Postgraduate Medical Training Research Articles

Effect of internet shutdown on postgraduate trainees in Manipur: A qualitative study

Background & objectives Internet shutdowns, although rare can be imposed by governments or affiliated entities and can intentionally disrupt online information and communication systems. While justified for maintaining public order, these shutdowns cause substantial economic losses, public suffering, and reputational damage. The internet shutdown in Manipur, initiated on May 3, 2023, due to civil unrest, has affected various sectors. The impact on doctors, amidst an era where internet access is considered as an integral part of practice, warrants deeper exploration of the challenges faced during such a prolonged shutdown period. Therefore, this study was conducted to explore the impact of internet shutdown among postgraduate trainees from two tertiary care hospitals in Manipur. Methods A study was conducted in two tertiary healthcare centers in Manipur from July to August 2023 among medical postgraduate trainees. Participants were selected using purposive sampling. Twenty-two in-depth interviews (IDIs) were conducted, recorded, and transcribed verbatim. Thematic analysis was done to identify codes, categories and themes. Results This qualitative study was undertaken among postgraduate trainees in two different academic institutes. A total of 21 IDIs were carried out. The major themes emerged from the study, namely, impact on professional life, impact on personal life, social consequences and coping. Internet shutdown affected patient care such as seeking timely opinions from consultants, delays in sharing patient reports and inconveniences in the hand-off process and the academic performance of postgraduate trainees like unavailability of study materials or keeping up with recent advancements. On a personal level, it negatively affected communication with family and friends, mental well-being and caused inconvenience in shopping and transactions. The study also found some positive impacts, such as less screen time leading to better sleep and increased physical activities. Interpretation & conclusions The findings of this study suggest that the internet shutdown significantly affected both the professional and personal aspects of postgraduate trainees’ lives in Manipur. The implementation of a targeted ban on social media platforms and the establishment of designated internet access points are proposed as potential alternatives.

Developing and Implementing a Milestone System: Experience of the Taiwan Association of Obstetrics and Gynecology

<p>台灣婦產科醫學會於1961年成立，1987年度辦理第一屆專科醫師考試，建立四年專科訓練規範。由於畢業後一般醫學訓練亦可抵扣專科醫師訓練資格，加上住院醫師工時規範，恐影響住院醫師訓練，故自2017年底開始規劃里程碑制度。參考美國畢業後醫學教育評鑑委員會(Accreditation Council for Graduate Medical Education, ACGME)及美國婦產科醫學會(americancollege of obstetricians and gynecologists, ACOG)聯合修訂、發表訓練內容，完成台灣婦產科醫學會住院醫師訓練里程碑初版，內容依照六大核心能力建立28項勝任能力5個層級。然而2023年透過線性回歸統計方式分析專科醫師考試成績與里程碑分數，發現兩者無顯著相關性。未來將透過即時分析，回饋各醫院，盼透過同儕比較，改善跨院際評核不一致現象，在執行面上，希望導入電子化表單，建立學生的學習歷程及分析。</p> <p> </p><p>The Taiwan Association of Obstetrics and Gynecology(TAOG)was established in 1961 and conducted its first board certification examination in 1987, formally establishing a structured 4-year training program for Taiwanese specialists.To provide postgraduate general medical training, which could be credited toward specialist training qualifications, and address challenges introduced by resident work-hour regulations, the TAOG subsequently developed a milestone-based evaluation system for residents. On the basis of training content collaboratively revised and published by the Accreditation Council for Graduate Medical Education and the American College of Obstetricians and Gynecologists, the TAOG produced the first version of its residency milestone framework in late 2017. This framework comprised6 core competencies segmented into 28 key competencies across five proficiency levels. Nevertheless, the results of a linear regression conducted in 2023 revealed no significant correlation between milestone scores and specialist examination results. In response, the TAOG will provide feedback to training hospitals,using peer comparisons to address discrepancies in interhospital evaluations. Additionally, the TAOG will implement electronic forms to streamline the documentation and analysis of residents’ learning progress.</p> <p> </p>

Improving Critical Care Teamwork: Simulation-Based Interprofessional Training for Enhanced Communication and Safety.

