RESUMO
Background and objective Both family medicine applicants and programs dedicate significant resources to the interview process, a time for both parties to make an impression on the other in an attempt to find their best match. Despite the importance of this process, little research has been completed to ensure the process efficiently addresses applicant preferences on interview day and the surrounding process. This study aimed to determine the factors influencing the family medicine applicant preferences regarding the pre-interview, interview, and post-interview ranking process. Methods The study method was a cross-sectional electronic survey utilizing anonymous questionnaires that assessed demographics, pre-interview, interview, post-interview ranking preference, and applicants' experiences applying to a community-based family medicine residency program after their interview for the 2020 application cycle. Results Out of the 106 family medicine applicants, 48 responded; 52.08% were males, 52.5% were married, 58.33% applicants were from the osteopathic medical school, 33.33% were from the allopathic Liaison Committee on Medical Education (LCME) non accredited medical school/international medical graduates (IMG's), and 8.33% were from the allopathic LCME accredited medical schools. Free hotel accommodation was not offered from half of the programs to 27.8% of the applicants in the 2020 match cycle (pre-pandemic). Respondents favored electronic means of scheduling interviews with a positive experience with the online self-scheduling Electronic Residency Application Service (ERAS) calendar. A significantly higher proportion of IMGs applied to a higher number of family medicine programs followed by the osteopathic applicants. There was no statistical difference found between osteopathic and allopathic applicants for the number of programs they got invited to; however, the difference was significant for osteopathic and allopathic LCME accredited applicants who interviewed and ranked programs in the range of 11-20 (62.96%, p=0.0013 and 66.67%, p=0.0018, respectively). The respondents' most important experiences were interviewing the program director, faculty members, and tour the hospital facility. When ranking programs, these family medicine applicants considered the strength of program training, the quality of current residents, and the program's geographic location as the top three most significant factors, with mean importance ratings of 5.08, 5.02, and 4.35, respectively. Applicants also considered how the current residents perceive the program director, prior teaching experience, and program diversity with mean importance ratings of 3.42, 2.89, and 2.09, respectively. Conclusion Although applicants' preferences for family medicine residency programs are similar to generally reported by The National Resident Matching Program (NRMP) surveys, some key differences do exist. The program leadership should consider these preferences from the candidates' perspective for a successful match in family medicine residency on both sides.
RESUMO
Ectopic pregnancy can be a life-threatening cause of acute abdomen. Broad ligament pregnancy accounts for 1% of ectopic abdominal pregnancies and complications can be calamitous. This case report highlights a 27-year-old G2P0010 female who presented with amenorrhea and acute right lower quadrant and pelvic pain. By last menstrual period (LMP), she was at seven weeks and two days gestation. Her past surgical history was significant for a prior right salpingo-oophorectomy. The physical examination was significant for severe right lower quadrant tenderness with guarding. The urine pregnancy test was positive with the serum quantitative beta-human chorionic gonadotrophin (Beta hCG) of 28011 MIU/ML (normal range <5 MIU/ML). The transvaginal ultrasonography demonstrated an empty uterus and a gestational sac containing a fetal pole in the right adnexal area. The crown-rump length was 7.2 mm, consistent with six weeks and four days, with a positive fetal heart rate and moderate free fluid in the cul-de-sac. The patient was taken for immediate diagnostic laparoscopy, which was converted to open laparotomy due to active bleeding from the right broad ligament and pelvic wall close to large pelvic vessels. In addition to the hemoperitoneum, intraoperative findings revealed a normal left fallopian tube and ovary and absent right fallopian tube and ovary. Right ureterolysis was done and hemostasis of the bleeding broad ligament and right pelvic sidewall was established. An adherent tissue was dissected from the right broad ligament and sent to pathology. The patient did well postoperatively. The final pathology showed an ectopic pregnancy with immature chorionic villi in the broad ligament. The diagnosis of ectopic pregnancy in the broad ligament is challenging. The location could be close to the major pelvic vessels and anatomic structures like the ureter and bowel, hence, it can cause massive hemorrhage with maternal morbidity and mortality. Diagnosis is often missed preoperatively and made intraoperatively. Hence, we emphasize that this differential be considered in reproductive-aged women who present with atypical presentations of acute abdomen and amenorrhea.