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• Breech presentation and skills for vaginal delivery represent a topic in obstetrics emergencies residency program. • Digital and formal lecture are possible way to face residents to rare emergencies. • Simulator represents a possible way to face emergencies difficult to learn on the bed-side.. A critical area of obstetrics that demands proficient training is the management of breech deliveries. There was a notable decline in the number of vaginal breech deliveries in the following years, establishing CS as the preferred method of delivery for such cases. Cohort studies using targeted screening and skilled practitioners demonstrated little differences between the two delivery. Skills acquisition at the patient's bedside is very difficult to obtain, particularly in the youngest trainees. Simulation teaching has largely become a part of the training curricula for many obstetrics and gynecology residency programs. This was a prospective, randomized, controlled, single-center study. Residents were randomly assigned in two groups with similar characteristics. Group A attended a formal lecture. Group B received the study material and recording of the lecture as digital home learning. Lecture and simulation focused on vaginal breech delivery. After one month both groups underwent a simulation test addressed to assist a vaginal breech birth. Four supervisors evaluated all videos. Time needed for birth, and evaluation scales as Objective Structured Clinical Examination were recorded. A questionnaire was completed online using Google Forms with 6 questions. The primary outcome was to compare the evaluation for each item and globally within groups. A secondary outcome was the evaluation of questionnaire results within the two groups. Thirty-two participants were recruited and randomized. None of the participants withdrew from the study. For the primary outcome, all examined variables (Time, Rumping, Legs, Body, Arms, Head, Total Point) did not present differences in supervisors' evaluations. For the secondary outcome, Group B showed higher values in two questions. The major finding of our study is that digital learning and formal lecture presented similar results on resident knowledge. Teaching programs involving mannequin simulation − both high and low fidelity − are reproducible and efficient for skill retain in obstetric emergencies, particularly in low incidence emergencies. The main limitation of our study was the small sample size. In addition, it is possible that a scenario without deviation or a lecture more focused on possible deviation from normal could modify residents' results facing breech delivery. [ABSTRACT FROM AUTHOR]

Recent technological advances have facilitated the development of new educational methods, such as simulation-based learning, in specialized bootcamps to enhance the learning of surgical residents. This study aimed to design, implement, and evaluate a basic surgical skills bootcamp for residents in general surgery, orthopedics, neurosurgery, and gynecology based on the learning gap in the current educational program. This intervention study focused on the design, implementation, and evaluation of a basic surgical skills bootcamp in a simulated operating room for first-year surgical residents in general surgery, orthopedics, neurosurgery, and gynecology. The study resulted in the creation of a comprehensive course plan and the execution of a 6-day training program. Evaluation of educational outcomes confirmed high learner satisfaction, improvement in Multiple Choice Questions (MCQ) exam scores, and acceptable scores in the Objective Structured Clinical Examination (OSCE). The findings of this study suggest that surgical bootcamps, when designed based on needs assessment and in line with scientific bootcamp design principles, play a crucial role in enhancing the satisfaction, knowledge, and skills of surgical residents. • Six-day surgical bootcamp improved residents' skills across multiple specialties. • Bootcamp significantly increased knowledge scores with large effect size (3.34). • Over 96 % of participants expressed satisfaction with the bootcamp experience. • Neurosurgery residents showed highest scores, gynecology most improvement. • Study recommends integrating bootcamps into standard surgical residency curricula. [ABSTRACT FROM AUTHOR]

Understanding the movement ecology of a species can provide valuable insight into responses to environmental change and inform management and conservation decision-making. Using acoustic telemetry, we tracked eight juvenile Green Sea Turtles (Chelonia mydas; curved carapace length, 50.59 ± 4.71 cm [42.8–57.9 cm], mean ± SD [range]) between July 2015 and December 2016 in Brewers Bay on St. Thomas, United States Virgin Islands, and characterized their movements—specifically area use, diving behavior, and rates of movement. We investigated how these movements were influenced by diel period, water temperature, barometric pressure, and wind speed. We found that the diel period significantly influenced space use, with turtles displaying behaviors typical to the species (i.e., resting at night and foraging during the day); however, the turtles in this study occupied relatively shallow habitats at night compared with turtles in other studies. Turtles showed strong fidelity to resting and foraging areas, consistently shuttling back and forth between the same areas diurnally, with one individual relying on the same resting area across the full 1.5-yr study. Warmer water temperatures were associated with shorter dive durations and higher rates of movement. Movement behaviors also shifted in response to indicators of storm activity (barometric pressure and wind speed), with turtles tending to dive deeper and for longer durations. Our results indicate that although some behavioral responses are consistent across Green Sea Turtles, others display plasticity, suggesting the management of this species in the face of increasing anthropogenic interactions must take into consideration local conditions. [ABSTRACT FROM AUTHOR]

Dermatology remains highly competitive, with strong USMLE Step 1 scores traditionally crucial for securing residency positions. The 2023–2024 cycle introduced significant changes, including pass/fail USMLE Step 1 score reports and an expanded program signaling system. This study explores dermatology residency applicant profiles within this new context. A survey of 2023–2024 dermatology applicants was conducted via social media to gather demographic and application data. A total of 63 survey responses were collected: 74.6% matched and 25.4% unmatched. The racial distribution was 54% White/Caucasian, 25.4% Asian/Pacific Islander, 9.5% Black/African American, 4.8% Hispanic/Latino, and 6.3% other. The median USMLE Step 2 score was 257 (215–277). Racial differences in USMLE Step 2 scores were significant (P = 0.031), but did not affect match rates (P = 0.116). Letters of recommendation from dermatology program directors were linked to lower match rates (P = 0.036). A positive correlation was found between the number of audition rotations completed and matching at such programs (r²=0.817). Of all matched respondents, 46.8% matched to a program they did not signal; of these, 50.0% matched to a program at which they completed an audition rotation and 40.9% to their home dermatology program affiliation. The mean number of interviews was 8.02, with matched applicants receiving more invitations than unmatched applicants (9.02 vs. 5.06, P = 0.002). The shift to pass/fail USMLE Step 1 scores and expanded program signaling did not notably affect the median USMLE Step 2 score from prior years or match rates among underrepresented minorities. Success in matching continues to depend on a holistic evaluation. [ABSTRACT FROM AUTHOR]

This article offers an up-to-date overview of resources tailored for dermatology residents in the United States preparing for their board certification exams. We have assembled a comprehensive list of exam preparation resources categorized by cost, alongside recommendations from attending and resident physicians regarding the most effective resources for each exam. Although examinations are only one facet of the training involved in becoming a competent dermatologist, these exams help residents focus on learning crucial aspects of medicine. This review aims to furnish a concise summary of available resources for dermatology residents, organized by cost. The average cost of a paid dermatology question bank resource in this review was approximately $279, reflecting the need for review resources for board exam preparation that can fit a resident physician's budget or are free to use. [ABSTRACT FROM AUTHOR]

To compare characteristics of Urogynecology training and number of "Incontinence and Pelvic Floor" cases logged between Obstetrics and Gynecology (OB/GYN) residencies affiliated and those not affiliated with Urogynecology fellowships. A retrospective descriptive analysis was performed of OB/GYN residency programs, their Urogynecology training, and association with Urogynecology fellowship programs during the 2023 to 2024 academic year. Program websites for Accreditation Council for Graduate Medical Education (ACGME)-accredited OB/GYN residency programs were reviewed to determine availability, timing, and length of Urogynecology training. ACGME data for "Incontinence and Pelvic Floor" cases were analyzed by training year and association with Urogynecology fellowship programs from the 2012–2013 to 2022–2023 academic year. Data was analyzed using SPSS. This research was conducted at Harbor-UCLA Medical Center. None. None. Information was obtained for 85.9% of programs. Nearly all (97.0%) had dedicated Urogynecology rotations, and 64.4% had rotations in >1 year of training. Association with Urogynecology fellowship did not affect the availability of Urogynecology training overall nor the overall number of rotations. Urogynecology rotations occurred most often in the third (PGY3) year of residency, though 43.6% of programs had training for junior (PGY1, PGY2) residents. Residencies with associated Urogynecology fellowships were more likely to have a rotation for PGY2 residents and for junior residents overall. From 2012 to 2023, the number of "Incontinence and Pelvic Floor" cases declined by 36.3%, with trainees at residencies not affiliated with Urogynecology fellowships logging more cases than those at a fellowship-affiliated residency. While the majority of OB/GYN residencies have dedicated Urogynecology training, most rotations are for senior residents. Training programs associated with Urogynecology fellowships are more likely to expose junior residents to the field, but their trainees log fewer "Incontinence and Pelvic Floor" cases overall. Earlier exposure may enrich surgical training and help residents prepare for their careers, whether in Urogynecology or as a generalist. [ABSTRACT FROM AUTHOR]

