Components of effective letters of recommendation: A cross-sectional survey of academic faculty.

INTRODUCTION: Conventional merit-based criteria, including standardized test scores and grade point averages, have become less available to residency programs to help distinguish applicants, making other components of the application, including letters of recommendation (LORs), important surrogate markers for performance. Despite their impact on applications, there is limited published data on LORs in the international setting. METHODS: A cross-sectional survey of academic faculty was conducted between 9 January 2023 and 12 March 2023 at two large academic medical centers in the United Arab Emirates. Descriptive statistics were used to tabulate variable frequencies. RESULTS: Of the 98 respondents, the majority were male (n = 67; 68.4%), Western-trained (n = 66; 67.3%), mid-career physicians (n = 46; 46.9%). Most respondents (n = 77; 78.6%) believed that the purpose of an LOR was to help an applicant match into their desired program. Letters rarely included important skills, such as leadership (n = 37; 37.8%), applicant involvement in research (n = 43; 43.9%), education (n = 38; 38.8%), or patient advocacy (n = 30; 30.6%). Most faculty (n = 81; 82.7%) were not familiar with standardized letters of recommendation. Only 7.3% (n = 7) of respondents previously received training in writing LORs, but 87.7% (n = 86) expressed an interest in this professional development opportunity. CONCLUSION: There is variability in perceptions and practices related to LOR writing in our international setting, with several areas for improvement. Given the increasing importance of LORs to a candidate's application, faculty development is necessary.

Medical Resident Awareness of Predatory Journal Practices in an International Medical Education System.

INTRODUCTION: Learning research methodology is increasingly becoming an essential part of graduate medical education worldwide, with many regulatory and accreditation bodies requiring residents to participate in scholarship. Research methodology workshops have become a standard part of medical curricula; however, there is limited data on how much training on journal selection and the publication process trainees receive. The alarming growth of predatory journals has made it increasingly difficult for researchers, especially trainees and early career physicians, to distinguish these publications from reputable journals. The purpose of this study is to assess the knowledge of reputable and predatory publishing practices amongst medical trainees in an international medical education setting in the United Arab Emirates. METHODS: A survey on credible journal practices based on the 'Think. Check. Submit' initiative was sent to all graduate medical education trainees at two large academic medical centers in Abu Dhabi, United Arab Emirates. Descriptive statistics were used to tabulate variable frequencies. RESULTS: Over half of the 160 respondents reported receiving prior research methodology training and 42.5% had at least one publication. The majority of the trainees selected impact factor and the quality of the peer-review process as characteristics of reputable journals. Ambiguous editorial board and rapid publication process were recognized as characteristics of predatory journals by >65% of trainees, however, 95% of all trainees were unaware of Beall's list or other resources to help select a journal for publication. 15.2% of trainees who received unsolicited emails from publishers submitted their manuscripts to the unfamiliar journals, citing peer recommendation and pressure to publish from their training programs as reasons. CONCLUSION: Trainees in the United Arab Emirates were mostly unaware of reputable publication practices and are vulnerable to publishing in predatory journals. Policy and educational reform are necessary to maintain the credibility and integrity of the scientific process.

Post-infectious and post-acute sequelae of critically ill adults with COVID-19.

BACKGROUND: Data on the post-acute and post-infectious complications of patients who have recovered from severe coronavirus disease 2019 (COVID-19) are limited. While studies report that approximately 5-15% of COVID-19 hospitalized patients require intensive care and mechanical ventilation, a substantially higher number need non-invasive ventilation and are subject to prolonged hospitalizations, with long periods of immobility and isolation. The purpose of this study is to describe the post-infectious sequelae of severe viral illness and the post-acute complications of intensive care treatments in critically ill patients who have recovered from severe COVID-19 infection. METHODS: We performed a retrospective chart review of adult patients initially hospitalized with confirmed COVID-19 infection, who recovered and were transferred to a general medical ward or discharged home between March 15, 2020 and May 15, 2020, dates inclusive, after an intensive care unit (ICU) or high dependency unit (HDU) admission in a designated COVID-19 hospital in the United Arab Emirates. Demographic data, underlying comorbidities, treatment, complications, and outcomes were collected. Descriptive statistical analyses were performed. RESULTS: Of 71 patients transferred out of ICU (n = 38, 54%) and HDU (n = 33, 46%), mean age was 48 years (SD, 9.95); 96% men; 54% under age 50. Mean ICU stay was 12.4 days (SD, 5.29), HDU stay was 13.4 days (SD, 4.53). Pre-existing conditions were not significantly associated with developing post-acute complications (Odds Ratio [OR] 1.1, 95% confidence interval [CI] 0.41, 2.93, p = 1.00). Fifty nine percent of patients had complications; myopathy, swallowing impairments, and pressure ulcers were most common. Delirium and confusion were diagnosed in 18% (n = 13); all were admitted to the ICU and required mechanical ventilation. Of note, of all patients studied, 59.2% (n = 42/71) had at least 1 complication, 32.4% (n = 23) had at least 2 complications, and 19.7% (n = 14) suffered 3 or more sequelae. Complications were significantly more common in ICU patients (n = 33/38, 87%), compared to HDU patients (n = 9/33, 27%) (OR 17.6, 95% CI 5.23, 59.21, p <0.05). CONCLUSION: In a subset of critically ill patients who recovered from severe COVID-19 infection, there was considerable short-term post-infectious and post-acute disability. Long-term follow-up of COVID-19 survivors is warranted.