Artificial Intelligence (AI) is reshaping medical education, particularly in the domain of competency-based assessment, where current methods remain subjective and resource-intensive. We introduce a multimodal AI framework that integrates video, audio, and patient monitor data to provide objective and interpretable competency assessments. Using 90 anesthesia residents, we established "ideal" performance benchmarks and trained an anomaly detection model (MEMTO) to quantify deviations from these benchmarks. Competency scores derived from these deviations showed strong alignment with expert ratings (Spearman's ρ = 0.78; ICC = 0.75) and demonstrated high ranking precision (Relative L2-distance = 0.12). SHAP analysis revealed that communication and eye contact with the patient monitor are key drivers of variability. By linking AI-assisted anomaly detection with interpretable feedback, our framework addresses critical challenges of fairness, reliability, and transparency in simulation-based education. This work provides actionable evidence for integrating AI into medical training and advancing scalable, equitable evaluation of competence.

Insights Into Infertility and Pregnancy Among Female Ophthalmologists.

Growth mindset, the belief that one's abilities are changeable, is a valued attribute in medical education. Developing a growth mindset is also in direct tension with systems that evaluate performance, such as in medical training. The senior resident role is a microcosm of this tension because it is a pivotal transition time from training to attending. A recently updated framework for clinical competency places trusted as the highest goal for trainees, defined as self-awareness that is bolstered by humility, integrity, and reliability. We provide strategies for both the senior and attending to foster a senior's goal of trusted status. This requires intentional work by both the senior and attending, but we posit that the attending role is paramount in first creating a learning environment that celebrates a growth mindset. The strategies work to promote self-reflection, active problem solving, and exploration of the gray areas of medical decision making to maximize the learning experience.

To examine current literature on integrating emerging technologies, artificial intelligence (AI), and informatics into medical imaging education. A systematic review of peer-reviewed literature published in the past 5 years was conducted, focusing on medical imaging education, radiography curricula, AI applications, and ethical considerations. Articles were analyzed to identify recurring themes and trends in implementing AI and informatics in medical imaging education programs. Four key themes emerged from the literature: integration of emerging technologies and AI in medical imaging education; foundational informatics concepts and emerging technologies essential for medical imaging professionals; clinical applications of AI in medical imaging practice; and ethical and professional considerations regarding AI adoption. Integrating AI and informatics into medical imaging education is increasingly recognized as essential, but curriculum constraints, faculty preparedness, and the evolving nature of AI technologies are challenges to integration. Ethical concerns, including bias in AI algorithms and the potential effect on professional decision-making, highlight the need for responsible implementation. International efforts to establish AI educational frameworks are emerging that emphasize the importance of scaffolding learning to gradually build competency. To ensure the safe and effective use of AI in medical imaging, structured education and professional training must be prioritized. Future research should explore best practices for AI and informatics curriculum development, standardized assessment of AI literacy, and long-term effects of AI on clinical decision-making. By addressing these areas, medical imaging professionals can remain at the forefront of technological advancements while maintaining ethical responsibility and patient-centered care.

Self-perceived skills in the diagnosis of hospital malnutrition, medical knowledge, and interest in nutrition: A cross-sectional study of medical residency programs.

Role transition can be a challenging time for specialist medical trainees. Insight into the move from junior to senior registrar in Intensive Care is needed to help trainees prepare for this transition, and educators to support them. This study investigated the role transition experiences of Intensive Care senior registrars to identify the knowledge, skills and capabilities required of trainees to ensure a successful transition. Australasian College of Intensive Care Medicine trainees who had completed at least a year as a senior registrar were invited via email from the College to participate in a one-on-one interview. Seven trainees responded and all agreed to an interview. Interviews were transcribed, deidentified and analysed thematically. Three themes represented the seven male participants' experiences: Apprehension, Weight of responsibility and Decision-making. These themes illustrate that the experience of moving from junior to senior ICU registrar is complex, requires a shift in decision-making focus and is characterised by uncertainty. Communication skill development appeared to be key to the perspectives shared by our participants. Leadership development warrants more attention in Intensive Care Medicine. This study provides junior doctors at the cusp of transitioning to the role of Intensive Care senior registrars with helpful insights for their own transition. The findings are also helpful to Intensive Care Medicine more broadly and re-imagining what may be required for contemporary and sustainable trainee development.

Depression Among Incoming Ophthalmology Trainees.

