1.Heterogeneity in studies of p16 in cervical lesions in different Malaysian institutions: Time to consider collaborative study
The Malaysian Journal of Pathology 2018;40(3):319-323
Introduction: Clinical decision making becomes difficult when clinical and methodological heterogeneity does not permit synthesis of results of multiple small studies. Aim: For studies done in Malaysia, to identity the sample sizes and heterogeneity present in the various studies which used p16 in evaluating lesions of the cervix. To evaluate if it would be possible for a single study to answer the various questions posed by the original authors. To highlight areas where the design features of future studies can be optimised. Materials and Methods: Various databases were searched using synonyms for p16 AND cervix AND Malaysia. These were assessed for broad conformity to a Diagnostic Test Accuracy format. Methodological and clinical heterogeneity indicators were extracted into standardised fields. Results: There were 5 studies eligible for inclusion. Each sought to study different aspects of the disease such as diagnostic grade stratification and pathogenesis. The study type broadly conformed to a Diagnostic Test Accuracy format. The study design used was either consecutive or non-consecutive. Sample size ranged from 75 to 201. Clinical heterogeneity was present in the choice of controls with some using normal and some using inflamed tissue. Methodological heterogeneity in applying the reference test, index test and different antibody clones were present. Conclusion: There was both clinical and methodological heterogeneity making synthesis of studies difficult. It is possible to design a study which would be able to answer all the questions posed by the original authors with internal validity while at the same time increasing sample size.
heterogeneity
2.Alternate careers for medical graduates and house officers in Malaysia
Amaramalar Selvi Naicker ; Vinoshini Devi A/P Kailaivasan ; Brenda Saria Yuliawiratman ; Arvindran Alaga ; Kevin Ng Wei Shan ; Manimalar Selvi Naicker ; Ohnmar Htwe
The Medical Journal of Malaysia 2021;76(2):183-189
Introduction: In recent years, many unresolved issues
pertaining to house officers in Malaysia have led to a longer
waiting time and a ‘glut’ of medical graduates with a
surprising 20% dropout amongst those who join the
housemanship programme. This appears to reflect the
changing times, mindsets and work expectations of
millennials who comprise this cohort reflecting a need to
consider possibilities of career shifts especially so in these
uncertain times. This study explores the perceptions,
awareness and interest in alternative career options
amongst recent graduates and house officers.
Materials and Methods: This was a study done between 2018
and 2019 using a questionnaire which was shared on
various social platforms. Data analysis was done using
Excel spreadsheet.
Results: A total of 450 house officers and 657 medical
graduates responded. Expectedly 66.8% claimed lifelong
passion whilst another 12.1% claimed family influence as
their reason to do medicine. Most were aware of their career
challenges and 40% of them were keen to consider career
change and reskilling indicating a possible shift from
traditional expectations of a medical career.
Conclusion: Whilst medicine is often considered a true
calling, current challenges will require mental and emotional
flexibility to explore other career opportunities. Thus,
engagement programmes should be directed at medical
graduates and house officers to identify and support those
open to career transitions. This will help address current
issues of internship bottleneck and rising dropout rates
amongst internees. Early career change engagements will
give them insight into their true career goals whilst opening
up opportunities for those who wish to change.