Factors influencing faculty job satisfaction: A quantitative study of private medical colleges in Karachi.

OBJECTIVE: To identify key factors influencing academic job satisfaction among faculty members of private medical colleges in an urban setting. METHODS: The cross-sectional, quantitative study was conducted from October to November 2021 at the Department of Community Health Sciences, Fazaia Ruth Pfau Medical College, Karachi, and comprised faculty members associated with 13 private medical colleges in Karachi. Data was collected using a 32-item questionnaire that was scored on a 5-point Likert scale. Key predictors of job satisfaction were identified and evaluated. Data was analysed using SPSS version 23. RESULTS: Of the 200 subjects surveyed, 106(52.7%) were males. The overall mean age was 29.4±5.2 years. There were 145(72.5%) respondents who were married, 106(53%) had employed spouses, 102(51%) were either professors or associate professors, and 93(46.5%) had professional experience of 1-5 years. Three principal factors were identified; career growth opportunities, working conditions and compensatory packages (p<0.001). The lowest mean satisfaction score was observed for compensatory packages (1.74±0.84), followed by working conditions (2.28±1.41) and career growth (2.38±1.39). CONCLUSIONS: Improving compensatory packages, working conditions and career growth opportunities were found to be crucial for enhancing job satisfaction among faculty members in Karachi-based private medical colleges.

How different is the Learning Environment of Public and Private Sector Medical Colleges in Lahore, Pakistan?

Background &Objective: Regular assessment of the Learning Environment (LE) of health professions education institutions is important for their continuous improvement and to keep the students motivated. Pakistan Medical & Dental Council (PM&DC) applies uniform standards of quality in all public and private sector medical colleges of the country. However, the learning environment of these colleges might be different due to differences in their geographic location, structure, utilization of resources, and modus operandi. This study was conducted to measure the learning environment in selected public and private sector medical colleges in the city of Lahore, Pakistan, using a pre validated instrument (Jhon Hopkins Learning Environment Scale). Methods: This cross-sectional descriptive study was conducted on 3,400 medical students from six public and private sector medical colleges of Lahore, during November and December 2020. Data was collected through Google forms. Two stage cluster random sampling technique was used to draw the study sample. John Hopkins Learning Environment Scale (JHLES) was used for data collection. Results: Overall JHLES mean score was 81.75 ±13.5. Public sector colleges had a significantly higher mean JHLES score (82.1) than private-sector colleges (81.1), with small effect size (0.083). Male students rated LE slightly higher than females (82.0 and 81.6 respectively). Conclusion: JHLES a relatively simpler tool (28 items) than DREEM, can be used effectively in the context of Pakistani environment to measure the LE in medical colleges. Both, public and private sector colleges had high overall JHLES mean scores, with public sector colleges having a significantly higher score than private-sector colleges.

Collaboration with medical colleges and public health institutions for implementation of national health programs: The way forward.

Health system strengthening is a much-needed priority to achieve the major public health goals of control, elimination, and eradication of various diseases. It depends on improving the country's ability to successfully perform essential functions while focusing on sustainability, equity, effectiveness, and efficiency. Medical colleges and public health institutions play an integral role in health system strengthening by educating and training the current and the future generations of health-care workforce with a vision to achieve the global standards in public health. This discussion focuses on the role of medical colleges and public health institutions in the success of various national health programs with a focus on challenges and improvement areas for the same.

Exploring the Gap Between Knowledge and Behavior Regarding Thalassemia Among University Students: A Cross-Sectional Study in the United Arab Emirates.

