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1.
Br J Anaesth ; 124(3): e63-e69, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31980155

RESUMO

The under-representation of women in academic leadership roles, including in anaesthesiology, is a well-documented phenomenon that has persisted for decades despite more women attending medical school, participating in anaesthesiology residencies, and joining academic faculties. The percentage of female anaesthesiologists who hold senior academic ranks or leadership roles, such as chair, lags behind the percentage of female anaesthesiologists overall. Trends towards increasing the numbers of women serving in educational leadership roles, specifically residency programme directors, suggest that there are areas in which academic anaesthesiology has been, and can continue, improving gender imbalance. Continued institutional efforts to recruit women into anaesthesiology, reduce gender bias, and promote interventions that foster gender equity in hiring and promotion will continue to benefit women, academic anaesthesiology departments, and the healthcare system overall.


Assuntos
Anestesiologia/tendências , Internato e Residência/tendências , Médicas/tendências , Sexismo/tendências , Centros Médicos Acadêmicos/organização & administração , Centros Médicos Acadêmicos/tendências , Anestesiologia/educação , Anestesiologia/organização & administração , Escolha da Profissão , Mobilidade Ocupacional , Educação de Pós-Graduação em Medicina/organização & administração , Educação de Pós-Graduação em Medicina/tendências , Feminino , Humanos , Internato e Residência/organização & administração , Liderança , Médicas/estatística & dados numéricos , Faculdades de Medicina/organização & administração , Faculdades de Medicina/tendências , Sexismo/prevenção & controle , Estados Unidos
2.
Urology ; 136: 51-57, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31785279

RESUMO

OBJECTIVE: To identify institutional factors that predict medical student decision to apply for the urology match. MATERIALS AND METHODS: American Urological Association (AUA) Match data from 2015 to 2019 were used to determine the number of applicants from each medical school who submitted rank lists. Associations between the applicant counts from each medical school and medical school characteristics were assessed using multivariable Poisson regression models. Data were obtained using publicly available datasets and a survey of urology program coordinators. RESULTS: There were 1916 medical students from 199 medical schools who submitted rank lists to the urology residency match. After adjusting for class size, schools with a urology residency program produced significantly greater number of urology applicants (RR 2.7; 95% CI, 2.2-3.4, p<0.001). Additional predictors included a shorter preclerkship curriculum (less than 18 months; RR 1.2, 95% CI 1.09-1.35, P <.001), number of urology residents (RR 1.11, 95% CI 1.05-1.17, P <.001), urology faculty (RR 1.1; 1.04-1.2; P = .01; per 10 faculty), top 20 residency ranking on Doximity (RR 1.2; 1.1-1.4, P <.001), and presence of urology interest group (RR 1.3, 95% CI 1.1-1.6, P = .005). Approximately 28% of applicants were female, and the percentage of female urology faculty at their institution significantly correlated with number of female applicants (ß = 0.22, 95% CI: 0.01-0.44; P = .049). CONCLUSION: To recruit more medical students into urology, departments should foster early preclinical exposure to specialty-specific interest groups, interaction with residents, and development of a diverse faculty.


Assuntos
Escolha da Profissão , Internato e Residência/estatística & dados numéricos , Internato e Residência/tendências , Faculdades de Medicina/estatística & dados numéricos , Urologia/educação , Feminino , Humanos , Candidatura a Emprego , Masculino , Estados Unidos
3.
Int J Radiat Oncol Biol Phys ; 106(1): 37-42, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31229573

