The MIR 2018 Exam: Psychometric Study and Comparison with the Previous Nine Years.

Background and Objectives: The aim of the present research is to study the questions used in the 2018 MIR exam (a test that allows access to specialized medical training in Spain), describe their psychometric properties, and evaluate their quality. Materials and Methods: This analysis is performed with the help of classical test theory (CTT) and item response theory (IRT). The answers given to the test questions by a total of 3868 physicians are analyzed. Results: According to CTT, the average difficulty index for all of the test questions was 0.629, which falls into the acceptable category. The average difficulty index with correction for random effects was 0.515, which corresponds to a value within the optimal range. The mean discrimination index was 0.277, which is in the good category, while the mean point biserial correlation coefficient, with a value of 0.275 fits in the regular category. The values of difficulty and discrimination calculated according to the model of two parameters of the IRT seem adequate with average values of -0.389 and 0.677. The Cronbach alpha score obtained for the overall test was 0.944. This value is considered as very good. Conclusions: A decrease was observed in the average values of discrimination in the last three calls, which may be related to the greater proportion of Spanish graduates that take the exam in the same year of finalization of their studies in Medicine.

Gastroenterology - Evolution of specialty choice in recent years.

INTRODUCTION: Gastroenterology is one of the medical specialties offered to residency training candidates each year. This project analyzes the data associated with the choice of a Gastroenterology residency program in recent years. MATERIAL AND METHODS: Data related to specialty selection were obtained from official reports with regard to the allocation of residency places by the Spanish Ministry of Health, Social Services and Equality. Information was collected from various teaching centers via their training guides, the Spanish National Catalogue of Hospitals and the National Transplant Organization. RESULTS: The median consecutive number involved in the choice of Gastroenterology training has decreased year after year, and this specialty is now positioned among the five most commonly selected residency programs in 2015. The median number of hospitals with a higher number of beds, adult liver transplantation activities and dedicated GI bleeding units is significantly lower. This is also true when centers are analyzed according to the presence of specific Gastroenterology on-call shifts for residents or their association with medical schools. Data from the past five years highlight Madrid, Aragón and the Basque Country as the autonomous communities where Gastroenterology is the most popular. Centers selected by candidates with the lowest median consecutive numbers from 2011-2015 included the university hospitals Ramón y Cajal, Santiago de Compostela and Gregorio Marañón. CONCLUSIONS: Gastroenterology has gradually escalated in the ranking of residency choices and is now one of the five most popular options. Potential residents prefer larger centers with complex-care patients and more research activity.

Oral squamous cell carcinoma associated with symphyseal dental implants: an unusual case report.

BACKGROUND: The development of squamous cell carcinoma (SCCa) around dental implants is an uncommon pathological manifestation. This case report describes a patient with history of oral lichen planus (OLP) and previous SCCa of the gingiva who developed SCCa adjacent to symphyseal implants. CASE DESCRIPTION: An 81-year-old edentulous woman with history of OLP developed an in situ SCCa on the left mandibular edentulous ridge. One of the authors, an oral and maxillofacial surgeon, performed a marginal mandibular resection of the lesion. Functional oral rehabilitation was achieved by means of two endosseous symphyseal implants. Three years after the patient underwent implant-supported reconstruction, the oral and maxillofacial surgeon detected an exophytic mass adjacent to the right implant and diagnosed it as recurrent SCCa. Two of the authors performed a marginal mandibular resection. One year later, the patient developed a recurrence over the resected area, requiring segmental mandibulectomy. CLINICAL IMPLICATIONS: This case report demonstrates that recurrent primary malignancy can masquerade as benign peri-implant complications. A high degree of vigilance is required in the follow-up of patients with previous cancer or premalignant lesions.

Botryoid odontogenic cyst: clinical and pathological analysis in relation to recurrence.

OBJECTIVES: Botryoid odontogenic cyst (BOC) is considered as an unusual multilocular variant of lateral periodontal cyst (LPC). Review of the literature indicates that this lesion has higher risk of recurrence than LPC, but objective reasons are still unknown. The aim of this study is identify main clinical and pathological variables associated with the risk of recurrence. STUDY DESIGN: A complete literature review about cases of BOC was made, from its first description up to the year 2006. A total of 67 cases of BOC were identified from year 1973 (first case) to the last publication in 2005. RESULTS: 85.2% of the BOCs were located in the jaw, affecting to women (54.8% of the cases) in the fifth decade of the life. This lesion shows a well- circumscribed unilocular (60%) or multilocular (40%) radiolucency. Recurrence rate of cases with follow-up data was 32,4%. CONCLUSIONS: Size and multilocular patterns could be the main factors associated to recurrence in BOC.