Objective Background Methods Results Conclusion To assess the feasibility and efficacy of group text messaging as a teaching tool to improve neurology resident knowledge and clinical pearl dissemination in an outpatient setting enriched with headache encounters, and to evaluate if learning points from this teaching method would influence resident care of subsequent patients.Inpatient neurology teaching during training is most often accomplished in team settings during rounds or conferences such as morning report, but outpatient teaching where headache is more likely encountered may be less consistently performed in such a setting where learning points may be shared. Few studies have evaluated whether group text messaging can be an innovative tool for teaching in residency training.Neurology residents in a continuity clinic pod at New York Presbyterian‐Weill Cornell were included in this cohort from December 2020 through March 2024. Group text messages deidentified of any patient information were sent to the resident pod by their preceptor after each clinic session featuring one text message regarding a takeaway learning point pertaining to each patient encounter. Residents were surveyed on their satisfaction with this teaching method and whether these text messages improved their outpatient neurology knowledge.A total of 230 text messages were sent to a cohort of 21 residents across 4 academic years. Text message topics covered a variety of neurological subspecialties, most commonly headache and facial pain (44.8%), general neurology (15.7%), and neuromuscular (14.3%). In our survey, 93% of resident respondents reported that receiving clinical pearls improved their outpatient neurology knowledge and changed how they cared for subsequent patients.Reinforcement of traditionally one‐on‐one learning points in a teaching outpatient setting to engage a group of residents was feasible across visit types. There was an overall very positive response to this teaching method, and residents reported improved knowledge, which influenced their care of subsequent patients. [ABSTRACT FROM AUTHOR]

Background: Addressing a lack of diversity in the physician workforce is a priority in the Canadian healthcare system. Data describing demographics of residents and their experiences of discrimination, harassment, and racism at work are incomplete. The objective of this work was to describe the demographics and perceptions of workplace discrimination and harassment for postgraduate medical trainees in Alberta. Methods: A cross-sectional survey based on the Chronic Workplace Discrimination and Harassment Scale was administered to all resident physicians in Alberta by e-mail invitation from the postgraduate medical education offices at the Universities of Alberta and Calgary, their residency training program directors, and the Professional Association of Residents of Alberta. Total score (median, interquartile range [IQR]) was compared by gender, racial, and intersecting gender and racial identities, with higher scores suggesting more frequent experiences of workplace discrimination and harassment (range 0 to 32). We performed thematic content analysis of open text responses. Results: There were 195 complete surveys returned from 1,752 Alberta residents (11.2% response rate), including 120 cisgender women (61.5%), 104 white participants (53.3%) and 74 white cisgender women (37.9%). The overall median score on the Chronic Workplace Discrimination and Harassment scale was 9 (IQR 5–14): cisgender women and gender diverse participants reported more frequent harassment, mistreatment, or discrimination than cisgender men (median 10 [IQR 6–15] versus 8 [4–13.5], p = 0.049). There was no difference in the frequency of reported discrimination between BIPOC and white respondents (median 9 [IQR 5–14.5] versus 9.5 [IQR 6–14], p = 0.72) or participants with intersecting race and gender identities (p = 0.26). Over 44% of BIPOC residents had been the target of a racial slur or joke from an attending physician or colleague in the past year and nearly 45% of all participants had witnessed an attending physician or colleague using a racial slur in the past year. Open text responses provided examples of mistreatment, harassment, discrimination, and racism from participants. Interpretation: These results demonstrate an unacceptable prevalence of harassment and racism witnessed or experienced at work by Alberta residents. Urgent action to identify, prevent, and remediate racism in the healthcare system must be a priority of medical schools and regulatory bodies. [ABSTRACT FROM AUTHOR]

Background: To examine the satisfaction rates and burnout feelings amongst residents physicians in different specialties and to examine associated affecting factors. Method: Clalit Health Services (CHS) is the largest health maintenance provider in Israel. A survey was designed by an interdisciplinary team with questions addressing residency and the balance between residency and personal life, as well as the balance between residency and personal life, and was sent to all residents of CHS via personal email from March to May 2022. Results: Four hundred sixty seven residents completed the survey. The mean satisfaction rate from the residency was 7.4 (± 1.93, 2–10). The highest satisfaction rate from residency was amongst anesthetics, psychiatrists and ophthalmologists (8.6, 8.1 and 8.0, respectively) while the lowest was among general surgeons, oncologists, plastic surgeons and orthopedic surgeons (6.8, 6.8, 6.7, 6.1, respectively). There was no correlation between satisfaction rates and monthly working hours or number of overnight shifts. Seventy four percent feel frequent burnout due to high workload and 68% feel frequent burnout due to high number of administrative tasks. Seventy three percent chose the work environment in their department as most influential of their residency experience, 61% chose relations between attending physicians and residents as most significant, and 60% chose the education during the residency as most influential during their residency training. Conclusions: Satisfaction rates from the residency training require improvement, with differences between the residencies. Number of working hours and number of overnight shifts did not correlate with the satisfaction rates. The factor that influences the most between satisfactory rate and less burnout is the relationship with colleagues and good training programs. Major efforts should be done to improve these factors. [ABSTRACT FROM AUTHOR]

Objective: To review United States chiropractic state boards acceptance of chiropractic residencies and fellowships as continuing education (CE). Methods: Between February 2024 and April 2024, board websites and accompanying policy documents for all 50 states and the District of Columbia were manually searched for content related to residencies and fellowships and whether they were considered CE. Information regarding CE credit requirements for new licensees was also collected. Results were tabulated in a spreadsheet and descriptive analysis was performed. Consensus among a minimum of 5 of 6 investigators was sought. Results: Four states (Arizona, Indiana, Kansas, and Minnesota) accept residencies or fellowships for CE credit, 6 states possess unclear regulatory language regarding these programs, and 41 states make no mention of these training programs among approved CE. Twenty-one states required CE credits during a licensee's initial renewal period, 1 state was unclear based on website content alone, and 29 states did not mandate CE for initial license renewal. More than 90% (19/21) of states that require CE for a licensee's first renewal do not or are unclear if they accept residencies or fellowships for credit. Conclusion: Few chiropractic state boards currently accept residencies and fellowships as approved CE. As the number of these postdoctoral training programs for chiropractors grow, more state boards may be asked to determine their CE policies on them. [ABSTRACT FROM AUTHOR]

Introduction: Neurosonology is a vital paraclinical investigation in modern neurology. However, access to education and certification in neurosonology for neurology residents and young specialists in Europe is challenging, and comprehensive data regarding this topic are scarce. Information regarding difficulties in neurosonology training across Europe may help bring this topic under the spotlight and act as a call for the harmonization of curricula across the continent. Methods: We performed an online survey targeting European neurology residents and young specialists, focusing on neurosonology training and certification. The survey was conducted between May and September 2023 and received responses from 282 participants representing 37 European countries. Results: There were disparities in neurosonology training during residency, with 6 (16.2%) out of 37 countries reporting a dedicated curriculum. The respondents expressed an overall lack of satisfaction with theoretical knowledge (rating their experience as very poor 28.0%, poor 20.2%, neutral 25.9%, good 19.3%, and very good 6.6%) and practical skills gained during their training (rating their experience as very poor 30.9%, poor 18.9%, neutral 22.6%, good 18.1%, and very good 9.5%). A total of 282 respondents (5.7%), 16 held a national certification in neurosonology, claiming obstacles such as high costs of certification and a limited number of certifying centers. Discussion: This survey reveals significant variations in neurosonology training across Europe, indicating difficulties in obtaining certification. Despite the increasing importance of neurosonology, many neurologists feel inadequately prepared and lack practical training during residency, emphasizing the need for better and more standardized access. Conclusion: The survey underscores challenges and disparities in neurosonology training and certification in Europe. Standardization of curricula and increased awareness about available certifications are crucial to address these issues. The interest in European Certification suggests a potential solution for enhancing neurosonology training at the international level. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the study was to investigate the effect of mentorship on self‐perceived theoretical and practical skill levels of German‐speaking residents affiliated to a scientific society with a focus on sports medicine. It was hypothesized that orthopaedic surgery residents with a mentor would report higher subjective theoretical and practical skills and less apprehension towards performing surgeries unsupervised compared to those without mentors. Methods: A 35‐item questionnaire was distributed among resident members of AGA—Society for Arthroscopy and Joint‐Surgery. The survey explored the current status of mentoring and self‐assessed theoretical and practical skill levels as well as apprehension towards performing surgeries unsupervised (1–10 scale with higher values indicating higher skill level or greater apprehension). Results: In total, 115 residents were included, of which 46 (40.0%) had a mentor. The majority of residents without a mentor (65.7%) reported the desire to have a mentor. Residents with a mentor reported significantly higher self‐assessed theoretical (p = 0.003) and practical skill levels (p < 0.001) and less apprehension towards performing surgeries unsupervised (p < 0.001) compared to residents without a mentor. The presence of formal mentorship programs increased the likelihood of having a mentor significantly (odds ratio [OR] 7.17, p < 0.001). Male and female participants did not differ significantly in self‐assessed skill level or apprehension towards performing surgeries unsupervised. Conclusion: Residents with a mentor reported greater subjective skill levels and stated less apprehension towards performing surgeries unsupervised compared to residents without a mentor. The majority of residents without a mentor stated that they would like to have a mentor. This may be achieved by establishing more formal mentorship programs as they facilitate mentorship. Level of Evidence: Level IV, cross‐sectional study. [ABSTRACT FROM AUTHOR]

