Undergraduate exposure and confidence to amputations and amputee care: a national survey of final-year UK medical students

Traditionally, the formalised teaching of medical students has begun at senior trainee level, with teaching from junior trainees being very limited and informal. A pilot programme was set up in a large university teaching hospital for interns to provide structured bedside clinical teaching to final-year medical students as an adjunct to their formal teaching. Derived from the success of this, a similar programme was run the following year. Feedback from the pilot programme and its successor was evaluated using a five-point Likert scale, and open illustrative comments were also collected. There was a highly positive response to the initial programme, with final-year students being very positive about participating as teachers the following year. Some proceeded to run the programme the following year, providing feedback to suggest improvements on the pilot programme. Junior trainees can organise and provide an additional option to traditional formal undergraduate clinical bedside teaching, which is well received by students. It also provides a forum through which trainees can hone teaching methods and improve clinical skills. A programme was set up for interns to provide structured bedside clinical teaching to final-year medical students.

Background: This study examined the impact of the COVID-19 pandemic and national lockdown restrictions on the clinical exposure of final-year medical students rotating through the orthopaedic surgery department at a medical school in Pretoria, South Africa. Methods: A retrospective review (1 April through 30 June 2020) of final-year students at Sefako Makgatho Health Sciences University, whose departmental rotation was disrupted due to the national lockdown (COVID group), was conducted. Their attendance was compared with that of the previous year’s final-year students (non-COVID group) who experienced uninterrupted lectures during the equivalent duration in 2019. The two groups were statistically compared, with the threshold for statistical significance set at P<0.05. Results: The COVID group attended 13 days of the orthopaedic block, while the non-COVID group attended 15 days. The overall attendance of the COVID group, in different clinical settings, was significantly less (P<0.001) than that of the non-COVID group. Even after accounting for online and in-person attendance, the COVID group attended significantly fewer lectures (13 vs 15; P=0.001) than the non-COVID group. Conclusions: This study demonstrated a significant reduction in musculoskeletal training and clinical exposure of final-year medical students at our institution in 2020. To adapt to the national lockdown regulations, a number of measures were put in place, such as online teaching, extension of the academic calendar, and distribution of personal protective equipment. These steps were crucial for maintaining the standard of teaching for final-year students during the national lockdown, as suggested by the exam results.

IntroductionChoosing a medical specialty is a pivotal moment in a physician’s career, shaped by personal interests, clinical experiences, and professional interactions. Obstetrics and gynecology (OB-GYN) offers a unique blend of surgical and medical care focused on women’s health. Given the growing demand for OB-GYN specialists, understanding the factors that influence students’ decisions is essential for workforce planning. This study compares the factors influencing first-year and final-year medical students at the University of Bonn in their decision to pursue OB-GYN.MethodsA total of 325 medical students participated in this longitudinal study, with 112 first-year and 213 final-year students completing digital surveys. The surveys assessed interest in OB-GYN, the importance of work-life balance, night shifts, future income, and the option for outpatient care. Statistical analyses, including Chi-square and McNemar’s tests, were used to identify significant changes in perceptions between the two groups.ResultsInterest in pursuing OB-GYN declined from 60% among first-year students to 32% among final-year students (p < 0.001). The number of students concerned about night shifts increased from 48% in the first year to 76% in the final year (p < 0.001). Work-life balance was a critical factor for 97% of final-year students compared to 80% of first-year students (p < 0.01). The potential for outpatient care grew in importance, with 90% of final-year students prioritizing it in their specialty decision (p < 0.001).DiscussionThe findings show that clinical exposure, lifestyle considerations, and mentorship significantly impact students’ interest in OB-GYN. Notably, interest in the specialty declined sharply from 60 to 32%, underscoring the importance of addressing key deterrents such as concerns about work-life balance. These challenges suggest that educational reforms should focus on creating flexible career paths and enhancing mentorship opportunities to attract and retain OB-GYN specialists. By tackling students’ concerns about lifestyle and offering adaptable career options, the specialty can sustain interest and ensure a sufficient future workforce to meet women’s healthcare needs.

