Search

Introduction: COVID‐19 resulted in medical students volunteering to join the health care workforce. Our study aimed to evaluate the perception of clinical staff on the benefit of students' pandemic response. The secondary aims were to (i) evaluate medical students' team working skills, (ii) identify specialties where medical students were most effective, and (iii) identify areas for further training. Methods: We conducted a national survey of doctors and nurses. This was conducted in line with a pre‐specified protocol by the International Student Surgical Network UK (Incision UK), with support from The Royal Society of Medicine Students Section Collaborative and MedEd Collaborative. A questionnaire was developed and disseminated following AMEE guidance. Survey responses were quantitatively and qualitatively analysed. Results: Of the recorded responses (n = 283), the largest group of respondents was junior doctors, (n = 110, 38.9%), and medicine was the most reported specialty (n = 76, 26.9%) of respondents, followed by primary care, with the lowest responses coming from surgery (n = 25, 8.8%). Of the total responses (n = 283), 76.8% of respondents reported that the student response had a positive impact during the pandemic. Four themes were identified: (i) impact on health care service, (ii) impact on health care staff and patients, (iii) student's professional development and (iv) additional training that students require. Conclusion: Students were an effective part of the pandemic. However, without appropriate definition of their role within a clinical setting, students may be forced to balance learning and service provision. Providing students with dedicated clinical support roles and ward‐based learning roles with a competency‐based approach holds potential to be both a powerful learning tool and strengthen health care systems to face future crises. [ABSTRACT FROM AUTHOR]

Understanding the role of the tumor microenvironment (TME) in lung cancer is critical to improving patient outcomes. We identified four histology-independent archetype TMEs in treatment-naïve early-stage lung cancer using imaging mass cytometry in the TRACERx study (n = 81 patients/198 samples/2.3 million cells). In immune-hot adenocarcinomas, spatial niches of T cells and macrophages increased with clonal neoantigen burden, whereas such an increase was observed for niches of plasma and B cells in immune-excluded squamous cell carcinomas (LUSC). Immune-low TMEs were associated with fibroblast barriers to immune infiltration. The fourth archetype, characterized by sparse lymphocytes and high tumor-associated neutrophil (TAN) infiltration, had tumor cells spatially separated from vasculature and exhibited low spatial intratumor heterogeneity. TAN-high LUSC had frequent PIK3CA mutations. TAN-high tumors harbored recently expanded and metastasis-seeding subclones and had a shorter disease-free survival independent of stage. These findings delineate genomic, immune, and physical barriers to immune surveillance and implicate neutrophil-rich TMEs in metastasis., Significance: This study provides novel insights into the spatial organization of the lung cancer TME in the context of tumor immunogenicity, tumor heterogeneity, and cancer evolution. Pairing the tumor evolutionary history with the spatially resolved TME suggests mechanistic hypotheses for tumor progression and metastasis with implications for patient outcome and treatment. This article is featured in Selected Articles from This Issue, p. 897., (©2024 The Authors; Published by the American Association for Cancer Research.)

Background: Malaria continues to be a public health problem in Kenya, with an estimated 37.2 million people at high risk of the disease. The disease burden is compounded by inequalities in health service availability, housing, socioeconomic conditions, and access to education., Objectives: We aimed to determine the status of community-based, health education interventions. Based on the findings, to develop an educational module for medical students to combat malaria in Kenya., Methods: A systematic review was conducted to identify different educational interventions, their successes and limitations, and legal challenges leading to low uptake and adherence to malaria prevention interventions from 2000-2023. Consequently, a 6-week online educational pilot was conducted with healthcare students from Kenya, Japan, the UK, and Cyprus., Results: Despite developing a national malaria strategy and monitoring and evaluation strategies, Kenya has not been able to meet the incidence reduction targets set by the World Health Organisation, underscoring the need for more work in identifying the barriers to implementing strategies and optimising the distribution of public health interventions. Student teams proposed innovative solutions, including two-tier malaria control strategies, maternal malaria clinical education, community awareness through schools and NGOs, and a 10-year health system strengthening and immunisation plan., Conclusions: Public education regarding prevention strategies and increasing their adoption remains a key challenge in combating malaria in Kenya. In this regard, digital tools can facilitate international collaborative health education and exchange of best practices, allowing students and faculty to engage across boundaries and prepare them to be future-ready physicians connected to the global community.

Competing Interests: None

Psychological distress among medical professionals due to the novel coronavirus disease 2019 (COVID-19) pandemic is of great concern as it may lead to mental health problems and, furthermore, work leaves. Studies suggest that immediate psychological interventions are needed to protect medical staff during this chaotic situation. However, the importance of mental healthcare for the "future" medical staff, such as medical students, remains underestimated compared with that of current medical professionals. Medical students also face potential mental health stressors during their degrees and clinical clerkships, further increasing the risk of their psychological disorders. Hence, they should also be protected from burnout by various measures at governmental, organizational, and individual levels. To maintain a sustainable, robust healthcare system, medical professionals, students, and society should unite and collaboratively overcome the hardships of the COVID-19 pandemic., Competing Interests: None, (Copyright © Japan Medical Association.)