Thalassemia is humanity's most common genetic disorder and represents a serious healthcare challenge in the United Arab Emirates. Increasing awareness is a crucial part of any successful strategy to prevent thalassemia. This research examined knowledge levels and attitudes regarding thalassemia screening, counseling, and monitoring from medical and nonmedical students at Ajman University. This was a cross-sectional, descriptive study conducted among a convenience sample of Ajman university students in the UAE. A questionnaire was distributed which was composed of three main sections. The first section covered participants' demographic data. The second section covered general knowledge of thalassemia and its screening measures. The third section assessed risk factors, regulations, and preventive measures. The data were analyzed using the statistical package for social sciences (SPSS) version 24. A total of 523 participants completed the whole survey. Generally, there was a good level of awareness of thalassemia and thalassemia screening among participants. Approximately three-quarters of participants (76.5%) agreed that thalassemia screening should be compulsory for the individual and the majority of students and 92.7% recognized the importance of thalassemia screening for both partners. Approximately three-quarters (75.9%) of participants disagreed that fetuses with thalassemia should be aborted. More than half of the participants disagreed that thalassemia carriers and patients should be prevented from marrying each other. Generally, older respondents (final year students), respondents who had dealt with thalassemia patients, and respondents with relatives with thalassemia had more comprehensive knowledge of thalassemia. Campaigns focusing on college and university students should be regarded as an essential element of the thalassemia prevention strategy for contemporary UAE society.

NLM and the IAIMS initiative: Cross-institutional academic/advanced systems contributing to the evolution of networked information and resources.

The Integrated Academic/Advanced Information Systems (IAIMS) program began in 1983 and was based on a study by the Association of American Medical Colleges (AAMC). Donald A.B. Lindberg M.D. was a member of the AAMC Advisory Committee. The U.S. National Library of Medicine (NLM) grants for IAIMS were initiated in 1984 the same year Dr. Lindberg became Director of the NLM. This chapter presents an overview of IAIMS and its progression through three stages with Dr. Lindberg's leadership.

Building a sustainable rural physician workforce.

