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1.
Ann R Coll Surg Engl ; 102(1): 49-53, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31755741

RESUMO

INTRODUCTION: Testicular torsion treatment rests on the horns of a dilemma, with widespread national variation in whether the responsible surgical specialty is general surgery or urology, even in hospitals with both general surgery and urology emergency service assets. This study aimed to quantify higher surgical trainee operative experience and confidence in managing suspected testicular torsion in a single UK deanery (Wales). MATERIALS AND METHODS: Anonymised logbook data were obtained via the Intercollegiate Surgical Curriculum Programme version 10 using the head of school report function for all general surgery (n=53) and urology (n=15) higher surgical trainees, which were combined with the distribution of an electronic self-administered questionnaire. RESULTS: Median operative scrotal explorations recorded for all general surgery higher surgical trainees and senior general surgery higher surgical trainees (ST7+) was 7 (range 1-22) and 10 (range 1-22), compared with 21 (range 9-64, p=0.00104) and 24 (19-64, p<0.001) for urology higher surgical trainees. The questionnaire response rate was 64.6% (general surgery 31/50, urology 11/15). Confidence levels in assessing adult and paediatric patients were lower in general surgery when compared with urology higher surgical trainees: median adult confidence rate 7/10 compared with 9/10, and paediatric confidence rate 7/10 compared with 8/10 (p<0.001 and p=0.053, respectively). All higher surgical trainees preferred urology as the accountable hospital specialty when both assets were available. DISCUSSION AND CONCLUSION: General surgery higher surgical trainees receive less than 50% of the operative exposure of urology higher surgical trainees in emergency scrotal surgery, which has important implications for curriculum competence development and patient safety.


Assuntos
Cirurgia Geral/educação , Torção do Cordão Espermático/cirurgia , Urologia/educação , Adulto , Atitude do Pessoal de Saúde , Criança , Competência Clínica/normas , Educação de Pós-Graduação em Medicina/estatística & dados numéricos , Cirurgia Geral/estatística & dados numéricos , Hospitais de Ensino/estatística & dados numéricos , Humanos , Masculino , Pediatria/educação , Pediatria/estatística & dados numéricos , Inquéritos e Questionários , Urologistas/educação , Urologistas/normas , Urologia/estatística & dados numéricos , País de Gales
3.
BMC Med Educ ; 19(1): 247, 2019 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-31277625

RESUMO

BACKGROUND: In Australia, the number of medical graduates per year has increased at a greater rate than the increase in the number of specialist training places. Consequently, competition for training positions is intensifying. There is anecdotal evidence to suggest that medical graduates are acquiring additional qualifications to compete with their peers Stevenson 2017 ( https://insightplus.mja.com.au/2017/36/specialty-training-places-the-other-looming-crisis/ ). Our study investigates this phenomenon of additional credentialing and demonstrates the number and type of postgraduate and research qualifications obtained by specialists in training in Australia. This is the first study to assess the number and type of credentials acquired by registrars in each specialty and to provide insight into differences between specialities. METHODS: Information on specialists in training was obtained through the Medicine in Australia: Balancing Employment and Life (MABEL) survey conducted between 2008 and 2014. The number of any additional qualifications and specific PhD, Master's degree, postgraduate diploma/certificate and research degrees from medical school were assessed for each specialist training scheme in the database. RESULTS: Overall, 995 registrars representing 13 specialties were included. Just under a third (30.4%) completed a research-based degree during their medical degree and almost half (46.7%) of specialist registrars obtained further qualifications after completing medicine. A significantly higher proportion of ophthalmology (78.6%) and paediatric (67.5%) registrars, and a lower percentage of emergency medicine (36.7%) registrars, held postgraduate qualifications. Overall, 2.4% of registrars held a PhD and 10.1% held a Master's degree. A higher percentage of either PhD or Master's was held by ophthalmology (64.3%) and surgical (30.6%) trainees and a lower percentage by anaesthetics (6.3%) and physician trainees (7.9%). Postgraduate diplomas or certificates were most common among paediatric (41.2%) and obstetrics and gynaecology (25.6%) registrars. CONCLUSION: This is the first study to investigate the additional qualifications of specialists in training in Australia. Almost half of specialists in training surveyed (46.7%) have completed some form of additional study, whether it is a PhD, Master's, postgraduate diploma/certificate or research degree from medical school. Trainees of specialist training schemes are more qualified than specialists who trained in the past Aust Fam Physician 32:92-4, 2003.


