Medical Council Research Articles

Evaluate the impact of foundation course conducted at the level of 1st-year MBBS students at Assam Medical College, Dibrugarh – A student perspective

Background: Since 2019, the Medical Council of India (MCI) has started to introduce Competency-based Medical Education, which highlighted the importance of an 1-month duration foundation course. This period is considered necessary for the students to adapt to the new environment in the college. The present study was done to evaluate the impact of foundation course conducted at the entry level of MBBS students. Aims and Objectives: The objectives of the study are as follows: 1. Evaluate the input of the students on all the topics of the Foundation course modules and 2. Based on student’s input, improve the course for future sessions. Materials and Methods: All the new 1st-year medical students admitted in November 2022 were the study subjects. The guidelines laid down by the MCI were followed when implementing the foundation program. A pre-designed Google Form questionnaire, which included items that were appropriate to the research question, was circulated among the students, and input from them was used to evaluate the program. Feedback was received from students using a three-point Likert Scale. Results: It was observed that after the implementation of the 1-month duration foundation course, knowledge of the students as well as the need and the importance regarding all the modules increased and was found to be extremely significant statistically (P < 0.0001). Conclusion: Overall, the sessions in the foundation were positively received by the students. The information thus gathered will enable us to enhance the program for the following year and fulfill the objectives of the course.

An Integrated Competency-based Curriculum for Undergraduate Medical Education Programme in Bhutan

Introduction: Training of health human resources is an integral component of strengthening health systems. In Bhutan, the postgraduate training programme commenced in 2014 and the undergraduate programme is scheduled to begin in 2024.Methods: The curriculum was drafted by a team of experts and reviewed over multiple rounds with medical educators, health administrators and field experts from within and outside the country. The curriculum was validated by a team of experts from the university and the medical council. The curriculum for the Bhutan Medicine Programme adopted an integrated approach for teaching-learning and assessments.Results: Core competencies have been defined to meet the needs of a graduate that is prepared to face the challenges of the present and the future. Learning objectives are constructively aligned with teaching-learning and assessment tools. The five-year programme includes the Foundation of Medicine, Early Clinical Exposure, System integration through module-based learning, Clinical rotations including professorial attachments and internship. Community medicine, behavioural sciences and medical humanities are incorporated through the first to fourth years. We foresee a challenge in the acceptance of an integrated curriculum from sections of senior clinicians and teachers who have been trained in a traditional curriculum. A series of faculty development programmes have been conducted to discuss advantages of an integrated approach.Conclusion: Implementation of an integrated curriculum requires adequate faculty together with faculty development. Faculty recruitment is ongoing at the time of publication.

Evaluation of the preclinical hospital visit programme with students' feedback at the University of Nottingham, UK.

Background . The General Medical Council's publication Tomorrow's Doctors recommends that medical students should attain professional awareness at an early stage of their education. Accordingly, in the University of Nottingham, basic science teaching is integrated with clinical practice, by attaching medical students to hospital specialty teams and general practices in the community, as regular timetabled 'hospital visits' from the beginning of their medical education. We evaluated the feedback forms of the preclinical (1st and 2nd years) medical students retrospectively based on their experience of the hospital-based clinical teaching programme over 2 years. The hospital visit programme was modified based on the student feedback following which the effectiveness of the modified programme was revaluated post-test. Methods . This study was based on a quasi-experimental design in which comparisons of pre-test and post-test feedbacks with 337 feedback forms in each group were analysed in the study period. Quantitative response questions in the feedback were statistically analysed using independent t-test, and free text questions were qualitatively analysed and grouped into themes. Results . Data analyses showed significant difference (p<0.001) between the pre- and post-test groups. The main feedback themes identified were number of the patients examined, organization of the visit, patient selection, introductory talk, and briefing and debriefing before and after the visit. Conclusion . The structure of the hospital visit programme was influenced by the available infrastructure, flexibility of access and delivery of clinical teaching. The programme helped build professional attitudes in both staff and students and encouraged independent learning.

