New Generation Of Doctors Research Articles

Interventional Neuroradiology: Why Don't Brazilian Female Physicians Like It?

Abstract Objective Much has been discussed about gender diversity in all professional fields, particularly in medicine. Recent studies showing that there are fewer than ten female professionals in interventional neuroradiology (INR) in a continental country like Brazil, and less than thirty in all of Latin America, have prompted an investigation into the causes of the low numbers of women choosing to follow this medical specialty. This project intended to reveal the reasons through an anonymous form applied to women in the final year of the three medical residencies considered prerequisites for INR in Brazil: neurology, radiology and neurosurgery. Materials and Methods The questionnaire addressed to each of the three fields contemplated the professionals' preference to follow their respective subspecialties, in addition to common considerations that could be deemed barriers to INR. Results Surprisingly, the weak link in the chain was demonstrated to be radiology, which is the exclusive prerequisite residency for training in INR in many countries. However, in Brazil, most doctors who graduate in INR come from Neurosurgery and, secondly, from neurology. These two specialties together account for less than half of the female residents compared to radiology alone. Conclusion All of the following items were already expected: difficulty in reconciling a double shift; employment opportunity; long training time; the lack of female leaders inspiring new generations of doctors; issues involving radiation and motherhood; and still the barriers of misogyny and machismo. But specific studies need to be conducted to find out why very few radiology residents follow INR training in Brazil.

THE USE OF MODERN PEDAGOGICAL TECHNOLOGIES IN TEACHING THE DISCIPLINE «HUMAN ANATOMY»

In the context of healthcare reform in Ukraine, the priority task of higher educationinstitutions is the quality of professional education of healthcare specialists. Among themost important principles of forming a unified educational environment is the achievementof a high level training of future doctors by introducing a unified technology for managingthe educational quality. In the process of European integration and globalization, as theUkrainian educational system enters the global information space, there is a need fora radical renewal of higher education system in our country, taking into account the positiveexperience of European and worldwide countries. It is time to optimize the public healthsector and train a new generation of doctors in accordance with international standards.The aim – to conduct a theoretical analysis of the scientific psychological, pedagogical,educational, methodological and medical publications, as well as the methodologicalwork of the department concerning the use of modern pedagogical technologies in theprocess of professional training of future doctors.Conclusions. The introduction of modern pedagogical technologies in the professionaltraining of future doctors ensures the formation of professional competence throughthe development of students’ skills in individual and research work, interpersonalcommunication, teamwork, analysis and synthesis, creativity, ability to co-operatewith specialists of other specialties, solve problems and make decisions. Duringthe study of the discipline «Human Anatomy», it is advisable to use simulation learning technologies and the case method, as they contribute to the development of skills andpractical abilities, the capacity for self-learning, a change in the thinking paradigm,ensure the memorization of the significant amount of information and the training ofspecialists who behave as effectively as possible in complex clinical situations. Simulationtraining technologies allow to reproduce repeatedly and accurately the important clinicalscenarios and provide an opportunity to adapt the learning situation for each student.

ПРОЕКТНЫЙ ПОДХОД К ФОРМИРОВАНИЮ НОВОЙ ГЕНЕРАЦИИ ДОКТОРОВ НАУК КАК ПРИОРИТЕТНАЯ ЗАДАЧА СТРАТЕГИЧЕСКОГО УПРАВЛЕНИЯ РАЗВИТИЕМ СОВРЕМЕННОГО РОССИЙСКОГО ВУЗА

ПРОЕКТНЫЙ ПОДХОД К ФОРМИРОВАНИЮ НОВОЙ ГЕНЕРАЦИИ ДОКТОРОВ НАУК КАК ПРИОРИТЕТНАЯ ЗАДАЧА СТРАТЕГИЧЕСКОГО УПРАВЛЕНИЯ РАЗВИТИЕМ СОВРЕМЕННОГО РОССИЙСКОГО ВУЗА

