Moises Gallegos MD MPH MEHP

All Publications

• Woman with growing scalp mass. Journal of the American College of Emergency Physicians open Gallegos, M., Ashenburg, N., Duanmu, Y. 2024; 5 (4): e13227

  View details for DOI 10.1002/emp2.13227

  View details for PubMedID 38988592

• An unknown (and unexpected) cause of septic shock. Journal of the American College of Emergency Physicians open Kang, A., Gupta, P., Wong, S., Tung, J., Gallegos, M. 2024; 5 (4): e13248

  View details for DOI 10.1002/emp2.13248

  View details for PubMedID 39076254

• A case of acute onset right lower quadrant abdominal pain. Journal of the American College of Emergency Physicians open Taylor, M., Gallegos, M. 2024; 5 (1): e13104

  View details for DOI 10.1002/emp2.13104

  View details for PubMedID 38298477

• Trends of Academic Faculty Identifying as Hispanic at US Medical Schools, 1990-2021. Journal of graduate medical education Saxena, M. R., Ling, A. Y., Carrillo, E., Alvarez, A., Yiadom, M. Y., Bennett, C. L., Gallegos, M. 2023; 15 (2): 175-179

  Abstract

  Background: According to recent census data, Hispanic and Latino populations comprise the largest minority group in the United States. Despite ongoing efforts for improved diversity, equity, and inclusion, Hispanics remain underrepresented in medicine (UIM). In addition to well-established benefits to patient care and health systems, physician diversity and increased representation in academic faculty positively impact the recruitment of trainees from UIM backgrounds. Disproportionate representation (as compared to increases of certain underrepresented groups in the US population) has direct implications for recruitment of UIM trainees to residency programs.Objective: To examine the number of full-time US medical school faculty physicians who self-identify as Hispanic in light of the increasing Hispanic population in the United States.Methods: We analyzed data from the Association of American Medical Colleges from 1990 to 2021, looking at those academic faculty who were classified as Hispanic, Latino, of Spanish Origin, or of Multiple Race-Hispanic. We used descriptive statistics and visualizations to illustrate the level of representation of Hispanic faculty by sex, rank, and clinical specialty over time.Results: Overall, the proportion of faculty studied who identified as Hispanic increased from 3.1% (1990) to 6.01% (2021). Moreover, while the proportion of female Hispanic academic faculty increased, there remains a lag between females versus males.Conclusions: Our analysis shows that the number of full-time US medical school faculty who self-identify as Hispanic has not increased, though the population of Hispanics in the United States has increased.

  View details for DOI 10.4300/JGME-D-22-00384.1

  View details for PubMedID 37139207

• Physician Pipeline and Pathway Programs: An Evidence-based Guide to Best Practices for Diversity, Equity, and Inclusion from the Council of Residency Directors in Emergency Medicine. The western journal of emergency medicine Parsons, M., Caldwell, M. T., Alvarez, A., Davenport, D., Gallegos, M., Landry, A., Gottlieb, M., Natesan, S. 2022; 23 (4): 514-524

  Abstract

  Improving the diversity and representation in the medical workforce requires intentional and deliberate efforts to improve the pipeline and pathway for underrepresented in medicine (UIM) applicants. Diversity enhances educational experiences and improves patient care and outcomes. Through a critical review of the literature, in this article we offer evidence-based guidelines for physician pipeline and pathway programs (PP). Recommendations are provided regarding considerations on the types of programs and surrounding implementation to ensure a sound infrastructure and framework. We believe this guide will be valuable for all leaders and faculty members seeking to grow the UIM applicant pool in our efforts to advance diversity, equity, and inclusion within medicine.

