Specialty Preferences Research Articles

Factors Associated with Medical Students' Career Choices Regarding Internal Medicine in Uganda.

BackgroundThere is an unmet need for internal medicine physicians in Uganda owing to the growing burden of diseases. This study aimed at evaluating the factors associated with career choices of undergraduate medical students regarding internal medicine in Uganda.MethodsWe conducted a cross-sectional study in the first 3 weeks of October 2021 via WhatsApp messenger. Medical students in the 3rd to 5th year of study who had completed internal medicine clinical rotations and pursuing a Bachelor of Medicine and Bachelor of Surgery (MBChB) degree at 7 Ugandan universities (4 public and 3 private) were enrolled. Multivariable logistic regression model was constructed to determine factors associated with a career choice in internal medicine.ResultsWe enrolled 418 participants, median age was 24 (interquartile range (IQR): 23–26) years, 67.7% were male, and 36.1% had a family member or relative who was a doctor. Most of the students (84.0%) were interested in research. The top three most preferred specialties were internal medicine (52.6%), surgery (51.2%), and obstetrics and gynaecology (51.0%). Overall, 186 (44.5%) participants reported plans to pursue a Master of Medicine degree in internal medicine. Interest in research was the only factor independently associated with 2.5-fold higher odds of pursuing a career in internal medicine (adjusted odds ratio: 2.5, 95% CI: 1.4–4.6, p = 0.003). About 73% of the participants strongly agreed that internal medicine requires wide reading.ConclusionThere is a strong interest to pursue a career in internal medicine among Ugandan medical students. We recommend an increase in training opportunities in Internal Medicine, especially in view of the growing disease burden and increasing population growth.

Factors affecting the choice of becoming a neurosurgeon in the western region of Saudi Arabia.

The preference of medical specialty for students can start even before enrollment into medical school, or as late as following their graduation. During their senior years, students often get a prospective on the working environment and the difficulties faced in the field. This, along with other factors, can strongly alter their career choice. This study aims to explore the degree of interest in neurosurgical specialty among medical students and the factors influencing their choice of becoming a neurosurgeon in the western region of Saudi Arabia. This is a cross-sectional study which was done across three universities of the western region of Saudi Arabia including King Saud bin Abdulaziz University for Health Sciences, Umm Al Qura University, and King Abdulaziz University. A sample of 1023 students from the second medical year up to the internship was conducted, and out of them, 585 (57.2%) were males and 438 (42.8%) were females. Three hundred and fifty-nine (35.1%) of the students were interested in neurosurgery, while 664 (64.9%) were not. The data show that females have more interest (40.8% of females) compared to males (35.1% of males). Furthermore, there was a general trend toward a decrease in the interest in neurosurgery with time. The impact on patients "rewarding feeling" was the most reported attraction to the specialty, followed by income. Stress was the most reported deterring factor among students. Neurosurgery is one of the most challenging specialties, yet it is still considered one of the most competitive ones. Many factors have been found to influence medical students' choices to apply for neurosurgical training as we described. Interestingly, we noted higher interest among female students, and among college freshmen compared to their counterparts. Further studies should be conducted on a larger scale to analyze these findings.

The Relationship Among Emotional Intelligence, Specialty Preference, and Burnout Among Physicians-in-Training

Burnout among physicians-in-training has increased at an alarming rate, leading the American College of Graduate Medical Education to impose mandates aimed at securing their well-being. One factor contributing to burnout is choosing a specialty that is not aligned with one’s personality. Studies have shown that higher emotional intelligence (EQ) skills are associated with better choice-making and lower burnout levels. A survey was used to evaluate the impact of EQ on burnout levels among physicians-in-training who changed their specialty compared to those who remained in their original specialty. There was no difference in burnout and EQ levels between physicians-in-training who changed their specialty and those who did not. Further, this study showed that a change in specialty does not moderate the effect of EQ on burnout. The findings also indicate that culture and support may be important structural factors affecting burnout.