Background: Nutritional status plays an important role in determining individual’s health. Obesity is closely associatedwith dyslipidemia, mainly through insulin resistance mechanisms and proinflammatory adipokines, which contribute tothe development of metabolic syndrome. However, recent evidence suggests that obesity‑related dyslipidemia does notfollow a single, uniform pathophysiological pattern; instead, its characteristics may vary across individuals. This studyaimed to examine the relationship between nutritional status and dyslipidemia among residents of the Internal Medicine Specialist Program at RSUP Prof. dr. I.G.N.G. Ngoerah, Denpasar. Methods: This cross‑sectional study was conducted in August 2023 at RSUP Prof. dr. I.G.N.G. Ngoerah, Denpasar. The study subjects were residents of the Internal Medicine Specialist Program. Data were collected through measurements of body mass index (BMI) as an indicator of nutritional status and lipid profile examination as an indicator of dyslipidemia. The association between variables was analyzed using the Chi‑Square test, with statistical significance set at p<0.05. Results: A total of 115 subjects were enrolled in the study, with 60% men and 40% women and a mean age of 31.25 ± 3.82 years. Of these, 74 subjects (64,3%) were classified as obese, and 57 subjects had dyslipidemia. Forty‑six (46) subjects had presented with obesity and dyslipidemia, while 11subjects had dyslipidemia in the absence of obesity. Meanwhile, 30 subjects had neither obesity nor dyslipidemia, and 28 participants were obese without dyslipidemia. The Chi‑Square test showed a significant association between nutritional status and dyslipidemia (p<0,001). Conclusion: This study demonstrates a significant relationship between nutritional status and dyslipidemia. Further research is needed to explore specific factors that contribute to obesity and dyslipidemia among residents in specialist medical training programs.Keywords: nutritional status, obesity, dyslipidemia, resident physicians, PPDS

Improving College Readiness Through a High School Surgery Exposure Program.

Background: Polycystic ovary syndrome (PCOS) affects millions of young women worldwide, yet awareness remains suboptimal even in medical trainees. This study explored the knowledge, attitudes, and practices (KAP) regarding PCOS among 320 female medical students in Telangana, India, a group particularly vulnerable due to academic stress, irregular lifestyles, and limited personal health prioritization. Methods: A validated, web-based cross-sectional survey was conducted among undergraduate and postgraduate female medical students aged 18–30 years. KAP scores were categorized as low (<37), moderate (38–45), or high (>45) using visual binning. Associations with age, menstrual regularity, BMI, stress levels, and PCOS diagnosis were analyzed using chi-square tests and independent t-tests. Results: Most participants (63.1%) showed moderate KAP, 24.1% low, and only 12.8% high. Higher KAP was significantly associated with older age (p=0.016), menstrual irregularity (p=0.029), and previous PCOS diagnosis (p<0.001). Students diagnosed with PCOS reported significantly higher stress levels (mean 3.30 versus 2.99, p=0.007). BMI was significantly linked to PCOS diagnosis (p=0.015). Conclusions: Moderate levels of PCOS awareness have been recorded with personal diagnosis being the strongest driver of knowledge. The elevated stress among affected students highlights the emotional burden of the condition. These findings emphasize the need for structured PCOS education, early screening, and psychosocial support within medical curricula to empower future physicians to better care for themselves and their patients.

Risks of Failure in Advanced Trauma Life Support Courses.

Background: The development of information technology in the health sector encourages the implementation of Electronic Medical Records (EMR) to improve the efficiency and quality of hospital services. UKI General Hospital has implemented EMR, but still faces technical and operational challenges that hinder system optimization. Objective: This study aims to analyze the implementation of EMR at UKI General Hospital and evaluate its impact on the quality of hospital services. Method: The study used a mixed-method approach with data collection techniques through questionnaires, interviews, and quantitative and qualitative data analysis. The sample consisted of health workers and administrative staff involved in the use of EMR. Results: The results of the study indicate that the implementation of EMR has increased efficiency in patient data management, but there are still obstacles such as limited infrastructure, lack of HR training, and difficulties in adapting to technology. Conclusion: The implementation of EMR contributes to improving the quality of hospital services, but improvements are still needed in technical aspects and HR readiness. Suggestion: Improvements in infrastructure, medical personnel training, and strategic policies are needed to support more effective implementation of EMR.