This study intends to assess the level of religiosity and resilience of the first- and final-year medical students as well as the link between religiosity and resilience. In this study, it is hypothesized that religiosity and resilience differ between first-year and final-year medical students and that there is a positive relationship regarding both variables among first-year and final-year medical students. This study used the IIUM Religiosity Scale (IIUMRelS) created by Diana Mahudin, Noraini Noor, and Mariam Adawiah Dzulkifli (Mahudin et al., 2016) and the Resilience Scale developed by Bochaver et al, (2021) based on the idea from Connor and Davidson (2003). 195 medical students from South Sulawesi universities who met the requirements of being Muslim and aged between 18 and 25 were included in the study. Between first- and final-year students, the two research variables showed no statistically significant differences. Additionally, this research discovered a strong link between religiosity and resilience in first- and final-year medical students. According to the study’s findings, religiosity positively correlated with resilience in both first- and final-year students of the medical study program, where it contributed to resilience by 24.8% for first-year students and 19.4% for final-year students.&#x0D; Keywords: medical students, resilience, religiosity, first-year students, final-year students

Geographic mal-distribution towards urban over rural medical practice exists worldwide. The James Cook University medical school has focused its selection and curriculum on selecting and training students to address medical workforce needs for local regional, rural and remote areas. This study investigates final-year James Cook University medical students' intended rural practice modality and association with rurality of upbringing. Cross-sectional survey of final-year James Cook University medical students in 2018 (n=147; response rate=76%). Association between students' rurality of hometown at entry to medical school and self-reported intentions for rural practice. Overall, final-year students' preferred rural practice modality was "for a specific number of years" (38, 25%), followed by "periodic short-term locum" (33, 23%), "permanently based" (26, 18%), "orbiting" (21, 14%), "none" (14, 10%), "long-term shared position" (9, 6%) and "specialist outreach clinics" (6, 4%). Urban hometown at entry to medical school was associated with students preferring periodic rural practice, with rural-origin students contrastingly preferring more permanent rural practice. Only 10% of James Cook University medical students did not want a rural career in any form, suggesting the majority, regardless of urban or rural hometown, are open to some type of rural practice. Urban-origin medical students around Australia might be a significant, untapped resource for periodic and more permanent rural practice if they can be provided with extended, immersive rural placements experiences. Government funding models should provide increased funding for immersive rural placements, and promotion of orbiting and longer-term job share practice modalities.

Objective: To determine the prevalence of anemia and its associated risk factors among final-year medical students at Sana'a University, Yemen.&#x0D; Methods: This cross-sectional study was conducted among 269 final year students randomly selected from the medical faculties of Sana'a University in the period from January to April 2018. Data were collected using a structured questionnaire, while venous blood samples were collected by venipuncture into EDTA tubes. Hemoglobin (Hb) concentration was estimated using an automated hematology analyzer in the Laboratory Department of the University of Science and Technology in Sana’a city. Data were analyzed using appropriate statistical tests, and statistical significance was considered at P-values &lt;0.05.&#x0D; Results: The mean Hb concentration of final-year medical students at Sana’a University was 15.1 ± 1.9 g/dL. The mean Hb concentration for male students was 16.3 ± 1.5 g/dL, while the mean Hb concentration for female students was 13.1 ± 1.5 g/dL. Anemia was prevalent among 12 (4.5%) out of 269 medical students and was significantly associated with the gender and smoking status of the students, where females (OR = 5.9, 95% CI: 1.8–27.4; P = 0.011) and smokers (OR = 6.3, 95% CI: 1.2–3.7; P = 0.002) were about six times more likely to be anemic compared to their counterparts. In contrast, there was no statistically significant association between anemia and age, family size, family income, presence of chronic disease(s), khat chewing, exercise, or history of blood transfusion.&#x0D; Conclusions: The prevalence of anemia among final-year medical students at Sana'a University is low compared to other studies elsewhere. The female gender and smoking are the risk factors significantly associated with anemia among medical students. Further large-scale studies among medical and non-medical students from different levels of study at public and private universities of the country are recommended.

