Doctors In Postgraduate Training Research Articles

Analysis and evaluation of peer group support for doctors in postgraduate training following workplace violence and aggression.

Workplace violence and aggression toward healthcare staff has a significant impact on the individual, causing self-blame, isolation and burnout. Timely and appropriate support can mitigate harm, but there is little research into how this should be delivered. We conducted multi-speciality peer groups for London doctors in postgraduate training (DPT), held over a 6-week period. Pre- and post-group burnout questionnaires and semi-structured interviews were used to evaluate peer support. Thematic analysis and descriptive statistical methods were used to describe the data. We found four themes: (a) the experience and impact of workplace violence and aggression on DPT, (b) the experience of support following incidents of workplace violence and aggression, (c) the impact and experience of the peer groups and (d) future improvements to support. DPTs showed a reduction in burnout scores. Peer groups are effective support for DPT following workplace violence and aggression. Embedding support within postgraduate training programmes would improve access and availability.

Perceived opportunities of clinical reasoning learning in postgraduate psychiatry training: Trainees' and faculty's perspectives.

Learning clinical reasoning is less effective in isolation of clinical environments because contextual factors are a significant component in the clinical reasoning process. This study investigated the differences in opinions between novice and expert clinicians on learning clinical reasoning in the workplace. The author used a cross-sectional online survey design to investigate the perceived learning of six clinical reasoning skills in 13 learning opportunities. Questionnaires were emailed to 41 postgraduate psychiatry trainee doctors and 37 faculty members. Data were analyzed descriptively. The Chi-square test was used to compare the responses of the two groups. Statistical significance was set at P < 0.05. The combined response rate was 73.07%. The two groups perceived the learning of advanced clinical reasoning skills to be lower than that of basic skills. There were significant differences in the perceived learning of basic clinical reasoning skills in self-study/exam preparations (P = 0.032), general hospital grand rounds (P = 0.049), and clinical rounds (P = 0.024 for consultant-led rounds and P = 0.038 for senior peer-led rounds). There were also significant differences in the perceived learning of advanced clinical reasoning skills among peer-led tutorials (P = 0.04), journal clubs (P = 0.006), morning reports (P = 0.002), and on-call duties (P = 0.031). The trainees showed a significant preference for structured learning environments rather than clinical environments, especially for advanced clinical reasoning skills. Trainees likely struggled with cognitive overload in clinical environments. Local postgraduate psychiatry programs will likely benefit from implementing multiple educational interventions that facilitate teaching and learning clinical reasoning in complex clinical environments.

General internal medicine: acquiring clinical acumen from bedside to front door with opportunities for undergraduate and postgraduate training.

A general physician's training and experience enables them to manage a variety of acute and chronic medical conditions with multi-system pathology, while specialising in one specific area of medicine. In every illness there are other problems outside the specialty, requiring the wider expertise of the generalist as patients have multiple comorbidities and the multitude of disease pathology presenting are quite complex requiring a multi-faceted approach. The horizons of general internal medicine have broadened with a wide landscape of acute illnesses that are now being admitted under general medicine which is the path of least resistance. As we strive relentlessly while working on the ward at the bedside and in acute portals, we ought to remind ourselves of what are the attractions of general internal medicine and lead by example for the undergraduates and postgraduate doctors in training who see us as role models for doing clinical medicine, teaching, training and research.