Background/Objectives: Whole food, plant-based (WFPB) diets have been associated with reduced cardiovascular risk and enhanced overall health. However, nutrition education in medical training remains limited. This study evaluated an experiential WFPB intervention known as the “Plant Plunge.” Methods: A total of 64 medical student participants attended weekly one-hour nutrition seminars on campus led by a local nonprofit, received complimentary WFPB lunches, and were encouraged to eat a WFPB diet for four weeks. Semi-structured interviews explored program perceptions. Pre- and post-intervention assessments measured nutrition knowledge, and a post-program survey assessed attitudes toward the intervention. Results: We analyzed a total of 14 interviews, 25 pre- and post-intervention knowledge assessments, and 49 post-intervention surveys. Qualitative analysis identified seven major themes: (1) improved physical health outcomes; (2) increased awareness of nutrition’s role in medicine; (3) concerns about feasibility and accessibility of WFPB diets; (4) personal empowerment and behavioral change; (5) educational value of seminars; (6) social engagement and peer support; and (7) relevance to future clinical practice. Mean scores on the knowledge assessment significantly improved from 73.3% to 87.0% (p = 0.045) following the Plant Plunge. Survey responses revealed that 65% of participants agreed that they increased knowledge of food ingredients, 54% indicated increased likelihood of selecting plant-based options, and 43% agreed that finding WFPB foods was easy, with 16% disagreeing. Conclusions: The Plant Plunge improved medical students’ nutrition knowledge, dietary attitudes, and perceived readiness for lifestyle counseling while offering an experiential model of nutrition education. Short, experiential nutrition programs may serve as scalable approaches to strengthen nutrition training and support chronic disease prevention.

Reasoning-driven large language models in medicine: opportunities, challenges, and the road ahead.

Healthcare provider pain knowledge is critical in surgical settings, where effective pain management plays a key role in the prevention of chronic postsurgical pain. Despite this, little is known about the pain training and knowledge of surgical residents. To comprehensively assess Canadian surgery residents' knowledge and attitudes toward pain - including associated factors, training sources, understanding of biopsychosocial and pediatric pain management, and perceived preparedness for managing pain. General and orthopedic surgery residents (N = 110, median age = 29.9 years) recruited from 27 accredited residency programs across Canada completed measures of pain training, perceptions, and experience as well as the Knowledge and Attitudes Survey Regarding Pain (KASRP)-a validated 41-item measure of provider pain knowledge. Descriptive statistics examined overall pain knowledge (% correct on the KASRP), pain knowledge sources and training, perceived preparedness, personal pain experiences, and knowledge of the biopsychosocial model. Multiple linear regression examined resident factors (eg, sex, speciality) associated with increased pain knowledge. Residents scored 75.1% (SD = 8.6, range = 43.9-95.1) on average on the KASRP-which is below the 80% passing score. Three items pertaining to opioid tolerance and opioid administration were answered incorrectly by >70% of residents. In contrast, an average correct score of 86.5% was obtained on pediatric pain knowledge items. Personal experience with postsurgical pain was associated with greater overall pain knowledge (β = 0.24, P = 0.01). Canadian surgery residents demonstrated pain knowledge below the level generally considered adequate among health care providers, with areas of relative strength and gaps in knowledge identified. Collectively, these results underscore the importance of expanding both the breadth and depth of surgery residents' pain education and training.

Introduction Addressing the social determinants of health (SDOH) can improve cancer-related outcomes and is widely recognized as integral to patient care. Despite this, little is known about how medical oncology residents perceive their role in addressing SDOH. Understanding their views is important not only because SDOH impact outcomes, but also because residency training should prepare oncologists to respond to evolving societal needs. In this study, we use Figured World (FW) theory to explore how residents negotiate their role within the sociocultural world of medical oncology training. Methods We conducted semi-structured interviews with 11 medical oncology residents from the four faculties of medicine in Québec, Canada. Participants were recruited through program directors, newsletters, and snowball sampling. Interviews were audio- and video-recorded, transcribed verbatim, and thematically analyzed. FW theory helped orient our analysis toward how residents make meaning of their roles and responsibilities, how they perceive societal expectations, and how they see themselves within the context of medical oncology training. Results We identified four key themes: (a) becoming an oncologist: what does it mean and entail?, (b) dealing with SDOH in medical oncology: a distressing role, (c) exploring the roots of powerlessness when confronted with SDOH, and (d) negotiating their roles and positioning themselves relative to others in addressing SDOH. Conclusion Residents expressed a desire to engage with SDOH but felt largely unprepared to do so, pointing to gaps in training and support. These findings call for a rethinking of how oncology residency training shapes professional identity, ensuring that future oncologists are prepared to take on roles that encompass both clinical care and social accountability.

The medical education system is not designed to recognize and support the nuanced needs of medical trainees from historically marginalized groups. Consequently, many from this cohort must persevere through their medical training with various unmet needs. Within the medical education system, there have long been systemic barriers, or structural inequities, that make training more difficult for trainees from historically marginalized groups; the situation is unfair and can translate into unequal educational outcomes. Regrettably, the convention of ignoring the impact of structural barriers and resultant inequities for trainees from historically marginalized groups may lead to assumptions of innate deficiencies. This deficiency discourse obscures the impact of structural barriers on these individuals' learning, well-being, and academic outcomes. In this paper, we present a novel framework to bring attention to these challenges. This framework emerges from Maslow's 'Hierarchy of Needs' theory to emphasize the importance of comprehensively considering trainee needs that ultimately support their learning and flourishing. Practically, this modified framework may be used directly by trainees themselves to reflect on their needs, and by educators charged with supporting them to more fully bear in mind the lived experiences of trainees. At the programmatic level, the framework may reveal inequities that may be differentially influential within a cohort - thereby informing efforts to support all trainees.

