2-year Programme Research Articles

Clinical supervisors’ experience of a first-time application of entrustable professional activities in clinical supervision of medical students: findings from a Swedish pilot study

BackgroundRecently, all medical universities in Sweden jointly developed a framework for Entrustable Professional Activities (EPAs) for work-based training and assessment. This framework is now being introduced nationally in the new 6-year undergraduate medical programme that directly lead to a licence to practise. When EPAs are introduced, it is of central importance to gain clinical supervisors’ acceptance to apply the framework in their supervision of students. The aim of this study was therefore to investigate how clinical supervisors, not familiar with EPAs, experience clinical supervision using the framework for EPAs.MethodsWe used a purposive sampling to recruit clinical supervisors. They were given written information on EPAs with a selection of suitable EPAs and the Swedish observation rating scale for assessment of autonomy, and they were offered to attend a 30-minute introductory web course. The participants were informed that EPAs were to be tested, and the students were asked to participate. After the study period the clinical supervisors participated in semi-structured interviews. Inductive qualitative content analysis was used to analyse the transcribed interviews.ResultsThree general themes emerged in the qualitative analysis: Promoting Feedback, Trusting Assessments and Engaging Stakeholders. The participants described benefits from using EPAs, but pointed out a need for preparation and adaptation to facilitate implementation. The structure was perceived to provide structured support for feedback, student involvement, entrustment decisions, enabling supervisors to allow the students to do more things independently, although some expressed caution to rely on others’ assessments. Another concern was whether assessments of EPAs would be perceived as a form of examination, steeling focus from formative feedback. To understand the concept of EPA, the short web-based course and written information was regarded as sufficient. However, concern was expressed whether EPA could be applied by all clinical supervisors. Involvement and adaption of the workplace was pointed out as important since more frequent observation and feedback, with documentation requirements, increase the time required for supervision.ConclusionsEPAs were accepted as beneficial, promoting structured feedback and assessments of the students’ autonomy. Preparation of supervisors and students as well as involvement and adaptation of the workplace was pointed out as important.

Staffing Patterns of Non-ACGME Fellowships with 4-Year Residency Programs: A National Survey.

Emergency medicine (EM) is one of few specialties with variable training lengths. Hiring a three-year graduate to continue fellowship training in a department that supports a four-year residency program can lead to conflicts around resident supervision. We sought to understand hiring and clinical supervision, or staffing, patterns of non-Accreditation Council for Graduate Medical Education (ACGME) fellowships hosted at institutions supporting four-year residency programs. We performed a web-based, cross-sectional survey of non-ACGME fellowship directors (FD) hosted at institutions supporting four-year EM residency programs. We calculated descriptive statistics. Our primary outcome was the proportion of programs with four-year EM residencies that hire non-ACGME fellows graduating from three-year EM residencies. Of 119 eligible FDs, 88 (74%) completed the survey. Seventy FDs (80%) indicated that they hire graduates of three-year residencies. Fifty-six (80%) indicated that three-year graduates supervise residents. Most FDs (74%) indicated no additional requirements exist to supervise residents outside of being hired as faculty. The FDs cited department policy, concerns about quality and length of training, and resident complaints as reasons for not hiring three-year graduates. A majority (10/18, 56%) noted that not hiring fellows from three-year programs negatively impacts recruitment and gives them access to a smaller applicant pool. Most non-ACGME fellowships at institutions with four-year EM programs recruit three-year graduates and allow them to supervise residents. This survey provides programs information on how comparable fellowships recruit and staff their departments, which may inform policies that fit the needs of their learners, the fellowship, and the department.

Reforming Medical Physics and Radiopharmaceutical Science Training Through a Programmatic Approach to Assessment.

