No abstract available.
Education, Medical/manpower ; Education, Medical/standards* ; Education, Medical, Graduate/standards ; Education, Premedical/standards ; Korea ; Medicine, Oriental Traditional/standards*

Clinical Competence ; Education, Medical, Graduate ; standards ; Education, Medical, Undergraduate ; standards ; Female ; Humans ; Internship and Residency ; standards ; Male

AIMTo determine the attitudes of training grade (Senior House Officer - SHO, Specialist Registrar - SpR) and non-training grade doctors (both Staff Grade and senior or Consultant level) towards the place of research in the curriculum for junior doctors and also the pursuit of research by senior (but non-academic) clinicians.

MATERIALS AND METHODSA survey of a range of doctors from differing grades (above) was sent to all doctors of the employing Trust (comprising most of the regional training scheme) with a number of fixed questions but also an opportunity to provide free-text responses. Percentages of the fixed responses were estimated and free-text responses were grouped into main themes and miscellaneous items.

RESULTSDespite much criticism of the current protected research time for higher trainees in psychiatry in the UK and the anticipated abolition of this within the new training structure after August 2007, we found surprising and strong support for structured research training, experience and the opportunity to pursue this at senior level even for non-academic clinical consultants.

CONCLUSIONSUrgent review of the new training grade curriculum is needed with emphasis on how to address the research opportunities for trainees and seniors without compromising clinical, teaching and managerial obligations. A better use of such opportunities was strongly supported rather than the proposed abolition, which seems to be fast approaching.

Biomedical Research ; education ; Education, Medical, Graduate ; methods ; Humans ; Psychiatry ; education ; Referral and Consultation ; standards ; United Kingdom

Education, Medical, Graduate ; standards ; General Surgery ; education ; Humans ; Singapore ; Workload ; statistics & numerical data

INTRODUCTIONThe purpose of this study was to understand the learning of internal medicine of 7th year medical students through records of the "Learning Passport".

MATERIALS AND METHODSBetween June 2005 and June 2006, data from the learning passport (a type of logbook) of 207 7th year medical students at the Department of Internal Medicine, National Taiwan University Hospital (NTUH) were collected.

RESULTSAmong the 19 symptoms/signs listed in the logbook, a large number of students did not learn well on low back pain, skin rash, oedema, oliguria and anxiety/depression; only a few students rated themselves as knowledgeable about anxiety/depression, malaise, skin rash, headache and anorexia. Among the 16 diseases listed, a large number of students did not learn well on chronic obstructive pulmonary disease, stroke, hypertension, coronary artery disease and cirrhosis; only a few students rated themselves as knowledgeable about shock, respiratory failure, consciousness disturbance, sepsis and renal failure. Among the 21 physical examination skills listed, a large number of students did not learn well on the male genitalia, eyes, cognitive status, mental state and the digital rectal examination; only a few students rated themselves as fully competent about cognitive status, mental state, eyes, neurology examination and ENT examination. Among the 11 laboratory skills and image interpretation skills listed, a large number of students did not learn well on blood smear, Gram's stain and specimen sampling; only a few students rated themselves as fully competent about the interpretation of brain computed tomographic (CT) scan, blood smear and Gram's stain. Among the 12 procedures and therapeutic skills listed, a large number of students did not learn well on observation of lumbar puncture, basic cardiopulmonary resuscitation (CPR) and aseptic procedure; only a few students rated themselves as fully competent about basic CPR and transfusion management.

CONCLUSIONSThe weak points of intern training conducted by the Department of Internal Medicine, NTUH were revealed by analysis obtained from their logbooks. Thus, we need to strengthen the learning of the interns in these specific parts and assess their performance based on the use of portfolios.