Publication requirement for faculty promotion in medical institutions in India: 'Mind the gap'.

Background . We assessed the balance between the number of publications required by medical teachers and the publication space available in the Indian medical journals. Methods . The Medical Council of India (MCI) website, its guidelines and documents were searched and we extracted data on the number of medical colleges, undergraduate and postgraduate seats and faculty requirement. The required number of assistant professors and associate professors was calculated. The publication requirements were estimated according to MCI's February 2020 guidelines. A publication which satisfied the above guidelines for promotion was counted as 'eligible publication'. Indian medical journals indexed in any of the MCI-permitted databases were identified, and the number of eligible articles in them in 2019 was counted. Results . India has a total of 79 798 MBBS seats, 33 025 postgraduate seats and 4231 superspecialty seats in MCI-certified medical institutions and to teach them 35 285 assistant professors and 23 116 associate professors are required. Assuming that each publication could serve a maximum of 3 teachers, we will need approximately 50 696 eligible publications in the next 7 years. A search of applicable databases, identified 162 unique Indian medical journals of which 79 were indexed in PubMed/PubMed Central. Among the remaining 63 were indexed in DOAJ, 14 in EMBASE, 3 in Scopus and 3 were indexed only in WOSSCIE. These journals cumulatively published a total of 8508 eligible publications in 2019. Conclusion . The publication space in Indian medical journals is limited, thus there is a need to have a national medical repository such as MedRxiv to prevent publication in predatory journals.

Rating of French maxillofacial surgeons on their Google® business account: Current status and reflections for equitable communication

IntroductionOnline reputation is misattributed in France in academic publications. However, this phenomenon is growing. The objective of this study was to establish an inventory of the e-reputation of French maxillofacial surgeons through the opinions posted on their professional Google® account. Material and methodsA descriptive study included all the surgeons registered on the list of the French National Medical Council in “maxillofacial surgery and stomatology”. Data collection was carried out from February to April 2022. ResultsAmong the 483 surgeons included, 61.1% had received at least one opinion, the number of per surgeon was 22.2. The average was 4.3/5. Among the 4433 written comments completing the review, 85% were positive. The average response rate of surgeons was 10% and was all the more important as the rating of the opinion was lower. Stomatology (65.3%), aesthetic surgery of the face (15.1%) and orthognathic surgery (14.5%) were the most commented maxillofacial procedures. DiscussionThe online image of French maxillofacial surgeons was very positive. However, faced with a defamatory or insulting comment, the surgeon found in an unbalanced situation where he could not respond without risking betraying medical. We recall some common-sense recommendations for managing one's e-reputation and some legislative adjustments for better regulation of these platforms, also considering legal and ethical aspects.

Driving Behaviour, Road Crash Involvement, Working Commute (MyDRIVE) Questionnaire: Testing Data Quality, Scaling Assumptions, Reliability and Validity Among Malaysian Medical Doctors

Introduction: The Driving Behaviour, Road Crash Involvement, Working Commute (MyDRIVE) questionnaire was developed to assess medical doctors’ experience with road crash involvement. The objective of this research was to validate the driving behavioural component of MyDRIVE for medical practitioners in Malaysia. Method: This was a multi-stage study involving item specification, domain specification and domain assessment. Following item pools among the experts, Malaysian Medical Association (MMA) members and their contacts who are partially or fully registered with the Malaysian Medical Council (MMC) were surveyed via an online questionnaire between April 2020 and May 2021. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) was done with 150 participants and 824 participants, respectively on separate analysis to ensure the factor validity. We examined the standardized loadings, AVE and CR to determine the convergent validity. The discriminant validity was tested through the Fornell-Larcker matrix. Reliability analysis was performed through Cronbach alpha and composite reliability. Results: EFA resulted in reduction of items from 44 items to 23 items with six constructs. Composite reliability (CR) revealed all domains have a CR of above 0.7, except for Driving Under Alcohol Influence (DAI) (0.605). The remaining factors are Distracted Mind &amp; Negative Emotion (DMNE) (0.843), Safe Driving Habit (SDH) (0.862), Fatigue Driving (FD) (0.903), Recreational &amp; Prescribed Driving (RPD) (0.748), and Driving Under Influence of Caffeine (DCI) (0.836). For discriminant validity the square root of AVE for all constructs were greater than its correlations with other latent constructs. Conclusion: Our study finds the driving behavioural component of the MyDRIVE questionnaire among the Malaysian medical doctors to have good reliability and validity. Future studies should consider using MyDRIVE’s driving behaviour component to assess driving behaviour among doctors.