Programmatic assessment approaches can be extended to the design of allied health professions training, to enhance the learning of trainees. The Australasian College of Physical Scientists and Engineers in Medicine worked with assessment specialists at the Australian Council for Educational Research and Amplexa Consulting, to revise their medical physics and radiopharmaceutical science training programs. One of the central aims of the revisions was to produce a training program that provides standardized training support to their registrars throughout the 3 years, better supporting their registrars to successfully complete the program in the time frame through providing timely and constructive feedback on the registrar's progression. We used the principles of programmatic assessment to revise the assessment methods and progression decisions in the three training programs. We revised the 3-year training programs for diagnostic imaging medical physics, radiation oncology medical physics and radiopharmaceutical science in Australia and New Zealand, incorporating clear stages of training and associated progression points. We discuss the advantages and difficulties that have arisen with this implementation. We found 5 key elements necessary for implementing programmatic assessment in these specialized contexts: embracing blurred boundaries between assessment of and for learning, adapting the approach to each specialized context, change management, engaging subject matter experts, and clear communication to registrars/trainees.

Historical background and current situation of pharmacy education in Mongolia.

In Mongolia, the medical education system with a long history has developed with its characteristics since ancient times. Modern medical education, including pharmacy education, began to grow in 1921. Before modern pharmaceutical science developed in Mongolia, pharmacy and pharmacy education were part of Traditional Mongolian Medicine and education. Medical knowledge and experience were transferred from generation to generation through simple teaching. From the sixteenth century, Manba Datsan was established in religious temples to teach Mongolian medicine through discipleship. Modern pharmacy education in Mongolia began in 1926 with the course training of pharmacy technicians, and pharmacist training started in 1961. Pharmacy technician training with a 3-year and pharmacist training with 5-year programs oriented on patient-centered pharmaceutical care are implemented in Mongolia. Pharmacy technicians can also study towards a B. degree in Pharmacy with an additional 3 years of training. As of 2023, seven state-owned and private higher education institutions offer pharmacy education and the number of institutions and students of pharmacy is expected to increase. The pharmacy education policy and the license examination type may be reformable, and the curricula should be regularly updated in line with international trends.

Resident Involvement in Curricular and Clinical Practice Change and Satisfaction With Training According to Length of Training in Family Medicine.

Most research in residency training has focused on quality improvement within a single program. We explored resident involvement in curricular and clinical practice change, the learning environment, and resident satisfaction in 3-year family medicine residencies compared to matched 4-year residencies. We used two surveys to capture data. One was for program directors, which assessed the level of resident involvement in curricular and practice transformation. The second was a resident survey, which asked residents to rate their involvement in curricular change and practice transformation, the learning environment, and satisfaction with training. Both were administered annually between 2013 and 2019. Response rates ranged from 84.6% to 100%. Findings revealed no overall difference in resident involvement in curricular change, but the program director survey findings indicated that a higher proportion of residents in 4-year programs were using a broader diversity of approaches to working on quality improvement (QI) projects compared to those in 3-year programs. We also found statistical differences in the number of QI projects completed per year, with 34.1% completing three or more in 4-year programs compared to 13.3% in 3-year programs (P<.001). We found a positive correlation between resident involvement, learning environment, and satisfaction with training for both 3-year (range 0.489-0.666; P=.001) and 4-year residents (range 0.441-0.529; P=.001). Four-year residents were involved in a greater number of quality improvement projects and had a more diverse profile of involvement than those in 3-year residency programs. Involvement in practice and curricular change and the learning environment were associated with greater levels of resident satisfaction with training in both 3-year and 4-year programs.

Analysis and Design Directions for the 4-year University Beauty Department Curriculum and Microdegree Programs