CHAPTER 1: CHARACTERISING AUSTRALIA'S RURAL SPECIALIST PHYSICIAN WORKFORCE: THE PROFESSIONAL PROFILE AND PROFESSIONAL SATISFACTION OF JUNIOR DOCTORS AND CONSULTANTS: Objective: To assess differences in the demographic characteristics, professional profile and professional satisfaction of rural and metropolitan junior physicians and physician consultants in Australia. DESIGN, SETTING AND PARTICIPANTS: Cross-sectional, population level national survey of the Medicine in Australia: Balancing Employment and Life longitudinal cohort study (collected 2008-2016). Participants were specialist physicians from four career stage groups: pre-registrars (physician intent); registrars; new consultants (< 5 years since Fellowship); and consultants. MAIN OUTCOME MEASURES: Level of professional satisfaction across various job aspects, such as hours worked, working conditions, support networks and educational opportunities, comparing rural and metropolitan based physicians. RESULTS: Participants included 1587 pre-registrars (15% rural), 1745 physician registrars (9% rural), 421 new consultants (20% rural) and 1143 consultants (13% rural). Rural physicians of all career stages demonstrated equivalent professional satisfaction across most job aspects, compared with metropolitan physician counterparts. Some examples of differences in satisfaction included rural pre-registrars being less likely to agree they had good access to support and supervision from qualified consultants (odds ratio [OR], 0.6; 95% CI, 0.3-0.9) and rural consultants being more likely to agree they had a poorer professional support network (OR, 1.9; 95% CI, 1.2-2.9). In terms of demographics, relatively more rural physicians had a rural background or were trained overseas. Although most junior physicians were women, female consultants were less likely to be working in a rural location (OR, 0.6; 95% CI, 0.4-0.8). CONCLUSION: Junior physicians in metropolitan or rural settings have a similar professional experience, which is important in attracting future trainees. Increased opportunities for rural training should be prioritised, along with addressing concerns about the professional isolation and poorer support network of those in rural areas, not only among junior doctors but also consultants. Finally, making rural practice more attractive to female junior physicians could greatly improve the consultant physician distribution. CHAPTER 2: GENERAL PHYSICIANS AND PAEDIATRICIANS IN RURAL AUSTRALIA: THE SOCIAL CONSTRUCTION OF PROFESSIONAL IDENTITY: Objective: To explore the construction of professional identity among general physicians and paediatricians working in non-metropolitan areas. DESIGN, SETTING AND PARTICIPANTS: In-depth qualitative interviews were conducted with general physicians and paediatricians, plus informants from specialist colleges, government agencies and academia who were involved in policy and programs for the training and recruitment of specialists in rural locations across three states and two territories. This research is part of the Training Pathways and Professional Support for Building a Rural Physician Workforce Study, 2018-19. MAIN OUTCOME MEASURES: Individual and collective descriptors of professional identity. RESULTS: We interviewed 36 key informants. Professional identity for general physicians and paediatricians working in regional, rural and remote Australia is grounded in the breadth of their training, but qualified by location - geographic location, population served or specific location, where social and cultural context specifically shapes practice. General physicians and paediatricians were deeply engaged with their local community and its economic vulnerability, and they described the population size and dynamics of local economies as determinants of viable practice. They often complemented their practice with formal or informal training in areas of special interest, but balanced their practice against subspecialist availability, also dependent on demographics. While valuing their professional roles, they showed limited inclination for industrial organisation. CONCLUSION: Despite limited consensus on identity descriptors, rural general physicians and paediatricians highly value generalism and their rural engagement. The structural and geographic bias that preferences urban areas will need to be addressed to further develop coordinated strategies for advanced training in rural contexts, for which collective identity is integral. CHAPTER 3: SUSTAINABLE RURAL PHYSICIAN TRAINING: LEADERSHIP IN A FRAGILE ENVIRONMENT: Objectives: To understand Royal Australasian College of Physicians (RACP) training contexts, including supervisor and trainee perspectives, and to identify contributors to the sustainability of training sites, including training quality. DESIGN, SETTING AND PARTICIPANTS: A cross-sectional mixed-methods design was used. A national sample of RACP trainees and Fellows completed online surveys. Survey respondents who indicated willingness to participate in interviews were purposively recruited to cover perspectives from a range of geographic, demographic and training context parameters. MAIN OUTCOME MEASURES: Fellows' and trainees' work and life satisfaction, and their experiences of supervision and training, respectively, by geographic location. RESULTS: Fellows and trainees reported high levels of satisfaction, with one exception - inner regional Fellows reported lower satisfaction regarding opportunities to use their abilities. Not having a good support network was associated with lower satisfaction. Our qualitative findings indicate that a culture of undermining rural practice is prevalent and that good leadership at all levels is important to reduce negative impacts on supervisor and trainee availability, site accreditation and viability. Trainees described challenges in navigating training pathways, ensuring career development, and having the flexibility to meet family needs. The small number of Fellows in some sites poses challenges for supervisors and trainees and results in a blurring of roles; accreditation is an obstacle to provision of training at rural sites; and the overlap between service and training roles can be difficult for supervisors. CONCLUSION: Our qualitative findings emphasise the distinctive nature of regional specialist training, which can make it a fragile environment. Leadership at all levels is critical to sustaining accreditation and support for supervisors and trainees. CHAPTER 4: PRINCIPLES TO GUIDE TRAINING AND PROFESSIONAL SUPPORT FOR A SUSTAINABLE RURAL SPECIALIST PHYSICIAN WORKFORCE: Objective: To draw on research conducted in the Building a Rural Physician Workforce project, the first national study on rural specialist physicians, to define a set of principles applicable to guiding training and professional support action. DESIGN: We used elements of the Delphi approach for systematic data collection and codesign, and applied a hybrid participatory action planning approach to achieve consensus on a set of principles. RESULTS: Eight interconnected foundational principles built around rural regions and rural people were identified: FP1, grow your own "connected to" place; FP2, select trainees invested in rural practice; FP3, ground training in community need; FP4, rural immersion - not exposure; FP5, optimise and invest in general medicine; FP6, include service and academic learning components; FP7, join up the steps in rural training; and FP8, plan sustainable specialist roles. CONCLUSION: These eight principles can guide training and professional support to build a sustainable rural physician workforce. Application of the principles, and coordinated action by stakeholders and the responsible organisations, are needed at national, state and local levels to achieve a sustainable rural physician workforce.