Multiprofessional Survey on the Role and Impact of Medical Associate Professions in the NHS

Background: With the global scarcity of the healthcare workforce, innovations in healthcare professional (HCP) roles include the model introduced in the 1960s in the USA of medical associate professionals (MAPs). Since 2003 in the UK, MAPs had a scope of practice defined by local employers. In 2024, the UK Parliament passed a resolution to bring the MAPs under regulation by the General Medical Council. However, multidisciplinary team and public awareness of MAPs have come under scrutiny, due to uncertainties around roles, unmonitored expansion of scope of practice, patient safety concerns, and competition for jobs and training with doctors. There is a need for rigour in exploring the opinions of the whole spectrum of HCPs, especially locally employed doctors (LEDs), Specialty and Associate Specialities (SAS) and international medical graduates (IMGs) who not only make up a large cohort of doctors in the UK but work closely with MAPs and support their prescribing and ordering investigations functions. Aim: Designed by a multi-professional working group, an online survey of HCPs was conducted to explore the role of MAPs in patient care, and how workforce plans around the roles align with the roles, responsibilities, and training of doctors. Findings: A total of 583 responses were collected which included consultants (43%), postgraduate doctors in training, General Practitioners, LEDs, IMGs (75%), nurses, and allied health professionals. Role: 53% of respondents were uncertain of the specific role of MAPs within the team; 43% agreed primary roles of MAPs involved delivering specific, well-defined skill-based services, reducing workload (20%), and providing continuity (19%). 89% emphasised the importance of a clear distinction between the roles of doctors and MAPs. Patient Safety: 77% agreed that MAPs currently may pose a risk to patient safety. 89% recognised the risk associated with MAPs working beyond their scope. 69% agreed with the need for a competency framework for MAPs. Supervision: 75% expressed concerns about the increased clinical risk and burden faced by doctors in supervisory roles. Impact on Doctors: 69% reported reduced job prospects and 67% reduced training opportunities. Regulation: 74% agreed with regulation by an independent regulator, not the GMC. Free text: The analysis of free-text comments revealed a predominantly negative sentiment regarding the role of MAPs. Concerns about patient safety, lack of proper training, additional workload implications for doctors, the potential for misrepresentation, the erosion of training opportunities for doctors, the risk of scope creep, and confusion among patients. Conclusion: Innovation in healthcare professional roles and functions is key to supporting the human resource shortage in health systems. The results of this survey from Multiprofessional respondents including IMGs, suggest that caution is required in how roles are positioned to the public, to avoid blurred lines of responsibility or interchange between professional roles, and to avoid confusion and consequent risk to the public. MAPs need a robust national framework of competencies, an independent regulator for licensing, and support doctors but not compete for resources, jobs, and training opportunities.

'Experience days': promoting interprofessional collaboration and understanding for postgraduate doctors in training.

An 'experience day' is a novel concept in medical education, targeted at postgraduate doctors in training. In this article, the term postgraduate doctors in training includes all junior doctors, ranging from foundation year level to junior specialist doctors to higher specialist registrars. Experience days offer postgraduate doctors in training the opportunity to shadow other healthcare professionals in their working environment, to enhance their perspective of their role as a clinician and their understanding of the complex interplay of services. The aim is to promote interprofessional collaboration and to encourage consideration of the expectations placed upon members of the multidisciplinary team and reflection on whether these are realistic. Taster days are a well-established educational opportunity for junior doctors, supported by Health Education England. However, there is a paucity of literature concerning shadowing for doctors who have already qualified, or those who wish to shadow services that they work alongside. This article introduces the concept of experience days for postgraduate doctors in training.

Symptoms of depression and anxiety and stress among postgraduate trainees in Sri Lanka: Risk factors and implications for practice.

High workload, long working hours, and the need to study and work simultaneously put postgraduate trainee doctors at a high risk of depression, anxiety, and stress. A cross-sectional descriptive study was conducted among all postgraduate trainees registered at the Postgraduate Institute of Medicine (PGIM), Sri Lanka, using the 21-item Depression Anxiety Stress Scale (DASS-21). Eleven-point two percent (11.2%) had depressive symptoms, 8.9% had anxiety symptoms, and 1.9% had high levels of stress. Being female, having a past or current mental illness, not being supported by the trainers, being unfairly treated by trainers, dissatisfaction with the work environment, difficulty in coping with long working hours, and poor peer support were significantly associated with symptoms of depression and anxiety, and stress (P < 0.01). Given the association between psychological distress and the characteristics of training and work environment, the postgraduate training programs should be reviewed to ensure the psychological well-being of trainees.