The purpose of this paper is to propose directions that should be considered when designing microdegree programs in 4-year university beauty departments, in order to adapt to rapidly changing society and industries. To gather data, we utilized the Academic Research Information Service (RISS) to collect and analyze literature on the curriculum of 4-year university beauty departments and literature regarding directions for domestic microdegree programs. As a result, the problems in the curriculum of 4-year university beauty departments have been identified as ‘Lack of emphasis on practical skills’, ‘Disorganized curriculum structure’, ‘Absence of personalization and suitability considerations’, ‘Inadequate incorporation of industry changes and trends’, ‘Challenges in practical application’, ‘Incomplete educational environment and facilities’, ‘Failure to address student demands and opinions’. As suggestions for the direction of domestic microdegree programs, it has been proposed to ‘The development and operation of microdegree programs focused on competency-based education in specific fields according to students' career interests is necessary’, ‘Promotional activities for motivating student engagement and participation in microdegree courses are required’, ‘Continuous student needs assessment, evaluation, and monitoring are necessary for improving the quality of microdegree programs and fostering institutional innovation’, ‘Enhancement of credit recognition for diverse educational experiences and collaboration with industries and government policies is needed’, ‘An establishment of a microdegree committee within universities and the promotion of participation from industry representatives, government policies, alumni, professors, and current students should be encouraged’, ‘The review of government support programs is necessary, and microdegree programs should not be operated superficially by universities solely for the sake of achieving results based on government support’, ‘The organization of competitions utilizing microdegree learning experiences and providing certification opportunities for job-related competencies should be implemented’. Based on the analysis of literature, the following conclusions were drawn regarding the directions to consider when designing microdegree programs in 4-year university beauty departments ‘Establishment of a committee for quality management of microdegree education’, ‘Design and feedback of microdegree programs based on the demands of beauty department students’, ‘Encouragement of easy goal-setting for beauty department students using microdegrees’, ‘Enhancement of competencies through integration between microdegrees and academic disciplines’, ‘Provision of job experience opportunities through microdegrees’, and ‘Importance of industry-academia collaboration and expansion of resources for microdegrees’.

Registered nurses' knowledge and interpretation of ECG rhythms: A cross-sectional study.

Electrocardiographic (ECG) monitoring and recording are seen as the most commonly used non-invasive diagnostic tool to identify cardiac arrhythmia and myocardial damage in the clinical setting. There is an expectation that critical care nurses are ideally trained to interpret abnormalities and morphology in the ECG more proficiently than nurses from general ward areas. However, the ability to interpret and recognise ECG abnormalities is dependent on which critical care area nurses are currently working in and their level of experience. The aim of this study was to investigate registered nurses' knowledge in being able to identify and interpret select electrocardiographic rhythms. This was a cross-sectional study that evaluated registered nurses' knowledge of electrocardiogram rhythm identification and interpretation. A convenience sample of 105 registered nurses currently enrolled in a 2-year Master's programme leading to critical care specialism and advanced practice nurse award were recruited. A 20-item multiple choice questionnaire that provided examples of electrocardiogram rhythm (n=14) abnormalities and rhythm abnormalities caused by electrolyte disturbances (n=6) RESULTS: The study included registered nurses from critical care and general ward areas. The overall results were poor with only 55% of questions answered correctly. Coronary care nurses scored the highest in identifying ECG rhythms (12/20 ± 1.58; p < .001). When ECG abnormalities associated with electrolyte imbalances were analysed, both groups were unable to identify the effects of hypokalaemia and hypomagnesaemia effectively (p = .748). Length of time as a registered nurse (r = -0.304, p = .002) and length of time in current work environment were weakly correlated (r = -0.328, p = .001). Having a critical care background showed a positive relationship with nursing knowledge of ECG rhythm identification (r = 0.614, p < .001). The results of this study demonstrate that nurses have a poor knowledge of ECG rhythm identification and interpretation, a consistent finding from other work. A possible solution is a revamp of education and training associated with ECG recognition and morphology. Monitoring and assessing ECG morphology provide important details about cardio-electroconductive stability, especially with fluctuations in serum electrolyte levels seen in critical illness or trauma. For this, critical nurses must improve their proficiency through education/training or internal quality improvement activities in detecting abnormalities associated with ECG changes beyond those most easily recognizable rhythms such as atrial fibrillation or ventricular tachycardia.