Background and purpose: Training and education is essential for best practice medicine and is especially important in a rapidly evolving field such as neurology. Due to improved imaging techniques and laboratory testing, there is a better understanding of the pathophysiology of diseases. As a result more treatments have become available. The most important developments in neurology over the last two decades and their effect on training and education are described. In addition, how future training should be aware of the challenges ahead of us is described. Methods: This is a narrative review describing developments and challenges based on personal experience and the literature. Results: Due to major developments in radiological and immunological testing, major changes have been seen in different subspecialties of neurology, including but not limited to, the treatment of ischaemic stroke, the development of new entities in the field of demyelinating diseases and auto‐immune encephalitis, and diffuse glioma. These developments challenge the education and training in neurology with, ahead of us, technological developments, an aging population, and potentially more superspecialization. Conclusion: Although there are differences in the training curricula between European countries, the developments and future challenges within the field of neurology are very similar. In the development of future curricula it is important to face these developments and challenges and to adapt to them. [ABSTRACT FROM AUTHOR]

The objective of this study was to evaluate the effectiveness of a pilot artificial intelligence (AI) certificate program in aiding radiology trainees to develop an understanding of the evolving role and application of artificial intelligence in radiology. A secondary objective was set to determine the background of residents that would most benefit from such training. This was a prospective pilot study involving 42 radiology residents at two separate residency programs who participated in the Radiological Society of North America Imaging AI Foundational Certificate course over a four-month period. The course consisted of 6 online modules that contained didactic lectures followed by end-of-module quizzes to assess knowledge gained from these lectures. Pre- and post-course assessments were conducted to evaluate the residents' knowledge and skills in AI. Additionally, a post-course survey was performed to assess participants' overall satisfaction with the course. All participating residents completed the certificate program. The mean pre-course assessment score was 37 %, which increased to 73 % after completing the modules (p < 0.001). 74 % (31/42) endorsed the belief the course improved familiarity with artificial intelligence in radiology. Residency program, residency year, and reported prior familiarity with AI were not found to influence pre-course score, post-course score, nor score improvement. 57 % (24/42) endorsed interest in pursuing further certification in AI. Our pilot study suggests that a certificate course can effectively enhance the knowledge and skills of radiology residents in the application of AI in radiology. The benefits of such a course can be found regardless of program, resident year, and self-reported prior resident understanding of radiology in AI. [ABSTRACT FROM AUTHOR]

Copyright of Saudi Medical Journal is the property of Saudi Medical Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Die Urologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: The aim of this study is to investigate and highlight the most important factors influencing the candidate's selection for residency matching by program directors of surgical and non-surgical specialties in Saudi Arabia. Method: This cross-sectional study was conducted in the Central, Eastern, Western, Northern, and Southern regions of Saudi Arabia from February 1, 2023, to August 31, 2023. A total of sixty-one program directors completed a questionnaire, which was adapted and validated from a previous study with permission and tailored to meet the objectives of this research. Results: The mean age of the study population was 40.2 years, with surgical specialty program directors being older at 41.7 years and nonsurgical specialty program directors being younger at 39.6 years. In both cases, the highest importance was given to 'Applicant's attitude and professionalism', followed in surgical specialties by 'Doing clinical rotations in the PD institution' and 'Performance in clinical rotation during internship' in non-surgical specialties. with a mean score of 4.13 and 4.95, respectively. The importance of 'The impression/opinion of current residents' has had a certain importance in both specialties. While the number of research projects was prioritized more by surgical PDs (38.6%) compared to non-surgical PDs (29.4%). Conclusion: This study highlights the critical role of professionalism and a positive attitude in clinical rotations and interviews for program acceptance in Saudi Arabia. The significance of letters of recommendation and research focus varies between surgical and non-surgical program directors. Program directors should adopt effective recruitment strategies that incorporate practical implications during internships. Key messages: This research focuses on the evolving area of residency applicant selection criteria in Saudi Arabia. In 2024, over 6400 individuals were nominated for residency programs across the country, with approximately 5100 successfully matched following interviews. These statistics underscore the complexity and competitiveness of the matching system in Saudi Arabia, underscoring the urgency for similar research. Such studies are essential to provide guidance to future applicants, helping them navigate the selection process effectively and avoid common pitfalls. [ABSTRACT FROM AUTHOR]

Background: A survey of medical physics residency program directors was conducted in Spring 2021 to examine the current state of brachytherapy (BT) training during residency. In this related work, a subsequent survey of therapeutic medical physics residents in 2022 was conducted to assess the confidence and experience of the trainees. Concerns for access to high‐quality and diverse training in BT have escalated in importance due to recent declines in BT utilization. Methods: A survey consisting of 26 questions was designed by a working unit of the Brachytherapy Subcommittee of the American Association of Physicists in Medicine (AAPM) and approved for distribution by the Executive Committee of the AAPM. The survey was distributed to current trainees and recent graduates of the Commission on Accreditation of Medical Physics Education Programs accredited therapeutic medical physics residency programs by the AAPM. The participant response was anonymously recorded in an online platform and subsequently analyzed using spreadsheet software. Results: The survey was distributed to 796 current medical physics residents or recent graduates over the course of 6 weeks in February and March of 2022. The survey received 736 views and a total of 182 responses were collected, with 165 respondents completing the survey in full. Among those responses, 110 had completed their residency training, with program start dates ranging from calendar years 2015 to 2021. Individual responses from the survey takers (including partial survey submissions) were evaluated and analyzed to compile results. Conclusions: Medical physics residents reported the highest levels of confidence and caseload for gynecological BT procedures when compared with other surveyed treatment techniques. This indicates opportunities to improve training and increase access to clinical caseload are needed in order to improve competency and confidence. Time constraints (clinical and rotation‐based) were indicated as impediments to BT proficiency. Medical physics residents reported enthusiasm for additional training opportunities in BT, and it is evident that additional structure and programs are required to ensure adequate access to BT training during residency. [ABSTRACT FROM AUTHOR]

