Young Physicians Research Articles

Coping strategies, resilience and quality of life: reaction to the COVID-19 pandemic among Romanian physicians

BackgroundThe COVID-19 pandemic has presented multiple psychological challenges for healthcare workers, such as anxiety, depression, burnout, and substance use disorders. In this research, we investigate the different ways Romanian physicians dealt with the difficult period of the COVID-19 pandemic. We also analyze how positive and negative stress-reducing strategies, as well as demographic variables, affect their psychological resilience and quality of life. Our goal is to provide a comprehensive overview of how physicians coped with the unprecedented global health challenges.MethodsWe carried out a national cross-sectional study of 265 physicians in Romania between January 2021 and January 2022 using a web-based questionnaire. The study employed a web-based questionnaire to assess coping mechanisms using the COPE inventory, resilience through the Connor-Davidson Resilience Scale 25 (CD-RISC 25), and quality of life via the WHOQOL-BREF scale. The COPE inventory, consisting of 60 items across 15 subscales, categorizes coping strategies into problem-focused, emotion-focused, and dysfunctional types, with each item rated on a 4-point scale. The CD-RISC 25 measures resilience on a 5-point Likert scale, with total scores ranging from 0 to 100. WHOQOL-BREF assesses quality of life through 26 items in 4 domains: physical, mental, social relations, and environmental, scored from 1 to 5 and converted to a 0–100 scale for domain scores. Univariate and multivariate linear regression models were employed to discern the intricate relationships between coping strategies, resilience levels, quality of life dimensions, and pertinent demographic factors.ResultsThe average CD-RISC score among participants was 66.2. The mean scores for the values for the QOL subscales were 64.0 for physical well-being, 61.7 for psychological well-being, 61.2 for social relationships, and 64.7 for environment. Individuals tend to use problem-focused and emotion-focused coping more than dysfunctional mechanisms, according to the COPE inventory. Problem-focused and emotion-focused coping are positively correlated with resilience, while dysfunctional coping is negatively correlated. Resilience is significantly influenced by gender and professional status, with males and senior specialists reporting higher levels while younger physicians and residents reporting lower levels.ConclusionsOur data points to specific protective characteristics and some detrimental factors on physicians' resilience and quality of life during the pandemic.

Sexual Harassment Among Chinese Psychiatrists and Its Impact on Quality of Life: A Cross-Sectional Survey.

Sexual harassment (SH) is a prevalent issue in various professional fields worldwide. The current study aims to investigate the incidence of SH targeting psychiatrists in China and explore its impact on quality of life (QOL). A consecutive recruitment of 1093 psychiatrists was conducted from 6 hospitals in China. The recorded data included participants' socio-demographic characteristics, experiences of workplace SH within the previous year, and their QOL. SH comprised verbal harassment, physical harassment, and displaying of sexual organs. The Chinese version of the World Health Organization Quality of Life Brief Version (WHOQOL-BREF) was employed to assess QOL. We compared the demographic characteristics and QOL between the SH group and the non-SH group. Multiple logistic regression analysis was used to identify independent demographic correlates of SH. In total, 13.8% (n = 151) of the psychiatrists reported SH, with 5.8% reporting it once, 4.4% reporting it twice, and 3.6% reporting it three times or more. Psychiatrists who had encountered SH exhibited lower QOL across social, psychological, physical, and environmental domains. Multiple logistic regression analysis revealed that young physicians and those with shorter work experience had a higher likelihood of experiencing SH. The high prevalence of SH among Chinese psychiatrists is of concern. Given its detrimental effects on the well-being of physicians and the quality of medical care they provide, it is crucial to develop specialized employee training programs for this population to effectively manage workplace SH.

“Vidyarthimitra” Vaidya Madhav Vasudev Kolhatkar: A mentor who has empowered generations of physicians

