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Western Affiliates. Affiliated Colleges contribute to the dynamic student experience. Students enrolled at these campuses, are within steps of Western's Main Campus, enjoy the best of both worlds. All Other Undergraduate Applicants - Ontario Universities' Application Centre. Complete the 1. 05. Browse 105D University Programs. Students who complete undergraduate programs at Ontario universities. View this video to see why an Ontario university might. Ontario College Transfers. Canadian University Transfers. If you're applying to Honours-level programs. A guide to Ontario's universities for high school students. It provides information about university programs. ONTransfer: Ontario Council on Articulation and Transfer. You want to transfer to another college or university. University of Toronto Mississauga applicants who have. 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Ground beef intended for National School Lunch Program recalled. A Central California meat company is recalling more than 5. The U. S. Department of Agriculture says Thursday the problem was discovered during an inspection that was prompted by customer complaints. The recalled meat from Central Valley Meat Company in Hanford was intended for use by the National School Lunch Program. The meat being recalled was produced on April 1 and shipped to distribution centers in Arkansas, California, Montana and Texas. The USDA and the company have not received any reports of illness or injury from the consumption of the meat. The Contracting of America’s National School Lunch Program and its Nutritional Consequences : An Article by Robyn Ziperstein“No nation is any healthier than its children or more prosperous than its farmers.”– President Harry Truman. Introduction. If President Truman’s vision is the goal of the National School Lunch Program (NSLP), then the program is in need of changes. Small farmers are struggling to compete with larger food providers. Government subsidies favor large corporate farms which can achieve economies of scale. These larger producers favor less nutritionally dense foods due to ease of production and cost effectiveness. As a result, one- third of American children are overweight and obese. The lunch program began with propitious intentions. The federal government began to subsidize school lunches as a way to manage giant farm surpluses, while simultaneously supporting a suffering population. Since then, the school lunch program has become dominated by a few large food contractors designed to feed a population suffering from a lack of resources, without catering to its basic health needs. Without sufficient changes, this nutritional deficit will continue to contribute to childhood obesity and big businesses will continue to dominate distribution of goods. This paper is constructed in four sections. It begins with an overview of the school lunch program and its changes over time. The discussion will then turn to contracts and how they affect the outcomes of school lunches. Next, problems and controversies surrounding the school lunch program will be examined including financial contract abuses by large companies, nutritional deficiencies, and lack of clean facilities. Lastly, this paper will explore potential solutions to the school lunch programs shortcomings. Overview of the National School Lunch Program. Harry Truman signed the National School Lunch Act in 1. The subsidies were intended to safeguard the health and well- being of the nation’s children and encourage the consumption of domestic agricultural commodities. By 1. 97. 0, 2. 2 million children participated, and by 1. Since the program began, more than 2. Nearly all schools participate today. The program began at a time when malnutrition due to poverty was a major concern. While poverty is still an issue in. America, underweight children are rare, and overweight children are becoming a majority, especially among the poor. Policies originally designed to ensure adequate food consumption by the poor have instead contributed to obesity rates by encouraging recipient students to eat excessively at school. Overeating occurs because school meals are required only to achieve a calorie target under the NSLP. This provision is called “offer versus serve.” No matter what is served, the food must contain a certain number of calories. This provision allows children to decline certain parts of the meals while dining, but children generally eat the whole meal and consume more calories than they need. Additionally, regulatory standards specify that school lunches should provide one. However, the meals often do not meet these desired standards. Local school food authorities make decisions about what foods to serve and how those foods are prepared. Ill- defined nutritional guidelines, limited funds, and lack of understanding and motivation contribute to the poor quality of food production and supply in the school economy. Accordingly, some critics say recipients may be better off receiving income rather than food as children have diverse nutritional needs, making implementation and construction of a single policy that benefits everyone difficult. Contracts with the Big Three Companies and their Role in the NSLPThe US food service contracting industry has been centered on three source companies: Aramark, Compass Group, and Sodexo. With a combined annual revenue of about $4. In total, the eight largest