Observations on the Representation of Asians in Surgical Training and Leadership.

INTRODUCTION: Diversity in medicine has a positive effect on outcomes, especially for Asian patients. We sought to evaluate representation of Asians across entry and leadership levels in surgical training. METHODS: Publicly accessible population data from 2018 to 2023 were collected from the US Census Bureau, the Association of American Medical Colleges, and the American Board of Surgery (ABS). Frequencies based on self-identified Asian status were identified, and proportions were calculated. RESULTS: The US census showed Asians constituted 4.9% of the US population in 2018 versus 6% in 2023. The proportion of Asian medical students rose from 21.6% to 24.8%; however, Asian surgical residency applicants remained constant at 20%. ABS certifications of Asians have increased from 13.7% to 18.5%. ABS examiners increased from 15.7% to 17.1%. CONCLUSIONS: In 5 years, Asians have made numeric gains in medical school and surgical training. However, Asian representation lags at Board examiner levels compared to the medical student population. The ABS has made recent efforts at transparency around examiner and examinee characteristics. A pillar of ensuring a well-trained surgical workforce to serve the public is to mandate that all surgical trainees and graduates undergo fair examinations, and are fairly assessed on their qualifications. Observed progress should further invigorate all surgical applicants, residents and leadership to take an even more active role in making surgery more diverse and welcoming to all, by including careful analyses of diversity at all levels.

Physician Assistants in Plastic Surgery: A Descriptive Analysis Using the National Commission on Certification of Physician Assistants Dataset.

ABSTRACT: Physician assistants (PAs) play a vital role in the US health care system, particularly amid the persistent surgeon shortage and escalating health care demands. We aim to characterize the current cohort of PAs in plastic surgery by comparing them to PAs in all other specialties. Using a cross-sectional analysis of the 2022 National Commission on Certification of PAs dataset, we examined demographic and practice characteristics of PAs in plastic surgery with those in all other specialties. Analysis included descriptive and bivariate statistics. In 2022, 1.0% of PAs worked in plastic surgery, with the specialty's numbers nearly doubling from 2015 (n = 647) to 2022 (n = 1186). Bivariate analysis among PAs in plastic surgery and those in other settings revealed several important attributes (all P's < 0.001); PAs in plastic surgery were younger (median age, 36 vs 39), identified as female (91.0% vs 69.4%), resided in urban locations (97.6% vs 92.5%), and performed a higher proportion of clinical procedures (66.5% vs 33.9%). Furthermore, a statistically significant higher percentage of PAs in plastic surgery reported high job satisfaction and was more likely to report no symptoms of professional burnout. The expanding PA profession amid the scarcity of surgeons presents an ideal prospect for enhanced collaboration. In an era where surgeon burnout is increasingly common and PAs express a readiness to function at an advanced level, expanding PAs' role becomes desirable and imperative. This collaborative approach has the potential to address workforce challenges, elevate patient care, and enhance provider satisfaction.

[Quality-assured treatment in certified breast cancer centre networks in Upper Franconia, Germany: An analysis based on data of the Bavarian Cancer Registry]. / Qualitätsgesicherte Behandlung in zertifizierten Versorgungsnetzwerken von Patientinnen mit Mammakarzinom in der Region Oberfranken: Eine Analyse auf Basis von Bayerischen Krebsregisterdaten.

OBJECTIVES: Breast cancer is the most common cancer and the most common cancer-related cause of death among women in Germany. The treatment in certified breast cancer centre networks is recommended to ensure high-quality care. The aim of the study was to determine the percentage of breast cancer patients receiving cancer treatment in certified breast cancer centre networks in Upper Franconia, Germany. METHODS: This study considered the location of treatment and the certification status of providers with regard to initial diagnosis, surgery, chemotherapy, and radiation during breast cancer care. Based on this, we compared patient characteristics receiving cancer care in certified and non-certified cancer centres and their networks. The evaluation was based on a dataset of the Bavarian Cancer Registry (4/2017-3/2022). RESULTS: The analysis included 5,545 primary tumors from a total of 5,355 patients (age: 64.5±14.2 years; 99.2% female). The percentage of patients receiving care in certified breast cancer centre networks was 78.8% for initial diagnosis, 82.6% for surgery, 79.5% for chemotherapy, and 99.6% for radiation, respectively. The weighted mean across all treatment sequences was 84.3%. Patients receiving care in certified care networks were significantly younger for three therapy sequences (p+<+0.001). In addition, an above-average proportion of patients with advanced tumor stages were treated in non-certified care networks, especially for diagnosis and surgery (p+<+0.001). CONCLUSIONS: Regarding the different treatment sequences, we found differences in the proportion of patients who received quality-assured treatment in certified breast cancer centre networks in Upper Franconia. When comparing similar analysis, the results show an average care percentage of patients receiving care in certified care networks. Furthermore, it should be ensured that patients receive comprehensive information about receiving care in certified cancer centre networks.

