Background: Teachers in medicine do not only teach scientific facts about health and disease to their learners but they are also looked up to as role models. Little is known about the qualities of consultant-faculty members who are regarded as role models by Filipino internal medicine residents. Objective: This study aimed to determine the reasons why consultant-faculty members are considered role models by Filipino internal medicine residents. Methods: A cross-sectional survey was conducted among internal medicine residents at a tertiary national university hospital in the Philippines. Participants were asked to give the reasons for citing consultant-faculty members who they consider as role models. Results: There were 81 residents who participated (93% response rate) who gave a total of 332 qualities as reasons for citing them as role models. The most commonly cited quality category was those of personal qualities (35.84% of all responses). This was followed by academic, clinical, teaching, leadership and research qualities. Physical qualities were the least cited (0.30% of all responses). Across the four batches of residents, personal qualities were consistently cited the most number of times, while physical qualities were consistently cited the least. Conclusion Filipino internal medicine residents identified personal qualities as the most frequent reason for considering their consultant-faculty as role models.
Internal Medicine

BACKGROUND: Internal medicine (IM) doctors in Japan play the role of primary care physicians; however, the shortage of rural physicians continues. This study aims to elucidate the association of age, sex, board certification, type of work, and main clinical work with the retention or migration of IM doctors to rural areas. METHODS: This retrospective cohort study included 82,363 IM doctors in 2010, extracted from the national census data of medical doctors. The explanatory variables were age, sex, type of work, primary clinical work, and changes in board certification status. The outcome was retention or migration to rural areas. The first tertile of population density (PD) of municipalities defined as rural area. After stratifying the baseline ruralities as rural or non-rural areas, the odds ratios (ORs) of the explanatory variables were calculated using generalized estimation equations. The analyses were also performed after age stratification (<39, 40-59, ≥60 years old). RESULTS: Among the rural areas, women had a significantly higher OR for retention, but obtaining board certification of IM subspecialties had a significantly lower OR. Among the non-rural areas, physicians who answered that their main work was IM without specific subspecialty and general had a significantly higher OR, but obtaining and maintaining board certification for IM subspecialties had a significantly lower OR for migration to rural areas. After age stratification, the higher OR of women for rural retention was significant only among those aged 40-59 years. Those aged under 40 and 40-59 years in the non-rural areas, who answered that their main work was IM without specific subspecialty had a significantly higher OR for migration to rural areas, and those aged 40-59 years in the rural areas who answered the same had a higher OR for rural retention. CONCLUSIONS Obtaining and maintaining board certification of IM subspecialties are possible inhibiting factors for rural work, and IM doctors whose main work involves subspecialties tend to work in non-rural areas. Once rural work begins, more middle-aged female IM doctors continued rural work compared to male doctors.
Middle Aged ; Humans ; Male ; Female ; Retrospective Studies ; East Asian People ; Certification ; Physicians ; Internal Medicine

Objectives To learn the echocardiography skills of intensivists after receiving a basic critical care echocardiography training course, and investigate factors that may influence their performance. Methods We completed a web-based questionnaire that assessed the skills in ultrasound scanning techniques of intensivists who took a training course on basic critical care echocardiography held in 2019 and 2020. Mann-Whitney test was used to analyze the factors which might affect their performance on image acquisition, recognizing clinical syndrome, and measuring the diameter of inferior vena cava, left ventricular ejection fraction and left ventricular outflow tract velocity-time integral.Results We enrolled 554 physicians from 412 intensive care units across China. Among them, 185 (33.4%) reported that they had 10%-30% chance of being misled by critical care echocardiography when making therapeutic decision, and 34 (6.1%) reported that the chance was greater than 30%. Intensivists who performed echocardiography under the guidance of a mentor and finished ultrasound scanning more than 10 times per week reported significant higher scores in image acquisition, clinical syndrome recognition, and quantitative measurement of inferior vena cava diameter, left ventricular ejection fraction and left ventricular outflow tract velocity-time integral than those without mentor and performing echocardiography 10 times or less per week respectively (all P < 0.05).Conclusion The skills in diagnostic medical echocardiography of Chinese intensivists after a basic echocardiographic training course remain low, and further quality assurance training program is clearly warranted.
Humans ; Clinical Competence ; East Asian People ; Echocardiography/standards* ; Stroke Volume ; Ventricular Function, Left ; Self-Assessment ; Physicians/standards* ; Internal Medicine/standards*