Assessment Of Workplace Related Factors Affecting Tolerance Of Ambiguity Among Trainee Doctors.

To assess workplace factorsinfluencing the tolerance of ambiguity among trainee doctors. The sequential mixed-method study was conducted from June 2021 to February 2022 at the Fauji Foundation Hospital, Islamabad, Pakistan, and comprised postgraduate trainee doctors of either gender associated with various specialties.Thebaseline toleranceof ambiguity scorewas establishedusingtheToleranceofAmbiguity in Medical Students and Doctors scale. A group of selected trainees was interviewed face-to-face to examine the workplace factors that they regarded as beneficial or detrimental to their tolerance of ambiguity. Quantitative data was analysed using SPSS 24 and thematic analysis was done for qualitative data. Of the 132 subjects, 59 (21.9%) were males and 73 (55.3%) were females. The overall mean age was 20.95±2.186 years. Of the total, 55(41.7%)subjects were in the first year of training, 28(21.2%) in the second year, 26 (19.6%) in the third year, and 23(17.4%) in the fourth year. There were 78(59.1%)trainees who were married compared to 54 (40.9%) who were unmarried. Against the baseline tolerance of ambiguity score of 132, the overall aggregate mean tolerance of ambiguity level was 71.28 ± 5.81 showing a moderate level. There was no significant correlation between the tolerance of ambiguity and the trainees'age, years oftraining and maritalstatus(p>0.05).The qualitative phase comprised interviews with 9(6.8%) subjects.Thematic analysis suggested that the traineesperceivedautonomy,peersupport,supervisorsupport,manageable workload, and professional development opportunities asfacilitat or softolerance of ambiguity,whilebarrierswere identified as poor physical environment, attitude ofseniors and supervisors, management issues and excessive workload.During the coronavirus diseae-2019 pandemic, excessive workload and fear of infection were identified asfactors affecting tolerance of ambiguity. The medical trainees were found to have a moderate level of tolerance to ambiguity. Autonomy, peer support, supervisor support, manageable workload, and professional development opportunities contributed positively to this aspect.

Reflection in clinical practice: guidance for postgraduate doctors in training.

Reflection in clinical practice: guidance for postgraduate doctors in training.

Improving Confidence and Knowledge in Raising Concerns: A Development Half-Day for Representatives of Postgraduate Doctors in Training

AimsRaising a concern is an integral duty for a doctor. The General Medical Council guidelines on Good Medical Practice state that a culture should be promoted that allows “all staff to raise concerns openly and safely”. Appointment of Postgraduate Doctors in Training to Representative (Rep) positions can be an effective way to allow trainee voices to be heard. Here we present the results of a Development Half-Day created to empower Reps with the knowledge and confidence to represent peers effectively within a large mental health Trust. The training session was identified as a ”change idea” in a wider Quality Improvement Project (QIP) seeking to improve trainee confidence in raising concerns.Methods16 Postgraduate Doctors in Training Reps were invited to attend a Development Half-Day in November 2022. The day included talks on their roles and responsibilities, respectful challenge and maintaining well-being.Quantitative and qualitative data were gathered using anonymous questionnaires completed before and after the session. The questionnaire contained 4 questions asking them to rate their knowledge of their role as a rep and confidence in raising trainee concerns. This was quantified using a 1-10 scale for each question with 1 being lowest confidence/knowledge and 10 being highest. Mean scores and standard deviations were calculated. A paired one-tailed t-test was used to assess the statistical significance of the difference in pre- and post-session scores.Results9 Reps attended the Development Half-Day and completed the pre- and post-session questionnaires.There was a statistically significant improvement between pre- and post-session scores for all questions (all p values &lt;0.05). Importantly there was a significant increase in the confidence felt by reps in knowing where and who to raise trainee concerns to (p &lt; 0.05).Qualitative feedback indicated that attendees found the session useful and they appreciated that it was in-person. The only suggestion for improvement was for the session to have been held earlier, closer to when reps were initially appointed; this will be a change that will be implemented in the next “Plan, Do, Study, Act” cycle of the QIP.ConclusionImplementation of a Development Half-Day for Trainee Reps was shown to have a significantly positive impact on their confidence in their roles and their ability to respectively challenge seniors. The Reps additionally reported being better equipped at knowing where and who to raise concerns to. This will hopefully aid in their ability to signpost and empower other trainees to do the same.