Abstract In medical education, the influence of exceptional teachers reverberates across generations, shaping the knowledge, skills, and values of countless physicians. This article focuses on the life and contributions of Vaidya Madhav Vasudev Kolhatkar, whose impact extends far beyond the confines of academics and profoundly influences the practice of Ayurveda and the lives of those he has guided. In his abbreviated life span of 53 years, he left an enduring legacy that continues to shape and inspire the practice of Ayurveda in Maharashtra. He was instrumental in ushering in a transition from allopathic, integrative methodologies to a purist, principle-based approach in the clinical practice of Ayurveda physicians in Maharashtra. He was distinguished for his remarkable achievements as a successful academician for almost 25 years and a lifetime clinician, instilling the much-needed confidence in young physicians to establish genuine clinical practice of Ayurveda. The researcher in Vaidya Madhav Vasudev Kolhatkar is epitomized by the influential work “Ayurvediya Triskandha Kosha,” completed by his students after his accidental death. He was honored with the “Pride of Maharashtra Award” in 2010. He was “Vidyarthimitra” (a friend of students) in the true sense that hundreds of his students continue to perpetuate his enduring legacy, embodying the core of his teachings with remarkable dedication and excellence.

Misconception between palliative care and euthanasia among Thai general practitioners: a cross-sectional study

BackgroundPalliative care lower medical expenses and enhances quality of life, but misconception with euthanasia delays timely care and makes inappropriate patient management.ObjectiveTo examine the magnitude of misconceptions between palliative care and euthanasia among Thai general practitioners, explore the association with knowledge, attitudes, and practical experience, and assess the association between misconception and confidence in practicing and referring patients to palliative care centers.MethodsAll 144 general practitioners who were going to start residency training at Maharaj Nakorn Chiang Mai Hospital in 2021 participated in this observational cross-sectional study. A chi-square test was utilized to examine the relationship between misconception and knowledge, attitude, practical experience, confidence to practice, and confidence to refer patients. Multivariable logistic regression was carried out while controlling for age, sex, knowledge, attitude, and experience to examine the relationship between misconception and confidence to practice and refer patients for palliative care. Statistical significance was defined at p < 0.05.ResultsAbout 41% of general physicians had misconceptions regarding palliative care and euthanasia. High knowledge was associated with a lower level of misconception (p = 0.01). The absence of misconceptions was weakly associated with a higher level of confidence in practicing palliative care, with an adjusted odds ratio of 1.51 (95% confidence interval 0.73 to 3.10, p = 0.07).ConclusionHigh misconception rates between palliative care and euthanasia among young Thai physicians might impact their confidence in delivering palliative care. Training initiatives for medical students and practitioners can mitigate misconceptions, fostering better palliative care utilization in Thailand.

How to Overcome the Barriers Behind Writing Case Reports for Beginners and Young General Physicians.

Case reports are fundamental to clinical medicine that trace back to ancient Egypt preceding Hippocrates in the history of medicine. Case reports contribute to academic development and new clinical research. However, among cases presented at an annual academic conference for Japanese generalists, only a few cases were later published in peer-reviewed journals, highlighting potential barriers regarding the writing of case reports, such as mentorship absence. This paper aimed to offer guidance and strategies to novice and young general physicians in overcoming barriers and effectively composing case reports for international peer-reviewed journals. This paper focuses on case reports for general physicians with extensive experience in writing case reports for international peer-reviewed journals. We conducted a narrative review to help beginners and young general physicians in writing case reports and discussed strategies for overcoming these barriers. We propose the following three tips as important processes for writing case reports: recognize the types of suitable cases for case reports; select a journal for submission using a list of candidate journals for general physicians; and organize the discussion section with one theme per paragraph. In addition, we provide a list of journals that specifically focus on case reports, along with important pointers for beginners and young general physicians that will assist authors in the field of general medicine in choosing appropriate journals for submission. We hope that understanding and applying these tips will aid beginners and young general physicians in writing case reports.

Qualityof life in the digital age: young adult hematopoietic stem cell transplantation patients and healthcare providers' views of telehealth.

The COVID-19 pandemic shifted the healthcare field from in-person clinic visits to virtual-based telehealth appointments. This study explored young adult (YA) hematopoietic stem cell transplantation (HSCT) patient and physician communication preferences and quality of life. One researcher conducted semi-structured interviews with n = 10 YA HSCT patients and n = 10 healthcare providers (HPs). HPs included physicians (n = 5) and advanced practice provider (APP) (nurse practitioners and physician assistants) (n = 5). Interviews lasted approximately 10-15min, were held over Zoom®, and were audio-recorded. Interviews were professionally transcribed verbatim, and two independent researchers conducted a thematic analysis using Dedoose®. Common themes included the following: (1) convenience, (2) improved communication, (3) technology issues, and (4) quality of life for patients and physicians. In general, most patients (n = 7; 70%) preferred in-person visits over telehealth for initial appointments, stating they chose the "social connection" and "engagement" associated with in-person visits. For "check-ins" and follow-up appointments (n = 5; 50%), patients preferred hybrid appointments. Physicians (n = 4; 80%) preferred telehealth stating it was "convenient," "timesaving," and improved "compliance." In contrast, all APP staff (n = 5; 100%) preferred in-person visits, stating in-person improved "relationships" with patients and was more "convenient" than using electronic devices for telehealth. Providers differed in preference. APP personnel preferred in-person visits and HSCT physicians preferred telehealth appointments. YA HSCT patients preferred in-person for initial appointments and hybrid clinic visits for follow-up appointments.

