of wearable users stated that they had used a wearable to track their health daily or nearly daily during the past month, and 78.1% of respondents were willing to share wearable data with a healthcare provider. Participants with a lot of trust were significantly more willing to share their wearable data with a healthcare provider (AOR:1.49;[95% CI 1.27-1.73]), after controlling for covariates. Increasing income levels resulted in a higher likelihood of using a wearable to track health data (AOR:1.33;[95% CI 1.29-1.37]) and increased frequency of tracking health metrics on wearables (AOR:1.10;[95% CI 1.06-1.13]). Men are also less likely to use wearables (AOR:0.62;[95% CI 0.54-0.70]) and track their health with them continuously (AOR:0.85;[95% CI 0.74-0.97]) than women.

Conclusion:
This study suggests that increasing levels of trust in the healthcare system, increasing income, and being female are associated with greater adoption of wearable technology for health information tracking and sharing.

Navigating the intersection between wearable technology, health data sharing, and trust in the U.S. healthcare system

Background: Resource limitations for medical students (MS) lead to higher attrition and decreased rate of overall matching, including matching into competitive specialties. Research shows that there are factors that influence student recruitment into competitive specialties including early research involvement, availability of specialty academic residency programs, accessibility of educational resources, mentorship, and networking opportunities. The Meharry
Medical College American Medical Association funded, Inter-institutional Multispecialty Interest Group Retreat [MIIGR] was developed in a resource limited environment, to impact these factors amongst MS. The purpose of this study is to analyze the students’ perception of MIIGR for navigating the medical career process (MCP) and the influence of factors impacting recruitment.
Methods; A survey was given to 179 medical students before and after the MIIGR. Among the 179 that completed the initial survey, 86 completed the post-survey. Eight were first years, 35 were second years, and 43 were third years. Forty of those who responded attended last year’s interest group retreat. Shapiro-Wilk and Levene's tests were used to determine the normality and homogeneity of each pre- and post-survey question. Data was examined overall and by year. All
analyses and graphics were conducted using R/RStudio version 4.3.2 and SPSS Version 29.
Results: After the MIIGR, MS had a significantly clearer understanding of the nature and role of a competitive application (p-value < 0.001), how to produce a competitive application for residency (p-value < 0.001), how objective measures play in a competitive application for residency (p-value < 0.001), role that research plays in a competitive application for residency (p-value < 0.001), the role that publications and frameworks that support publication activity play in a competitive application (p-value < 0.001), resources that can help in a competitive application (p-value < 0.001), the role of sub-internships play a competitive application for residency (p-value < 0.001) after attending the retreat. Survey data points also displayed utilized
scores (4 or 5) for MS who agree or strongly agree with the following: 93% of MS stated that faculty/residency program directors encouraged students to ask questions and actively participate, further MS noted the following ; increased awareness of residency program requirements(94%); that the retreat effectively increased awareness of available educational resources(75%); believed the retreat effectively enhanced early specialty involvement in research opportunities(74%); reported the retreat increased networking or awareness of networking opportunities;(88%)MS were able to connect with external mentors in their desired
specialty in the initial period after the IGR(67%),;provided some initial benefits and resources that otherwise may not have been as easily accessible due to not having specific academic specialty programs at their institution; (84%) reported an increased awareness of the competitive culture of various subspecialties;(87%) and 88% of attendees intended to use the information they gained from the retreat to position themselves to be a more competitive residency candidate.
Conclusion : MS perceived an improved awareness and utilization of resources potentially improving the navigation of MCP and applicant recruitment. Further research will evaluate longterm outcomes.

Navigation Through the Medical Career Process in a Resource Limited Environment

Background 
As public awareness of autism spectrum disorder (ASD) increases, so does the number of adults seeking assessment. Research regarding ASD, a neurobiological disorder with behavioral presentations, often overlooks autistic adults in favor of childhood expressions. Barriers for adults seeking autism assessments–including lengthy wait times and low provider knowledge–drive many individuals to self-diagnostic tools and leave them without appropriate accommodations or therapies. To date, a comprehensive study revolving around the occurrence or degree of autistic tendencies in healthcare students has not been conducted. The present research explored the relationship between pre-healthcare distinction and variegated autistic trait manifestations as defined by RAADS-R scores and subscores. 

