Training Programs For Physicians Research Articles

Evaluating Diagnostic and Pharmacologic Management Cost of Chronic Abdominal Pain and Chronic Constipation in Iranian Children

Background: Abdominal pain and constipation are the most common symptoms in children and because of lacking a well-defined diagnostic criteria for these symptoms various aspect of medical care in these patients are increased. Objectives: The current study aimed to evaluate the number and the cost of diagnostic and pharmacologic management of chronic abdominal pain and chronic constipation in children aged less than 18 years managed by general physicians or pediatricians before the patient is examined by pediatric gastroenterologist. Patients and Methods: In a cross-sectional study a sample of 91 consecutive patients with chronic abdominal pain and chronic constipation aged less than 18 years managed by pediatricians and general physicians were interviewed, examined and a questionnaires (based on the Rome III criteria) were filled, before they visited a pediatric gastroenterologist in an outpatient gastroenterology clinic. Cost and number of pharmacologic management and paraclinical workups done were calculated in total for the two symptoms separately. Results: There were 91 patients, among which 55 (60.4%) had come with chronic abdominal pain and 36 (39.6%) had come with chronic constipation. The calculated cost per case for general physician and pediatrician visits and paraclinical and pharmacological management for patients with chronic abdominal pain was $ 65.1 and for chronic constipation was $ 53.2. For chronic abdominal pain cost per case for general physician visit was $ 8.6, for pediatricians was $ 26.9, for paraclinical management was $ 27.7 and for pharmacological management was $ 1.9. Similarly for the patients with chronic constipation cost per case for general physician visit was $ 14.8, for pediatricians was $ 28.1, for paraclinical management was $ 7.7, and for pharmacological management was $ 2.6. Conclusions: This study suggests that symptoms like chronic abdominal pain, and chronic constipation seem to put a heavy burden on the economy of the country, so training programs for pediatricians and general physicians that can well train them to handle such symptoms may decrease the number of clinical visits, repetitive investigation procedures, and utilizing multiple prescription drugs. Also media, magazines, booklets in hospitals, clinics and drug stores can help to educate parents and they in turn can cooperate better with the physician and will cope with long term symptoms of such problems in their children better.

Comparison between cancer specialists and general physicians regarding the education of nurse practitioners in Japan: a postal survey of the Japanese Society of Clinical Oncology

Japanese physicians' attitudes regarding the education of nurse practitioners (NPs) are not well described. A survey was mailed to 1,094 board members of the Japanese Society of Clinical Oncology (JSCO) and the Japanese Primary Care Association (JPCA), and the directors of the clinical training program for physicians. The physicians of JSCO were classified as the cancer specialist group, and both the board members of JPCA and the directors of the clinical training program for physicians constituted the general physician group. We compared the responses of cancer specialists and general physicians. The survey response rate was 25.9% (69 of 266) in the cancer specialist group and 19.4% (161 of 828) in the general physician group. The median age of respondents was 53 and 55 years, respectively, of which 84 and 79%, respectively, were men. We found that the percentages of respondents who considered NP education necessary were almost identical in the 2 groups (r = 0.898, p < 0.0001). Education items considered necessary for NPs by >80% respondents in both groups included many symptoms, emergency management, basic procedures, general screening, palliative care including management against adverse effects, health education, and communication. More cancer specialists than general physicians (p < 0.01) expected NPs to be educated in multidisciplinary practice and palliative care, including management against adverse effects. Our study suggests that cancer specialists expect NPs to provide symptom management and psychosocial support, clarify information, provide education, and work as a member of a multidisciplinary team.

Introducing medical abortion in Turkey: Perspectives of physicians

ObjectiveTo better understand the knowledge, attitudes, and perspectives on medical abortion (MA) held by physicians in Turkey. MethodsThe study was conducted in 4 provinces. Pretested, structured, self-administered questionnaires were answered by 187 obstetricians-gynecologists (ob-gyns) and 268 general physicians (GPs). ResultsAlthough MA is not yet available at reproductive health facilities in Turkey, 96% of the ob-gyns and 82% of the GPs said they had heard about it. Moreover, 60% of the former and 5% of the latter said they had performed MAs, most commonly using misoprostol alone. More than 90% of the ob-gyns and 13% of the GPs had performed surgical abortions, and most (71% and 78%) thought that MA should be offered in the country. ConclusionMost physicians in Turkey are aware of MA, with a large majority supporting its wider use. However, their concerns about the method and the incorrect understanding of its risks and possible complications may explain the reluctance of some physicians to provide MA services. These issues should be covered in physician training programs before the formal introduction of MA, while advocacy efforts press for registering mifepristone and misoprostol for its use.