Future Dreams of Junior and Senior Medical Students at a Public Saudi Medical School

BackgroundMedical education is a challenging profession requiring students to acquire various skills and develop them continuously before and after graduation. The study aimed to assess the students’ preference toward specialty and determine their preferred residency program and future ambitions regarding administrative and leadership positions.MethodologyThis is a cross-sectional self-administered survey that included medical students in 1st year, and 5th year and internship at Imam Mohammad Ibn Saud Islamic University (IMSIU). The questionnaire consisted of demographic information and questions about the student’s choices regarding plans.ResultsFour hundred and fifty-eight (458) medical students out of 583 students (55.5% junior and 44.5% senior students) enrolled themselves in the study and completed the survey. Findings revealed that medical students’ top five preferred future general medical specialties were surgery (34.5), followed by internal medicine (18.3), family medicine (17.2), dermatology (14.6), and emergency medicine (15.9). The junior students were found to be more inclined toward dermatology, medical genetics, and surgical general specialties. The findings showed that 63% of the students were interested in becoming future leaders, with 52.8% of them wishing to become head of a medical department. When asked about their desired qualifications, 85.8% preferred the Saudi Board.ConclusionSurgery was the most favorable specialty among medical students, followed by internal medicine, family medicine and dermatology, and emergency medicine. The study showed a significant difference between males and females and seniors and juniors in preference of specialty and medical qualification, the female medical students prefer to specialize in dermatology (p=0.027), neurology (p=0.028), and obstetrics and gynecology (p=0.001) as a general specialty significantly more than male medical students. It shows that students are interested in future leadership goals.

Improved Thermal Properties and Erosion Resistance of Silicone Composites With Hexagonal Boron Nitride

In this article, silicone rubber (SiR) is filled with industry preferred micro-silica and specialty hexagonal boron nitride (h-BN) nanosheets, by varying the ratio between the two fillers, while keeping the filler to matrix ratio the same in all three composites. The fillers are added to SiR using an electrostatic disperser which aids in homogenizing the filler-polymer mixture by means of shearing force along with elongation. The performance of synthesized silicone composites are evaluated using thermal, erosion resistance, morphological, mechanical, and high-temperature dielectric properties. Addition of as low as 5 wt% h-BN fillers significantly improved the thermal properties; 6%–20% improvement in thermal conductivity and in less than half the weight loss compared to only silica filled composites with laser erosion. The morphological and mechanical analyses showed improved filler dispersion and filler to silicone matrix interaction owing to good filler dispersion achieved through the electrostatic dispersing method. The dielectric properties measured in wide frequency range, between 10 <sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">−4</sup> and 10 <sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">3</sup> Hz and at elevated temperatures (up to 175 °C) showed a negligible effect of increase in h-BN content. Thus, this article implies that low amounts of h-BN in silica-silicone composites improve thermal conductivity and erosion resistance significantly and not altering the dielectric responses of these hybrid composites even at elevated temperatures. Hence these composites can find applications both in the high voltage industry and as electronic packaging materials.

The Unmatched Integrated Plastic Surgery Applicant: A Focus on Improving the Application.

The Unmatched Integrated Plastic Surgery Applicant: A Focus on Improving the Application.

Learning Environment is the Prevailing Factor in Surgical Residents’ Favorite Rotations