Methods 
The cross-sectional study population consisted of 69 undergraduate students (34 pre-medical, 19 pre-dental, and 16 pre-nursing) enrolled in the 2024 Summer Health Professions Education Program at UTHealth Houston. The cohort was administered the RAADS-R screening tool followed by a 31-item QuestionPro survey measuring demographic, academic, and subjective data inquiring about participants’ feelings and confidence to obtain their desired healthcare degree in light of their RAADS-R results. Statistical analyses, including one-way t-tests, ANOVA, Fisher’s Exact, and linear regressions, were run to establish relationships between RAADS-R scores and various measures. 

Results 
One-way t-tests revealed that autistic traits along all RAADS-R categories are more significantly expressed (p<0.001) in pre-healthcare students than in the general population. Additionally, the cohort demonstrated significantly higher (p<0.001) language-driven behaviors and lower (p<0.05) social relatability-driven autistic behaviors than is required for diagnostic consideration. ANOVA tests revealed no significant variance (p>0.05) in RAADS-R scores between pre-healthcare tracks, which may be attributable to small group sizes. Fisher’s Exact tests revealed statistically significant (p<0.05) relationships between total RAADS-R scores and participants’ degree of surprise regarding their results and confidence in obtaining their desired degree. Further investigation with linear regression models confirmed a moderate positive linear relationship between total RAADS-R scores and participant surprise (r2=0.15, p<0.05) and a modest negative linear relationship between confidence to obtain their desired degree and total RAADS-R score (r2=0.07, p<0.05). 

Conclusion 
Results reveal an association between autistic trait manifestations and the pursuit of a pre-healthcare degree. These results introduce questions about why pre-healthcare students express higher autistic traits, how autistic traits impact student confidence to pursue healthcare degrees, and the implications on medical education, workplace culture, and accessibility of healthcare careers for adults expressing autistic traits.

Relationship Between Pre-Healthcare Track and Variegated Autistic Trait Manifestations as Defined by RAADS-R Scores

Introduction
Rutgers-Robert Wood Johnson Medical School’s (RWJMS) distinction program in Medical Innovation and Entrepreneurship (DiMIE) is an application-based multi-year innovation and entrepreneurship program for interested medical students. This study sought to examine the impact of the DiMIE Program on students’ acquisition of key entrepreneurial skills as well as attitudes toward completion of the program, and to investigate intentions to continue innovation in participants' future careers.

Methods
A Rutgers IRB-approved nineteen-question survey was distributed via email to all program participants who successfully attained their DiMIE. The survey was voluntary and participants were provided with the option to leave any questions unanswered. f

Results
86% (31/36) DiMIE alumni completed the survey. 68% (21/31) of participants were not confident or neutral in their entrepreneurial skills before beginning DiMIE. However, 84% (26/31) of participants felt the DiMIE improved their confidence in pursuing entrepreneurship The most reported tangible skills developed during the program were identification of clinical needs, design thinking, networking abilities, deck creation, pitch presentation skills, and market research. Participants noted a strong relationship with their mentor as one of the keys to success. 34% (10/29) of DiMIE alumni continued to grow their innovative ideas after completion of the requirements. 87% (27/31) said they were likely to do entrepreneurial projects in the future. Participants felt that adequate mentorship was instrumental for better project design and insight into clinical needs, and many desired more opportunities to connect with entrepreneurs. 

Discussion & Conclusions
Participants desire to learn more technical entrepreneurial skills and receive guidance in moving forward with their creative ideas. Medical institutions wishing to develop entrepreneurship programs should prioritize building robust networking communities, hosting workshops, and formally integrating innovation and entrepreneurship into medical school curricula. This integration will not only help medical students engage in entrepreneurship, but it also endows them with skills applicable to many areas of medicine including leadership, teamwork, and the ability to problem-solve in the future healthcare landscape.