Background: Burnout among resident physicians during training has been prevalent, prompting training centers to introduce interventions at the individual or organizational level. However, empirical evidence is crucial before implementing such programs in practice. Methods: A systematic review and meta-analysis was carried out to evaluate the effectiveness of individual and organizational interventions in reducing burnout among resident physicians. Searching was done across five databases—PubMed, Scopus, ScienceDirect, Embase, and Cochrane Library from 1 December 2023 to 26 August 2024. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was used for our reporting of study selection process. Eligibility criteria were randomized or non-randomized designs, with prospective intervention, with a comparator group focused on individual or organizational interventions reducing burnout, in any language and publication date. The Maslach Burnout Inventory scores for emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA) were the three outcome measures. Two investigators independently extracted the data. The risk of bias was evaluated using Cochrane risk-of-bias tool for randomized trials (RoB2) and non-randomized studies of interventions (ROBINS-I). Cohen's d and heterogeneity was estimated using a random-effects DerSimonian-Laird model and visualized by forest plots. Sensitivity analyses were carried out by leave-one-out meta-analysis. Results: We identified 33 eligible studies (n = 2536), comprising 25 (75.8%) individual intervention studies and 8 (24.2%) organizational intervention studies. Cohen's d for individual intervention versus control were as follows: EE -0.25 (95% CI -0.40 to -0.11, p < 0.01, I2 = 49.3%), and DP -0.17 (95% CI -0.32 to -0.03, p = 0.02, I2 = 50.0%). The organizational intervention showed no significant association with any domain. Sensitivity analyses were robust in all outcomes, with differences in intervention description and design identified as potential contributors to heterogeneity. Conclusions: Various interventions, including individual coaching, meditation, and organization interventions, have been implemented to improve resident burnout. The effectiveness of intervention demonstrated none to small practical significance in improving burnout. Data inconsistency and high risk of bias across studies limited the validity of the pooled results. Further studies should focus on a combined approach. Registration: The study was registered on PROSPERO, under PROSPERO registration number CRD42022349698. [ABSTRACT FROM AUTHOR]

Introduction: Difficulties in recruitment of veterinary specialists to academia is an ongoing problem for university teaching hospitals. The aim of this study was to determine the proportion of veterinary neurology specialists that plan to work in academia after their residency training and identify the main factors that may influence that decision. Methods: An electronic survey was distributed to European College of Veterinary Neurology (ECVN) residents in training and those that completed their residencies within the previous 12 months. Results: Despite similar numbers of residents training in clinical practice and academic institutions, most respondents (79.7%) planned to work in private practice. The most influential factors for deciding future workplace were quality of life, salary, location, and the number of other specialists (with specialists in subjects other than neurology viewed as more important than neurologists) working in the same institution. The most common reasons for not choosing academia were low compensation, excessive bureaucracy, and high administrative workload compared to private clinical practice. Discussion: Academic institutions need to review support for academic staff and provide stronger mentorship to overcome these problems and ensure provision of high-quality undergraduate teaching in veterinary neurology as well as promoting advancement of the field through basic and applied research. [ABSTRACT FROM AUTHOR]

Background: Starting the first job as a young physician is a demanding challenge. Certain skills are important to master this transformation that go beyond the theoretical knowledge and practical skills taught in medical school. Competencies such as communication, leadership and career management skills are important to develop as a young physician but are usually not sufficiently taught in medical school in a structured and comprehensive way. Methods: We performed an online survey among final year medical students regarding how they perceive their current competency level in communication, leadership and career management skills. We also assessed how they rate the importance to acquire these competencies and the current emphasis during their medical school education regarding these topics. Results: Of 450 final year medical students 80 took part in the voluntary survey and 75 complete datasets were returned (16.7%). The majority of respondents rated different communication skills, leadership skills and career management skills as important or very important for their later clinical work. However, most students felt to be poorly or very poorly prepared by the current medical school curriculum, especially for certain leadership and career management skills. Overall, 90.7% of participants expressed interest in an additional educational course that covers subjects of communication, leadership and career management skills during the later stage of medical school, preferably as a hybrid in-person session that also offers synchronous online participation. Conclusions: The results of the survey express the need to address communication, leadership and career management skills in the medical curriculum to be better prepare students for the demands of residency and their further course as physicians. An educational format during the final year of medical school may be suitable to address mentioned topics in the framework of clinical practical exposure. [ABSTRACT FROM AUTHOR]

Introduction: For general surgeons practising in rural areas, multiple factors influence care beyond skills learned in residency. The British Columbia Privileging Dictionary (BCPD) defines core and non-core procedures that shape the scope of general surgeons. Moreover, the Royal College has adopted a Competence by Design (CBD) curriculum which employs entrustable professional activities (EPAs) that list surgical skill residents must be proficient in by graduation. Our goal is to understand the current practice patterns of rural general surgeons in BC based on these policies and local factors. Methods: Medical service plan (MSP) data were collected from 2011 to 2021 based on general surgeons working in rural subsidiary agreement (RSA) communities. The MSP fee codes were organised into core or non-core procedures, as outlined by the BCPD. EPAs were assessed and compared to the non-core procedures. Results: From 2011 to 2021, 223,103 procedures were performed in rural sites in BC. On average, 90.97% (standard deviation = 20.78) of procedures done in all communities were BCPD core procedures. The most common non-core surgical care performed by general surgeons was in plastic surgery (n = 8035). Over 8% of procedures performed were not general surgery EPAs. Notably, none of the EPAs are considered non-core privileges and all EPAs have been performed in rural settings. Conclusion: General surgeons working in rural settings perform multiple procedures outside of EPAs which account for over 8% of their caseload and approximately 6% of procedures performed are non-core privileges. This provides some insight into the potential limitations of the BCPD on graduates hoping to practise in rural communities. As the CBD curriculum has been reported to provide a more flexible approach to learning, it may be tailored to suit residents' learning and career goals, including varied surgical skills to suit rural needs. Introduction: Pour les chirurgiens généraux exerçant en zone rurale, de multiples facteurs influencent les soins, et ce au-delà des compétences acquises en résidence. Le British Columbia Privileging Dictionary (BCPD) définit les procédures essentielles et non essentielles qui déterminent le champ d'action des chirurgiens généraux. En outre, le Collège royal a adopté un programme d'études intitulé « La compétence par conception » (CPC) qui utilise des activités professionnelles confiables (APC) qui énumèrent les compétences chirurgicales que les résidents doivent maîtriser avant d'obtenir leur diplôme. Notre objectif est de comprendre les modes de pratique actuels des chirurgiens généralistes ruraux en Colombie-Britannique en fonction de ces politiques et des facteurs locaux. Méthodes: Les données du Medical Service Plan (MSP, Plan de service médical) ont été recueillies entre 2011 et 2021 auprès des chirurgiens généralistes travaillant dans les communautés du « Rural Subsidiary Agreement » (RSA). Les codes d'honoraires du MSP ont été organisés en procédures essentielles ou non essentielles, comme indiqué par le BCPD. Les APC ont été évalués et comparés aux procédures non essentielles. Résultats: Entre 2011 et 2021, 223 103 procédures ont été réalisées dans des sites ruraux en Colombie-Britannique. En moyenne, 90,97% (écart-type = 20,78) des procédures effectuées dans toutes les communautés étaient des procédures de base du BCPD. Les soins chirurgicaux non essentiels les plus courants effectués par les chirurgiens généraux étaient la chirurgie plastique (n = 8035). Plus de 8% des procédures réalisées n'étaient pas des APC de chirurgie générale. Il est à noter qu'aucune des APC n'est considérée comme un privilège non essentiel et que toutes ont été réalisées en milieu rural. Conclusion: Les chirurgiens généraux travaillant en milieu rural pratiquent de nombreuses procédures en dehors de l'APC, représentant plus de 8% de leur charge de travail et environ 6% des procédures pratiquées sont des privilèges non essentiels. Cela donne une idée des limites potentielles du BCPD pour les diplômés qui espèrent exercer dans les communautés rurales. Étant donné que le programme d'études CPC est réputé offrir une approche plus souple de l'apprentissage, il peut être adapté aux objectifs d'apprentissage et de carrière des résidents, notamment en leur permettant d'acquérir des compétences chirurgicales variées pour répondre aux besoins des zones rurales. [ABSTRACT FROM AUTHOR]

Study Design: A fused deposition modeling three-dimensional (3D)-printed model of the L4–5 vertebra for lumbar discectomy was designed. The model included separately printed dura mater, spinal cord, ligamentum flavum, intervertebral disc (from thermoplastic polyurethane), and bony structures (from polylactic acid), and the material cost approximately US$ 1 per model. A simple plumbing endoscope was used for visualization. Dura mater injury was assessed by painting two layers on the dura mater, which peeled off with trauma. Purpose: Endoscopic spine surgery is a subject of high interest in neurosurgery given its minimally invasive nature; however, it has a steep learning curve. This study evaluated the effectiveness of a cost-efficient 3D-printed model when teaching this technique to neurosurgery residents. Overview of Literature: Only a few studies have investigated the efficacy of such a model. Methods: Eight residents with >2 years of training participated. Residents performed the procedure bilaterally and twice at 1-week intervals. Results: From the 32 surgeries, four were excluded because of facet removal (as it widened the surgical corridor), leaving 28 surgeries for analysis. Initial surgeries demonstrated a mean operation time of 21 minutes 18 seconds (standard deviation [SD], 2 minutes 32 seconds), which improved to a mean of 6 minutes 45 seconds (SD, 37 seconds) in the fourth surgery (F(3, 17)=19.18, p<0.0001), demonstrating a significant reduction in surgical time over successive surgeries. The median area with the paint removed decreased, from 161.80 (85.55–217.83) to 95.13 mm2 (12.62–160.54), (F(2.072, Inf)=2.04, p=0.128); however, this was not significant. Resident feedback indicated high satisfaction with the educational value of the model. Conclusions: The developed fully 3D-printed model provides a viable and scalable option for neurosurgical training programs, enhancing the learning experience while maintaining low costs. This model may be an excellent stepping stone for learning lumbar spine endoscopy, acclimating to the two-dimensional view, progressing to cadaver models, and, eventually, independent surgery. [ABSTRACT FROM AUTHOR]