Assuntos
Educação de Pós-Graduação em Medicina/estatística & dados numéricos , Definição da Elegibilidade , Especialização , Austrália , Estágio Clínico , Educação de Pós-Graduação em Medicina/normas , Avaliação Educacional , Humanos , Internato e Residência , Estudos Longitudinais , Modelos Educacionais , Especialização/estatística & dados numéricos
4.
BMC Med Educ ; 19(1): 257, 2019 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-31292002

RESUMO

BACKGROUND: The rapidly rising rates of brain diseases due to the growing ageing population and the explosion in treatment options for many neurological conditions increase the demand for neurologists. We report trends in doctors' career choices for neurology; investigate factors driving their choices; and compare doctors' original choices with their specialty destinations. METHODS: A multi-cohort, multi-purpose nation-wide study using both online and postal questionnaires collected data on career choice, influencing factors, and career destinations. UK-trained doctors completed questionnaires at one, three, five, and ten years after qualification. They were classified into three groups: graduates of 1974-1983, graduates of 1993-2002, and graduates of 2005-2015. RESULTS: Neurology was more popular among graduates of 2005-2015 than earlier graduates; however, its attraction for graduates of 2005-2015 doctors reduced over time from graduation. A higher percentage of men than women doctors chose neurology as their first career choice. For instance, among graduates of 2005-2015, 2.2% of men and 1.1% of women preferred neurology as first choice in year 1. The most influential factor on career choice was "enthusiasm for and commitment to the specialty" in all cohorts and all years after graduation. Only 39% who chose neurology in year 1 progressed to become neurologists later. Conversely, only 28% of practicing neurologists in our study had decided to become neurologists in their first year after qualification. By year 3 this figure had risen to 65%, and by year 5 to 76%. CONCLUSIONS: Career decision-making among UK medical graduates is complicated. Early choices for neurology were not highly predictive of career destinations. Some influential factors in this process were identified. Improving mentoring programmes to support medical graduates, provide career counselling, develop professionalism, and increase their interest in neurology were suggested.


Assuntos
Escolha da Profissão , Educação de Pós-Graduação em Medicina/estatística & dados numéricos , Corpo Clínico Hospitalar/educação , Neurologia/educação , Inquéritos e Questionários , Atitude do Pessoal de Saúde , Feminino , Humanos , Satisfação no Emprego , Masculino , Estudos Retrospectivos , Fatores de Tempo , Reino Unido , Adulto Jovem
6.
J Bone Joint Surg Am ; 101(12): e56, 2019 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-31220032

RESUMO

BACKGROUND: The representation of women in orthopaedics in the United States remains among the lowest in all fields of medicine, and prior research has suggested that this underrepresentation may stem from lower levels of interest among female medical students. Of the many proposed reasons for this lack of interest, the male-dominated nature of the field is one of the most commonly cited. The purpose of this study was to determine the degree to which the representation of women among orthopaedic faculty and residents influences female medical students at that institution to apply for a residency in orthopaedics. METHODS: Using data provided by the Association of American Medical Colleges, we identified all U.S. medical schools that were affiliated with an orthopaedic surgery department and an orthopaedic surgery residency program (n = 107). For each institution, data on the representation of women among the orthopaedic faculty and residents from 2014 through 2016 were collected, as well as data on the proportion of female medical school graduates who applied to an orthopaedic residency program from 2015 through 2017. The association between institutional factors and the female medical student orthopaedic application rate was assessed. RESULTS: Of 22,707 women who graduated from medical school during the 3-year study period, 449 (1.98%) applied to an orthopaedic surgery residency program. Women who attended medical school at institutions with high orthopaedic faculty sex diversity were more likely to apply for a residency in orthopaedics (odds ratio [OR], 1.30; 95% confidence interval [CI], 1.04 to 1.64; p = 0.023), as were women who attended medical school at institutions with high orthopaedic resident sex diversity (OR, 1.30; 95% CI, 1.05 to 1.61; p = 0.019). CONCLUSIONS: In this study, we found that increased sex diversity among orthopaedic faculty and residents was associated with a greater likelihood that female medical students at that institution would apply for an orthopaedic residency. These results suggest that at least some of the factors currently impeding female medical student interest in orthopaedics may be modifiable. These findings may have important implications for efforts to improve the sex diversity of the field of orthopaedics going forward.