Examining teacher transition pathways towards knowledge generation environments

ABSTRACT National standards that centre on the underpinning epistemic practices of the discipline has emphasised the need for teachers to focus much more on knowledge generation approaches to learning. Adopting a complexity perspective, we attempt to understand how teachers shift over time by examining their epistemic orientation to knowledge generation and their understanding of the nature of the epistemic tools of language, dialogue and argument that underpin these environments. Ninety-five teachers participated in a 2-year professional development programme to implement the Science Writing Heuristic (SWH) approach – a recognised generative learning approach. Using a longitudinal latent profile analysis of four waves of data, three different teacher profiles emerged (low, medium and high). Teacher transition to higher profiles was not uniform, took time, and required them to engage with the epistemic systems of orientation and tools. The results highlight that teacher PD needs to be tailored to promote richer transitions to implementing generative learning environments.

Assessing the Effect of a 2-Year Mindfulness-Based Training Programme on Personal and Professional Functioning: A Mixed-Methods Study

ObjectivesMindfulness-based interventions are increasingly a part of mainstream society. The training of professionals to teach these programmes is an important element in maintaining the quality and integrity of this approach. The objective of this study was to examine the experience of trainees undertaking a 2-year training curriculum and how this supported adaptation when they began teaching.MethodThe study was a convergent mixed-methods design, including a descriptive survey of trainees using a questionnaire and a descriptive phenomenological exploration of trainees’ experiences using focus group interviews.ResultsA significant majority of graduates were women and either health professionals or coaches. Most graduates continued to teach after completion of the training, predominantly Mindfulness-Based Stress Reduction (MBSR) or an adapted MBSR. Qualitative analysis revealed themes related to the structure and content of the curriculum, changing identity, sensitivity to local context, the importance of learning this approach in a community, and embodied experience. The latter two themes were particularly significant when navigating challenging emotional and somatic experiences.ConclusionsTeachers-in-training internalised the essential qualities of mindfulness as an awareness practice. This capacity required the effort of personal practice alongside theoretical understanding, the support of community and a willingness to be present with a wider range of experience. These factors combined to support the embodiment of the essential qualities of mindfulness. A majority of graduates actively explored teaching MBIs in their professional contexts after completion, and the personal shifts that they experienced through the cultivation of mindful living during the training provided a robust foundation on which to begin teaching a contemporary mindfulness approach to others in a context sensitive way.PreregistrationThis study is not preregistered.

A Dual Perspective on Academic Advising: Challenges Faced by Community College Transfers and Faculty Advisors in Engineering

This study provides a deeper understanding of the challenges facing community college transfer students in engineering and their faculty advisors at a 4-year research university. Using a phenomenological approach, data was analyzed from interviews with nine engineering transfers and seven faculty advisors. The findings unveiled nuanced barriers faced by engineering transfers and their faculty advisors, including transfers’ academic unpreparedness and struggles with nonacademic responsibilities; advisors’ heavy workload, disconnection with other student services, and lack of communication with community college advisors; and restrictions on course selection and program requirements in 4-year engineering programs. The findings provide meaningful insights into developing new policies and practices to improve the academic advising experience for engineering transfers.

Dental public health education in Egypt: a cross-sectional survey

Background and aimDental Public Health (DPH) education prepares future workforce to promote positive oral health behaviors, prevent oral diseases, and monitor disease distribution and trends taking into considerations best practices, needs and available resources. Scarce information is available about dental education in African countries and Egypt has the greatest number of dental schools in Africa. This study assessed the undergraduate DPH education in Egyptian universities including topics taught, methods of teaching, assessment, and the academics’ specialties.MethodsA survey targeted 43 Egyptian universities with Bachelor of Dentistry (BDS) programs identified on the website of the Supreme Council of Egyptian Universities in 2022. Thirty-six deans could be reached by post and/ or email. The survey appraised the school profile and capacity, and methods of teaching and assessment in DPH courses in undergraduate dental programs. The survey also inquired who taught DPH courses and what was covered in the courses. Descriptive statistics were displayed.ResultsWe received 21 (58.3%) responses from 36 deans/ senior officials. Of the universities, 52.4% were private and 47.6% were public. Most participants reported that DPH courses in BDS programs were taught by Pediatric Dentistry academics (71.4%) and DPH academics (57.1%) in 3rd, 4th and 5th years of the 5-year BDS programs. Teaching DPH consisted of face-to-face lectures (100%) and seminars (95.2%) and assessment included written exams with close ended questions (95.2%) and open-ended questions (71.4%). Twenty schools reported teaching the definition of DPH, definition of oral health, and determinants of oral diseases. Nine schools addressed the planning of oral health services and five schools taught about remuneration and payment systems.ConclusionTeaching and assessment of DPH in Egyptian dental schools use traditional methods with limited active engagement of the students. Variations among the schools exist in the DPH topics covered and most instructors were not primarily specialized in DPH. Development of dental/ oral health services calls for more emphasis on DPH education in the curriculum in Egypt.