companies hold 7. These companies do not strictly provide food services to schools. Ten percent of school lunch providers have 1. The equally concentrated supply chain for food products magnifies the size and power of these companies. Historical developments in agricultural products have given large agribusiness and foodservice firms most of the power. Global marketing of new agri- chemicals after World War II helped shape emerging industrial markets, particularly for grain companies. The Green Revolution development of special hybrid seeds in the 1. Technological achievements by these businesses have reduced the cost of food products, which has in turn made cheap food more abundant. Since the NSLP operates on surpluses, agricultural subsidies have pumped school lunches full of less expensive, less nutritionally dense ingredients. Generally, healthier food tends to be more expensive to produce, and agribusiness makes it easier for contractors to construct unhealthy meals at a low cost. The food service management company contracted by a school is responsible for the preparation and management of the school meal program. In vended meal contracts, the contractor’s only responsibility is to provide the meals, meaning foods are pre- packaged and pre- plated. This does not include management of the program or final preparation or service of the meals. If the contract becomes a food service management contract (FSMC), it is no longer considered a vended meals contract. Vended contracts are ones in which the contractor manages some aspect of the school food service program, usually preparing and serving the meal and/or managing the school meal programs. The school codes concerning FSMCs vary between states. When a SFA contracts with a food service management company, the state agency is required to review each contract annually to make sure all regulatory requirements are satisfied. Moreover, each state must conduct a thorough on- site review, once every five years to ensure compliance. The National School Lunch Program allows a SFA to contract with a management company (such as Aramark, Sodexo, or Compass Group) to manage school food service operations; however, it is the SFA’s responsibility to ensure its food service operation complies with the proposed agreement under the program. The SFA is responsible for ensuring that cost limitations are secure, including the use of nonprofit food service funds to pay only allowable costs, verifying eligibility of children for free and reduced price meals, ensuring only reimbursable meals are included on the claim for reimbursement, and not allowing accrual of all income and expenses to the FSMC. Specific procedures must be followed to ensure validity of all meals and claims at the school under the jurisdiction of the SFA. The SFA manages these procedures, regardless of whether the SFA operates food services itself or uses a food service management company. Problems and Controversies: Compliance, Safety and Health Issues. Congress’ Government Accountability Office opened an investigation into potential contract abuses by food service management companies involved with the National School Lunch Program, and found that the process of contracting has several issues. There was concern about possible overcharges and food vendor rebates to contractors that were not given to client agencies, against federal requirements. The investigation probed whether companies carried out their responsibilities and abided by the terms of their contracts. Sodexo agreed to a $2. July for failing to pass on rebates to several school districts in. New York. Rosa De. Lauro, Representative of Connecticut and Chair of the House Agriculture Appropriations Subcommittee, wrote a letter to. USSecretary of Agriculture Tom Vilsack asking for a general investigation into the National School Lunch Program. She wrote to alert the state education and agriculture agencies that a review of the settlement between Andrew Cuomo and Sodexo for overcharging the New York School districts would reveal questionable practices and corruption by the Sodexo Corporation, which dominates school lunch contracts. The investigation revealed Sodexo had earned rebates from suppliers that were not passed on to schools. Contracts with school districts often require savings to be shared, and withholding them is a violation of federal law. In response, Sodexo hired its first outside lobbyists this year at Gephardt Group Government Affairs and Trammell and Company to help with its troubles. It spent $7. 0,0. A 2. 00. 9 report by USA Today found that the safety standards of the Agricultural Marketing Service (AMS), a part of the USDA that buys meat for school lunches, were lower than the standards of the average fast food restaurant in the country. It found instances where the AMS bought ground beef that retailers and fast- food chains rejected because of high amount of indicator bacteria, which indicates an increased probability that the meat contains insidious pathogens. It also found the AMS testing procedures for ground beef substantially deficient. For 1. 00,0. 00 pounds of ground beef, the AMS may only test one sample. By comparison, many fast food chains take samples of their ground beef every 1. The fast food restaurants test their ground beef ten to fifteen times more often than the USDA tests school lunch beef. The report also revealed that the School Lunch Program purchases chicken for schools that KFC and the Campbell Soup Company would not use. The chicken bought by the USDA would have gone to compost or pet food if it were not being eaten by schoolchildren. Communication problems with the FDA have resulted in repeated use of suppliers with a long history of food safety violations. As a result of a salmonella outbreak in 2. Beef Packer Inc. During the recall, the government bought four orders from the company for the school lunch program, one of which tested positive for salmonella. The other three orders were used for school lunches. Since then, Beef Packers Inc. According to the Center for Disease Control, at least 2.