Assuntos
Educação de Pós-Graduação em Medicina/estatística & dados numéricos , Internato e Residência/estatística & dados numéricos , Ortopedia/educação , Médicas/estatística & dados numéricos , Faculdades de Medicina/estatística & dados numéricos , Feminino , Humanos , Estudantes de Medicina , Estados Unidos
7.
Med Educ Online ; 24(1): 1624132, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31199206

RESUMO

Background/Objective: To identify factors associated with underrepresentation of women in the largest medical specialties. Methods: The authors obtained specialty-specific data from the Association of American Medical Colleges, National Residency Match Program and Journal of the American Medical Association Graduate Medical Education Supplement from 2014 on the gender of trainees and faculty members, residency program director (PD)-rated importance of interview selection and rank list formation criteria, and characteristics of matched NRMP participants. They used linear regression to evaluate whether factors were associated with representation of female trainees in the 18 largest specialties that participated in the NRMP. They hypothesized that factors representing lower student exposure or higher research requirements would be associated with lower representation of women. Results: In 2014, representation of women as trainees ranged from 13.7% in Orthopedic Surgery to 82.5% in OB/Gyn. On multivariable analysis, the factors associated with specialties having lower percentages of female trainees were: not being part of the third year core (slope = 0.141, p = 0.002), having lower specialty mean step 1 scores (slope = 0.007, p = 0.017), and having lower percentages of female faculty members. For each 1% increase in female faculty, the percentage of female trainees increased by 1.45% (p < 0.001). Conclusions: Two exposure-related factors, percentage of female faculty members and being part of the third year core, were associated with underrepresentation of women as trainees. Future research could help examine whether these are causal associations. Medical schools and training specialties should investigate whether strategies to enhance mentorship and increase exposure to non-core specialties will increase the proportion of women in fields in which they are underrepresented.


Assuntos
Educação de Pós-Graduação em Medicina/estatística & dados numéricos , Medicina/estatística & dados numéricos , Distribuição por Sexo , Feminino , Humanos , Masculino , Faculdades de Medicina/estatística & dados numéricos , Estados Unidos
8.
BMC Med Educ ; 19(1): 136, 2019 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-31068165

RESUMO

BACKGROUND: Lack of providers in surgery, anesthesia, and obstetrics (SAO) is a primary driver of limited surgical capacity worldwide. We aimed to identify predictors of entry into Surgery, Anesthesia, and Obstetrics and Gynecology (SAO) fields and preference of working in the public sector in Brazil which may help in profiling medical students for recruitment into these needed areas. METHODS: A questionnaire was applied to all Brazilian medical graduates registered with a Board of Medicine from 2014 to 2015. Twenty-three characteristics were analyzed. Logistic regression was used to determine predictors' influence on outcome. RESULTS: There were 4601 (28.2%) responders to the survey, of which 40.5% (CI 34.7-46.5%) plan to enter SAO careers. Of the 23 characteristics analyzed, eight differed significantly between those who planned to work in SAO and those who did not. Of those eight characteristics, just three were significant predictors in the regression model: preference for working in the hospital setting, having spent more than 70% of their clinical years in practical activities, and valuing the substantial earning potential. These three factors explained only 6.3% of the variance in SAO preference. Within the graduates who preferred SAO careers, there were only two predictors for working in the public sector ("preparatory time before medical school" and valuing "prestige/status"). CONCLUSIONS: Factors affecting specialty and sector choice are multifaceted and difficult to predict. Future programs to fill provider gaps should identify methods other than medical student profiling to assure specialty and sector needs are met.


Assuntos
Anestesiologia/educação , Educação de Pós-Graduação em Medicina/estatística & dados numéricos , Cirurgia Geral/educação , Mão de Obra em Saúde/tendências , Obstetrícia/educação , Estudantes de Medicina/estatística & dados numéricos , Adulto , Brasil , Escolha da Profissão , Feminino , Pesquisa sobre Serviços de Saúde , Humanos , Masculino , Especialização
9.
S Afr Med J ; 109(4): 254-258, 2019 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-31084691

RESUMO

BACKGROUND: The 2011 Health Professions Council of South Africa mandate requires a research component in the form of an MMed degree to permit specialist registration. Registrars consider that the time required to complete an MMed interferes with clinical training, service delivery obligations, and study and exam time. Net research time to completion is difficult to establish because MMed research activity is often intermittent, starting and finishing anywhere within the 4-year clinical training period. Conversely, gross dissertation completion time (DCT) is easily calculated by subtracting the ethics approval date from the dissertation submission date. OBJECTIVES: To use gross DCT as a proxy to assess the time needed by registrars to finish the required research project. Additionally, the effect of four variables, namely dissertation format, clinical discipline, university research resources and the introduction of the 2011 ruling on gross DCT, was determined. METHODS: The sample was 213 MMed dissertations, downloaded from the public domain. The dissertation submission date was subtracted from the ethics approval date to give the gross DCT in months. Descriptive analysis and χ2 testing were used to determine the effects of the four variables on gross DCT, with significance set at p<0.05. A 12-month proposal preparation time was added to the gross DCT to fully reflect the MMed research timeline. RESULTS: Sampled dissertations were from 2005 to 2017 and all eight MMed training universities were represented, as were 23 clinical disciplines. The mean (standard deviation) gross DCT was 31.0 (19.6) months, with a wide completion range of 0.2 - 109 months. When 12 months' proposal preparation time was added, gross mean research completion time rose to 43 months (31 + 12 = 43). A mere 41% of dissertations were sufficiently concluded to free up the final year for exam preparation. Gross DCT was not significantly affected by the 2011 requirement, university resources or clinical discipline. Dissertation format (publication ready v. monograph) significantly decreased gross DCT (p=0.01). CONCLUSIONS: Large standard deviations and a wide range of finishing times detract from the positive findings that most dissertations were completed within the 4-year clinical training time period. Publication-ready dissertations significantly shortened MMed completion time. Unique study and work commitments and lack of research experience challenge speedy MMed completion. Existing research and supervisory supportive structures should be remodelled to better suit the research needs of the andragogic specialist registrar.


