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1.
Phys Med ; 125: 104499, 2024 Aug 12.
Article in English | MEDLINE | ID: mdl-39137616

ABSTRACT

To ensure the continued advancement of the medical physics profession, the European Federation of Organisations for Medical Physics (EFOMP) has designed a mentorship programme. This programme aims to support Early Career Medical Physicists by providing them with the guidance needed for both professional and personal development to meet the continually evolving demands of the medical physics field within their working environments. The EFOMP mentorship programme is an important step forward in supporting the next generation of medical physicists. This article provides an overview of the history, framework, goals, and implementation strategy of this programme. The programme will have two main orientations: mentoring, which will help mentees to improve their scientific, professional and soft skills, and enabling, which aims to prepare a sufficient number of early career professionals to get involved within EFOMP's activities, join the EFOMP structures and represent the European Medical Physics community to National and International Organisations. Each year a survey from mentors and mentees will be conducted and analysed by the European and International Matters Committee and the Early Career Special Interest Group to identify areas for improvement and to evaluate the degree of satisfaction and achievements of the participants. By providing structured mentoring, fostering professional development, and promoting sustainability, EFOMP aims to ensure that early career medical physicists are well-prepared to meet the challenges of the future and continue to advance the field of medical physics as a community.

2.
Article in English | MEDLINE | ID: mdl-39120653

ABSTRACT

PURPOSE: European training pathways for surgeons dedicated to treating severely injured and critically ill surgical patients lack a standardized approach and are significantly influenced by diverse organizational and cultural backgrounds. This variation extends into the realm of mentorship, a vital component for the holistic development of surgeons beyond mere technical proficiency. Currently, a comprehensive understanding of the mentorship landscape within the European trauma care (visceral or skeletal) and emergency general surgery (EGS) communities is lacking. This study aims to identify within the current mentorship environment prevalent practices, discern existing gaps, and propose structured interventions to enhance mentorship quality and accessibility led by the European Society for Trauma and Emergency Surgery (ESTES). METHODS: Utilizing a structured survey conceived and promoted by the Young section of the European Society of Trauma and Emergency Surgery (yESTES), we collected and analyzed responses from 123 ESTES members (both surgeons in practice and in training) across 20 European countries. The survey focused on mentorship experiences, challenges faced by early-career and female surgeons, the integration of non-technical skills (NTS) in mentorship, and the perceived role of surgical societies in facilitating mentorship. RESULTS: Findings highlighted a substantial mentorship experience gap, with 74% of respondents engaging in mostly informal mentorship, predominantly centered on surgical training. Notably, mentorship among early-career surgeons and trainees was less reported, uncovering a significant early-career gap. Female surgeons, representing a minority within respondents, reported a disproportionately poorer access to mentorship. Moreover, while respondents recognized the importance of NTS, these were inadequately addressed in current mentorship practices. The current mentorship input of surgical societies, like ESTES, is viewed as insufficient, with a call for structured programs and initiatives such as traveling fellowships and remote mentoring. CONCLUSIONS: Our survey underscores critical gaps in the current mentorship landscape for trauma and EGS in Europe, particularly for early-career and female surgeons. A clear need exists for more formalized, inclusive mentorship programs that adequately cover both technical and non-technical skills. ESTES could play a pivotal role in addressing these gaps through structured interventions, fostering a more supportive, inclusive, and well-rounded surgical community.

