The need for national medical licensing examination in Saudi Arabia.

BACKGROUND: Medical education in Saudi Arabia is facing multiple challenges, including the rapid increase in the number of medical schools over a short period of time, the influx of foreign medical graduates to work in Saudi Arabia, the award of scholarships to hundreds of students to study medicine in various countries, and the absence of published national guidelines for minimal acceptable competencies of a medical graduate. DISCUSSION: We are arguing for the need for a Saudi national medical licensing examination that consists of two parts: Part I (Written) which tests the basic science and clinical knowledge and Part II (Objective Structured Clinical Examination) which tests the clinical skills and attitudes. We propose this examination to be mandated as a licensure requirement for practicing medicine in Saudi Arabia. CONCLUSION: The driving and hindering forces as well as the strengths and weaknesses of implementing the licensing examination are discussed in details in this debate.

Mesenchymal Stem Cells Loaded with p5, Derived from CDK5 Activator p35, Inhibit Calcium-Induced CDK5 Activation in Endothelial Cells.

The potential use of stem cells as therapeutics in disease has gained momentum over the last few years and recently phase-I clinical trials have shown favourable results in treatment of a small cohort of acute stroke patients. Similarly, they have been used in preclinical models drug-loaded for the effective treatment of solid tumours. Here we have characterized uptake and release of a novel p5-cyclin-dependent kinase 5 (CDK5) inhibitory peptide by mesenchymal stem cells and showed release levels capable of blocking aberrant cyclin-dependent kinase 5 (CDK5) signaling pathways, through phosphorylation of cyclin-dependent kinase 5 (CDK5) and p53. These pathways represent the major acute mechanism stimulating apoptosis after stroke and hence its modulation could benefit patient recovery. This work indicates a potential use for drug-loaded stem cells as delivery vehicles for stroke therapeutics and in addition as anticancer receptacles particularly, if a targeting and/or holding mechanism can be defined.

Reliability and validity of an Arabic version of the revised two-factor study process questionnaire R-SPQ-2F.

OBJECTIVE: How students accomplish their learning and what they learn is an indicator of the quality of student learning. An insight into the learning approaches of a student could assist educators of the health profession in their planning for the first year of study. The aim of this study was to develop a reliable and valid Arabic version of the revised two-factor study process questionnaire. MATERIALS AND METHODS: The translation of the revised two-Factor Study Process Questionnaire (R-SPQ-2F) into Arabic was done by an established forward-backward translation procedure. The Arabic version was then distributed to high school graduates applying for a place in the medical program at King Fahad Medical City. A total of 83 students voluntarily completed the questionnaire. The internal consistency and construct validity of the Arabic version of the R-SPQ-2F were computed. RESULTS: The exploratory factor analysis revealed two components. The two factors were similar to the main scales described in the original English questionnaire. The main scales were the deep and surface approach. The items for the subscales (deep motive, deep strategy and surface motive, surface strategy) had a high internal consistency of more than 0.80. CONCLUSIONS: The results of this study should provide a valid and reliable instrument for the evaluation of the study approaches of Arabic speaking students.

The ability of the pre-admission criteria to predict performance in a Saudi medical school.

OBJECTIVE: To evaluate the ability of preadmission criteria used in most health professional schools in Saudi Arabia to predict the in-program performance. METHODS: This retrospective cohort study was conducted at King Fahd Medical City, Faculty of Medicine, Riyadh, Kingdom of Saudi Arabia between July and September 2008. Four sets were used to examine the predictive power of preadmission variables. The variables are the academic abilities (high school grades), aptitude test, achievement test, and an interview. The criterion variables were the undergraduate grade point averages' (GPAs) of medical college students (n=193). The correlation between admission variables and the GPA was examined using Pearson's correlation coefficient and regression analyses. RESULTS: Inclusion of all 4 admission tools in a regression analysis as predictors of GPA performance revealed that only the achievement test was statistically predictive of the GPA. Approximately 6.5% of variance in the GPA can be accounted for by the current admission criteria. CONCLUSION: The current admission criteria provide some insight into the predicted future performance of students. The inclusion of other valid and reliable admissions tools, such as the multiple mini-interviews and the questionnaire for candidate's suitability to follow a problem-based learning curriculum, should be considered.

Traditional healers in Riyadh region: reasons and health problems for seeking their advice. A household survey.

OBJECTIVES: The objectives were to study sociodemographic characteristics of complementary and alternative medicine (CAM) visitors, rate of their visits, health problems, and reasons for the visits. DESIGN: This was a cross-sectional study. SETTING: This study was conducted in Riyadh city and its suburbs. SUBJECTS: The sample size was calculated to be 462 families, selected according to the World Health Organization multistage random cluster sampling technique and was divided into 40 clusters. The 40 clusters were distributed proportionally according to the size of population in the catchment area. INTERVENTION AND OUTCOME MEASURES: A well-structured questionnaire that contains the items that fulfill the research objectives was used to collect the data by trained research assistants. RESULTS: The study includes 1408 individuals; 61% were female. About 42% of the participants consulted traditional healers (TH) sometime before and 24% within the past 12 months. There were more visits to TH in elderly people (> or =60 years), females, married, divorced, or widows and illiterate people. Common types of traditional healing included reciting the Holy Quran (62.5%), herb practitioners (43.2%), cautery (12.4%), and cupping (4.4%). Cautery was used more in suburban areas than in the city. The nationalities of the TH were Saudis (86%), Sudanese (3%), Yemenis (1%), Indians (1%), and others (9%). The common medical problems for seeking TH help were abdominal pain, flatulence, low back pain, sadness, depression, and headache. The common reasons for visiting TH were belief of success of CAM (51%), preference of natural materials (29%), and nonresponse to medical treatment (25%). Factors independently associated with consultation of TH were dissatisfaction with physician diagnosis (odds ratio [OR] = 122), failure of medical treatment (OR = 80), success of TH (OR = 79), long waiting time for physicians (OR = 20) and knowledge that some herbs are harmful (OR = 1.4). CONCLUSIONS: In this study, about half of the participants have visited TH. Abdominal pain was the most common presenting health problem. CAM is a reality and it deserves more investigation and appropriate legislation and control.