Physician experiences with teleconsultations amidst conflict in Sudan

The current conflict in Sudan severely hinders the accessibility of health services across the country. To address this, several initiatives were proposed including offering services using teleconsultations. This study aimed to assess Sudanese doctors' teleconsultation experience, perception, and concerns during the recent conflict. This cross-sectional survey focused on Sudanese medical officers, residents, specialists, and consultants living inside or outside the country having a practice license from the Sudan Medical Council and conducting teleconsultations with Sudanese patients during the conflict period. The questionnaire was distributed to personal and professional contacts and via social media platforms in the English language among doctors who provided teleconsultation during the conflict. Data analysis was performed using the Statistical Package for Social Sciences software version 26. The study enrolled 2463 clinicians from 17 different specialties, and females represented more than half the sample (56.8%). Internal medicine was the most frequent specialty (36.1%) and the majority (68.7%) of clinicians had less than 5 years of work experience. Voice call was the most frequent platform (50.1%) used for teleconsultation during the conflict and had the highest convenience score (p < 0.01), whereas messaging platforms had the lowest score. Most clinicians (73.3%) agreed that teleconsultations created a trusted patient-physician relationship and provided good-quality care (61.8%). However, 85.1% highlighted the importance of physical touch in medical practice. Clinicians were concerned that incomplete information (81.4%), missed diagnosis (76.8%), medicolegal problems (71.0%), and prescription errors (68.4%) could arise with teleconsultations. Most respondents (70.7%) emphasized the importance of continuing to offer teleconsultation even after the war abated. In conclusion, physicians who participated in the current study agreed that teleconsultation provided quality care even in this dire crisis in Sudan. Based on our study findings, we recommend upscaling telemedicine interventions including teleconsultations at the national level. This would require unified coordination efforts of a wide mix of stakeholders to address concerns identified in the current study.

Riga Native Johann Christian Weltzien (1767–1829), Author of a Book on “Мedical Рolice”

On the basis of the archival materials, first identified by the authors, and the published historical sources that have not yet come to the attention of historians of science, this article reconstructs the biography of Johann Christian Weltzien (1767–1829), doctor of medicine and surgery. In 1785, Weltzien became a court physician. In 1799, in the retinue of Grand Duke Konstantin Pavlovich, he participated in Italian and Swiss military campaigns. After that, Weltzien was assigned to the Сourt of Grand Duke Konstantin Pavlovich of Russia and stayed at his court until 1810. He started his charitable activities in the Medico-Philanthropic Committee. From May 1810 to the middle of 1825, Weltzien was a physician at the Imperial Page Corps. It turned out that around the same time, in 1804–1825, he was a member of the Medical Council. Furthermore, as there were two medical councils under two ministries at the time, in 1811–1822, he was a member of both. Since 1825, Weltzien lived on his estate in Somel, now Vaiatu Manor in Estonia, and died in St. Petersburg. Weltzien’s work as a provincial physician prompted him to write a book on medical police, which was published in 1785. It has been established that this remained his only book on the topic. The article shows that Weltzien became one of the first ideologists of state care for public health in the Russian Empire. Weltzien’s ideas, expressed over 200 years ago, regarding the state having mechanisms to impact public health and the importance of not excluding it from solving health problems have not lost their significance even today.