Impact of surgical complications on the operating surgeon, Biggs et al

I felt one coming. Disbelief, guilt, self-doubt, shame and sadness were my companions. Amidst the turmoil, I tried to cope according to expectations: repeated updates with the intensive care unit specialist, lengthy empathic conversations with the wife and the rest of the family, a phone call to the general practitioner. Nothing I did would bring my patient back to life. Nothing helped me to understand why he aspirated, developed acute respiratory distress syndrome and died. Maybe I jinxed it. Studies have shown that nearly 80% of healthcare personnel are emotionally affected by a near miss or adverse event at least once in their career [1, 2]. Regardless of a complaint or lawsuit, doctors show a higher prevalence of mental health sequelae compared to nurses [3]. The most common symptom is hypervigilance, which lasts longer than 6 months in 28% of doctors after a patient safety incident [4] Biggs et al. [5] conducted an online survey using the Twitter feed of the European Society of Coloproctology, the Association of Coloproctology of Great Britain and Ireland and the Association of Surgeons of Great Britain and Ireland. A total of 94% of 82 respondents reported personal involvement in a serious surgical complication in the previous 5 years. A negative impact on personal/family life was noted by 55% and over 25% reported a negative impact on interactions with colleagues. Stress was coped with through discussion with colleagues, ensuring optimal management of the complication, and involvement with patients and relatives. Alarmingly, 54% reported that the support provided by the institutions was felt to be inadequate, and 10% reported that no support was available. Perceived managerial support and information about rights have shown positive associations with reduced defensive practices and well-being in a previous study [6] Our profession is unique due to the direct effects of clinical and technical decisions on patients' outcomes. In the case of adverse outcomes, the mental pressure can be hard to endure. In recent years, a surge of young doctor suicides emerged in the UK and in Australia. Biggs et al. have shown that collegial support is essential for coping with stress. Sharing experiences with the new generation of doctors and surgeons and teaching about developing resilience should be part of a just and ‘blame free’ culture. I would like to encourage you to share the article by Biggs et al. with your clinical lead and clinical service manager to support the participation of your institution in peer support programmes. For all we know, each one of us may be the next second victim.

Application of medical simulation in the education of medical students in the area of gynecology and obstetrics.

The education of new generations of doctors faces major challenges. The education system should ensure access to modern and effective educational techniques. Medical simulation is a method that is developing very dynamically. Currently, every medical university in Poland has access to the facilities of a Medical Simulation Centre. Many types of simulations can be used. The variety of techniques is considerable. Starting from simple trainers, through advanced patient simulators to hybrid simulation or virtual reality. Thanks to their use, it is possible to teach basic medical procedures in a safe way, without compromising the patient's intimacy. An additional advantage is the possibility to train in an interdisciplinary team. The aim of this work was to present the possibility of using medical simulation as a method of effective and interesting teaching of medical students in the field of gynaecology and obstetrics. The authors described different techniques and levels of simulation sophistication. The basic tasks of the teacher were also described. The paper may be an interesting complement to the knowledge of education for each physician involved in the work with students.

Empowering junior doctors: a qualitative study of a QI programme in South West England

AimTo explore how the South-West Foundation Doctor Quality Improvement programme affected foundation year 1 (F1) doctors’ attitudes and ability to implement change in healthcare.MethodsTwenty-two qualitative interviews were carried out with...

Problems and challenges in managing the new generation of doctors in Chinese hospitals

The new generation of doctors (doctors born after 1980) now plays a critical role in the Chinese hospital system, as they are the main force in current hospital clinical practice. The rapid changes in the social and economic environment have made the new generation of doctors have a different perspective from previous generations. Content analysis is used in this study to analyze survey research, case studies and related information. The new generation of doctors is confronted with pressures of employment, promotion and social pressures including those caused by tension between doctors and patients, which the previous generation did not face. They are characterized as innovative, pragmatic and self-centred, although the most significant issues are in the hospital environment rather than personal characteristics. Transparent, fair and meticulous management evaluation, reasonable income reflecting their work values and good career development planning, the study concludes, are the key points in the management of the new generation doctors.

Failing to retain a new generation of doctors: qualitative insights from a high-income country

BackgroundThe failure of high-income countries, such as Ireland, to achieve a self-sufficient medical workforce has global implications, particularly for low-income, source countries. In the past decade, Ireland has doubled the number of doctors it trains annually, but because of its failure to retain doctors, it remains heavily reliant on internationally trained doctors to staff its health system. To halve its dependence on internationally trained doctors by 2030, in line with World Health Organisation (WHO) recommendations, Ireland must become more adept at retaining doctors.MethodThis paper presents findings from in-depth interviews conducted with 50 early career doctors between May and July 2015. The paper explores the generational component of Ireland’s failure to retain doctors and makes recommendations for retention policy and practice.ResultsInterviews revealed that a new generation of doctors differ from previous generations in several distinct ways. Their early experiences of training and practice have been in an over-stretched, under-staffed health system and this shapes their decision to remain in Ireland, or to leave. Perhaps as a result of the distinct challenges they have faced in an austerity-constrained health system and their awareness of the working conditions available globally, they challenge the traditional view of medicine as a vocation that should be prioritised before family and other commitments. A new generation of doctors have career options that are also strongly shaped by globalisation and by the opportunities presented by emigration.DiscussionUnderstanding the medical workforce from a generational perspective requires that the health system address the issues of concern to a new generation of doctors, in terms of working conditions and training structures and also in terms of their desire for a more acceptable balance between work and life. This will be an important step towards future-proofing the medical workforce and is essential to achieving medical workforce self-sufficiency.

