Internal Medicine Doctors Research Articles

Characteristics of Medical School Graduates who Underwent Problem-Based Learning

In this study, we compared the choice of medical specialty and subspecialty interest among problem-based-learning (PBL) graduates and non-PBL graduates. Questionnaires were mailed to a total of 1398 female doctors who graduated from Tokyo Women's Medical University (TWMU) between 1989 and 2003. The response rate was over 30%, giving 248 respondents who had undergone a PBL curriculum (PBL+) and 220 subjects who had not (PBL-). Current specialty of the graduates were compared between the PBL+ and PBL-, and also compared with the general Japanese female doctors (Control 1 and 2) of similar age groups. Respondents were analysed in terms of their interests in subspecialty medical care or general medical practise, which includes comprehensive medical care, primary care and basic medicine. Internal medicine doctors working in the university hospitals were compared with those working outside the university hospitals. Internal medicine doctors were also compared with specialists in ophthalmology, otolaryngology, dermatology and psychiatry. Subjects were compared by odds ratio (OR) to examine group difference in the field of interest. OR >2.0 was considered statistically significant. Most doctors in all groups chose internal medicine. More PBL+ internal medicine doctors showed interests in comprehensive medical care and primary care; more PBL+ internal medicine doctors working outside university hospitals showed interest in comprehensive medical care and primary care when compared with those who were working in the university hospitals. The PBL- graduates did not show such a characteristic. More PBL+ graduates who chose internal medicine showed interest in holistic medical practices such as primary care and community medicine and more PBL+ specialists showed sustained interest in their respective fields.

A pilot survey of junior doctors’ confidence in tasks related to broad aspects of competence

Medical authorities and society are recommending that postgraduate medical education prepare physicians for broad aspects of competence. The most effective ways to prepare physicians for these are not known. The aim of this pilot study was to survey junior doctors’ growth in confidence in different physician roles. A total of 165 junior doctors in internal medicine completed a self-administered survey of confidence levels in physician roles. Confidence levels between training levels were compared. Confidence in the roles of medical expert, communicator and collaborator increased between PRHOs and SHOs. Confidence levels increased in all roles between PRHOs and SpRs, but confidence between SHOs and SpRs increased only in the roles of collaborator and scholar. Confidence in the role of professional was low and did not increase significantly between training levels. The SHO year was rated as only moderately useful in facilitating learning of the tasks. These results suggest that growth of confidence in the physician roles proceeds at different rates during postgraduate training. Additional research is needed to identify effective ways for junior doctors to learn broad aspects of competence. Longitudinal tracking will be important to evaluate the effect of educational interventions on patient care.

Trastorno doloroso y vértigo referido al oído: Derivación frecuente al ORL

We revise the temporomandibular dysfunction or myofacial painful syndrome, a clinical entity that shows a high prevalence at the ear, nose and throat (ENT) specialist's surgery. They are polysymptomatic patients seen at the ENT , which are sent by the Internal Medicine and family doctors. As symptoms the patients present vertiginous feeling, tinnitus and/or deafness. We discuss the concept, the ethiopathogenia, diagnosis and the treatment of this syndrome. For the ENT specialist it is a challenge to choose the most appropriate type of treatment in order to obtain a satisfying result. In spite of the great amount of issues referring to this subject, there are still controversies regarding the orientation of the patients and the type of treatment to use.

Comparison of knowledge on asthma: doctors completing internal medicine residency and doctors completing medical school.

Asthma has been reported as a disease of increasing prevalence. To assess the level of information and knowledge about asthma by means of a questionnaire among recent graduate physicians applying for medical residency at the Clinical Hospital of the University of São Paulo Medical School, Brazil. 14 multiple-choice questions for asthma diagnosis and management. University of São Paulo Medical School (FMUSP). Recent graduate physicians applying for the medical residency program at FMUSP in 1999 (n = 448) and physicians that had completed 2 year of internal medicine residency (n = 92). We applied a questionnaire with 14 multiple-choice questions about the management of asthma based upon the Expert Panel Report 2 - Guidelines for the Diagnosis and Management of Asthma, NIH/NHLBI, 1997 (EPR-2). The medical residency program in Internal Medicine improved treatment skills (the ability to propose adequate therapy) when compared to medical education (a score of 57.2% versus 46.9%, P < 0.001) but not diagnosis knowledge (understanding of asthma symptoms related to medicine intake) (33.5% versus 33.3%, P = 0.94). Treatment skills were higher among physicians who received their Medical Degree (MD) from public-sponsored medical schools in comparison with those from private schools [49.7 (SE 1.17)] versus [41.8 (SE 1.63)], P < 0.001. Medical schools might consider reevaluating their programs regarding asthma in order to improve medical assistance, especially when considering the general results for residents, as they were supposed to have achieved performance after completing this in-service training.

５年間試行した薬剤師同行内科総回診におけるディスカッションで診断に至った薬剤副作用症例

５年間試行した薬剤師同行内科総回診におけるディスカッションで診断に至った薬剤副作用症例

Educational needs of internal medicine residency graduates: general internist versus subspecialists

Residency training is inadequate with respect to the needs of general internal medicine doctors in several areas. We undertook this study to determine the practice habits and educational requirements of general versus subspecialty internists. A survey was mailed to 138 doctors who had completed at least a three-year university-based internal medicine post-graduate training. Sixty-three (46%) responded, of whom 32 completed additional training in a subspecialty of internal medicine. Many (14 of 32) subspecialists described their practice as general internal medicine (GIM) with a subspecialty emphasis. GIM was as important to their practice as it was to the general internists. General internists saw non-internal medicine disciplines as important but subspecialists did not. General internists frequently performed procedures that were not formally taught during training, while subspecialists rarely if ever performed a procedure outside the scope of their fellowship training. Internal medicine training programmes should be able to individualize training based on the career choices of trainees such that training will more fully prepare trainees for practice.

THE EUROPEAN EXCHANGE SCHEME FOR JUNIOR DOCTORS IN INTERNAL MEDICINE: An Exciting and Successful Experiment

THE EUROPEAN EXCHANGE SCHEME FOR JUNIOR DOCTORS IN INTERNAL MEDICINE: An Exciting and Successful Experiment