RESUMO

PURPOSE: We sought to characterize temporal trends of radiation oncology resident-reported external beam radiation therapy (EBRT) case experience with respect to various disease sites, including trends in stereotactic radiosurgery and stereotactic body radiation therapy cases. METHODS AND MATERIALS: Summarized, deidentified case logs for graduating radiation oncology residents between 2007 and 2018 were obtained from the Accreditation Council for Graduate Medical Education national summary data report. Mean number of cumulative cases and standard deviations per graduating resident by year were evaluated. Cases were subdivided into 12 disease-site categories using the Accreditation Council for Graduate Medical Education classification. Analysis of variance was used to determine significant differences, and strength of association was evaluated using Pearson correlation. RESULTS: The number of graduating residents per year increased by 66% from 114 in 2007 to 189 in 2018 (P < .001, r = 0.88). The overall mean number of EBRT cases per graduating resident decreased by 13.2% from 521.9 in 2007 to 478.5 in 2018, with a decrease in the ratio of nonmetastatic to metastatic cases per graduating resident. There was significant variation among the disease categories analyzed; however, the largest proportionate decreases were seen in hematologic, lung, and genitourinary malignancies. Stereotactic radiosurgery volume per graduating resident increased from an average of 27.9 cases in 2007 to 50.3 in 2018 (P < .001, r = 0.96). Stereotactic body radiation therapy volume per graduating resident increased as well, from a mean of 6 cases in 2007 to 55.6 cases in 2018 (P < .001, r = 0.99). CONCLUSIONS: We report a longitudinal summary of resident-reported experience in EBRT cases. These findings have implications for future efforts to optimize residency training programs and requirements.


Assuntos
Internato e Residência/tendências , Neoplasias/radioterapia , Radioterapia (Especialidade)/tendências , Carga de Trabalho , Análise de Variância , Competência Clínica , Neoplasias Hematológicas/radioterapia , Humanos , Internato e Residência/estatística & dados numéricos , Estudos Longitudinais , Neoplasias Pulmonares/radioterapia , Metástase Neoplásica/radioterapia , Neoplasias/classificação , Radioterapia (Especialidade)/estatística & dados numéricos , Radiocirurgia/estatística & dados numéricos , Radiocirurgia/tendências , Radioterapia/estatística & dados numéricos , Radioterapia/tendências , Estudos Retrospectivos , Fatores de Tempo , Neoplasias Urogenitais/radioterapia , Carga de Trabalho/estatística & dados numéricos
4.
Interface (Botucatu, Online) ; 24: e190159, 2020.
Artigo em Português | LILACS | ID: biblio-1040193

RESUMO

As Diretrizes Curriculares do curso de graduação em Medicina de 2014 incluem a Saúde Mental (SM) como uma das áreas obrigatórias do internato. O objetivo deste trabalho é apresentar o internato integrado de SM e de Medicina de Família e Comunidade (MFC) da Universidade Federal do Rio de Janeiro (UFRJ) e a fundamentação da escolha da Atenção Primária à Saúde (APS) como cenário de formação dos internos. Trata-se do relato da experiência do internato integrado de SM e MFC da UFRJ e da discussão de seus marcos teóricos. A alta prevalência de sofrimento psíquico e transtornos mentais na APS, o fato de ela ser a porta de entrada do Sistema Único de Saúde (SUS) e o fato de que a faculdade de Medicina deve formar médicos generalistas fazem deste cenário lócus privilegiado para o treinamento dos internos de Medicina em SM.(AU)


Las Directrices Curriculares del Curso de Graduación en Medicina de Curso de 2014 incluyen la salud mental (SM) como una de las áreas obligatorias del internado. El objetivo de este trabajo es presentar el internado integrado de SM y Medicina de Familia y Comunidad (MFC) de la UFRJ y la fundamentación de la Escuela de Atención Primaria de la Salud (APS) como escenario de formación de los internos. Se trata del relato del internado integrado de SM y MFC de la UFRJ y de la discusión de sus marcos teóricos. La alta prevalencia de sufrimiento psíquico y trastornos mentales en la APS, el hecho de que la APS es la puerta de entrada del sistema único de salud (SUS) y el hecho de que la facultad de medicina debe formar a médicos generalistas, hace que este escenario sea un locus privilegiado para el entrenamiento de los internos de medicina en salud mental.(AU)