3.
Anat Sci Educ ; 2024 Aug 01.
Article in English | MEDLINE | ID: mdl-39090772

ABSTRACT

Case-based learning (CBL) is a student-centered pedagogy where medical students are given a real-world clinical problem. At St George's University of London (SGUL), anatomy academics can volunteer to facilitate CBL sessions for pre-clinical undergraduate medical students. The major benefits of facilitating CBL sessions from the perspective of a non-medically qualified early career anatomy academic (ECAA) include exposure to clinical cases that help the academic develop an understanding over key clinical cases at the context of clinical anatomy and other disciplines including physiology, pathology, and pharmacology. Furthermore, facilitating CBL sessions assists in the acquisition of basic knowledge over history taking, the conduction of clinical examinations, the investigations performed for the diagnosis of a condition as well as how it is managed. The major benefits of facilitating CBL sessions from the perspective of a medically qualified ECAA include staying in touch with the clinical aspect of medicine and becoming familiar with the country's healthcare system and its professional standards. Perceived benefits shared by both the non-medically and medically qualified ECAA include the opportunity to become familiar with the structure and key elements of the pre-clinical medical curriculum as well as gain experience in facilitating small group teaching sessions. Overall, facilitating CBL sessions can help non-medically and medically qualified ECAAs in different contexts that may help them with their individual career goals, can encourage collaborative discussions between clinical and non-clinical anatomy academics as well as help bridge the gap between the anatomy teaching approaches employed by non-medically qualified and medically qualified anatomy academics.

4.
Chron Mentor Coach ; 8(1): 169-177, 2024 Jun.
Article in English | MEDLINE | ID: mdl-39119330

ABSTRACT

The National Academies of Science stresses the importance of research mentoring. We assessed the internal consistency and application of a novel 33 item mentor evaluation survey and explored differences across subgroups. The survey was administered annually to mentees. The response rate was 17.8% for a sample of 710 respondents. The survey exhibited strong internal validity with Cronbach Alpha > 0.89 for each subscale. Overall scores across the three domains were high. Basic Science trainees scored their mentor significantly lower than those in Translational or Clinical Science across domains (0.11-0.25 points). Underrepresented Racial Ethnic Groups (UREG) trainee scores were significantly lower in academic guidance and personal communication. Women had lower scores in 4 out of 5 domains. The survey is a modified instrument to assess mentee experience, although further validation against mentee outcomes is needed.

5.
Arthroplast Today ; 29: 101416, 2024 Oct.
Article in English | MEDLINE | ID: mdl-39206054

ABSTRACT

Background: There is a paucity of data regarding compensation for early-career adult reconstruction surgeons. This study aims to quantify the time throughout the full episode of care for a Medicare primary total hip/knee arthroplasty and convert to per-hour pay for early-career arthroplasty surgeons at various geographic locations and practice settings. Using Center for Medicare and Medicaid Services data, this study also compares the compensation of early-career vs established total joint arthroplasty (TJA) surgeons. Methods: Between January 2022 and January 2023, 3 early-career surgeons in 3 different locations collected prospective data on time spent in patient care during the global period following primary TJAs (pTJAs). A weighted average time spent per pTJA during global period was calculated with the 2024 work relative value unit and conversion factor to establish a per-hour rate. This rate was compared to the compensation rates of other healthcare-related fields and established TJA surgeons using Relative Value Scale Update Committee (RUC) values. Results: A total of 334 pTJAs (148 hips and 186 knees) were performed among 3 surgeons, and per-hour rates of $87.62 and $87.70 were found, respectively. These are less than hospital/healthcare system/health insurance/med tech CEOs, lawyers, dentists, and travel nurses. Early-career TJA surgeons were found to take 7.98%-8.68% longer than RUC standard times for a TJA episode of care. Conclusions: This study quantifies the per-hour compensation of early-career arthroplasty surgeons, who earn lower compensation rates to travel nurses and take longer than Center for Medicare and Medicaid Services RUC times for pTJAs. Given the increasing demand for pTJAs, decreasing reimbursement rates, and concern over burnout, access to quality pTJA care for patients is concerning.

