Profiling medical specialties and informing aspiring physicians: a data-driven approach.

A detailed, unbiased perspective of the inter-relations among medical fields could help students make informed decisions on their future career plans. Using a data-driven approach, the inter-relations among different medical fields were decomposed and clustered based on the similarity of their working environments.Publicly available, aggregate databases were merged into a single rich dataset containing demographic, working environment and remuneration information for physicians across Canada. These data were collected from the Canadian Institute for Health Information, the Canadian Medical Association, and the Institute for Clinical Evaluative Sciences, primarily from 2018 to 2019. The merged dataset includes 25 unique medical specialties, each with 36 indicator variables. Latent Profile Analysis (LPA) was used to group specialties into distinct clusters based on relatedness.The 25 medical specialties were decomposed into seven clusters (latent variables) that were chosen based on the Bayesian Information Criterion. The Kruskal-Wallis test identified eight indicator variables that significantly differed between the seven profiles. These variables included income, work settings and payment styles. Variables that did not significantly vary between profiles included demographics, professional satisfaction, and work-life balance satisfaction.The 25 analyzed medical specialties were grouped in an unsupervised manner into seven profiles via LPA. These profiles correspond to expected and meaningful groups of specialties that share a common theme and set of indicator variables (e.g. procedurally-focused, clinic-based practice). These profiles can help aspiring physicians narrow down and guide specialty choice.

Virtual breakout rooms: an effective approach to offer guidance to medical students on residency applications.

Peer mentorship on residency applications has been difficult due to recent public health measures, prompting a shift from in-person events to virtual platforms. To address gaps in career exploration, we created a virtual, non-recorded space that allowed medical students and residents to discuss the Canadian Resident Matching Service (CaRMS) process meaningfully and transparently. Attendees reported a greater understanding of the match process and reduced anxiety after the event. This model provides a virtual framework that can be adapted for various mentorship opportunities.

Le mentorat par les pairs offert aux étudiants concernant les demandes de résidence a été difficile à mettre en œuvre en raison des récentes mesures de santé publique, entraînant le transfert des activités en personne vers les plateformes virtuelles. Pour combler les lacunes dans l'exploration des carrières, nous avons créé un espace virtuel, sans enregistrement, qui a permis aux étudiants et aux résidents de discuter du processus du Service canadien de jumelage des résidents (CaRMS) de manière approfondie et transparente. Les participants ont indiqué qu'à la suite de la rencontre, ils comprenaient mieux le processus de jumelage et qu'ils étaient moins anxieux. Ce modèle virtuel peut être adapté et utilisé pour diverses activités de mentorat.

Engaging medical trainees in resource stewardship through resident-led teaching sessions: a choosing wisely educational initiative.

Implication Statement Overuse of healthcare resources is prevalent, including among medical trainees. As front-line clinicians and near-peers, residents are well-positioned to teach resource stewardship to medical students and address barriers students may face while trying to "choose wisely." We describe the implementation of two resident-led, case-based teaching sessions for medical students that focus on resource stewardship. Similar teaching models can be adapted by residents at their own institutions to enhance resource stewardship proficiency amongst trainees.

L'utilisation excessive des ressources en soins de santé est fréquente, y compris parmi les étudiants en médecine. En tant que cliniciens de première ligne et quasi-pairs des étudiants en médecine, les résidents sont bien placés pour leur enseigner la gestion des ressources et pour les aider à surmonter les obstacles à « choisir avec soin ¼. Nous décrivons la mise en œuvre de deux sessions d'enseignement animées par des résidents fondées sur l'étude de cas et axées sur la gestion des ressources. Des modèles d'enseignement similaires peuvent être adaptés par les résidents dans leurs institutions respectives afin d'améliorer les compétences des étudiants en matière de gestion des ressources.

Career decision making in undergraduate medical education.