Involving Physicians in Upstream Conversations: The Serious Illness Communication Checklist

Background: Early discussion of end-of-life issues has been found to be associated with better quality of life, reduced use of aggressive care, earlier hospice referral, improved bereavement outcomes for survivors,...

Response to Mahendran Letter

Back to table of contents Previous article Next article Communications and UpdatesFull AccessResponse to Mahendran LetterSamuel F. Law, M.D., F.R.C.P.C., Paul S. Links, M.D., F.R.C.P.C., Wes Shera, Ph.D., Brian D. Hodges, M.D., Ph.D., Juveria Zaheer, M.D., Pozi Liu, M.D., Ph.D., and Xuzhu Huang, M.D., Ph.D.Samuel F. LawTorontoSearch for more papers by this author, M.D., F.R.C.P.C., Paul S. LinksTorontoSearch for more papers by this author, M.D., F.R.C.P.C., Wes SheraTorontoSearch for more papers by this author, Ph.D., Brian D. HodgesTorontoSearch for more papers by this author, M.D., Ph.D., Juveria ZaheerTorontoSearch for more papers by this author, M.D., Pozi LiuChinaSearch for more papers by this author, M.D., Ph.D., and Xuzhu HuangChinaSearch for more papers by this author, M.D., Ph.D.Published Online:1 Apr 2012https://doi.org/10.1176/appi.ajp.2012.12010006rAboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail To the Editor: We thank Dr. Mahendran's attention to this concerning topic, as one of our goals for the article was to point out how psychiatric training and competence are sorely missing in a growing number of primary care physicians around the world for a diverse range of reasons. In China, this has been largely because of historical, political, and resource-limitation reasons, most notably for singling out psychiatry as a nonpriority in the delivery of a shorter, less intensive rural physician training program. The attendant significant negative impact over the years on the mental health of the country's rural population is well documented in our article. In Dr. Mahendran's report, this absence of competence is related to medical modernization that lost sight of the centrality of psychiatry as part of general medicine. We advocate that as psychiatrists, we cannot lose sight of this and should increase our championing of psychiatric training at all levels of medical education, lest psychiatry become irrelevant at the most basic level of medical care.TorontoChinaThe authors' disclosures accompany the original article.Accepted for publication in January 2012. FiguresReferencesCited byDetailsCited ByNone Volume 169Issue 4 April 2012Pages 433-434 Metrics PDF download History Accepted 1 January 2012 Published online 1 April 2012 Published in print 1 April 2012

A global template for reforming residency without work-hours restrictions: Decrease caseloads, increase education. Findings of the Japan Resident Workload Study Group

Background: Japanese physician training programs are currently not subject to rigorous national standardization. Despite residency restructuring in 2004, little is known about the current work allocation of residents in Japan.Aims: We quantified the amount of time that Japanese junior residents spend in service versus education in the context of caseload, fatigue, and low-value administrative work.Methods: In this prospective, time-and-motion study, the activity of 1st- and 2nd-year residents at three Japanese community hospitals was observed at 5-min intervals over 1 week, and categorized as patient care, academic, non-patient care, and personal. Self-reported sleep data and caseload information were simultaneously collected. Data were subanalyzed by gender, training level, hospital, and shift.Results: A total of 64 participating residents spent substantially more time in patient care activities than education (59.5% vs. 6.8%), and little time on low-value, non-patient work (5.1%). Residents reported a median 5 h of sleep before shifts and excessive sleepiness (median Epworth score, 12). Large variations in caseload were reported (median 10 patients, range 0–60).Conclusions: New physicians in Japan deliver a large volume of high-value patient care, while receiving little structured education and enduring substantial sleep deprivation. In programs without work-hour restrictions, caseload limits may improve safety and quality.