Understand the characteristics of residents' favorite rotations to improve the ability of educators to maximize positive learning experiences. Novel cross-sectional survey developed through thematic analysis of focus groups with residents using 4-point Likert scales ranked from "Not at all important" to "Extremely important." Single university-affiliated urban hospital PARTICIPANTS: Clinical surgical residents BACKGROUND: Resident assessments of learning experiences vary between rotations leading to the development of "favorite" rotations. A novel survey instrument containing 31 characteristics divided into 4 thematic categories was developed following analysis of surgical resident focus groups. Clinical surgical residents were asked how important each characteristic was for determining their favorite rotation on a 4-point Likert Scale from "not at all important" to "extremely important." Two-sided independent sample T-tests were used. The response rate was 59% (33/56) with proportional representation of postgraduate levels. Overall, 67% (22/33) of residents reported their favorite rotation was in their preferred specialty, 70% (23/33) reported their favorite rotation required >70 hours per week in the hospital, and 97% (32/33) of residents reported their favorite rotation required <2 days of clinic. Overall, the average ranking of the categories from most to least important was content (mean = 2.84, SD = 0.48), learning environment (mean = 2.67, SD = 0.57), working environment (mean = 2.38, SD = 0.56), and accomplishment (mean = 2.31, SD = 0.57). The only category with a statistically significant difference between junior and senior resident was content with seniors ranking it most important (mean = 3.35, SD = 0.93) compared to junior residents who ranked it least important (mean = 2.21, SD = 1.25), p = 0.01. Personal characteristics such as "Attendings cared about my learning" (mean = 3.56, SD = 0.50) and "I felt good at my job" (mean = 3.45, SD = 0.67), tended to be more important than structural characteristics such as "call schedule" (mean = 2.71, SD = 0.86), "formal didactics" (mean = 2.67, SD = 1.04), and "work-life balance" (mean = 2.70, SD = 0.99). This study demonstrates a novel understanding of the factors that contribute to resident preferences for certain rotations. Junior and senior residents attribute importance differently, which may provide the basis for level-appropriate improvements. Personal factors tended to be more contributory than structural factors, highlighting additional dimensions to examine when considering how to optimize certain rotations.

Women's interest in surgery as a career in the early postgraduate period: a national longitudinal study.

Women remain underrepresented in Surgery in Aotearoa New Zealand (AoNZ). This study described interest in surgical careers by gender in the early postgraduate period and associated influencing factors. AoNZ medical graduates between 2012 and 2016 responding to an Exit Questionnaire (EQ) at graduation and 3 years later (PGY3) as part of the Medical Schools Outcomes Database and Longitudinal Tracking Project (MSOD) were included. Analyses of specialty preferences and influences by gender were performed. Of 992 participants, 58% were women. At EQ, 158 participants (16%) had a surgical preference: 21% of men and 14% of women (P < 0.01). By PGY3, this was 20% of men and 10% of women (P < 0.01). A logistic regression found women were half as likely as men to have a surgical preference at PGY3. Those with a surgical preference at EQ were over 23 times more likely to have a surgical preference at PGY3, irrespective of gender. There were significant differences in self-reported career influencing factors between women and men at EQ and PGY3, as well as between PGY3 women with a surgical and those with a non-surgical preference. These included nature of the specialty, training requirements, lifestyle, family and personal factors. Increasing the proportion of women in Surgery requires a multifaceted approach starting during medical school and continuing through early postgraduate years. More needs to be done to make surgical experiences as an undergraduate and junior doctor appealing to women.

Learning objectives of Belgian general practitioner trainees regarding their hospital training: A qualitative study

Background In Europe, hospital training is integrated in the postgraduate curriculum of General Practitioners (GPs) according to the European Directives. However, little is known about the specific learning objectives of GP trainees during this training. Objectives This exploratory study investigated GP trainees’ expected learning objectives for their hospital training and the factors influencing the learning process. Methods Semi-structured interviews were conducted in three focus groups consisting of first-year GP trainees before their hospital training. Data were coded thematically and analysed in NVivo. Results A total of 22 Belgian GP trainees (55% females, average age of 26.2 years) were interviewed. Three major themes emerged: learning objectives, factors influencing learning and organisational aspects. GP trainees mainly wanted to improve their knowledge of common conditions by conducting consultations and follow certain patients’ hospitalisation trajectory. Emergency medicine or internal medicine was the preferred specialty. Other GP trainees wanted to learn more about some specific conditions. Conversely, an overloaded work schedule was dreaded to hinder effective learning. Regular meetings and supervision from their hospital trainer were deemed crucial to strengthen GP trainees’ learning trajectory. Conclusion GP trainees wanted to learn more about both common conditions and some specific conditions. Their previous year in a GP setting strengthened their confidence and facilitated purposeful learning. Relieving GP trainees from administrative tasks when working as supplementary doctors could strike a better balance between the continuity of the clinical department and their personal learning objectives.

Determining Factors Influencing Specialty Preferences of Iranian Medical Doctors: A Qualitative Study.