This study evaluates a simulation-based interprofessional education (IPE) program implemented at theNational Cheng Kung University Hospital between 2018 and 2023. The program aimed to improve teamwork, communication, and collaboration among healthcare professionals in high-acuity environments such as emergency departments and intensive care units (ICUs). A prospective, mixed-methods approach was used to assess the program's effectiveness. The study enrolled 237 participants, including postgraduate medical trainees, nurses, respiratory therapists, and administrative staff. Two high-fidelity clinical scenarios-multiple trauma and respiratory distress with shock-were designed to simulate real-world emergencies. Participants' teamwork performance was evaluated using the Team Emergency Assessment Measure (TEAM), while qualitative feedback was collected via structured questionnaires and thematically analyzed. Quantitative analysis revealed significant improvement in leadership communication (p = 0.0328) and positive trends in teamwork dimensions such as completion and effective communication. However, global team performance showed only modest numerical gains. (p=0.5201) Qualitative feedback highlighted recurring themes such as unclear task delegation, delayed recognition of patient condition changes, and inconsistent use of communication techniques like call-outs and check-backs. The simulation-based IPE program significantly enhanced interprofessional collaboration and clinical competencies among participants. However, specific areas, particularly communication, leadership, and situational awareness, require further attention in future training sessions. These findings underscore the importance of continuous refinement of simulation programs to prepare healthcare teams for high-stakes clinical scenarios effectively.

Learning from the lived experiences of medical women working and studying at the national hospital in Fiji: A mixed methods study.

Our study aimed to explore the experience of attaining higher education among women in medicine at the largest national hospital in Fiji, focusing on barriers and enablers to completing training, and to explore women's perception of gender-based discrimination in the world of medicine. Findings subsequently informed evidence-based recommendations on enablers and barriers at the hospital and medical university to improve experiences of women in medicine. We conducted a mixed-method study, emphasising the phenomenological qualitative component. All women doctors working at the national hospital were invited to complete a survey, and those with past or present engagement in postgraduate specialty medical training participated in semi-structured interviews. Survey data were analysed using descriptive statistics. Interviews were transcribed, coded then organised using thematic analysis. Reflexivity and triangulation were employed at all levels of the research to ensure rigour. Four distinct themes were found to illuminate women's enablers and barriers. Participants described work-life stress, absence of advocacy, coercion-control-power and inflexible systems as barriers. For enablers, they described inner strength, social circles, work culture and mentors/role models/advocates. Participants had mixed perspectives on gender-based discrimination in the workplace, with unanimity in calling for protected maternity leave entitlements. Challenges only become true barriers when enablers are eclipsed by them. Institutional support helps mitigate these barriers especially for those women who lack social support. Gender based discrimination continues in the Pacific, commonly covertly, especially in terms of policy gaps regarding maternity leave during training.

Formulation of workplace-based assessments (WBAs) and entrustable professional activities (EPAs) for postgraduate medical trainees in clinical biochemistry

Formulation of workplace-based assessments (WBAs) and entrustable professional activities (EPAs) for postgraduate medical trainees in clinical biochemistry

Knowledge, Attitudes, and Practices (KAP) of Postgraduate Medical Trainees Regarding Patient Care in Diabetes and Hypertension.

Diabetes and hypertension are common chronic illnesses that need to be effectively managed. To improve patient outcomes, healthcare workers' knowledge, attitudes, and practices (KAP) are essential. This study aimed to evaluate the KAP of postgraduate medical trainees regarding the management of diabetes and hypertension. A cross-sectional study was conductedover one year from January 2023 to December 2023. The study participants were 384 postgraduate medical trainees who fulfilled the predetermined inclusion and exclusion criteria. A validated questionnaire that evaluated attitudes toward patient-centered care, knowledge of clinical guidelines, and illness management methods was used to gather data. SPSS version 26 (IBM Corp., Armonk, NY) was used for statistical analysis to investigate correlations between KAP levels and demographic characteristics. Of the 384 trainees, 320 (83.33%) correctly identified clinical guidelines for diabetes managementand 290 (75.75%) for hypertension management. The majority (350 (91.67%)) supported patient-centered care, with 320 (83.33%) believing that patients should be actively involved in treatment decisions. In terms of practices, 300 (78.13%) regularly monitored blood glucose levels, and 320 (83.33%) routinely checked blood pressure in hypertensive patients. Adherence to national treatment guidelines was reported by 280 (72.92%) for diabetes and 270 (70.31%) for hypertension. Younger trainees and those with 6-12 months of clinical experience exhibited higher KAP scores. Significant associations were found between age, clinical experience, and training program and KAP levels. Although postgraduate trainees show strong knowledge of and favorable attitudes toward managing diabetes and hypertension, there is room for improvement in their practical application, particularly with regard to medication adherence and following guidelines, in order to provide high-quality patient care.

