Background: Medical education has undergone significant changes over the past few decades, with a focus on studentcentered learning, problem-based learning, competency-based learning, and outcome-based education. Among these, internal medicine diagnostics plays a crucial role in preparing students for clinical practice. However, there is limited research on the factors influencing student satisfaction in this course. Studies by Harden et al. (1999) and Irby et al. (2010) have emphasized the importance of continuous evaluation and effective teaching methods in medical education. This study aims to assess student satisfaction with the internal medicine diagnostics course within the “Physician” program at the Mongolian National University of Medical Sciences (MNUMS), aligning with these global trends. Aim: The primary objective of this study is to evaluate student satisfaction with the internal medicine diagnostics course in the Physician program. Specific objectives include: Assessing satisfaction with the diagnostics course in the 2nd year of the basic medical education program, evaluating satisfaction with the internal medicine diagnostics course in the 3rd year, exploring the relationship between these two courses. Materials and Methods: This analytical study was conducted from June 2023 to June 2024, involving 1,167 students enrolled in the “Physician” program at MNUMS. Data were collected using a 34-item questionnaire, including:Demographic information (5 questions),General satisfaction (17 questions),Internal medicine diagnostics-specific satisfaction (12 questions). Satisfaction was measured using a 5-point Likert scale (1=strongly disagree, 5=strongly agree). Data were analyzed using SPSS Statistics 26, employing descriptive statistics, ANOVA, T-tests, and regression analysis. Effect sizes were calculated using Cohen’s d and Partial Eta Squared (η²), with statistical significance set at p<0.05. Results: Overall satisfaction: The average satisfaction score was 3.98±0.73. 2nd-year diagnostics course: Highest satisfaction (4.07±0.90), particularly with “course content” (4.07±0.90). 3rd-year internal medicine diagnostics course: Lowest satisfaction (3.97±0.78), especially with “learning environment” (3.90±0.90). Gender and Year Differences: No significant gender-based differences (p>0.05). Satisfaction with the internal medicine diagnostics course decreased as students progressed to higher years (B=-0.172, p=0.016). Course Relationship: A strong positive correlation was found between the two courses (r=0.818, p<0.001), but the effect size was minimal (η²=0.008). Conclusion The above-average student satisfaction reflects the quality of the curriculum content and the effectiveness of teaching methodologies. The decline in satisfaction with internal medicine courses as students progress may be due to course difficulty and resource limitations. The weak correlation between the two subjects suggests the need for further development of integrated learning.

Background: Thyroid hormone disorders have an adverse effect on human spermatogenesis. Thyroid function has regulated by hypothalamic-pituitary-thyroid axis and thyroid stimulation hormone is a critical measurement of thyroid disorders. This study aimed to investigate the relationship between thyroid stimulating hormone and sperm parameters. Methods: This study has conducted 99 man who have visited RMC and Ojinmed IVF centers. Serum level of thyroid stimulating hormone (TSH) was measured by automated immunoassay analyzer (TOSOH AIA-360, Japan). Semen analysis was done in all the participants and evaluated by World Health Organization’s guidelines(2010). Results were calculated by SPSS 26 program. Results: The average age was 35.2±5.76. The mean serum TSH level was 1.37±0.57 and 1.85±1.16 normal subjects and spermatogenesis dysfunction group, respectively. Furthermore, serum TSH level and sperm parameters were significantly different between two groups (p<0.05). Logistical regression analysis showed that increased TSH level negatively affected the motility (r=-0.28; p<0.05) and progressive motility (r=-0.34;p<0.05) of sperm more than other parameters (r=-0.34; p=0.035). There was no correlation between serum TSH and other sperm parameters. We analyzed binary logistic regression for TSH with spermatogenesis dysfunction in case control groups. According to the analysis, elevation of serum TSH level increases the risk of spermatogenesis dysfunction by 5.0 times (OR=5.06, p<0.05). Conclusions Subclinical hypothyroidism adversely affect some sperm parameters, including motility and progressive motility. Subclinical hypothyroidism increases the risk of spermatogenesis dysfunction.