Clinical Competence ; Education, Medical, Graduate ; standards ; Educational Measurement ; methods ; Hospitals, University ; Internal Medicine ; education ; Self Efficacy ; Taiwan

Postgraduate Family Medicine (FM) training is important to train future primary care doctors to provide accessible and cost effective healthcare. In Singapore, a structured postgraduate FM training programme has been available for 20 years. This programme is characterised by involvement of both FM and non-FM doctors, well written modules and a rigorous assessment process. However, challenges faced by both the current healthcare system and training structure underlie the need to review the training structure to ensure its relevancy for future Family Physicians (FPs) to manage the needs of their patients. A workgroup was formed to review the current FM postgraduate programme and to explore the possibility of using the Accreditation Council for Graduate Medical Education (ACGME) framework to enhance our current system. The workgroup felt that broad-based training and comprehensive coverage of topics are areas that are important to retain in any new FM residency programme. Weaknesses identified included a lack of early FM exposure and the need to strengthen formative assessments. New organisational structures such as Family Medicine Centres (FMC) need to be established and the involvement of the private sector in any FM residency progammes could be enhanced. The implementation of the FM Residency Programme in 2011 presented a unique opportunity to realign FM postgraduate education in line with the national objectives and to equip FPs with the necessary knowledge and skills for managing the future healthcare needs of Singaporeans.
Clinical Competence ; standards ; Curriculum ; standards ; Education, Medical, Graduate ; organization & administration ; standards ; Family Practice ; education ; Humans ; Internship and Residency ; organization & administration ; Program Development ; Singapore

INTRODUCTIONThe emergence of operative laparoscopy has brought a great demand for training surgical residents, but there are no clear guidelines regarding choice of procedure for training, proficiency assessment and accreditation. We aim to examine from a trainee's point of view, the safety and efficacy of laparoscopic appendicectomy (LA) as a laparoscopic training procedure.

MATERIALS AND METHODSA retrospective analysis of all the consecutive cases of LA done by a trainee in paediatric laparoscopic surgery from September 2003 to February 2005 was done.

RESULTSA total of 70 consecutive patients (37 males and 33 females) aged 3 to 15 years (mean, 10.5 +/- 2.5) with suspected appendicitis underwent LA. Twelve (17.1%) patients had acute appendicitis, 25 (35.7%) had acute suppurative appendicitis adherent to the caecum with localised and/or pelvic pus pocketing, 29 (41.4%) had perforated appendicitis with generalised peritonitis and 4 (5.7%) had normal appendix [mesenteric adenitis (1), omental infarct (1), torted Meckel's diverticulum (1) and primary peritonitis (1)]. There were no operative complications and none required conversion to open surgery. The operative duration ranged from 25 to 110 minutes (mean, 55.6 +/- 23.4). There were two complications; one had adhesive intestinal obstruction and underwent successful laparoscopic adhesiolysis and one had umbilical wound infection.

CONCLUSIONSLA is a safe and effective laparoscopic training procedure, in addition to being effective for all stages of appendicitis, as well as concurrent lesions encountered in children with suspected appendicitis.

Acute Disease ; Adolescent ; Appendectomy ; education ; methods ; Appendicitis ; surgery ; Child ; Child, Preschool ; Education, Medical, Graduate ; Female ; Hospitals, Pediatric ; standards ; Humans ; Internship and Residency ; Laparoscopy ; Male ; Retrospective Studies ; Safety ; Singapore

INTRODUCTIONLittle is known about the attitudes of Singaporean patients towards the intraoperative involvement of trainee surgeons. We aimed to discover if patients would consent to having a trainee surgeon perform their surgery under the supervision of a consultant and if patients would agree to having their photographs or X-rays used for education or research. We sought to discover if patients' decisions were related to demographic factors such as ethnicity, gender, age, socioeconomic status and previous hospitalisation.

MATERIALS AND METHODSA questionnaire was administered to 104 patients immediately after their consent was obtained at the Orthopaedic Surgery Clinic and Hand and Reconstructive Microsurgery Clinic at the National University Hospital, Singapore or after admission at the Day Surgery Centre. Only patients undergoing elective orthopaedic or hand surgery were recruited.

