[Career choice of ivorian medical students at the end of curriculum: influencing factors and aspirations]. / Choix de carrière des étudiants en médecine ivoiriens en fin de cursus : facteurs d'influence et aspirations.

Introduction: The implantation of health structures in Côte d'Ivoire to improve geographical accessibility to care remains unequal between rural and urban areas. The medical student has to decide on his or her career choice in this context, while also taking into account personal preferences. The aim of our study was to evaluate the factors influencing the speciality choice of medical students at the faculty of medicine of Félix Houphouët-Boigny University in Abidjan. Methodology: Medical students enrolled in the 6th year completed an anonymous self-administered questionnaire. The questionnaire was in paper format and was divided into three parts: socio-demographic criteria; speciality choice; and factors influencing career choice. Students were asked to rate the extent to which they perceived each of the 24 items as influencing their career choice using a Likert scale ranging from 1 (no influence) to 5 (strong influence). The factors were compared according to the speciality choice (medical or surgical). Results: The 3 most chosen specialties were: cardiology (17.9%), gynaecology-obstetrics (15.7%) and paediatrics (9.6%). The desire to take the internship competition was more frequent among students who chose a surgical speciality (p = 0.02). The choice of a medical speciality was more influenced by the willingness to work part-time (p = 0.04). Students who choose a medical speciality were more guided by social commitment than those who chose a surgical speciality (p = 0.04). In contrast, the latter were more influenced by prestige among colleagues (p = 0.04) and immediate postoperative outcomes (p = 0.01). Conclusion: The efficient equipment of health structures could contribute to the development of other less chosen specialities by making them more attractive. A reorganisation of the system with the deployment of teachers in regional hospitals with a minimum of equipment is indispensable in order to allow a "decentralization" of the specialization curriculum, especially for the surgical specialties.As for the aspiration to part-time work, it can be explained by the need to reconcile family and professional life, but also by a sometimes unspoken project to develop a lucrative extra-medical activity in order to make up insufficient wages.

[Mistreatment of students and associated factors in the Faculty of Medicine of Parakou in 2018]. / Maltraitance des étudiants et facteurs associés à la Faculté de Médecine de Parakou en 2018.

INTRODUCTION: Several studies around the world have shown a significant increase in student mistreatments in the Faculty of Medicine. The purpose of our study was to analyze student mistreatments and associated factors in the Faculty of Medicine of the University of Parakou (FM/UP) in 2018. METHODS: We conducted a cross-sectional, descriptive and analytical survey among the students of the Faculty of Medicine of the University of Parakou from 1st to 28 February 2018. Participants were second-year medical students (PCEM2), fourth-year medical students (DCEM2) and sixth-year medical students (DCEM4) attending the academic year 2017-2018 and who had freely given their informed consent to participate in the study. RESULTS: One hundred percent of students of the FM/UP had experienced mistreatment at least once. Students had frequently experienced mistreatment in 34.34% of cases. Humiliation, verbal violence and instigation to personal services were the most common types of violence. However, approximately 10% of students had experienced sexual harassment. Perpetrators of mistreatments were doctors/teachers, nurses and interns. Female students were three times more sexually harassed than their colleagues of the opposite sex (p=0.0069). The older the students were and enrolled in the second-year of the Faculty of Medicine, the more they experienced humiliation (p=0.0001 for age and p<0.0001 for education) and verbal violence (p=0.0007 for age and p<0.0001 for education). CONCLUSION: This study highlights that all the students of the FM/UP have experienced mistreatment at least once after enrolment in the university. Based on this study, university officials should implement communication strategies to change the abusive behavior of teachers and supervisors. A register of complaints would also be useful in reducing this phenomenon.

[Chronic kidney disease: do generalists and nephrologists differ in their care?]. / Insuffisance rénale chronique: connaissances et perception par les médecins généralistes.

INTRODUCTION: Chronic kidney disease (CKD) is a major public health problem. We report an evaluation of the CKD perception from a French family physician's (FP) point of view. METHODS: A questionnaire was sent to a representative and independently selected sample of 497 FP, i.e. 20% of the FP working in the administrative region Lorraine. There were 214 completed surveys, i.e. response rate: 43%. RESULTS: Age of FP was: < 40 years of age: 13%, 40-50: 40%, > 50: 47%. The geographic working place was urban: 41%, rural: 22%, urban and rural: 37%. Ninety-nine per cent of FP has a nephrologist, devoted to CKD referral. Twenty-one per cent of FP has a comprehensive picture of CKD and 75% thinks that CKD diagnostic is difficult Thirty per cent of FP were aware of CKD guidelines. For FP, risk-factors for CKD were: hypertension: 93%, diabetes: 99%, age over 65: 64%, urinary infection: 34%, hematuria/proteinuria: 78%, anaemia: 43%, therapeutics associated with risk of renal injury: 79%, all of these circumstances: 20%. The referral decision to a nephrologist was done at a mean creatinine clearance of 41+/-12 ml/min. Age over 80, dementia, and cancer were considered to be a contra-indication of renal replacement therapy, for respectively 30%, 69%, and 63% of FP. CME was associated with better awareness of guidelines, and use of clearance rather than serum creatinin. CONCLUSION: From FP point of view, overall awareness of CKD guidelines is low. In the context of the current nephrology services, greater sharing of CKD care with FP is needed.