Parent being a physician: Any influence upon job stress in young physicians

Purpose: The purpose of this research is to inspect the whether being the child of a physician would be of importance for how young physicians experience job stress. Methodology: The data collected from the public Hospital in Lahore are used to test the relationship among turnover intention and job satisfaction, work stress and work-family conflict. The data collected in this study was analyzed by using SPSS. Findings: The results from this study shows Female physicians with a physician parent reported higher levels of job stress over the whole period compared with males with a physician parent. This gender difference did not occur within the group without a physician parent. Male young physicians showed a trend (not quite significant) to be less stressed than their peers without a physician parent. Women physicians were overrepresented in a group with persisting high stress level over the period.

Exploring yarigai: The meaning of working as a physician in teaching medical professionalism

Introduction The shift in medical professionalism now considers the well-being of physicians, given the prevalence of burnout and the importance of work-life balance. To reconsider the question ‘Why do doctors work for the patient?’ and explore the meaning of working as a physician, this study adopts the concept of ‘yarigai,’ which represents fulfillment and motivation in meaningful work. The authors’ research questions are: How do doctors recount experiences of yarigai in caring for patients? What kind of values are embodied in their stories about yarigai? Method They adopted narrative inquiry as the methodology for this study. They interviewed 15 doctors who were recognized by their colleagues for their commitment to patient-centered care or had demonstrated yarigai in caring for patients. The semi-structured interviews were conducted face-to-face with each participant by the Japanese researchers, yielding 51 cases of patient-doctor interactions. After grouping the interview data, they translated the cases into English and identified four representative cases to present based on the set criteria. Results From the 51 case studies, they constructed four representative narratives about the yarigai as a physician. Each of them spoke of (1) finding positive meaning in difficult situations, (2) receiving gifts embodying ikigai, (3) witnessing strength in a seemingly powerless human being, and (4) cultivating relationships that transcend temporal boundaries, as being rewarding in working as a physician. The main results of the study, which are the narratives, are described in the main body of the paper. Conclusion The stories on yarigai gave intrinsic meanings to their occupational lives, which can be informative for students, residents, and young physicians when contemplating the meaning of their work as doctors. Rather than demanding selfless dedication from physicians towards patients, they believe it more important to foster yarigai, derived from the contribution to the well-being of others through patient care.

The efficacy of pediatric elbow radiographic guidance in diagnosis of lateral humeral condyle fracture.

Although lateral humeral condyle fracture is common, the incidence of missed diagnosis is very high. Delayed and missed diagnosis led to significant morbidities and loss of functions. We designed a pediatric elbow radiographic guidance aiming to improve the accuracy of diagnosis. This study was aimed to evaluate the efficacy of the radiographic guidance for the diagnosis of lateral condyle fracture. A cross-sectional study was conducted after defining the essential parameters as a guidance for assessing the pediatric elbow radiographs. We included medical students, emergency medicine, orthopedic, and radiology residents and fellows into this study. A questionnaire was used to evaluate the efficacy of the guidance. All participants underwent a pretest evaluation, followed by studying the guidance, and then finished a posttest evaluation. Baseline characteristics, diagnostic scores, and parameter evaluation scores were collected. The pretest and posttest scores were analyzed using paired t-test. Association between baseline characteristics and diagnostic scores were analyzed using multiple regression analysis. We included 177 participants. Average diagnostic score was significantly increased after using the guidance, from 12.2 ± 1.9 to 13.0 ± 1.7 (p < 0.0001). Medical students showed the most improvement, from 11.9 ± 1.9 to 13.1 ± 1.3 (p <0.001). All means of essential parameter evaluation scores were significantly improved in overall participants.The pediatric elbow radiographic guidance is useful for evaluation and diagnosis of lateral condyle fracture, especially for young physicians and trainees. Therefore, this should be recommended in routine medical education and general practice.

