Residency Training Research Articles

What Military Applicants Value When Choosing a Residency in Gynecologic Surgery and Obstetrics.

Military medical students participate in a separate residency match program, distinct from their civilian counterparts. There is limited information regarding factors that applicants find important when selecting a residency program in Gynecologic Surgery and Obstetrics (GSO). We aimed to identify factors that influence applicant program selection. A voluntary, anonymous, 45-question survey was distributed to military candidates pursuing GSO residency training in the fall of 2023. Participants were asked to rate the factors they considered most important when ranking residency programs. Thirty-seven of the sixty (61.7%) applicants completed the survey. The culture of the residency program was deemed "important" by most participants (94.6%), followed by surgical volume (70.3%) and obstetric volume (70.3%). When asked to rank selection factors, the culture of the residency program, geographic location, and surgical volume were among the top 5 influential factors for the majority of applicants. Participants considered the following factors "not important": Salary (military pay versus civilian salary) (43.2%), research opportunities (32.4%), and availability of abortion training (21.6%). Most military applicants (62.2%) stated that abortion restrictions would not affect program selection, while 37.8% reported that this would affect their rankings. Gynecologic Surgery and Obstetrics military applicants deemed the residency program's culture, surgical volume, and obstetrical volume to be the most important factors impacting residency program selection. Residency programs can use these findings to promote program strengths, improve program shortfalls, and guide applicant recruitment.

Can grit predict well-being?

BackgroundBurnout affects over 50% of surgical residents, and efforts focused on well-being during training are needed. Grit, defined as perseverance toward achieving long-term goals, is a measure of mental fortitude and may be protective against burnout and predictive of well-being.MethodsAn anonymous electronic survey was distributed to surgical and non-surgical resident trainees as well as general surgery faculty. Grit was measured using a 12-question validated Grit Scale and well-being was measured using a 5-question validated WHO-5 Well-Being Index. Linear regression was used to identify associations between post-graduate year (PGY), grit, and well-being. Student’s t-test was used to compare grit and well-being scores among male and female trainees.Results23/38 (60.5%) surgical residents completed the survey. Grit scores ranged from 3 to 4.67 (scale of 1–5) and well-being scores from 24 to 84 (scale of 0–100). There was no correlation between grit and well-being (R2 = 0.01, p < 0.63) or between PGY class and grit (R2 = 0.06, p < 0.27). However, there was a positive correlation between PGY class and well-being (R2 = 0.18, p < 0.05). Female residents trended towards higher grit (4.12 female vs 3.76 male, p < 0.07) and lower well-being (53 vs 60, p < 0.18). Compared with non-surgical residents, there were no significant differences in mean grit or well-being. The pooled trainee group demonstrated a positive correlation between PGY class and well-being (R2 = 0.09). Faculty reported higher grit (4, p < 0.03) and well-being (68.8, p < 0.002) than residents.ConclusionDespite high overall grit, trainees experience relatively low well-being; this effect is exaggerated in females. Grit and well-being trend to increase with PGY years and as faculty. The lack of association between grit and well-being in trainees suggests that intrinsic grit is not enough; well-being is impacted by external factors and encourages future work to identify and modify these factors for a positive impact on trainees.

Knowledge, attitudes, and practice of primary care professionals regarding community activities: a descriptive study.

Promoting health via a community approach is one of the most effective strategies for reducing the current incidence of chronic diseases. Primary care (PC), through the implementation of community activities (CA), has the potential to achieve this goal. Yet the implementation of CA at health centers is not standardized and is often thanks only to the voluntariness of health professionals. To ascertain the knowledge, attitudes, and practices of PC professionals regarding the implementation of CA. We carried out a cross-sectional study by circulating a self-administered online questionnaire on CA, across the period December 2022 through June 2023 in Galicia (Spain). All health professionals working in the Galician Health Service PC setting were invited to participate. A total of 521 health professionals participated in the study. They included all types of PC health professionals (physicians, general and specialist nurses -midwives, pediatrics, family and community, mental health- and social workers), including residents in training. Only 14.8% and 12.5% of professionals correctly identified CAs and social prescription (SPr) interventions, respectively. Furthermore, 93.9% recognized that the development of CA in health centers was deficient. Despite this, 76.5% showed a good attitude toward participation in CA. PC professionals find it difficult to identify CA and SPr interventions. Therefore, it is necessary to improve the training of these professionals in the implementation of CA with a view to enhancing population health, reducing the incidence of chronic diseases, and helping lessen the healthcare burden of the health system.