Outcome of smoking cessation counselling of HIV‐positive persons by HIV care physicians

Smoking is the most prevalent modifiable risk factor for cardiovascular diseases among HIV-positive persons. We assessed the effect on smoking cessation of training HIV care physicians in counselling. The Swiss HIV Cohort Study (SHCS) is a multicentre prospective observational database. Our single-centre intervention at the Zurich centre included a half day of standardized training for physicians in counselling and in the pharmacotherapy of smokers, and a physicians' checklist for semi-annual documentation of their counselling. Smoking status was then compared between participants at the Zurich centre and other institutions. We used marginal logistic regression models with exchangeable correlation structure and robust standard errors to estimate the odds of smoking cessation and relapse. Between April 2000 and December 2010, 11 056 SHCS participants had 121 238 semi-annual visits and 64 118 person-years of follow-up. The prevalence of smoking decreased from 60 to 43%. During the intervention at the Zurich centre from November 2007 to December 2009, 1689 participants in this centre had 6068 cohort visits. These participants were more likely to stop smoking [odds ratio (OR) 1.23; 95% confidence interval (CI) 1.07-1.42; P=0.004] and had fewer relapses (OR 0.75; 95% CI 0.61-0.92; P=0.007) than participants at other SHCS institutions. The effect of the intervention was stronger than the calendar time effect (OR 1.19 vs. 1.04 per year, respectively). Middle-aged participants, injecting drug users, and participants with psychiatric problems or with higher alcohol consumption were less likely to stop smoking, whereas persons with a prior cardiovascular event were more likely to stop smoking. An institution-wide training programme for HIV care physicians in smoking cessation counselling led to increased smoking cessation and fewer relapses.

A Review of Primary Care Training Programs in Correctional Health for Physicians

Background: Despite the health consequences of incarceration, there are no national standards for teaching physicians about correctional health. The purpose of this study was to survey existing correctional health training programs for primary care physicians. Summary: Programs were identified through literature and Web search, snowballing, and professional meetings. Programs were contacted and asked to complete a survey. Correctional health programs exist in a variety of disciplines. We identified 22 in primary care. Programs seek to improve public health, reduce stigma, and recruit physicians to correctional health. Curricula covered specific health problems as well as the impact of incarceration on families and communities. Relationships between the academic center and the correctional facilities were varied. Barriers include issues of security, time, financial resources, and stigma. Programs evaluate their learners, as well as educational and clinical outcomes. Conclusions: A variety of correctional health programs currently exist. A national model curriculum could strengthen teaching in correctional health.

Assessment of a residency training program in endocrinology and nutrition by physicians: Results of a survey

Background and objectiveThe current training program for resident physicians in endocrinology and nutrition (EN) organizes their medical learning. Program evaluation by physicians was assessed using a survey. Material and methodThe survey asked about demographic variables, EN training methods, working time and center, and opinion on training program contents. ResultsFifty-one members of Sociedad Castellano-Manchega de Endocrinología, Nutrición y Diabetes, and Sociedad Andaluza de Endocrinología y Nutrición completed the survey. Forty-percent of them disagreed with the compulsory nature of internal medicine, cardiology, nephrology and, especially, neurology rotations (60%); a majority (>50%) were against several recommended rotations included in the program. The fourth year of residence was considered by 37.8% of respondents as the optimum time for outpatient and inpatient control and monitoring without direct supervision. The recommended monthly number of on-call duties was 3.8±1.2. We detected a positive opinion about extension of residence duration to 4.4±0.5 years. Doctoral thesis development during the residence period was not considered convenient by 66.7% of physicians. Finally, 97.8% of resident physicians would recommend residency in EN to other colleagues. ConclusionsEndocrinologists surveyed disagreed with different training program aspects such as the rotation system, skill acquisition timing, and on-call duties. Therefore, an adaptation of the current training program in EN would be required.

Valoración del programa de formación de médicos residentes en Endocrinología y Nutrición por facultativos: resultados de una encuesta

Background and objective The current training program for resident physicians in endocrinology and nutrition (EN) organizes their medical learning. Program evaluation by physicians was assessed using a survey. Material and method The survey asked about demographic variables, EN training methods, working time and center, and opinion on training program contents. Results Fifty-one members of Sociedad Castellano-Manchega de Endocrinología, Nutrición y Diabetes, and Sociedad Andaluza de Endocrinología y Nutrición completed the survey. Forty–percent of them disagreed with the compulsory nature of internal medicine, cardiology, nephrology and, especially, neurology rotations (60%); a majority (>50%) were against several recommended rotations included in the program. The fourth year of residence was considered by 37.8% of respondents as the optimum time for outpatient and inpatient control and monitoring without direct supervision. The recommended monthly number of on-call duties was 3.8 ± 1.2. We detected a positive opinion about extension of residence duration to 4.4 ± 0.5 years. Doctoral thesis development during the residence period was not considered convenient by 66.7% of physicians. Finally, 97.8% of resident physicians would recommend residency in EN to other colleagues. Conclusions Endocrinologists surveyed disagreed with different training program aspects such as the rotation system, skill acquisition timing, and on-call duties. Therefore, an adaptation of the current training program in EN would be required.