Application of sentiment and word frequency analysis of physician review sites to evaluate refractive surgery care

BackgroundOnline physician reviews increase transparency in health care, helping patients make informed decisions about their provider. Language processing techniques can quantify this data and allow providers to better understand patients' experiences, perspectives, and priorities. The objective of this study was to assess patient satisfaction and understand the aspects of care that are valued by patients seeking refractive care using sentiment and word frequency analysis. MethodsWritten reviews and Star ratings for members of the Refractive Surgery Alliance Society practicing in the United States were collected from Healthgrades, a popular physician rating website. Surgeons with at least one written review were included in the study. Reviews were scored from -1 (most negative) to +1 (most positive) using Valence Aware Dictionary sEntiment Reasoner (VADER). Reviews were stratified by demographic characteristics, namely gender, region, and years in practice. Word frequency analysis was applied to find the most common words and phrases. ResultsA total of 254 specialists and 3104 reviews were analyzed, with an average of 4.4/5 stars and mean 48 ratings each. Most physicians had positive reviews (96%, average VADER ​= ​0.69). Younger physicians (<20 years since residency) had significantly higher Stars rating than senior peers (>20 years) (P ​< ​0.001). A similar trend was observed in VADER score (0.71 vs 0.69), although not statistically significant (P ​= ​0.06). No statistical differences were observed between Stars rating and VADER score by gender (P ​= ​0.66, P ​= ​0.83) or by geographical region (P ​= ​0.74, P ​= ​0.07). "Staff" (n ​= ​1269), "professional" (n ​= ​631), "office" (n ​= ​523), "questions" (n ​= ​424), and "friendly" (n ​= ​386) were frequently used in reviews, along with phrases such as "the staff" (n ​= ​273) and "my questions" (n ​= ​174). "Surgery" (n ​= ​719), "staff" (n ​= ​576), "procedure" (n ​= ​251), "experience" (n ​= ​243), and "professional" (n ​= ​240) were the most common words in positive reviews, while "surgery" (n ​= ​147), "office" (n ​= ​86), "staff" (n ​= ​54), "time" (n ​= ​47), and "insurance" (n ​= ​28) were the most commonly used in negative reviews. ConclusionsBoth the average Stars and VADER sentiment score suggest a high satisfaction among refractive patients. Word frequency analysis revealed that patients value non-clinical aspects of care, including interactions with staff, insurance coverage, and wait-times, suggesting that improving non-clinical factors could enhance patient satisfaction with refractive surgery.

Sleep disorders, stress coping strategies and neurobehavioral aspects: an outlook on the impact of covid‑19 in first‑year resident physicians.

The COVID-19 pandemic had a profound impact on the physical and mental health of healthcare professionals. The present study explored the relationship between sleep disorders, stress, coping strategies and neurobehavioral aspects among young physicians during the second wave of the COVID-19 pandemic. Through a multi-assessment approach, this cross-sectional study collected sociodemographic and occupational data from first-year resident doctors in southern Italy. Subjective sleep quality, chronotype, work-related stress, coping approach and mood state were assessed by administering validated questionnaires during face-to-face interviews. Among the 258 resident physicians enrolled in the study, ~25% complained of poor sleep quality, mainly male subjects [odds ratio (OR), 2.52]. Alcohol consumption resulted as a risk factor for poor sleep quality (OR, 1.97). None of the participants reported work-related stress showing, on the contrary, a high score for the vigor factor in the profile of mood state, in particular in subjects with previous working experience with COVID patients and prevention (P<0.040 and P<0.035, respectively). Women were more likely to adopt coping strategies that involved the search for social support, confirming their tendency to manage stressful situations through emotion-focused mechanisms. The set of these results represents a sight on the attitude of young physicians in their approach to facing the COVID-19 pandemic, in its second wave. The pandemic has turned the spotlight on the importance of prevention and early diagnosis of physical health and mental well-being. Further studies are performed to monitor long-term consequences on health status.

