Continuation Of Medical Education Research Articles

Discontents and Blessings of Emergency Distance Learning During Covid-19: A Qualitative Study in Two Universities of Karachi, Pakistan

Objective: The purpose of this research was to investigate the perceptions of undergraduate medical students, faculty and administrators, regarding their experience of emergency distance online teaching, the challenges faced, and future opportunities digital learning. Study Design and Setting: A qualitative study design was used with a phenomenology approach. This study was conducted in two public sector universities in Karachi in November and December 2021. Methodology: In-depth-interviews (IDIs) were used to assess the perceptions of administrators and faculty, and focus group discussions (FGDs) for perceptions of medical students. Qualitative data was analyzed by thematic analysis. Results: Participants reported unpreparedness of institutions, internet connectivity and technological expertise issues, lack of student-teacher engagement, untrained faculty, lack of practical and clinical exposure, loss of learning environment and infrastructure issues, as the barriers, while appreciating the convenience, flexibility, time-efficiency, accessibility and continuity of medical education as the advantages of distance learning. Conclusion: The new dictum of education is digital learning and it is here to stay. The consensus opinion seems to be for blended learning, with theoretical component of curriculum being delivered online and practical and clinical, face-to-face.

Awareness of Ethical Issue in Online Teaching for Medical Education, West Bengal, lndia

Currently, the world is responding to a pandemic of contagious respiratory disease caused by a novel corona virus and its emerging new variants of concern, COVID-19 that has impacted all aspects of our lives, including education. Hence, online classes have become a key component in the continuity of medical education, it allows the students to interact with their teacher face-to-face through the internet using online tools and so on, which can be combination of blended learning (attending classes along with virtual class). In online learning, academic dishonesty in institutions is one of the major ethical challenges which is affecting negatively on the character and personality of student. The present study is conducted to assess the perceptions and awareness of ethical issues in online learning by study participants. A self-administered online questionnaire using Google Forms® having combination of closed- and open-ended questions was given to participants. The data collected was analyzed in excel sheets using simple statistical tool. 62 (36%), out of 171 students disagreed that online teaching sessions were more effective and helped them to study better, they considered it is not effective in delivering or promoting effective teaching learning in medical education considering various barriers to it. However, 19 (76%) out of 25 faculty agreed that Online learning in medical education enables students to continue their education similar to the traditional approach. Participants awareness on ethical issues was good when using online learning systems in medical education and the students should be made fully knowledgeable about ethical issues to avoid unethical behavior during their academic period.

DISTANCE LEARNING DURING THE WAR IN UKRAINE: EXPERIENCE OF INTERNAL MEDICINE DEPARTMENT (ORGANISATION AND CHALLENGES)

The beginning of the military aggression by the Russian Federation induced the suspension of education at all levels. Starting from March 14th, the training has continued in a remote format. But, although all educational institutions had the experience of distance learning, teaching during the war revealed its own features. During the war in Ukraine, health care facilities remain a military target, causing casualties among medical personnel. This, together with medical workers` abduction and migration, resulted in a shortage of medical staff. Under such conditions, the contribution of senior students and higher medical institution graduates was significant. Therefore, the continuation of medical education during the war is of great importance for an effective health care system functioning.
 The aim. Highlight the experience of distance learning organisation at the clinical department during the war and the problems were discovered during the class.
 Materials and methods. Classes were held daily with the mandatory synchronous and asynchronous parts, and the organisational component ensured their connection. The asynchronous component was organised by answering an extended clinical case, which included several theoretical questions and five mandatory tasks. To decrease the load for the teacher, the time limit for answering clinical case has been set, and a template of standard comments has been created. In addition, students were required to answer KROK2 tests. The synchronous component of distance learning was implemented using a Google Meet video conference, held daily according to a pre-approved schedule. In order to increase the level of student's communication skills, improve clinical thinking, as well as the practical application of the acquired knowledge, a "clinical" simulation was carried out during each video conference.
 Due to the pandemic of COVID-19, institutions of higher medical education had a well-established mechanism of the distance learning organisation. However, active hostilities on the territory of Ukraine led to additional obstacles. The lack of sufficient resources to meet the physiological needs limited the students' opportunities to study because, according to A. Maslow, the fulfilment of basic needs is important to an effective cognitive activity. The sound of air raid sirens required interrupting the online part and descending into a bomb shelter. A chronic shortage of basic needs realisation led to a disturbance of the emotional state and consequently hindered the effective processing and memorisation of the material. The absence of stable Internet and being in different time zones also interfered with efficient education. Students' participation in volunteer activities impeded their ability to engage in and concentrate on the educational process.
 Conclusions. Despite the sudden start of military aggression, institutions of higher medical education quickly switched to distance learning. As in the times of the COVID-19 lockdown, online education consisted of synchronous and asynchronous parts connected through the organisational component. However, active military operations and the constant threat of aerial attacks have created additional obstacles: security issues during the study, emotional state of students and teachers, problems with the Internet, power blackout, and being in different time zones. In addition, students` volunteer activities impeded full engagement in the learning process.