Assessment of Metered-Dose Inhalers with Spacer Technique among Postgraduate Trainees

OBJECTIVES Most obstructive airway disease medications are used via inhalers, and their proper use is significant for effectively treating these diseases. Most patients misuse it. However, some studies showed that many physicians also do not know the proper meter dose inhaler with the spacer technique. This study aimed to assess metered-dose inhalers with spacer technique among postgraduate trainee doctors. METHODOLOGY This cross-sectional study was carried out in the Khyber Teaching Hospital Peshawar. The total time was six months, from Dec 6 2020, to Jun 5 2021. Postgraduate trainee (PGT) doctors of either gender with an age range of 25 to 35 years were included in the study from different departments. Those with every use of inhalers were excluded from the study. Demographic details of PGTs, like age and gender, were recorded. RESULTS Among 96 patients, males were 85 (88.54%), and females were 11 (11.46%). The mean age was 30.02±1.84 years, and the mean training experience was 2.0521 ±0.89. Inhaler technique was Proper in 20 (20.83%), Improper in 51 (53.13%) and Poor in 25 (26.04%) doctors. Those with more training periods, pulmonology rotation, attended workshops on inhaler techniques and with relatives using inhalers were more acknowledged of proper meter dose inhalers (MDIs) with spacer technique. CONCLUSION Only one-fifth of the postgraduate trainees know proper MDIs techniques. The attendance of workshops and pulmonology rotation is encouraged to enhance the knowledge of physicians regarding MDIs techniques.

Addressing burnout problems among postgraduate trainee doctors: Reflexing on the article “Prevalence of Burnout and Psychiatric Illness among Postgraduate Trainee Doctors of a Tertiary Care Hospital”

Addressing burnout problems among postgraduate trainee doctors: Reflexing on the article “Prevalence of Burnout and Psychiatric Illness among Postgraduate Trainee Doctors of a Tertiary Care Hospital”

Widening access to SHINE (simulation to help in neonatal emergencies) to include neonatal qualified in specialty (QIS) course students

Simulation is known to improve clinical skills and team communication. A full-day neonatal emergency simulation course was established in 2018 for paediatric postgraduate doctors in training. It consists of four scenarios and two workshops for eight candidates; running 4 times per year. The candidates are split into 2 groups allowing each to ‘lead’ a scenario with traditionally faculty placed as nursing plants. In contrast, simulations run on our neonatal unit involve both nursing staff and medical candidates, allowing for true multidisciplinary working. Access and funding for simulation can be more difficult for nurses but it is known that the protected environment and the sense of security enhance nursing students’ self-esteem and confidence, thus promoting learning [1]. The aim of the study was to make the SHINE course more authentic to real life with a multidisciplinary approach to the scenarios; to see if inviting neonatal unit nurses to the course affected the postgraduate doctors in training feedback (which has always been consistently positive); and to assess if the nurses felt it was beneficial for their training. We invited four nurses to SHINE who were about to complete their Neonatal Qualified in Specialty (QIS) Course. They took the nursing role in the scenarios either caring for the baby (a manikin) in the neonatal unit or carrying the labour ward delivery nursing bleep. We evaluated the relevance, confidence levels, and the learning environment for both the doctors and nurses attending the course via a written anonymous survey. The doctor’s feedback was very positive and comparable to previous courses ran with all of them recommending the course to their colleagues, and they felt they had enough opportunity to interact. The nurses felt sessions were very relevant to their current practice and all of them improved their level of confidence. They felt there was the correct number of scenarios and workshops; that the debriefings were well structured and educational; the learning environment was safe and supportive; and all would recommend the course to a colleague. Comments included ‘Really enjoyed the day and it has definitely helped me to feel more confident – especially as I’ve only just started holding the bleep.’ SHINE is a well-established sought-after course shown to be effective and highly valued by paediatric postgraduate doctors in training. Given the positive feedback, we will be inviting four nurses to each SHINE course and integrating it in to Qualified in Specialty training. 1. Koukourikos K, Tsaloglidou A, Kourkouta L, Papathanasiou IV, Iliadis C, Fratzana A, Panagiotou A. Simulation in Clinical Nursing Education. Acta Inform Med. 2021;29(1):15–20.