In-Hospital Arrangements for Preoperative Simulation

Neurosurgeons of the future must possess the ability to engage in preoperative simulation. However, given the changing medical practices and redistribution of tasks among physicians, the significance of radiological technologists is increasing. In this article, we describe the collaboration between radiological technologists and the hospital system to simplify preoperative simulation for young physicians. Preparation for preoperative simulation is a collaborative process with radiological technologists, aiming to facilitate mutual learning and risk management. It involves recognizing and utilizing the expertise of certified radiological technologists for imaging and additional surgical support, with due consideration given to the additional fees. The creation of an in-hospital arrangement system for preoperative simulation ensures more efficient and safer workflow.

Prevalence, knowledge, and concerns regarding the use of heated tobacco products and electronic cigarettes among young Japanese physicians.

Heated tobacco products (HTPs) and e-cigarettes (ECs) have gained traction as alternatives for harm reduction, especially in Japan. In particular, the use of HTPs is rapidly gaining popularity among young adults in Japan, with a prevalence of 10.9% in 2020. Despite uncertainties regarding the health effects of HTPs and ECs, concerns regarding nicotine and carcinogens persist. Although physicians play a vital role in smoking cessation, they lack awareness and concerns regarding HTPs. This study aimed to assess the prevalence, knowledge, and concerns regarding HTPs and ECs among young Japanese physicians. A cross-sectional online survey was conducted in 2021 with 529 young Japanese physicians aged 24-39 years. Parameters assessed included awareness, smoking status, knowledge of HTPs and ECs, and concerns related to HTPs. Statistical analyses were conducted to assess prevalence, knowledge, and concerns by smoking status using the chi-squared test and logistic regression. Most participants were aware of HTPs (89.0%) and ECs (71.3%). Young male physicians preferred HTPs, while females favored ECs. Primary sources of information included newspapers and stories (56.8%), and TV (37.4%). Non-smokers (89.0%) demonstrated limited knowledge of these products. Concerns were highest and lowest among non-smokers and HTP users, respectively, with safety concerns being the most prevalent. Young physicians exhibited lower smoking rates than the general population, but HTP use was prominent among young male physicians. Concerns varied based on smoking status, indicating the need to address these issues among healthcare professionals. Despite high awareness, knowledge gaps, particularly among non-smokers, highlight the importance of public health and educational campaigns to disseminate knowledge among physicians, regardless of medical specialty.

(307) Prevalence of Sexual Dysfunction and Pursuit of Sexual Medicine Evaluation Among Male Physicians

Abstract Introduction While the epidemiology of male sexual dysfunction in the general population is well studied, little is known regarding the prevalence of sexual dysfunction in male physicians and their likelihood of seeking treatment. Objective To characterize the prevalence of sexual dysfunction, evaluation patterns, and barriers to treatment among male physicians. Methods Between June 2022 and October 2022, male physicians were invited to complete a questionnaire regarding sexual function. Surveys were disseminated electronically via social media and professional medical societies using Qualtrics (Provo, UT). Results 235 responses were included in the final analysis. The mean age of respondents was 36.3 ± 7.4 years. 27 (11.5%) reported having seen a doctor for sexual health. Of these 27,11 (40.7%) saw a physician for erectile dysfunction, 8 (29.6%) for low libido, 6 (22.2%) for premature ejaculation, 2 (7.4%) for delayed ejaculation, and 9 (33.3%) for some other concern. An additional 29 (13.9%) respondents considered establishing care for sexual issues but didn’t, mostly due to being too busy (N=18, 62.1%). Of the 56 respondents who had either seen or thought about seeing a physician for sexual health issues, the mean IIEF score was 24.4 ± 8.7 with 18 (32.1%) qualifying as having at least mild ED and 7 (12.5%) having severe ED (Table 2). 46 (19.6%) respondents reported having taken medication to improve erectile function. Only 12 (5.1%) respondents reported having ever been diagnosed with low testosterone. Among the 56 respondents who had either seen or thought about seeing a physician for sexual health issues, those who worked more hours (&amp;gt;60 hours per week) were least likely to see a physician (7.2%) compared to those working the fewest hours (33.3%), p=0.02. Conclusions In a cohort of young male physicians, 25.4% had seen or considered seeing a doctor for sexual health concerns, and nearly 1 in 5 had taken medication for erectile dysfunction. Given the highly demanding work schedules, occupational stress, and a variety of other factors associated the medical profession, male physicians appear to be at higher risk for sexual dysfunction than the general population. Moreover, male physicians face significant and unique barriers in access to care for sexual dysfunction. Disclosure No.