The impact of Longitudinal Integrated Foundation Training: preliminary experiences in the United Kingdom

BackgroundThe United Kingdom health system is challenged with retaining doctors entering specialty training directly after their second foundation year. Improving doctors’ training experience during the foundation programme may aid such retention. The Longitudinal Integrated Foundation Training (LIFT) pilot scheme aimed to provide a programme that improves the quality of their foundation training experience, advance patient-centred care and provide doctors with more experience in the primary care settings.MethodsDuring this pilot study, three methods were employed to evaluate and compare doctors’ experiences across their 2-year foundation training programme: Horus ePortfolio assessment of six domains for good medical practice analysed using a T-test, online survey assessments analysed using a 2-tailed chi-square test, and focus group feedback sessions with thematic analysis.ResultsDoctors completing LIFT (n = 47) scored a higher but non-significant mean score on all six domains for good medical practice versus doctors completing traditional foundation training (n = 94). By the end of foundation training, 100% of LIFT doctors rated their understanding of how primary and secondary care work together as high versus 78.7% of traditional doctors (p < 0.05). Improvements in wellbeing were observed among LIFT doctors, along with a reduction in the proportion of doctors considering leaving medical training. A significantly greater number of LIFT doctors versus traditional doctors rated their compassion for patients as high (100% versus 86.8%; p < 0.05), intended to become general practitioners (23.1% versus 13.5%; p < 0.05) and rated the extent to which they felt well informed and able to consider a general practice career rather than a hospital career as high (91.7% versus 72.3%, respectively; p < 0.05). Some LIFT doctors felt they had reduced exposure to secondary care, received less on-call experience and considered working a half-day to be problematic; challenges ameliorated by the end of the 2-year foundation programme.ConclusionThe LIFT programme enhanced the quality of foundation training and improved doctors’ experiences and competencies, generating valuable insights for the future of education and healthcare delivery. Applying the principles of LIFT to foundation training helps doctors to be more compassionate and patient-centred, leading to enhanced individualised patient care.

New Models of Higher Education for Low-Income countries

In low-income countries, increasing access to higher education is particularly challenging. While tertiary education may boost a country's prosperity, the high cost of education, despite subsidies, remains a barrier to access. The digitisation of existing approaches to tertiary education is insufficient, and a more radical approach is needed.&#x0D; &#x0D; The Atlantic Technological University has been working on two approaches that hold potential for addressing this challenge. A work-based degree in engineering has placed a student in Mozambique in a mining company, where they will learn the required practical engineering skills and study online. Although this approach will allow the student to earn an income as they study, the fees will still be significant as it is based on existing forms of online learning. Separately, the university is developing a 2-year low-cost Engineering programme based on free online content, modest payment for examinations, and supervision of a capstone project.&#x0D; &#x0D; This paper focuses on the design of these programmes and the challenges involved. Attendees will learn how these new models of higher education for low-income countries could potentially address the cost barrier to access and significantly increase participation in tertiary education, leading to improved prosperity and economic growth.

Education for Tobacco Use Disorder Treatment: Current State, Evidence, and Unmet Needs.