Availability of Certified Sexual Assault Nurse Examiners in Appalachian States.

INTRODUCTION: Sexual assault nurse examiners are crucial care providers in cases of sexual assault. However, it is not clear whether sexual assault nurse examiner availability differs throughout the 13 states that comprise the Appalachian region of the United States. Therefore, this cross-sectional analysis identified sexual assault nurse examiner availability in 13 states and determined differences in availability by both county-level Appalachian status and county-level rurality status. METHODS: Data were downloaded from 2 public sexual assault nurse examiner registries for the included 13 states. Descriptive statistics of sexual assault nurse examiner certification type and availability by state were calculated. In addition, bivariate analyses of sexual assault nurse examiner availability by rurality and by Appalachian status were performed using 2-sample z-tests for equality of proportions. RESULTS: State-level sexual assault nurse examiner availability ranged from 0.34 to 0.86 sexual assault nurse examiners per 100,000 residents. Sexual assault nurse examiner availability in these 13 states did not differ by Appalachian status. However, rural areas had significantly lower sexual assault nurse examiner availability than urban areas in these 13 states. DISCUSSION: These data support previous literature on the need for stronger sexual assault nurse examiner programs in rural areas in the United States. Future research should take sexual assault prevalence into account to determine whether local sexual assault nurse examiner access needs, as well as appropriate support for sexual assault nurse examiners, are being met throughout Appalachian states.

Variation in Oral Board Examination Accommodations Among Specialties.

Importance: Board certification can have broad implications for candidates' career trajectories, and prior research has found sociodemographic disparities in pass rates. Barriers in the format and administration of the oral board examinations may disproportionately affect certain candidates. Objective: To characterize oral certifying examination policies and practices of the 16 Accreditation Council for Graduate Medical Education (ACGME)-accredited specialties that require oral examinations. Design, Setting, and Participants: This cross-sectional study was conducted from March 1 to April 15, 2023, using data on oral examination practices and policies (examination format, dates, and setting; lactation accommodations; and accommodations for military deployment, family emergency, or medical leave) as well as the gender composition of the specialties' boards of directors obtained from websites, telephone calls and email correspondence with certifying specialists. The percentages of female residents and residents of racial and ethnic backgrounds who are historically underrepresented in medicine (URM) in each specialty as of December 31, 2021, were obtained from the Graduate Medical Education 2021 to 2022 report. Main Outcome and Measures: For each specialty, accommodation scores were measured by a modified objective scoring system (score range: 1-13, with higher scores indicating more accommodations). Poisson regression was used to assess the association between accommodation score and the diversity of residents in that specialty, as measured by the percentages of female and URM residents. Linear regression was used to assess whether gender diversity of a specialty's board of directors was associated with accommodation scores. Results: Included in the analysis were 16 specialties with a total of 46 027 residents (26 533 males [57.6%]) and 233 members of boards of directors (152 males [65.2%]). The mean (SD) total accommodation score was 8.28 (3.79), and the median (IQR) score was 9.25 (5.00-12.00). No association was found between test accommodation score and the percentage of female or URM residents. However, for each 1-point increase in the test accommodation score, the relative risk that a resident was female was 1.05 (95% CI, 0.96-1.16), and the relative risk that an individual was a URM resident was 1.04 (95% CI, 1.00-1.07). An association was found between the percentage of female board members and the accommodation score: for each 10% increase in the percentage of board members who were female, the accommodation score increased by 1.20 points (95% CI, 0.23-2.16 points; P = .03). Conclusions and Relevance: This cross-sectional study found considerable variability in oral board examination accommodations among ACGME-accredited specialties, highlighting opportunities for improvement and standardization. Promoting diversity in leadership bodies may lead to greater accommodations for examinees in extenuating circumstances.