Quality assurance procedures in assessment - a descriptive study of medical colleges in Pakistan.

OBJECTIVE: To identify the quality assurance procedures being implemented in the assessment system of medical colleges in Pakistan. METHODS: The cross-sectional study was conducted from March 2015 to December 2017 in medical training institutions recognised by the Pakistan Medical and Dental Council across Pakistan and Azad Jammu and Kashmir, and comprised individuals designated by the respective institutional administrations. The mixed method technique was employed using a semi-structured questionnaire. Data was analysed using SPSS 21. RESULTS: Of the 49 institutions, 20(41%) were in the public sector and 29(59%) were in the private sector. Overall, 35(71.4%) institutions followed a written assessment policy provided by the affiliated university, 9(18%) never did so, 22(44.8 %) had content experts checking if the questions matched the objectives, 42(85.7%) took strict steps to prevent cheating in exams, and 26(53.1%) analysed theory exam statistically. Discrimination index, difficulty index, reliability, and point biserial were 14(28.6%), 13(26.5%), 12(24.4%), and 7(14.3%) of the medical colleges respectively. Only 12(24.5%) institutions provided written feedback on the results, and 15(30.6%) conducted annual internal audit. CONCLUSION: General issues related to quality assurance procedures in assessments were found to be in place in majority of the colleges. However, a large proportion did not have them.

Whose Voices Are Heard? Speaker Gender Representation at the Society of Cardiovascular Anesthesiologists Annual Meeting.

OBJECTIVE: Gender disparities in academic medicine continue to be prevalent despite significant advances in the number of women entering medicine over the last decades. The purpose of the present study was to investigate gender representation of speakers at Society of Cardiovascular Anesthesiologists (SCA) Annual Scientific Sessions meetings from 2015 to 2018. DESIGN: Observational study. SETTING: Internet analysis and cross-sectional survey. PARTICIPANTS: Speakers at the SCA Annual Scientific Sessions meetings from 2015 to 2018. INTERVENTIONS: Individual speakers in the main program, problem-based learning discussions, workshops, and fellow sessions were analyzed for speaker gender. Speakers' names, pronouns, institutional biographies, and accompanying images were matched with public online data and were used to identify gender. Gender data from the 2019 SCA Diversity Survey respondents were used to estimate gender of the SCA membership. MEASUREMENTS AND MAIN RESULTS: Between 2015 and 2018, the number of lectures given by women was 22% to 25%. A statistically significant difference was found in the expected versus observed proportion of women in speaking slots for all combined sessions (2015-2018; p = 0.0027, 0.0023, 0.0018, 0.025, respectively). There also was a statistically significant difference in the expected versus observed proportion of women in speaking slots in the main sessions (2015-2018; p ≤ 0.0001, 0.00069, 0.00019, 0.00019, respectively). For the workshops, problem-based learning discussions, and fellow sessions, no statistically significant difference was found in the observed versus expected proportion of women in speaker slots. CONCLUSIONS: Between 2015 and 2018, the majority of lectures at the SCA annual meetings were given by men, with women consistently giving 22% to 25% of individual lectures. When all sessions were combined, there was a statistically significant difference in the expected versus observed proportion of women in speaking slots.

Mentoring in a resource-constrained context: A single-institutional cross-sectional study of the prevalence, benefits, barriers and predictors among post-graduate medical college fellows and members in South-Eastern Nigeria.