Abstract P41: How to Implement International Recommendations in Daily Practice in a Large EMS Center

Introduction: Continuous professional development and education associated with Evaluation of health Professional Practices (EPP) has been legally implemented and is mandatory in France since 2004. EPP applies to all aspects of the health care system, including pre-hospital EMS and their call centers. EPP must comply with one of the restricted proposals issued by Health Authorities. The aim of this presentation is to lay out the methodology selected to achieve this legal requirement in an EMS serving 1.5 million population. Methods: The proposed methods were: clinical audit compared with standards, identification of existing procedures, identification of clinical decision trees, identification of patient's pathway to optimised final care. Among these methods, identification of patient's clinical pathway was selected as the best method for a call center study, since it allows to monitor the overall handling of an emergency call, from the early phone call to the final point of care. Among the various pathologies, cardiac arrest was selected because: 1 - The release of new AHA recommendations in 2010, 2 - Similar “cardiac arrest” EPP developments in the hospital where the EMS is based, 3 - The need for quality control of all cardiac arrest calls. Expected results: EPP in the EMS is divided in 3 steps: Step 1: results from studying the running procedures, regarding call handling of cardiac arrests including triage performed by operators and medical dispatchers (physicians). Retrospective study of files that were triaged as cardiac arrests by operators. Duration: 6 months. Step 2: elaboration of an action plan: Sharing of the results with operators and medical dispatchers. Setting up of a global team training program for both operators and physicians, in agreement with new AHA guidelines. Duration: 6 months. Step 3: new retrospective study based on the same methodology than step 1, done after 6 months. The comparison of results of both studies will lead to the selection of pertinent indicators allowing continuous quality control. Conclusion: This EPP aims at evaluating and improving the management of emergency calls. It is expected to bring other benefits, such as easing the implementation of new guidelines, or defining new indicators for a continuous quality control.

Physician Communication in the Operating Room: Expanding Application of Face-Negotiation Theory to the Health Communication Context

Communication variables that are associated with face-negotiation theory were examined in a sample of operating-room physicians. A survey was administered to anesthesiologists and surgeons at a teaching hospital in the southwestern United States to measure three variables commonly associated with face-negotiation theory: conflict-management style, face concern, and self-construal. The survey instrument that was administered to physicians includes items that measured these three variables in previous face-negotiation research with slight modification of item wording for relevance in the medical setting. The physician data were analyzed using confirmatory factor analysis, Pearson's correlations, and t-tests. Results of this initial investigation showed that variables associated with face-negotiation theory were evident in the sample physician population. In addition, the correlations were similar among variables in the medical sample as those found in previous face-negotiation research. Finally, t-tests suggest variance between anesthesiologists and surgeons on specific communication variables. These findings suggest three implications that warrant further investigation with expanded sample size: (1) An intercultural communication theory and instrument can be utilized for health communication research; (2) as applied in a medical context, face-negotiation theory can be expanded beyond traditional intercultural communication boundaries; and (3) theoretically based communication structures applied in a medical context could help explain physician miscommunication in the operating room to assist future design of communication training programs for operating-room physicians.

Skills and educational needs of accident and emergency nurses in Ghana: an initial needs analysis.