Innovation and evaluation of vocational pharmaceutical education system under the 1 + X certificate system in China.

BACKGROUND AND OBJECTIVES: The 1 + X certificate system, introduced in China in 2019, integrates academic credentials with vocational skill certificates to meet the heightened demand for skilled talents in the growing economy. This study aims to innovate and evaluate the vocational pharmaceutical education system under the 1 + X certificate framework, specifically addressing the gap between theoretical education and workplace requirements. MATERIALS AND METHODS: A retrospective observational approach analyzed 490 pharmacy students over two academic years. The 2021 cohort underwent 1 + X integrated education, while the 2020 cohort followed conventional education. We collaborated closely with industry partners to identify and compile typical job competencies, formulating work projects aligned with industry demands. Combining the skill level standards and assessment content of "1+X Pharmaceutical Purchasing and Sales" and "1+X Pharmaceutical Preparation", we revised the course standards, incorporating typical work projects into the 2021 pharmacy professional teaching curriculum. This constituted the fundamental content of the 1 + X education reform. Statistical analysis compared course scores and 1 + X certificate examination performance. RESULTS: The 2021 cohort, under the 1 + X educational model, demonstrated higher average scores in pharmacy courses, with significant improvements in pharmacology (1 + X vs. Traditional education: 58.40 ± 14.20 vs. 53.44 ± 14.67), clinical pharmacotherapy (72.74 ± 10.28 vs. 63.15 ± 11.03), and pharmaceutical distribution and marketing (79.34 ± 10.96 vs. 67.50 ± 15.82). 1 + X certificate pass rates and satisfaction with the model were also higher than the 2020 cohort. CONCLUSION: The 1 + X certificate system is useful for developing talent in Chinese vocational education, effectively integrating assessments with industry standards. Future research should aim at evaluating long-term outcomes and improving quantitative skills assessments for enhanced effectiveness.

Provision of Stroke Care Services by Community Disadvantage Status in the US, 2009-2022.

Importance: Stroke center certification is granted to facilities that demonstrate distinct capabilities for treating patients with stroke. A thorough understanding of structural discrimination in the provision of stroke centers is critical for identifying and implementing effective interventions to improve health inequities for socioeconomically disadvantaged populations. Objective: To determine whether (1) hospitals in socioeconomically disadvantaged communities (defined using the Area Deprivation Index) are less likely to adopt any stroke certification and (2) adoption rates differ between entry-level (acute stroke-ready hospitals) and higher-level certifications (primary, thrombectomy capable, and comprehensive) by community disadvantage status. Design, Setting, and Participants: This cohort study used newly collected stroke center data merged with data from the American Hospital Association, Healthcare Cost Report Information datasets, and the US Census. All general acute hospitals in the continental US between January 1, 2009, and December 31, 2022, were included. Data analysis was conducted from July 2023 to May 2024. Main Outcomes and Measures: The primary outcome was the likelihood of hospitals adopting stroke care certification. Cox proportional hazard and competing risk models were used to estimate the likelihood of a hospital becoming stroke certified based on the socioeconomic disadvantage status of the community. Results: Among the 5055 hospitals studied from 2009 to 2022, 2415 (47.8%) never achieved stroke certification, 602 (11.9%) were certified as acute stroke-ready hospitals, and 2038 (40.3%) were certified as primary stroke centers or higher. When compared with mixed-advantage communities, adoption of any stroke certification was most likely to occur near the most advantaged communities (hazard ratio [HR], 1.24; 95% CI, 1.07-1.44) and least likely near the most disadvantaged communities (HR, 0.43; 95% CI, 0.34-0.55). Adoption of acute stroke-ready certification was most likely in mixed-advantage communities, while adoption of higher-level certification was more likely in the most advantaged communities (HR,1.41; 95% CI, 1.22-1.62) and less likely for the most disadvantaged communities (HR, 0.31; 95% CI, 0.21-0.45). After adjusting for population size and hospital capacity, compared with mixed-advantage communities, stroke certification adoption hazard was still 20% lower for relatively disadvantaged communities (adjusted HR, 0.80; 95% CI, 0.73-0.87) and 42% lower for the most disadvantaged communities (adjusted HR, 0.58; 95% CI, 0.45-0.74). Conclusions and Relevance: In this cohort study examining hospital adoption of stroke services, when compared with mixed-advantage communities, hospitals located in the most disadvantaged communities had a 42% lower hazard of adopting any stroke certification and relatively disadvantaged communities had a 20% lower hazard of adopting any stroke certification. These findings suggest that there is a need to support hospitals in disadvantaged communities to obtain stroke certification as a way to reduce stroke disparities.

