Medical education in Syria at a time of crisis: Analysis of the results of the knowledge-based National Medical Examination.

OBJECTIVE: This study explored how the Syrian crisis, training conditions, and relocation influenced the National Medical Examination (NME) scores of final-year medical students. METHODS: Results of the NME were used to denote the performance of final-year medical students between 2014 and 2021. The NME is a mandatory standardised test that measures the knowledge and competence of students in various clinical subjects. We categorised the data into two periods: period-I (2014-2018) and period-II (2019-2021). Period-I represents students who trained under hostile circumstances, which refer to the devastating effects of a decade-long Syrian crisis. Period-II represents post-hostilities phase, which is marked by a deepening economic crisis. RESULTS: Collected data included test scores for a total of 18 312 final-year medical students from nine medical schools (from six public and three private universities). NME scores improved significantly in period-II compared with period-I tests (p < 0.0001). Campus location or relocation during the crisis affected the results significantly, with higher scores from students of medical schools located in lower-risk regions compared with those from medical schools located in high-risk regions (p < 0.0001), both during and in the post-hostilities phases. Also, students of medical schools re-located to lesser-risk regions scored significantly less than those of medical schools located in high-risk regions (p < 0.0001), but their scores remained inferior to that of students of medical schools that were originally located in lower-risk regions (p < 0.0001). CONCLUSION: Academic performance of final year medical students can be adversely affected by crises and conflicts, with a clear tendency to recovery upon crises resolution. The study underscores the importance of maintaining and safeguarding the infrastructure of educational institutions, especially during times of crisis. Governments and educational authorities should prioritise resource allocation to ensure that medical schools have access to essential services, learning resources, and teaching personnel.

Familial Mediterranean fever and scleroderma: a rare case report from Syria.

Familial Mediterranean fever (FMF) is an inherited autoinflammatory disease that affects the skin, joints, serous membranes and other various organs. Presentation of FMF can be solely but it can coexist with other conditions. It has been shown that it can be accompanied by various different disorders. Scleroderma is an autoimmune dermatologic condition that can present with systemic manifestations. No previous cases about the coexistence of FMF and scleroderma were previously documented, therefore we report the first case in Syria of a 10-year-old female that presented with clinically clear signs of both conditions (periodic fever and serous chest pain in addition to skin hyperpigmentation). The patient's symptoms required full genetic testing along with the proper antibody detection and The diagnosis of FMF and scleroderma was confirmed by genetic testing and treatment was started.