Assuntos
Dissertações Acadêmicas como Assunto , Pesquisa Biomédica/educação , Educação de Pós-Graduação em Medicina , Pesquisa Biomédica/normas , Pesquisa Biomédica/estatística & dados numéricos , Educação de Pós-Graduação em Medicina/métodos , Educação de Pós-Graduação em Medicina/normas , Educação de Pós-Graduação em Medicina/estatística & dados numéricos , Humanos , África do Sul , Especialização/normas , Fatores de Tempo
10.
Actas urol. esp ; 43(4): 169-175, mayo 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-181081

RESUMO

Objetivo: Conocer el estado actual de la actividad y formación académica de los residentes y urólogos jóvenes en España. Material y métodos: Se diseñó una encuesta anónima de 32 preguntas, desde el Grupo de Trabajo de Residentes y Jóvenes Urólogos de la Asociación Española de Urología (RAEU), dirigida a evaluar la actividad académica de los residentes, definida por: número de comunicaciones a congresos, publicaciones en revistas nacionales e internacionales, rotaciones clínicas dentro de España y en el extranjero, realización de máster, doctorado (PhD), aplicaciones para presentar el examen de la European Board of Urology y competencias en idiomas de residentes. La encuesta fue enviada vía email y difundida vía redes sociales. Resultados: Se obtuvieron 91 respondedores; el 66% afirmaron no tener publicaciones en revistas científicas, el 67% no han realizado rotaciones en el extranjero. Solo el 21% afirmaron presentarse al examen EBU. Solo el 2% de los respondedores han realizado un fellowship, aunque la mayoría (82%) no lo han realizado, pero sí estarían interesados. Sin embargo, el 67% de los respondedores opinan que la relevancia de la actividad académica/investigadora es alta a muy elevada. Conclusiones: Los resultados indican que la actividad académica, la producción científica y la publicación de artículos de los residentes y urólogos jóvenes en España es baja. Así también, la participación en el examen EBU, así como la realización de máster, PhD, rotaciones y fellowship, son bajas. Sin embargo, la valoración de la actividad científica es considerada como muy relevante


Objective: To study the current status of the activity and academic training of residents and young urologists in Spain. Material and methods: From the working group of residents and young urologists of the Spanish Association of Urology (AEU), an anonymous survey of 32 questions was designed. Its aim was to evaluate the academic activity of residents, defined by: number of communications to congresses, publications in national and international journals, clinical rotations within Spain and abroad, master's degree, Doctorate (PhD), applications to the European Board of Urology exam and language competences. The survey was sent via email and disseminated through social networks. Results: Ninety-one respondents were obtained; 66% affirmed not having publications in scientific journals, 67% did not perform rotations abroad. Only 21% claimed to have taken the EBU exam. Only 2% of the respondents had completed a Fellowship. Although most of them (82%) had not done so, they would be interested. However, 67% of respondents believed that the relevance of academic/research activity is from high to very high. Conclusions: Our results indicate that academic activity, scientific production and publication of articles of the residents and young urologists in Spain is low. Moreover, participation in the EBU exam, the completion of a master's degree, PhD, rotations and fellowship is low. In contrast, the assessment of scientific activity is considered to be very relevant


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Urologistas/educação , Internato e Residência/estatística & dados numéricos , Educação de Pós-Graduação em Medicina/estatística & dados numéricos , Espanha , Inquéritos e Questionários , Urologistas/estatística & dados numéricos , Educação de Pós-Graduação em Medicina/tendências
11.
FEBS Open Bio ; 9(5): 830-839, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31034166