Impact of COVID-19 pandemic on accredited programs and graduates who sat for the American Society for Clinical Pathology Board of Certification examination: graduates' perspective.

OBJECTIVE: Students in health profession education programs were severely affected by the COVID-19 pandemic at both didactic and clinical training levels. The purpose for this American Society for Clinical Pathology Board of Certification (ASCP BOC) study was to determine the impact of the COVID-19 pandemic on graduates. This study represents the perspectives of laboratory professional graduates who sat for the BOC certification in their respective professional disciplines. METHODS: A survey was sent to all graduates from the National Accrediting Agency for Clinical Laboratory Science (NAACLS), Accrediting Bureau of Health Education Schools (ABHES), and Commission on Accreditation of Allied Health Education Programs (CAAHEP) accredited programs who sat for the ASCP BOC examination in 2020 and 2021 to determine the impact of COVID-19 on laboratory professional graduates during the pandemic. RESULTS: A total of 180 graduates responded to the survey. The majority of graduates indicated that at least 1 didactic program component was shifted to an online system during the pandemic and that both clinical and nonclinical student laboratories were affected. Although program completion for most graduates was not delayed, one-third of graduates delayed taking their respective BOC exam. Due to the lack of knowledge application through practical hands-on laboratory experience in their educational programs, graduates reported feeling a lack of readiness with regards to preparing for the national certification examination as well as for employment. CONCLUSION: The study results showed the pandemic greatly impacted the education experience and readiness for the ASCP BOC examinations for graduates. Factors such as the absence of in-person learning and hands-on experience-both crucial aspects in laboratory training-and the ripple effects as a result of the pandemic, such as job loss, financial constraints, and health concerns, contributed to the decreased quality of education for graduates.

Professional training and autonomy of nursing teachers in the qualification of higher education in nursing / Formación y autonomía profesional de docentes de enfermería en la titulación de educación superior en enfermería / Formação e autonomia profissional dos docentes de enfermagem na qualificação do ensino superior em enfermagem

ABSTRACT Objectives: to identify the aspects related to professional training and autonomy of undergraduate nursing teachers of a public institution in Brasília, Federal District, in order to contribute to the course management and qualification. Methods: mixed method study conducted with 77 teachers. A semi-structured questionnaire was applied, where quantitative items were evaluated through the Student's T and ANOVA (p<0.05%) parametric tests. The qualitative part underwent content analysis with use of the IRAMUTEQ software and descending hierarchical classification. Results: the training of professionals was focused mostly (67.5%) on their initial area of expertise, and their mean values in autonomy-related factors were low and moderate. Two categories emerged in the qualitative analysis: "Identifying teacher autonomy" and "Applying teacher autonomy". Conclusions: understanding the meaning and degree of autonomy perceived by teachers can foster the reflection on the praxis and enhance their performance.

RESUMEN Objetivos: identificar aspectos relacionados con la formación profesional y la autonomía de los docentes universitarios de enfermería de una institución pública en Brasilia, Distrito Federal, para contribuir a la gestión y calificación del curso. Métodos: investigación de método mixto realizada con 77 docentes. Se aplicó un cuestionario semiestructurado, donde los ítems cuantitativos se evaluaron mediante las pruebas paramétricas T de Student y ANOVA (p<0.05%). La parte cualitativa se sometió a análisis de contenido con el uso del software IRAMUTEQ y clasificación jerárquica descendente. Resultados: con la formación enfocada principalmente (67.5%) en su área inicial de experiencia, los profesionales expresaron promedios bajos y moderados en factores relacionados con la autonomía. En el análisis cualitativo surgieron dos categorías: "Identificar la autonomía del docente" y "Aplicar la autonomía del docente". Conclusiones: comprender el significado y el grado de autonomía percibido por los docentes puede fomentar la reflexión de la praxis y mejorar su desempeño.