Tobacco use is undertreated in the medical setting. One driver may be inadequate tobacco use disorder treatment (TUDT) training for clinicians in specialties treating tobacco-dependent patients. We sought to evaluate the current state of TUDT training for diverse professionals and how these skills are assessed in credentialing exams. We performed a focused review of current educational practices, evidence-based strategies, and accreditation exam contents focused on TUDT. Among medical students, participants in reviewed studies reported anywhere from 45 minutes to 3 hours of TUDT training throughout their 4-year programs, most often in the form of didactic sessions. Similarly, little TUDT training was reported at the post-graduate (residency, fellowship, continuing medical education) levels, and reported training was typically delivered as time-based (expected hours of instruction) rather than competency-based (demonstration of mastery) learning. Multiple studies evaluated effective TUDT curricula at varied stages of training. More effective curricula incorporated longitudinal sessions and active learning, such as standardized patient encounters or proctored patient visits. Knowledge of TUDT is minimally evaluated on certification exams. For example, the American Board of Internal Medicine blueprint lists TUDT as <2% of one subtopic on both the internal medicine and pulmonary exams. TUDT training for most clinicians is minimal, does not assess competency, and is minimally evaluated on certification exams. Effective, evidence-based TUDT training incorporating active learning should be integrated into medical education at all levels, with attention paid to inclusion on subsequent certifying exams.

PROBLEMS WITH ORTHOPEDIC SURGERY TRAINING IN PAKISTAN

PROBLEMS WITH ORTHOPEDIC SURGERY TRAINING IN PAKISTAN

126 National Survey of Staffing Patterns of Non-ACGME Fellowships at 4-Year Residency Programs

126 National Survey of Staffing Patterns of Non-ACGME Fellowships at 4-Year Residency Programs

Intersectional Disparities in Emergency Medicine Residents’ Performance Assessments by Race, Ethnicity, and Sex

Previous studies have demonstrated sex-specific disparities in performance assessments among emergency medicine (EM) residents. However, less work has focused on intersectional disparities by ethnoracial identity and sex in resident performance assessments. To estimate intersectional sex-specific ethnoracial disparities in standardized EM resident assessments. This retrospective cohort study used data from the Association of American Medical Colleges and the Accreditation Council for Graduate Medical Education Milestones (Milestones) assessments to evaluate ratings for EM residents at 128 EM training programs in the US. Statistical analyses were conducted in June 2020 to January 2023. Training and assessment environments in EM residency programs across comparison groups defined by ethnoracial identity (Asian, White, or groups underrepresented in medicine [URM], ie, African American/Black, American Indian/Alaska Native, Hispanic/Latine, and Native Hawaiian/Other Pacific Islander) and sex (female/male). Mean Milestone scores (scale, 0-9) across 6 core competency domains: interpersonal and communications skills, medical knowledge, patient care, practice-based learning and improvement, professionalism, and system-based practice. Overall assessment scores were calculated as the mean of the 6 competency scores. The study sample comprised 128 ACGME-accredited programs and 16 634 assessments for 2708 EM residents of which 1913 (70.6%) were in 3-year and 795 (29.4%) in 4-year programs. Most of the residents were White (n = 2012; 74.3%), followed by Asian (n = 477; 17.6%), Hispanic or Latine (n = 213; 7.9%), African American or Black (n = 160; 5.9%), American Indian or Alaska Native (n = 24; 0.9%), and Native Hawaiian or Other Pacific Islander (n = 4; 0.1%). Approximately 14.3% (n = 386) and 34.6% (n = 936) were of URM groups and female, respectively. Compared with White male residents, URM female residents in 3-year programs were rated increasingly lower in the medical knowledge (URM female score, -0.47; 95% CI, -0.77 to -0.17), patient care (-0.18; 95% CI, -0.35 to -0.01), and practice-based learning and improvement (-0.37; 95% CI, -0.65 to -0.09) domains by postgraduate year 3 year-end assessment; URM female residents in 4-year programs were also rated lower in all 6 competencies over the assessment period. This retrospective cohort study found that URM female residents were consistently rated lower than White male residents on Milestone assessments, findings that may reflect intersectional discrimination in physician competency evaluation. Eliminating sex-specific ethnoracial disparities in resident assessments may contribute to equitable health care by removing barriers to retention and promotion of underrepresented and minoritized trainees and facilitating diversity and representation among the emergency physician workforce.