Shaping Future Healthcare Leaders: The Impact of Innovation Programs on Medical Students

Background
Peer tutoring has a long history of benefitting student learners while also advancing tutors’ understanding of the presented material. This type of tutoring is widely used in medical schools to help pre-clinical students study challenging material. However, some students find that this type of support is not extended into the clinical phases of medical education.. The aim of this project was to develop a peer-tutoring program tailored to the core clinical phase at Geisinger Commonwealth School of Medicine to support student success during clerkship rotations, on their NBME Subject Examinations, and on the USMLE Step 2 CK exam. 

Methods
For each of the seven core clerkships (internal medicine, surgery, family medicine, neurology and psychiatry, and obstetrics/gynecology and pediatrics), a series of presentations were created by fourth year medical students pursuing the respective specialties. These presentations were created referencing material from a variety of board preparation resources and textbooks. Each presentation was designed to be interactive and utilize a similar format: a case presentation to anchor the topic of interest in a real-world example, followed by high-yield material related to the case, explanation and progression of the clinical case, integration and application of the relevant information presented. The presentations for all clinical disciplines is repeated throughout the year, hosted synchronously on Microsoft Teams in the evenings or weekends to allow students from all clinical campuses to attend without interfering with clinical duties. 

Results
To date we have successfully run the above-described peer tutoring program for nearly two clerkship blocks with overwhelmingly positive student feedback on post-session surveys. We plan to collect and analyze student performance data at the end of the academic year to assess the effect of peer tutoring attendance on subject exam and usmle step 2CK performance. 

Conclusion
Moving forward, we hope to expand our program to include a more robust orientation to the program during the Transition to Clerkships Course, workshops to review test-taking strategies, and cumulative review sessions to supplement board examination preparation. Overall, this project should provide a model for peer-tutoring in the clinical phase of medical school, and will likely improve student performance at Geisinger Commonwealth School of Medicine. 


STAT! Learning – A peer tutoring program designed for the clinical rotation year

Abstract Title 

The Impact of White Coat Ceremonies on Physician Professionalism 



Background 

For first-year medical students, reciting the Hippocratic oath and donning the medical white coat during the white coat ceremony (WCC) is a common practice among medical schools in the United States. The first WCC was organized by the Arnold P. Gold Foundation, a nonprofit organization that sought to humanize healthcare through the White Coat Ceremony. Before starting medical school, the WCC is a defining moment in commencing the journey of an aspiring physician. During this event, first-year medical students recite the Hippocratic Oath--stating a doctor's core values and responsibilities. 



Methods 

First- and second-year California University of Science and Medicine (CUSM) medical students were evaluated with a survey before and after attending their WCC to assess student professionalism. This survey included a 6-point Matrix Likert Scale of ACGME core competencies, as well as multiple-choice and free-response questions. Pre- and post-surveys were compared using paired t-tests. 



Results 

The average Hippocratic oath score increased from 3.85 to 4.58 (p = 0.01). 24% of students ranked their “understanding of professionalism” higher post-WCC. Most respondents (81%) either strongly agreed or agreed that the WCC instills professionalism after attending the WCC. In a free response question regarding “words associated with WCC”, the word “respect” had the most responses (n=26 and 20) pre and post WCC respectively. Pre-WCC, celebration (12), tradition (8), and achievement (7) were the most common responses. Post-WCC, celebration (11), social event (8), initiation (7). Several negative adjectives included: “indoctrinating”, “overrated”, “self-aggrandizing”, “self-congratulatory”, “elitist”, and “pretentious” (2). 



Conclusion 

The WCC significantly increases students' knowledge of the Hippocratic oath and affects student perspectives on professionalism.

The Impact of White Coat Ceremonies on Physician Professionalism

Background 
The arts and humanities are well acknowledged for their ability to foster creativity, empathy, communication, and reducing physician burnout, but medical education has only taken small steps towards formal integration. As cited by an AAMC 2020 report The Fundamental Role of the Arts and Humanities in Medical Education: “the arts and the humanities play a unique and not fully realized role in this educational process, and we strongly encourage increased integration of the arts and humanities into curricula.” The Medical Humanities initiative (MHI) provides more formal opportunities to engage with the medical humanities throughout medical education.