Does Early Exposure Change Pediatric Residents' Perceptions of Developmental-Behavioral Pediatric Care?

ABSTRACT Objective: To explore the impact of a new “Intro to DBP” rotation on pediatric residents' interest in developmental-behavioral pediatrics (DBP) and comfort in providing DBP care. Methods: All first-year pediatric residents participated in a new 1-week DBP rotation. Experiences included clinic visits; interdisciplinary evaluations; asynchronous online learning; and lectures, journal clubs, and/or case conferences. Participants completed pre- and postrotation surveys. Surveys focused on awareness of the DBP field; career plans; and perceived importance of, comfort with, and interest in learning about DBP care. We analyzed data using descriptive statistics and Bhapkar's test to compare distribution differences on pre- and postrotation Likert scales; we reviewed open-ended questions to identify themes. Results: Thirty-two residents participated; 56% had no previous exposure to DBP. After the rotation, there was a statistically significant increase in resident-reported importance of DBP care (p &lt; 0.0001), comfort in providing DBP care (p &lt; 0.0001), and interest in pursuing a DBP fellowship (p = 0.0048). Themes identified from open-ended responses suggested that the rotation led to a broader understanding of the DBP field, reinforcement and expansion of knowledge pertinent to all pediatric care, and improved understanding of systems of care. Conclusion: Brief, early exposure to DBP during pediatric residency training led to increased awareness of and comfort in providing DBP care. Residents described a broader understanding of the depth and breadth of DBP and its applicability to all aspects of pediatric care. Early introduction to DBP during residency training may stimulate greater interest in the field and greater comfort among general pediatricians to provide DBP care.

The price of pressure: nationwide survey on lifestyle disturbances, occupational burnout and compromised perceived-competency among radiology residents in China.

The competency of radiology directly affects the quality and equity of medical services. Due to their different occupational characteristics compared to other specialists, this study aims to evaluate the impacts of lifestyles on competency and burnout in radiology residents in China. A nationwide, cross-sectional survey was conducted from December 1, 2020 to April 30, 2021. A total of 12,208 radiology residents during their standardized residency training in China were invited. Multivariate linear regression and logistic regression were conducted to identify perceived competency and burnout associated with lifestyles. Of the 3,666 participants, 58.02% were female, 82.24% were aged <30 years, 40.53% were from the Eastern region, and 92.06% obtained a bachelor's degree. The radiology residents with high-level lifestyles had higher competency (β = 0.16, 95% CI = [0.01, 0.32]), particularly in the realms of sleep, physical activity, and alcohol consumption. The correlation was stronger in residents with longer work hours and more night shifts. Residents with insomnia (OR = 7.69, 95% CI = [4.23, 14.67]) and less exercise (OR = 6.24, 95% CI = [1.33, 29.37]) had higher burnout risk, while residents who smoked had a lower risk (OR = 0.60, 95% CI = [0.40, 0.89]). And lifestyle factors had a slightly different impact on emotional exhaustion and depersonalization. Radiology residents' lifestyles can be emphasized, as it may reflect their pressure and wellbeing and influence their concentration, competency, burnout and performance. Policymakers and hospital administrators should incorporate practical and modifiable strategies into work routines to improve the lifestyle quality of residents.

Trends in general surgeon operative practice patterns in a modern cohort

IntroductionAnalyzing general surgeons’ operative case mix can provide an update on contemporary practice patterns and inform pragmatic residency training. MethodsWe performed a retrospective cohort study of general surgeons in Florida, Iowa, and Maryland, 2016–2020. Cases were identified using billing codes. The Cochran-Armitage test of trends was used to evaluate the proportion of practice devoted to specific case types and operative setting over time. ResultsGeneral surgeons (n ​= ​1300) performed 1,287,745 cases. The mean (±SD) annual volume per surgeon for all procedures was 356 (±250), with 198 (±152) general surgery operations, 57 (±142) endoscopic procedures, and 101 (±109) other cases. On average, surgeons operated on 7.1 (±2.6) different organ systems. Trends toward a lower proportion of general surgery operations, and a greater proportion of subspecialty procedures and surgery in the outpatient setting over time were demonstrated (p ​< ​0.001). ConclusionThe practice pattern of the general surgeon continues to be heterogeneous, reflecting the persistent need for a broad training paradigm that permits specialization.