Medical interns in district health services: an evaluation of the new family medicine rotation in the Western Cape of South Africa

BackgroundIn 2021, South Africa introduced a 6-month internship rotation in family medicine, in the second year of a 2-year internship programme for newly qualified doctors. This was a major change from the previous 3-months training in family medicine, and expanded the training platform to smaller district hospitals and primary health care (PHC) facilities, many of which had never had interns. The medical disciplines in South Africa needed to know if this change in the internship programme was worthwhile and successful. The aim of this study was to assess the new family medicine rotation for medical interns at district health facilities in the Western Cape Province.MethodsDescriptive exploratory qualitative research included six intern programmes across the province. Purposeful sampling identified a heterogeneous group with maximum variation in experience. Overall, eight interns, four managers, four supervisors and four intern curators were included. Individual semi-structured interviews were audio-recorded and the transcripts were thematically analysed using the framework method and Atlas-ti software.ResultsFour major themes emerged around the varied structure and organisational characteristics of the rotations, the orientation and arrival of interns, their learning during the rotation, and impact on health services. A programme theory was developed that defined the key inputs (i.e. infrastructure, communication, orientation, preparation, prior learning and guidelines), processes (i.e. model of the rotation, clinical training and supervision, clinical teaching), outputs (i.e. more independent decision making, approach to undifferentiated problems, approach to chronic care and continuity, development of procedural skills, approach to sequential coordination of care and referrals, working in a multidisciplinary team and inter-professional learning, integration of multiple competencies, as well as becoming more person and community orientated).ConclusionsThe new rotation in family medicine was positively experienced by most interns, supervisors and managers. It should lead to improved quality of care, better preparation for obligatory community service, and an increased likelihood of considering a career in district level health services. This study will form part of an exploratory sequential mixed methods study that incorporates the key issues into a questionnaire for a descriptive survey of all interns in a subsequent study.

A Nationwide Evaluation of Cardiothoracic Resident Research Productivity

BackgroundEvaluating the research productivity of cardiothoracic surgery residents during their training and early career is crucial for tracking their academic development. To this end, the training pathway of residents and the characteristics of their program in relation to their productivity were evaluated. MethodsAlumni lists from integrated 6-year thoracic surgery (I-6) and traditional thoracic surgery residency programs were collected. A Python script was used to search PubMed for publications and the iCite database for citations from each trainee. Publications during a 20-year time span were stratified by the year of publication in relation to the trainee’s graduation from thoracic surgery residency. Trainees were analyzed by training program type, institutional availability of a cardiothoracic surgery T32 training grant, and protected academic development time. ResultsA total of 741 cardiothoracic surgery graduates (I-6, 70; traditional, 671) spanning 1971 to 2021 from 57 programs published >23,000 manuscripts. I-6 trainees published significantly more manuscripts during medical school and residency compared with traditional trainees. Trainees at institutions with cardiothoracic surgery T32 training grants published significantly more manuscripts than those at non-T32 institutions (13 vs 9; P = .0048). I-6 trainees published more manuscripts at programs with dedicated academic development time compared with trainees at programs without protected time (22 vs 9; P = .004). ConclusionsI-6 trainees publish significantly more manuscripts during medical school and residency compared with their traditional colleagues. Trainees at institutions with T32 training grants and dedicated academic development time publish a higher number of manuscripts than trainees without those opportunities.

3-year medical education in North America: A student perspective

There has been a rise in the amount of medical schools in the United States and Canada that are offering 3-year programs to graduation. From a student perspective, there are numerous pros and cons with the authors overall being in favor of an accelerated medical education.