(306) Physician Infertility: A Growing Problem

Abstract Introduction Physician infertility has become a growing concern, documented by the high rates of infertility physicians experience as a result of their strenuous work schedules, environmental exposures, and delayed childbirth due to their extensive years of training. The implications in fertility extend beyond an individual's desire to have children, as it can impact their physical, emotional, and social well-being; furthermore, the inability to conceive can cause significant emotional distress, resulting in depression, anxiety, and a decrease in overall quality of life. Assisted reproductive technologies (ART) are a viable, although imperfect, option for both male and female physicians who have had to postpone starting a family due to career-related concerns. We seek to explore the magnitude of this problem, including the pros and cons of assisted reproduction techniques in aiding physicians’ family planning. Objective To understand and document the complex issue of the prevalence of physician infertility, as well as current barriers and proposed solutions from an in-depth organized literature review. Methods We compiled and synthesized available data to better understand the role of infertility in physician family planning using 49 articles regarding various aspects of the current state of physician infertility. We included specific analyses for surgeons and comparisons of both male and female physicians. Further, we assessed the existing barriers to correcting this issue as well as prominent proposed solutions for alleviating this complex phenomenon. Results Infertility has been documented to affect 24.1-32.0% of physicians in studies surveying 3153 physicians across various specialties, starkly contrasting with the national rate of infertility of 13.4%. Compared to physicians in non-surgical specialties, surgeons tend to have fewer children, be older at first pregnancy, work longer hours, experience more pregnancy complications, and have more preterm births. The data further reveals even greater disparities in examining just female surgeons, showing how gender plays a role in this problem. Physicians both seek the help of ART (18%-28% vs 5.2-12% in non-physician populations) and conceive through ART (8%-13% vs 1.7%) at higher rates than the general population. Given these threatening realities of infertility for physicians, we have compiled corrective suggestions in the literature, including executing changes to residency programs regarding insurance coverage and work flexibility, implementing longitudinal family planning educational initiatives geared toward trainees, and a need for greater support for family planning. Conclusions Physicians' reproductive health is crucial to their well-being, and policy and advocacy should address their specific infertility risks and management. While ART advances offer opportunities for infertility treatment, their high costs and arduous processes make them challenging for physicians to use. There's a need for more education, research, and support to allow young physicians to freely choose a medical career without overwhelming concerns about future family growth. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Larry Lipshultz: AbbVie (Consultant), American Medical Systems/Boston Scientific (Speaker), Augmenta LLC (Stockholder), Aytu BioScience (Consultant), Contraline, Inc. (Consultant), Endo Pharmaceuticals (Consultant/Speaker), Inherent Biosciences (Advisor), Lipocine (Consultant).

How Do We Establish the Utility and Evidence of General Medicine in Japan?

Hospital Medicine in the United States has achieved significant progress in the accumulation of evidence. This development has influenced the increasing societal demand for General Medicine in Japan. Generalists in Japan actively engage in a wide range of interdisciplinary clinical practices, education, and management. Furthermore, Generalists have also contributed to advances in research. However, there is limited evidence regarding the benefits of General Medicine in Japan in all these areas, with most of the evidence derived from single-center studies. In Japan, the roles of Generalists are diverse, and the comprehensive definition of General Medicine makes it difficult to clearly delineate its scope. This results in an inadequate accumulation of evidence regarding the benefits of General Medicine, potentially making it less attractive to the public and younger physicians. Therefore, it is necessary to categorize General Medicine and collect clear evidence regarding its benefits.

Factors affecting young doctors' choice of medical specialty-A qualitative study.

Young doctors' choice of medical specialty is essential to maintaining a sufficient health workforce and developing a sustainable healthcare system. The choice of specialization is the result of numerous factors, including doctors' preferences, population needs, and the number of available residency slots. The aim of this article is to explore the factors taken into consideration by young Polish physicians in choosing their future specialty. We have conducted 30 structured interviews with randomly selected recent medical school graduates (17 female and 13 male). The study was conducted from December 2022 until February 2023 using online platforms. Data from in-depth interviews were coded using NVivo Release 1.6.1. Then thematic analysis was performed. Respondents indicated remuneration and career-associated factors as the main determinants, emphasizing that work-life balance, personal motivations, and the flexibility to choose the type of workplace (hospital vs. outpatient clinic) were even more important. Young doctors expect flexibility in working hours and better working conditions in future work, and these factors are important when choosing a medical specialty. Significant difficulties during the selection of medical specialty include limited residency slots in preferred specializations and lack of knowledge concerning the everyday aspects of work in a particular specialty. Factors and limitations influencing the choice of medical specialty should be taken into account by policymakers to address the shortages of doctors in deficit specialties. Knowledge about doctors' preferences regarding their medical specialty could support the development of targeted policies to increase the attractiveness of deficit specialties and reduce the uneven distribution of medical staff.