Surgical trainee experiences from 2013 to 2023 within the United Kingdom as reported by the General Medical Council National Training Survey

IntroductionThe General Medical Council (GMC) issues annual surveys to all doctors within the United Kingdom (UK) in a formal postgraduate training scheme. This facilitates the monitoring of experiences for quality assurance purposes. Low job satisfaction has been associated with heightened levels of burnout and staff turnover, alongside deteriorating clinical care and productivity levels. MethodsWe gathered and extracted data from the publicly available online GMC reporting tool. Data ranged from 2013 to 2023 and spanned 12 postgraduate surgical training programmes across all 18 indicators available. In total, 198 individual metrics were recorded, in addition to burnout. We conducted trend analysis and yearly average mean scores for individual metrics, burnout and geographical differences for 141 individual training programmes within the 16 training regions. ResultsOf the 198 metrics analysed, 83 (42 ​%) were found to have statistically significant negative trends (P ​< ​0.05), in comparison to 24 (12 ​%) with positive trends. 5 specialities had over 50 ​% of metrics showing a significant negative trend. Overall satisfaction was negative in all 12 programmes, with eight reaching significance (P ​< ​0.05). Of 141 individual training programmes, 29 ​% showed a significantly negative trend in overall satisfaction, with 1 ​% demonstrating a significant positive trend (P ​< ​0.05). ConclusionOur study is the first to explore long-term trends in trainee reported surgical training experiences within the UK. Our data have revealed widespread worsening trainee reported experiences and dissatisfaction across multiple specialities and geographical regions, especially in key areas of overall satisfaction, self-development, and clinical supervision.

Event I. The development of oriental medicine in Russia in the XVIII-XIX centuries. The role of scientists of the Imperial Medico-Surgical (Military Medical) Academy

The article presents the history of nascence traditional oriental medicine in Russia during XVIII–XIX centuries. The first information about oriental medicine was brought to Russia in the XVIII century by doctors, who visited Mongolia and China as members of embassy expeditions. The first decades of the XVIII century can be considered as beginning of a systematic study oriental treatment methods. It was possible thanks to the many years efforts of the employees of the Russian ecclesiastical mission in Beijing. This organization from 1715 to 1864 years served religious, diplomatic and scientific functions. An invaluable contribution to the study of Chinese medicine was made by the leaders of the mission. Major role belongs to Nikita Yakovlevich Bichurin (father Iakinf), archimandrite of the IX mission. He was fluent in Chinese, studied the primary sources of medical literature, translated significant treatises into Russian, and taught Chinese to the mission staff. The head of the X mission, Pavel Ivanovich Kamensky, compiled a Chinese-Russian medical dictionary, reorganized the mission, and insisted on the need to introduce the position of a doctor among the staff. Starting from 1821, doctors O.P. Voitsekhovsky, P.E. Kirillov, A.A. Tatarinov, S.I. Bazilevsky and P.A. Kornievsky, graduates of the Imperial Medical and Surgical (Military Medical) Academy worked as physician of the X–XIV missions. Doctors continued to study the theoretical concepts of Chinese medicine, philosophical and cultural traditions that underlie healthcare. In addition to medical work, in accordance with the instructions of the Medical Council at the Ministry of Foreign Affairs, they explored epidemiology, healthcare organization and the process of training doctors in China, analyzed Eastern approaches in the diagnosis and treatment of diseases, pharmacopoeia, used of herbal remedies, methods of prevention and health maintenance. The scientific approach, knowledge of the Chinese language, and a long stay in the country allowed them to lay the foundations of Oriental medicine in Russian, acquaint medical community with the methods of treatment and prevention of diseases adopted in China, introduce acupuncture, moxa, the use of new types of herbal remedies, enrich the collections of medicinal plants.

