Oman Medical Research Articles

Factors Predicting the Choice of Specialization Among Medical Students and Junior Doctors in Oman: A Cross-Sectional Study

Background: Choosing a medical specialization is a crucial, career-defining decision for medical students and junior doctors. Objectives: This study aimed to identify variables impacting junior postgraduate doctors' and medical students' choice of specialty in Oman. Methods: A cross-sectional study was conducted at Sultan Qaboos University (SQU) and the Oman Medical Specialty Board (OMSB) in Muscat, Oman. A two-part, self-administered questionnaire was electronically distributed to 247 respondents of different positions and levels of education, including doctors enrolled in the General Foundation Program, interns, and medical students undergoing their junior and senior clinical rotations. Sociodemographic characteristics were compared to determine factors influencing the choice of medical specialization. Results: The most popular choice of specialty was pediatrics (14.6%), followed by family medicine (10.9%), psychiatry (9.3%), and general medicine (8.5%). Medical specialties were chosen more frequently than surgical or diagnostic specialties (60.7% vs. 27.5% and 10.9%, respectively), regardless of gender or current position/level. Significant variations in specialty preferences were observed based on the respondents’ level of paternal educational attainment (P = 0.026) and future desired location of residency (P < 0.001). The factors identified by the participants as most important when selecting preferred specialties were working hours/lifestyle after completion of training (77.3%), positive experiences with a clinician/teacher of a particular specialty (72.5%), and income potential (70.9%). Conclusions: The findings of this study may contribute to healthcare workforce planning strategies aimed at supporting insufficiently staffed specialties, taking into account the needs of patients as well as the interests and preferences of future doctors.

Setting Sail into a New Era of Medical Research in Oman

It is with both great pleasure and a considerable sense of excitement that we present this inaugural issue of the Journal of the Oman Medical Association (ISSN: 2813-8759) [...]

Quality of Life Among Postgraduate Medical Residents in Oman: A Cross-sectional Survey.

To assess the quality of life (QoL) of medical residents enrolled in the various postgraduate programs of the Oman Medical Specialty Board (OMSB). The data for this cross-sectional study was collected from January to June 2022. All postgraduate residents who were enrolled in all 19 OMSB training programs were targeted. An online English version of the validated 36-Item Short Form Health Survey (SF-36) was used to assess the participants' self-reported QoL. The participants were 425 OMSB residents (mean age = 29.6±2.2 years), of whom 289 (68.0%) were female, 259 (60.9%) were married, and 295 (69.4%) were enrolled in medical specialties. Overall, female residents reported significantly poorer QoL than male residents in all subscales of SF-36 (p =0.001). Married residents reported lower bodily pain scores than unmarried residents (p =0.005), although the latter endorsed better physical functioning, general health, and mental health. Residents in laboratory specialties had higher scores than those in medical and surgical specialties in most QoL dimensions including physical health, role functioning, energy/fatigue, emotional well-being, bodily pain, and general health (p ≤ 0.003). Psychiatry residents reported the lowest overall QoL. Postgraduate medical residents in Oman reported significant variations in QoL based on specialization, gender, and marital status. These findings underscore the need for targeted interventions to tackle health inequalities and improve the QoL of this population.

Knowledge and Confidence of Omani Pediatric Residents in Managing Diabetic Ketoacidosis: A Cross-Sectional Survey