Perception of nephrology in Europe: a strategy to improve recruitment of motivated fellows

ABSTRACT Background The shortage of applications for fellowships in nephrology is a worldwide challenge. This is the first survey to explore in Europe the reasons physicians choose (and do not choose) a career in nephrology. Methods An anonymous questionnaire was sent to the presidents of societies that are members of the European Renal Association (ERA), who invited trainees and nephrologists to respond. Statistical analysis was performed using SPSS v.26. (SPSS Inc., Chicago, IL, USA). Continuous variables were compared by Student's t-test or by one-way ANOVA. Results Responders included 516 (49%) females and 542 (51%) males. They comprised 278 (26%) trainees, and 780 (74%) nephrologists. The majority (64%) believe that students have an unfavourable perception of nephrology. For trainees, nephrology is not considered an attractive option due to ‘chronically ill patients’ (35%), ‘lack of contact during undergraduate training’ (37%), ‘nephrology is too challenging’ (38%), ‘poor remuneration’ (22%), ‘negative role models’ (15%), and ‘long working hours’ (14%). The factors with the greatest impact on choosing a career include a positive role model (46%), practical experience during medical school and early postgraduate training (42%). Conclusion Trainees emphasize that work–life balance is very important for the younger generation. A strong mentorship along with early engagement is associated with a higher likelihood of pursuing a career in nephrology. It is crucial to create a strategy that will provide a positive experience, renew the interest in nephrology careers and ensure enough nephrologists to treat the growing number of patients with kidney disease.

‘Maybe we’re not past the traditional gender roles then!’ Exploring less than full-time training among men in Scotland: a qualitative study

ObjectivesA more sustainable work–life balance is desired by trainees, and increasing access to flexibility in training may improve staff morale and retention. Although a number of less than full-time (LTFT)...

Workplace discrimination and harassment among Alberta postgraduate medical trainees: a cross-sectional survey

BackgroundAddressing a lack of diversity in the physician workforce is a priority in the Canadian healthcare system. Data describing demographics of residents and their experiences of discrimination, harassment, and racism at work are incomplete. The objective of this work was to describe the demographics and perceptions of workplace discrimination and harassment for postgraduate medical trainees in Alberta.MethodsA cross-sectional survey based on the Chronic Workplace Discrimination and Harassment Scale was administered to all resident physicians in Alberta by e-mail invitation from the postgraduate medical education offices at the Universities of Alberta and Calgary, their residency training program directors, and the Professional Association of Residents of Alberta. Total score (median, interquartile range [IQR]) was compared by gender, racial, and intersecting gender and racial identities, with higher scores suggesting more frequent experiences of workplace discrimination and harassment (range 0 to 32). We performed thematic content analysis of open text responses.ResultsThere were 195 complete surveys returned from 1,752 Alberta residents (11.2% response rate), including 120 cisgender women (61.5%), 104 white participants (53.3%) and 74 white cisgender women (37.9%). The overall median score on the Chronic Workplace Discrimination and Harassment scale was 9 (IQR 5–14): cisgender women and gender diverse participants reported more frequent harassment, mistreatment, or discrimination than cisgender men (median 10 [IQR 6–15] versus 8 [4–13.5], p = 0.049). There was no difference in the frequency of reported discrimination between BIPOC and white respondents (median 9 [IQR 5–14.5] versus 9.5 [IQR 6–14], p = 0.72) or participants with intersecting race and gender identities (p = 0.26). Over 44% of BIPOC residents had been the target of a racial slur or joke from an attending physician or colleague in the past year and nearly 45% of all participants had witnessed an attending physician or colleague using a racial slur in the past year. Open text responses provided examples of mistreatment, harassment, discrimination, and racism from participants.InterpretationThese results demonstrate an unacceptable prevalence of harassment and racism witnessed or experienced at work by Alberta residents. Urgent action to identify, prevent, and remediate racism in the healthcare system must be a priority of medical schools and regulatory bodies.

A Review of Educational Supervision in UK Postgraduate Medical Training: Roles, Responsibilities, and Impact on Trainee Development.

This review examines the roles and responsibilities of educational and clinical supervisors in the UK postgraduate medical education system, focusing on their impact on trainee doctors' educational experiences and professional development. Guidance from the General Medical Council and the Department of Health underscores the importance of consistent supervision in various clinical settings. Educational supervisors are critical in helping trainees establish clear, competency-based goals, engage in career planning, and develop resilience. Supervisors are expected to build productive relationships, provide structured feedback, and support workplace-based assessments. Various feedback models, including Pendleton's and one-minute preceptor models, are discussed for their effectiveness in promoting reflective practice and competence. By fostering open communication and structured assessment, educational supervisors help trainees navigate the complexities of clinical practice and advance in their medical careers. This review outlines the essential supervisory skills, training recommendations, and best practices contributing to effective supervision and trainee success within the UK medical education framework.