Methods
The MHI incorporates humanities-based teaching at the Warren Alpert Medical School of Brown University (WAMS) through (1) wellness focused lunch sessions that engage students and faculty/staff in art forms including movement, music, and visual art; (2) a year-long pre-clinical elective course (PCE) that offers lectures from leaders in the medical arts and humanities; (3) established arts-based curriculum from Brown’s Internal Medicine Residency Arts and Medicine Track into WAMS clinical skills curriculum; (4) a committee of both undergraduate and graduate students that provides opportunities for leadership and mentorship from physicians and scholars working in medical humanities; and (5) the integration of disparate events and groups in the Providence area into a centralized resource/hub, facilitating student access and scholarly collaboration.

Results
In January 2024, the MHI held an introductory event at WAMS to highlight its mission, with one-third of WAMS students in attendance. Qualitative and quantitative feedback gathered in a post-event survey demonstrated enthusiasm for more formal exposure to the medical humanities as part of their education with 97% of students indicating interest in future lunch and learn sessions and 54.5% of students interested in taking a PCE on the subject. Upon implementation in 2024-2025, the Initiative will continue to collect metrics to characterize curriculum impact, including the Brief Resilience Scale and Subjective Happiness Scale, which were previously used by the Brown Arts & Medicine Track for Internal Medicine Residents to assess the impact of medical humanities programming on resident wellness and burnout. 

Conclusion
The MHI has received strong initial support from current medical students, residents, faculty, and deans. The Initiative offers a unique opportunity to strengthen the medical humanities presence at Brown, with the ultimate goal of fostering scholarship and leadership opportunities for students, while simultaneously improving student wellness and strengthening the ability of future physicians to provide empathetic care. 


The Value of Medical Humanities Education in Medical Student Training

Background
Medical school introduces unique challenges to romantic relationships and future life or personal planning. While research on relationships exists for physicians, there remains a significant gap in understanding romantic relationships among medical students. To address this gap, the University of Miami Miller School of Medicine (UMMSM) Wellness Advisory Council initiated a multi-institutional survey study as a student-led wellness initiative.

Methods
An anonymous Qualtrics survey covering demographics and history of romantic relationships was distributed to UMMSM and Tulane medical students via email. Outcomes were analyzed to discern differences among students in relationships with partners in medicine, with partners outside medicine, and not in relationships.

Results
A total of 326 out of 1564 medical students (21% response rate) completed the survey. Relationship status indicated that 67% were currently in a romantic relationship, while 9% reported no prior relationship experience. Of the 326 respondents, 27% were in relationships within medicine (WM), 40% were in relationships outside medicine (OM), and 33% were not in a relationship (NR).

For WM, on a scale of 1-10 (1 = the least, 10 = the most), the average score for their partner’s support for their medical education was 9.73, family’s support of the relationship was 9.11, and satisfaction for the relationship was 8.60. For OM, the scores were 9.50, 9.13, 8.68, respectively.

For NR, 72% were actively seeking relationships, primarily through friends, dating apps, and social outings. On a scale of 1-10, the average score for the ease of finding time for a relationship was 3.01 and their satisfaction with the search was 2.64. Those not seeking relationships cited reasons like poor timing, career focus, and lack of good options.

No significant differences between WM and OM were found when comparing family’s support and satisfaction with the relationship. However, there was a significant difference in partner’s support of their medical education (p = 0.03).

Conclusion
Our study found that medical students generally have high relationship satisfaction despite the challenges of medical school. Both WM and OM students reported strong family support. However, there was a significant difference in perceived support from partners for student’s medical education. Schools should integrate wellness programs to help partners outside of medicine better understand these challenges to bridge the gap. For single students, there is a clear demand for relationships, suggesting that schools could enhance student wellness by facilitating relationship-forming social events.

To Date Within Medicine or Outside Medicine? A Multi-Institutional Survey Study

Background: As competition for medical school admission intensifies, there is greater focus on the hidden curriculum—informal lessons learned during medical training that influence patient care, burnout resilience, and professional identity. Anticipatory socialization, the preliminary adoption by students of beliefs and behaviors perceived as essential for medical school success before matriculation, plays a crucial role in this process.

Anticipatory socialization impacts medical student and resident development, but limited research exists on its impact on pre-medical students' identity formation. This early identity shapes future professional behavior. This study explores how anticipatory socialization influences pre-medical students’ professional identity formation, focusing on how this process affects volunteering. Moreover, through the framework of self-determination theory, a general motivation theory, this study examines how motivational shifts influenced by anticipatory socialization impact intrinsic motivation for volunteering among pre-medical students.