Density and regional distribution of radiologists in a low-income country: the Ghana situation

BackgroundThis study assessed the density and distribution of radiologists across all 16 regions in Ghana to generate reference information for planning and policy formulation to encourage radiology specialization and in designing systems to improve the dissemination of radiological services across all the regions in Ghana.MethodA cross-sectional design was used to collect secondary data on all radiologists (n = 93) registered with the Medical and Dental Council of Ghana (MDCG) as of December 2022. This information collected on the records of the MDCG was confirmed with records from the Ghana Association of Radiologists. Population and land area data were also collected from the National Statistical Service of Ghana for each region in the country. The Stata statistical software version 15 was used to analyze the data collected.ResultsThere were 93 radiologists in the country. The majority were male (n = 60, 65%) and about one-third of the radiologists were female. The national density of radiologists was 1.9 radiologists per 5000 km2. Only 3 of the 16 regions in the country had a better distribution of radiologists per 5000 km2. There were three radiologists per million people in Ghana with a skewed regional distribution. Seven out of the 16 regions lacked radiologists. The proportion of female radiologists stationed within the Greater Accra and Ashanti regions was 87.9% (29/33). The Bono, Eastern, Northern, and Western regions had one female radiologist each.ConclusionsActions are needed to improve the shortage and skewed distribution of radiologists. The outcome will help to improve radiological services across all the regions in Ghana.

Survey of United Kingdom oral and maxillofacial surgery (OMFS) specialists and trainees about the reasons that they retain or drop their registration with the General Dental Council (GDC) including a summary of changes in the numbers registered with the GDC 2014-2023

When dual degree OMFS training was mandated in the UK in 1995, OMFS specialists were required to be registered with both the General Dental Council (GDC) and General Medical Council (GMC). In 2005 this legal requirement for dual registration with both regulators was removed. During 2021 the authors surveyed UK OMFS specialists and trainees asking them why they chose to remain on or leave the Dental Register to give context to the changing numbers of OMFS specialists and trainees holding Dental Registration between 2014 and 2023. In 2014 of 539 OMFS specialists and trainees only 62 (12%) were solely GMC registered, that is, they had let their Dental Registration lapse. In 2023, of 709 OMFS specialists and trainees, 320 (45%) were solely GMC registered. Those whose first qualification was medicine were less likely to be dually registered. Of those who replied to the survey and remained dually registered, most (40%) based this decision on ‘worries about the consequences’ of dropping their dental registration. Some other reasons were not based on fact at that time. Cost was the most common reason (49%) given for dropping their GDC registration by respondents who were only registered with the GMC. On the positive side, the January 2023 GDC position statement about OMFS who are not on the Dental Register removed the GDC’s previous restriction on location of practice and teaching dental students. However the statement does not unambiguously allow OMFS surgeons to practice across the full OMFS curriculum. Will the 2023 GDC position statement alter the trend of OMFS specialists and trainees towards single medical registration?

Universal precautions required: Artificial intelligence takes on the Australian Medical Council's trial examination.

The potential of artificial intelligence in medical practice is increasingly being investigated. This study aimed to examine OpenAI's ChatGPT in answering medical multiple choice questions (MCQ) in an Australian context. We provided MCQs from the Australian Medical Council's (AMC) medical licencing practice examination to ChatGPT. The chatbot's responses weregraded using AMC's online portal. This experiment was repeated twice. ChatGPT was moderately accurate in answering the questions, achieving a score of 29/50. It was able to generate answer explanations to most questions (45/50). The chatbot was moderately consistent, providing the same overall answer to 40 of the 50 questions between trial runs. The moderate accuracy of ChatGPT demonstrates potential risks for both patients and physicians using this tool. Further research is required to create more accurate models and to critically appraise such models.