The consequences of Ireland\u2019s culture of medical migration

BackgroundIn recent years, Ireland has experienced a large-scale, outward migration of doctors. This presents a challenge for national policy makers and workforce planners seeking to build a self-sufficient medical workforce that trains and retains enough doctors to meet demand. Although, traditionally, medical migration has been considered beneficial to the Irish health system, austerity has brought a greater level of uncertainty to the health system and, with it, a need to reappraise the professional culture of migration and its impact on the Irish health system.MethodsThis paper illustrates how a culture of migration informs career and migration plans. It draws on quantitative data—registration and migration data from source and destination countries—and qualitative data—in-depth interviews with 50 doctors who had undertaken postgraduate medical training in Ireland.ResultsOf 50 respondents, 42 highlighted the importance of migration. The culture of medical migration rests on two assumptions—that international training/experience is beneficial to all doctors and that those who emigrate will return to Ireland with additional skills and experience. This assumption of return is challenged by a new generation of doctors whose professional lives have been shaped by globalisation and by austerity. Global comparisons reveal the comparatively poor working conditions, training and career opportunities in Ireland and the relative attractiveness of a permanent career abroad.ConclusionIn light of these changes, there is a need to critically appraise the culture of medical migration to determine if and in what circumstances migration is appropriate to the needs of the Irish health system. The paper considers the need to reappraise the culture of medical migration and the widespread emigration that it promotes.

Is imperfection becoming easier to live with for doctors?

ObjectiveBeing involved in serious patient injury is devastating for most doctors. During the last two decades, several efforts have been launched to improve Norwegian doctors’ coping with adverse events and complaints.MethodsThe method involved survey to a representative sample of 1792 Norwegian doctors in 2012. The questions on adverse events and its effects were previously asked in 2000.ResultsResponse rate was 71%. More doctors reported to have been involved in episodes with serious patient harm in 2012 (35%) than in 2000 (28%), and more of the episodes were reported as required by law. Doctors below age 50 report better support from colleagues, more collegial retrospective discussion on the event and less patient/family blame. In all, 27% of the doctors had been reported to the Norwegian Board of Health Supervision; 79% of these complaints were rejected; 73% of the doctors who had received a reaction from the health authorities found the reaction reasonable, but almost one out of five practiced more testing and referrals after a complaint and 25% claimed that the complaint had made them into a more fearful doctor.ConclusionOur results indicate that adverse events are being met more openly in 2012 than in 2000, and that coping with imperfection and patient complaints is less devastating for new generations of doctors.

Advanced medicine and modern Iraq: Dr Abdul-Mujib and the rise and fall of Iraqi surgical capacities

Abstract Continuing with our series acknowledging the recollections of Iraqis of their experiences in the country, we present Dr Abdul-Mujib Cadili. Following an examination of the founding of the Iraqi Royal Medical College (IRMC) and its standing as the first such Institution in Iraq, Dr Cadili recounts his own experience of attending the programme from 1968 to 1974 – from recollections of his time at IRMC through residency, military service and emergency surgeries in the internecine wars of 1970s’ Kurdistan, before working in the UAE and the United Kingdom in an effort to advance his training before settling in the United Kingdom to work as a surgeon and begin his family with his wife Sawsan. Returning to Iraq Cadili founded the Al-Rafidain hospital in Baghdad where the first kidney and gall bladder surgeries in Iraq were performed, as well as the (smuggled!) introduction of a laparoscopic machine under the sanctions regime. Cadili describes meeting with Saddam Hussein, service in the Iran–Iraq War, before suffering through the 1991 Gulf War, which was launched by the US-led coalition in 1991. After run-ins with Ba’thist superiors Cadili left Iraq and re-started his surgical career following immigration to Canada in 1997. Cadili found a calling through medicine, remains a leading surgeon in his adopted country and stands out as a standard bearer for Iraqi medicine. An Iraqi surgeon currently living in Calgary, Alberta, Canada, recalls attending a lecture Dr Cadili gave in Baghdad around 1995. Dr Cadili was presenting the results of his first 300 cases of laparoscopic surgery and the Calgary-based Iraqi surgeon was one of about 200 physicians attending the talk in Baghdad. He remembered how all in attendance were dazzled by Dr Cadili’s knowledge and ambition. They were amazed at how a lone surgeon had managed to revolutionize surgeries while under economic embargo, travel restrictions and the many other challenges imposed on Iraqis. He saw Dr Cadili as a glimmer of light in the darkness for a new generation of doctors. We are pleased to present Dr Cadili’s recollections in IJCIS.