6.
Astrobiology ; 24(7): 754-763, 2024 Jul.
Article in English | MEDLINE | ID: mdl-39023354

ABSTRACT

To support training and foster retention in the emerging field of astrobiology, NASA has funded opportunities for graduate students and early career scientists to develop a community, foster interdisciplinarity, increase confidence, and showcase career options. The design of these opportunities builds on research on factors that increase retention, including feeling competent, having autonomy and a sense of purpose, having a sense of identity, and being connected to others in the field. Findings are reported from retrospective studies of two NASA career-building opportunities, the Astrobiology Graduate Conference and the International Astrobiology Summer School held in Santander, Spain. We present evidence that attendees gain confidence by presenting to, and working with, their peers, and feel competent to express their ideas and interests and build relationships in the field that continue after the experiences. Many say that they feel less isolated and go on to present or publish with colleagues they meet. Their career options also expand by meeting potential colleagues from different disciplines. Based on the findings, participating in either of these long-running programs shows clear positive impact on early career astrobiology professionals.


Subject(s)
Career Choice , Exobiology , Exobiology/education , United States , United States National Aeronautics and Space Administration , Humans
7.
Psychol Health ; : 1-23, 2024 Jun 30.
Article in English | MEDLINE | ID: mdl-38946146

ABSTRACT

Early career professionals (ECPs) are a critical target for physical activity (PA) promotion. Affect contributes to an established PA intention-behaviour gap and is pertinent among ECPs. OBJECTIVE: The purpose of this study was to examine the feasibility and acceptability of a web-based intervention and explore the effects on secondary outcomes (moderate-to-vigorous PA (MVPA), emotion regulation, multi-process action control constructs). METHODS: Adults aged 25-44 who were employed at least part-time in a desk-based job and not meeting PA guidelines (<150 min MVPA) were recruited and randomized into a 6-week online intervention integrating acceptance and commitment principles and affect regulation strategies, or a control group. RESULTS: Forty adults were recruited and randomized to the web-based intervention (n = 21) and waitlist control (n = 19). The recruitment rate was 29%, retention was 75%, engagement was 68%, and satisfaction was high in both quantitative and qualitative assessment. Participants allocated to the intervention improved MVPA (ηp2=0.30), emotion regulation (ηp2 =0.49), behavioural regulation (ηp2=0.53), affective attitude (ηp2=0.23), identity (ηp2=0.24), and constructs of mindfulness (ηp2=0.44), and valued living (ηp2=0.20). CONCLUSIONS: Primary outcomes concerning feasibility were adequate and secondary outcomes improved, suggesting a full-scale randomized controlled trial is feasible with minor modifications. A large-scale study is warranted to establish intervention effectiveness.

8.
Angew Chem Int Ed Engl ; 63(35): e202319892, 2024 Aug 26.
Article in English | MEDLINE | ID: mdl-39046086

ABSTRACT

The concepts of sustainability and sustainable chemistry have attracted increasing attention in recent years, being of great importance to the younger generation. In this Viewpoint Article, we share how early-career chemists can contribute to the sustainable transformation of their discipline. We identify ways in which they can engage to catalyse action for change. This article does not attempt to answer questions about the most promising or pressing areas driving research and chemical innovation in the context of sustainability. Instead, we want to inspire and engage early-career chemists in pursuing sustainable actions by showcasing opportunities in education, outreach and policymaking, research culture and publishing, while highlighting existing challenges and the complexity of the topic. We want to empower early-career chemists by providing resources and ideas for engagement for a sustainable future globally. While the article focuses on students and early-career chemists, it provides insights to further stimulate the engagement of scientists from diverse backgrounds.


Subject(s)
Chemistry , Humans , Chemistry/economics , Chemistry/education , Chemistry/trends , Sustainable Development
9.
Heart Rhythm ; 2024 Jul 23.
Article in English | MEDLINE | ID: mdl-39053751