Objective: To describe the profile and professional trajectory of the obstetrics and gynecology (ObGyn) graduates over the past decade, at a referral university hospital. Methods: A cross‐sectional study was conducted, utilizing a survey that targeted graduates of the ObGyn residency program from the last decade, asking about demographics, medical undergraduate, residency details, post‐residency trajectory, satisfaction levels, and social media usage. A descriptive analysis was performed. Comparative analyses, including gender‐based differences, were assessed using chi‐squared or Fisher exact tests (P < 0.05). Results: Among 126 graduates, 84 agreed to participate (66.67%), predominantly comprising females with an average age of 33 years. Most identified themselves as white. The majority had pursued their undergraduate studies at the same institution (78.6%) and subsequently acquired specialized titles in ObGyn from the national society. Most of them were employed in both public and private sectors (71.08%). Male graduates held the majority of medical shifts in obstetrics. A significant gender‐based salary discrepancy was noted, favoring males. More than half of the professionals utilized social media for work‐related purposes. Many expressed the necessity for supplementary education beyond public health, particularly career management. Conclusion: The findings highlight a predominance of female and white individuals among the graduates. Overall, graduates expressed contentment with their education and professional engagements. A gender‐based income disparity was identified, favoring male graduates. Studies like this can provide insights for improving medical residency education. Synopsis: Graduates were mostly satisfied with ObGyn training, recognizing the increasing role of social media in their activities. A gender‐based income disparity favors male graduates. [ABSTRACT FROM AUTHOR]

Background: Ultrasound (US) has become integral to obstetrics and gynecology (Ob/Gyn), necessitating proficient training during residency. Despite its clinical importance, there is a perceived gap in the quality and structure of postgraduate ultrasound education in Germany. Methods: A cross-sectional survey was conducted among Ob/Gyn residents in Germany from October 2023 to March 2024, using the LimeSurvey platform. The survey, distributed via email, social media, and physical flyers, garnered 211 participants, with 115 completing all sections. The questionnaire covered demographic details, US training experiences, and the perceived importance of US in clinical practice. Results: Although US was highly valued by respondents, with an average of 26.1% of their clinical activity devoted to it, there was significant dissatisfaction with the training quality. Key issues included inadequate supervision, the necessity of self-training, and low participation in certification courses. Despite 93.0% awareness of professional US organizations like the German Society for Ultrasound in Medicine (DEGUM), engagement with structured training programs was minimal. Discussion: The study highlights a critical need for standardized US training protocols and curricular reform in Ob/Gyn residencies in Germany. The discrepancy between the recognized importance of US and the quality of training indicates a pressing need for improvements. Addressing these gaps through comprehensive, structured educational reforms could significantly enhance the proficiency and confidence of future Ob/Gyn specialists, ultimately improving patient care. [ABSTRACT FROM AUTHOR]

Orthopedic residency and fellowship applicants with a strong research record are highly valued for their potential in continuing academic excellence. Despite this, the association between research productivity during training and future academic productivity as an attending orthopedic surgeon is not well-established. We assess the effects of research output during different periods of surgical training as well as residency location on long-term academic productivity as an attending shoulder and elbow surgeon. A search of the 2022-2023 American Shoulder and Elbow Surgeons Fellowship Directory was conducted to identify a list of orthopedic shoulder and elbow fellowship faculty members. Each surgeon's residency, fellowship and current institution of practice were determined and stratified by geographic location. Total publication counts acquired before residency, during residency, during fellowship, and after fellowship were collected for each faculty member. Attending publication rates and H-indices were calculated. A multivariate linear regression model was created, and significance was set at a P value <.05. A total of 149 shoulder and elbow fellowship faculty members representing 34 fellowship programs were identified. The average number of total publications per surgeon was 88.8 ± 102. The average attending publication rate was 5.29 ± 6.89 publications per year. The average H-index for included surgeons was 27.8 ± 24.4. The number of publications acquired before residency (β = 0.293; P <.001), during residency (β = 0.110; P =.025) and during fellowship (β = 0.593; P <.001) were significantly associated with an increased attending publication rate, but no association was observed with the H-index [before residency (β = −0.221; P =.574), during residency (β = 0.045; P =.866), during fellowship (β = 0.198; P =.678)]. There were no significant differences in total publication count (P =.397), attending publication rate (P =.237), or H-index (P =.364) based on location of residency training. Research output before and during surgical training is predictive of continued academic productivity as a shoulder and elbow surgeon. In particular, greater productivity during surgical fellowship was most predictive of academic output as an attending. While long-term academic productivity does not seem to be influenced by the geographic location of residency training, attending surgeons practicing in the Midwest had significantly greater total publication counts and H-indices but similar annual publication rates. [ABSTRACT FROM AUTHOR]

The nature of a dedicated research time during surgical residency has evolved from a traditional basic science laboratory experience to include translational and outcomes research, investigations in improving surgical education, secondary degrees, and other clinical fellowships as trainees have sought an increasingly wide range of experiences. Moreover, many surgical specialties have seen a burst of innovation with new devices, implants, tools, and software to improve the care of surgical patients and minimize complications. This environment has led to a surge in interest in innovation, often focused on surgical device development. Despite this groundswell of interest in innovation at the trainee and program level, there is little structure or curriculum available which outlines a formalized pathway for innovation within a surgical residency, nor is there information on how the success of that program may be evaluated. We present the model we developed for a Surgical Innovation Fellowship and propose means for evaluation of the success of that fellowship. [ABSTRACT FROM AUTHOR]

Context: Successful fish stocking relies upon releasing cohorts directly into habitat containing suitable supporting resources. To facilitate this, an emerging trend has seen fish released onto artificial reefs. Aims: We compared the residency and movement patterns of juvenile sparids (yellowfin bream – Acanthopagrus australis), stocked on artificial reefs and natural habitat, to determine the suitability of incorporating artificial structures as release sites in future stocking programs. Methods: Forty hatchery-reared yellowfin bream were evenly divided and stocked on either artificial reef or natural habitat within an east-Australian estuary, and tracked using acoustic telemetry. Key results: Artificial reefs provided greater habitat complexity than the natural habitat and fish stocked onto these structures showed greater fidelity to their release site and were detected for longer periods of time than those stocked into less complex natural habitat. Conclusions: The high residency levels of fish around artificial reef sites indicate they contain resources to support stocked juvenile sparids. Implications: Stocked yellowfin bream can tolerate a range of salinity and temperatures, allowing flexibility in stocking programs. Future stocking of bream or other sparids should consider releasing fish onto artificial reefs where available. Additionally, the deployment of reefs could aid existing stocking programs. Successful fish stocking relies upon releasing cohorts directly into habitat containing suitable supporting resources. We compared residency and movement patterns of juvenile yellowfin bream stocked on artificial reefs and less complex natural habitat. Fish stocked on artificial reefs showed greater fidelity to their release site and were detected for longer periods. Future stocking of bream or other sparids should consider releasing fish onto artificial reefs, with benefits these structures provide likely to be greater for estuaries lacking naturally complex habitats. [ABSTRACT FROM AUTHOR]

Within the landscape of medical physics education, residency programs are instrumental in imparting hands‐on training and experiential knowledge to early‐career physicists. Ensuring access to educational opportunities for physicists with disabilities is a legal, ethical, and pragmatic requirement for programs, considering that a significant proportion of the United States population has a disability. Grounded in conceptual frameworks of competency‐based medical education and the social model of disability, this work provides an introduction to some practical recommendations for medical physics residency programs. Strategies include embracing universal design principles, fostering partnerships with disability service offices, using inclusive language, developing and publicizing clear procedures for disclosing disabilities and requesting accommodations, and maintaining an overall commitment to equitable access to education. This work urges medical physics residency leadership to proactively move towards training environments that support the needs of residents across the spectrum of disability, highlighting why disability inclusion fundamentally enriches diversity. [ABSTRACT FROM AUTHOR]