Abstract Introduction Diabetic ketoacidosis (DKA) is a common complication of type 1 diabetes mellitus. Unfortunately, medical errors are not uncommon during the management of DKA leading to significant morbidity and mortality. There are many studies conducted to assess the knowledge of junior doctors in the management of DKA in many countries including Bahrain and Iraq. Objectives This study aims to assess the knowledge and confidence of Omani pediatric residents in the management of DKA and compare the findings with the results of previous studies from the region. Materials and Methods A cross-sectional study was conducted among all enrolled pediatric residents in the Oman Medical Specialties Board in 2021, using an online survey that consists of three parts with a total of 30 questions to gain information about demographics, knowledge, and overall confidence in the management of DKA in children. The questionnaire was adopted from the Bahraini and Iraqi studies. Results In total, 69 pediatric residents (15M:54F) out of 84 had responded to the survey, giving a response rate of 82%. More than half of the responders were junior residents R1 and R2 (59.3%). The overall performance score of knowledge among the residents mainly ranged between 50 and 75%. However, R2 resident performance was better as their score ranged between 80 and 85%. Only 5.7% of our residents had a performance score above 90%. The overall confidence of residents in managing patients with DKA was directly proportional to their year of residency, ranging from not confident to very confident, demonstrating that most residents from R1 to R3 rated themselves as “fair” compared with 58.3% of 4th-year residents who rated themselves as confident. In comparison to similar studies in Bahrain and Iraq, our junior residents showed better knowledge in some aspects, for example, identifying the correct biochemical criteria to diagnose DKA, 88.7 vs. 65% from Bahrain and 20.7% from Iraq. Conclusion The overall knowledge and confidence of the Omani pediatric residents were satisfying. However, there are still some gaps in knowledge to be bridged about the management of pediatric DKA. Continuous educational activities are desired. Therefore, more sessions about DKA management are to be scheduled, perhaps applying some simulation training to boost their knowledge and confidence.

Burnout and Stress Among Residents in Four Gulf Cooperation Council Countries Using the Copenhagen Burnout Inventory and Stress Overload Scale-Short Form

Physician burnout and stress can have consequential effects on healthcare services and are a leading cause for medical errors and lower quality of care. This is the first study to assess the prevalence rates and associated variables for burnout and stress levels of medical residents in four Gulf Cooperation Council (GCC) countries by combining the Copenhagen Burnout Inventory (CBI) and Stress Overload Scale-Short Form (SOS-S) as assessment tools. A cross-sectional, quantitative research method design using an online survey. This online survey was distributed to second year and above medical residents training in tertiary healthcare centres in four GCC countries (Saudi Arabia, Kuwait, Bahrain, and Oman). Eligible residents (n = 16,686) were recruited via convenience sampling. Out of 2,886 respondents, 996 responses were excluded due to incomplete information. The data was collected from 13th September 2020 to 15th November 2020. Of 1,890 included medical residents, 961 (50.8%) were females, and the mean (SD) age was 29.5 (3.2) years old. Personal burnout prevalence rates were the highest, followed by work-related and patient-related burnout (98.4%, 97.8%, and 79.3%, respectively). Arab and Kuwait Board residents had the highest rates of burnout across all domains. Stress overload scores were high with 51.6% of residents at high risk for illness, with Saudi Board residents most likely to be at high risk and Oman Medical Specialty Board residents at low risk. Burnout predictors included: no access to a wellness programme (p = 0.000), longer shifts (p = 0.000), high personal vulnerability (p = 0.000), and intention to leave (p = 0.05). Our findings show that burnout and stress rates are high for GCC residents, suggesting a significant problem for residents to provide the highest quality of healthcare possible. Further research is needed to evaluate the efficacy of residency wellness interventions to address this issue.

Performance Prediction of the Family Medicine Applicants of Oman Medical Specialty Board in Multiple Mini-interviews Using the International Foundations of Medicine Exam and Situational Judgment Test

Background: Entry into postgraduate medical training programs should be based on valid selection measures predictive of training performance. A situational judgment test (SJT) is often used during the residency selection process to measure knowledge and behavioral attributes. Objectives: This study aimed to test the validity of the International Foundations of Medicine (IFOM) examination and an SJT for predicting performance during multiple mini-interviews (MMI) of the applicants for a family medicine residency program in Oman. Methods: This retrospective cross-sectional study was conducted at Oman Medical Specialty Board (OMSB) during the application process of residency for the academic year 2021. Data were collected from 80 applicants to the OMSB Family Medicine Residency Program. Before participating in the MMI panels, all applicants underwent pre-interview tests (comprising the IFOM examination and SJT). Multiple regression analysis was performed to determine the predictors of the MMI score. Results: A total of 67 applicants completed the entire selection process cycle and were included in the study. The SJT score was a significant predictor of the MMI score (r = 0.367; P = 0.002), whereas the IFOM score was not a significant predictor (r = 0.105; P = 0.396). Conclusions: This study supports using SJT as an additional selection measure alongside the MMI panel for entry to OMSB residency training.