Cardiopulmonary Resuscitation ; Critical Care ; Cross-Over Studies ; Humans ; Intensive Care Units ; Internal Medicine ; Internship and Residency ; Logistic Models ; Medical Staff ; Mortality ; Observational Study ; Organization and Administration ; Patients' Rooms ; Prospective Studies ; Renal Replacement Therapy ; Retrospective Studies ; Running ; Survival Rate

According to the fact that many coronavirus disease 2019 (COVID-19) patients are seeking for medical help due to some other possible clinical symptoms, besides respiratory symptoms, all the internal medicine departments (including emergency department) could be involved. Moreover, an increasing number of physician are going to work in fever clinic, isolation wards and supporting the medical work in Hubei Province in the future. For a better medical work implementation of physician against COVID-19 and the interpretation of this viral transmission, the work guide was drawn up by Hunan Medical Association, Internal Medicine Specialized Committee.
Betacoronavirus ; China ; Coronavirus Infections ; epidemiology ; Humans ; Internal Medicine ; organization & administration ; Pandemics ; Physicians ; Pneumonia, Viral ; epidemiology ; Practice Guidelines as Topic

OBJECTIVE: Suicide has recently become an important social problem. Thus, we analyzed prescription drugs that cause suicidal ideation. METHODS: Of 156 drugs on the the Minister of Food and Drug Safty (MFDS) EZ-Drug site that had “suicide” listed as a side effect, 78 had “suicide” listed as a warning or contraindication; those 78 drugs were analyzed using data from the 2016 Health Insurance and Review and Assessment Services National Patient Sample (HIRA-NPS). RESULTS: 51 “suicide risk” drugs was identified. Of all patients, 5.2% had received such drugs. The prescription rate was 0.8% of all prescriptions, accounting for 1.6% of all prescription days. From logistic regression analysis, the prescription rate for the drugs was approximately 1.1 times higher for women than for men. With regard to age, the prescription rate for patients 66 years and older was 15.5 times higher than those for patients 25-years and lower. With regard to medical departments, the prescription rates in psychiatry and dermatology departments were 8.1 times higher and 0.6 times lower than those in internal medicine departments, respectively. With regard to region, the prescription rates in Daegu and Jeju were 1.3 times higher and 0.79 times lower than those in Seoul, respectively. CONCLUSION: Drug-induced suicidal behavior is possible, and therefore efforts are needed to prevent it.
Clergy ; Daegu ; Dermatology ; Female ; Humans ; Insurance, Health ; Internal Medicine ; Logistic Models ; Male ; Prescription Drugs ; Prescriptions ; Seoul ; Social Problems ; Suicidal Ideation ; Suicide

Long duty hours have been associated with significant medical errors, adverse events, and physician “burn-out”. An innovative night float (NF) system has been implemented in our internal medicine program to reduce the negative effects of long duty hours associated with conventional full-call systems. However, concerns remain if this would result in inadequate training for interns. We developed a structured questionnaire to assess junior doctors’ perceptions of the NF system compared to full calls, in areas of patient safety, medical training, and well-being. Ninety-seven (71%) of the 137 doctors polled responded. Ninety-one (94%) felt the NF system was superior to the full call system. A strong majority felt NF was beneficial for patient safety compared to full call (94% vs. 2%, p<0.001). The NF system was also perceived to reduce medical errors (94% vs. 2%, p<0.001) and reduce physician “burn-out” (95% vs. 5%, p<0.001). Beyond being a practical solution to duty-hour limitations, there was a significant perceived benefit of the NF system compared to the full call in terms of overall satisfaction, patient safety, reducing medical errors and physician “burn-out”.
After-Hours Care ; Asian Continental Ancestry Group ; Education, Medical ; Humans ; Internal Medicine ; Medical Errors ; Patient Safety ; Patient Satisfaction