Background: The medical specialty choice of physicians directly affects the healthcare system, community wellbeing, and their own professional life. It is therefore important to identify its underlying factors to predict such medical career choices and to draw up a comprehensive evidence-based public health policy and health human resources planning. The present qualitative study aimed to identify these determinants of career choices through semi-structured interviews with medical doctors in the context of country-specific social and cultural characteristics.Methods: The present qualitative study was carried out in 2019-2020 at Shiraz University of Medical Sciences (Shiraz, Iran). The target population was medical students, junior doctors, and medical residents. The purposive sampling method was used to recruit the participants and sampling continued until data saturation, i.e., no new information could be extracted. Data were collected through individual, face-to-face, semi-structured interviews and analyzed using the conventional content analysis method. Inductive thematic analysis was used to interpret the data based on which a thematic map was developed illustrating the factors influencing medical specialty preferences in Iran. Data trustworthiness was assessed according to the criteria proposed by Guba and Lincoln.Results: Analysis of the interview data resulted in three main themes and fourteen sub-themes. The main themes were “Personal determinants”, “Career-related factors”, and “Interpersonal influences”. The most important sub-themes were personal interests, income, and prestige.Conclusion: The determinants influencing the specialty preferences of Iranian medical doctors are identified. Our findings will facilitate the development of a comprehensive evidence-based public health policy, health human resources planning, and appropriate medical education policy.

A cross-sectional study of student empathy across four medical schools in Denmark—associations between empathy level and age, sex, specialty preferences and motivation

BackgroundProfessional empathy has been associated with a range of positive patient- and clinician outcomes and is therefore considered important to develop for future physicians. Measuring changes in empathy scores among medical students by using the Jefferson Scale of Empathy (Student version) (JSE-S) has led to mixed results. So far, no investigation of Danish medical students’ empathy development has been conducted. The aim of this study was therefore to examine the associations between empathy scores among Danish medical students and medical school, year of curriculum, age, sex, co-habitation, and parental status, specialty preferences and motivations for choosing medicine as a future profession.MethodsThis was a cross-sectional questionnaire study. All medical students from four medical schools in Denmark in their first, third and sixth year (N = 4,178) were invited to participate in the study in October 2020. The associations between JSE-S sum score and the above explanatory factors were analysed by uni- and multivariable linear regression models.ResultsThe JSE-S was completed by 672 medical students. The overall mean score was 112.7. There were no statistically significant differences in empathy between medical schools, first, third- and sixth- year medical students, age groups or parental status. Female students and students living with a spouse or partner scored higher on JSE-S than male students or students living alone, and the sex difference remained statistically significant in the multivariable regression. In both the univariable and multivariable setting, preference for future medical specialty was statistically significant, with a decrease in scores for students choosing surgery-specialties. Motivational factors were not statistically significantly associated with empathy, although there was a slight upwards trend for one of the motivational categories, named “personal experiences”.ConclusionsOverall, our results showed neither decrease nor increase but instead rather stable empathy scores across years of curriculum of medical students in Denmark, adding to the mixed picture of empathy development among medical students. Our findings are consistent with positive associations found in international studies between empathy scores and higher age, female sex, specialty preferences for psychiatry and general practice and altruistic motivations for choosing to enroll. Although specialty preferences are changing during medical education, they may be used meaningfully as predictors of individual student empathy levels.

Changing Attitudes Toward Specialty Choice and the CaRMS Residency Match During COVID-19: A Cross-sectional Pilot Study of Canadian Medical Students