RESUMO Objetivos: identificar aspectos relativos à formação profissional e à autonomia dos docentes de graduação em Enfermagem de uma instituição pública de Brasília, Distrito Federal, de forma a contribuir na gestão e na qualificação do curso. Métodos: estudo misto, realizado com 77 docentes. Aplicou-se questionário semiestruturado, onde os itens quantitativos foram avaliados por testes paramétricos: Teste t-student e ANOVA (p<0,05%). A parte qualitativa passou por análise de conteúdo com subsídio do software IRAMUTEQ, e foi empregada a Classificação Hierárquica Descendente. Resultados: com formação voltada majoritariamente (67,5%) à sua área de atuação inicial, os profissionais expressaram médias baixas e moderadas nos fatores relacionados à autonomia. Na análise qualitativa emergiram duas categorias: "Identificando a autonomia docente" e "Aplicando a autonomia docente". Conclusões: entender o significado e o grau de autonomia percebido pelo docente pode fomentar a reflexão da práxis e potencializar sua atuação.

Odontólogos del Registro Nacional de Prestadores Individuales de Salud / Characterization of dentists registered in the National Register of Individual Health Providers, Chile

Objetivo Caracterizar a los odontólogos que ejercen la profesión en Chile, inscritos en el Registro Nacional de Prestadores Individuales. Material y método Estudio descriptivo, transversal, efectuado con la base de datos del Registro Nacional de Prestadores Individuales de la Superintendencia de Salud, solicitada vía Ley de Transparencia. Resultados A fecha de septiembre de 2014, se encontraban registrados 15.901 odontólogos titulados, desde 1945 en adelante. Su promedio de edad es 42,9 ± 11,46 años. El 54% son varones, y el 46%, mujeres. El 89,6% de los odontólogos chilenos estudió en Chile, el 73% de ellos en universidades tradicionales. Un 7,3% de los profesionales registrados son extranjeros, cuya gran mayoría estudió fuera del país. Para ellos, la vía más común de revalidación de título es mediante convenios con el Ministerio de Relaciones Exteriores. La universidad tradicional con más titulados es la Universidad de Chile, mientras que la Universidad Mayor es la privada con mayor egreso. En el último quinquenio, la cantidad total de titulados de universidades privadas superó al total de egresados de universidades tradicionales. Existen 4.339 registros de especialidad, un 49% de ellos certificado en el quinquenio 2009-2013. La especialidad más frecuente es Ortodoncia, con un 19,5% del total. La vía de certificación más frecuente es el posgrado universitario. Conclusiones Esta investigación constituye uno de los escasos estudios con información oficial y no especulativa sobre odontólogos en Chile. Consideramos que el Registro Nacional de Prestadores Individuales debe mejorar el acceso y registro de sus datos, para así caracterizar de forma adecuada, tanto demográfica como académicamente, a estos profesionales.

Objective To characterise dentists who practice in Chile, enrolled in the National Register of Individual Providers. Material and method Descriptive and cross-sectional study conducted with the database of the National Register of Individual Providers of the Superintendency of Health, requested through the Transparency Law. Results In September 2014, there were 15,901 registered dentists, of whom 54% were male, and graduated from 1945 onwards. Their mean age was 42.9 ±11.46 years. The large majority (89.6%) of Chilean dentists studied in Chile, 73% of them in traditional universities, and 7.3% of registered professionals are foreigners, most of whom studied abroad. For them, the most common route of degree equivalency is through agreements with the Chilean Ministry of Foreign Affairs. The traditional university with most graduates is the University of Chile, while Universidad Mayor is the private university with most graduates. In the last 5 years, the total number of graduates from private universities surpassed the total of graduates from traditional universities. There are 4,339 specialty records in the register, 49% of them certified in the period 2009-2013. The most common specialty is orthodontics (19.5% of the total). The most common route of certification is a university degree. Conclusions This study is one of the few with official, non-speculative information about dentists in Chile. We believe that the National Register of Individual Providers should improve access and registration of their data, with the purpose of properly characterising these professionals, demographically and academically.