Medical students developing confidence and patient centredness in diverse clinical settings: a longitudinal survey study.

BackgroundMedical student clinical confidence and positive attitudes to patient centredness are important outcomes of medical education. The clinical placement setting is regarded as a critical support to these outcomes, so understanding how the setting is influential is important. The aim of this study was to compare students’ attitudes towards patient-centredness and clinical confidence as they progressed through their medical course, and understand the influence of diverse clinical placement zones.MethodsStudents at one Australian medical school completed a questionnaire at the beginning of second year and at the end of their third year of medical training. The questionnaire measured attitudes to patient centred care, clinical confidence, role modelling experiences and clinical learning experiences. Descriptive analyses investigated change in these attitudes over time. Repeated measures analysis of variance was used to assess the influence of placement location on each variable of interest. Responses to two open-ended questions were also coded by two researchers and themes were identified.ResultsStudent confidence increased over the course of two years of clinical training (p < 0.001), but attitudes to patient centredness (p = 0.933) did not change. The location of clinical placements (urban, outer urban and rural) was unrelated to levels of confidence or patient centredness. Students had positive attitudes towards patient-centredness throughout, and noted its importance in contributing to quality care. Patient-centred care was encouraged within the clinical placements, and was influenced by positive and negative role modelling, direct teaching, and opportunities to practise patient-centred care.ConclusionsA new generation of doctors with a strong patient-centred focus is emerging. Medical schools have a responsibility to facilitate clinical placements that will support the acquisition and maintenance of skills in patient centred care through positive role modelling.

The Impact of Medical Student Participation in Emergency Medicine Patient Care on Departmental Press Ganey Scores.

IntroductionPress Ganey (PG) scores are used by public entities to gauge the quality of patient care from medical facilities in the United States. Academic health centers (AHCs) are charged with educating the new generation of doctors, but rely heavily on PG scores for their business operation. AHCs need to know what impact medical student involvement has on patient care and their PG scores.PurposeWe sought to identify the impact students have on emergency department (ED) PG scores related to overall visit and the treating physician’s performance.MethodsThis was a retrospective, observational cohort study of discharged ED patients who completed PG satisfaction surveys at one academic, and one community-based ED. Outcomes were responses to questions about the overall visit assessment and doctor’s care, measured on a five-point scale. We compared the distribution of responses for each question through proportions with 95% confidence intervals (CIs) stratified by medical student participation. For each question, we constructed a multivariable ordinal logistic regression model including medical student involvement and other independent variables known to affect PG scores.ResultsWe analyzed 2,753 encounters, of which 259 (9.4%) had medical student involvement. For all questions, there were no appreciable differences in patient responses when stratifying by medical student involvement. In regression models, medical student involvement was not associated with PG score for any outcome, including overall rating of care (odds ratio [OR] 1.10, 95% CI [0.90–1.34]) or likelihood of recommending our EDs (OR 1.07, 95% CI [0.86–1.32]). Findings were similar when each ED was analyzed individually.ConclusionWe found that medical student involvement in patient care did not adversely impact ED PG scores in discharged patients. Neither overall scores nor physician-specific scores were impacted. Results were similar at both the academic medical center and the community teaching hospital at our institution.

Praca lekarska dr Wandy Błeńskiej jako przykład holistycznego podejścia do pacjenta

The World Health Organization defines health as ‘a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.’ This definition promotes holistic approach towards patients. New discoveries and developments in medical science, lead to breaking up medicine into narrow specialities. New generation of health workers needs role models that are able to enhance the status of medical profession and to oppose negative consequences of fragmentation of medicine and commercialization in health sector. The author of the article proposed Dr Wanda Blenska – doctor of leprosy patients from Uganda - as a role model of holistic approach in medicine. Doctor Wanda Blenska took efforts to understand her leprosy patients and support them in all their needs. Her service not only included treatment of ‘leprosy’ as infectious disease, but also physical and psychological rehabilitation of patients, orthopaedic and cosmetic surgery, or even changing the patient’s environment to ensure their highest possible physical, mental and social well-being. Doctor Wanda Blenska left a message to the new generation of doctors: first of all, medical profession is a vocation; care for patients should be motivated by desire to relief the patients’ suffering and not only by own financial benefits; doctors should see a human being in every patient and respect and treat them in a holistic way.