COVID-19 Medical Research in Oman: A Bibliometric and Visualization Study.

ObjectivesTo study the quantum and pattern of the COVID-19-related medical research publications that had contributions from researchers in Oman, using bibliometric analysis.MethodsData on the COVID-19-related medical research publications with contributions from authors in Oman were sourced from the Scopus database. The main search keywords were ‘COVID-19’ and ‘Oman’. The search included data from 1 December 2019 till 21 August 2021. A bibliometric method utilizing citation analysis and science mapping was applied to the selected data. VOSviewer software was used for constructing and visualizing various bibliometric networks.ResultsThe search query returned 360 documents which included those by authors from Oman. After excluding 83 of these due to irrelevance, 277 documents were finally selected for analysis. Three macro research themes emerged: treatment of COVID-19 cases, epidemiology and impact of COVID-19, and etiology and clinical manifestations of COVID-19. A total of 4533 sources were cited in the selected 277 documents. Most articles were published in the International Journal of Infectious Diseases (IJID), followed by Oman Medical Journal, and Sultan Qaboos University Medical Journal. The most cited references included the Lancet, followed by the New England Journal of Medicine, and the Journal of the American Medical Association. The largest number of papers were authored by researchers from Sultan Qaboos University followed by the Oman Ministry of Health. Regarding the number of citations received per paper, the top rank went to the Ministry of Health, followed by Sultan Qaboos University Hospital and Khoula Hospital.ConclusionsOman has significantly contributed to the COVID-19-related medical knowledge despite the challenges of conducting research amidst the increased workload during the pandemic. Most publications in Oman were collaborative projects. Based on the evaluated literature, further research focusing on vaccines and therapeutics is warranted.

The prevalence and factors associated with anxiety symptoms among resident physicians in Oman: a cross-sectional study

BackgroundAnxiety disorders are a significant factor associated with physician burnout and poor patient care, reported to have a significant frequency among the youth in the Middle East. However, to date, no study has explored the prevalence of anxiety among resident physicians in the Arabian Gulf country of Oman. This cross-sectional study, conducted among a random sample of residents affiliated with the Oman Medical Specialty Board, aimed to examine the frequency and factors associated with anxiety symptoms among them. Participants were asked to complete the General Anxiety Disorder Assessment (GAD-7) to assess anxiety, as well as a socio-demographic questionnaire.ResultsIn a total of 251 residents, the prevalence of anxiety was 14.7% (GAD-7 cut-off score ≥ 10). More than 60% of the respondents were female (68.9%). The age breakdown ranged from 25 to 30 years old (66.5%) and the majority were married (64.9%). More than 70% of respondents attended at least 5 shifts in their weekly schedule and received at least 5 on-call shifts from the hospital per week. Logistic regression showed that residents with chronic disease were 2.5 times (95% CI 1.36–4.72, p = 0.003) more likely to have anxiety than those without them. Those residents who did not exercise were 2.1 times (95% CI 1.04–4.46, p = 0.038) more likely to have anxiety than those who exercise often or regularly. Residents who received 6 or more on-calls from the hospital were 2.6 times (95% CI 1.35–5.25, p = 0.005) more likely to have anxiety than those who received 5 or fewer on-calls in a month.ConclusionsThe factors seemingly responsible for anxiety symptoms in this sample of resident physicians are those that are typically associated with poor work-life balance and unhealthy lifestyles. Pending further scrutiny, these results could be used to lay the groundwork for the identification of those who will require more protracted help during their training in Oman and in other culturally similar Middle Eastern countries.

Communication and Patient Care in Radiography

Communication and Patient Care in Radiography

Knowledge, attitudes, and practices toward research among Oman medical specialty board residents.