Relación entre el desempeño en el examen de ingreso a la residencia y en el de especialización en pediatría en la ciudad de Buenos Aires / Correlation between results of the residency admission test and of pediatric certification test in Buenos Aires, Argentina

En la Ciudad de Buenos Aires (CABA) los ingresantes al sistema de residencia en pediatría lo hacen mediante un examen unificado y, al finalizar, rinden su examen de especialización en la Universidad de Buenos Aires (UBA). Existe evidencia de que el desempeño en determinadas evaluaciones podría predecir el rendimiento posterior. El objetivo de este estudio es evaluar si existe relación entre el examen de ingreso a la residencia (EIR) y el de especialización (EE) en pediatría. Se trata de una investigación transversal que incluye todos los sujetos que aprobaron el EIR de pediatría en CABA en 2004-2009 y que rindieron EE de pediatría en la UBA. Se obtuvo el puntaje de cada sujeto en ambos exámenes y se calculó la correlación correspondiente. Las notas fueron divididas en quintiles, calculando la proporción de alumnos que mejoró su ubicación en el segundo examen con respecto al primero. Se obtuvieron datos de 303 participantes. El examen de ingreso (calificación máxima de 60 puntos) mostró una mediana de 45.0 puntos (IIC: 43.0-48.7) y el examen de especialización (calificación máxima de 10 puntos) mostró una mediana de 6 puntos (IIC: 6-8), verificándose una correlación significativa entre la calificación del EIR y la del EE (r = 0.37, p < 0.001). En relación al quintil de referencia, 43.8% de los alumnos mejoró su ubicación en el EE respecto de la obtenida en el EIR, sin que se registraran diferencias entre residentes de hospitales pediátricos y de hospitales generales (45.6 vs. 31.5%; p = 0.1).

In the city of Buenos Aires (CABA), pediatric residents enter the residency program after taking a unified admission test. After completion of the program and passing a final test, the Universidad de Buenos Aires (UBA) provides a professional certification. The objective of this study is to determine if the results obtained in the residency admission test (RAT) and those of the professional certification test (PCT) correlated. This is a cross-sectional study, that included all subjects who passed the pediatrics RAT in CABA in 2004-2009, and that attended the pediatric PCT of the UBA. The score for each subject in both tests was obtained and the corresponding correlation was calculated. Results were divided in quintiles, and the proportion of subjects who improved their position in the PCT with respect to the RAT was calculated. Data from 303 subjects was obtained. The RAT showed a median of 45.0 (over 60 maximum) (IC-range: 43.0-48.7), and the PCT showed a median of 6 points (over 10 max.)(IC-range: 6-8). A significative correlation between results in RAT and PCT was observed (r = 0.37, p < 0.001). Based on their position in the RAT, 43.8% of subjects improved their position in the PCT, without differences between residents attending pediatric and general hospitals (45.6 vs. 31.5%; p = 0.1). In the case of pediatric residents, results of the residency admission test correlate with those obtained in the professional certification test.

Certificación y recertificación de especialistas en anestesiología: una mirada desde CONACEM / Certification and recertification specialist anesthesiology: a look from CONACEM

Desde 1984 la Corporación Autónoma de Certificación de Especialidades Médicas (CONACEM) ha certificado 12.294 especialistas médicos en Chile. La disciplina de Anestesiología inició su certificación en 1985, habiendo reconocido hasta diciembre de 2012 a 716 especialistas. Para la certificación existen tres vías posibles: a) haber aprobado un Programa de Formación Universitario Acreditado, lo que hizo el 53 por ciento de los postulantes; b) cumplir los requisitos de Adiestramiento en Práctica durante 5 años, lo que hizo un 41 por ciento de los postulantes. c) haber sido formado en el extranjero de acuerdo a programas convalidados. Existen 7 programas universitarios acreditados, de 3 años de duración, con un cupo total anual de 39 alumnos que se desarrollan en Santiago y provincias. Salvo los médicos aprobados en los Programas Universitarios acreditados, el resto de los postulantes requieren dar un examen práctico; desde 2002 se ha agregado un examen escrito, cuya aprobación es requisito para dar el práctico, y que ha resultado tener buena discriminación (49 por ciento de rechazo promedio en el período de 11 años de existencia). Las certificaciones dadas hoy, tienen una duración de 10 años al inicio y serán de 7 años en la recertificación. La caducidad de las certificaciones está aparejada al proceso de recertificación, de lo cual se discuten las razones que lo avalan; se presentan los requisitos y tabla de créditos a cumplir, elaborada por CONACEM. La legislación vigente y en proceso, requiere la actuación de al menos una entidad certificadora, condición que ha sido otorgada legalmente en forma única por el Ministerio de Salud a CONACEM a partir del 11/02/2014...