The Impact of COVID-19 on the Job Satisfaction of Cardiothoracic Trainees in the United Kingdom: An Insight From the General Medical Council National Training Survey.

Introduction The National Training Survey (NTS) is conducted annually by the General Medical Council (GMC) to monitor and report on the quality of postgraduate medical education and training. The coronavirus disease 2019 (COVID-19) pandemic had a significant impact on training in cardiothoracic surgery due to the unprecedented restructuring of surgical activity across the UK. We aim to evaluate how the job satisfaction of cardiothoracic surgery trainees was impacted by COVID-19 using the National Training Survey. Methods The National Training Survey in cardiothoracic surgery from 2017 to 2024 was obtained from the General Medical Council website. Job satisfaction for trainees was evaluated using 17 indicators: Adequate Experience, Clinical Supervision, Clinical Supervision Out of Hours, Educational Governance, Educational Supervision, Feedback, Handover, Induction, Local Teaching, Overall Satisfaction, Regional Teaching, Reporting Systems, Rota Design, Study Leave, Supportive Environment, Teamwork and Workload. The pre-pandemic score for each indicator was an average of 2017, 2018 and 2019, while the post-pandemic score was an average of 2022, 2023 and 2024. The overall job satisfaction per year, combining all indicators, was also analysed. Results Thirty-eight cardiothoracic centres were included in this study. There was a reduction in trainees' job satisfaction from pre- to post-pandemic surveys when comparing all 17 indicators together (scored out of 100) (73.87 versus 70.97, p<0.001). There were six out of 17 (35.29%) indicators that demonstrated a significant decrease in job satisfaction amongst trainees: Regional Teaching (70.53 versus 54.53, p<0.001), Adequate Experience (78.65 versus 72.34, p=0.003), Local Teaching (68.26 versus 62.92, p=0.037), Educational Governance (73.78 versus 70.36, p=0.033), Clinical Supervision Out of Hours (91.16 versus 87.95, p=0.005) and Clinical Supervision (91.98 versus 88.92, p=0.014). Conclusion Trainees' job satisfaction significantly decreased after the COVID-19 pandemic. Although the most recent survey suggests job satisfaction amongst trainees may be recovering, further work needs to be done to ensure training standards return to pre-pandemic levels.

The Evaluation of Mini-Clinical Evaluation Exercise (Mini-CEX) for Assessing Neurology Cases Among Postgraduate Medicine Students.

Background Traditional assessments in postgraduate medical training tend to emphasize cognitive skills while often neglecting the psychomotor and affective domains. The mini-clinical evaluation exercise (mini-CEX) addresses these limitations by evaluating clinical, communication, and humanistic skills with immediate feedback. This study aimed to evaluate the acceptability and feasibility of the mini-CEX in assessing neurology cases among postgraduate internal medicine students at a medical college in North India. Methods Between March and July 2024, 10 postgraduate medicine students and 14 faculty members participated in the study. Each student completed at least four mini-CEX sessions, during which performance across seven core skills was rated using a nine-point scale. Immediate feedback was provided by faculty following each session. Both student and faculty feedback were collected to assess the acceptability and feasibility of the mini-CEX. Descriptive statistics were used to evaluate these factors, while paired t-tests were applied to measure improvements in student performance. Results A total of 63 mini-CEX sessions were conducted, with an average observation time of 18.77 minutes and an average feedback time of 10.08 minutes. Significant improvements in clinical skills were observed among second-year (P = 0.04) and third-year(P = 0.01) residents, with second-year residents also showing gains in humanistic skills (P = 0.03). Student feedback was largely positive, with nine out of 10 (90%) participants expressing satisfaction and eight out of 10 (80%) recommending the continued use of the tool. Faculty feedback indicated that 10 of 14 (71.4%) supported its continued useand eight of 14 (57%) found it better than traditional assessment methods. Conclusions The mini-CEX is a feasible and acceptable formative assessment tool for neurology cases, effectively enhancing clinical and communication skills. Despite concerns regarding subjectivity, the mini-CEX shows promise for wider implementation in postgraduate, and potentially undergraduate, medical training.

Theories and Practices in Learning and Assessment for Postgraduate Medical Education: A Review.

