Time for a mandatory urology rotation? Adequacy of urological exposure during medical school - a survey of graduates of the University of the West Indies, Trinidad and Tobago.

INTRODUCTION: To objectively assess the self-reported adequacy and utility of exposure of our students to urology during their training. MATERIALS AND METHODS: A questionnaire was sent to the University of the West Indies graduating class of 2018, now functioning as medical interns. A questionnaire was designed to collect information regarding respondent demographics, perceptions of their urology exposure during their medical school training as well as their attitudes towards the specialty. The survey was also designed to capture respondents' comfort levels with commonly encountered urological scenarios and investigations. The survey was distributed in February 2019 using the online survey tool, Survey Monkey. RESULTS: A total of 196 surveys were distributed, of which 107 responses were returned. Clinic exposure was the most common form of interaction with the specialty during training. Their exposure to common urological procedures was low with only 9.3% and 4.7% having seen a circumcision or prostate biopsy respectively by graduation; 21.7% and 47.7% indicated that they were uncomfortable to review a KUB X-ray and CT respectively to identify a stone; 96.2% considered urology to be an important clinical sub-specialty but 42.4% indicated that their exposure to urology did not prepare them to manage urological conditions that they have encountered since graduation; 87.8% of respondents supported the idea of a urology rotation. CONCLUSION: The exposure of medical students to urology during their medical training is poor. There remains much room for improvement in exposing our medical students to urology during their training. A dedicated urology rotation should be strongly considered. This study has applications not just within the Caribbean, but further afield.

The association between indices of obesity and common clinical measures in adults with and without type 2 diabetes

OBJECTIVE: To determine if there are any differences in anthropometric measurements, lipid profile, blood pressure and body shape between diabetics and non-diabetics. DESIGN AND METHODS: This cross-sectional study comprised 309 subjects with 91 males and 218 females; there were 217 diabetics and 92 non-diabetics. The sample was taken from three hospitals in Trinidad. Lipid profile and blood pressure were taken from each facility’s physicians’ notes while anthropometric measurements were taken from the patients themselves. RESULTS: The diabetic group had elevated body mass index, and waist to hip ratios were significantly higher (p<0.05) when compared to non-diabetics. There was no significant difference in lipid profile and blood pressure between diabetics and non-diabetics. As age increased, the prevalence of type 2 diabetes mellitus was higher. Of the 217 diabetics, 173 were of East Indian descent. With regards to gender, more males were found to be diabetics resulting from having an android body shape as compared to females (gynoid body shape). It was deduced that waist to hip ratio was the best indicator of type 2 diabetes mellitus based on the area under the curve analysis. CONCLUSION: Of all the anthropometric measurements used, waist to hip ratio was found to be the most effective indicator of type 2 diabetes mellitus in Trinidadians, while body mass index was found to be the least.