The 2014 Curricular Guidelines of the medical undergraduate courses include Mental Health (MH) as one of the required areas of internship. The objective of this paper is to present the integrated internship for MH and Family and Community Medicine (FCM) of UFRJ, as well as the rationale for choosing Primary Health Care (PHC) as the setting for the internship training. It presents a report of the experience of the integrated internship for MH and FCM of UFRJ and the discussion of its theoretical frameworks. The high prevalence of psychological distress and mental disorders in PHC, the fact that PHC is the gateway to the unified national health system (SUS) and the fact that the medical school must train general practitioners, make PHC a privileged locus for the training of medical interns in mental health.(AU)


Assuntos
Atenção Primária à Saúde/normas , Saúde Mental/educação , Educação Médica/legislação & jurisprudência , Internato e Residência/tendências , Medicina de Família e Comunidade
5.
J Bone Joint Surg Am ; 101(18): e96, 2019 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-31567811

RESUMO

BACKGROUND: Orthopaedic surgery has generally lagged behind other surgical subspecialties with respect to racial and ethnic diversity in its U.S. residency programs. Efforts have been made to increase the number of underrepresented minorities (URMs) applying to orthopaedic surgery residencies; however, the impact on diversity at the residency program level is unknown. The purpose of this study was to determine whether orthopaedic surgery residency programs have become more racially diverse over time. METHODS: The Graduate Medical Education Track database was queried for individual racial/ethnic identification of orthopaedic surgery residents in U.S. Accreditation Council for Graduate Medical Education (ACGME)-accredited programs for 15 consecutive years (2002-2003 through 2016-2017). The number of URMs in each residency program during each academic year was recorded. The number of programs per year with no URMs, 1 URM, 2 URMs, and >2 URMs was recorded, and the change over time was assessed. RESULTS: The number of programs per year with >1 URM resident decreased over time, from 61 programs in 2002 to 53 programs in 2016, with the trough being 31 programs in 2010 (p < 0.0001). The number of programs per year without any URM residents increased over the period of study, from 40 programs in 2002 to 60 programs in 2016, with the peak being 76 programs in 2011 (p < 0.0001). CONCLUSIONS: The number of residency programs with >1 URM resident has decreased significantly over time, suggesting that diversity at the program level is limited. Program-level diversity should be further examined as a potential barrier to the recruitment of URMs to orthopaedics. Difficulty attracting URM residents to certain programs may have the unintended consequence of effectively limiting potential positions for these candidates, which can decrease the odds of minority students matching into orthopaedics and, therefore, perpetuate the cycle of lack of diversity in our field.


Assuntos
Diversidade Cultural , Grupos Étnicos/estatística & dados numéricos , Internato e Residência/tendências , Grupos Minoritários/estatística & dados numéricos , Ortopedia/educação , Estudantes de Medicina/estatística & dados numéricos , Feminino , Humanos , Masculino , Ortopedia/tendências , Distribuição por Sexo , Estados Unidos
6.
Plast Reconstr Surg ; 144(4): 597e-605e, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31568292

RESUMO

BACKGROUND: Rhinoplasty is known for its complexity in planning and execution. For trainees, knowledge acquisition is often adequately attained. The mastery of skills, however, occurs by means of hands-on exposure, which continues to be a challenge. This article discusses the positive progress made in rhinoplasty training, and objectively demonstrates a need for more hands-on rhinoplasty exposure for residents. METHODS: A systematic review was performed in adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Concurrently, an online survey was developed, assessing resident comfort and training in rhinoplasty, and e-mailed to Canadian and U.S. plastic surgery training programs. RESULTS: ONE HUNDRED THIRTY-EIGHT: residents completed the survey, 62 junior (first- to third-year residents) and 76 senior residents (fourth- to sixth-year residents). Seventy-two percent of senior residents (95 percent of sixth-year residents) reported adequate rhinoplasty exposure, as opposed to 13 percent of junior residents. Seventy-five percent of senior residents most often participated as observers or first assistants, 25 percent participated as co-surgeons, and 73.9 percent did not perform a key rhinoplasty step more than five times. Residents felt the three most difficult steps of rhinoplasty were nasal osteotomy (76.1 percent), caudal septum/anterior nasal spine manipulation (65.2 percent), and nasal tip sutures (55.8 percent), and 73.9 percent felt that simulator training would substantially improve confidence. CONCLUSIONS: Despite sufficient exposure to rhinoplasties, residents were least confident in performing rhinoplasties relative to other aesthetic procedures, likely because of the high proportion of rhinoplasty exposure that is observational as opposed to hands-on acquisition of surgical maneuvers in the operating room. The survey established the maneuvers residents find the most difficult, and as programs adopt competency-based training, developing rhinoplasty simulators targeting specific identified steps may help improve competence for rhinoplasty skills.


