U.S. medical resident familiarity with national tuberculosis guidelines.
BACKGROUND
The ability of medical residents training at U.S. urban medical centers to diagnose and manage tuberculosis cases has important public health implications. We assessed medical resident knowledge about tuberculosis diagnosis and early management based on American Thoracic Society guidelines.


METHODS
A 20-question tuberculosis knowledge survey was administered to 131 medical residents during a single routinely scheduled teaching conference at four different urban medical centers in Baltimore and Philadelphia. Survey questions were divided into 5 different subject categories. Data was collected pertaining to institution, year of residency training, and self-reported number of patients managed for tuberculosis within the previous year. The Kruskal-Wallis test was used to detect differences in median percent of questions answered correctly based on these variables.


RESULTS
The median percent of survey questions answered correctly for all participating residents was 55%. Medical resident knowledge about tuberculosis did not improve with increasing post-graduate year of training or greater number of patients managed for tuberculosis within the previous year. Common areas of knowledge deficiency included the diagnosis and management of latent tuberculosis infection (median percent correct, 40.7%), as well as the interpretation of negative acid-fast sputum smear samples.


CONCLUSIONS
Many medical residents lack adequate knowledge of recommended guidelines for the management of tuberculosis. Since experience during training influences future practice patterns, education of medical residents on guidelines for detection and early management of tuberculosis may be important for future improvements in national tuberculosis control strategies.
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, USA. petros@jhmi.edu
Petros C
PC
Karakousis
Frangiscos G
FG
Sifakis
Ruben Montes
RM
de Oca
Valerianna C
VC
Amorosa
Kathleen R
KR
Page
Yukari C
YC
Manabe
James D
JD
Campbell
D000995:Antitubercular Agents / Q000009:adverse effects / Q000627:therapeutic use; D015142:Baltimore; D002983:Clinical Competence; D015658:HIV Infections / Q000150:complications; D006801:Humans; D007396:Internship and Residency; D015143:Philadelphia; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D012955:Societies, Medical; D014376:Tuberculosis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000635:transmission; D014481:United States
D000995:Antitubercular Agents