Shielding during medical training: an exploration of effects, consequences and best practices

Shielding during the COVID-19 pandemic impacted postgraduate medical training, likely affecting between 7% and 14% of trainees. We examine the burden of shielding on this cohort and provide strategies for future working practices. Seventeen postgraduate doctors in training took part in non-incentivised, virtual focus groups or interviews. Focus group content underwent thematic analysis. Results were validated in subsequent focused interviews. Shielding trainees reported guilt, limited support and occasionally stigmatisation. Rotational changes and returning to work were also difficult and led to contractual challenges. Departmental support, IT provision and proactivity were key to successful shielding. Early discussion with training bodies was deemed essential to plan objective onward progression. As we enter an era of endemic COVID-19, adjusted working practices will continue. Embedding successful working practices for shielding at national and local levels will minimise the long-term impact on postgraduate medical training.

AWARENESS OF BRAIN DEATH DOCUMENTATION AMONG POST GRADUATE TRAINEES IN LAHORE

Brain death is the complete and irreversible cessation of all activity in the brain, including the brain stem and cortex. It's critical to declare someone brain dead to stop providing life support or donating their organs. This study was carried out to evaluate postgraduate trainee doctors’knowledge and understanding of brain death in the Lahore cityas the Punjab Human Organ Transplant Authority (PHOTA) moves towards cadaveric donor program. Utilizing the universal sample approach, a questionnaire-based survey with 150 senior trainee registrars from several postgraduate fields was conducted at four teaching hospitals in Lahore. The registrars had 45 minutes to finish a pre-validated questionnaire form that inquired about their perspectives, knowledge, and the procedure for determining brain death. Quantitative data were shown as means, whereas qualitative data was shown as frequencies. SPSS software version 21 was used for statistical analysis. The questionnaire was given to 150 postgraduate trainees in total, of which 70% were men and 30% were women. Approximately 88.90% of participants were able to define brain death as the total cessation of all brain functioning, including brainstem reflexes. 121 doctors (82%) said yes when asked if they would perform brainstem reflexes twice, six hours apart. Only 40(26.66%) doctors were able to reliably identify the absence of brain stem responses, such as the corneal and pupillary reflexes. Just 10 (6.66%) out of 150 participants were able to correctly define what a positive apnea test means, but 33.33% of respondents agreed that it is a necessary test to demonstrate the cessation of brain stem activity. 15.50% of resident doctors had knowledge that a committee of four doctors was required to declare brain deathThe gold standard test for determining brain death, according to 4.66% of responders, is cerebral angiography. 95% of respondents were ignorant of the measures being taken by the Punjab Human Organ Authority (PHOTA) concerning the dead organ harvesting program or that such a program even existed. Although everyone agreed that getting an agreement before organ harvesting was required but only five trainees understood the exactmethodologyof taking consent and how it functioned. The PGRs lacked knowledge about brain death, its detection and documentation, concerning cadaveric donor organ donation and transplantation. The results of this study showed a lot of work needed to start cadaveric organ transplant safely.