Transformational learning and professional identity formation in postgraduate competency-based medical education.

Residency programmes are in transition to a framework for competency-based medical education (CBME). The intersection of CBME with transformational learning (TL) experiences and professional identity formation (PIF) - particularly within senior learners in transitional states - is unknown but important to understand in order to develop and implement strategies to support trainees' professional development. Through inductive qualitative methods, we conducted semi-structured interviews (n= 22) of current trainees and recent graduates from adult cardiology residency training programmes within Canada to explore the impact of TL experiences on residents' professional growth and identity formation. Interviews were analysed using thematic analysis informed by TL theory. CBME did not appear to influence trainees' experiences of disorienting dilemmas and TL. Important clinical encounters and interpersonal relationships - in particular, those between mentor and mentee - shaped trainees' professional development as cardiologists ('enabling factors' for TL and PIF). 'Imposter phenomenon' was widely prevalent in our sample study population even among graduates who had already completed their training. Requisite elements for transformation (disorienting dilemmas, critical reflection, discourse and action) also contributed to PIF. TL experiences influenced PIF in senior learners but infrequently intersected with CBME; these experiences were more commonly prompted by disorienting dilemmas relating to clinical outcomes or interpersonal interactions independent of CBME-specific architecture.

Psychopathology teaching in residency program – An art losing its shine: Psychiatry trainee residents’ experience

Abstract Background: Teaching psychopathology in a residency program is considered the “heart” of the training program. There is a lack of data on evaluating psychiatry resident training in psychopathology. Aim: The aim of this study was to evaluate residents’ experience and satisfaction in terms of training and teaching psychopathology during the psychiatry residency program. Methods: It was a mixed-method design study and was cross-sectional. A total of 53 psychiatry residents (pursuing postgraduate courses) participated. Participants were assessed using qualitative and quantitative questionnaires. Qualitative interviews consisted of open-ended questionnaires. The student satisfaction questionnaire was quantitative. Results: In terms of dissatisfaction with the teaching specific skills during postgraduation, the most common dissatisfaction reported was with the quality of the clinical environment (35.8%), psychopathology taught during the course of the training period (34.0%), and the teaching of skills of interview technique to elaborate and label the psychopathology during the course of the training period (32.1%). Conclusion: Most of the residents were not satisfied with the teaching of psychopathology. Supervision was not adequate from the seniors and teachers for teaching psychopathology. The most commonly emerged strategy to teach psychopathology was the supervision of clinical interviews with real patients, and the initial 1st year should be more focused on teaching psychopathology in clinical settings. It can be said that there should be some competency-based training programs for the residents.

Evaluating the efficacy of a cost-effective, fully three-dimensional-printed vertebra model for endoscopic spine surgery training for neurosurgical residents.