The need for hands-on training and supervision for entry-level physicians in a country with low surgical staffing density: a nationwide survey in Ghana

BackgroundDespite the largely unmet need, relatively few medical school graduates enrol in surgical residency and fewer surgical specialists work rurally in low- and middle-income countries. Surgical housemanship is the only formal training for medical graduates who will become the main surgical care providers in underserved areas. This study aimed to evaluate Ghanaian surgical housemanship (internship) and its impact on independent medical practice.MethodsA nationwide questionnaire survey of surgical trainees from seven teaching or regional-level hospitals ascertained the experience and self-confidence levels for 35 training objectives set by the Medical and Dental Council of Ghana, and suggestions to improve surgical training quality.ResultsOf 310 respondents, 59.7% experienced ≤ 10 cases for each topic, and 24.8% reported self-confidence as ≤ 2 points (out of 5). More than 90% of respondents experienced ≤ 10 cases for gastric, colorectal and liver cancer management. Teaching hospital trainees had lower proportions of those experiencing > 10 cases (36.6% versus 43.7%) and reporting self-confidence ≥ 4 (46.5% versus 55.8%), respectively, compared with those from regional/other-level hospitals. 40% of respondents were not confident about their surgical skills, and 70.5% requested better-supervised and practical surgical skills training. The proportion of respondents who reported limited supervision was higher among those from teaching hospitals, reported self-confidence scores < 4, and experienced ≤ 10 cases for each topic. 67% of respondents were satisfied with their surgical housemanship and 75.8% perceived surgical rotation as relevant to their future work.ConclusionsMost surgical trainees are concerned about their surgical skills. A structured curriculum with specific goals and better-supervised surgical skills training should be established. Inclusion of regional/other-level hospitals in surgical training may reduce the supervisory burden in teaching hospitals.

Teaching Medical Anthropology in UK Medical Schools: Cultivating Autoethnographic Practice among Medical Students

Behavioural and social sciences (BSS) are a core component of undergraduate medical education in the United Kingdom. Despite the formal recognition of BSS by the UK’s General Medical Council (GMC), anthropology remains largely at the periphery in the medical curriculum. Medical students often describe it as ‘fluffy’ or as ‘common sense’, in comparison to biomedical learning content. To make anthropology more relevant and applicable to future clinical practice, we draw on ethnographic data (interviews, focus groups, field notes and reflective texts written by medical students) collected by an anthropologist during fieldwork in two UK medical schools. We suggest moving this content out of the preclinical phase and instead incorporating it into the clinical phase. Specifically, we propose that having students conduct a micro-autoethnography during the clinical phase brings together two crucial aspects of medical student training: BSS principles and formation of a professional identity. Embedding these concepts in this specific context will allow students to process tensions they may feel between interactions they observe in a clinical context and team versus what they have been formally taught. This process allows them to negotiate their own professional identity between practice and ideal while more robustly situating BSS content in a relevant and immediately applicable manner within the current constraints of the medical curriculum.

Role and position of Indonesian Medical Disciplinary Honour Council: fair medical dispute resolution

The main aim of this study is to offer a detailed account of the role and status of the Medical Ethics Council of Indonesia (MKDKI) in promoting the fair resolution of medical disputes in Indonesia. This study is a form of normative legal research. The research findings suggest that MKDKI should be the designated authority for resolving medical disputes since it has the requisite expertise in applying professional discipline in the medical domain. Moreover, MKDKI is a reputable organization assessing whether a physician has breached professional disciplinary norms. The phrase "can" in Article 66 paragraph (1) of Law Number 29 of 2004 governing Medical Practice includes the option to file a complaint against MKDKI or choose not to do so. Legal ambiguity may arise, requiring substituting the term "can" with "must." Consequently, all grievances related to medical matters must be addressed exclusively through MKDKI as an obligatory measure. Conducting a judicial review of Article 66, paragraph (1) of Law Number 29 of 2004 regarding Medical Practice is essential. Furthermore, it is crucial to consider the jurisdiction of the Medical Council of Indonesia (MKDKI) in establishing compensation for parties involved in disputes. For the sake of legal precision for both medical professionals and the general population, every decision made by the MKDKI (Medical Knowledge and Decision-making Institute) must be thoroughly evaluated.

