RESUMEN
CONTEXT AND OBJECTIVE: A cold climate towards primary care (PC) within medical academia could form a barrier against choosing family medicine (FM) as a career option. This study was designed to determine whether medical students' knowledge of and attitudes towards FM predicted their career choice. DESIGN AND SETTING: Cohort study conducted at two different medical schools. METHODS: After completing a PC course at the Albacete Medical School in 2005-2006, 81 second-year students were asked to give responses to a questionnaire. In their sixth year (2009-2010), 79 students in Albacete and 42 in Seville (taken as an unexposed cohort) were asked to give responses too. Their choice of specialty was investigated in 2011. RESULTS: In Albacete, the questionnaire was answered by 79 second-year and 76 sixth-year students; in Seville, it was answered by 26 sixth-year students. After completing the PC course, 69.3% said they would like to become a family doctor. This percentage decreased to 40.3% at the end of the undergraduate course (P < 0.0001). In the sixth year, the attitudes towards FM worsened, yet these were significantly more favorable than those in Seville. Only 12 students chose FM; they obtained significantly worse scores in their specialty selection examination than their peers (P < 0.0001). CONCLUSION: In the Albacete Medical School, the students' opinion about FM worsened over the undergraduate course, although it was still better than the Seville students' stance. In any case, FM was seen to be a minority option.
Asunto(s)
Selección de Profesión , Educación de Pregrado en Medicina , Medicina Familiar y Comunitaria/educación , Conocimientos, Actitudes y Práctica en Salud , Estudiantes de Medicina/estadística & datos numéricos , Adulto , Estudios de Cohortes , Femenino , Humanos , Masculino , Atención Primaria de Salud , Facultades de Medicina , Autoinforme , España , Estadísticas no Paramétricas , Adulto JovenRESUMEN
ABSTRACT: CONTEXT AND OBJECTIVE: A cold climate towards primary care (PC) within medical academia could form a barrier against choosing family medicine (FM) as a career option. This study was designed to determine whether medical students' knowledge of and attitudes towards FM predicted their career choice. DESIGN AND SETTING: Cohort study conducted at two different medical schools. METHODS: After completing a PC course at the Albacete Medical School in 2005-2006, 81 second-year students were asked to give responses to a questionnaire. In their sixth year (2009-2010), 79 students in Albacete and 42 in Seville (taken as an unexposed cohort) were asked to give responses too. Their choice of specialty was investigated in 2011. RESULTS: In Albacete, the questionnaire was answered by 79 second-year and 76 sixth-year students; in Seville, it was answered by 26 sixth-year students. After completing the PC course, 69.3% said they would like to become a family doctor. This percentage decreased to 40.3% at the end of the undergraduate course (P < 0.0001). In the sixth year, the attitudes towards FM worsened, yet these were significantly more favorable than those in Seville. Only 12 students chose FM; they obtained significantly worse scores in their specialty selection examination than their peers (P < 0.0001). CONCLUSION: In the Albacete Medical School, the students' opinion about FM worsened over the undergraduate course, although it was still better than the Seville students' stance. In any case, FM was seen to be a minority option.