RESUMO

Although the historical bases for graduate training in the United Kingdom (UK) and Scandinavia both stem from the original concept developed by von Humboldt, and both award a 'PhD degree', their paths have diverged. There are thus significant differences in the manner in which graduate training is organised. To analyse these differences, two UK graduate programmes (School of Medicine, Cardiff University; Institute of Integrative Biology, University of Liverpool) and two Scandinavian graduate schools (Faculty of Medicine and Dentistry, University of Bergen; Karolinska Institutet, Stockholm) completed a Self-evaluation questionnaire developed by Organisation of PhD Education in Biomedicine and Health Sciences in the European System (ORPHEUS)). Analysis of the completed questionnaires shows differences concerning requirements for admission, the training content of PhD programmes, the format of the PhD thesis, how the thesis is assessed and the financial model. All programmes recognise that PhD training should prepare for employment both inside and outside of academia, with emphasis on transferable skills training. However, the analysis reveals some fundamental differences in the direction of graduate programmes in the UK and Scandinavia. In the UK, graduate programmes are directed primarily towards teaching PhD students to do research, with considerable focus on practical techniques. In Scandinavia, the focus is on managing projects and publishing papers. To some extent, the differences lead to a lack of full recognition of each other's theses as a basis for doing a postdoc. This paper describes the basis for these differences and compares the two approaches and points to areas in which there is, or might be, convergence.


Assuntos
Educação de Pós-Graduação/estatística & dados numéricos , Educação de Pós-Graduação em Medicina , Educação de Pós-Graduação em Odontologia/estatística & dados numéricos , Educação de Pós-Graduação em Medicina/estatística & dados numéricos , Noruega , Suécia , Reino Unido , Universidades
12.
Mol Genet Genomic Med ; 7(5): e668, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30938092

RESUMO

BACKGROUND: While genetic counseling has expanded globally, Mexico has not adopted it as a separate profession. Given the rapid expansion of genetic and genomic services, understanding the current genetic counseling landscape in Mexico is crucial to improving healthcare outcomes. METHODS: Our needs assessment strategy has two components. First, we gathered quantitative data about genetics education and medical geneticists' geographic distribution through an exhaustive compilation of available information across several medical schools and public databases. Second, we conducted semi-structured interviews of 19 key-informants from 10 Mexican states remotely with digital recording and transcription. RESULTS: Across 32 states, ~54% of enrolled medical students receive no medical genetics training, and only Mexico City averages at least one medical geneticist per 100,000 people. Barriers to genetic counseling services include: geographic distribution of medical geneticists, lack of access to diagnostic tools, patient health literacy and cultural beliefs, and education in medical genetics/genetic counseling. Participants reported generally positive attitudes towards a genetic counseling profession; concerns regarding a current shortage of available jobs for medical geneticists persisted. CONCLUSION: To create a foundation that can support a genetic counseling profession in Mexico, the clinical significance of medical genetics must be promoted nationwide. Potential approaches include: requiring medical genetics coursework, developing community genetics services, and increasing jobs for medical geneticists.


Assuntos
Educação de Pós-Graduação em Medicina/estatística & dados numéricos , Utilização de Instalações e Serviços/estatística & dados numéricos , Aconselhamento Genético/estatística & dados numéricos , Determinação de Necessidades de Cuidados de Saúde/estatística & dados numéricos , Mão de Obra em Saúde/estatística & dados numéricos , México
13.
PLoS One ; 14(4): e0214378, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30933988

RESUMO

BACKGROUND: Migration of physicians has been a cause for global concern. In China, reforms of the higher education and healthcare systems have led to a shortage of postgraduate training positions relative to the number of medical graduates. Medical graduates opt for non-clinical roles or move abroad to pursue further training and practice opportunities. The impact of this physician migration is not known. This study quantifies where Chinese migrant physicians to the U.S. were educated, where they went to practice, and how these trends have changed over time. METHODS: We combined data on physician characteristics from the 2008 and 2017 American Medical Association Physician Masterfiles with demographic information from the Educational Commission for Foreign Medical Graduates. Using a repeated cross-sectional approach, we reviewed the available data, including citizenship at entry to medical school, medical school attended, practice specialty, and practice location. RESULTS: The number of Chinese-educated physicians (CEPs) to the United States (US) has increased over the past 10 years, from 3,878 in 2008 to 5,355 in 2017 (+38.1%). The majority held Chinese citizenship at entry to medical school (98.4% vs 97.1%) with the remainder being citizens of other East Asian nations. Of the Chinese citizens identified in 2008, 913 (19.3%) attended medical school outside of China; in 2017, 376 (6.7%) attended medical school outside of China, representing a decrease of 58.8%. Overall, in 2017, four Chinese medical schools provided 32.1% of all Chinese-educated physicians in the US. Over 50% of the CEPs were practicing in Internal Medicine, Anatomic/ Clinical Pathology, Anesthesiology, Family Medicine or Neurology. Compared with all IMGs, CEPs are more likely to be Anatomic/ Clinical Pathologists and Anesthesiologists. CEPs were concentrated in several states, including New York, California and Massachusetts. In 2017, a lower proportion of CEPs in the US healthcare workforce were in residency training, compared to 2008 (13.2% vs 22.8%). CONCLUSIONS: Unlike trends from some other South Asian countries, the number of CEPs in the US has increased over the past 10 years. Migration trends may vary depending on citizenship and country of medical school training. The majority of Chinese-educated graduates come to the US from relatively few medical schools. Fewer CEPs currently in residency training might indicate lower success rates in securing GME training in the US.