PS-124 A 8-year Long Successful Project Of Global Health Education For Paediatric Residents: The Junior Project Officer (jpo)

Background The pressure to incorporate issues of global health into pre-/post-graduate medical curricula is increasing in order to provide new generations of doctors with a multicultural perspective on health care. Herein we update the experience of a partnership between the Paediatric Residency Program (PRP) of the Padua University (Italy) and the Non-Governmental Organisation ‘Doctors for Africa CUAMM’ (CUAMM), recently published in the Italian Journal of Paediatrics, which aims to offer residents the opportunity to attend a 6-month elective in Africa, called ‘JPO’. Methods The constitutive elements of the JPO are: a memorandum-of-understanding between Padua University and CUAMM; periodic site-visits; candidate selection process; pre-departure educational course; preceptorship in Padua and Africa; personalised learning objectives and job description; hands-on experience; evaluation; feed-backs/reports. The African hospitals (Beira- Mozambique and Wolisso/Ethiopia) were chosen based on the presence of paediatrics in staff from CUAMM. Results Between 2006 and 12/2013, 16 residents, aged 27–33 years, three attending the III, ten the IV and three the V year of residency consecutively joined the JPO. All worked in paediatric in-patient units; eight in out-patient clinics, six in emergency rooms, nine in community health centres. Thirteen were involved in teaching activities; six in clinical research. All residents completed successfully the 6-month elective and achieved their learning objectives. Conclusions To our knowledge no other European PRP provides international electives based on such strategic framework. We updated this experience convinced of the importance of stimulating a debate on this matter, of generating criticisms, ideas and hopefully inspiring similar experiences.

Obstetrics and gynaecology training in Europe needs a next step

Changing societal demands on doctors necessitate changes in the training of gynaecologists. Adapting this training will need well-thought-out and comprehensive planning that addresses the needs of the major stakeholders: society, patients, and doctors themselves. Doctors need to be cognizant of societal issues such as rapidly rising healthcare costs and budgetary crises, and be able to participate in the solutions. This demands effective medical leadership, which has been a neglected area in postgraduate training. It has become increasingly evident that a holistic view of the patient rooted in proper teamwork and systems-based practice is essential to provide patient-centered care. Specialists need to expand their skill set to participate in this kind of care. Furthermore, the feminisation of the medical profession and a new generation of doctors rejecting the constraints of the traditional model of medical care introduce new professional perspectives. This manuscript briefly reviews the challenges faced in the training of European gynaecologists in an effort to provoke discussion about how to best train the gynaecologists of the future.

The teaching of Bioethics and the decision making: impacts at medical students

The evolution and consolidation of the Bioethics discipline after four decades of development and expansion throughout the world along with the Biotechnology development and the increasingly complex human relationships that started to question about the limits of the beginning and the end of life in relation to the technology advancements, and even to the limits of the Humankind concept. In that way a new Science is consolidated, being able to be replicated and taught. However, how effective the teaching of Bioethics is? In its current epistemological state of development, has the teaching of Bioethics been contributing to the training of professional staff that will be dealing with bioethics dilemmas in a daily basis? Within this context, this paper seeks to understand the impacts that the teaching of bioethics has over Medicine students, considering analysis in the 1st, 6th an 9th semesters of the undergraduate course. The statistical results obtained and presented in this paper show that, despite the great development and dissemination of Bioethics, its impact over the training of the new generation of doctors seems to be low, so that the interdisciplinary relationship particular of the discipline, the epistomological influence is still a one-way route, meaning that even if Medicine contributes to the formulation of Bioethics, Bioethics seems to be of little relevance when contributing to the formation of modern medicine, as observed in data that show strong corporatism among students. It should be noted, however, that there are results showing instability in the opinions that permit to affirm that Bioethics make chance to the doubt, avoiding dogmas and pre-conceived decisions to be formulated in an ethic dilemma situation.

Medical educators: the new generalists identifying the core traditions of the profession to create the next generation of doctors.

Medical educators: the new generalists identifying the core traditions of the profession to create the next generation of doctors.

Educating a new generation of doctors to improve the health of populations in low- and middle-income countries.

Francesca Celletti and colleagues from WHO argue that a transformation in the scale-up of medical education in low- and middle-income countries is needed, and detail what this might look like.

John Kingdom Guy Webb

John Webb, who died on 17 August 2010, aged 91, was one of the first generation of doctors who specialised exclusively in the care of children. He had a very...