[The « Osler ¼ group : a new opportunity to think about « becoming a physician ¼]. / Le groupe « Osler ¼ : une nouvelle opportunité pour réfléchir sur le « devenir médecin ¼.

Issues of professionalism and professional identity formation, particularly amongst young doctors, have been the object of increasing attention. This is explained in part by the evolution of the hospital environment (specialization, shorter stays), as well as by the prevalence of physician burnout and suicide. In this context, the CHUV implemented a pilot project within the department of internal medicine aiming to support its residents in the construction of their professional identity. The Osler group convened 10 residents led by an attending physician and a senior resident from the internal medicine department as well as an attending physician of the liaison psychiatry department. The experience has been a success, with residents describing clear benefits of the group.

Les enjeux de professionnalisme et d'identité professionnelle chez les médecins font l'objet d'un intérêt croissant, en raison des évolutions du milieu hospitalier (spécialisation, raccourcissement de la durée de séjour) ainsi que de phénomènes comme le burn-out ou le suicide. C'est dans ce contexte que le CHUV a mis en place un projet pilote dans le Service de médecine interne (SMI) pour soutenir les médecins assistants dans la construction de leur identité professionnelle, valoriser la transmission de l'expérience clinique et leur offrir un espace de parole et d'échange. Le groupe « Osler ¼ a ainsi réuni dix assistants pour des rencontres animées par un médecin cadre et une cheffe de clinique du SMI, ainsi qu'un médecin cadre du Service de psychiatrie de liaison. L'expérience a été un succès, les assistants exprimant clairement les bienfaits du groupe, notamment quant à leur rapport au métier.

Surgical and endovascular hybrid approach in peripheral arterial disease of the lower limbs.

BACKGROUND: Multilevel peripheral arterial disease is frequently observed in patients with intermittent claudication or critical limb ischemia. This report evaluates the efficacy of one-stage hybrid revascularization in patients with multilevel arterial peripheral disease. PATIENTS AND METHODS: A retrospective analysis of a prospective database included all consecutive patients treated by a hybrid approach for a multilevel arterial peripheral disease. The primary outcome was the patency rate at 6 months and 1 year. Secondary outcomes were early and midterm complication rate, limb salvage and mortality rate. Statistical analysis, including a Kaplan-Meier estimate and univariate and multivariate Cox regression analyses were carried out with the primary, primary assisted and secondary patency, comparing the impact of various risk factors in pre- and post-operative treatments. RESULTS: 64 patients were included in the study, with a mean follow-up time of 428 days (range: 4 - 1140). The technical success rate was 100 %. The primary, primary assisted and secondary patency rates at 1 year were 39 %, 66 % and 81 %, respectively. The limb-salvage rate was 94 %. The early mortality rate was 3.1 %. Early and midterm complication rates were 15.4 % and 6.4 %, respectively. The early mortality rate was 3.1 %. CONCLUSIONS: The hybrid approach is a major alternative in the treatment of peripheral arterial disease in multilevel disease and comorbid patients, with low complication and mortality rates and a high limb-salvage rate.