ABSTRACT

BACKGROUND: The declining number of electrophysiologists pursuing academic research careers could have a negative impact on innovation for patients with heart rhythm disorders in the coming decades. OBJECTIVE: The objective of this study was to explore determinants of research engagement after graduation from electrophysiology (EP) fellowship programs and to evaluate associated barriers and opportunities. METHODS: A mixed methods survey of EP fellows and early-career electrophysiologists was conducted, drawing from Heart Rhythm Society members. The survey encompassed 20 questions on demographics, research involvement, perceived research barriers, and perspectives on research time and opportunities. Responses were analyzed with robust Poisson regression. RESULTS: Of 259 respondents, those with dedicated research blocks during their fellowship had a significantly higher interest in future research (relative risk, 1.15; P = .04). The number of peer-reviewed publications modestly influenced interest in continued research (relative risk, 1.0034 per publication; P < .0001), but there was no relationship to gender or race. Educational resources, networking opportunities, mentorship, funding, and protected time to enhance research engagement were important themes in the qualitative analysis, whereas key barriers to post-fellowship research were lack of mentorship, insufficient resources, and time constraints, in that order, particularly with respect to women in research. Notably, no significant differences in barriers were observed between community training programs and academic centers. CONCLUSION: Research experience and mentorship during EP fellowship were key determinants of subsequent research success after training, with similar findings by sex and race. These findings explain how fellowship training influences a physician's research practice after training and highlights opportunities to modify EP fellowships and to augment research retention.

12.
World J Biol Psychiatry ; 25(6): 342-351, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38905131

ABSTRACT

OBJECTIVES: This survey assessed psychiatry residents'/early-career psychiatrists' attitudes towards the utility of therapeutic drug monitoring (TDM) of antipsychotics. METHODS: A previously developed questionnaire on attitudes on TDM utility during antipsychotic treatment was cross-sectionally disseminated by national coordinators between 01/01/2022-31/12/2023. The frequency of using TDM for antipsychotics other than clozapine was the main outcome in a linear regression analysis, including sex, clinical setting, caseload, and factors generated by an exploratory factor analysis. Comparisons between residents and early-career psychiatrists, respondents working in in- and outpatient settings, and low-/middle- and high-income countries were performed. RESULTS: Altogether, 1,237 respondents completed the survey, with 37.9% having never used TDM for antipsychotics. Seven factors explained 41% of response variance; six of them were associated with frequency of TDM use (p < 0.05). Items with highest loadings for factors included clinical benefits of TDM (factors A and E: 0.7), negative expectations for beliefs of patients towards TDM (factor B: 0.6-0.7), weak TDM scientific evidence (factor C: 0.8), and TDM availability (factor D: -0.8). Respondents from low-/middle-income countries were less likely to frequently/almost always use TDM compared to high-income countries (9.4% vs. 21.5%, p < 0.001). DISCUSSION: TDM use for antipsychotics was poor and associated with limited knowledge and insufficient availability.


Subject(s)
Antipsychotic Agents , Attitude of Health Personnel , Drug Monitoring , Psychiatry , Humans , Antipsychotic Agents/therapeutic use , Female , Male , Cross-Sectional Studies , Surveys and Questionnaires , Adult , Internship and Residency , Europe , Practice Patterns, Physicians'/statistics & numerical data , Societies, Medical , Psychiatrists
13.
Women Birth ; 37(4): 101636, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38917646

ABSTRACT

PROBLEM: There is a lack of understanding of the experiences of early career midwives which lead to workforce attrition. BACKGROUND: In the Australian midwifery setting, workforce attrition in conjunction with the ageing profile of the workforce is of increasing concern. Midwives in the earliest stages of their career are most vulnerable to career attrition, however limited research specifically engages with this cohort. AIM: To understand the professional and social circumstances that led early career midwives to leave clinical practice, how their midwifery background influenced career trajectories, and what would compel them to return to clinical practice. METHODS: Semi-structured interviews were conducted with 11 early career midwives who had left the profession within 5 years of qualification. Transcripts underwent thematic analysis. FINDINGS: Three themes described early career midwives' experiences: transition to professional practice, an untenable workplace culture, mental health impacts of early clinical midwifery practice. Two further themes emerged about experiences post-midwifery careers: influence of midwifery on subsequent career, and conditions for re-entry. DISCUSSION: Challenges with transitioning to professional midwifery practice in conjunction with untenable workplace culture led to such deterioration in wellbeing that remaining within the profession became unfeasible for early career midwives. Desire to remain within health care was apparent, however re-entry to the profession was deemed by most to be out of the question. CONCLUSION: Early workforce retention strategies should be the focus of future workforce planning and policy. Larger scale inquiry foregrounding early career midwives is necessary to inform strategies for midwifery workforce retention in Australia.