Student perceptions towards online learning in medical education during the COVID-19 pandemic: a mixed-methods study.

This mixed-methods study was undertaken to ascertain undergraduate medical students' perceptions of remote learning following the COVID-19 restrictions. 545 students participated in this study. Data was collected using a validated questionnaire and four focus group discussions. Regarding recorded lectures, the quantitative findings indicated that they were important during online learning and the qualitative findings explained that the recorded lectures enabled individual students to pace and customize their learning. The majority of the students agreed that recorded lectures were relevant to their learning, though they watched less than 50% of recorded lectures. Qualitative findings described procrastination as the rationale for not watching the videos. The online live lectures had a relatively higher percentage of contribution towards learning in comparison with instructor recorded video lectures. Students were more engaged with live lectures, and 63.3% of respondents agreed. Qualitative findings confirmed the opportunities for interacting with peers and better clarification of doubts by teachers during live lectures. Online learning with recorded and live lectures provided continuity in medical education during the COVID-19 pandemic. When compared to recorded video lectures, synchronous live lectures were regarded as superior by students largely due to the opportunity to directly communicate with the instructor and receive quick feedback.

Challenges faced by 1st phase MBBS students during online teaching of competency-based medical education curriculum – COVID times

BACKGROUND: Competency-based medical education (CBME) is a learner-centered, outcome-based approach which motivates self-learning. Currently, the world is experiencing COVID-19 pandemic which led to shutdown of colleges, and hence, online teaching has become a key component in the continuity of medical education. The main aim of the study is to analyze the impact of COVID-19 pandemic on online teaching among 1st-year MBBS students and to assess the challenges faced during this time. METHODS: After obtaining institutional ethics committee clearance, a mixed-method study design was used to collect data from 100 respondents among 1st-year MBBS students of Kurnool Medical College, Kurnool, during the month of September 2020. A prevalidated, semi-structured questionnaire was sent to the participants through Google Forms. The quantitative analysis was done through survey questions on a five-point Likert scale. RESULTS: The reported challenges to online medical education during COVID-19 pandemic were lack of in-person communication (57%), technical issues while attending online classes (49%), difficulty in time management (50%), confusion in understanding course expectations/competencies (44%), and more focused on theory than practicals (59%). Some of them stated that “having online classes is really helpful than not having any classes at all.” CONCLUSIONS: Hence, we conclude that though challenges mentioned above were faced during online teaching of CBME curriculum, effective leadership and student teamwork would be helpful in successful online teaching.

