Country Of Medical Qualification Research Articles

To What Extent the Emergency Physicians in Riyadh City Are Aware of Patient Radiation Exposure From Diagnostic Imaging Requested in the Emergency Department.

IntroductionRadiological imaging that uses ionizing radiation in emergency departments (EDs) has increased with advances in radiological diagnostic methods. Emergency (ER) physicians’ awareness of the radiation doses and the associated cancer risks that the patients are exposed to was surveyed using a questionnaire.AimsTo assess the ER physicians’ awareness of radiation doses associated with the diagnostic imaging and to describe their practice about discussing radiation risk with patients at different hospitals in Riyadh city, Saudi Arabia.MethodsA prospective, questionnaire-based observational study was conducted in 2016 among 176 ER physicians at different hospitals in Riyadh city. The percentage knowledge score and the frequency of discussing radiation risk with patients based on responses to three scenarios were rated on a visual analog scale (VAS), where a score of 100 indicated that physicians would always discuss it.ResultsThe overall mean knowledge score was 28% (95% CI: 22-34). None of the studied parameters (gender, experience, country of medical qualification, type of degree, and employment level) showed a significant correlation with the overall awareness of ED physicians about radiation exposure. Over three-quarters of physicians (77%) underestimated the lifetime risk of fatal cancer attributed to a single computed tomography (CT) scan of the abdomen. Majority of physicians (60%) reported never discussing radiation risk with patients. The frequency at which physicians were discussing radiation risk with patients varied greatly depending on the clinical scenario (mean VAS scores between 46 and 82).ConclusionsER physicians of different hospitals in Riyadh city had a varied knowledge about the radiation exposure risks, although overall the perception was inadequate. The physicians should receive education, and the diagnostic imaging request may need to include information on radiation doses and risks.

Prevalence of GMC performance assessments in the United Kingdom: a retrospective cohort analysis by country of medical qualification

BackgroundThe demographics of doctors working in the UK are changing. The United Kingdom (UK) has voted to leave the European Union (EU) and there is heightened political discourse around the world about the impact of migration on healthcare services. Previous work suggests that foreign trained doctors perform worse than UK graduates in postgraduate medical examinations. We analysed the prevalence by country of primary medical qualification of doctors who were required to take an assessment by the General Medical Council (GMC) because of performance concerns.MethodsThis was a retrospective cohort analysis of data routinely collected by the GMC. We compared doctors who had a GMC performance assessment between 1996 and 2013 with the medical register in the same period. The outcome measures were numbers experiencing performance assessments by country or region of medical qualification.ResultsThe rate of performance assessment varied significantly by place of medical qualification and by year; χ2(17) = 188, p < 0.0001, pseudo-R2 = 15%. Doctors who trained outside of the UK, including those trained in the European Economic Area (EEA), were more likely to have a performance assessment than UK trained doctors, with the exception of South African trained doctors.ConclusionsThe rate of performance assessment varies significantly by place of medical qualification. This is the first study to explore the risk of performance assessment by individual places of medical qualification. While concern has largely focused on the competence of non-EEA, International Medical Graduates, we discuss implications for how to ensure European trained doctors are fit to practise before their medical licence in the UK is granted. Further research is needed to investigate whether these country effects hold true when controlling for factors like doctors’ sex, age, length of time working in the UK, and English language skills. This will allow evidence-based decisions to be made around the regulatory environment the UK should adopt once it leaves the EU. Patients should be reassured that the vast majority of all doctors working in the UK are competent.

Migration of doctors from developing countries to Australia: an estimate from surveys of doctors