Assuntos
Internato e Residência/métodos , Modelos Educacionais , Rinoplastia/educação , Treinamento por Simulação , Previsões , Humanos , Internato e Residência/tendências , Autorrelato
8.
Oral Maxillofac Surg Clin North Am ; 31(4): 621-626, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31416664

RESUMO

Simulation involves the re-creation of real-life situations, processes, or structures for the purpose of improving safety, effectiveness, and efficiency of health care services: simulation provides a controlled and safe environment for training and assessment. In an age in which regulatory burdens, fiscal challenges, and renewed focus on patient safety increasingly constrain surgical residency programs, innovation in teaching is vital for the future of oral and maxillofacial surgery (OMS) training. Of the simulation technologies in modern day health care education, many have found their way into OMS training. This article reviews these technologies, and some examples of their uses in OMS.


Assuntos
Competência Clínica , Tecnologia Educacional/tendências , Cirurgia Geral/educação , Internato e Residência , Otolaringologia/educação , Treinamento por Simulação , Educação Baseada em Competências , Avaliação Educacional , Humanos , Internato e Residência/métodos , Internato e Residência/tendências , Procedimentos Cirúrgicos Reconstrutivos/educação , Treinamento por Simulação/tendências
9.
Pediatrics ; 144(2)2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31363070

RESUMO

Physician-scientists represent a critical component of the biomedical and health research workforce. However, the proportion of physicians who spend a significant amount of effort on scientific research has declined over the past 40 years. This trend has been particularly noticeable in pediatrics despite recent scientific work revealing that early life influences, exposures, and health status play a significant role in lifelong health and disease. To address this problem, the Duke University Department of Pediatrics developed the Duke Pediatric Research Scholars Program for Physician-Scientist Development (DPRS). The DPRS is focused on research training during pediatric residency and fellowship. We aim to provide sufficient research exposure and support to help scholars develop a research niche and scholarly products as well as identify the career pathways that will enable them to achieve their research goals. Herein, we describe the DPRS's organizational structure, core components, recruitment strategies, and initial results, and we discuss implementation challenges and solutions. Additionally, we detail the program's integration with the department's residency and fellowship training programs (with particular reference to the challenges of integrating research into small- to medium-sized residency programs) and describe the development and integration of related initiatives across Duke University School of Medicine. The program served as the basis for 2 successful National Institutes of Health Stimulating Access to Research in Residency (R38) applications, and we hope it will serve as a model to integrate formalized research training for residents and fellows who wish to pursue research careers in academic medicine.


Assuntos
Pesquisa Biomédica/educação , Pesquisa Biomédica/métodos , Pessoal de Laboratório Médico/educação , Pediatras/educação , Desenvolvimento de Programas/métodos , Pesquisa Biomédica/tendências , Escolha da Profissão , Competência Clínica , Humanos , Internato e Residência/métodos , Internato e Residência/tendências , Pessoal de Laboratório Médico/tendências , Tutoria/métodos , Tutoria/tendências , Pediatras/tendências
10.
Am Surg ; 85(6): 579-586, 2019 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-31267897

RESUMO

We aim to investigate the prevalence of posttraumatic stress disorder (PTSD), physician burnout (PBO), and work-life balance (WLB) among surgical residents, fellows, and attendings to illustrate the trends in surgeon wellness. A cross-sectional national survey of surgical residents, fellows, and attendings was conducted screening for PTSD, PBO, and WLB. The prevalence of screening positive for PTSD was more than two times that of the general population at all levels of experience, and more than half have an unhealthy WLB. The prevalence of PTSD, PBO, and unhealthy WLB declined with increasing level of experience (P < 0.001). One deviation in this trend was a lower prevalence of PBO among surgical fellows compared with residents and attendings (P < 0.001). Surgeon wellness improved with increasing level of experience. The incorporation of wellness programs into surgical residencies is essential to the professional development of young surgeons to cultivate healthy lasting habits for a well-balanced career and life.