Abstract Objective To review United States chiropractic state boards acceptance of chiropractic residencies and fellowships as continuing education (CE). Methods Between February 2024 and April 2024, board websites and accompanying policy documents for all 50 states and the District of Columbia were manually searched for content related to residencies and fellowships and whether they were considered CE. Information regarding CE credit requirements for new licensees was also collected. Results were tabulated in a spreadsheet and descriptive analysis was performed. Consensus among a minimum of 5 of 6 investigators was sought. Results Four states (Arizona, Indiana, Kansas, and Minnesota) accept residencies or fellowships for CE credit, 6 states possess unclear regulatory language regarding these programs, and 41 states make no mention of these training programs among approved CE. Twenty-one states required CE credits during a licensee’s initial renewal period, 1 state was unclear based on website content alone, and 29 states did not mandate CE for initial license renewal. More than 90% (19/21) of states that require CE for a licensee’s first renewal do not or are unclear if they accept residencies or fellowships for credit. Conclusion Few chiropractic state boards currently accept residencies and fellowships as approved CE. As the number of these postdoctoral training programs for chiropractors grow, more state boards may be asked to determine their CE policies on them.

Abstract Background Undergraduate medical education and residency training are critical periods for conducting research. Medical diagnoses and therapies are direct results of successful research efforts that have advanced several scientific fields. This review highlights the importance of incorporating scientific research training into the curricula of undergraduate medical education and residency programs. Methods We utilized key databases such as PubMed, Web of Science, and Google Scholar to conduct a narrative review of English-language articles published between 2002 and 2024. Ultimately, we selected 49 studies that examined the attitudes of undergraduate medical students and residents toward research, the common challenges they encounter while participating in research activities, and the strategies that support and encourage their involvement, all in alignment with our study objectives and keywords. In addition, we identified several relevant themes, including the value of research experience in shaping well-rounded medical professionals; the integrity of research practices in residency selection, which addresses concerns such as the arms race and misrepresentation, as well as the balance between quality and quantity; striking a balance between research and clinical training while promoting equity and inclusion; and effective programs and mentorship strategies to enhance research engagement. Results Translating the positive attitudes of undergraduate medical students and residents into improved knowledge and practice necessitates the development of structured mentoring programs and advanced training systems. Institutions must provide the necessary tools, guidance, and support to overcome research barriers. This will help establish an environment in undergraduate medical education and residency training that values research, facilitates access to it, and integrates it into the curriculum. Conclusions To address the critical shortage of physician-researchers and improve evidence-based medical practice, it is crucial for medical schools to focus on research education and create avenues for student involvement. By tackling research challenges and implementing supportive strategies, these efforts empower the next generation of physician-researchers to embrace research, contribute to medical progress, and uphold the highest standards of patient care.

Abstract Purpose The aim of this study is to investigate and highlight the most important factors influencing the candidate’s selection for residency matching by program directors of surgical and non-surgical specialties in Saudi Arabia. Method This cross-sectional study was conducted in the Central, Eastern, Western, Northern, and Southern regions of Saudi Arabia from February 1, 2023, to August 31, 2023. A total of sixty-one program directors completed a questionnaire, which was adapted and validated from a previous study with permission and tailored to meet the objectives of this research. Results The mean age of the study population was 40.2 years, with surgical specialty program directors being older at 41.7 years and nonsurgical specialty program directors being younger at 39.6 years. In both cases, the highest importance was given to ‘Applicant’s attitude and professionalism’, followed in surgical specialties by ‘Doing clinical rotations in the PD institution’ and ‘Performance in clinical rotation during internship’ in non-surgical specialties. with a mean score of 4.13 and 4.95, respectively. The importance of ‘The impression/opinion of current residents’ has had a certain importance in both specialties. While the number of research projects was prioritized more by surgical PDs (38.6%) compared to non-surgical PDs (29.4%). Conclusion This study highlights the critical role of professionalism and a positive attitude in clinical rotations and interviews for program acceptance in Saudi Arabia. The significance of letters of recommendation and research focus varies between surgical and non-surgical program directors. Program directors should adopt effective recruitment strategies that incorporate practical implications during internships.

Study Design A fused deposition modeling three-dimensional (3D)-printed model of the L4–5 vertebra for lumbar discectomy was designed. The model included separately printed dura mater, spinal cord, ligamentum flavum, intervertebral disc (from thermoplastic polyurethane), and bony structures (from polylactic acid), and the material cost approximately US$ 1 per model. A simple plumbing endoscope was used for visualization. Dura mater injury was assessed by painting two layers on the dura mater, which peeled off with trauma. Purpose Endoscopic spine surgery is a subject of high interest in neurosurgery given its minimally invasive nature; however, it has a steep learning curve. This study evaluated the effectiveness of a cost-efficient 3D-printed model when teaching this technique to neurosurgery residents. Overview of Literature Only a few studies have investigated the efficacy of such a model. Methods Eight residents with >2 years of training participated. Residents performed the procedure bilaterally and twice at 1-week intervals. Results From the 32 surgeries, four were excluded because of facet removal (as it widened the surgical corridor), leaving 28 surgeries for analysis. Initial surgeries demonstrated a mean operation time of 21 minutes 18 seconds (standard deviation [SD], 2 minutes 32 seconds), which improved to a mean of 6 minutes 45 seconds (SD, 37 seconds) in the fourth surgery (F(3, 17)=19.18, p

Introduction: Urological conditions significantly impact global health, with increasing demand for urologists in both developed and developing countries. Disparities in access to surgical care between high-income countries (HICs) and low- and middle-income countries (LMICs) are evident. Despite advancements in urology, LMIC training programs often follow outdated curricula and traditional methods. Methodology: A comprehensive search strategy identified urology training programs in LMICs using the EduRank website, Google searches, and PubMed. Data were collected from the literature, official documents, and online resources, focusing on variables such as program duration, research requirements, and resident salaries. Results: The analysis revealed significant variability in program structures and requirements across LMICs. Residency training durations ranged from 4 to 6 years, with inconsistent research obligations and resident salaries averaging USD 12,857 annually, with a range from USD 5412 to USD 18,174. Fellowship opportunities were limited, with only a small number of programs achieving international accreditation. Conclusions: This study reveals disparities among urology training programs in LMICs, emphasizing the challenges faced by LMICs in providing comprehensive education. Outdated curricula, limited faculty, and insufficient resources contribute to the variability in training quality within LMICs. To bridge these gaps, there is a pressing need for standardized and locally tailored educational frameworks. Future research should focus on direct comparisons with programs in HICs to develop strategies that improve training opportunities and ensure equitable access to advanced urological education and care worldwide.

Abstract Background Starting the first job as a young physician is a demanding challenge. Certain skills are important to master this transformation that go beyond the theoretical knowledge and practical skills taught in medical school. Competencies such as communication, leadership and career management skills are important to develop as a young physician but are usually not sufficiently taught in medical school in a structured and comprehensive way. Methods We performed an online survey among final year medical students regarding how they perceive their current competency level in communication, leadership and career management skills. We also assessed how they rate the importance to acquire these competencies and the current emphasis during their medical school education regarding these topics. Results Of 450 final year medical students 80 took part in the voluntary survey and 75 complete datasets were returned (16.7%). The majority of respondents rated different communication skills, leadership skills and career management skills as important or very important for their later clinical work. However, most students felt to be poorly or very poorly prepared by the current medical school curriculum, especially for certain leadership and career management skills. Overall, 90.7% of participants expressed interest in an additional educational course that covers subjects of communication, leadership and career management skills during the later stage of medical school, preferably as a hybrid in-person session that also offers synchronous online participation. Conclusions The results of the survey express the need to address communication, leadership and career management skills in the medical curriculum to be better prepare students for the demands of residency and their further course as physicians. An educational format during the final year of medical school may be suitable to address mentioned topics in the framework of clinical practical exposure.