The specialty of emergency medicine is highly reliant on a well-trained team of providers. Ghana has recently begun a specialist training program for physicians and the need to train specialist emergency nurses has been recognized. The first step to developing this training is to conduct a needs assessment. This study was conducted to elucidate current nursing functioning and gain knowledge of the educational desires and needs for nurses in the Accident and Emergency Center (A&E) at Komfo Anokye Teaching Hospital (KATH). Three nurses from the University of Michigan (UM) worked collaboratively with the nursing leadership at KATH to conduct a needs assessment of currently practising nurses in the A&E. The UM nurses observed nursing practice in the department and KATH nurses participated in a multiple choice exam, a self-assessment questionnaire of educational desires, answered written open-ended questions and participated in focus groups. KATH nurses scored relatively low on a general knowledge multiple choice exam, and indicated through the self-assessment that they would like to learn more about many topics. Open-ended questions gave further insight into areas of knowledge gaps. Several themes including Cohesion, Carrying out Orders/Decision Making and Overwhelming Volume, emerged from observations in the emergency department. Current nurse knowledge and function as well as areas to focus on for future specialty training in emergency nursing have been identified by this needs assessment. The emergency department nurses shared an overwhelming interest in increasing their skill level, learning new methods of patient care and implementing new technologies into their clinical practice.

2010 Canadian Cardiovascular Society/Canadian Society of Echocardiography Guidelines for Training and Maintenance of Competency in Adult Echocardiography

Guidelines for the provision of echocardiography in Canada were jointly developed and published by the Canadian Cardiovascular Society and the Canadian Society of Echocardiography in 2005. Since their publication, recognition of the importance of echocardiography to patient care has increased, along with the use of focused, point-of-care echocardiography by physicians of diverse clinical backgrounds and variable training. New guidelines for physician training and maintenance of competence in adult echocardiography were required to ensure that physicians providing either focused, point-of-care echocardiography or comprehensive echocardiography are appropriately trained and proficient in their use of echocardiography. In addition, revision of the guidelines was required to address technological advances and the desire to standardize echocardiography training across the country to facilitate the national recognition of a phy sician's expertise in echocardiography. This paper summarizes the new Guidelines for Physician Training and Maintenance of Competency in Adult Echocardiography, which are considerably more comprehensive than earlier guidelines and address many important issues not previously covered. These guidelines provide a blueprint for physician training despite different clinical backgrounds and help standardize physician training and training programs across the country. Adherence to the guidelines will ensure that physicians providing echocardiography have acquired sufficient expertise required for their specific practice. The document will also provide a framework for other national societies to standardize their training programs in echocardiography and will provide a benchmark by which competency in adult echocardiography may be measured.

What does the future hold for general medicine?

General medicine is being challenged by increasing numbers of patients who are presenting with multiple comorbidities and a decline in numbers of suitably trained personnel to manage these patients. A resurgence in generalist care, with collaboration between generalists and specialists, is the key to successfully managing patients who present with acute medical conditions. Better funded collaborative training programs for general physicians, which promote a diversity of skills and address clinical demand in a proscriptive manner, are needed. Research aimed at designing acute services to match local clinical demand is also required.

How Much Do Physicians in Latin America Know About Behavioral Variant Frontotemporal Dementia?

Diagnosis of behavioral variant frontotemporal dementia (bvFTD) can be especially challenging during the early stages for several reasons, including the fact that (a) behavioral disturbances in bvFTD can mimic the symptomatic profile of psychiatric disorders; (b) neuropsychological performance may be relatively spared; and (c) changes in structural neuroimaging may go undetected. Most frequently, bvFTD is not included as part of medical or residency training outside the field of cognitive neurology. The present study aimed at examining bvFTD-related practices concerning academic and professional training, diagnosis, and treatment across Latin America. We surveyed the academic and professional aspects of clinical practice related to bvFTD of 596 physicians from different fields throughout the continent. We discuss several aspects concerning Latin American physicians' training on dementia and bvFTD, the way in which they approach the differential diagnosis of bvFTD, and their most frequent strategies for the treatment of this condition. We conclude that information about bvFTD deserves more attention in both undergraduate and postgraduate medical education in Latin America, and that understanding clinical practices related to FTD can help design more efficient training programs for physicians in this and other world regions.

Development of the competency-based objective resident education using virtual patients system

The Accreditation Council for Graduate Medical Education (ACGME) requires U.S. physician training programs to teach and evaluate their trainees in six core competencies. Developing innovative methods to meet the ACGME requirements is an ongoing area of research in medical education. Here we describe the development of the Competency-based Objective Resident Education using Virtual Patients (CORE-VP) system, a web-based virtual patient simulator to teach and measure the ACGME core competencies. The user interface was built on Wavemaker technology including AJAX and javascript. A Flash component allows graphical navigation of the physical exam and linking of digital images and video to desired anatomic areas. The system contains tools for case authorship, management and execution and permits linking of files or web-based hypermedia content. Each case is designed to mimic a real-life patient encounter and includes history, physical exam, laboratory/ radiology, diagnosis and management. Automa­ted, multi-factorial, evaluation metrics were developed for each ACGME core competency. Upon completion of a case trainees receive immediate feedback in the form of an automated Performance Summary. We have developed a web-based virtual patient simulator called CORE-VP to teach and measure the ACGME core competencies. Work is currently underway to test and validate the system.