OBJECTIVES:The Accreditation Council for Graduate Medical Education has mandated residency programs to teach the basic principles of research in residency programs. This study aimed to assess the research knowledge, attitude, and practice among the Oman Medical Specialty Board (OMSB) residents. Secondarily, it aimed to asses associations between different factors and research-related knowledge, attitude, and practice.MATERIALS AND METHODS:This cross-sectional study was conducted among all residents who were involved in OMSB various training programs in the academic year 2018/2019. A validated self-administered questionnaire was used. Hard copies of the questionnaire were delivered to residents in addition to the online forms. Data were entered using EpiData entry software and analyzed using SPSS version 24.RESULTS:A total of 256 residents participated in the study with a response rate of 46.5%. Around 55% of included residents have poor knowledge level, and 44% have moderate knowledge level. The study showed that the majority (93%) of the residents have positive research attitude. However, the practice domain showed that only 27.8% of residents have published articles as first or coauthor. Lack of time was reported as a major hindrance in nearly two-thirds of the residents. Lack of training (56%), lack of research-focused curriculum (47%), and lack of effective supervision (46%) were among major reported obstacles beside others.CONCLUSIONS:This study showed that OMSB residents have inadequate knowledge and lagging research practices, but a positive attitude toward research. This emphasizes the need for research-focused curricula and further training. In addition, applying new regulations, including mandatory manuscript submission, may improve the practice status.

Internet Addiction and Depression Among Postgraduate Residents: A cross-sectional survey.

ObjectivesThis study aimed to estimate the prevalence of social media usage and Internet addiction among Oman Medical Specialty Board (OMSB) residents and to determine associations between Internet addiction, sociodemographic characteristics and symptoms of depression.MethodsThis cross-sectional study took place between January and March 2017. All 499 residents enrolled in OMSB training programmes during the 2016–2017 academic year were targeted. A self-administered questionnaire was distributed to collect information concerning sociodemographic characteristics. In addition, the Patient Health Questionnaire-9 and Internet Addiction Test were used to screen for depression and Internet addiction, respectively.ResultsA total of 399 residents participated in the study (response rate: 80%). Overall, 115 residents (28.8%) had varying degrees of depression and 149 (37.3%) were addicted to the Internet; moreover, among those addicted, 54 (36.2%) had depression. While no significant associations were observed between Internet addiction and sociodemographic characteristics, the association between Internet addiction and depression was statistically significant (P = 0.012).ConclusionInternet addiction was clearly detected among many OMSB residents, with a significant association observed between Internet addiction and depression. Although a causal link between these two variables cannot be established as depression is multifactorial in origin, the disadvantages and harmful effects of excessive Internet and social media usage need to be addressed. Further research on the consequences of Internet addiction and its effect on quality of life and academic achievement is recommended.

Research Publications of the Oman Medical Specialty Board.

ObjectivesTo date, the quantity and the quality of research publications conducted within the Oman Medical Specialty Board (OMSB) have not been assessed. In this review, we sought to assess the quantity and quality of research publications affiliated with the OMSB.MethodsWe retrieved data systematically from PubMed, Scopus, Web of Science, and Google Scholar. We searched all publications published until December 2018.ResultsA total of 133 published articles affiliated with the OMSB were retrieved. Half of the publications were original studies, and 30.8% were case reports or series. Reviews and editorials represented 6.8% and 8.3%, respectively. Among the original studies, 79.4% were cross sectionals and 50.0% were retrospective in nature. Among the prospective studies, 58.8% were questionnaire-based surveys. The impact factors of the journals ranged between 0.82 and 4.40, except for one journal with an impact factor of 15.10.ConclusionsThe quantity and quality of the publications from the OMSB is still low. However, training and policy change in the residency curriculum is key to improve the status.

Dopamine Dysregulation Syndrome in Parkinson Disease and Remission After Treatment With Aripiprazole.

Department of Medicine, Neurology Unit, Sultan Qaboos University Hospital, Al Khould, Oman Oman Medical Specialty Board, Muscat, Oman [email protected] Department of Medicine, Neurology Unit, Sultan Qaboos University Hospital, Al Khould, Oman Directorate General of Health Services, Muscat, Oman Received June 15, 2021; accepted after revision July 29, 2021.