Assuntos
Esgotamento Profissional/epidemiologia , Promoção da Saúde/organização & administração , Satisfação no Emprego , Satisfação Pessoal , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Cirurgiões/psicologia , Adulto , Esgotamento Profissional/psicologia , Estudos Transversais , Bolsas de Estudo/tendências , Feminino , Humanos , Internato e Residência/tendências , Masculino , Corpo Clínico Hospitalar/tendências , Pessoa de Meia-Idade , Determinação de Necessidades de Cuidados de Saúde , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Cirurgiões/educação , Estados Unidos , Adulto Jovem
11.
Surgery ; 166(5): 726-734, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31280867

RESUMO

BACKGROUND: Several models have been introduced to improve and restructure surgical training, but continued barriers exist. Residents are uniquely positioned to offer perspective on practical challenges and needs of reformatting surgical education. This study aimed to establish a nationwide, Delphi consensus statement on the perceptions of Canadian residents regarding the future of general surgery training. METHODS: Canadian general surgery residents participated in a moderated focus group using the Nominal Group Technique to discuss early subspecialization, competency-based medical education, and transition to practice. Qualitative verbal data were transcribed, categorized into themes, and synthesized into recommendation statements. During an iterative Delphi survey, resident leaders ranked each statement on a 5-point Likert scale of agreement. The survey was terminated once consensus was achieved (≥2 survey rounds and Cronbach's α ≥ 0.80). RESULTS: A total of 66 statements were synthesized by 16 members of the Canadian Association of General Surgeons Resident Committee. A total of 49 residents participated in the Delphi consensus, which was achieved after 2 voting rounds (Cronbach's α = 0.93). Participants agreed that (1) residency should focus on achieving standardized competencies and milestones based on resident ability to meet specific measurable metrics, (2) early streaming should be offered after "core" milestones and competencies have been achieved, and (3) an explicit period should allow transition-to-independent practice with tailored rotations, greater autonomy, and resident-run clinics. We identified 10 barriers to competency-based medical education implementation. CONCLUSION: A nationwide consensus regarding the future of surgical training was established among current residents. These findings can inform and help implement guidelines and national curricula that meet the needs of the trainee and address the many challenges they face during their training.


Assuntos
Educação Baseada em Competências/tendências , Consenso , Cirurgia Geral/educação , Internato e Residência/tendências , Modelos Educacionais , Adulto , Canadá , Competência Clínica , Educação Baseada em Competências/métodos , Técnica Delfos , Feminino , Grupos Focais , Humanos , Internato e Residência/métodos , Masculino , Pesquisa Qualitativa , Cirurgiões/educação
13.
Urologe A ; 58(8): 870-876, 2019 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-31168674

RESUMO

The current version of the urology training program will concentrate on the mediation of competences and skills in various fields of action for outpatient urology instead of persisting on the minimum and reference numbers of surgical and diagnostic procedures. However, the following fields of action must be fulfilled: microbiology, andrology and systemic cancer therapy. There is justifiable concern that various institutions will lose their permission for a complete 5­year residency program based on the above-mentioned demands since not all institutions have all subspecialties in urology. Those institutions need to define new ways of residency training such as interdisciplinary programs within their own institution between disciplines like pediatric surgery, gynecology and medical oncology. Other options are combined training programs between regional urology departments with different main focuses or training programs between institutions and urologists in private practice. There is an unmet need to improve residency training as well as board examinations by new structures and a reliable curriculum. Based on the changed main focuses of the new version of urology training, we need to discuss the future of residency programs. It might be helpful to discuss two different types of urology training with a common trunk for the first three years followed by a more outpatient-based residency training for the general urologist and a more specialized training for the inpatient urologist to be educated in complex treatment modalities. An open mind to broadening our own horizon, respectful discussion with other departments and the development of common, reliable and interdisciplinary contents represent indispensable prerequisites to realize such an innovative future training program.


