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ChatGPT, a language model developed by OpenAI, has been tested in several medical board examinations. This study aims to evaluate the performance of ChatGPT on the Portuguese National Residency Access Examination, a mandatory test for medical residency in Portugal. The study specifically compares the capabilities of ChatGPT versions 3.5 and 4o across five examination editions from 2019 to 2023. A total of 750 multiple-choice questions were submitted to both versions, and their answers were evaluated against the official responses. The findings revealed that ChatGPT 4o significantly outperformed ChatGPT 3.5, with a median examination score of 127 compared to 106 (p = 0.048). Notably, ChatGPT 4o achieved scores within the top 1% in two examination editions and exceeded the median performance of human candidates in all editions. Additionally, ChatGPT 4o's scores were high enough to qualify for any specialty. In conclusion, ChatGPT 4o can be a valuable tool for medical education and decision-making, but human oversight remains essential to ensure safe and accurate clinical practice.

Introduction: There is a high heterogeneity in the structure of postgraduate medical training evaluation worldwide. However, in contrast to other countries, there have been no scientific studies of the final medical board examination, in Portugal. The present study aimed to evaluate the adequacy of the medical board examination including its validity as measured by its association with medical school grade average and national seriation examination., Material and Methods: Cross-sectional, observational study. We analyzed the final results on the medical board examination of 2439 physicians, across 47 specialties, who completed their training in 2016 and 2017, using measures of central tendency and variability. We assessed the association between these grades and the national exam to initiate residency, and the grade average in Medical School., Results: Measures of central tendency and variability, and consequent shape measures, revealed that the distribution of the scores of the final medical board exam is extremely negatively asymmetric and leptokurtic. A positive association was also found between the results in this exam and the score on national exam to initiate residency, and the grade average in Medical School., Conclusion: Although the medical board examination was, in general, positively associated with scores on the national exam to initiate residency, and the mean final Medical School grades, thus indicating its potential validity, our results demonstrate that this exam presents no satisfactory discriminative capacity. Therefore, there is room to improve the actual postgraduate medical examination model, including changes in its classification system and potentially consider other assessment models.

Introduction: The satisfaction with the medical profession has been identified as an essential factor for the quality of care, the wellbeing of patients and the healthcare systems' stability. Recent studies have emphasized a growing discontent of physicians, mainly as a result of changes in labor relations., Objectives: To assess the perception of Portuguese medical residents about: correspondence of residency with previous expectations; degree of satisfaction with the specialty, profession and place of training; reasons for dissatisfaction; opinion regarding clinical practice in Portugal and emigration intents., Material and Methods: Cross-sectional study. Data collection was conducted through the "Satisfaction with Specialization Survey", created in an online platform, designed for this purpose, between May and August 2014., Results: From a total population of 5788 medical residents, 804 (12.25 %) responses were obtained. From this sample, 77% of the responses were from residents in the first three years. Results showed that 90% of the residents are satisfied with their specialty, 85% with the medical profession and 86% with their place of training. Nevertheless, results showed a decrease in satisfaction over the final years of residency. The overall assessment of the clinical practice scenario in Portugal was negative and 65% of residents have plans to emigrate after completing their residency., Conclusion: Portuguese residents revealed high satisfaction levels regarding their profession. However, their views on Portuguese clinical practice and the results concerning the intent to emigrate highlight the need to take steps to reverse this scenario.

Background: Hepatic vascular control techniques employed during liver surgery are usually associated with ischemia-reperfusion injury, which could cause acute renal dysfunction. The murine model has been used in the study of this injury. Hydroxyethyl starch has recognized anti-inflammatory properties and improves microcirculation. Third generation hydroxyethyl starches, namely 130/0.4, show a better safety profile than previous molecules., Objectives: Evaluation of renal injury in a murine model of partial normothermic hepatic ischemia-reperfusion injury and assessment of hydroxyethyl starch 130/0.4 effect on this injury., Methods: Seventy-two male Wistar rats were randomized into six groups with identical characteristics (n = 12 x 6). In three of them, the ischemia-reperfusion injury groups, we placed a clamp in the vascular pedicle of the median and left liver lobes, inducing hepatic ischemia (70%), and removed the clamp 60 minutes later (IRI + HES and IRI + HS groups, with HES or hypertonic saline (7.5%) administration during reperfusion, respectively, and IRI group, without fluid therapy). The control groups were sham-operated without hepatic ischemia and treated likewise (sham + HES, sham + HS and sham groups). After 120 minutes of reperfusion in the ischemia-reperfusion injury groups and 180 minutes in the controls we drew blood from the aorta artery for creatinine, urea and alanine aminotransferase quantification and removed kidney and liver samples for histopathological analysis., Results: As already published by our group, the partial hepatic ischemia-reperfusion injury model showed liver injury. In the present work, the IRI group had higher creatinine, urea and histopathological score than sham (p < 0.05). Creatinine and urea mean concentrations were significantly lower both in IRI+HES (23.08 µmol/L and 8.38 mmol/L, respectively) and IRI + HS (26.59 µmol/L and 7.82 mmol/L) when compared to IRI (40.101 µmol/L and 11.25 mmol/L). There was no significant difference between IRI + HES and IRI + HS groups (serum markers and histopathology)., Conclusion: The hepatic ischemia-reperfusion injury murine model was effective in producing kidney injury. Both the hydroxyethyl starch 130/0.4 and the hypertonic saline protected the kidney in this context and were not harmful for this organ in the controls. Further studies are necessary to assess clinical implications of hydroxyethyl starch 130/0.4 administration in liver surgery.