Graduate Medical Education Accreditation Across Borders: Toward a Remote Alternative.

Graduate Medical Education Accreditation Across Borders: Toward a Remote Alternative.

Perception and Usage of Point of Care Devices: A Cross-sectional Study Targeting Residents and Trainers in Oman.

ObjectivesThe use of mobile technologies and handheld computers by physicians has increased worldwide. However, there are limited studies globally regarding training physicians on the use of such devices in clinical practice. In addition, no studies have been conducted previously in Oman addressing this issue among postgraduate medical trainees and trainers. The present study explores the practice and perception of resident doctors and trainers towards the use of mobile technologies and handheld devices in healthcare settings in Oman.MethodsThis cross-sectional study was conducted using a validated questionnaire disseminated via email to all residents and trainers in five major training programs of the Oman Medical Specialty Board (OMSB). The questionnaire explored three main areas; perception, usage, and perceived barriers of handheld devices.ResultsOverall, 61.4% of the residents and 28.3% of the trainers responded to the questionnaire. Both types of participants agreed that the use of such devices positively affects clinical decision-making. In total, 98.8% of the participating residents and 86.7% of the trainers frequently used handheld devices. Both OMSB residents and trainers agreed that lack of time, training, and applications were the most common factors limiting the use of these devices. Participants emphasized the need for constructive training regarding the use of handheld devices as healthcare resources.ConclusionsPoint-of-care devices are positively perceived and frequently used by OMSB trainees and trainers. However, constructive training on the effective usage of these devices in clinical decision-making is needed. Further future studies to evaluate the impact of using such devices in patient care should be conducted.

Assessing Family Medicine Residents’ Communication Skills in Oman Using the Communication Assessment Tool: A Cross-sectional Study

Objective: Primary care physicians are the first means of access to further healthcare services and act as a doorkeeper for different specialties at the secondary and tertiary levels; thus, communication skills are one of the most vital skills to be taught to residents in the family medicine specialty. This study aimed to evaluate the communication skills of family medicine residents in Oman from the perspective of their patients. Methods: This cross-sectional study was performed at the Family and Community Medicine Clinic of Sultan Qaboos University Hospital as well as various Ministry of Health training health centers in Muscat, Oman. An Arabic version of the validated 14-item Communication Assessment Tool (CAT) was used to evaluate patients’ perceptions regarding the communication skills of family medicine residents at the end of their consultation. Data were collected between September 2020 and May 2021 from 602 patients who received care or interacted with 60 residents from the Oman Medical Specialty Board (OMSB) Family Medicine Residency Program at different residency levels. Results: The mean percentage of CAT items rated as excellent was 73.8%. The item “Treated me with respect” was most commonly rated as excellent (84.2%), whilst the item "Involved me in decisions as much as I wanted" was least frequently rated as excellent (62.0%). Various factors were found to significantly affect CAT rating, including residency level, type of clinic, number of times seeing the same resident, and the patient's education level. In contrast, other factors such as time of consultation, the gender of either the resident or the patient, and the nationality of the patient did not affect CAT rating. Conclusion: Some areas of weakness especially with the item "encouraged me to ask questions" and involved me in decisions as much as I wanted" identified in the communication skills of OMSB family medicine residents. These findings are comparable with those reported by similar studies worldwide.

Prevalence of Depression among Oman Medical Specialty Board Residents

I read with great interest the paper published by Al-Houqani et al,1 in the March 2019 issue of the Oman Medical Journal, which investigated the prevalence of depression among Oman Medical Specialty Board residents. The results indicated that the prevalence of depression was 28.8%, and the correlates were gender, level of residency, sleep duration, and exercise.

Factors Associated with Choice of Career in Family Medicine Among Junior Doctors in Oman.