Assuntos
Educação de Pós-Graduação em Medicina/métodos , Internato e Residência/organização & administração , Internato e Residência/tendências , Urologia/educação , Andrologia , Criança , Currículo , Previsões , Ginecologia , Humanos , Oncologia , Pediatria
14.
Int J Radiat Oncol Biol Phys ; 105(1): 31-41, 2019 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-31039422

RESUMO

PURPOSE: To report radiation oncology (RO) workforce and cancer incidence trends in Canada and explore the relationship between the two. METHODS AND MATERIALS: Canadian radiation oncologist, trainee, and cancer incidence data from 1990 to 2018 were collected from the following publicly accessible administrative and health information databases: Canadian Post-MD Education Registry (1990-2018), Canadian Medical Association Physician Data Centre (1994-2018), Canadian Institute for Health Information/Scott's Medical Database (1990-2017), Canadian Cancer Registry (1990-2017), and Statistics Canada (1990-2017). Descriptive statistics were used to summarize the data. RESULTS: The Canadian RO workforce grew from 240 radiation oncologists in 1990 to 567 in 2018, with the largest growth period from 2005 to 2015 adding 207 radiation oncologists. Regional analyses revealed steady or stepwise growth in all Canadian regions, except in Québec, where the number of radiation oncologists decreased from 86 in 1990 to 57 in 2003 before rising to 139 by 2018. Trainee totals were between 54 and 173 per year with 2 periods of growth (1990-1996 and 2001-2008) and regression (1996-2001 and 2008-2018), signifying trainee supply variability. Female proportions of the workforce and trainees, respectively, rose steadily from 18% to 38% and 28% to 50%, while the workforce proportion with non-Canadian medical degrees decreased from 40% to 26%. Radiation oncologists younger than 40 years increased from 70 to 171, whereas those age 60 years and older decreased from 85 in 1990 to 31 in 2002 and then increased to 108 in 2017. Annual cancer incidence rose steadily from 103,780 to 206,290 cases/year. The annual cancer incidence-to-provider ratio fluctuated (364-475:1) and trended lower with time, and proportional cancer incidence-to-provider ratios varied between 0.7:1 and 1.6:1 in Canada's regions before approaching 1:1. CONCLUSIONS: Our study demonstrates the challenges and successes of managing the Canadian radiation oncologist workforce. These data will inform policy makers and other stakeholders to ensure that the profession meets the current and future needs of Canadian cancer patients.


Assuntos
Neoplasias/epidemiologia , Médicas/estatística & dados numéricos , Radio-Oncologistas/estatística & dados numéricos , Radioterapia (Especialidade)/estatística & dados numéricos , Adulto , Distribuição por Idade , Canadá/epidemiologia , Bolsas de Estudo/estatística & dados numéricos , Bolsas de Estudo/tendências , Feminino , Médicos Graduados Estrangeiros/estatística & dados numéricos , Médicos Graduados Estrangeiros/tendências , Planejamento em Saúde , Humanos , Incidência , Internato e Residência/estatística & dados numéricos , Internato e Residência/tendências , Masculino , Pessoa de Meia-Idade , Médicas/tendências , Radio-Oncologistas/provisão & distribução , Radio-Oncologistas/tendências , Radioterapia (Especialidade)/educação , Radioterapia (Especialidade)/tendências , Fatores de Tempo
15.
Neurol India ; 67(2): 516-529, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31085870

RESUMO

The Achanta Lakshmipathi Neurosurgical Center (ALNC) and Post Graduate Institute of Neurological Surgery is a private teaching neurosurgical institution located in the VHS (Voluntary Health Services) Hospital Chennai. It has been a leader and trendsetter among the private academic neurosurgical training institutions, and because of its unique legacy, has influenced the progress of Neurosurgery in India. The center was the second neurosurgical Institute to be created by Prof. B Ramamurthi and has trained neurosurgeons in the unique ALNC school of Neurosurgery. The Institute has grown to become a centre of excellence in microsurgery, and spinal surgery and has become a training centre for neurosurgery since 1985. The unique humanitarian aspects of the Voluntary Health Services Hospital helped in bringing the best of Neurosurgery to all strata of society. Forty years after its inception, the ALNC continues its delivery of excellence in clinical neurosurgery and academics.