Knowledge and Practice of Present and Future Dentists about Nutrition Counseling in Yazd, Iran in 2022

Background: Inadequate nutrition can affect oral health. Compromised oral health can also alter food choices and negatively lead to poor nutrition. This study aims to assess the knowledge and practice of dentists and dental students regarding nutrition counseling.&#x0D; Methods: In this cross-sectional study, a valid and reliable four-part questionnaire was conducted among senior students and dentists in Yazd city in February 2022. All 40 senior students in the Faculty of Dentistry were selected by census method, and 98 dentists were selected randomly from all the names registered in the system of Medical Council. Data were analyzed by SPSS version 25 and t-test and Chi-square tests were used (P-value &lt; 0.05)&#x0D; Results: Out of a score 9, the mean score of knowledge was 7.12 ± 1.75 for dentists and 6.48 ± 1.2 for students. The mean score of dentists was higher than students (P = 0.03). Out of a score of 10, the mean score of dentists and students' practice were 3.26 ± 2.43 and 3.20 ± 1.82, respectively. There was no significant difference regarding the mean score practice in two groups (P = 0.879).&#x0D; Conclusions: The knowledge level of both groups was not good but acceptable, and the quality of practice in both groups was poor. It seems that there is a need for corrective educational interventions to improve the practice of dentists and dental students.

Blueprinting of Assessment for the Lower Limb in Undergraduate Anatomy Curriculum.

Competency-based medical education is followed by most of the medical schools in India. Health universities are changing their question paper pattern and practical assessment pattern to ensure valid and reliable evaluation of student learning but assessment of entire curriculum competencies is a difficult task to achieve. Assessment blueprinting can provide a guiding map for balanced and rational assessment. It ensures similar exam content from year to year (over- or under-representing a topic can be avoided). The assessment blueprint provides ideas of appropriate formats for the knowledge/skills being assessed. The study aims toobserve facilitators' perceptions and develop an assessment blueprint for the anatomy curriculum. Thiseducationalmixed-method study was conducted inthe Department of Anatomy of All India Institute of Medical Sciences, Jodhpur, India. Perceptions of 13 facilitators of the Anatomy Departmentabout assessmentblueprinting were observed on a five-point Likert scale. Topics of the lower limb were identified based on the Undergraduate Curriculum Volume-1 document provided by the National Medical Council of the Government of India. Weightage to each topic was given on the basis of anatomical importance and clinical significance at the undergraduate level. Marks for the topic as per relative weightage werecalculated. The blueprint was prepared and validated by the subject expert of the institute. An example question paper template was prepared as per the assessment blueprint. In the present study, all 13 (100%) participants agreed that there is a need for a valid assessment framework to maintain the reliability of assessment, 11 (85%) participants agreed that an assessment blueprint can provide a valid tool for assessment, and 10 (77%) participants agreed that assessments are not planned as per learning domain requirement, and planning of assessment as per blueprintrequires more time and resource. Of the participants,eight (62%) agreed that all topics or competencies are not included while setting the question paper. The blueprint for assessment of the lower limb provided an idea of high-weightage and low-weightage topics and the suitable types of questions for these topics. Assessment is the key element of competency-based medical education. For a complete, valid, and reliable assessment, a blueprint for assessment is the need of the hour. Assessment blueprinting in this study showed that the anterior thigh region, hip joint, knee joint, and vascularand nerve supply of the lower limbare topics with maximum weightage for the lower limb in the medical anatomy undergraduate curriculum.It can help in reducing under or over-representation of content. With the help of a blueprint, the examiners can assess the majority of contentwithout any intentional or unintentional bias.