ObjectivesThe number of family physicians in Oman is far below that recommended by the World Health Organization. This study aimed to determine factors influencing junior doctors’ choice of a career in family medicine.MethodsThis cross-sectional study was conducted between March and June 2018 and targeted applicants to Oman Medical Specialty Board residency programmes during the 2018–2019 academic year. Applicants were grouped according to their choice of either family medicine (n = 64) or other specialities (n = 81). A self-administered questionnaire was utilised to compare the applicants’ sociodemographic characteristics, factors influencing their choice of career and their Myers-Briggs Type Indicator® (MBTI) personality traits.ResultsA total of 52 family medicine and 43 other residency applicants participated in the study (response rates: 81.3% and 53.1%, respectively). Most family medicine applicants were female (86.5%), married (65.4%) and resided in rural areas (73.1%); moreover, 19.2% were ≥30 years of age. Overall, emphasis on continuity of care, opportunity to deal with a variety of medical problems, the ability to use a wide range of skills and knowledge, early exposure to the discipline, opportunity to teach and perform research and the influence of family or friends were important factors in determining choice of a career in family medicine. Moreover, the MBTI analysis revealed that family medicine applicants were commonly extroverted-sensing-thinking-judging personality types.ConclusionKnowledge of the factors influencing career choice among junior doctors may be useful in determining future admission policies in order to increase the number of family physicians in Oman.

Prevalence and determinants of suicidality among medical students in Oman

Objective The aim was to explore the stress sources and determine the prevalence of suicidal ideation among medical students and its association with demographic characteristics and stress factors. Patients and methods A cross-sectional study was conducted on Oman Medical College students of preclinical and clinical years. Data were collected using a semistructured questionnaire with sections on sociodemographic factors, stress factors, and assessment of suicidality. Prevalence of suicidal ideation and behavior in the past was assessed with the help of questions in the General Health Questionnaire pertaining to suicide. Results A total of 314 medical students participated in the study. The average age of the participants was 22.13 years. Most students who participated in the study were females (76.4%). Regarding the year of study, 66.6% of students belonged to the preclinical years, whereas 33.4% of participants were currently undergoing clinical training. The higher level of stress was associated with problems related to nutrition, poor sleep, emotional problems, and difficulties in the study courses. Overall, 33.4% of medical students had a lifetime prevalence of suicidal ideation. It was also seen that the rates of making a suicidal plan (8%) or attempting suicide (4.5%) were lower. Results also indicate that the prevalence of suicidal ideation is higher among students in the preclinical years when compared with students in clinical training. Conclusion The prevalence of suicidal ideation and attempts among medical students was in the higher range in international comparison. Medical students are future doctors who are in need to be protected from avoidable causes of morbidity and mortality including suicide. There is a necessity for further investigations to identify the core sources of emotional distress and academic burden in this population and then propose strategies consequently.

Prevalence of Depression among Oman Medical Specialty Board (OMSB) Residents.

ObjectivesWe sought to estimate the prevalence of depression among Oman Medical Specialty Board (OMSB) residents and determine the relationship between depression and sociodemographic characteristics.MethodsWe conducted a cross-sectional survey from January to March 2017. A self-administered questionnaire was distributed to all residents enrolled under different OMSB training programs. Information was obtained on the sociodemographic characteristics. The Patient Health Questionnaire-9 (PHQ-9) was used to screen for depressive symptoms.ResultsA total of 399 residents (158 males and 241 females) participated in the study. Overall, 115 residents had a PHQ-9 score of 5 or more, giving a prevalence of depression of 28.8%. Of those who were depressed, 85 (73.9%) had mild depression, 20 (17.4%) had moderate depression, and 10 (8.7%) had severe depression. There was a significant association between depression and participants’ gender (p = 0.030), level of residency (p = 0.006), sleep duration (p = 0.001), and exercise (p = 0.019). There was no significant association between depression with the other demographic characteristics such as marital status (p = 0.489), specialty (p = 0.370), smoking (p = 0.953), or drug use (p = 0.060).ConclusionsDepression is a common issue among medical residents. Health education on the harmful effects of depression needs to be addressed. Further research on the consequences of depression and its effects on quality of life and academic performance is needed.