BACKGROUND: Globally, the post-graduate medical education has undergone tremendous changes with emphasis on training, services and research to equip trainees with competence for independent professional development. However, not all the fellows and members of the West African Post-graduate Medical College and the National Post-graduate Medical College of Nigeria recognise the values of mentoring in achieving the career success. AIM: The study was aimed at describing the prevalence, benefits, barriers and predictors of mentoring in a cross-section of the Post-graduate Medical College fellows and members in a tertiary health institution in South-Eastern Nigeria. PARTICIPANTS AND METHODS: A cross-sectional study was carried out among 168 study participants who were sampled from the Post-graduate Medical College fellows and members in the Federal Medical Centre, Umuahia, Nigeria. Data collection was done using a pre-tested, self-administered questionnaire that elicited information on awareness, prevalence, barriers and benefits of mentoring. RESULTS: The age of participants ranged from 26 to 59 (41 ± 9.4) years. All the respondents were aware of the mentorship. The prevalence of mentoring was 33.3%. The most common benefit was personal and professional growth and development (100.0%). The most common barrier was the pressure of professional duties and personal exigencies (100.0%). The most significant predictor of mentoring had departmental mentoring programme participants who had departmental mentoring programmes were two times more likely to have mentoring relationships when compared to their counterparts who had none (adjusted odds ratio = 2.32; 95% confidence interval: 1.20-3.10; P = 0.002). CONCLUSION: The level of awareness of mentoring was very high but did not translate to appropriate involvement in mentoring. The most common benefit was personal and professional growth and development. The most common barrier was the pressure of professional duties and personal exigencies. The most significant predictor of mentoring relationship had departmental mentoring programme.

Reforming Medical Education in Pakistan through strengthening Departments of Medical Education.

OBJECTIVE: To review the current status of departments of medical education in all public and private medical colleges located in the city of Lahore, Pakistan. METHODS: This was a quantitative, cross sectional descriptive study; conducted from March to October 2015 in Pakistan Medical & Dental Council (PM&DC) recognized medical colleges located in Lahore, Pakistan. Respondents were the heads of departments of medical education or any other well-informed faculty member. A questionnaire was prepared to obtain information about the current status of the departments of medical education (DMEs). The investigator personally visited all medical colleges for data collection. Both verbal and written consents were obtained and the questionnaire was administered to the resource persons. The data was organized and entered in SPSS for descriptive analysis. RESULTS: Out of the 18 medical colleges in Lahore, six (33.3%) belonged to public sector and 12 (66.7%) were from private sector. All medical colleges reported to have a functional DME. However, eight had established DMEs during the past five years. Only one (5.6%) head of DME was working on full-time basis. Eleven (61.1%) heads of DMEs did not have any formal qualification in medical education. Eight (44.4%) colleges claimed to have adequate human resources for DME. Thirteen (72.2%) colleges mentioned that adequate financial resources were available for running DMEs. It is encouraging to see that DMEs in private sector medical colleges are playing increasingly significant role in managing educational activities. Similarly, the senior management of private sector seems to be relatively more eager to promote educational activities. CONCLUSION: There is an increasing recognition towards establishing DMEs in the medical colleges, but their infrastructure, proper functioning and availability of human and financial resources are serious impediments requiring immediate attention.

Academic Health Center Psychology Representation to the Council of Faculty and Academic Societies (CFAS) of the Association of American Medical Colleges (AAMC).

This paper outlines the perspectives of the two currently appointed representatives of the Association of Psychologists in Academic Health Centers (APAHC) to the Council of Faculty and Academic Societies (CFAS) of the Association of American Medical Colleges (AAMC). The authors focus on why it is important for psychologists, especially those in academic health centers (AHCs), to be part of CFAS. The goal of the paper is to demonstrate how involvement in organizations like the AAMC helps AHC psychologists serve as ambassadors for psychology in AHCs and assists AHC psychologists in staying fluent regarding hot topics within academic medicine. The first author is a more senior member of APAHC, and so reflects the perspective of long-serving APAHC members; the second author reflects the perspectives of newer generations of APAHC members, those who have been active in APAHC for 10 years or less. The authors discuss their experiences being at national CFAS meetings. They describe meeting events including presentations such as those by national policy experts and scholars; and speed mentoring with medical residents from the AAMC Organization of Resident Representatives. Of special importance has been their opportunities for informal conversations with the AAMC's President and CEO, Board Chair, and Chief Public Policy Officer. They also have participated in networking functions that encourage interdisciplinary knowledge sharing and relationship building.