Assuntos
Neurocirurgiões/tendências , Neurocirurgia/educação , Neurocirurgia/tendências , Procedimentos Neurocirúrgicos/tendências , Academias e Institutos/tendências , Humanos , Índia , Internato e Residência/tendências
16.
Orthop Clin North Am ; 50(3): 337-344, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31084836

RESUMO

Data from the US Census Bureau, the Accreditation Council for Graduate Medical Education, and the American Academy of Orthopaedic Surgeons reveal that orthopedic surgery is the least diverse of any surgical specialty and that diversity within orthopedics is not improving. Considerable data from both medicine and business suggest that improving diversity within the orthopedic surgery specialty would be of significant benefit to the orthopedic surgery profession and to patients. Multiple avenues for increasing diversity exist, including large-scale pipeline programs as well as personal and institutional efforts examining biases and decision-making processes.


Assuntos
Grupos de Populações Continentais , Diversidade Cultural , Ortopedia/educação , Competência Cultural , Previsões , Acesso aos Serviços de Saúde , Humanos , Internato e Residência/tendências , Ortopedia/tendências , Satisfação do Paciente , Relações Médico-Paciente , Estados Unidos
18.
World Neurosurg ; 127: e1026-e1038, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30980978

RESUMO

BACKGROUND: In the past decade, smartphone applications (Apps) have experienced remarkable development across all fields of medicine, including neurosurgery. However, owing to a lack of regulatory oversight and peer review, a clear need exists for a comprehensive review and audit of the existing available Apps. In the present study, we systematically reviewed the existing mobile Apps in neurosurgery, evaluated their clinical use by neurosurgery residents in Canada, and performed a quality audit of the most popular Apps. METHODS: Indexed Apps were identified from either the Google Play Store or the iOS App Store using a comprehensive list of keywords related to neurosurgery. A subsequent cross-sectional survey of 76 Canadian neurosurgery residents was conducted, including a section on smartphone App use. We next evaluated the most popular Apps among the residents using the Healthcare Smartphone App Evaluation Tool and performed a quality audit of their content using established medical references. RESULTS: The survey identified 118 mobile Apps related to neurosurgery. The 3 most used Apps used by the current cohort of Canadian neurosurgery residents were Neurosurgery Survival Guide, Neuromind, and the Journal of Neurosurgery App. Each of these 3 Apps received an excellent score on the Healthcare Smartphone App Evaluation Tool. A quality audit of 30 pages of the Neurosurgery Survival Guide and 40 clinical scores of the Neuromind App, performed by 10 neurosurgery residents, failed to reveal inaccurate or false statements. CONCLUSION: The present study has highlighted the current landscape of neurosurgery mobile Apps and their use among neurosurgery residents.


Assuntos
Internato e Residência/tendências , Aplicativos Móveis/tendências , Neurocirurgia/educação , Neurocirurgia/tendências , Smartphone/tendências , Inquéritos e Questionários , Canadá/epidemiologia , Humanos
19.
J Emerg Med ; 56(4): e61-e64, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30979407

RESUMO

The number of allopathic emergency medicine (EM) programs has been progressively increasing over the years. In 2018, allopathic EM postgraduate year-1 spots, compared with 2012, increased by around 60% to reach 2278 positions. EM is considered a competitive specialty and therefore, in this article we help guide students interested in EM through the allopathic match requirements, application process, interviews, and ranking EM programs. Additionally, we tackle the combined emergency medicine residency programs, namely the combined EM-Family Medicine (FM), EM-Anesthesiology, EM-Internal Medicine (IM), EM-IM-Critical Care Medicine, and EM-Pediatrics residency programs. Finally, we explain the increased likelihood of matching with the single graduate medical education accreditation system expected to happen in the year 2020.