Prevalence of burnout and psychiatric illness among postgraduate trainee doctors of a tertiary care hospital

Objective: Burnout is a state of physical and emotional depletion, and it is a result of prolonged exposure to the stressful working environment. Burnout has three primary symptoms: (a) emotional exhaustion (EE) occurs due to a depletion of emotional resources, feeling no longer to give any more to their job; (b) depersonalization (DP) occurs in response to EE, making employees detached from their job and developing uncaring attitudes to their work; and (c) reduced personal accomplishment (PA) with perceiving less enjoyment from their work. Psychological distress is also higher among medical students and doctors than that in the general population. In this study, we intended to study the prevalence of burnout and various psychological problems among postgraduate trainee (PGT) doctors of a tertiary care hospital. Methods: In this cross-sectional study of one year, we recruited postgraduate training doctors whoever gave valid and informed consent. Results: We included 170 PGTs from various clinical departments at the time of our study, but 126 PGTs were included as the sample population. They were assessed for sociodemographic determinants first. Then received assessment using sociodemographic pro forma and Abbreviated Maslach Burnout Inventory and International Classification of Diseases 10 for screening psychiatric morbidity among them. Results: In this study, 31.7% of PGTs had high EE, 34.9% of them higher DP, and 30.2% of them a high burnout rate. Of them, 31.7% of PGTs had a reduced PA with a score ≤ 25 percentile. In this study, 83.3% had no psychiatric illness and 16.7% had a psychiatric disorder. Among psychiatric disorders, 4% had harmful use of tobacco, 4% had mild depression, 1.6% had panic disorder, 4.8% had mixed anxiety depression, 1.6% had obsessive-compulsive disorder, 0.8% had harmful use of alcohol. Highest EE was noted among PGTs from the Department of Anesthesiology, followed by those from the Departments of Pulmonary Medicine and then Radiotherapy. Conclusion: One-third of PGTs suffered from burnout. Psychiatric diseases were also increased with a higher burnout rate.

The impact of artificial intelligence on clinical education: perceptions of postgraduate trainee doctors in London (UK) and recommendations for trainers

BackgroundArtificial intelligence (AI) technologies are increasingly used in clinical practice. Although there is robust evidence that AI innovations can improve patient care, reduce clinicians’ workload and increase efficiency, their impact on medical training and education remains unclear.MethodsA survey of trainee doctors’ perceived impact of AI technologies on clinical training and education was conducted at UK NHS postgraduate centers in London between October and December 2020. Impact assessment mirrored domains in training curricula such as ‘clinical judgement’, ‘practical skills’ and ‘research and quality improvement skills’. Significance between Likert-type data was analysed using Fisher’s exact test. Response variations between clinical specialities were analysed using k-modes clustering. Free-text responses were analysed by thematic analysis.ResultsTwo hundred ten doctors responded to the survey (response rate 72%). The majority (58%) perceived an overall positive impact of AI technologies on their training and education. Respondents agreed that AI would reduce clinical workload (62%) and improve research and audit training (68%). Trainees were skeptical that it would improve clinical judgement (46% agree, p = 0.12) and practical skills training (32% agree, p < 0.01). The majority reported insufficient AI training in their current curricula (92%), and supported having more formal AI training (81%).ConclusionsTrainee doctors have an overall positive perception of AI technologies’ impact on clinical training. There is optimism that it will improve ‘research and quality improvement’ skills and facilitate ‘curriculum mapping’. There is skepticism that it may reduce educational opportunities to develop ‘clinical judgement’ and ‘practical skills’. Medical educators should be mindful that these domains are protected as AI develops. We recommend that ‘Applied AI’ topics are formalized in curricula and digital technologies leveraged to deliver clinical education.