A fused deposition modeling three-dimensional (3D)-printed model of the L4-5 vertebra for lumbar discectomy was designed. The model included separately printed dura mater, spinal cord, ligamentum flavum, intervertebral disc (from thermoplastic polyurethane), and bony structures (from polylactic acid), and the material cost approximately US$ 1 per model. A simple plumbing endoscope was used for visualization. Dura mater injury was assessed by painting two layers on the dura mater, which peeled off with trauma. Endoscopic spine surgery is a subject of high interest in neurosurgery given its minimally invasive nature; however, it has a steep learning curve. This study evaluated the effectiveness of a cost-efficient 3D-printed model when teaching this technique to neurosurgery residents. Only a few studies have investigated the efficacy of such a model. Eight residents with >2 years of training participated. Residents performed the procedure bilaterally and twice at 1-week intervals. From the 32 surgeries, four were excluded because of facet removal (as it widened the surgical corridor), leaving 28 surgeries for analysis. Initial surgeries demonstrated a mean operation time of 21 minutes 18 seconds (standard deviation [SD], 2 minutes 32 seconds), which improved to a mean of 6 minutes 45 seconds (SD, 37 seconds) in the fourth surgery (F(3, 17)=19.18, p <0.0001), demonstrating a significant reduction in surgical time over successive surgeries. The median area with the paint removed decreased, from 161.80 (85.55-217.83) to 95.13 mm2 (12.62-160.54), (F(2.072, Inf)=2.04, p =0.128); however, this was not significant. Resident feedback indicated high satisfaction with the educational value of the model. The developed fully 3D-printed model provides a viable and scalable option for neurosurgical training programs, enhancing the learning experience while maintaining low costs. This model may be an excellent stepping stone for learning lumbar spine endoscopy, acclimating to the two-dimensional view, progressing to cadaver models, and, eventually, independent surgery.

Correction to “Educational outcomes necessary to enter pharmacy residency training: 2023 update”

Correction to “Educational outcomes necessary to enter pharmacy residency training: 2023 update”

3D-printed model is a useful addition in orthopedic resident education for the understanding of tibial plateau fractures

This study aimed to explore the role of the three-dimension (3D) printed models in orthopedic resident training of tibial plateau fractures. A total of 41 residents from our institution were divided into two groups. The intervention group, consisting of 20 residents, had access to 3D-printed models illustrating thirteen tibial plateau fractures. In contrast, the control group, comprising 21 residents, received digital images of thirteen identical tibial plateau fractures. Evaluation of learning outcomes included the accurate identification of tibial plateau fracture patterns, deduction of traumatic mechanisms, preoperative plan, assessment time, and subjective questionnaire responses. The participants with 3D printed models scored significantly higher in both the Schatzker classification and Luo three-column classification compared to those without 3D printed models. Residents in the intervention group performed better in accuracy in deducing traumatic mechanisms compared to the control group. In addition, the sum score of preoperative plan in the intervention group was significantly higher than that in the control group. Specifically, participants with 3D printed models scored higher in surgical approach choice and implants placement than these in the control group. Residents exposed to 3D printed models also spent less time to complete the assessment than those with access only to digital imaging. Subjective assessments indicated that 3D-printed models boosted confidence in fracture identification, improved preoperative plan for fracture management and enhanced the understanding in injury mechanism of tibial plateau fractures. Furthermore, residents agreed that the use of 3D-printed models heightened their interest in learning tibial plateau fractures. Therefore, the addition of 3D printed models significantly contributed to a comprehensive understanding of tibial plateau fractures, the improvement in fracture identification, inferring injury mechanisms and preoperative plan.

Evaluating the Performance of ChatGPT, Gemini, and Bing Compared with Resident Surgeons in the Otorhinolaryngology In-service Training Examination.

Large language models (LLMs) are used in various fields for their ability to produce human-like text. They are particularly useful in medical education, aiding clinical management skills and exam preparation for residents. To evaluate and compare the performance of ChatGPT (GPT-4), Gemini, and Bing with each other and with otorhinolaryngology residents in answering in-service training exam questions and provide insights into the usefulness of these models in medical education and healthcare. Eight otorhinolaryngology in-service training exams were used for comparison. 316 questions were prepared from the Resident Training Textbook of the Turkish Society of Otorhinolaryngology Head and Neck Surgery. These questions were presented to the three artificial intelligence models. The exam results were evaluated to determine the accuracy of both models and residents. GPT-4 achieved the highest accuracy among the LLMs at 54.75% (GPT-4 vs. Gemini p=0.002, GPT-4 vs. Bing p<0.001), followed by Gemini at 40.50% and Bing at 37.00% (Gemini vs. Bing p=0.327). However, senior residents outperformed all LLMs and other residents with an accuracy rate of 75.5% (p<0.001). The LLMs could only compete with junior residents. GPT- 4 and Gemini performed similarly to juniors, whose accuracy level was 46.90% (p=0.058 and p=0.120, respectively). However, juniors still outperformed Bing (p=0.019). The LLMs currently have limitations in achieving the same medical accuracy as senior and mid-level residents. However, they outperform in specific subspecialties, indicating the potential usefulness in certain medical fields.

