Long-term trends in international medical electives fees: a database mining study.

BACKGROUND: Abroad medical electives are recognized as high-impact practice and considered a necessity to provide global health training. As of recently, the COVID-19 pandemic and its related travel restrictions prohibited most international elective activities. Another important barrier to abroad electives that received comparably little attention is elective and application fees, which - combined - may be as high as $5000 per month, and may prevent students with limited financial resources from applying for an international elective. Elective fees have never been systematically analyzed and trends in teaching and application fees have rarely been subject to dedicated scientific investigations. METHODS: Using data from two large elective reports databases, the authors addressed this gap in the literature. The authors analyzed trends in abroad elective fees within the last 15 years in some of the most popular Anglo-American elective destinations among students from Germany, including the United States of America, Australia, New Zealand, the Republic of South Africa, Ireland and the United Kingdom. RESULTS: The authors identified n = 726 overseas elective reports that were uploaded between 2006 and 2020, of which n = 438 testimonies met the inclusion criteria. The United Kingdom and Australia were the most popular elective destinations (n = 123 and n = 113, respectively), followed by the Republic of South Africa (n = 104) and the United States of America (n = 44). Elective fees differed substantially-depending on the elective destinations and time point. Median elective fees were highest in the United States of America (€ 1875 for a 4-week elective between 2018-2020), followed by the Republic of South Africa (€ 400) and Australia (€ 378). The data also suggests an increasing trend for elective fees, particularly in the United States. CONCLUSIONS: Rising fees warrant consideration and a discussion about the feasibility of reciprocity and the bidirectional flow of students in bidirectional exchange programs.

Nutrition Coverage in Medical Licensing Examinations in Germany: An Analysis of Six Nationwide Exams.

The state of nutrition education in medicine is inadequate, with nutrition-related topics being poorly integrated into lectures. Most medical students receive only a few contact hours of nutrition instruction during their entire time at medical school. Identifying potential barriers that may explain the paucity of nutritional knowledge in medical students is thus of paramount importance. The extent of nutrition coverage in the second part of Germany's nationwide medical licensing exam is currently unknown. We addressed this issue and assessed nutrition content, as well as students' scores, in this pivotal test prior to their graduation. We performed a post hoc analysis of six nationwide medical licensing examinations (2018-2020) undertaken by 29,849 medical students and screened 1920 multiple-choice questions for nutrition-related content. Nutrition-related questions accounted for a minority of the questions (2.1%, n = 40/1920). A considerable number of the questions (n = 19) included only a single nutrition-related answer option that was frequently incorrect and served as a distractor. About 0.5% of questions were entirely nutrition related. Despite undeniable barriers, the inclusion of additional nutrition-related examination questions could serve as an incentive to engage students and medical schools in enhancing medical nutrition education. The recently published competence-oriented learning objective catalog in Germany could play a pivotal role in this context, leading to better recognition of nutrition-related topics in medical education.

Current Sex Distribution of Cooking and Food Shopping Responsibilities in the United States: A Cross-Sectional Study.

Home cooking is an important obesity prevention strategy and associated with benefits for diet and health. Although cooking may be a joyful act of mindfulness, it also requires planning, preparation and time. Historically, women have been more likely to fulfill the role of food shopping and cooking. More recent studies suggested a transition in traditional household role assignments towards a larger involvement of males. This study examined the current sex distribution of cooking and food shopping responsibilities in the United States of America based on a nationally representative sample of 9078 citizens from the National Health and Nutrition Examination Surveys (2017-2020). More than 80% of women aged 25 years or older indicated that they were the person who did most of the planning/preparing of meals in their families, whereas the percentage of males responding affirmatively was substantially lower, ranging from 38.73% to 43.20% depending on age. Analyses on food shopping duties revealed a comparable distribution. In multivariate regression, female sex was associated with significantly higher odds of being the main food shopper/meal preparer in the family (OR: 4.82 (4.14-5.60) and 5.54 (4.60-6.67), respectively). Our data suggest that the majority of food shopping and cooking duties are still performed by women, which has important implications for public health nutrition initiatives.