Assuntos
Medicina Osteopática/educação , Critérios de Admissão Escolar/estatística & dados numéricos , Educação de Pós-Graduação em Medicina/tendências , Humanos , Internato e Residência/métodos , Internato e Residência/tendências , Estados Unidos
20.
Gac. sanit. (Barc., Ed. impr.) ; 33(2): 112-118, mar.-abr. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-183672

RESUMO

Objetivos: Los objetivos de este estudio son describir la frecuencia de exposición y la actitud de los médicos internos residentes (MIR) de la Comunidad de Madrid (CM) con la industria farmacéutica (IF), y analizar la asociación con la especialidad, el entorno profesional y la formación recibida. Métodos: Estudio descriptivo mediante encuesta electrónica durante mayo y junio de 2015 a los MIR de la CM. Se recogieron variables sociodemográficas y de relación con la IF en cuatro bloques: frecuencia de interacción, actitudes y percepciones, entorno y marco regulatorio, y habilidades adquiridas; con los dos primeros se elaboró un índice sintético de relación con la IF (ISIF). Análisis bivariado y multivariado de regresión logística. Resultados: Respondieron 350 residentes (28% de medicina familiar y comunitaria [MFyC]), 57% de especialidades hospitalarias y 15% de otras). El 98% refirió haber tenido relación con la IF. El 20% creía que influye en su prescripción y el 48% en los demás médicos. El 96% no había recibido información de su colegio profesional, el 80% desconocía si había normas en su sociedad científica y el 50% no sabía si las había en su institución. El 65% consideró necesaria más formación. Los residentes de especialidades hospitalarias presentaron más probabilidad de presentar un ISIF igual o superior al percentil 75 que los de MFyC (odds ratio [OR]: 3,96; intervalo de confianza del 95% [IC95%]: 1,88-8,35). Formarse en entornos informales se asoció a un ISIF menor o igual al percentil 25 (OR: 2,83; IC95%: 1,32-6,07). Conclusiones: Los MIR de la CM tienen un alto nivel de contacto con la IF y creen que su influencia es limitada. Los residentes de especialidades hospitalarias presentan mayor contacto. Las regulaciones son poco conocidas por los residentes, que consideran que es necesaria más formación


Objective: To assess the frequency of exposure and attitudes to the pharmaceutical industry (PI) of residents in the Region of Madrid (RM), Spain, and to analyse the association with specialty, professional environment and training. Methods: Cross-sectional electronic survey in May and June 2015 of all medical residents in RM. We collected sociodemographic variables and those of interaction with the PI in four blocks: frequency of interactions, attitudes and perceptions, environment and regulatory framework, and skills; with the first two blocks we created a Synthetic PI Interaction Index (SPIII). Bivariate and multivariate analysis of logistic regression. Results: 350 resident's responses (28% family and community medicine [FCM], 57% hospital, 15% others). Ninety-eight percent reported interacting with the PI. Twenty percent believed their prescribing was influenced by the PI and 48% believed it was influenced by other doctors. Sixty-five precent considered more training necessary. Ninety-six percent had received no information from their college of physicians, 80% did not know the regulations in their medical society and 50% were unaware of those of their institution. Hospital specialty residents showed more likelihood of SPIII ≥ percentile 75 than those of FCM (odds ratio [OR]: 3.96; 95% confidence interval [95%CI]: 1.88-8.35). Training in informal settings was associated with SPIII ≤ percentile 25 (OR: 2.83; 95%CI: 1.32-6.07). Conclusions: The medical residents in RM had a high level of interaction with the PI and believed its influence low. Hospital specialty residents showed more interaction with the PI. Regulations were not well known by residents and they consideredmore training necessary


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Indústria Farmacêutica/tendências , Tecnologia Farmacêutica/educação , Internato e Residência/tendências , Prescrições de Medicamentos/classificação , Ética Farmacêutica , Conflito de Interesses , Relações Interinstitucionais , Temas Bioéticos
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