Assuntos
American Medical Association , Assistência à Saúde/estatística & dados numéricos , Educação de Pós-Graduação em Medicina/estatística & dados numéricos , Médicos/estatística & dados numéricos , China , Assistência à Saúde/tendências , Educação de Pós-Graduação em Medicina/tendências , Feminino , Médicos Graduados Estrangeiros , Migração Humana/estatística & dados numéricos , Humanos , Medicina Interna/estatística & dados numéricos , Internato e Residência , Masculino , Estados Unidos
14.
Intern Med ; 58(13): 1859-1864, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-30918184

RESUMO

Objective To describe the clinical research support systems in Japanese board certification programs of internal medicine and to assess the relationship between these support systems and the scholarly activities of residents. Methods In 2018, a 26-item web questionnaire was mailed to 542 points of contact of hospitals listed as certified residency programs of internal medicine in order to obtain information about the presence of a research support system and scholarly activity from 2016. We used hospital characteristic data from the Japanese Diagnostic Procedure Combination database, a national inpatient database, and the annual report of the Japanese Society of Internal Medicine. Results A total of 228 hospitals (42%) responded to the survey. There were regular research lectures in 129 hospitals (57%), protected time (time to perform research during working hours) in 53 hospitals (23%), research consultations in 175 hospitals (77%), regular journal clubs in 213 hospitals (77%), regular research conferences in 151 hospitals (66%), data warehouses in 139 hospitals (61%), and financial research support from the hospital budget in 140 hospitals (61%). A multivariate analysis showed that none of the research support systems were related to the number of conference presentations. In contrast, protected time [odds ratio (OR) 3.66, 95% confidence interval (CI) 1.43-9.39] and regular research conferences (OR 2.20, 95% CI 1.14-4.23) were related to the presence of clinical research presentations in scientific conferences hosted by residents. Conclusion Protected time and regular research conferences were related to the scholarly activity of residents in Japanese teaching hospitals.


Assuntos
Pesquisa Biomédica/organização & administração , Educação de Pós-Graduação em Medicina/organização & administração , Escolaridade , Hospitais de Ensino/organização & administração , Medicina Interna/educação , Medicina Interna/organização & administração , Internato e Residência/organização & administração , Adulto , Pesquisa Biomédica/estatística & dados numéricos , Currículo , Educação de Pós-Graduação em Medicina/estatística & dados numéricos , Feminino , Humanos , Medicina Interna/estatística & dados numéricos , Internato e Residência/estatística & dados numéricos , Japão , Masculino , Inquéritos e Questionários , Adulto Jovem
15.
Surgery ; 165(6): 1093-1099, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30879637

RESUMO

BACKGROUND: The transition from fourth-year medical student to surgical intern is difficult. A lack of repetitions, experience, and knowledge is problematic. We report our experience using simulation-based technical and nontechnical skills to assess the competency of surgical interns in July and January of their intern year. DESIGN: As part of a larger assessment effort, our general surgery interns (2010-2016) have been tested on performing an emergent cricothyrotomy, interpreting 2 arterial blood gases, and reading 3 chest x-rays in fewer than 7 minutes. We retrospectively analyzed general surgery interns' performance on these 3 tests (total score = 20). RESULTS: A total of 210 interns completed both July and January (identical) assessments. Overall mean scores improved from July (12.62 ± 3.44) to January (16.5 ± 2.46; P < .05). During the study period general surgery interns' mean baseline scores improved in both July (P < .05) and in January (P < .05). Although most individual general surgery interns did improve their total scores (92% improved, 3% same, 5% worse) between July and January (P < .05), in January 40% could not perform an emergent cricothyrotomy swiftly, and 6% missed a tension pneumothorax on chest x-ray. CONCLUSION: Our data suggest that surgical interns start residency training with low levels of skill and comprehension with emergent cricothyrotomy, arterial blood gas, and chest x-ray. They improve with 6 months of clinical and simulation training. Encouragingly, overall scores for both July and January assessments have improved during the study period. Given that some interns still struggle in January to perform these three tasks, we believe that 2018 interns are better, but still potentially lack critical knowledge and skill.


