INTRODUCTIONThe introduction of the residency programme in Singapore allows medical students to apply for residency in their graduating year. Our study aimed to determine the interest levels and motivating factors for pursuing emergency medicine (EM) as a career among medical students in Singapore.

METHODSA self-administered questionnaire was distributed to Year 1-5 medical students in 2012. Participants indicated their interest in pursuing EM as a career and the degree to which a series of variables influenced their choices. Influencing factors were analysed using multinomial logistic regression.

RESULTSA total of 800 completed questionnaires were collected. 21.0% of the participants expressed interest in pursuing EM. Perceived personality fit and having done an elective in EM were strongly positive influencing factors. Junior medical students were more likely to cite the wide diversity of medical conditions and the lack of a long-term doctor-patient relationship to be negative factors, while senior medical students were more likely to cite personality fit and perceived prestige of EM as negative factors.

CONCLUSIONCareful selection of EM applicants is important to the future development of EM in Singapore. Our study showed that personality fit might be the most important influencing factor in choosing EM as a career. Therefore, greater effort should be made to help medical students explore their interest in and suitability for a particular specialty. These include giving medical students earlier exposure to EM, encouraging participation in student interest groups and using appropriate personality tests for career guidance.

Career Choice ; Decision Making ; Emergency Medicine ; education ; manpower ; Female ; Humans ; Internship and Residency ; Male ; Motivation ; Regression Analysis ; Singapore ; Students, Medical ; Surveys and Questionnaires

OBJECTIVE: In respect of the health and safety of the public, universal access to health care is an issue of the greatest importance. The geographic distribution of doctors is one of the important factors contributing to access to health care. The aim of this study is to assess the imbalances in the geographic distribution of neurosurgeons across Korea.METHODS: Population data was obtained from the National Statistical Office. We classified geographic groups into 7 metropolitan cities, 78 non-metropolitan cities, and 77 rural areas. The number of doctors and neurosurgeons per 100000 populations in each county unit was calculated using the total number of doctors and neurosurgeons at the country level from 2009 to 2015. The density levels of neurosurgeon and doctor were calculated and depicted in maps.RESULTS: Between 2009 and 2015, the number of neurosurgeons increased from 2002 to 2557, and the ratio of neurosurgeons per 100000 populations increased from 4.02 to 4.96. The number of neurosurgeons per 100000 populations was highest in metropolitan cities and lowest in rural areas from 2009 to 2015. A comparison of the geographic distribution of neurosurgeons in 2009 and 2015 showed an increase in the regional gap. The neurosurgeon density was affected by country unit characteristics (p=0.000).CONCLUSION: Distribution of neurosurgeons throughout Korea is uneven. Neurosurgeons are being increasingly concentrated in a limited number of metropolitan cities. This phenomenon will need to be accounted when planning for a supply of neurosurgeons, allocation of resources and manpower, and the provision of regional neurosurgical services.
Geographic Mapping ; Health Manpower ; Health Services Accessibility ; Hospital Distribution Systems ; Korea ; Neurosurgeons ; Neurosurgery ; Resource Allocation

OBJECTIVES: Since 2000, the National Health Service (NHS) in the United Kingdom (UK) has challenged for a large-scale reforms. This study aims to review those reforms to reflect in the dental care system in Korea. METHODS: Reports and papers that were published from 2000 to 2015 and were related to the NHS dental care system and reforms were searched. Among them, official reports from the government or organization were prioritized. RESULTS: In 2002, the “NHS Dentistry: Options for Change” report suggested rebuilding the structure to meet the standard of care, improving the remuneration system, and modernizing the workforce. Eight years later, the government proposed the “NHS Dental Contract: Proposals for Pilots” to improve accessibility to oral health and dental care. The pilot was based on three elements: registration, capitation, and quality. In 2015, the Department of Health announced the “Dental Contract Reform: Prototypes.” These prototypes include the clinical pathway, measurement and remuneration by quality of care, and a weighted capitation and quality model reimbursement system. CONCLUSIONS: The changes to the UK dental care system has implications. First, national coverage should be extended to improve accessibility to dental care. Second, the dental care system is necessary to reform focused on patient-centered and prevention. Third, registration and remuneration by quality of care needs to be introduced. Fourth, change should start from the basic steps, such as forming consensus or preparing manuals, to strengthening personnel and conducting a pilot study. Most of all, the new system will center on clinical leadership.
Consensus ; Critical Pathways ; Delivery of Health Care* ; Dental Care ; Dentistry ; Great Britain ; Health Care Reform* ; Health Manpower ; History of Dentistry ; Korea ; Leadership ; Legislation, Dental ; National Health Programs ; Oral Health ; Pilot Projects ; Remuneration ; Standard of Care

The Sustainable Development Goals (SDGs), officially known as ‘Transforming our world: the 2030 agenda for sustainable development’ has 17 “Global Goals” with 169 targets. This is the resolution by member countries as an intergovernmental agreement that acts as the Post 2015 Development Agenda (successor to the Millennium Development Goals). In conjunction with the United Nations SDG, World Health Organization published “The global strategy on human resources for health: workforce 2030”. It is primarily aimed at planners and policy-makers of WHO Member States and, its contents are of value to all relevant stake holders including medical education providers in the health workforce area. This article tried to explore the future direction of medical education to achieve the SDG in relation to Korean context.
Conservation of Natural Resources* ; Education, Medical* ; Health Manpower ; Humans ; Public Sector ; Social Control, Formal ; Social Skills ; United Nations ; World Health Organization

BACKGROUND:The incidence of human immunodeficiency virus (HIV) infection in the Philippines is increasing. HIV-related stigma in the health care setting is a known barrier to healthcare access for people living with HIV (PLHIV).