Subject(s)
Career Choice , Interviews as Topic , Job Satisfaction , Midwifery , Nurse Midwives , Qualitative Research , Humans , Australia , Female , Adult , Nurse Midwives/psychology , Workplace/psychology , Personnel Turnover/statistics & numerical data , Pregnancy , Attitude of Health Personnel , Middle Aged , Career Mobility
14.
F1000Res ; 13: 324, 2024.
Article in English | MEDLINE | ID: mdl-38826614

ABSTRACT

Background: The crisis in research culture is well documented, covering issues such as a tendency for quantity over quality, unhealthy competitive environments, and assessment based on publications, journal prestige and funding. In response, research institutions need to assess their own practices to promote and advocate for change in the current research ecosystem. The purpose of the scoping review was to explore ' What does the evidence say about the 'problem' with 'poor' research culture, what are the benefits of 'good' research culture, and what does 'good' look like?' Aims: To examine the peer-reviewed and grey literature to explore the interplay between research culture, open research, career paths, recognition and rewards, and equality, diversity, and inclusion, as part of a larger programme of activity for a research institution. Methods: A scoping review was undertaken. Six databases were searched along with grey literature. Eligible literature had relevance to academic research institutions, addressed research culture, and were published between January 2017 to May 2022. Evidence was mapped and themed to specific categories. The search strategy, screening and analysis took place between April-May 2022. Results: 1666 titles and abstracts, and 924 full text articles were assessed for eligibility. Of these, 253 articles met the eligibility criteria for inclusion. A purposive sampling of relevant websites was drawn from to complement the review, resulting in 102 records included in the review. Key areas for consideration were identified across the four themes of job security, wellbeing and equality of opportunity, teamwork and interdisciplinary, and research quality and accountability. Conclusions: There are opportunities for research institutions to improve their own practice, however institutional solutions cannot act in isolation. Research institutions and research funders need to work together to build a more sustainable and inclusive research culture that is diverse in nature and supports individuals' well-being, career progression and performance.

15.
Alzheimers Dement ; 20(7): 4727-4736, 2024 07.
Article in English | MEDLINE | ID: mdl-38865429

ABSTRACT

INTRODUCTION: Despite representing an essential workforce, it is unclear how global policy efforts target early-career dementia researchers (ECDRs). Thus, this study aimed to provide an overview of policies through which ECDRs are considered and supported by dementia plans and organizations. METHODS: G20 member states were evaluated for their national dementia plan alongside policies of leading dementia organizations. Data targeting support for ECDRs were extracted and subject to content analysis using inductive coding. Findings were categorized and narratively synthesized. RESULTS: Only China, Denmark, England, Greece, Northern Ireland, Scotland, Spain, and the United States mentioned ECDRs in their national plan. Additionally, 17 countries formalized ECDR support via dementia organizations. Support efforts included research funding, dissemination and networking, career development, and research advice. DISCUSSION: Few nations formally recognized ECDRs in dementia plans or through dementia organizations. To facilitate equal prospects for ECDRs, top-down approaches are urged to enhance and align their efforts. HIGHLIGHTS: Few G20 countries (8/46) had national dementia plans for early-career researchers. Targeted support comes from government and nongovernmental dementia organizations. Support includes funding, training, advice, research dissemination, and networking. Inconsistent definitions and eligibility criteria are barriers to accessing support. Global coordination and top-down policy will aid early-career dementia researchers.