Objective: To determine the prevalence of anemia and its associated risk factors among final-year medical students at Sana'a University, Yemen.&#x0D; Methods: This cross-sectional study was conducted among 269 final year students randomly selected from the medical faculties of Sana'a University in the period from January to April 2018. Data were collected using a structured questionnaire, while venous blood samples were collected by venipuncture into EDTA tubes. Hemoglobin (Hb) concentration was estimated using an automated hematology analyzer in the Laboratory Department of the University of Science and Technology in Sana’a city. Data were analyzed using appropriate statistical tests, and statistical significance was considered at P-values &lt;0.05.&#x0D; Results: The mean Hb concentration of final-year medical students at Sana’a University was 15.1 ± 1.9 g/dL. The mean Hb concentration for male students was 16.3 ± 1.5 g/dL, while the mean Hb concentration for female students was 13.1 ± 1.5 g/dL. Anemia was prevalent among 12 (4.5%) out of 269 medical students and was significantly associated with the gender and smoking status of the students, where females (OR = 5.9, 95% CI: 1.8–27.4; P = 0.011) and smokers (OR = 6.3, 95% CI: 1.2–3.7; P = 0.002) were about six times more likely to be anemic compared to their counterparts. In contrast, there was no statistically significant association between anemia and age, family size, family income, presence of chronic disease(s), khat chewing, exercise, or history of blood transfusion.&#x0D; Conclusions: The prevalence of anemia among final-year medical students at Sana'a University is low compared to other studies elsewhere. The female gender and smoking are the risk factors significantly associated with anemia among medical students. Further large-scale studies among medical and non-medical students from different levels of study at public and private universities of the country are recommended.

Aim Plastic surgery incorporates all anatomical regions, age groups and tissue types; clinical challenges vary from trauma and burns to congenital defects and cancer. Although ∼50% of workload is trauma, it is often misperceived to revolve around cosmetic work. This study investigated national undergraduate plastic surgery exposure and perceptions amongst UK medical students. Method Ethical approval was granted. Permission was obtained from 27 UK medical schools. A national survey was conducted (31/03/23-07/07/23). National trends were analysed, with comparisons between established and new medical schools, and surgical and non-surgical aspirants. Results Data included 2513 students from 27 UK medical schools. 29.2% had surgical career aspirations. Students perceived plastic surgery as challenging, competitive, and impacting quality-of-life, however most had no formal teaching (56.3%); merely 6.2% had clinical exposure. Breast reconstruction was the most recognised procedure; the least were head and neck cancer surgery, fasciotomy, and hand fracture repair. Students at new medical schools were more likely to overestimate private practice and pursue the profession, but less likely to have sutured (22.2% vs 34.7%). Surgical aspirants were less likely to overestimate private practice, but more confident in their understanding of plastic surgery, and more likely to pursue it (p&amp;lt;0.001). Conclusions This was the largest UK national plastic surgery undergraduate curriculum survey to-date. A greater need for undergraduate plastic surgery teaching was determined. Significant heterogeneity across medical schools was identified. Formation of a national undergraduate plastic surgery curriculum, led by professional bodies, may tackle disparities amongst medical schools, improve accessibility and facilitate knowledge in hand trauma and burns.

In Syria, medical students were placed on call to provide sufficient human resources during COVID-19 pandemic. This research aimed to explore the ability and willingness of the final-year medical students to assist during COVID-19 in the Syrian war-torn and fragile health-system. Final-year Syrian medical students were approached between 9th-17th April 2020 through an online questionnaire. Students’ COVID-19-related medical knowledge (5-point score), clinical judgement (5-point score), and preparedness and willingness to integrate in healthcare facilities were assessed. A 10-point score was created, and linear regression and Tukey’s HSD test were conducted. 1673 valid responses were received, of which 1199 (71.66%) responses were from the final-year students. Of the latter, 728 (60.71%) scored 4 points or higher in the medical knowledge score (mean 3.69 points), while 298 (24.85%) scored 4 or higher in the clinical judgement score. Final-year students scored significantly higher than the fourth-year students in the clinical judgement score. Finally, 682 (56.88%) of the final-year students expressed willingness to volunteer with healthcare teams. Final-year medical students may provide medical aid, on voluntary basis, by working in fragile health systems during pandemics. However, this should be undertaken in cases of extreme need. Sufficient personal protective measures, intensive training, and adequate supervision should be guaranteed.