Since 1984, 12.294 different medical specialists have been certified in Chile by the Corporación Autónoma de Certificación de Especialidades Médicas (CONACEM). The certification in Anestesiology specialty was initiated in 1985 reaching 716 candidates approved until December 2012. Three ways are available to achieve certification: a) to be approved by a reputable university program in the specialization; this way has been used by 53 percent of postulants; b) to fulfill the requirements of a 5 years practical training program, as 41 percent of postulants did; c) to have passed a training program abroad, similar to those in force in Chile (< 5 percent). There are 7, three-year-long reputable university programs with a total annual capacity of 39 students; half of it is for programs developed in provinces. With the exception of doctors completing reputable university programs, others postulants are require to pass a five days practical examination. Since 2002 a written test has been added, which must be taken and approved as a condition of the practical examination. Written examinations have demonstrated good discriminative capacity (52 percent average approval in 11 years). Extended certifications currently have a 10 years duration for the first time and 7 years for subsequent recertification. Revocation of certification involves installing a recertification mechanism. The reasons that support the recertification are analyzed, and also present the requirements to obtaining it. Current legislation requires that certification and recertification are done by accrediting entities. CONACEM has been legally recognized by de Ministery of Health since February 2014 as the unique entity to perform that labor...

Resultado del examen de certifcación de médico pediatra de la Sociedad Argentina de Pediatría, años 2001-2010 / Performance on the Board of Pediatrics certifcation examination by the Sociedad Argentina de Pediatría, 2001-2010

Introducción. La certifcación de los profesionales garantiza su adecuado desempeño, pero el examen correspondiente debe ser periódicamente evaluado. Objetivo. Describir el resultado del examen de certifcación de médico pediatra (ECMP) de la Sociedad Argentina de Pediatría (SAP), analizando el impacto de edad y el tiempo desde la graduación de los inscriptos. Métodos. Se analizaron los examinados por el ECMP, valorando tasa de aprobación e institución formadora (2001-2010), y edad y años transcurridos desde la graduación (2001- 2005). Resultados. De 2527 profesionales pertenecientes a 138 instituciones, aprobó el 69,6%. Los aprobados presentaron edades (31,7 ± 4,1 contra 35,6 ± 6,2; p <0,0001) y años desde la graduación (6,3 ± 4,0 contra 9,0 ± 5,9; p <0,0001) menores que los desaprobados. La proporción de aprobados fue mayor en instituciones acreditadas por SAP por 5 años (78,4% contra 48,8%; OR= 3,8 IC95%= 3,1-4,7; p <0,001). Conclusión. Aprobaron el ECMP 69,6%. Los más jóvenes, con menos años de graduación y pertenecientes a programas acreditados por SAP, tuvieron mayor probabilidad de aprobar.

Introduction. Professional certifcation guarantees professional's performance, but the examination tool must be periodically evaluated. Objective. To describe the result of the pediatric certifying examination (PCE) of the Sociedad Argentina de Pediatría (SAP), between 2001-2010 analyzing the impact of the age and the elapsed time since the graduation and to describe the performance of training institutions in this period. Methods. Cross-section study. Data were ob-taind from the records of Board of Pediatrics of the SAP. The results of the PCE, were analyzed assessing examination pass rate and training institutions (2001-2010), and age and elapsed time since graduation of the examined professionals (2001-2005). Results. Of 2527 professionals from 138 institutions, 69.6% passed. Those that passed were younger (31.7 ± 4.1 vs. 35.6 ± 6.2 years; p <0.0001) and had less years since graduation (6.3 ± 4.0 vs. 9.0 ± 5.9; p <0.0001) than those who did not pass. The examination pass rate was higher in institutions accredited by SAP (78.4% vs. 48.8%; OR= 3,8 IC95%= 3,1-4,7; p <0.001). The pass rate was signifcantly higher in institutions with accredited programs for 5 years than those not accredited (78.4% vs. 48.8%, OR= 3.8 95% CI= 3.1 to 4.7, p <0.001). The pass rate at accredited institutions for 3 years (53.7%) and 1 year (48.7%) showed no statistically signifcant differences with non-accredited institutions. Conclusion. The certifying examination pass rate was 68.5%. Younger professionals with fewer years since graduation, and trained in SAP 5 years accredited programs were signifcantly more likely to pass the examination.