The Canadian residency match process has been dramatically restructured due to COVID-19. The impact of these changes on specialty choice and access to career-development opportunities among Canadian medical students remains largely unknown. The objective of this study was to assess whether students’ strategy and level of confidence entering the Canadian residency match have changed as a result of the pandemic. A 28-item online survey was distributed to Canadian medical students from the classes of 2021-2024, as well as the class of 2020 graduates planning to enter the 2021 CaRMS (Canadian Resident Matching Service) match. The survey was developed based on existing literature and included questions on demographics, access to educational opportunities, and personal strategies for matching. Descriptive statistics, t-tests, and Spearman’s correlations were used to analyze the data. Eleven percent of respondents reported a change in specialty preference due to COVID-19. Forty-three percent of respondents reported changing their strategy for the CaRMS match. Respondents interested in a surgical specialty were more likely to report a change in their match strategy (p = .0150), including applying to more programs (p = .0012) and exploring other specialties (p = .0118). Clerks were also more likely to report a change in their matching strategy (p = .0195) and specialty choice (p = .0194) compared to pre-clerks. Medical students felt that COVID-19 negatively impacted their ability to access scholarly opportunities and confidence regarding the match, which may have long-term implications for trainee well-being, residency match logistics, and long-term physician resource planning. ©CIKD Publishing

Factors influencing the choice of radiology as a medical specialty in Ireland

PurposeTo gain further insight into Irish medical students’ and interns’ specialty preferences and explore the various factors that influence choice of specialty with a focus on radiology. MethodsAn online cross-sectional survey was conducted of medical students and interns enrolled at a single Irish institution. Survey topics included specialty preferences, associated influential factors, exposure to radiology to date, and respondents’ interest in and understanding of radiology. ResultsCardiology, emergency medicine, and paediatrics had the highest overall interest levels, with 27.0% (n = 133/492) of all participants declaring an interest in radiology. The most frequently selected reason for considering radiology as a specialty was the varied nature of the field. Men reported considering a career in radiology more often than women (x2 (1, n = 433) = 9.464, p = 0.002) and non-European respondents considered radiology less often than their Irish and European peers (x2 (1, n = 436) = 7.510, p = 0.006). While there was no significant association between exposure to radiology and interest in the specialty, participants with previous exposure to radiology were found to be more knowledgeable about the roles and responsibilities of a radiologist. ConclusionThe outcomes of this study support previous research which concludes that medical students’ choice of specialty is multifactorial. A strategic approach needs to be taken towards undergraduate radiology education which accounts for class composition, emphasises the diversity and impact of the field, and provides clinical exposure to the subject matter, as a tailored means of steering more students and interns towards the underserved discipline.

Gerontological nursing in Ghana: Preferences and perceptions of nursing students

ABSTRACT Undergraduate nursing students in developed countries are reported to have poor perceptions and low preference for gerontological nursing. However, perceptions and preferences of undergraduate nursing students toward gerontological nursing in low-income countries have not been well explored. This study explored the perceptions and preferences of undergraduate nurses in Ghana toward gerontological nursing. A mixed method study design was used to explore Ghanaian undergraduate nursing students’ perceptions and preferences for caring for older people. One hundred and seventy-four nursing students were surveyed and 30 of them were interviewed. Quantitative data were analyzed descriptively using SPSS version 27. Content analysis was used to analyze qualitative data to generate themes. Response rate in the study was 73%. The majority of participants (95.4%) were below the age of 29. Gerontological nursing was ranked as the least preferred nursing specialty among graduating undergraduate nurses. Poor perceptions and inadequate knowledge about the care of older people were largely responsible for the lack of preference for gerontological nursing. Improving undergraduate nursing students’ knowledge about gerontological nursing is critical in correcting poor perceptions about gerontological nursing.