Assuntos
Competência Clínica/estatística & dados numéricos , Educação de Pós-Graduação em Medicina/estatística & dados numéricos , Avaliação Educacional/estatística & dados numéricos , Cirurgia Geral/estatística & dados numéricos , Internato e Residência/estatística & dados numéricos , Currículo , Cirurgia Geral/educação , Humanos , Estudos Retrospectivos , Treinamento por Simulação/estatística & dados numéricos , Fatores de Tempo
16.
S Afr Med J ; 109(3): 182-185, 2019 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-30834876

RESUMO

BACKGROUND: Trauma electives in South Africa (SA) are common and many foreign-based surgeons have undertaken such electives over the past 3 decades. Despite this, little academic attention has been paid to these electives, which remain largely informal and unstructured. This project aims to redress this deficit. OBJECTIVES: To investigate and document the extent of trauma clinical electives and to assess their impact on the careers of foreign surgeons who have undertaken such electives. METHODS: A mixed methods-style questionnaire was compiled, which sought to document the demographics of surgeons undertaking an SA trauma clinical elective, the trauma clinical experience they had prior to the elective, as well as the volume of experience they acquired during the elective. RESULTS: Sixty questionnaires were sent out and 21 were completed. There were 16 male and 5 female respondents. Only 17 had undertaken a formal trauma rotation before their elective in SA. The mean number of major resuscitations managed prior to rotating through surgery departments in SA was 15, and the mean number managed during a 12-month rotation in SA was 204. It would take each respondent 14 years in their country of origin to acquire an equivalent level of exposure to major resuscitation. During the year before their elective, each surgeon had been exposed to a mean number of the following: 0.5 gunshot wounds (GSWs), 2 stab wounds (SWs), 0.1 blast injuries and 19 road traffic accidents (RTAs). The equivalent mean number for their year in SA was 106 GSWs, 153 SWs, 4 blast injuries and 123 RTAs. The time necessary to achieve a similar level of exposure to their SA experience if they had remained in their country of origin was 213 years for GSWs, 73 years for SWs, 41 years for blast injuries and 7 years for RTAs. Compared with their SA elective, it would take each respondent 3 years to insert as many central venous lines, 9 years to perform the same number of tube thoracostomies, 9 years to manage as many surgical airways, 18 years to explore as many SWs of the neck and 93 years to explore as many GSWs of the neck. Furthermore, it would take 33 years to see and perform as many laparotomies for SWs to the abdomen, 374 years to perform an equivalent number of GSWs to the abdomen and 34 years of experience to perform as many damage-control laparotomies in their countries of origin. In terms of vascular trauma, it would take 23 years to see as many vascular injuries secondary to SWs and 77 years to see an equivalent number of vascular injuries secondary to GSWs. CONCLUSIONS: A trauma clinical elective in SA provides an unparalleled exposure to almost all forms of trauma in conjunction with a well-developed academic support programme. Formalising these trauma electives might allow for the development of exchange programmes for SA trainees who wish to acquire international exposure to advanced general surgical training.


Assuntos
Educação de Pós-Graduação em Medicina/estatística & dados numéricos , Médicos Graduados Estrangeiros/educação , Cirurgiões/educação , Procedimentos Cirúrgicos Operatórios/educação , Traumatologia/educação , Ferimentos e Lesões/cirurgia , Educação de Pós-Graduação em Medicina/métodos , Feminino , Médicos Graduados Estrangeiros/estatística & dados numéricos , Cirurgia Geral/educação , Humanos , Masculino , África do Sul , Procedimentos Cirúrgicos Operatórios/estatística & dados numéricos , Inquéritos e Questionários
17.
Plast Reconstr Surg ; 143(3): 940-949, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30817668