Background: Modern medical education increasingly integrates Outcome- Based Education (OBE) and Problem-Based Learning (PBL) approaches to improve training quality. The Mongolian National University of Medical Sciences (MNUMS) implemented an OBE curriculum in 2013, creating a need to examine student satisfaction as a measure of program effectiveness. Student satisfaction is recognized as a key indicator of educational quality and is linked to outcomes such as graduate retention and institutional reputation. Aim: To assess the level of student satisfaction in the medical doctor (MD) training program and identify factors influencing it, in order to provide a basis for improving training quality. Materials and Methods: A cross-sectional survey was conducted in 2023– 2024 among 1167 students (third- to sixth-year MD students) at MNUMS. Participants had a mean age of 22.2 ± 1.5 years, and 79.9% were female. A questionnaire with 23 questions (including 16 Likert-scale items on satisfaction) was administered; responses were given on a 5-point Likert scale. Data were analyzed using SPSS version 26. Descriptive statistics, independent t-tests, one-way ANOVA, Pearson correlation analysis, exploratory factor analysis, and multiple linear regression were performed. All statistical tests were twotailed, and significance was set at p<0.05. Results: The satisfaction survey demonstrated high internal consistency (Cronbach’s α = 0.927). Overall satisfaction with the training program was moderately high, with a mean score of 3.51 ± 0.84 out of 5. Fourth-year students reported the highest satisfaction with teaching methods (mean 3.97 ± 0.67), whereas third-year students gave the lowest rating for the sufficiency of learning materials (mean 2.98 ± 1.01); these differences were statistically significant (p<0.001). Additionally, satisfaction with clinical training declined by the final year of study, with a mean rating of 3.16 in the sixth year compared to 3.70 in the third year (p<0.001). No significant difference in overall satisfaction was observed between male and female students (p>0.05). Exploratory factor analysis (KMO = 0.950; Bartlett’s test p<0.001) identified two key underlying factors influencing perceived training quality, which together explained 55.83% of the total variance: (1) “Curriculum organization and teaching methodology,” and (2) “Material resources and learning environment.” Correlation and regression analyses further indicated that better course organization and active teacher engagement were associated with higher student satisfaction (p<0.01). Conclusion The study shows that enhancing teaching methods and improving curriculum coherence are needed to further improve the quality of the MD training program. Additionally, strengthening educational resources and updating instructional approaches are crucial for raising satisfaction levels, particularly for senior (sixth-year) students. These findings provide an evidence- based foundation for curriculum and policy improvements to boost student satisfaction and overall educational outcomes.

BACKGROUND. To evaluate educational environment, it is important to use confidential and accepted tool. Dundee Ready Education Environment Measure (DREEM) (3) is a globally accepted and widely used tool to measure the education environment. Regular assessment of educational environment to evaluate teachers’ teaching method, students’ perception and their outcome and making the necessary adjustment to it is one of the factors affecting students’ knowledge, clinical practice and their motivation (4). In the MNUMS program, educational environmental assessment is one of the most important parts and we are unaware of any report of research work. Therefore, the researchers decide to carry this study. AIM OF THE STUDY. This study aimed to evaluate the educational environment in Nursing school of MNUMS using globally accepted DREEM Questionnaire. MATERIALS AND METHODS. This cross-sectional analytic study was carried out in Faculty of Nursing in Darkhan, Dornogobi and Gobi-Altai aimag out of 9 branch school of MNUMS during the academic year 2015-2016 and 2016-2017. DREEM questionnaire was used to collect data from 306 nursing students. RESULT. Most of the participants were female accounted around 89.9% (275) and male were 10.1% (31). By age, age of 17-19 were 25.5%(78), 20-22 were 52.0% (159), 23-25 were 15.0%(46), >26 were 7.5% (23). The mean item score was highest in Dornogobi school of 3.8 and lowest in Nursing school of 3.6. 4th year students’ 68.6% (210) agreed to “more on positive side” for their academic self perception and 22.5% (69) agreed “moving in right direction” for their academic self perception. All domains were statistically significant specially the perception of curriculum (0.854**) and perception of learning (0.803**) have high correlation. On the other hand, perception of educational atmosphere (0.444**) and perception of teachers have moderate correlation. The reliability of questionnaire was confirmed by Cronbach alpha and it is counted as reliable if it is more than 0.7. The perception of curriculum was relatively low in 2nd year students but higher in 3rd year students. The perception of educational atmosphere was relatively low in 4th year students but higher in 1st year students. CONCLUSION. The nursing school program is in same level. Students are satisfied with their academic self perception and perception of teachers. The result showed that 68.2% (209) of students consider positive aspect of educational environment (p<0.001). Students of all 4 school of MNUMS with same level of nursing school program are satisfied with their knowledge, clinical skills and educational atmosphere among the students. Dornogobi school students’ 65% assessed perception of teacher as “model instruction”.