  View details for DOI 10.5811/westjem.2022.2.54875

  View details for PubMedID 35980420

• Holistic Review, Mitigating Bias, and Other Strategies in Residency Recruitment for Diversity, Equity, and Inclusion: An Evidence-based Guide to Best Practices from the Council of Residency Directors in Emergency Medicine. The western journal of emergency medicine Gallegos, M., Landry, A., Alvarez, A., Davenport, D., Caldwell, M. T., Parsons, M., Gottlieb, M., Natesan, S. 2022; 23 (3): 345-352

  Abstract

  Advancement of diversity, equity, and inclusion (DEI) in emergency medicine can only occur with intentional recruitment of residency applicants underrepresented in medicine (UIM). Shared experiences from undergraduate and graduate medical education highlight considerations and practices that can contribute to improved diversity in the resident pool, such as holistic review and mitigating bias in the recruitment process. This review, written by members of the Council of Residency Directors in Emergency Medicine (CORD) Best Practices Subcommittee, offers best practice recommendations for the recruitment of UIM applicants. Recommendations address pre-interview readiness, interview approach, and post-interview strategies that residency leadership may use to implement holistic review and mitigate bias for recruitment of a diverse class.

  View details for DOI 10.5811/westjem.2022.3.54419

  View details for PubMedID 35679505

• Simulation-Based Mastery Learning Improves the Performance of Donning and Doffing of Personal Protective Equipment by Medical Students. The western journal of emergency medicine Miller, D. T., Pokrajac, N., Ngo, J., Gallegos, M., Dixon, W., Roszczynialski, K. N., Ng, K., Taleghani, N., Gisondi, M. A. 2022; 23 (3): 318-323

  Abstract

  Medical students lack adequate training on how to correctly don and doff personal protective equipment (PPE). Simulation-based mastery learning (SBML) is an effective technique for procedural education. The aim of this study was to determine whether SBML improves proper PPE donning and doffing by medical students.This was a prospective, pre-test/post-test study of 155 medical students on demonstration of correct PPE use before and after a SBML intervention. Subjects completed standard hospital training by viewing a US Centers for Disease Control and Prevention training video on proper PPE use prior to the intervention. They then participated in a SBML training session that included baseline testing, deliberate practice with expert feedback, and post-testing until mastery was achieved. Students were assessed using a previously developed 21-item checklist on donning and doffing PPE with a minimum passing standard (MPS) of 21/21 items. We analyzed differences between pre-test and post-test scores using paired t-tests. Students at preclinical and clinical levels of training were compared with an independent t-test.Two participants (1.3%) met the MPS on pre-test. Of the remaining 153 subjects who participated in the intervention, 151 (98.7%) reached mastery. Comparison of mean scores from pre-test to final post-test significantly improved from an average raw score of 12.55/21 (standard deviation [SD] = 2.86), to 21/21(SD = 0), t(150) = 36.3, P <0.001. There was no difference between pre-test scores of pre-clinical and clinical students.Simulation-based mastery learning improves medical student performance in PPE donning and doffing in a simulated environment. This approach standardizes PPE training for students in advance of clinical experiences.

  View details for DOI 10.5811/westjem.2022.2.54748

  View details for PubMedID 35679489

• Faculty Recruitment, Retention, and Representation in Leadership: An Evidence-Based Guide to Best Practices for Diversity, Equity, and Inclusion from the Council of Residency Directors in Emergency Medicine. The western journal of emergency medicine Davenport, D., Alvarez, A., Natesan, S., Caldwell, M. T., Gallegos, M., Landry, A., Parsons, M., Gottlieb, M. 1800; 23 (1): 62-71

  Abstract

  Improving the recruitment, retention, and leadership advancement of faculty who are under-represented in medicine is a priority at many academic institutions to ensure excellence in patient care, research, and health equity. Here we provide a critical review of the literature and offer evidence-based guidelines for faculty recruitment, retention, and representation in leadership. Recommendations for recruitment include targeted recruitment to expand the candidate pool with diverse candidates, holistic review of applications, and incentivizing stakeholders for success with diversity efforts. Retention efforts should establish a culture of inclusivity, promote faculty development, and evaluate for biases in the promotion and tenure process. We believe this guide will be valuable for all leaders and faculty members seeking to advance diversity, equity, and inclusion in their institutions.