Estado actual de las especialidades médicas en Chile: realidad en el sistema público no municipalizado / Present status of medical specialties in the Chilean public health system

To adequately plan the post graduate training of physicians, we need to know the needs for specialists in the country and the most prevalent diseases and causes of consultations. In 2004, the National System of Health Services assessed the number of hours and types of specialities available, their regional distribution and calculated an approximate number of physicians in charge of those specialities, determining an equivalent per 44 weekly hours of physician. This number of hours is the maximum that a physician is allowed to work per week. Fifty six percent of specialists correspond to basic specialities (3,688 physicians equivalent to 44 hours, 33 percent to primary specialities (2,205 physicians) and 10 percent to subspecialties (666 physicians). The regional distribution of basic specialties is proportional to the population of each region. However, there are gaps in the distribution of primary specialties and subspecialties. The demand for specialists, assessed measuring the yield in minutes of each hired hour, determined that 54 percent of specialist hours are delicated to the new health program that guaranties the access to certain specialties in a predefined lapse, to all beneficiaries (AUGE). Moreover the demand for attentions to cover this health system has a gap of 30 percent in hours or 800 specialists. This motivated the creation of new posts for specialties during 2005 and 2006, equivalent to 250 physicians hired for 44 hours per week.

Análisis de un Programa Universitario de Formación de Postgrado en Endocrinología, luego de 24 años de su inicio / Analysis of a university training program in endocrinology

The Pontificia Universidad Católica de Chile has a two decades experience in training endocrinology specialists. This communication explains the operation of the training program and the results of a survey, answered by 90 percent of Endocrinologists that were trained at the center. This survey covers different aspects of the program such as the strengths and weaknesses of the academic teaching and the present position of the trainees. Questions about the working environment and the relationship with their teachers during the application of the program are also included. These results can be useful for other University centers that are planning a training program in endocrinology and for those physicians that are planning to become endocrinologists.

Disponibilidad de médicos en Chile al año 2004 / Availability of physicians in Chile at the year 2004

Background: The number of physicians available in a given country, their efficiency, quality and specialization is of utmost epidemiological importance. Aim: To evaluate the availability of physicians in Chile. Material and methods: The information about the number of physicians in Chile up to the year 2004, was obtained from the Ministry of Health, national universities and the register of immigrant physicians since 1950. Results: The total number of physicians licensed to practice was 25,542, of whom 2,700 are immigrants. The physician/inhabitant ratio increased from 1/921 in 1998 to 1/612 in 2004. The greater impact in the increment of available physicians was given by the immigration of professionals and by the increase in the number of physicians graduated from national universities, mainly from the new private universities. Forty two percent of physicians work at public services and 61 percent of these are certified specialists. The regional distribution of general practitioners and basic specialists is adequate. Along the country, the mean physician/beneficiary ratio is 8.45/10,000, the specialist/beneficiary ratio is 4.9/10,000 and the general practitioner/beneficiary ratio is 2.3/10,000. Conclusions: The national information of available physicians, especially in the private sector, should be improved. Immigration of physicians should be regulated, maintaining validation examinations and a National Medical Test to assess medical proficiency should be instituted.

Certificación de la mortalidad materna / Certification of maternal mortality

Las estadísticas de mortalidad deben utilizarse como fuente de información en salud de una población, porque reflejan los casos en que no pudo actuarse oportunamente y en donde no podía hacerse mayor acción. El diagnóstico correcto por el profesional de salud en la certificación como causa básica de la muerte materna permite producir y analizar datos relacionados con condiciones de vida y problemas de salud que desencadenaron la muerte, en determinado lugar...