Methodological model for teaching residents of foreign language professional communication based on an integrated approach

Importance. The widespread use of foreign language education in non-linguistic universities is due to a number of factors that determine the development of professional activity in various industries. Medicine and healthcare are among the key areas of human activity that require regular updating of knowledge and improvement of professional skills of a specialist in the context of scientific and technological progress. Medical professionals are required to keep abreast of the latest achievements of science and technology, to study new methods of diagnosis, treatment and prevention of diseases in order to provide patients with better medical care. Using the example of the COVID-19 pandemic, the world community realized that the emergence of such threats requires rapid response and cooperation between various countries and organizations. Only through the experience of interaction between scientists and medical professionals from different countries, it was possible to jointly normalize the epidemiological situation around the world. The World Health Organization has played a key role in coordinating international efforts to combat coronavirus infection by providing all the necessary information in foreign languages, mainly English and French. In view of this, there is a social demand in the labor market for medical workers who speak English perfectly, and in higher educational institutions there is a demand for language courses from students of residency. The main purpose of the study is to develop a methodological model for teaching residents of foreign language professional communication based on an integrated approach.Research Methods. To achieve the main goal, theoretical and empirical research methods are applied, which make it possible to study and analyze existing theories and concepts on the topic of developing a methodological model for teaching residents of foreign language professional co mmunication based on an integrated approach. Based on the analysis of the academic literature on the research topic, the regularities of the construction of the methodological model, its functions and component composition are revealed. Modeling of the educational process makes it possible to create an effective methodological model for teaching residents of foreign language professional communication based on an integrated approach.Results and Discussion. The conducted research makes it possible to identify the didactic functions of the methodological model: 1) orienting; 2) regulatory; 3) formative; 4) controlling. Based on the identified didactic functions, a methodological model for teaching residents of foreign la nguage professional communication based on an integrated approach is developed, which is structurally presented in the form of five consecutive blocks: 1) prerequisites; 2) goal setting block; 3) content block; 4) operational and activity block; 5) evaluation and performance block.Conclusion. The developed methodological model for teaching residents of foreign language professional communication based on an integrated approach allows creating a simulation of the educational process in order to identify the strengths and weaknesses of the proposed teaching met hodology. The obtained research results are supposed to be used in the methods of foreign language teaching in medical universities in the training of residents.

A Realistic Ingeniously Designed Cleft Palate Simulator for Training of Residents: Bridging the Gap Between Theory and Practice.

Cleft palate is a congenital deformity that presents significant challenges in surgical correction. Proper training with an educational model for can greatly enhance the learning curve and improve patient outcomes. This article discusses the development and evaluation of an economical cleft palate model designed to enhance surgical skills and confidence among residents. The model was constructed using dental casts, acrylic resin, foam sheets, double-sided adhesives, infant feeding tubes, and red dye. Tertiary care center. Surgical residents. The assembly time and material costs were recorded. To evaluate its effectiveness, participants' feedbacks were collected and analyzed. The cleft palate model was produced at a cost of 250 INR per unit, with assembly taking approximately 15 minutes. Overall, 32 residents completed the simulation exercise of cleft surgery on the model. Participants gave the model an average score of 4 (±0.60) for realistic anatomical appearance, 3.5 (±1.3) for replicating the tactile nature of human tissue. Anatomical accuracy and ability to manipulate tissue and perform suturing received a rating of 3.4 (±1.1) and 3.7 (±0.81), respectively. The model's value as a training tool scored 4.4 (±0.51), with an overall satisfaction rating of 4.6 (±0.22) among residents. Our cleft palate model offers an economical, practical, and accessible solution for surgical training. This model is a viable alternative to more complex and expensive training tools and potentially enhancing the training of healthcare professionals in cleft palate repair.

Chinese Anesthesiology Milestones in Resident Evaluation: Reliability, Validity, and Correlation with Objective Examination Scores: a Cross-sectional Study.