RESUMO

BACKGROUND: Prior studies have shown a lack of diversity among plastic surgery trainees. The authors evaluate trends in minority representation among applicants to plastic surgery and the correlation with practicing residents, compared to other specialties. METHODS: The Association of American Medical Colleges Electronic Residency Application Service provided applicant data for integrated, independent plastic surgery, and other select specialties from 2010 to 2016. Journal of the American Medical Association Graduate Medical Education annual reports and Association of American Medical Colleges graduate student questionnaires provided resident and medical student data. Binomial distribution analysis was used to assess differences in Black, Hispanic, and female proportions of applicants and residents. Best-fit trend lines were compared among groups and specialties. RESULTS: Women have seen an increase in integrated and independent resident representation (+2.23 percent and +0.7 percent per year, respectively) over the past 7 years, despite a relative decrease in applicants. The proportion of female applicants and residents correlated yearly for all specialties (p > 0.05). Conversely, for all years and all specialties, the Black proportion of applicants was significantly higher than the resident representation of the same year (p < 0.05). Hispanic applicant and resident representation have seen a minimal change. CONCLUSIONS: Female representation among trainees has increased greatly, but there has been a decline in Black representation of integrated plastic surgery residents despite increases in medical school graduates and applicants. The data highlight a discrepancy between the population of applicants and residents suggesting that barriers starting from medical school may contribute to the lack of diversity in plastic surgery.


Assuntos
Educação de Pós-Graduação em Medicina/estatística & dados numéricos , Internato e Residência/estatística & dados numéricos , Grupos Minoritários/estatística & dados numéricos , Cirurgiões/estatística & dados numéricos , Cirurgia Plástica/educação , Afro-Americanos/estatística & dados numéricos , Feminino , Hispano-Americanos/estatística & dados numéricos , Humanos , Masculino , Faculdades de Medicina/estatística & dados numéricos , Faculdades de Medicina/tendências , Fatores Sexuais , Cirurgiões/educação , Cirurgiões/tendências , Cirurgia Plástica/estatística & dados numéricos , Cirurgia Plástica/tendências , Estados Unidos
18.
Rev Epidemiol Sante Publique ; 67(2): 106-113, 2019 Apr.
Artigo em Francês | MEDLINE | ID: mdl-30733052

RESUMO

BACKGROUND: The French public health medical residency was created in 1984 to train medical public health specialists. Knowledge was lacking on the career of the trained practitioners, with the sole study dating from 1995. In this study, the French national association of medical public health residents aimed to describe the training and career of all medical public health specialists since the inception of the residency. METHODS: An online survey took place during the first semester of 2012 to collect information on all medical public health specialists graduated from the French public health medical residency. Descriptive analysis of the collected information was performed. RESULTS: Replies from 563 graduated medical public health residents were collected from all over the country and years since the inception of the training. Ninety-eight percent of the informants were in activity. They mostly worked in public healthcare facilities (56%) and public administration (16%). Their main areas of practice were: epidemiology, clinical research, biostatistics (37%); health management information system (19%); health policy (14%). Eighty-eight percent of the respondents held a master degree, 29% a PhD. Practical training during the medical residency was deemed as very useful or needed by 73% of the informants, theoretical training by 43%. Sixty-eight percent of informants were very or fully satisfied by their carrier, 29% rather satisfied. CONCLUSION: This is the first study to achieve coverage of more than 45% of all medical public health specialists graduated since the inception of the public health medical residency. Full employment, wide-range activities, evolving carriers can explain the high satisfaction rates. The public health medical residency being the main access point to the public health medical specialty, the impact of the initial training on the career should lead to rethink the design of the public health medical residency to fulfil the needs in the public health sector.


Assuntos
Escolha da Profissão , Educação de Pós-Graduação em Medicina , Internato e Residência , Saúde Pública/educação , Medicina Social/educação , Especialização , Adulto , Mobilidade Ocupacional , Estudos Transversais , Currículo , Educação de Pós-Graduação em Medicina/métodos , Educação de Pós-Graduação em Medicina/estatística & dados numéricos , Feminino , França/epidemiologia , Humanos , Internato e Residência/estatística & dados numéricos , Masculino , Medicina Social/estatística & dados numéricos , Especialização/estatística & dados numéricos
20.
Ann Pathol ; 39(2): 144-150, 2019 Apr.
Artigo em Francês | MEDLINE | ID: mdl-30711337

RESUMO

Medical education is currently facing great changes that affect all medical specialties, including anatomical pathology. Due to rapidly increasing medical knowledge and diagnostic complexity, we are living an era of teaching resources mutualization. We present different tools that allow large numbers of students to access courses, self-evaluations, and competencies assessments. MOOC platforms and e-learning platforms are central to these new online tools, which include the French National Platform of Medical Specialties, dedicated to the teaching of 50,000 medical residents in France. We also discuss "serious games" and the use of images and virtual slides in anatomical pathology teaching. These new modalities can deliver essential knowledge to large student populations, but they must be used in conjunction with adapted teacher-led courses focusing on competencies and professional skills in order to be fully effective.


Assuntos
Patologia Clínica/educação , Educação a Distância , Educação de Pós-Graduação em Medicina/organização & administração , Educação de Pós-Graduação em Medicina/estatística & dados numéricos , França
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