Objective: To identify where reproductive endocrinology and infertility (REI) fellows trained for residency. Design: Observational, cross-sectional study. Setting: Not applicable. Subject(s): Reproductive endocrinology and infertility fellows. Intervention(s): Not applicable. Main Outcome Measure(s): Percentage of fellows who completed residency training at an institution with an REI fellowship program. Result(s): A total of 289 fellows were identified among the graduating fellowship classes from 2023–2027. Of those fellows, 69.9% completed residency at an institution that had an associated REI fellowship program, and 19.7% remained at the same institution for residency and fellowship. In the last 5 years, 34.4% of obstetrics and gynecology residency programs have had at least 1 resident enter REI fellowship. Conclusion(s): Most matriculated REI fellow physicians train at residency programs that have an associated REI fellowship program.

Abstract Background Anesthesiologists provide crucial anesthesiology services in the operating room and non-operating room locations. Combined with an aging and growing Israeli population, there is an increasing demand for anesthesiology services. A previous study performed in 2005 showed that most anesthesiologists are immigrant physicians with few Israeli medical school graduates. Since then, physician immigration decreased, many have retired and demand for anesthesia services has increased while insufficient numbers of new anesthesiologists were trained, leading to a shortage, limiting surgeries and other procedures in many hospitals. The present study examined the composition of the Israeli anesthesiology workforce in 2021and compared it to the 2005 workforce. Methods A cross-sectional survey of demographic and professional information about each Israeli hospital anesthesiologists was solicited from 34 anesthesiology department chairs responsible for 36 Israeli acute care hospitals. Results There are 1313 anesthesiologists in the 36 hospitals, resulting in a ratio of 14.2 anesthesiologists per 100,000 population. 22.6% of anesthesiologists will reach retirement age over the next ten years. The proportion of female anesthesiologists was 28.7%. While Israeli medical school graduates increased to 18.1% from 12.2% in 2005, non-Israeli citizens and non-permanent residents comprised 8.5% of the workforce. Conclusions Despite growth in the ratio of anesthesiologists per population, a workforce shortage is expected to worsen over the next ten years due to retirements, shortened call hours, and the Yatziv reform which bans graduates of certain overseas medical schools from obtaining Israeli Medical Licenses. The current workforce has compensated for the existing shortage of anesthesiologists by enlisting non-Israeli trainees from overseas. Yet, it is crucial to maintain and enlarge the local Israeli workforce to forestall a worsening shortage.

Abstract Background The quality of education and the learning environment significantly influence dental trainees’ success and experiences. However, the impact of the educational environment on dental residents in Saudi Arabia remains unexplored. This study aimed to assess the educational environment among dental residents at King Abdulaziz Medical City (KAMC) using the Postgraduate Hospital Educational Environment Measure (PHEEM) instrument, shedding light on its influence and providing insights for improvement. Methods A cross-sectional survey was conducted among 85 dental residents from various specialties at King Abdulaziz Medical City in Riyadh, Saudi Arabia, using the PHEEM instrument to evaluate the educational environment. Data analysis involved descriptive statistics, the Shapiro-Wilk test for score normality, and comparative analyses to explore the relationships between PHEEM scores and sociodemographic characteristics, specialties, residency years, and health habits. Results A total of 85 dental residents completed the survey. The majority of participants were aged 25 years and older (96.5%), female (56.5%), and single (78.8%). Most of the participating dental residents were Saudi board orthodontic residents (18.8%), and they were at the R2 level of training (32.9%). 88.2% were non-smokers, and 78.8% of them practiced physical activity. The PHEEM assessment revealed an overall score of 117.12 out of 160, with subscale scores of 41.54 out of 56 for role autonomy, 44.66 out of 60 for teaching, and 30.92 out of 44 for social support. Factors like age, marital status, and smoking were associated with lower scores, while being female and physically active were linked to higher scores. Notably, R3 residents had significantly lower scores than R1 residents (p

Abstract Background This study aims at investigating and evaluating the categorical knowledge of residency using an internet-based examination. Methods All in-training examinees from 32 Thailand’s general surgery residency training institutions participating in the online examination. One hundred fifty Multiple Choice questions (MCQs) were selected for this examination from a pool of previous MCQs used for board certification examinations. Baseline chracteristic of the examinee including residency year, training institution (medical schools and public health-based training institutions), regional-based area of the institution, overall test score, scoring by subcategory, total time to complete the examination, and the length of accredited as a training centre time were collected and analysed. Results Total 613 examinees. The mean total score of 1st and 3rd year residency of a public health hospital institution differed from those with medical school-based training. On average, the scores in 4 out of 10 categories of residency from medical school training institutions were higher. However, residency from institutions with over 7 years of experience tended to score higher in the Liver, Biliary and Pancreas category. Conclusions The average scores of MCQs exams which reflect the medical knowledge for general surgical residency training at medical schools do not significantly differ from those of individuals undergoing public health training. Additionally, the mean scores of MCQs exams did not differ between high-experience training institutions and recent accredited training centers.

Introduction: Burnout is a concerning clinical syndrome comprising excessive stress, lack of satisfaction, and a feeling of being overworked. In India, postgraduate residents who shoulder the entire burden of patient care, are prone to suffer from burnout. Only a few Indian studies have been carried out to estimate the prevalence of burnout among postgraduate resident doctors. Our study, the first of its kind from eastern India, aims to address this lacuna. Materials and Methods: This was a single-institution cross-sectional observational study carried out using an online semi-structured form comprising demographic data and the Maslach Burnout Inventory. Appropriate statistical tests were carried out to analyze the data obtained. Results: The study received a response rate of 79.2%. Of the participants, 44.1% were females, 54.9% were males, and 1% identified as other gender. The mean age (standard deviation) of the participants was 28.02 (3.67) years. Overall, 75% of the participants experienced burnout. Younger participants, females, clinical residents, those in a relationship, and 2nd year of residency reported higher emotional exhaustion. Depersonalization was associated with lower age, being in a relationship, metropolitan upbringing, and 2nd year of residency. The lower personal accomplishment was seen in those coming from metropolitan and rural backgrounds. Conclusion: Burnout has serious implications on psychological and physical health of the residents. Interventions for effective management will greatly improve the overall mental health and work performance of the junior doctors.

Virtual reality (VR) integration into surgical education has gained immense traction by invigorating skill-building in ways that are unlike the traditional modes of training. This systematic review unites current literature relevant to VR in surgical education to showcase tool transferability, and subsequent impact on knowledge acquisition, skill development, and technological innovation. This review followed the PRISMA guidelines and included three databases. Among the 1926 studies that were screened, 31 studies met the inclusion criteria. ChatGPT assisted in generating variables for data extraction, and the authors reached unanimous consensus on 13 variables that provided a framework for assessing VR attributes. Surgical simulation was examined in 26 studies (83.9%). VR applications incorporated anatomy visualization (83.9%), procedure planning (67.7%), skills assessment (64.5%), continuous learning (41.9%), haptic feedback (41.9%), research and innovation (41.9%), case-based learning (22.6%), improved skill retention (19.4%), reduction of stress and anxiety (16.1%), and remote learning (12.9%). No instances of VR integration addressed patient communication or team-based training. Novice surgeons benefited the most from VR simulator experience, improving their confidence and accuracy in tackling complex procedural tasks, as well as decision-making efficiency. Enhanced dexterity compared to traditional modes of surgical training was also notable. VR confers significant potential as an adjunctive teaching method in plastic and reconstructive surgery (PRS). Studies demonstrate the utility of virtual simulation in knowledge acquisition and skill development, though they lack targeted approaches for augmenting training related to collaboration and patient communication. Given the underrepresentation of PRS among surgical disciplines regarding VR implementation in surgical education, longitudinal curriculum integration and PRS-specific technologies should be further investigated.

Background and objective: Video-based learning may be beneficial in surgical education, both in the preparation for surgery and to evaluate surgical performance. The use of a video is not yet anchored in European urology residency programs, and it is unclear how frequently residents use videos. The purpose of this study is to investigate whether and how urology residents utilize videos to prepare for surgical procedures and evaluate their surgical performance. Methods: We conducted a European-wide, survey-based, needs assessment among urology residents. The survey was distributed electronically among the participants in the European Urology Residents Education Program 2022 and all the members of the European Society of Residents in Urology. Key findings and limitations: Seventy-two surveys were completed by the residents of 12 nationalities. Of the residents, 98.6% used videos in preparation, mainly for open, laparoscopic, and robotic procedures. YouTube was by far the most used source. Of the residents, 86% believed that a postsurgical video review would be helpful. In total, 39% of the residents actually had this possibility. Of them, 30% had the opportunity to do this together with a supervisor. Conclusions and clinical implications: This study demonstrated that European urology residents often use videos to prepare surgical procedures. Considering that the majority of the respondents use YouTube as the main source of videos, this seems not to be formalized within their training. Although most residents would value a postsurgical video review, preferably together with a supervisor, the latter is not available to the majority. We recommend the use of professional, and not public, video channels and easier access to postsurgical video review. Patient summary: Video-based learning may have an important role in surgical education. Videos often are a source of education for European urology residents to prepare for surgical procedures. Although most residents would appreciate a postsurgical video review or video-based coaching, this is not available to the majority of them.