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A resident or house officer is a physician (one who holds the degree of M. D., D. O., D. M. D., D. P. M. Successful completion of a residency program is a requirement to obtaining an unrestricted license to practice medicine in many jurisdictions. Residency training may be followed by fellowship or . A physician may choose a residency in anesthesiology, ophthalmology, cardiothoracic surgery, dermatology, emergency medicine, family medicine, internal medicine, neurology, neurosurgery, obstetrics and gynecology, otolaryngology, pathology, pediatrics, plastic and reconstructive surgery, psychiatry, physical medicine and rehabilitation, radiology, radiation oncology, oral and maxillofacial surgery, general surgery, urology or other medical specialties. Residents have graduated from an accredited medical school and hold a medical degree (MD, DO, MBBS, MBCh. B). Residents are, collectively, the house staff of a hospital. This term comes from the fact that resident physicians traditionally spend the majority of their training . Duration of residencies can range from three years to seven years, depending upon the program and specialty. A year in residency begins between late June and early July depending on the individual program, and ends one calendar year later. Depending on the number of years a specialty requires, the term junior resident may refer to residents that have not completed half their residency. Senior residents are residents in their final year of residency. Some residency programs refer to residents in their final year as chief residents (typically in surgical branches). Alternatively, a chief resident may describe a resident who has been selected to extend his or her residency by one year and organize the activities and training of the other residents (typically in internal medicine and pediatrics). If a physician finishes a residency and decides to further his or her education in a fellowship, he or she is referred to as a . Residency Navigator combines their feedback with objective data on residency programs across 27. Help Blog Company Contact Privacy. Post- residency physicians are referred to as attending physicians, or consultants (in Commonwealth countries). However, the above nomenclature applies only in educational institutes in which the period of training is specified in advance. In privately owned, non- training hospitals, in certain countries, the above terminology may reflect the level of responsibility held by a physician rather than their level of education. ERAS 2017 Participating Specialties & Programs. You may view the list of programs in a specific specialty by clicking the. Guide to Combined Internal Medicine and Pediatrics Residency Training. A list of active Med-Peds programs (map) 2. Combined Medicine-Pediatrics Programs. NRMP Announces Record High Number of Positions Offered and Filled with Release of 2016 Main Residency. Apply to Programs; Select. Rank order list entry. History. The first formal residency programs were established by Sir William Osler and William Stewart Halsted at the Johns Hopkins Hospital. Residencies elsewhere then became formalized and institutionalized for the principal specialties in the early 2. But even mid- century, residency was not seen as necessary for general practice and only a minority of primary care physicians participated. By the end of the 2. North America though, very few new doctors went directly from medical school into independent, unsupervised medical practice, and more state and provincial governments began requiring one or more years of postgraduate training for medical licensure. Residencies are traditionally hospital- based, and in the middle of the twentieth century, residents would often live (or . Pay was minimal beyond room, board, and laundry services. It was assumed that most young men and women training as physicians had few obligations outside of medical training at that stage of their careers. The first year of practical patient- care- oriented training after medical school has long been termed . Residencies were separate from internship, often served at different hospitals, and only a minority of physicians did residencies. Argentina. Specialized fields such as neurosurgery or cardio- thoracic surgery require longer training. Through these years, consisting of internships, social services, and occasional research, the resident is classified according to their residency year as an R1, R2, R3 or R4. After the last year, the . To be fully licensed, one must first finish a medical training program that usually lasts 5 to 6 years (varies between universities), followed by 1 year of medical and surgical internship. During this internship a national medical qualification exam is required, and, in many cases, an additional year of unsupervised medical