RESULTSSixty-eight per cent of the patients refused to have a trainee surgeon perform their surgery. However, 96% of the patients consented to the use of their photographs or X-rays for teaching. Demographic factors found to be statistically significant were education level and age of the patients. Patients with higher educational levels were more likely to refuse trainee surgeons compared to the group with little or no education [odds ratio (OR), 4.57] but they were more likely to consent to the use of their photographs or X-rays (OR, 0.13).

CONCLUSIONSMost patients are reluctant to have a trainee surgeon operate on them. This was strongly related to the level of education attained by the patient and the age of the patient.

Adult ; Aged ; Aged, 80 and over ; Clinical Competence ; standards ; Education, Medical, Graduate ; standards ; Educational Measurement ; Educational Status ; Female ; Hand ; surgery ; Health Care Surveys ; Humans ; Informed Consent ; Internship and Residency ; standards ; Male ; Middle Aged ; Orthopedics ; education ; Prospective Studies ; Singapore ; Surveys and Questionnaires

The MRCP(UK) PACES examination has been sat by almost 40,000 candidates in 10 countries around the world since its introduction in 2001. The examination assesses skills of relevance to the practice and delivery of high quality clinical care and is the leading international postgraduate summative assessment of this kind. In 2009, the examination was revised, and this article describes those revisions, focussing on the clinical skills assessed.
Clinical Competence ; standards ; statistics & numerical data ; Communication ; Curriculum ; Education, Medical, Graduate ; standards ; statistics & numerical data ; Educational Measurement ; methods ; standards ; statistics & numerical data ; Health Knowledge, Attitudes, Practice ; Humans ; Internationality ; Physician-Patient Relations ; Point-of-Care Systems ; Program Evaluation ; United Kingdom ; Workplace

American Diagnostic Radiology Residency and Fellowship programmes are Graduate Medical Education programmes in the United States (US) equivalent to the Postgraduate Medical Education programmes in Singapore. Accreditation Council for Graduate Medical Education (ACGME) accredited diagnostic radiology residency programmes require 5 years total with Post Graduate Year (PGY) 1 year internship in a clinical specialty, e.g. Internal Medicine following medical school. PGY Years 2 to 5 are the core years which must include Radiology Physics, Radiation Biology and rotations in 9 required subspecialty rotations: Abdominal, Breast, Cardiothoracic, Musculoskeletal, Neuroradiology, Nuclear and Paediatric Radiology, Obstetric & Vascular Ultrasound and Vascular Interventional Radiology. A core curriculum of lectures must be organised by the required 9 core subspecialty faculty. All residents (PGY 2 to 4) take a yearly American College of Radiology Diagnostic In-Training Examination based on national benchmarks of medical knowledge in each subspecialty. Because the American Board of Radiology (ABR) examinations are changing, until 2012, residents have to take 3 ABR examinations: (i) ABR physics examination in the PGY 2 to 3 years, (ii) a written examination at the start of the PGY 5 year and (iii) an oral exam at the end of the PGY 5 year. Beginning in 2013, there will be only 2 examinations: (i) the physics and written examinations after PGY 4 will become a combined core radiology examination. Beginning in 2015, the final certifying examination will be given 15 months after the completion of residency. After residency, ACGME fellowships in PGY 6 are all one-year optional programmes which focus on only one subspecialty discipline. There are 4 ACGME accredited fellowships which have a Board Certifi cation Examination: Neuroradiology, Nuclear, Paediatric and Vascular Interventional Radiology. Some ACGME fellowships do not have a certifying examination: Abdominal, Endovascular Surgical Neuroradiology and Musculoskeletal Radiology. One year unaccredited fellowships can also be taken in Breast, Cardiothoracic or Women's Imaging.
Accreditation ; Clinical Competence ; statistics & numerical data ; Communication ; Curriculum ; Education, Medical, Graduate ; statistics & numerical data ; Educational Measurement ; Educational Status ; Fellowships and Scholarships ; statistics & numerical data ; Health Knowledge, Attitudes, Practice ; Humans ; Internship and Residency ; statistics & numerical data ; Radiology ; education ; standards ; Singapore ; United States