Aims: The aims of this study were to describe the demographic, socioeconomic, and educational factors associated with core surgical trainees (CSTs) who apply to and receive offers for higher surgical training (ST3) posts in Trauma & Orthopaedics (T&O). Methods: Data collected by the UK Medical Education Database (UKMED) between 1 January 2014 and 31 December 2019 were used in this retrospective longitudinal cohort study comprising 1,960 CSTs eligible for ST3. The primary outcome measures were whether CSTs applied for a T&O ST3 post and if they were subsequently offered a post. A directed acyclic graph was used for detecting confounders and adjusting logistic regression models to calculate odds ratios (ORs), which assessed the association between the primary outcomes and relevant exposures of interest, including: age, sex, ethnicity, parental socioeconomic status (SES), domiciliary status, category of medical school, Situational Judgement Test (SJT) scores at medical school, and success in postgraduate examinations. This study followed STROBE guidelines. Results: Compared to the overall cohort of CSTs, females were significantly less likely to apply to T&O (OR 0.37, 95% CI 0.30 to 0.46; n = 155/720 female vs n = 535/1,240 male; p < 0.001). CSTs who were not UK-domiciled prior to university were nearly twice as likely to apply to T&O (OR 1.99, 95% CI 1.39 to 2.85; n = 50/205 vs not UK-domiciled vs n = 585/1,580 UK-domiciled; p < 0.001). Age, ethnicity, SES, and medical school category were not associated with applying to T&O. Applicants who identified as ‘black and minority ethnic’ (BME) were significantly less likely to be offered a T&O ST3 post (OR 0.70, 95% CI 0.51 to 0.97; n = 165/265 BME vs n = 265/385 white; p = 0.034). Differences in age, sex, SES, medical school category, and SJT scores were not significantly associated with being offered a T&O ST3 post. Conclusion: There is an evident disparity in sex between T&O applicants and an ethnic disparity between those who receive offers on their first attempt. Further high-quality, prospective research in the post-COVID-19 pandemic period is needed to improve equality, diversity, and inclusion in T&O training. Cite this article: Bone Jt Open 2024;5(8):697–707.

Abstract Background Recruitment to residency programs in hospitals located in other than major hubs (“remotely located”) is a challenge in many countries. In 2011, the Israeli Ministry of Health launched a 10-year financial incentive to encourage physicians to enroll in residency programs in such hospitals. Nearly 1 billion New Israeli Shekels (260 million US$) were invested in that program which had only limited success. As a new physician association’s collective agreement is impending, we aimed to measure the effectiveness of selected incentives in attracting medical school graduates to residencies in remotely located hospitals. Methods This study included Israeli medical students in their final year of medical school. We used an online questionnaire with multiple-choice demographic questions and a 5-point Likert scale to gauge the effect of various incentives on their preference for residency location. Results Between July and November 2022, 522 students responded (405 studied in Israeli medical schools [out of 705 students] and 117 in foreign medical schools [out of 1936 students]). Forty-two percent had at least one clerkship in a remotely located hospital, and 24% had included at least one remotely located hospital among their top five choices for internship. Only 13% reported that they prefer a residency program in those institutions. The incentive selected by students as most persuasive was government assistance in acceptance to and financial support for a fellowship abroad, followed by a financial grant and fewer on-call hours. Only 7% of the students indicated that no incentive would influence them to choose a remotely located hospital for their residency training. Medical education in a remotely located university and the choice of at least one remotely located hospital among the top five choices for internship were significantly associated with positive incentive receptivity, whereas male sex and older age were associated with negative receptivity. Conclusion This study on the attitudes of Israeli medical school graduates toward incentives aimed at attracting them to residencies in remotely located institutions revealed that career development opportunities and assistance in obtaining fellowships might influence their choice.

Objective: The pathway to cardiothoracic surgery is often obscure for premedical students and aspiring applicants and requires navigating various known and unknown obstacles. Recognizing the challenges encountered on the path to a career in cardiothoracic surgery in the United States, we present this guide for students interested in the field to maximize success in their premedical, preclinical, and preresidency years. Methods: This is a joint collaboration between the Thoracic Surgery Residents Association and the Thoracic Surgery Medical Student Association. Drawing from firsthand experiences and insights gathered from numerous student applicants and current surgical residents, a comprehensive guide was constructed for students from the point of undergraduate school to advanced training options, including super-fellowship training. Results: Several intricacies to cardiothoracic surgery career planning were discussed, including differences between traditional and integrated/fast-track pathways, college and medical school selection, networking, performing during clinical rotations, extracurricular and research activities, building mentorship relationships, and pursuing alternate career and advanced training opportunities. Conclusions: For premedical students and aspiring applicants, the road to cardiothoracic surgery requires meticulous planning, grit, and thoughtful dedication. This document consolidates firsthand insights and advice from numerous aspiring and matched applicants to serve as a comprehensive guide for students seeking a career in cardiovascular and thoracic surgery.

Abstract Background Medical residency constitutes a highly demanding and taxing phase in the professional journey of physicians. Factors such as low income, excessive workloads, and uncertainty regarding their career trajectory can contribute to diminished job satisfaction among residents. Neglecting this issue can have enduring negative effects on the quality and quantity of healthcare services provided. This research aims to explore the challenges encountered during medical residency and propose viable solutions. Methods In this qualitative study conducted in 2023, interviews were employed to identify challenges, facilitators, barriers, and potential solutions associated with transitioning from residency to a job. In the qualitative section, a purposive selection process led to the inclusion of 26 interviewees, and for the Delphi method, 17 experts were purposefully chosen at three hierarchical levels: macro (Ministry of Health), intermediate (university), and executive (hospital). Qualitative data underwent analysis using a conceptual framework, while Delphi data were subjected to quantitative analysis. Results The qualitative analysis revealed five general themes with 13 main categories and 70 sub-categories as challenges, two general themes as facilitators, and barriers to the transition from residency to a job. Additionally, eight main categories with 52 interventions were identified as solutions to overcome these barriers. In the Delphi stage, the number of proposed solutions was streamlined to 44 interventions. The most significant challenges identified in this study included high workload during residency, low income, career-related uncertainties, issues related to welfare services, and challenges in education and communication. Conclusion The decline in residents’ willingness, coupled with the substantial work and financial pressures they face, poses a serious threat to the healthcare system, necessitating significant reforms. Transitioning from residency to a full-fledged job emerges as a potential avenue to address a substantial portion of the expressed needs. Implementing these reforms demands resolute determination and collaboration with sectors beyond the healthcare system, integrated into a comprehensive national healthcare plan that considers the country’s capabilities.

Background: This study aims at investigating and evaluating the categorical knowledge of residency using an internet-based examination. Methods: All in-training examinees from 32 Thailand's general surgery residency training institutions participating in the online examination. One hundred fifty Multiple Choice questions (MCQs) were selected for this examination from a pool of previous MCQs used for board certification examinations. Baseline chracteristic of the examinee including residency year, training institution (medical schools and public health-based training institutions), regional-based area of the institution, overall test score, scoring by subcategory, total time to complete the examination, and the length of accredited as a training centre time were collected and analysed. Results: Total 613 examinees. The mean total score of 1st and 3rd year residency of a public health hospital institution differed from those with medical school-based training. On average, the scores in 4 out of 10 categories of residency from medical school training institutions were higher. However, residency from institutions with over 7 years of experience tended to score higher in the Liver, Biliary and Pancreas category. Conclusions: The average scores of MCQs exams which reflect the medical knowledge for general surgical residency training at medical schools do not significantly differ from those of individuals undergoing public health training. Additionally, the mean scores of MCQs exams did not differ between high-experience training institutions and recent accredited training centers. [ABSTRACT FROM AUTHOR]