COVID-19 ONLINE CROSS-TRAINING PROGRAM

Background:The need for continuity in medical education with the advent of COVID -19, has been highlighted in light of the current global pandemic situation. As the risks posed by COVID -19 must be balanced against the need to care for patients and protect health care workers, cross-training of various health care professions is now more important than ever. In response to the global pandemic and in line with current practice, the Ministry of National Security, King Abdul-Aziz Medical City-Jeddah, has established a cross-training working task force comprising medical educational specialists from various specialtiesto develop an educational platform that includes up-to-date learning resources to provide healthcare professionals with the knowledge they need to treat critical, suspected, and confirmed COVID -19 patients.The main objective of this manuscript is to describe and discuss the implementation process of the cross-training modules. In addition, the manuscript aims to address the knowledge gap related to COVID -19 management by measuring the perceptions of medical students and healthcare professionals. Methods:A qualitative, descriptive study was conducted in the King Abdul-Aziz Medical City (KAMC) National Guard using the COVID -19 cross-training e-learning platform. The training participants were primarily physicians, then health care workers, students and interns from different universities (KSAU-HS) to be able to treat COVID -19 patients in different areas. This platform was equipped with all the necessary functions to create e-learning training courses. The content of the educational material was to be delivered using two main teaching methods: (1) Virtual learning modules consisting of basic and advanced courses. (2) Simulation-based instruction, consisting of computer-based and simulation manikin-based courses. First, a needs assessment survey was distributed to approximately 150 medical students and health professionals. Then, another self-assessment survey was distributed to approximately 1000 participants. Results: In the needs assessment survey, the majority of participants (22.3%) were from the Department of Internal Medicine. In the feedback survey, the majority of participants were from the Department of Nursing (15.7%). Overall, participants consider the Cross-Training Module/Unit Content & Structure to be adequate in terms of its purpose (P 0.908) results also indicate that participants are satisfied with the provisions (P 0.374) and that the Cross-Training was relevant and helpful to the circumscribed and included professions (P 0.731). Conclusion: As synthesis research, this study revealed the perceptions of health professionals and medical students regarding the implementation of an e-learning strategy for cross-training as a teaching tool. Participants indicated that the training program was most helpful because the course materials were strongly tailored to their areas of expertise.

The Change of Medical Education Landscape in the Midst of COVID-19 Pandemic

The COVID-19 outbreak started late 2019 has systematically changed the lives of people around the globe. Medical schools have to implement changes in the teaching methodology to observe social distancing order. The pandemic perpetuates a paradigm shift in medical teaching, from face-to-face to virtual and online teaching. Virtual teaching has become the new learning norm but limited in replacing clinical teaching. It has been considered as one of the most viable options for the long-term durability and continuity of medical education. The fluidity of such educational changes, especially during the pandemic warrants preparation of the online infrastructure learning, literacy of the learners and preparation by the teachers during this period.

Development and Implementation of an Online Virtual Teaching Curriculum for the Continuity of Undergraduate Medical Education in Surgical Anatomy.