HANS LAUBER (1876-1952) – NAZI COLLABORATOR, OPHTHALMOLOGIST, AND DEAN OF THE UNIVERSITY OF WARSAW FACULTY OF MEDICINE IN 1939-1940 Hans Lauber (1876-1952) – a distinguished ophthalmologist and scholar associated with Vienna and Warsaw – entered the history of medicine as one of the pioneers in the study of the physiology and pathology of the visual field and as a co-creator of perimetry standards. The author of 90 scientific papers and two textbooks, he designed his own diagnostic instruments, including a perimeter, a light-spot projector, and a lamp for examining the fundus of the eye in red-free light. From 1931 to 1940 he headed the Department and Clinic of Eye Diseases at the Infant Jesus Hospital in Warsaw, and from 1939 to 1940 served as Dean of the Faculty of Medicine at the University of Warsaw. With financial support from the John Warden Foundation, managed by Irena Warden, he modernized the Warsaw Eye Clinic and developed the first postgraduate medical training program in Poland. Lauber’s figure, however, remains ambiguous. During the occupation he took over the management of the Ophthalmology Clinic at the Jagiellonian University in Kraków, which after the war became the subject of accusations of Germanizing the staff, brutal treatment of patients, and medical experimentation. Although war crimes were never proven, his activities during World War II remain controversial to this day. This article presents a detailed biography of Hans Lauber, clarifies inconsistencies found in the existing literature, and discusses his scientific output and his significance the development of ophthalmology in Poland and Europe.

Pediatric multimorbidity has emerged as a significant clinical challenge that extends beyond the traditional single-disease model of pediatric care. The coexistence of multiple chronic conditions in children and adolescents generates complex diagnostic and therapeutic scenarios that demand advanced clinical reasoning, coordinated care, and long-term management strategies. This review synthesizes current international evidence on pediatric multimorbidity, with a specific focus on its implications for diagnostic complexity, therapeutic burden, polypharmacy, and healthcare utilization, framed within an internal medicine perspective. The findings highlight that pediatric multimorbidity follows identifiable patterns of disease clustering, frequently involving neurodevelopmental, mental health, respiratory, metabolic, and neurologic conditions. These patterns are associated with increased diagnostic uncertainty due to overlapping symptoms, atypical presentations, care fragmentation, and medication-related confounding. Therapeutic management is similarly complex, with polypharmacy and cumulative treatment burden representing central risks for patient safety and quality of life. Care coordination and family-centered approaches emerge as critical mechanisms for mitigating complexity, while gaps in transition planning to adult care remain a persistent challenge. From an educational standpoint, pediatric multimorbidity offers a valuable framework for teaching core internal medicine competencies, including diagnostic reasoning under uncertainty, systems-based practice, and patient-centered care. This review underscores the need to integrate multimorbidity-focused approaches into medical training and clinical practice, particularly within healthcare systems in Mexico, Colombia, and Ecuador.

To examine the role of developmental and behavioral pediatric clinicians in diagnosing and managing Fetal Alcohol Spectrum Disorders (FASD), identify barriers related to diagnostic system variability and clinician preparedness, and propose a functional framework to complement existing diagnostic systems based on findings from the 2023 Society of Developmental and Behavioral Pediatrics (SDBP) survey. An anonymous survey of SDBP members assessed diagnostic practices, clinician preparedness, and training needs regarding FASD. Responses were analyzed descriptively to identify patterns in diagnostic system use and perceived training adequacy. Of 913 members surveyed, 199 responded (22%), with 97 reporting active involvement in FASD care. Among these, 34% used the University of Washington 4-Digit Code, 34% used Diagnostic and Statistical Manual of Mental Disorders-5 criteria, and 26% followed the Hoyme guidelines. Only 24% felt "very prepared" to diagnose FASD, whereas 58% desired additional training in both diagnosis and management. The lack of a standardized diagnostic framework contributed to variability in clinical practice and clinician confidence. Findings highlight significant gaps in clinician confidence and the lack of standardized diagnostic practices. This article underscores the importance of enhancing FASD education within medical and psychology training and proposes adopting a functional classification system (FASD levels 1, 2, and 3) to bridge existing diagnostic frameworks and promote consistency in care. Strengthening clinician capacity in FASD recognition and management is essential to improving early identification, timely intervention, and long-term outcomes for affected children.