BACKGROUND: It is unclear how medical students prioritize different factors when selecting a specialty. With rising under and unemployment rates a novel approach to career counselling is becoming increasingly important. A better understanding of specialty selection could lead to improved career satisfaction amongst graduates while also meeting the health care needs of Canadians. METHODS: Medical students from the University of Toronto participated in a two-phase study looking at factors impacting specialty selection. Phase I consisted of focus groups, conducted independently for each year, and Phase II was a 21-question electronic survey sent to all students. RESULTS: Twenty-one students participated in the focus group phase and 95 in the survey phase. Primary themes related to career selection identified in Phase I in order of frequency included personal life factors (36), professional life factors (36), passion/interest (20), changing interests (19) and hidden curriculum (15). The survey phase had similar results with passion (83), lifestyle (79), flexibility (75), employment opportunities (60) and family (50) being ranked as the factors most important in specialty selection. CONCLUSION: Personal factors, professional factors and passion/interest may be key themes for medical students when deciding which specialty to pursue. Targeting career counselling around these areas may be important.

CONTEXTE: On ne comprend pas bien comment les étudiants en médecine priorisent différents facteurs au moment de choisir une spécialité. Étant donné la hausse des taux de sous-emploi et de chômage, il devient de plus en plus important d'adopter une nouvelle approche d'orientation professionnelle. Une meilleure compréhension choix d'une spécialité pourrait accroître le niveau de satisfaction des diplômés en ce qui a trait à leur choix de carrière tout en satisfaisant aussi les besoins en soins de santé des Canadiens et Canadiennes. MÉTHODES: Les étudiants en médecine de l'Université de Toronto ont participé à une recherche comportant deux phases examinant les facteurs influençant le choix d'une spécialité. La Phase I comportait des groupes de discussion dirigés indépendamment pour chaque cohorte tandis que la Phase II consistait en un sondage électronique de 21 questions transmis à tous les étudiants. RÉSULTATS: Vingt et un étudiants ont participé à la phase des groupes de discussion et 95 à la phase du sondage. Les principaux thèmes liés au choix de carrière qui ont été identifiés durant la Phase I sont les suivants (en ordre de fréquence) : les facteurs de vie personnelle (36), les facteurs de vie professionnelle (36), la passion/l'intérêt (20), les champs d'intérêt changeants (19) et le curriculum caché (15). La phase de sondage a donné des résultats semblables. La passion (83), le style de vie (79), la souplesse (75), les possibilités d'emploi (60) et la famille (50) se sont révélés comme étant les facteurs les plus importants dans le choix d'une spécialité.Conclusion :Les facteurs personnels, les facteurs professionnels et la passion/l'intérêt pourraient être les principaux thèmes que partagent les étudiants en médecine au moment de décider à quelle spécialité ils aspirent. Il semble important de cibler les démarches d'orientation professionnelle sur ces thèmes.

Intermittent versus continuous oxygen saturation monitoring for infants hospitalised with bronchiolitis: study protocol for a pragmatic randomised controlled trial.

INTRODUCTION: Bronchiolitis is the most common reason for hospitalisation in infants in developed countries. The main focus of hospital care is on supportive care, such as monitoring for hypoxia and supplemental oxygen administration, as active therapies lack effectiveness. Pulse oximetry is used to monitor hypoxia in hospitalised infants and is used either intermittently or continuously. Observational studies have suggested that continuous pulse oximetry use leads to a longer length of hospital stay in stable infants. The use of continuous pulse oximetry may lead to unnecessary clinical intervention due to readings that are of little clinical significance, false-positive readings and less reliance on the clinical status. There is a lack of high-quality evidence to guide which pulse oximetry monitoring strategy, intermittent or continuous, is superior in infants hospitalised with bronchiolitis with respect to patient and policy-relevant outcomes. METHODS AND ANALYSIS: This is a multicentre, pragmatic randomised controlled trial comparing two strategies for pulse oximetry monitoring in infants hospitalised for bronchiolitis. Infants aged 1 month to 2 years presenting to Canadian tertiary and community hospitals will be randomised after stabilisation to receive either intermittent or continuous oxygen saturation monitoring on the inpatient unit until discharge. The primary outcome is length of hospital stay. Secondary outcomes include additional measures of effectiveness, acceptability, safety and cost. We will need to enrol 210 infants in order to detect a 12-hour difference in length of stay with a type 1 error rate of 5% and a power of 90%. ETHICS AND DISSEMINATION: Research ethics approval has been obtained for this trial. This trial will provide data to guide hospitals and clinicians on the optimal pulse oximetry monitoring strategy in infants hospitalised with bronchiolitis. We will disseminate the findings of this study through peer-reviewed publication, professional societies and meetings. TRIAL REGISTRATION NUMBER: NCT02947204.