RESUMO CONTEXTO E OBJETIVO: Um clima frio para a atenção primária na academia médica constitui uma barreira para escolher Medicina de Família (MF) como opção de carreira. Este estudo foi concebido para determinar se o conhecimento e as atitudes dos estudantes de medicina em relação à MF predizem a escolha da carreira. TIPO DE ESTUDO E LOCAL: Estudo de coorte realizado em duas faculdades de medicina. MÉTODOS: Depois de terem completado um curso de Cuidados Primários na Faculdade de Medicina de Albacete, em 2005-2006, 81 alunos do segundo ano foram convidados a responder a um questionário. No seu sexto ano (2009-2010), 79 estudantes de Albacete assim como 42 de Sevilha, tomados como coorte não exposta, foram convidados a responder também. Todos eles foram investigados sobre a escolha da especialidade em 2011. RESULTADOS: Em Albacete, 79 e 76 estudantes responderam no segundo e sexto anos, respectivamente, e 26 em Sevilha. Depois de terem concluído o curso de cuidados primários, 69,3% disseram que gostariam de se tornar médicos de família. Esta percentagem diminuiu para 40,3% no final da graduação (P < 0,0001). No sexto ano, as atitudes com relação à MF pioraram, mas estas foram significativamente mais favoráveis do que as de Sevilla. Apenas 12 alunos escolheram a MF; eles obtiveram pontuação significativamente piores no exame do que seus pares (P < 0,0001). CONCLUSÃO: Na Faculdade de Medicina de Albacete, a opinião dos alunos sobre a MF ao longo da graduação piorou; contudo ainda era melhor que as dos estudantes de Sevilha. Em qualquer caso, MF foi opção minoritária.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Adulto Joven , Estudiantes de Medicina/estadística & datos numéricos , Selección de Profesión , Conocimientos, Actitudes y Práctica en Salud , Educación de Pregrado en Medicina , Medicina Familiar y Comunitaria/educación , Atención Primaria de Salud , Facultades de Medicina , España , Estudios de Cohortes , Estadísticas no Paramétricas , AutoinformeRESUMEN
BACKGROUND: Family Medicine (FM) is regarded as one of the specialities less interesting to those who choose for resident physicians (MIR) in Spain. Our objective is to know the priority given to the choice of FM in 2011 and 2013 MIR exams, and what factors might be associated with this choice. METHODS: We obtained information on the website of the Ministry of Health for the graduates who could choose a speciality (11552 y 9182). The variables analyzed were: number obtained in the opposition, sex, speciality chosen, chosen city, medical school where they studied (for 117 and 155 students of a previous cohort study). We calculated the probability of choice of FM in relation to the order number in the exam and the other variables (Kaplan-Meier). RESULTS: 1963 and 1772 chose FM, respectively in 2011 and 2013. The median of the order number to choose FM was 7894 (95%CI:7720-8068) and 6561 (95%CI:6442-6680). There were gender differences, as women chose FM with fewer number and a higher proportion (p<0.00001). CONCLUSIONS: Graduates enrolled in the MIR exam have not special preference for FM. Women show a greater interest in this speciality.
Introducción: la Medicina Familiar (MF) está considerada entre las especialidades que menos interesan a quienes optan por ser médicos internos residentes (MIR) en España. Nuestro objetivo es describir la prioridad concedida a la elección de MF en las convocatorias MIR 2011 y 2013, y qué factores podrían estar asociados con esta elección. Métodos: de la web del Ministerio de Sanidad de España se obtuvo información de los opositores que optaron a plaza (11552 y 9182). Las variables analizadas han sido: número obtenido en la oposición, sexo, especialidad elegida, ciudad elegida, facultad donde estudiaron (para 117 y 155 en un estudio de cohorte previo). Se calculó la probabilidad de elección de MF en relación con el número de orden en la oposición y otras variables (Kaplan-Meier). Resultados: la MF fue elegida por 1963 y 1772, respectivamente en 2011 y 2013. La mediana del número en la oposición para elegir MF fue 7894 (IC 95 % 7720-8068) y 6561 (IC 95 % 6442-6680). Existían diferencias por sexo: las mujeres elegían MF con menor número y en mayor proporción (p < 0.00001). Conclusiones: los opositores MIR no tienen una especial preferencia por la MF. Las mujeres muestran un mayor interés por esta especialidad.
Asunto(s)
Selección de Profesión , Medicina Familiar y Comunitaria/educación , Internado y Residencia/estadística & datos numéricos , Especialización/estadística & datos numéricos , Medicina Familiar y Comunitaria/estadística & datos numéricos , Femenino , Humanos , Masculino , EspañaRESUMEN
River water is a small percentage of the total freshwater on Earth but represents an essential resource for mankind. Microbes in rivers perform essential ecosystem roles including the mineralization of significant quantities of organic matter originating from terrestrial habitats. The Amazon river in particular is famous for its size and importance in the mobilization of both water and carbon out of its enormous basin. Here we present the first metagenomic study on the microbiota of this river. It presents many features in common with the other freshwater metagenome available (Lake Gatun in Panama) and much less similarity with marine samples. Among the microbial taxa found, the cosmopolitan freshwater acI lineage of the actinobacteria was clearly dominant. Group I Crenarchaea and the freshwater sister group of the marine SAR11 clade, LD12, were found alongside more exclusive and well known freshwater taxa such as Polynucleobacter. A metabolism-centric analysis revealed a disproportionate representation of pathways involved in heterotrophic carbon processing, as compared to those found in marine samples. In particular, these river microbes appear to be specialized in taking up and mineralizing allochthonous carbon derived from plant material.