BackgroundFinal-year undergraduate medical students often do not feel well prepared for their start of residency training. Self-assessment of competences is important so that medical trainees can take responsibility for their learning. In this study, we investigated how final-year medical students self-assessed their competences as they neared their transition to postgraduate training. The aim was to identify areas for improvement in undergraduate training.MethodsIn the academic year 2019/2020, a national online survey was sent to final-year undergraduate medical students via their respective medical schools. The survey included ten facets of competence (FOC) most relevant for beginning residents. The participants were asked to self-assess their competence for each FOC on a 5-point Likert scale (1: strongly disagree to 5: strongly agree). We established an order of self-assessed FOC performance by means and calculated paired t-tests. Gender differences were assessed with independent t-tests.ResultsA total of 1083 students from 35 medical schools completed the questionnaire. Mean age was 27.2 ± 3.1 years and 65.8% were female. Students rated their performance highest in the FOCs ‘Teamwork and collegiality’ and ‘Empathy and openness’ (97.1 and 95.0% ‘strongly agree’ or ‘agree’, respectively) and lowest in ‘Verbal communication with colleagues and supervisors’ and ‘Scientifically and empirically grounded method of working’ (22.8 and 40.2% ‘strongly disagree’, ‘disagree’, or ‘neither agree nor disagree’, respectively). Women rated their performance of ‘Teamwork and collegiality’, ‘Empathy and openness’, and ‘Knowing and maintaining own personal bounds and possibilities’ significantly higher than men did (Cohen’s d > .2), while men showed higher self-assessed performance in ‘Scientifically and empirically grounded method of working’ than women (Cohen’s d = .38). The FOCs ‘Responsibility’, ‘Knowing and maintaining own personal bounds and possibilities’, ‘Structure, work planning, and priorities’, ‘Coping with mistakes’, and ‘Scientifically and empirically grounded method of working’ revealed lower self-assessed performance than the order of FOC relevance established by physicians for beginning residents.ConclusionsThe differences between the level of students’ self-assessed FOC performance and physicians’ ranking of FOC relevance revealed areas for improvement in undergraduate medical education related to health system sciences. Final-year students might benefit from additional or better training in management skills, professionalism, and evidence-based medicine. Surveys of self-assessed competences may be useful to monitor competence development during undergraduate training.

Medical students, as prospective physicians, should develop a good attitude toward organ donation since physicians can positively affect the decision to donate organs. This study compared perspectives toward organ donation between Thai second-year and final-year (sixth-year) medical students, and explored changes that might occur during medical school training. Second-year and final-year medical students at the Faculty of Medicine Siriraj Hospital, Mahidol University, were invited to participate in the survey. The demographic data of the participants were collected and the attitudes toward organ donation were measured from the questionnaire. In total, 89second-year and 60 final-year medical students voluntarily enrolled in the study. Nearly all the participating medical students supported organ donation and were willing to donate their organs after death. The majority of participants had a positive attitude toward organ donation in many perspectives, e.g., their beliefs, family issues, and donation procedure. There was a statistical difference between the proportion of second-year and final-year students who supported that a brain death condition is a true death (59.6% and 93.3%, respectively, p < 0.001) and who did not feel uncomfortable mentioning organ donation (82.0% and 96.7%, respectively, p = 0.007). In conclusion, there were significant differences in perspective between second-year and final-year students regarding brain death and discomfort perceived during organ donation-related situations. Experience gained during medical school could generate a more positive attitude toward organ donation. Therefore, medical schools play an essential role in nurturing a positive perspective toward organ donation in future physicians.