Despite the significant reform medical education has witnessed over the past decade,1,2 the coronavirus disease of 2019 (COVID-19) pandemic has kindled change that will persist for generations to come.3 Recommendations recently made by the Association of American Medical Colleges have advocated for the withdrawal of medical students from all clinical rotations at the height of the COVID-19 pandemic, and, more recently, for the cancellation of all in-person visiting rotations.3,4 In response, plastic surgeons have continued to innovate and address these educational challenges. The American Society of Plastic Surgeons now provides interested medical students with free access to its online Education Network, a program that offers over 90 educational modules on an array of essential plastic surgery topics.3 A recent report in the Journal describes the development of virtual plastic surgery subinternships for senior medical students unable to complete in-person rotations, with objectives that remain in line with Accreditation Council for Graduate Medical Education core competencies.4 However, and despite these notable efforts, there remains a paucity of attention targeted toward the continuity of medical education in surgical anatomy, a topic that remains particularly relevant as an essential competency for senior medical students before beginning postgraduate training in plastic surgery. To address this educational disparity, our group developed and implemented an online virtual anatomy teaching curriculum designed to help keep medical students up to date, prepared, and on-track for surgical rotations ahead. Topics covered thus far include the thorax, brachial plexus, forearm, hand, anterior abdominal wall, back, and lower extremity, with upcoming sessions scheduled for head and neck, craniofacial, intraabdominal, and pelvic anatomy. These sessions were designed not to replace core anatomy teaching, but rather to help reinforce essential concepts and discuss different surgical techniques, medical abnormalities, and clinically relevant variations, thus simulating and complementing intraoperative and clinical learning. [See Video (online), which shows a short segment from a breast anatomy lecture (image courtesy of Jad Abi-Rafeh).] Our initiative has so far amassed interest from 227 medical students; the majority of them (80 percent) are in their second and third years of medical training. Most recently, 68 percent of participants attended from our local institution, with the remainder representing local and international trainees from the United States, Canada, Mexico, Colombia, Indonesia, and The Netherlands. With the support of Plastic and Reconstructive Surgery’s social medial channels, interest from international attendees continues to grow. Through before-and-after tests administered to participants, a significant improvement in average test scores was observed following virtual learning (from 46 percent to 76 percent; p < 0.05), with retention of knowledge subsequently established at 2-week follow-up. All sessions are recorded in real time and remain available for future reference by all participants. {"href":"Single Video Player","role":"media-player-id","content-type":"play-in-place","position":"float","orientation":"portrait","label":"Video.","caption":"This video shows a short segment from a breast anatomy lecture (image courtesy of Jad Abi-Rafeh).","object-id":[{"pub-id-type":"doi","id":""},{"pub-id-type":"other","content-type":"media-stream-id","id":"1_syjxjg45"},{"pub-id-type":"other","content-type":"media-source","id":"Kaltura"}]} The role of virtual teaching resources in plastic surgery education continues to grow, with notable advantages established for both trainees and educators alike.3 Advancements in the field of simulation and virtual teaching in plastic surgery have complemented timely transitions to competency-based training curricula.5 Plastic surgeons must continue innovating and responding to evolving educational challenges to help foster excellence in our field. Thus, it is the authors’ wish that through this correspondence, the validity, efficacy, and reliability of virtual training platforms in surgical education is demonstrated, to help address evolving educational challenges and training the next generation of surgeons, during the time of the COVID-19 pandemic, and beyond. DISCLOSURE The authors have no financial interest to declare in relation to the content of this article. No funding was received for this work. Jad Abi-Rafeh, M.Sc.Faculty of Medicine Tyler Safran, M.D.Mirko S. Gilardino, M.D., M.Sc.Division of Plastic and Reconstructive SurgeryMcGill UniversityMontreal, Quebec, Canada

Rapid deployment of a telemedicine service in orthopaedic surgery during the COVID-19 pandemic.

Rapid deployment of a telemedicine service in orthopaedic surgery during the COVID-19 pandemic.

Use of Information Communication Technology by Medical Educators Amid COVID-19 Pandemic and Beyond

The COVID-19 pandemic has disrupted life and all forms of education. However, the impact on medical education is unique since the need for continuity of training medical students is urgent and traditionally calls for hands-on training and a physical presence. This is further compounded by the unavailability of teachers who are also serving as frontline health-care providers in the pandemic. This article discusses the role and types of information communication technology (ICT) tools in filling the gaps and ensuring educational continuity in medical education, collaboration, and learning, across the world in the current scenario. A variety of online collaboration tools and digital interventions are discussed. A comparison between the various ICT tools being used by medical educators is also presented. The potential and corresponding challenges of revamping the medical education system and incorporating ICT tools in the long run have also been discussed. Our work can serve as the basis of further studies on creating digital educational models in medical education.