This study aims to examine how traditional medicine doctors (醫生) of the Japanese colonial period in Korea treated patients and their own diseases with traditional medicine (漢方) and Western medicine (洋方) by analyzing Clinical Cases (治案) and A Diary of Jaundice Treatment (治疸日記) of Kim Gwangjin (金光鎭, 1885–1940). Through this inquiry, this study aims to reveal that the Japanese colonial period was a time when the traditional medicine and the Western medicine coexisted, and that this period cannot be simply defined as a dualism between “Western medicine, Japanese colonial government” versus “traditional medicine, governed public.” Kim Gwangjin's main method of medical treatment was traditional medicine. Clinical Cases include over 60 treatment cases, and they illustrate that he was a typical doctor at the time using traditional medical knowledge. In addition, Kim wrote A Diary of Jaundice Treatment from January 1939 to July 1940, a month before his death. The disease that led to his death was jaundice. He examined the changes in his abdomen every day, and recorded the changes in edema in upper extremities and testicles, urine and feces. While the treatment that Kim used in the early stages of jaundice were herbal medicines, he was not confined to the boundaries of the traditional medicine as he studied Western medicine to obtain a license of traditional medicine doctor from Japanese colonial government. He took a urine test to confirm whether his illness was jaundice or kidney disease and had X-ray imaging to check for pleurisy at a Western medical hospital in Daegu. Furthermore, he received a procedure to artificially drain bile, took a medicine to excrete bile into the feces, and had injection to treat neuralgia. Mostly, it was diarrhea that bothered Kim, who had been suffering from jaundice. Preventing diarrhea led to edema, and removing edema led to diarrhea again. He managed his symptoms by stopping the herbal medicine treatments and going on a raw food diet. Around this time, Kim relied the most on Ejisan (エヂ散). Ejisan was a type of new medicine mixed with traditional medicine and Western medicine that had the effect of treating edema and digestive disorders. Kim personally manufactured and took the drug until a month before his death, praising it as a necessary drug to treat jaundice. Kim was a traditional medical doctor during the Japanese colonial period. He also had the conventional wisdom that Western medicine was excellent in treating surgical diseases but not effective in internal medicine. However, he used both traditional medicine and Western medicine to treat symptoms of jaundice that have not been treated well and created a new medicine called Ejisan, which combined the two types of medicines. For him, Western medicine was a new medicine that improved the wrong aspects of traditional medicine or the old medicine, but there was still a realm of traditional medicine that Western medicine could not intervene. Furthermore, he published a new theory of traditional medicine called the Principle of Up and Down (升降論), which incorporates some Western medical knowledge. The Japanese colonial government required traditional medicine doctors to study Western medicine, and traditional medicine doctors had to learn Western medicine in order to survive. In the meantime, traditional medicine doctors such as Kim have brought about new changes by integrating the two medical treatments in the clinical field. The Japanese colonial government planned the demise of traditional medicine by forcing traditional medicine doctors to study the Western medicine, but the unexpected achievement brought about by traditional medicine doctors, who survived longer than the Japanese Empire and the colonial government, was an attempt to integrate Eastern and Western medicine.
Abdomen ; Asian Continental Ancestry Group ; Bile ; Daegu ; Diarrhea ; Diet ; Edema ; Feces ; Herbal Medicine ; Humans ; Internal Medicine ; Jaundice ; Kidney Diseases ; Korea ; Licensure ; Medicine, Traditional ; Methods ; Neuralgia ; Pleurisy ; Raw Foods ; Testis ; Upper Extremity

No abstract available.
Education ; Ethics ; Internal Medicine ; Internship and Residency

PURPOSE: This study attempted to develop a scale that measures the level of patients' recognition of the nurses' care, based on Watson's caring theory, and confirmed its reliability and validity. METHODS: The items were developed through a literature review and an expert content validity test. The questionnaires were administered to 285 inpatients of internal medicine and surgical units at two general hospitals. Construct validity was tested using exploratory and confirmatory factor analysis, and reliability was tested using Cronbach's alpha. RESULTS: This process resulted in a preliminary scale composed of 34 items; We used item analysis and five exploratory factor analyses, and consequently selected 14 items composed of three factors (respect, genuineness, and relationality). The confirmatory factor analysis verified the model fit and convergent and discriminant validity of the final items; criterion validity was confirmed with the positive correlation with the measurement scale of the patient-perceived quality of nursing . The overall scale reliability had a Cronbach's alpha of .92, which indicated internal consistency and reliability. CONCLUSION: The developed scale showed content, construct, and criterion validity, and reliability, as well as convergent validity for each item and discriminant validity between the factors. This makes it suitable for use in a diverse range of future studies on nurse communication using structural equation models.
Factor Analysis, Statistical ; Hospitals, General ; Humans ; Inpatients ; Internal Medicine ; Nursing ; Reproducibility of Results