  View details for DOI 10.5811/westjem.2021.8.53754

  View details for PubMedID 35060865

• A Brief Coaching Pilot Enhances Professional Identity Formation and Clinical Skills Acquisition During Emergency Medicine Clerkships Shortened by COVID-19. The western journal of emergency medicine Dixon, W., Gallegos, M., Williams, S. 1800; 23 (1): 30-32

  Abstract

  INTRODUCTION: The Covid-19 pandemic limited educational and career development opportunities for medical students, requiring innovative programs to accelerate professional identity formation and clinical skills acquisition.METHODS: We developed a brief coaching intervention that took place over the advanced (sub-internship) emergency medicine rotation at our institution. We trained coaches using a newly developed workshop, who met with students for an average of 4.5 hours over 3 weeks.IMPACT/EFFECTIVENESS: We showed that this coaching program was both feasible and impactful for faculty coaches and medical students.

  View details for DOI 10.5811/westjem.2021.12.53917

  View details for PubMedID 35060857

• Young Woman With Abdominal Pain and Hirsutism ANNALS OF EMERGENCY MEDICINE Hernandez, D. O., Moody, J., Gallegos, M. H. 2021; 78 (1): E7-E8

  View details for DOI 10.1016/j.annemergmed.2021.02.025

  View details for Web of Science ID 000663934300005

• Emergency Department Access During COVID-19: Disparities in Utilization by Race/Ethnicity, Insurance, and Income Western Journal of Emergency Medicine Lowe, J., Brown, I., Duriseti, R., et al 2021: 552-560

  Abstract

  In March 2020, shelter-in-place orders were enacted to attenuate the spread of coronavirus 2019 (COVID-19). Emergency departments (EDs) experienced unexpected and dramatic decreases in patient volume, raising concerns about exacerbating health disparities.We queried our electronic health record to describe the overall change in visits to a two-ED healthcare system in Northern California from March-June 2020 compared to 2019. We compared weekly absolute numbers and proportional change in visits focusing on race/ethnicity, insurance, household income, and acuity. We calculated the z-score to identify whether there was a statistically significant difference in proportions between 2020 and 2019.Overall ED volume declined 28% during the study period. The nadir of volume was 52% of 2019 levels and occurred five weeks after a shelter-in-place order was enacted. Patient demographics also shifted. By week 4 (April 5), the proportion of Hispanic patients decreased by 3.3 percentage points (pp) (P = 0.0053) compared to a 6.2 pp increase in White patients (P = 0.000005). The proportion of patients with commercial insurance increased by 11.6 pp, while Medicaid visits decreased by 9.5 pp (P < 0.00001) at the initiation of shelter-in-place orders. For patients from neighborhoods <300% federal poverty levels (FPL), visits were -3.8 pp (P = 0.000046) of baseline compared to +2.9 pp (P = 0.0044) for patients from ZIP codes at >400% FPL the week of the shelter-in-place order. Overall, 2020 evidenced a consistently elevated proportion of high-acuity Emergency Severity Index (ESI) level 1 patients compared to 2019. Increased acuity was also demonstrated by an increase in the admission rate, with a 10.8 pp increase from 2019. Although there was an increased proportion of high-acuity patients, the overall census was decreased.Our results demonstrate changing ED utilization patterns circa the shelter-in-place orders. Those from historically vulnerable populations such as Hispanics, those from lower socioeconomic areas, and Medicaid users presented at disproportionately lower rates and numbers than other groups. As the pandemic continues, hospitals should use operations data to monitor utilization patterns by demographic, in addition to clinical indicators. Messaging about availability of emergency care and other services should include vulnerable populations to avoid exacerbating healthcare disparities.

  View details for DOI 10.5811/westjem.2021.1.49279

• Asymptomatic ST elevation myocardial infarction HEART & LUNG Anderson, K. L., Shah, N. A., Gallegos, M., Chiang, I. 2018; 47 (4): 363–65

  View details for DOI 10.1016/j.hrtlng.2018.04.012

  View details for Web of Science ID 000438836800017

• Young Man With Sudden Onset of Shortness of Breath. Annals of emergency medicine Gallegos, M., Jenks, S. 2017; 69 (2): 264-272

  View details for DOI 10.1016/j.annemergmed.2016.07.005

  View details for PubMedID 28126126