Preferences, perceptions and barriers to E-learning among medical students during COVID-19 pandemic lockdown in India

Background: Following the imposition of the nationwide lockdown on 24th March 2020, many medical institutions adopted E-learning as a method to ensure continuity in medical education. Understanding perceptions and preferences of medical students and addressing their barriers are essential for a seamless learning experience.Methods: Data was collected using a semi-structured online questionnaire after obtaining informed consent. A total of 296 students of the second year MBBS and pre-final year were recruited using non probability sampling. Data pertaining to 286 students who returned the questionnaire was entered in Microsoft excel and analysed using SPSS version 21.Results: Majority of the participants 179 (62.5%) were female. Only 18 (6.2%) had advanced computer and internet usage skills. 138 (48.2%) students showed preference for blended mode of teaching. 203 (71.0%) of students showed preferences for non-interactive learning methods like slide share and YouTube videos. 180 (62.9%) cited that lack of personal interaction with the teacher followed by access to internet 67 (23.4%) and lack of hardware 53 (18.5%) as barriers in the e-learning. Significant differences were observed between female and male students in the teaching methods with regards to ease of understanding (p=0.009) and use of non-interactive platforms for e leaning (p=0.03).Conclusions: The study identified blended learning as an acceptable method of learning medical curriculum. Schedule flexibility, ease of understanding and absence of monotony of classroom teaching made e-learning more acceptable. lack of teacher-student interaction, lack of accesses to high speed internet and hardware were barriers perceived to e-learning among medical students.

Term Back / Detention Policy Revision Measures in Academic Medical and Allied Institutions of Pakistan in the COVID-19 Epidemic for the Session 2019-2020

The Pakistan Medical and Dental Council (PM&amp;DC) is the body concerned for the medical and dental education in Pakistan.1 The council was dissolved by an order of the President of Pakistan in October 2019, 2 but the order was revoked by the decision of the High Court of Pakistan.3 According to the PM&amp;DC return/detention policy, a medical student has two chances of exam for his promotion in the next academic class and if one of the students could not pass the two chances provided in at least one of his subjects, the student must pass the exam in 3rd attempt with loss of his / her academic year and must pursue medical studies with the junior class. If one of these students could not pass this or these subjects by exceeding the 3rd chance, the conceded institution offers the 4th and last opportunity to the student.1 If the student still cannot pass the subject in 4th and last opportunity, he is expelled from the establishment with the cancellation of his admission, and the dreams of such a student to become a doctor are fulfilled until he will only be readmitted upon reappearing in the PM&amp;DC competitive entrance test. But due to the sudden and unexpected outbreak of Covid-19, the medical community was the most affected. In some countries, more death rates have been reported among physicians who performed Covid-19 patient care tasks.4 Due to the lockdown policy of Govt. of Pakistan across the country, academic medical institutions were closed as a result of academic months of medical and dental students have also been wasted like other academic fields. The lockdown has been continued and we expect further academic waste from these students. The Pakistan Higher Education Commission has asked for conducting online courses for these students, but the clinical subjects of medical students cannot be taught online as they require direct clinical exposure to patients for the transmission of learning. required. Therefore, as a result of Covid-19, there is expected to be a waste of courses from almost all students across the country. However, in such circumstances, detained / term-back students will suffer a greater and irreparable waste of time as there may be many other technical difficulties regarding the continuation of medical education and the examinations of these students due to the Covid-19 disaster. Therefore, it may be good to revise the Term-Back / Detain policy for these medical, dental, and related students. The authors made the following suggestions for the PM&amp;DC and the institutions to consider this review.&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; 1) To Revise once the Term-Back / detention policy for the period 2019-2020 by allowing students to continue academic promotion during the next academic year with a unique relaxation in the policy.&#x0D; &#x0D; 2) Students who have not passed four chances and who are expelled from the establishment can be relaxed to have an additional chance to continue their medical studies, applicable for the year 2019-2020.&#x0D; &#x0D; 3) Relaxations are similar to those mentioned in the serial number. 1 and 2 for other courses such as Pharm-D, Bachelor of Nursing, etc.&#x0D; &#x0D; Health workers are the main force in the fight against Covid-19 in the exercise of their functions to manage the patients of Covid-19. Mortality rates among healthcare providers have also been reported due to high viral load. There may be a shortage of health care providers around the world. Therefore, facilitation attempts are necessary to help the bona fide medical profession maintain their numbers and needs in the health sectors and to meet the future needs of the world for these health workers. Consequently, in implementing the suggestions of the authors, hundreds to thousands of health professionals and paramedical services will be able to save and secure their future in the service of the sacred mission of saving and serving the sick community.