Subject(s)
Dementia , Research Personnel , Humans , Dementia/therapy , Biomedical Research , Health Policy
16.
JCPP Adv ; 4(2): e12235, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38827987

ABSTRACT

Meta-research, also known as "research on research" is a field of study that investigates the methods, reporting, reproducibility, evaluation, and incentives along the research continuum. Meta-research literacy is imperative to ensure high quality, transparent and reproducible primary data or meta-research products. In this commentary, we propose that early career researchers should be trained in meta-research as a foundation to develop a deeper understanding of the research process and ability to appraise the research literature and design high-quality original studies, irrespective of their chosen field of study. We discuss the importance of meta-research and open science from the perspective of an early career trainee, highlighting essential areas for growth and obstacles one may encounter.

17.
Res Involv Engagem ; 10(1): 57, 2024 Jun 10.
Article in English | MEDLINE | ID: mdl-38858792

ABSTRACT

BACKGROUND: Undertaking Patient and Public Involvement (PPI) when developing health and social care research grant applications is critical. However, researchers may not have any funding to undertake PPI when developing grants. In response, the National Institute for Health and Care Research- Research Design Service for Yorkshire and the Humber in the United Kingdom, provided Public Involvement Fund Awards of up to £600 to fund PPI activity when researchers were developing grant applications. Researchers provided post-activity reports about how they utilised the Public Involvement Fund. These reports were analysed with the aim of evaluating the usefulness of the Public Involvement Fund and to provide learning about supporting researchers to undertake PPI when developing grants. METHODS: The project was a qualitative document analysis of 55 reports. Initially a researcher coded four reports and three Public Contributors provided feedback. Researchers coded the remaining reports and identified key findings. A workshop was held with the three Public Contributors to develop the findings. RESULTS: Researchers accessing the Public Involvement Fund award were generally early career researchers or clinicians who did not have other sources of funding for pre-grant PPI input. Researchers felt the award was useful in enabling them to conduct PPI, which strengthened their grant applications. Some researchers found that the award limit of £600 and guidance encouraging expenditure within three months, made it difficult to undertake PPI throughout the full grant development process. Instead, the majority of researchers consulted Public Contributors on one or two occasions. Researchers struggled to recruit diverse members or run group sessions due to the time pressures of grant deadlines. Researchers wanted training on undertaking PPI alongside the financial support. CONCLUSIONS: Researchers, especially early career researchers found having a Public Involvement Fund award instrumental in enabling them to undertake PPI when developing grant applications. It would be beneficial for similar schemes to be widely available. Schemes need to provide sufficient funding to enable meaningful PPI and allow researchers to hold the award for long enough to facilitate involvement during the whole grant development process. Researchers continue to need training on undertaking PPI.


Undertaking Patient and Public Involvement (PPI) when developing health and social care research grant applications is important. This ensures that patients have a voice in deciding what topics are researched. However, researchers often do not have funding to undertake PPI when developing grants. In response, a regional research advice service in the United Kingdom established a small grant scheme (up to £600) to fund PPI activity. This was called the Public Involvement Fund (PIF). Researchers developing health and social care grant applications could apply. After spending the funding, researchers wrote reports to explain how they used the Public Involvement Fund and the challenges they faced. We analysed 55 reports submitted over a three-year period to understand researchers' experiences of the fund. Researchers found the funding critical in enabling them to undertake PPI. Many felt their grants were improved from consulting Public Contributors. For example, helping them to decide a topic, changing their research method or choosing a questionnaire. However, researchers sometimes struggled to recruit Public Contributors, particularly when the research was not about a specific health condition. Researchers wanted to be able to have the award for long enough to enable them to involve Public Contributors throughout the whole grant development process. Alongside funding, researchers also need specific training about undertaking PPI when developing grants. For example, how to recruit representative Public Contributors quickly. It is recommended that similar schemes to the PIF are available to enable researchers to fund PPI activities when developing grant applications.