BackgroundAustralia is a developed country in a developing region and does not train enough doctors to meet demand. It is therefore a destination country for medical migration. Estimation of Australia's dependence on international medical graduates is crucial for effective policy planning for self-sufficiency. No reliable data exist for the number of international medical graduates from developing countries who practise medicine in Australia. The eight states and territories of Australia have had separate systems for medical registration and different practices for surveying practising doctors; even now, no national coordinating system exists that routinely collects and publishes data about doctors and their country of medical qualification. We assessed the number of doctors working in Australia who completed their primary medical qualification in a developing country, and identify the most common source countries for medical migrants in Australia. MethodsWe used data from the eight state and territory medical boards that cover Australia, surveys of doctors in these regions, professional conversion examinations that enable immigrant doctors to be eligible to practise, and the immigration department. We used aggregate data from the surveys to estimate the number of doctors who had completed their primary medical degree in any country outside Australia. Depending on whether they had been surveyed or not, international medical graduates were classified as being from developed and developing countries with a combination of self-reported survey responses, immigration department data, and data from a deidentified sample of 2000 doctors' medical board records. We adjusted this estimate by comparing each region's survey data with its medical board registration data, which enabled international medical graduates who were not surveyed to be included. We used immigration department and conversion examination data to establish the most common source countries. FindingsMedical board data show that Australia has roughly 87 000 registered doctors. Region survey methods varied, but all the surveys underestimated the number of international medical graduates. About 21 000 (24%) doctors in Australia completed their primary medical qualification in a developing country. Seven of the top ten source nations were developing countries. They were India (supplied 800 doctors), Malaysia (supplied 400 doctors), Sri Lanka (supplied 240 doctors), South Africa (supplied 190 doctors), Pakistan (supplied 150 doctors), Iran (supplied 150 doctors), and Philippines (supplied 100 doctors). InterpretationAustralia depends on international medical graduates from developing countries. All but one of the top seven developing source countries have fewer than one doctor per 1000 people, and thus are already below the doctor to population ratio recommended by WHO. FundingBritish Foreign Office.

Bullying in the Australian medical workforce: cross-sectional data from an Australian e-Cohort study

This study aimed to describe the prevalence of perceived workplace bullying in the Australian medical workforce, and investigate the relationship between workplace bullying and job satisfaction, health status, and current and planned medical workforce participation. An electronic cross-sectional survey of doctors currently in the paid workforce, conducted between April 2008 and October 2009, was nested within a longitudinal cohort study investigating factors affecting the recruitment and retention of the Australian medical workforce. To address the specific aims of this study, a subset of questions in the survey investigated the prevalence of self-reported bullying; physical and mental health; workforce participation patterns; job satisfaction; and job stressors. Seven hundred and forty-seven participants responded to the bullying question and were included in this analysis. Twenty-five percent of participants reported being bullied in the last 12 months. There were no differences in the reported rates of bullying across age groups, sex and country of medical qualification. Bullied doctors were least satisfied with their jobs (P<0.001), had taken more sick leave in the last 12 months (P<0.001), and were more likely to be planning to decrease the number of hours worked in medicine in the next 12 months (P=0.01) or ceasing direct patient care in the next 5 years (independent of their age or the number of hours currently worked in patient care) (P=0.006). Our findings suggest that Australian doctors, independent of age or sex, have experienced workplace bullying, and although no conclusions can be made about causal pathways, there were strong associations between this exposure and poorer health and wellbeing, and on remaining in the medical workforce.

Effects of occupational violence on Australian general practitioners’ provision of home visits and after‐hours care: a cross‐sectional study

Occupational violence is increasingly recognized as a problem in general practice, and has been suggested as adversely affecting general practitioners' (GPs) provision of services to patients. The aim of this study was to investigate the association of experiences of violence and perceptions of risk of violence with provision of after-hours GP care and home visits. A questionnaire-based cross-sectional survey of GPs in three Australian Urban Divisions of General Practice was used. Five hundred and twenty-eight GPs completed the survey (response rate 49%). Of the GPs surveyed, 63.7% were subjected to some form of violence in the previous 12 months. Risk of violence influenced 10.2% of GPs' delivery of in-hours home visits and 22.0% of GPs' delivery of after-hours home visits. A further 4.7% of GPs reported not performing after-hours home visits at all during the previous 12 months because of safety concerns. On logistic regression, gender, location of practice and country of medical qualification were significantly associated with provision of in-hours and after-hours home visits. Experience of violence during the previous 12 months was not significantly associated with provision of home visits. This study's finding of GPs' self-reported restriction of practice and withdrawal from home visits and after-hours calls in response to risk of violence represents a significant primary health care issue. GPs' decision to provide after-hours calls and home visits is complex, and the finding of lack of significant association of experiences of violence with provision of home visits and after-hours calls is likely to be due to the cross-sectional nature of the study.