Medical Education Amid the COVID-19 Pandemic

The coronavirus pandemic has shaken the mankind to its core. Social distancing is the most important preventive strategy for the spread of this contagion, short of a vaccine. Implementation of the same has forced many countries in to a complete lock-down. Closure of schools and universities has made education uncertain at all levels. Medical education is no exception. In this pandemic, the need for uninterrupted generation of future doctors is felt more than ever in our living memory. Continuity of medical education is thus imperative. While “Live” patient contact is an irreplaceable tenet of clinical teaching, these extraordinary times demand exceptional measures. Pedagogical innovations involving technology and simulation based teaching (Online lectures, video case vignettes, virtual simulators, webcasting, online chat-rooms) need to be brought to the forefront. Since the medical educators have been pushed inevitably to rely on technology-based learning, they should not only embrace it but also develop and evaluate its sustainability and application in preclinical and clinical setting. Meanwhile, the students, whose medical education is stuck in this pandemic time, should realize that there is no better teacher than a first-hand experience, and they are eyewitnesses to the making of history.

Learning From Patients: Why Continuity Matters.

Patient continuity, described as the student participating in the provision of comprehensive care of patients over time, may offer particular opportunities for student learning. The aim of this study was to describe how students experience patient continuity and what they learn from it. An interpretive phenomenological study was conducted between 2015 and 2016. Seventeen fourth-year medical students were interviewed following a longitudinal clinical placement and asked to describe their experiences of patient continuity and what they learned from each experience. Transcripts were analyzed by iteratively refining and testing codes, using health system definitions of patient continuity as sensitizing concepts to develop descriptive themes. Students described three different forms of patient continuity. Continuity of care, or relational continuity, enabled students to build trusting and professional relationships with their patients. Geographical continuity allowed students to access information about patients from electronic records and their preceptors which allowed students to achieve diagnostic closure and learn to reevaluate their decisions. Students valued the learning that accrued from following challenging patients and addressing challenging decisions over time. Although difficult, these patient continuity experiences led students to critical reflection that was both iterative and deep, leading to intentions for future behavior. Patient continuity in medical education does not depend solely on face-to-face continuity. Within various patient continuity experiences, following challenging patients and experiencing unanticipated diagnostic and management outcomes trigger critical reflection in students, leading to deep learning.

Avoiding student infection during a Middle East respiratory syndrome (MERS) outbreak: a single medical school experience.

Purpose:In outbreaks of infectious disease, medical students are easily overlooked in the management of healthcare personnel protection although they serve in clinical clerkships in hospitals. In the early summer of 2015, Middle East respiratory syndrome (MERS) struck South Korea, and students of Sungkyunkwan University School of Medicine (SKKUSOM) were at risk of contracting the disease. The purpose of this report is to share SKKUSOM’s experience against the MERS outbreak and provide suggestions for medical schools to consider in the face of similar challenges.Methods:Through a process of reflection-on-action, we examined SKKUSOM’s efforts to avoid student infection during the MERS outbreak and derived a few practical guidelines that medical schools can adopt to ensure student safety in outbreaks of infectious disease.Results:The school leadership conducted ongoing risk assessment and developed contingency plans to balance student safety and continuity in medical education. They rearranged the clerkships to another hospital and offered distant lectures and tutorials. Five suggestions are extracted for medical schools to consider in infection outbreaks: instant cessation of clinical clerkships; rational decision making on a school closure; use of information technology; constant communication with hospitals; and open communication with faculty, staff, and students.Conclusion:Medical schools need to take the initiative and actively seek countermeasures against student infection. It is essential that medical schools keep constant communication with their index hospitals and the involved personnel. In order to assure student learning, medical schools may consider offering distant education with online technology.