18.
BMC Med Educ ; 24(1): 664, 2024 Jun 16.
Article in English | MEDLINE | ID: mdl-38880886

ABSTRACT

BACKGROUND: There is increasing demand for professional practice placement opportunities, supported by health professional educators, to enable future health workforce development. Early career health professionals performing the educator role is one strategy that can help meet this demand. However, there is a need to consider how best to prepare and support early career health professionals to become educators. This study aimed to explore the experiences and perspectives of early career occupational therapy clinical educators including their preparation and support needs. METHODS: Semi-structured interviews were completed with ten early career occupational therapists who had supervised their first or second student on a professional practice placement. The participants worked within an Australian tertiary hospital and health service in various clinical settings. Interviews were completed within six weeks of placement completion and lasted approximately one hour. They were recorded and transcribed verbatim and reflexive inductive thematic analysis was undertaken to identify key themes. RESULTS: Ten occupational therapists, who had been working for an average of two years and two months, consented to participate. Initially, participants expressed mixed emotions about taking on the clinical educator role. They then described their adjustment to the role responsibilities, challenges encountered, and the development of the educator-student relationship. Participants found that the experience of supervising a student enhanced their educator, clinical, and professional skills and confidence. The important support elements of tailored educator preparation, placement design, and timely access to relevant resources and experienced staff were identified. CONCLUSIONS: This study demonstrated how early career health professionals can possess desirable educator attributes, such as enthusiasm for taking on the role and cultivating collaborative learning relationships with their students. The experience of being an educator also presents a professional development opportunity for early career health professionals. Insights gained about the specific preparation and support needs of early career clinical educators warrant consideration by organisations and staff involved in the provision of student professional practice placements. Overall, this study's findings signify the importance of engaging and investing in early career health professionals to support student clinical education and to develop our current and future healthcare workforce.


Subject(s)
Qualitative Research , Humans , Australia , Female , Male , Adult , Occupational Therapists/psychology , Tertiary Care Centers , Occupational Therapy/education , Interviews as Topic
20.
Cureus ; 16(4): e57371, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38694641

ABSTRACT

BACKGROUND: The aims and ambitions of a surgeon in the early years of his professional career are to make a good reputation by providing excellent patient outcomes and avoiding complex and difficult surgeries. Revision lumbar spine surgeries (RLSSs) pose a significant challenge in terms of surgical management, as the moribund anatomy increases the risk of complications, adding to an unlikely outcome. OBJECTIVE: We conducted this study to determine the clinical indications and outcomes of RLSSs performed by an early career neurosurgeon. MATERIALS AND METHODS: This cross-sectional study was conducted after approval from the hospital's ethical committee, and data was collected in late December of 2022 and early January 2023, from retrospective records for a single early career neurosurgeon. A form was filled with each patient's data, such as age, gender, time since surgery, indication for surgery, operative findings, types of surgery performed, etc. All variables were noted for the patient and were further categorized, based on the clinical records, into many sub-categories. RESULTS: Almost 400 lumbar spine surgeries were performed by the surgeon, and about 45 (11.25%) were revision surgeries, and the full record was available for 42 surgeries. These patients' ages ranged from 22 to 70 years, and the mean age was about 46.74±13.29 SD. The common symptoms leading to revision surgeries were numbness and pain in 17 (40.5%) patients each; common per-operative findings were recurrent disc in eight patients (19%), infection in nine patients (21.4%), and fibrosis/adhesions in 16 (38.1%); most common surgeries performed were diskectomy in 11 (26.2%) and diskectomy plus release of adhesions in 12 (28.6%); complications occurred in 14 (33%), and good to excellent outcomes was recorded in 29 (69%) cases.  Conclusion: RLSSs are difficult compared to first-time lumbar spine surgeries, and the moribund anatomy predisposes to complications, and better shall be dealt with great care and, at the minimum, shall be embarked upon as a team.

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