RETHINKING UKRAINIAN MEDICAL TRAINING: STRATEGIES FOR MEDICAL EDUCATION AND SYSTEM IMPROVEMENT

This article delves into the current state and future prospects of Ukraine's healthcare system. It critically examines the strategic framework laid out in the “Strategy for the Development of the Healthcare System until 2030”. A pivotal aspect of the article is its analysis of the burden of cardiovascular diseases (CVDs) in Ukraine compared to the European Union. It highlights that the prevalence and impact of CVDs in Ukraine. &#x0D; The article underscores the necessity for comprehensive knowledge among medical professionals, especially in the context of the rising burden of cardiovascular diseases. It points out the inadequacies in the current medical education and training system in Ukraine in imparting this comprehensive knowledge. Drawing a comparison with the Chinese medical internship system, the article suggests that adopting a similar approach could significantly benefit Ukraine’s medical education system.&#x0D; In its conclusion, the authors emphasize the need to integrate foreign policies in training young physicians to build a more effective healthcare system.

A survey on the utilization of internet services to collect job information among medical students and initiation of video public relations activities for the recruitment of public health physicians based on the survey results

Objectives It is difficult for medical students to obtain information about public health physicians because there are very few public health physicians near them. To improve this situation, we surveyed the utilization of internet services to collect job information among medical students and produced six videos and conducted public relations activities for the recruitment of public health physicians based on the survey results.Methods The subjects of the survey were medical students in their third year or above from 18 universities. Public health teachers in these 18 universities sent their students anonymous self-administered questionnaires created with Google Forms mainly by e-mail. The questionnaires included the following items "internet services used to collect job information," "desired length of each video for knowing job information," and "information you want to know about your future work." The responses were reflected in the length and the content of the videos and the settings for their distribution.Results Responses were obtained from a total of 491 medical students, including 14 third-year students, 177 fifth-year students, and 300 sixth-year students. Homepages were the most frequently used online source for collecting job information (94.7%), followed by blogs (42.0%), Twitter (32.6%), and YouTube (18.9%). Medical students are less likely to use social networking services for collecting job information compared with non-medical job-hunting students. Regarding the length of the videos, 55.8% of the respondents preferred the length of one video to be less than 5 minutes, and 95.1% preferred it to be less than 10 minutes. Almost all of the respondents (93.1%) wanted to know the atmosphere of young public health physicians, and 74.1% also wanted to know the atmosphere of veteran physicians. Based on these results, we selected six public health physicians including young and veteran physicians and produced interview videos that conveyed the atmosphere of each doctor within 5 minutes per person. We refurbished the banner on the top page of the Japanese Association of Public Health Center Directors so that the videos uploaded to YouTube could be watched.Conclusion We clarified the current situation of the utilization of internet services for job-hunting activities among medical students and were able to initiate video public relations activities for the recruitment of public health physicians in accordance with the needs. It is necessary to increase awareness of the video platform among medical students and clinicians by deepening cooperation with local governments, universities, and medical institutions and expanding the human network both online and in person.

A report from Lybia of a young Italian emergency physician. What I learned and what I was forgetting

Dear Editor, Every emergency medicine resident enjoys facing new clinical cases, learning new invasive procedures, and acting like a detective when it comes to mysterious illnesses. Simulations are essential to train non-technical skills during university education, even though someone could believe that they are a waste of time.1,2 Although all these technical skills are essential to our training, our work goes beyond that. Sometimes we believe that we are superheroes, as we were called during the COVID-19 pandemic. The truth is that we learn every day from the patients and their stories because we treat sick people and not their diseases.3,4 The ability to communicate correctly with patients, relatives, and caregivers is mandatory for all emergency physicians, both resident and senior, and needs to be taught and learned.5,6 If we add the cultural background and the chance to work outside Western countries, then we can learn to work for the patient and not on the patient. [...]