practice as a social service physician. Applications are made individually program by program, and are followed by a postgraduate medical qualification exam. The scores during medical studies, university of medical training, curriculum vitae, and, in individual cases, recommendations are also evaluated. The acceptance rate into residencies is very low (~1- 5% of applicants in public university programs), physician- resident positions do not have a salary, and the tuition fees reach or surpass 1. USD per year in private universities, and 2,0. USD in public universities. For the reasons mentioned above, many physicians travel abroad (mainly to Argentina, Brazil, Spain and the United States) to seek postgraduate medical training. The duration of the programs varies between 3 and 6 years. In public universities, and some private universities, it is also required to write and defend a medical thesis before receiving a specialist degree. In France, students attending clinical practice are known as . The Residency, called . It is customary to delay submission of a thesis. As in most other European countries, many years of practice at a junior level may follow. French Residents cannot be called . They are still considered as students and become M. D. To be a licensed physician, one must finish a medical training program that in Greece lasts for 6 years. A 1- year obligatory rural medical service (internship) is necessary to complete the residency training. The duration of the residency programs varies between 3 and 7years. In Mexico physicians need to take the ENARM (National Test for Aspirants to Medical Residency) (Spanish, Examen Nacional de Aspirantes a Residencias Medicas) in order to have a chance for a medical residency in the field he or she wishes to specialize. The physician is allowed to apply to only one speciality each year (with an optional second choice). Approximately 3. 0,0. The selected physicians will bring their certificate of approval to the hospital that they wish to apply (Almost all the hospitals for medical residency are from government based institutions). The certificate is valid only once per year and if the resident decides to drop residency and try to enter to a different speciality he will need to take the test one more time (no limit of attempts). All the hosting hospitals are affiliated to a Public University and this institution is the responsible to give the degree of . This degree is unique but equivalent to the MD used in the UK and India. In order to graduate the trainee requires to present a thesis project and defend it. The length of the residencies is very similar to the American system. The residents are divided per year (R1, R2, R3, etc.). After finishing the trainee may decide if he wants to subspecialize (equivalency to fellowship) and the usual length of sub- specialty training ranges from 2 to 4 years. Foreign physicians do not get paid and indeed are required to pay an annual fee of $1. USD to the University institution that the hospital is affiliated with. All the specialties in Mexico are board certified and some of them have a written and an oral component, making these boards ones of the most competitives in Latin- America. Pakistan. First is MS/MD program run by various medical universities throughout country. It is 4- 5 year program depending upon speciality. Second is fellowship program (FCPS) by The College of Physicians and Surgeons (CPSP). In addition there are post fellowship programs by CPSP as a second fellowship in sub specialities. Both these programs are equal to any international standard program. Currently, all Spanish medical degree holders need to pass a competitive national exam to access to the medical training program. This competitive exam gives them the opportunity to choose both the hospital and the speciality they want between all the hospitals in the Spanish Healthcare Hospital Network. Currently, Medical Specialities last from 4 to 5 years and at the end the speciality degree is obtained. There are plans to change the training program system in a similar way the UK does. There has been some talks between Ministry of Health, the Medical College of Physicians and the Medical Student Association but it is not clear how this change process is going to be. United Kingdom. The Medical Act of 1. However, in some hospitals the . Obstetrics could be substituted for either. In principle, general practice in a . The posts did not have to be in general medicine: some teaching hospitals had very specialised posts at this level, so it was possible for a new graduate to do neurology plus neurosurgery or orthopaedics plus rheumatology, for one year before having to go onto more broadly based work. The pre- registration posts were nominally supervised by the General Medical Council, which in practice delegated the task to the medical schools, who left it to the consultant medical staff. The educational value of these posts varied enormously. On call work in the early days was full- time, with frequent night shifts and weekends on call. One night in two was common, and later one night in three. This meant weekends on call started at 9 am on Friday and ended at 5 pm on Monday (8. Less acute specialties such as dermatology could have juniors permanently on call. The European Union's controversial Working Time Directive. On call time was unpaid until 1. On call time was at first paid at 3. 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