A “Safe Space” for Learning and Reflection: One Schoolʼs Design for Continuity With a Peer Group Across Clinical Clerkships

The value of continuity in medical education, particularly during clerkships, is increasingly recognized. Previous clerkship-based models have described changes that emphasize continuity in patient care, learner supervision, and curriculum. The creation of continuous student peer groups can foster interactions that enhance mutual support through uncomfortable professional transitions during the clerkship years. Here, the authors describe a third-year clerkship model based at the San Francisco Veterans Affairs (VA) Medical Center called VA Longitudinal Rotations (VALOR), designed explicitly to establish a supportive learning environment for small peer groups.Seven groups of medical students (42 total) completed VALOR across three academic years between 2007 and 2009. On clerkships during VALOR, one hour per week was designated for faculty-facilitated sessions amongst peer groups. Students' perceptions of peer group support and overall program satisfaction were determined with immediate post surveys and focus groups at the end of VALOR, and with follow-up surveys 5 to 27 months after completing VALOR. Students strongly valued several elements of VALOR peer groups, including support through clerkship challenges, meeting for facilitated reflection, and appreciating patient experiences across the continuum of care. Students' appreciation for their peer group experiences persisted well after the conclusion of VALOR. VALOR students performed the same as or better than traditional clerkship students on knowledge and skill-based outcomes. The authors demonstrate that their third-year clerkship program using peer groups has built supportive learning networks and facilitated reflection, allowing students to develop critical professional skills. Student communication around patient care was also feasible and highly valued.

Lifelong learning and the maintenance of certification

Lifelong learning is critical to radiology and the method by which, as professionals, we have kept up to date on new knowledge and developments. The American Board of Medical Specialists and the American Board of Radiology, along with other professional societies such as the Council of Medical Specialty Societies and the ACR, identified a need and an opportunity to serve the public and our profession through the Maintenance of Certification (MOC) initiative. These issues of lifelong learning, public concern, and MOC—and their interrelationship—are discussed. Lifelong learning is defined as a continuation of medical education with an ongoing process of professional development along with self-assessment, which enables physicians to maintain the requisite knowledge, skills, and professional standards. Continuing professional development can be grouped into three categories: formal, nonformal, and informal learning. Examples from the author’s career illustrate key points. Future technologies and scientific discoveries affect radiology and make the commitment to lifelong learning even more critical. The challenge will be the maintenance of specialty certification and its components and competencies, along with the attainment of knowledge and the skills necessary in our unique practices for quality patient care in the evolving health care environment. These are important challenges to our boards, professional societies, specialty societies, institutions, and practicing community. It is critical to participate actively in these organizations and processes to continue development of the MOC initiative, because it is beneficial to patients, applicable to practicing physicians, and credible to public interests.

The Primary Medicine Initiative—Continuity in medical education

Primary care will play a central role in the new national healthcare program. Our osteopathic medical education programs must change if osteopathic physicians are to remain dominant in primary care and thereby play a large role in the revamped healthcare system. This article outlines a pilot program currently in development at the Michigan State University College of Osteopathic Medicine (MSU-COM). If successful, the MSU-COM program could be used as a blueprint for a similar nationwide program in osteopathic medical education.

Education and Training in Psychiatry: a Case Study in the Continuity of Medical Education

Education and Training in Psychiatry: a Case Study in the Continuity of Medical Education

Education and Training in Psychiatry. A Case Study in the Continuity of Medical Education. Edited by H. Walton. (Pp. 216; £12.00.) King Edward's Hospital Fund for London; distributed by Oxford University Press: Oxford. 1986.

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