This literature review explores key theories and practical strategies in postgraduate medical education. It examines essential learning strategies, such asdidactic and experiential teaching methods, structured lesson planning, and models such as Maslow's hierarchy and Kolb's experiential learning cycle. Active learning techniques and feedback models, crucial for guiding medical trainees' growth, are also discussed. The review then shifts focus to assessment, looking at both formative and summative approaches, Miller's pyramid of competence, and Van der Vleuten's utility equation. By evaluating assessment formats, blueprinting, and feedback, this review offers insights into educational strategies that enhance postgraduate medical training.

Postgraduate medical education in Public Health: the Italian scenario and a call to action

Abstract Introduction Public health training in Italy takes place within postgraduate medical training in Hygiene and Preventive Medicine. With 39 university schools of public health, spread across 17 of Italy’s 20 regions, the landscape is diverse. The government determines the number of available contracts annually. This study aims to provide an up-to-date analysis of the saturation of places in Public Health programmes, as well as an assessment of mobility trends between northern and southern Italy from 2017 to 2023. Methods Data on admissions, withdrawals and resignations were obtained from the Ministries of Universities and Health and from the archives of the ‘Associazione Liberi Specializzandi’ (ALS). Mobility was assessed as moving from the central-northern regions to the southern-islands of Italy, and vice versa, between registration with the Medical Council and specialisation programme enrollment. Results Between 2017 and 2023, a total of 2301 residents enrolled across Italy, out of 2953 available positions nationwide. During this period the number of available national places, increased from 180 to 576, impacting overall seat saturation. In 2017, 98.3% of positions were covered, compared to only 46.5% in 2023. Regarding the mobility trend, southern students attending northern schools increased from 8.3% in 2017 to 22.4% in 2023, while northern students attending southern schools decreased from 17.9% to 1%. However, the number of dropouts and withdrawals was higher in the North. Mobility students scored lower than non-mobility students nationally. Key messages • From 2017 to 2023, the number of residents enrolled increased, while the allocation rate decreased. There was a shift in mobility patterns, with more southern students moving north. • Addressing the identified inequalities and understanding the underlying factors driving mobility patterns is crucial for effective planning and allocation of resources.

Adults with congenital heart disease: what every cardiologist should know about their care.

As patients with congenital heart disease (CHD) continue to enjoy longer lives, non-congenital cardiologists and other healthcare professionals are increasingly encountering them in their practice and are challenged by their specific needs. Most under- and post-graduate medical training tends to overlook this common pathology, resulting in insufficient awareness of post-repair or post-palliation residual lesions and sequelae from previous interventions. In a strive towards improving the quality of care for this ever-growing cardiovascular patient cohort, it is prudent to outline the areas of concern and specific management needs pertaining to adult patients with CHD and share it with non-CHD professionals. The purpose of this paper is to offer essential guidance to physicians, including cardiologists, when they encounter a patient with CHD in a non-congenital healthcare setting.

Occupational Stress Among Italian Postgraduate Medical Trainees: A Pilot Study for the Validation of the SCOPE Questionnaire

The occupational environment may affect one’s psychophysical health by leveraging both external workplace stressors and individual psychological responses. We developed a comprehensive questionnaire to assess occupational stress among postgraduate medical trainees, investigating both situational and personal aspects. Exploratory factor analysis was used to identify the constructs captured by the questionnaire, and reliability was assessed by estimating Cronbach’s alpha. Construct-specific scores were computed, and their correlation with established pre-validated scales (criterion validation) was assessed. Four factors—“stress”, “coping”, “empathy”, and “trauma”—explained 50% of data variability and demonstrated satisfactory overall internal consistency (Cronbach’s alpha = 0.76). Significant correlations were found between the “stress” score and the “emotional exhaustion” component of the Maslach Burnout Inventory (MBI) (r = −0.76), the “coping” score and the “positive attitudes” component of the Coping Orientation to Problems Experienced Inventory (COPE) (r = 0.46), and the “empathy” score with the “empathic concern” (r = 0.52), “fantasy” (r = 0.41), and “perspective taking” (r = 0.45) components of the Interpersonal Reactivity Index (IRI). No significant differences in scores were found in terms of gender or medical specialization. This study suggests that the SCOPE questionnaire may be a promising tool for assessing workplace stress and psychological responses among medical residents.

India's role in the odyssey of medical training in South Africa.