Evaluating competency acquisition during residency training is crucial. The Anesthesiology Milestones have been implemented in the United States. The China Consortium of Elite Teaching Hospitals for Residency Education has also developed the Chinese Resident Core Competency Milestone Evaluation System. Despite this, Milestones tailored for anesthesiology have yet to be implemented in China. To address this gap, we have developed Chinese Anesthesiology Milestones. This study aims to assess the reliability and validity of the Chinese Anesthesiology Milestones and their correlation with objective examinations. In this single-center cross-sectional study, we included anesthesia residents enrolled in the standardized residency training program at our hospital during the academic year 2021 to 2022. The Chinese Anesthesiology Milestones were developed based on the American version of Anesthesiology Milestones 2.0 and the Chinese Resident Core Competency Milestone Evaluation System using the Delphi method. The Delphi panel comprised a diverse group, including education administrators, faculty from teaching hospitals, and anesthesia residents. Five attending anesthesiologists independently assessed the levels achieved by each anesthesia resident based on the Chinese Anesthesiology Milestones. Subsequently, they collaboratively discussed the ratings for each resident until a consensus was reached. The interrater reliability, internal consistency, and construct validity were assessed using Kendall's coefficient, Cronbach's α coefficient/ composite reliability, and average variance extracted, respectively. Higher values indicated better reliability or validity. The correlation between Milestone ratings and objective examination scores, including written examinations and Objective Structured Clinical Examinations, were analyzed using Pearson correlation. The Chinese Anesthesiology Milestones encompassed 6 competencies, including professionalism, medical knowledge and technical skills, patient care, interpersonal and communication skills, teaching ability, and life-long learning. Milestone evaluation data were available and analyzed from 66 residents. The Kendall's coefficient of concordance among raters ranged from 0.799 (95% confidence interval [CI], 0.793-0.918) to 0.942 (95% CI, 0.934-0.982). The average variance extracted, composite reliability, and Cronbach's α coefficient ranged from 0.782 to 0.920, 0.935 to 0.980, and 0.916 to 0.978, respectively. Correlations between objective examination scores and related Milestone subcompetencies were as follows: written examinations: r = 0.52 (95% CI, 0.22-0.71), technical skills stations: r = 0.51 (95% CI, 0.21-0.71), the oral test station: r = 0.66 (95% CI, 0.45-0.79), and the standardized patient station: r = 0.61 (95% CI, 0.36-0.76). The Chinese Anesthesiology Milestones demonstrated satisfactory interrater reliability, internal consistency, construct validity, and correlation with objective examination scores within our hospital.

A Multimodal Educational Boot Camp for Training Fellows in Pediatric Extracorporeal Membrane Oxygenation (ECMO).

Pediatric extracorporeal membrane oxygenation (ECMO) management presents unique challenges in acute care settings, requiring specialized expertise to manage critically ill children. Medical and surgical fellows often manage these patients, but prior residency training rarely provides sufficient ECMO exposure. We developed and evaluated a multimodal pediatric ECMO boot camp for new fellows. This boot camp was implemented during 5-hour sessions in August 2021, August 2022, and August 2023. The curriculum included a 45-minute introductory didactics session, 30-minute hands-on circuit demonstration, and four 30-minute small-group activity stations. To assess knowledge acquisition, pre- and posttests were administered; participants also completed a post-boot camp survey to evaluate their confidence and provide feedback. Forty-nine participants completed the boot camp, including 18 critical care, four cardiology, 11 pediatric surgery, 12 cardiothoracic surgery, and four pediatric emergency medicine fellows. Pre- and posttests demonstrated significant improvement in knowledge of ECMO circuit components and pressures (56% vs. 76%, p < .001). All of our participants agreed or strongly agreed that participating in the boot camp increased their confidence in troubleshooting ECMO emergencies. The inclusion of fellows from various clinical disciplines, offering a rich diversity of perspectives, was particularly valued by participants. Our results demonstrate the feasibility and effectiveness of establishing a pediatric ECMO boot camp to train new surgical and medical fellows. The curriculum not only improved ECMO knowledge but also boosted learners' confidence in managing ECMO-related challenges.

Assessment of Surgical Competences for Neck Dissection and Total Laryngectomy on Revascularized Cadaver Models: Onco-Neck-Score and Onco-Larynx-Score.