Attitudes and behaviours regarding e-cigarettes in people aged 15–30 years in the UK: a cross-sectional study

BackgroundThe use of e-cigarettes has been rising in the UK, with 7·7% of people aged over 16 years currently vaping daily or occasionally. Young people aged 16–24 years have the highest proportion of vapers at 11·1%. Therefore, this study investigated behaviours, attitudes, and beliefs about e-cigarettes among people aged 15–30 year in the UK. MethodsFor this cross-sectional study, we administered an online survey to a representative sample of people aged 15–30 years in the UK (based on a web panel) between Oct 1, and Nov 30, 2021. Questions related to respondent demographics; use of vaping or smoking products; motivations, attitudes, and behaviours related to vaping; and exposure to e-cigarette advertising. Ever use was described as use even “just once or twice”. We used multivariable logistic regression to identify factors associated with ever e-cigarette use. Findings1009 participants responded to the survey (mean age 23 years, 520 [51·5%] women, 470 [46.6%] men) and were included in the study. 222 (22·3%) participants vaped at least monthly, with one in ten doing it daily. Current smokers were the most likely to use e-cigarettes (453, 44·9%), followed by previous smokers (288, 28·5%) and never smokers (23, 2·3%). Of the 222 participants vaping at least monthly, 199 (89·6%) had used e-cigarettes containing nicotine. The most common reasons for vaping were having friends who used e-cigarettes (103, 46·4%) and quitting or reducing smoking (89, 40·1%). Most participants agreed that e-cigarettes are addictive (698, 75·1%), help people quitting smoking (597, 64·2%), and are bad for health (584, 62·8%). Warning labels on e-cigarettes were seen by 611 (65·7%) participants, and 489 (52·6%) had been exposed to e-cigarette advertising, especially online. Previous or current tobacco smokers were nine and 22 times more likely to use e-cigarettes than never smokers, respectively (odds ratio [OR] 8·5, 95% CI 5·2–14·0 for previous smokers and 22·3, 12·2–40·7 for current smokers). Perceiving e-cigarettes as harmful was associated with a 40% lower likelihood of vaping (OR 0·6, 0·49–0·83). InterpretationVaping seems relatively common among people aged 15–30 years in the UK, mainly among previous and current smokers. Caution should be taken as these findings might not be generalisable to the young UK population, and cross-sectional associations might not be causal. However, perceiving e-cigarettes as harmful might reduce their use, and many users seem unaware of their potential harms, which emphasises the need for further regulation on labelling, marketing, and sales. FundingNational Health and Medical Council.

Perception of Indian medical students regarding introduction of early clinical exposure

The Medical Council of India (MCI) has stressed the necessity of Early Clinical Exposure (ECE) for a better understanding of preclinical medical subjects. However, its implementation at the medical college level in the current Indian scenario is a big challenge due to the large classroom strength and smaller number of faculty in preclinical subjects. The aim of this study to introduce ECE in physiology at our medical college, we planned an ECE session on anaemia and recorded the students' perceptions regarding the same. We conducted an ECE session on Anemia designed by the subject experts of the Physiology and Medical Education Unit (MEU) faculty of our institute. We conducted a cross-sectional survey among MBBS students of 2019 batch using a pre-validated questionnaire via online Google form to capture their perceptions regarding the ECE session. After exclusion, a total of 127 responses from medical students were included for data analysis. The majority of the students responded that the overall format of the ECE session was appropriate and that the session was helpful to them in the clinical application of their knowledge about Anemia. More than 75% of students opined that the ECE session made basic science learning more interesting and they felt motivated to read further on the topic. About 80% of students preferred ECE over traditional teaching. In conclusion, Students find ECE to be interesting, motivating, and helpful for the clinical application of basic science knowledge into clinical practice. Hence, ECE should be conducted more frequently and more topics should be taught by ECE at all medical colleges.