Methods: Thirteen undergraduate, self-described pre-medical students from a North American university, who recently volunteered in a pre-medical capacity, participated in a semi-structured interview (September - November 2021). Open-ended questions explored their volunteer roles and the influence of their pre-medical identity on volunteering. Interviews were audio-recorded, transcribed, and thematically analyzed using content analysis within the framework of self-determination theory. Emerging themes in volunteering motivations, mindset changes due to the pre-medical identity, and the role of volunteering in medical school admissions were grouped into typologies, refined through group discussion.

Results: Thirteen semi-structured interviews were analyzed, revealing three major themes with eight subthemes. The first theme, volunteering motivation, included subthemes on motivations and goals. The second theme, the role of volunteering, had subthemes on lessons learned, challenges, and how volunteering should be evaluated in medical school applications. The third theme, the impact of pre-medical identities on volunteering, included subthemes on the impact of pre-medical identities, volunteering intentions, and the causes of pre-medical culture. Participants described a shift from intrinsic to extrinsic motivation for volunteering, before matriculation, due to anticipatory socialization, driven by the loss of self-determination theory’s three-factor structure (autonomy, competence, and relatedness) and various external factors.

Conclusion: In this study, anticipatory socialization among pre-medical students in North America, driven by peer competition, ambiguity in the medical school admissions process, and perceived expectations, caused a shift, based on self-determination theory, from intrinsic to extrinsic motivation for volunteering before matriculation. This shift is largely perceived by students as detrimental, with a return to intrinsic motivation seen as beneficial.

Volunteerism in Pre-Medical Education: Anticipatory Socialization's Role in Professional Identity Development

Background
Health professional organizations use lobbying to influence legislation that impacts patient care and their respective fields. Physician professional organizations (PPOs) are societies and associations that promote profession advancement through avenues such as research, practice guidelines, and continued medical education. PPOs spend lobbying dollars to advocate for specific interests, which vary by specialty, but research is lacking regarding lobbying patterns across PPOs. We sought to identify and quantify trends in lobbying spending with a focus on medical versus surgical PPOs. 

Methods
We extracted publicly available lobbying data from OpenSecrets (https://www.opensecrets.org) focusing on PPOs. We excluded coalitions, commercial groups, private practices, and all non-physician organizations. PPOs were further categorized as medical, surgical, or overlapping. We determined annual lobbying spending from 2014-2023 for each category and adjusted dollar values to 2023 USD using the Consumer Price Index inflation calculator. We used physician data from the American Association of Medical Colleges (AAMC) to calculate lobbying spending on a per-physician basis. A Mann-Kendall test was used to describe temporal trends in lobbying. 

Results
Over the study period, median spending by health professionals was $108 million/year, with PPOs contributing $71 million/year (65%). Overall, lobbying spending by health professionals trended downward but not significantly (p=0.06). In contrast, we found a significant downward trend in lobbying spending by PPOs over time (p<0.01). Within PPOs, lobbying spending was $32 million/year (45%) by medical specialty organizations and $12 million/year (16%) by surgical specialty organizations (10-year median values). PPOs in the overlapping category made up $27 million/year (39%) (median). Medical specialty organizations showed a significant downward trend over time in spending (p=0.04), while lobbying by surgical specialty organizations did not significantly change (p=0.09). PPO lobbying spending on a per-physician basis was $78/year for all physicians, $48/year for medical specialists, and $81/year for surgeons (median values). There were 521 lobbyists/year representing PPOs, with 352 (68%) representing medical specialties, 93 (18%) representing surgical specialties, and 79 (15%) in the overlapping category. 

Conclusion
In this study, we found that overall lobbying by health professional groups has remained stable. However, spending by PPOs and specifically those representing medical specialties have significantly decreased over time. Notably, although surgical specialty organizations made up a smaller percentage of total lobbying, their spending on a per-physician basis was generally higher. These findings assist in better understanding the complex intersection of lobbying and physician advocacy, while informing future efforts to evaluate priority issues for physician organizations.

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