Infodemics: Use of Peer Reviewed and Non-Peer Reviewed Information by Post Grad-uate Trainee Doctors for COVID-19 Pandemic in Pakistan.

Background: Reliable and peer reviewed information is of immense importance for preventive, diagnostic and curative solutions and efforts should be done to minimize inaccurate infodemics among post graduate trainee doctors. Objective: The aim of the study was to access the use of Peer Reviewed and Non-Peer Reviewed Information by post graduate trainee doctors for COVID-19 Pandemic in Pakistan. Methods: The study was analytical cross sectional in design and was conducted in 3193 post graduate trainee doctors employing Electronic Logbook (elog) system of College of Physicians and Surgeons, Pakistan. An online survey included demographic characteristics, year of training, specialty and sources of information used for COVID-19 pandemic. Results: Total 3193 study participants from all provinces of Pakistan were included with mean age of 28.68 years. Majority of participants (58.66%) used both peer reviewed and non-peer reviewed information source for getting updated guidelines and information about COVID-19. According to bivariate analysis results, significant differences were revealed between the source of information and the age (p &lt; 0.001), province (p &lt; 0.001) and gender (p &lt; 0.002). Multivariate logistic regression results showed that the age less than 30 years (AOR = 1.311, 95% (CI: 0.800, 2.146), working in Khyber Pakhtunkhwa province (AOR = 1.549, 95% (CI: 1.210-1.982) and female gender(AOR = 1.551, 95% (CI: 1.303, 1.847). was significantly associated with increased use of social media for getting information. Conclusion: Use of non-peer reviewed information for COVID-19 pandemic by postgraduate trainee doctors is common.

The Effect of COVID-19 Pandemic on Performance of Postgraduate Medical Trainee Doctors: A Nationwide Epidemiological Study in Pakistan.

To find out various organizational, personal, and systemic factors influencing the performance of the postgraduate trainee doctors in managing COVID-19 pandemic. Analytical cross-sectional study. Conducted in various medical institutions of Pakistan from 15th April to 30th June, 2020. An analytical cross-sectional study was conducted on 11,656 postgraduate doctors. They were contacted through the e-log system of College of Physicians and Surgeons Pakistan. Semi-structured questionnaire was used consisting of demographic details, presenting symptoms, systemic involvements, clinical features, diagnostic tests, management of cases, authenticity of the information used, telemedicine services, practice of preventive measures, training and interactive educational activities, performance-based tasks and details about workplace environment. Mean and standard deviation was reported for continuous variables. Bivariate and multivariate analyses were used to report p values. Among 11,656 postgraduate doctors, 3,193 (27.4%) were directly involved in the management of COVID-19 patients in designated special corona facilities. Multivariate analysis was performed to control confounders. The risk factors, found statistically significant with performance, were presence of comorbidity (OR 1.261; 95% C.I.1.06-1.50), allergic and autoimmune disorders (OR 1.18; 95% C.I.1.03-1.35), confirmed COVID-19 status due to exposure (OR 0.570; 95% C.I.0.41-0.81), and care provision to old parents (OR 1.299; 95% C.I.1.19-1.42). The effect of COVID-19 on performance of postgraduate doctors was multi-factorial.Significant risk factors were presence of a comorbidity, allergic and autoimmune disorders, and confirmed COVID-19 due to exposure. Key Words: COVID 19, Postgraduate trainee, Pandemic, Comorbidity, PCR.

A qualitative study regarding stress and coping in frontline postgraduate trainee doctors working at a COVID hospital

A qualitative study regarding stress and coping in frontline postgraduate trainee doctors working at a COVID hospital

What matters when managing childhood fever in the emergency department? A discrete-choice experiment comparing the preferences of parents and healthcare professionals in the UK

BackgroundFever among children is a leading cause of emergency department (ED) attendance and a diagnostic conundrum; yet robust quantitative evidence regarding the preferences of parents and healthcare providers (HCPs) for...