Current evidence suggests that around the transition from undergraduate to postgraduate training, deficiencies exist in doctors' knowledge of acute care. This study assessed Foundation Year 1 (FY1) doctors and medical students in intensive care/acute medicine with respect to their understanding of ICU practice and identifying critically ill patients. A qualitative questionnaire was formulated focusing on several targeted areas including training experience, broader ICU knowledge, formal assessment of ICU medicine and critically ill patients encountered outside the ICU. After successfully piloting the study, ethics approval was granted. In February 2010, the questionnaires were distributed to 50 final-year medical students at Brighton and Sussex Medical School and 50 FY1 doctors working at Worthing Hospital or the Royal Sussex County Hospital. One hundred percent of participants completed the questionnaires; 12.5% of medical students knew about the Surviving Sepsis Campaign compared to 62% FY1s (p&lt;0.05). Non-significant trends were evident when choosing three most useful observations for identifying sick patients. The study concluded medical students lack knowledge regarding assessment and monitoring of critically ill patients. Undergraduate training and ICU exposure did not differ between groups, however differences existed in understanding of ICU practice. There was a relative paucity in understanding from final year students regarding the Surviving Sepsis Campaign compared to FY1 doctors, which highlights the need for further improvement.

This paper reports the results of a case study investigating the importance and awareness of national student survey (NSS) improvement initiatives in one department at a university in the South of England. The paper is motivated by the observation that despite many initiatives that the Department put in place since 2011 in response to poor NSS results, the overall students’ satisfaction remained below the national average for the period 2011–2015. This situation raises two questions. First, are the initiatives put in place really important for students’ satisfaction when it comes to responding to the NSS questionnaire? Second, are the students even aware of these initiatives? To answer these questions, 57 initiatives that the Department put in place from 2011 to 2015 were documented using the minutes of various education committees. Through a questionnaire survey, the final-year students in the Department were asked to rate on a 5-point Likert scale the importance and their awareness of the initiatives. Descriptive, correlation analysis and t-tests are used to determine the importance and awareness of the initiatives. The data analysis was followed by two focus groups with selected students to gain further insights into the findings. The main results of the study are that many of the 57 initiatives are considered important but the students are not aware of the majority of the initiatives. These results have important implications for UK university departments trying to improve their NSS results.

Belastet in den Beruf – Empathie und Burnout bei Medizinstudierenden am Ende des Praktischen Jahres

Background: Critical-thinking ability plays a central role in clinical decision-making, particularly during internal medicine rotations where students encounter diverse and complex patient presentations. Modern medical education encourages structured assessment strategies such as OSCEs, Mini-CEX encounters, and case-based evaluations to strengthen diagnostic reasoning. This study explored the effect of these assessment strategies on critical-thinking development among undergraduate medical students. Methodology: A quasi-experimental study was conducted at LUMHS, Jamshoro, from January 2022 to June 2022, including 200 MBBS students (100 from 4th year and 100 from final year). Participants completed a pre-intervention assessment followed by exposure to structured assessment practices during internal medicine rotation. Activities included OSCE stations, Mini-CEX evaluations, and guided case discussions. A post-test was conducted at the end of the rotation. Data were analyzed using SPSS, with significance set at p&lt;0.05. Results: All groups demonstrated significant improvement in critical-thinking scores post-intervention. This can be attributed to the teaching methods that incorporate clinical cases. Final-year students must have scored higher pre and post-intervention scores due to better clinical exposure and possibly greater confidence. For both groups, the improvement made in diagnostic accuracy, clinical reasoning, and reflection- all with clinical reasoning were deemed statistically significant with p&lt;0.05. The greatest improvement was observed in the clinical Internal Medicine cases of pneumonia, sepsis, and acute presentations of the heart. Conclusion: The implementation of structured assessment strategies has a noticeable impact on final year medical students’ critical thinking performance. This reinforces the value of frequent use of OSCEs, and Mini-CEX exercises in the medicine rotation continuum. Such strategies greatly contribute to the honing and reinforcement of clinical judgement and decision making skills. Keywords: Internal medicine, critical thinking, OSCE, Mini-CEX, undergraduate medical education, clinical reasoning, competency-based training