EFFECT OF COUNSELLING ON PREFERENCE OF SPECIALITY IN DENTAL STUDENTS OF KHYBER COLLEGE OF DENTISTRY

Abstract;&#x0D; &#x0D; Objective: To identify the preferences of dental graduates in the field of post-graduate specialty, factors that may influence their decision to select a particular specialty, and the effect of counselling on specialty preferences.&#x0D; &#x0D; Methods: A pre-counselling and post-counselling questionnaire based study was carried out among final year students and House surgeons of Khyber College of Dentistry, Peshawar, between May to June 2020. A self-administered questionnaire, inquiring about the preference of specialty program, specialty subject and the reason for the preference, was given to the students. After filling the questionnaire, the participants were given a session on dental career counselling. After the session, they were again asked about their preference for a specialty for their future career. Both results were then compared.&#x0D; &#x0D; Results: The most prevalent specialty before counselling was Endodontics (36.2%). The second one was Oral and Maxillofacial Surgery (21.3%) and then Periodontics (16.3%). After counselling, preference for Oral and Maxillofacial Surgery remained the same, however, Endodontics and Periodontics were reduced to 33.8% and 13.8%, respectively. Among post-graduation specialty programs, FCPS was the most prevalent program (77.5%).&#x0D; Conclusion: Endodontics is the most preferred specialty among graduates followed by Oral and Maxillofacial Surgery. The most preferred program was FCPS. A single counselling session did not change the preference significantly. The reason most likely behind the preference was possession of unique set of skills for the specialty.&#x0D; Key words: Dental graduates preferences, Specialties, Counselling.

Reported completion of the USMLE Step 1 and match outcomes among senior osteopathic students in 2020.

The United States Medical Licensing Examination (USMLE) is not required for osteopathic students to match into postgraduate programs; however, it is unknown if taking the test improves their chances of matching. Our objective was to determine the association between taking the USMLE Step 1 and matching into the applicant's preferred specialty for senior osteopathic students applying to the 10 specialties to which students applied most in 2020. We performed a secondary analysis of the free and publicly available 2020 National Residency Match Program (NRMP) published match report for senior osteopathic students. First, we determined the number of senior osteopathic students that matched into their preferred specialty vs those that did not and stratified them by reported completion of the USMLE Step 1 within each specialty. Next, we calculated odds ratios (ORs) within each specialty for senior osteopathic students matching into their preferred specialty with and without the USMLE Step 1 utilizing the Fisher's exact test. Finally, we repeated the analysis with only senior osteopathic students who had reported USMLE Step 1 scores in ranges including or below the mean for those who matched in their specialty. For senior osteopathic students, reported completion of the USMLE Step 1 was associated with matching for those who applied to Internal Medicine (OR 3.3 [95% confidence interval 2.07 to 5.48]), Emergency Medicine (2.1 [1.35 to 3.17]), Pediatrics (4.4 [1.38 to 18.63]), Psychiatry (2.5 [1.34 to 4.98]), Anesthesiology (3.4 [1.57 to 7.32]), and General Surgery (3.1 [1.56 to 6.14]). After repeating the analysis with only senior osteopathic students who reported low USMLE Step 1 scores, the association remained significant for those who applied to Internal Medicine (2.5 [1.49 to 4.28]), Anesthesiology (2.6[1.17 to 5.54]), and General Surgery (2.5 [1.24 to 5.04]). In 2020, reported completion of the USMLE Step 1 by senior osteopathic students was associated with matching for those who applied to Internal Medicine, Emergency Medicine, Pediatrics, Psychiatry, Anesthesiology, and General Surgery. In addition, reported completion of the USMLE Step 1 with a low score was associated with matching for those who applied to Internal Medicine, Anesthesiology, and General Surgery.

Gender-based Differential Item Functioning Analysis of the Medical Specialization Education Entrance Examination

The Medical Specialization Education Entrance Examination is a national high-stake test for the placement of medical graduates in medical specialization training in Turkey. The purpose of this study is to determine whether the Medical Specialization Education Entrance Examination items display gender-related differential item functioning (DIF) by using Mantel-Haenszel and logistic regression methods. To determine the presence of item bias, content experts reviewed items. The analyzes were conducted on the answers of 11,530 physicians to the Basic Medical Sciences and Clinical Medical Sciences tests of the 2017 Medical Specialization Education Entrance Examination spring term. According to the Mantel-Haenszel method, there were eleven out of 234 items identified as showing B level gender-related DIF. While six of the items functioned in favor of male physicians, five of them were in favor of female physicians. Since the number of items in favor of each gender is close, DIF cancellation occurs. According to content areas, one histology and embryology, one internal medicine, and three gynecology and obstetrics items were in favor of female physicians, one physiology, two medical pharmacology, one pediatrics, and two surgical items were in favor of male physicians. To the experts’ reviews, there are no biased items. The medical specialty preferences of the physicians and content area of the displaying differential item functioning items overlapped.