OBJECTIVE: The study aimed to identify stigmatizing attitudes and practices towards PLHIV among healthcare workers in Philippine General Hospital.

METHODS: In this cross-sectional descriptive study, 375 healthcare workers were recruited via convenience sampling. A standardized questionnaire developed by the Health Policy Project was used.

RESULTS: The study demonstrated concerns regarding transmission, particularly during drawing blood (87.1%),assisting in labor and delivery (82%), and dressing wounds (80.4%). Use of special infection-control measures (76.1%),wearing double gloves (72.8%), additional infection-control procedures during labor and delivery (72.2%), and wearing gloves during all aspects of patient care (70.2%) were reported as well. Perceptions such as the belief that pregnant women who are HIV positive must inform their families of their HIV status (82.1%), and that PLHIV engage in irresponsible behaviors (69.1%) and are promiscuous (66.4%) were also detected.

CONCLUSION: The study confirmed the presence of HIV-related stigma among healthcare workers in Philippine General Hospital.This finding could potentially catalyze the development of stigma-reducing measures which could hopefully translate to improved healthcare for PLHIV.

Human ; Male ; Female ; Hiv Infections ; Social Stigma ; Health Services Accessibility ; Social Discrimination ; Health Care Facilities, Manpower, And Services ; Hiv

Bilingual teaching is a innovative method of higher education of China to gear the need of the world. Acupuncture and Moxibustion, a higher international TCM course, has been the model of bilingual teaching in many colleges and universities of TCM successively. To meet the aim and original intention of bilingual education in China, we have supplemented international acupuncture and moxibustion in teaching program for many years. The related contents about acupuncture and moxibustion of World Health Organization (WHO) and International Standardization Organization(ISO) have been added into the chapters of introduction, meridians and acupoints, the technology of acupuncture and moxibustion, the therapy of acupuncture and moxibustion. Teaching international acupuncture and moxibustion not only enlarges the international perspective of students, but also makes them more interested in learning Acupuncture and Moxibustion with a bigger sense of mission.
Acupuncture ; education ; Acupuncture Points ; Books ; China ; Humans ; Internationality ; Language ; Learning ; Meridians ; Teaching ; manpower ; methods ; Universities

With esoterica of Infantile Tuina by LI Dexiu and Infantile Tuina Therapy of LIU Kaiyun, the differences and similarities of manipulations, acupoints and the principles of treatment were studied so as to provide theoretical evidence to popularize tuina of LI Dexiu and LIU Kaiyun.
Acupuncture Points ; China ; Female ; History, 19th Century ; History, 20th Century ; Humans ; Infant ; Infant, Newborn ; Infant, Newborn, Diseases ; therapy ; Male ; Massage ; history ; manpower ; methods

The origin time, representative physicians and medical works of Xujiang acupuncture school were traced, so as to explore the academic origin and development and summarize the academic characteristic of Xujiang acupuncture school, which could make a better inheritance of academic essence and prompt the innovation and development of Xujiang acupuncture school.
Acupuncture ; education ; manpower ; Acupuncture Therapy ; methods ; Humans ; Physicians ; Qi

After being introduced to Japan, the Chinese acupuncture and massage therapy has changed a lot, in which the influence aroused by the blind practitioners cannot be ignored. Through analyzing the development and the transition of the blind acupuncture and massage industry in Japan, it is found that the tube needle technique, changeable acupoints concept, technical deviation and the importance on acupoints rather than meridians are still existed commonly today, which are introduced by the blind acupuncture and massage practitioners, the special group in Japan. In the process of development, the interaction with the governmental strategy has played the essential role in the consolidation of the above features.
Acupuncture ; education ; history ; manpower ; Acupuncture Points ; Acupuncture Therapy ; history ; History, 15th Century ; History, 16th Century ; History, 17th Century ; History, 18th Century ; History, 19th Century ; History, Ancient ; History, Medieval ; Humans ; Japan ; Massage ; history ; manpower ; Visually Impaired Persons

INTRODUCTIONParenteral nutrition (PN) is indicated for patients who are unable to progress to oral or enteral nutrition. There are no local studies done on estimating the cost of PN in acute settings. The aims of this study are to describe the demographics, costs of PN and manpower required; and to determine the avoidable PN costs for patients and hospital on short-term PN.

MATERIALS AND METHODSPatient data between October 2011 and December 2013 were reviewed. Data collected include demographics, length of stay (LOS), and the indication/duration of PN. PN administration cost was based on the cost of the PN bags, blood tests and miscellaneous items, adjusted to subsidy levels. Manpower costs were based on the average hourly rate.

RESULTSCosts for PN and manpower were approximately S$1.2 million for 2791 PN days. Thirty-six cases (18.8%) of 140 PN days were short-term and considered to be avoidable where patients progressed to oral/enteral diet within 5 days. These short-term cases totalled $59,154.42, where $42,183.15 was payable by the patients. The daily costs for PN is also significantly higher for patients on short-term PN (P <0.001).

CONCLUSIONIn our acute hospital, 90% of patients referred for PN were surgical patients. Majority of the cost comes from the direct daily cost of the bag and blood tests, while extensive manpower cost was borne by the hospital; 18.8% of our cohort had short-term avoidable PN. Daily PN may cost up to 60% more in patients receiving short-term PN. Clinicians should assess patient's suitability for oral/enteral feeding to limit the use of short-term PN.

Enteral Nutrition ; Health Care Costs ; Health Manpower ; economics ; Hematologic Tests ; economics ; Hospitals ; Humans ; Length of Stay ; economics ; Medical Overuse ; economics ; prevention & control ; Nutritional Support ; economics ; utilization ; Parenteral Nutrition ; economics ; utilization ; Singapore ; Time Factors