Ultraschall in der Anästhesie und Intensivmedizin - Ultraschall bei Gefäßpunktionen

Central venous catheterization and arterial catheterization are common procedures performed perioperatively by anesthetists. The traditional technique of locating surface landmarks was used to assist in vascular access. In patients with anatomical variants or pathological vessel changes it could be difficult or impossible to succeed with this traditional approach. Ultrasound-guided vascular access can improve patient safety in adults and children. Surrounding anatomical structures are visualized and the needle is advanced under continuous observation. Complications can be reduced and success improved. It is mandatory to offer an appropriate ultrasound training programs for physicians using this technique. This article summarizes the literature and describes a practical method of ultrasound-guided vascular access.

Accuracy of Pediatricians’ Screening and Referral for Early Childhood Caries after a Training Program

Background: Training of pediatricians on early childhood caries (ECC) screening and referral during their medical pediatric practice has been suggested to promote childhood dental care. Objectives: To assess the accuracy of pediatricians in detection of ECC and trauma and to estimate the rate of referral after being trained by a pedodontist. Materials and methods: The study was conducted at pediatric outpatient clinics of a governmental pediatric hospital in Alexandria, Egypt. Dental examination of 137 children- six to thirty six months of age was carried out independently by a pedodontist and pediatricians to identify cases of ECC and trauma after a training program for physicians about diagnosis of dental caries and referral needs. Results: Fifty dental conditions were detected among 33.6 % of the children (46 children) with a rate of 36.5%. The rate of ECC among children was 27.7% with pre-cavitated caries as the most common type (16.1%). The mean age of children with ECC is significantly higher than that of children without ECC ( t =3.23, P =0.002). The rate of dental trauma was 9%. The positive predictive value of pediatricians’ detection of ECC was 100%, the sensitivity was 94.74% and the specificity was 100%. The children referred for dental care by pediatricians represented 88 % of those referred by the pedodontist. Conclusion: Pediatricians can achieve high accuracy of identification of cases with ECC and of cases in need for dental referral through inservice training.

Smoking cessation intervention practices in Chinese physicians: do gender and smoking status matter?

Healthcare settings provide a major arena for administering smoking cessation interventions. However, few studies have reported differences in the frequency of practice in healthcare professionals by gender and smoking status. This might also be influenced by a difference in smoking prevalence by gender, especially in China and other developing countries. This study examined factors associated with the frequency of cessation intervention practices by smoking status among Chinese physicians in men and women. A cross-sectional survey was conducted in 2006 in physicians with direct patient contact from nine hospitals in Guangzhou with a response rate of 60.8%. Significantly more female physicians who were non-smokers (79.7%) reported "initiation and/or advice" smoking cessation interventions than male physicians who were smokers (71.2%) and non-smokers (71.6%). Factors significantly associated with "initiation and/or advice" were prior smoking cessation training (OR = 4.2, 95% CI 1.8-9.6) and lack of knowledge to help patients to quit (OR = 0.4, 95% CI 0.2-0.9) among male physicians who smoked; and organisational support (OR = 1.7, 95% CI 1.3-2.2) and successful past experience (OR = 0.4, 95% CI 0.2-1.0) among male physicians who did not smoke. Among female physicians who did not smoke, significant factors were agreeing that quitting smoking is the most cost-effective way to prevent chronic disease and cancer (OR = 3.0, 95% CI 1.4-6.1), helping patients stop smoking is part of expected role and responsibility (OR = 2.0, 95% CI 1.0-3.7), lack of knowledge to help patients to quit (OR = 0.5, 95% CI 0.2-1.0) and organisational support (OR = 1.3, 95% CI 1.0-1.6) for non-smoking female physicians. This study is the first to show that male physicians were less likely to provide smoking cessation counselling regardless of their smoking status while non-smoking female physicians were more active in advising patients on quitting. The findings highlight the need for developing tailored smoking cessation training programmes for physicians according to their smoking status and gender in China.