Female Medical Students’ Relationship Styles And Their Intended Primary Care and Non-Primary Care Postgraduate Specialty Preferences

Objective: To compare the predominant relationship/attachment styles of final year female medical students of a Pakistani medical college with their intended primary care and non-primary care post-graduate speciality preferences.&#x0D; Study Design: Cross-sectional comparative study.&#x0D; Place and Duration of Study: Sir Syed College of Medical Sciences for Girls, Karachi, from Feb to Apr 2019.&#x0D; Methodology: Final year MBBS students were included in the study. Students were asked to complete a validated relationship scales questionnaire to determine the dominant relationship/attachment style. Students were also asked to identify their intended first choice for post-graduate specialization from a list of 28 primary care and non-primary care post-graduate specialities.&#x0D; Results: Out of 113 female students, 48 (43%) were found to have a predominantly dismissing relationship style (among four variants of relationship styles). Out of 95 (84%) students opted for a non-primary care speciality for pursuing post-graduation, out of which 37 (33%) students chose Obstetrics and Gynaecology. Comparison of participant’s relationship styles with postgraduate speciality showed no significant difference (p-value=0.40).&#x0D; Conclusion: Medical students should be provided adequate and timely exposure to various specialities available for postgraduation (primary and non-primary care specialities) and should be guided appropriately to help them make informed career choices.

Keep up with progress-Ultrasound education requires change.

Despite increasing use of ultrasound imaging even beyond the circle of radiologists, low priority is given to student training. Until today, integration of ultrasound into clinical education at medical schools still lags far behind, and a curricular structure is oftentimes missing or implemented half-heartedly on a voluntary basis. Main reasons for not having ultrasound integrated are lack of time and poor funding. Finally, residents feel inadequately prepared for daily professional practice. For patient safety and satisfaction, however, it is highly desirable that ultrasound becomes second nature to the next generations of physicians, as the stethoscope already is.1 At our university hospital, we recently developed and implemented a multidisciplinary curriculum that integrates ultrasound as a compulsory part into medical education directly from start to finish. The curriculum follows a spiral course with four levels of training in which learning activities are repeated with continuously growing complexity. Competency-centred “probe-in-the-hand” courses are held in small groups of maximum six learners. Students start to practice ultrasonography by scanning each other, attending training in skills labs and, finally, deepen experience in clinical settings. Students should prepare self-determinedly for courses using learning videos available on the university's in-house network and on publicly available e-learning platforms. On the first training level, during preclinical education, ultrasonography is closely linked to anatomy dissection- and physiology courses. With this vertical integration, basic sciences are put into context and vice versa, clinical aspects are introduced into early medical training. At the same time, specific psychomotor skills are introduced. On the second level, in the third year of medical education, students apply point-of-care ultrasound in peers, skills lab simulations and ultrasound phantoms. The skills lab will be available during semester breaks to provide the opportunity to practice outside scheduled courses. On the third level, during advanced clinical education, students select a compulsory elective ultrasound course in a specialty of their choice, held at five consecutive dates following the concept of work-based learning. This allows students to direct their own learning and to focus on their preferred specialty. From then on, they conduct ultrasound examinations in patients. During the final year, students successively adapt skills and knowledge to growing medical experience. Now they are expected to use ultrasound with a large degree of independence and confidence. Entrustable professional activities are specified and assessed concomitantly. The longitudinal curriculum might serve as an inspiring example, however, with built-in flexibility according to requirements of each medical school and changing conditions. Incidental effects including enhancement of self-determined learning and mutual benefits regarding learning success in involved disciplines are expected. Costs and time can be saved by e-learning and appointment of student tutors. As participating departments share benefits arising from integration of ultrasound, they may contribute to the costs proportionally. In the interest of both patients and students, with an eye to the future, medical schools are encouraged to remove initial obstacles and tackle full and early integration of ultrasound into their curricula.

COMLEX-USA and USMLE for Osteopathic Medical Students: Should We Duplicate, Divide, or Unify?

COMLEX-USA and USMLE for Osteopathic Medical Students: Should We Duplicate, Divide, or Unify?