In surgical simulation, evaluation tools are necessary to allow the overall and specific level of each gesture to be assessed for learners, to allow active feedback and follow-up. The aim of this study was to create and validate a scale for the assessment of competences for neck dissection (ND) and total laryngectomy (TL) in head and neck surgical oncology simulation specific for revascularized cadavers' models. Two independent scales were created for ND and TL based on a two-round Delphi method. The scales were used during ND and TL simulation sessions on SimLife® (Symedis, Poitiers, France) model. Surgical steps were scored by 2 independent observers. To assess its ease of use, a questionnaire was answered by senior surgeons (SS) at the end of the sessions. Fifteen items were included in the final version for ND scale and 20 for TL scale. The results of 14 lateral ND and 8TL were included. The mean score was higher for SS (69 ± 6.4; 87.5 ± 8.5) than for residents (36.5 ± 11; 57.5 ± 13.2) for ND (P = 0.0006) and TL (P = 0.028) respectively. Six SS strongly agreed that this tool had a positive impact on resident training with stepwise feedback and accurately represented their competences. We developed a pedagogic tool built to assess surgical competence for head and neck surgical oncology on revascularized cadaver models. This tool has a good construct validity thanks to the expert reviewing with Delphi method and appears to have fine acceptability by the SS.

Summer Surgical Elective in Hong Kong

I completed a surgical elective with the Department of Plastic and Reconstructive Surgery in Queen Mary Hospital, Hong Kong Special Administrative Region (SAR), China. I was taught a great deal of surgical knowledge by the team and was inspired as I witnessed the life-changing operations they performed. The experience was professionally and culturally enriching and has cemented my desire to pursue surgery as a career to improve the lives of my future patients. In this article, I will discuss how I secured this elective and my personal experience during the elective. Additionally, I will briefly discuss some differences I observed between the healthcare systems in Hong Kong and Ireland, including different scopes of surgical practice, residency training, and also the similar challenges faced by both public healthcare systems.

The radiological primary survey: A systematic approach and guide to reading torso computed tomography images in trauma for surgeons

Background Trauma is a disease where time is of the essence. In many lower middle-income countries, definitive management and planning for trauma patients are often delayed after working hours because of either a lack of technicians to perform computed tomography (CT) scans or a lack of radiologists to interpret them. These lacunae can be bridged if more and more surgeons become confident in interpreting trauma CT images. Method In this narrative review, written in a ‘how to do it’ manner, we describe a way of doing a structured and quick ‘radiological primary survey’ of the torso CT, which we believe will help quickly identify major injuries systematically, thereby avoiding delays in management and forming a care plan. The method has been developed by a team of trauma surgeons and radiologists and stems from the DRS ABCDE technique used in interpreting trauma chest X-rays. Result The DRS ABCDE extrapolated to the trauma torso CT includes the following steps- Details, WRAP (W-windowing, R-Region, A-Axis, P-Phase), S- the Scout film, Airway, Breathing, Circulation, Disability and Extras. Conclusion The review will enable resident trainees and trauma care professionals to interpret trauma CTs using a structured approach.

Veterinary neurology residency training in Europe-A survey on preparation and plans.

Difficulties in recruitment of veterinary specialists to academia is an ongoing problem for university teaching hospitals. The aim of this study was to determine the proportion of veterinary neurology specialists that plan to work in academia after their residency training and identify the main factors that may influence that decision. An electronic survey was distributed to European College of Veterinary Neurology (ECVN) residents in training and those that completed their residencies within the previous 12 months. Despite similar numbers of residents training in clinical practice and academic institutions, most respondents (79.7%) planned to work in private practice. The most influential factors for deciding future workplace were quality of life, salary, location, and the number of other specialists (with specialists in subjects other than neurology viewed as more important than neurologists) working in the same institution. The most common reasons for not choosing academia were low compensation, excessive bureaucracy, and high administrative workload compared to private clinical practice. Academic institutions need to review support for academic staff and provide stronger mentorship to overcome these problems and ensure provision of high-quality undergraduate teaching in veterinary neurology as well as promoting advancement of the field through basic and applied research.