Apartheid had a devastating impact on medical education in South Africa. Until the development of the University of Natal Medical School in 1951, there were minimal opportunities for blacks (collectively Africans, Indians and so-called coloureds) to undertake undergraduate and postgraduate medical training in South Africa. At the height of apartheid (1968-1977), whites who had constituted 17% of the population, accounted for up to 87% of all medical graduates. The African majority, constituting 70% of the population had less than 5% of all medical graduates in South Africa. The global isolation of South Africa from the late 1940s further impacted negatively on the medical training for blacks in South Africa. During apartheid, the Government of India provided full scholarships to the marginalized in South Africa to study medicine in India. This initiative, coming at a time when India was grappling with its post-colonial challenges, was a remarkable yet seldom appreciated gesture.

The Empathy Quandary in Postgraduate Medical Training

Background: Empathy stands as a cornerstone of humanistic qualities and is essential in healthcare for understanding and alleviating emotional suffering. Despite its necessity, formal empathy training remains elusive in postgraduate medical education across the globe, contributing to decline of humanistic practice among trainees. This study aims to assess and establish the need for empathy training by evaluating the perspectives of postgraduate trainees and faculty. Materials and Methods: The study was conducted in a medical college of western India in 2023. Three online validated questionnaires were used to assess empathy-related perceptions among faculty and postgraduate trainees across various specialties. The questionnaires focused on demographic data, importance of empathy in patient care, empathy training, perceived levels of empathy, reasons for shortfalls in empathetic behavior and recommendations for nurturing empathy. Data were analyzed quantitatively and thematically. Results: A total of 150 and 127 responses were gathered and analyzed from faculty and trainees, respectively. Excessive workload, lack of formal training, and technology-dependent fast paced lifestyle were attributed for lack of empathy in clinical care. All the faculty agreed that empathy training is essential and majority (67%) believed that lack of empathetic behavior led to dissatisfaction among patients and caregivers. Conclusion: Empathetic communication and behaviors are fundamental competencies for health-care professionals. There is need for a structured training for empathy in postgraduate medical curriculum.

Postgraduate Training: eLogbook, Entrustable Professional Activities & Co.

The transformation of time-bound and procedure-oriented specialist medical postgraduate training towards a competency-based approach (competency-based medical education, CBME) has been demanded for several years. Many frameworks, like the CANMEDs (Canadian Medical Education Directives for Specialists) describe competencies that should be acquired by each physician. In Germany, the medical council has recently obligated a competency-based postgraduate training. Although the idea of CBME emphasizes the learning process at the working place, CBME has also been criticized to be too theoretical and detached from the clinical working practice. To close this gap, the concept of Entrustable Professional Activities (EPA) has been introduced. An EPA describes concrete clinical tasks that are successively entrusted to the trainee. The decision to entrust a task is supported by the sum of workplace-based assessments.Sustainable implementation of competency-based training requires close collaboration among all involved individuals and institutions. Furthermore, continuous feedback and open dialogue are crucial for identifying challenges and areas for improvement. The success of CBME hinges on the collective effort of all stakeholders to create a framework to enhance specialty training and an overall advancement in the field. This cooperative approach is essential to successfully translate the theoretical foundations of competency-based teaching into clinical practice and ensure high-quality specialty training.

Factors Affecting Job Satisfaction Among Medical Postgraduate Trainees In A Tertiary Hospital, Imphal, Manipur : A Mixed Method Study

Background: Doctors’ dissatisfaction with their jobs can have significant public health implications as it may adversely affect the clinical management of patients and it may affect their health as well. Objectives: To assess job satisfaction and explore the perceived barriers and facilitators of job satisfaction among postgraduate trainees in a tertiary hospital, Imphal. Materials and Methods: A mixed-method study was conducted among postgraduate trainees. For the quantitative component, all the postgraduate trainees (430) enrolled in a tertiary hospital were included. For the qualitative part, participants were approached for in-depth interviews using purposive sampling till the saturation point was reached. Data was summarised in mean, standard deviation, and percentage. Chi-Square test and ANOVA, followed by Bonferroni for comparison were applied. Thematic analysis was done for qualitative data. Results: Overall, 89.1% of the participants were not satisfied with their jobs. Out of 405 respondents, 96 persons disagreed, and 42 persons strongly disagreed on being satisfied with their working hours. Participants were most satisfied in domains of teamwork, leadership, empowerment and participation. Among postgraduate trainees of different departments, PMR was the most satisfied and Obstetrics and Gynaecology was the least satisfied. Conclusion: Most participants experienced burnout due to increased working hours and lack of work- life balance. They also expressed the need for rewards and recognition.