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This article provides structure to developing, implementing, and evaluating a successful coaching program that effectively meets the needs of learners. We highlight the benefits of coaching in medical education and recognize that many educators desiring to build coaching programs seek resources to guide this process. We align 12 tips with Kern's Six Steps for Curriculum Development and integrate theoretical frameworks from the literature to inform the process. Our tips include defining the reasons a coaching program is needed, learning from existing programs and prior literature, conducting a needs assessment of key stakeholders, identifying and obtaining resources, developing program goals, objectives, and approach, identifying coaching tools, recruiting and training coaches, orienting learners, and evaluating program outcomes for continuous program improvement. These tips can serve as a framework for initial program development as well as iterative program improvement. [ABSTRACT FROM AUTHOR]

Background/Objectives: Mental health disorders pose a substantial challenge for healthcare workers, particularly in the post-COVID-19 era. Public health medical residents (PHRs) played a pivotal role during the pandemic and were significantly affected by the heavy workload. This study aims to uncover potential associations between workload characteristics and symptoms of anxiety and insomnia in Italian PHRs based on data collected in 2022 through the Public Health Residents' Anonymous Survey in Italy (PHRASI) study. Methods: A total of 379 residents completed the self-administered questionnaire comprising the Generalized Anxiety Disorder-2 (GAD-2), and the Insomnia Severity Index (ISI). Results: While 36% PHRs reported anxiety symptoms (GAD-2 ≥ 3), 12% reported moderate-to-severe insomnia symptoms (ISI ≥ 15). The multivariate logistic regressions showed that a high work–life interference was associated with the presence of anxiety and insomnia symptoms, while attending two or more simultaneous traineeships was associated with insomnia symptoms. A high workload perceived was positively associated with both the mental health outcomes considered, while the perception of work environment manageability was negatively associated with them. Conclusions: These findings underscore the significant role of the workload in influencing the mental health status of PHRs and emphasize the importance of fostering a supportive work environment that prioritizes mental well-being [ABSTRACT FROM AUTHOR]

Danielle L Terry, Prabhdeep Bajwa Guthrie Medical Group, Sayre, PA, USACorrespondence: Danielle L Terry, Director of Behavioral Science, Guthrie Medical Group, One Guthrie Square, Sayre, PA, 18840, USA, Tel +1 570 887 3337, Fax +1 570 887 3585, Email Danielle.terry@guthrie.orgIntroduction: Supervision is considered a collaboration between a supervisor and supervisee and includes perceptiveness, responsiveness of the supervisor, a state of rapport, and specific learning tasks that allow the individual to work towards a goal. The alliance in supervision has been identified as a key ingredient of effective supervision, regardless of the type of treatment, population, or supervision model being used. While it is known that the medical training environment hosts high rates of burnout, little research has examined the role of supervisory alliance in regard to burnout, distress, and self-esteem. This study aimed to apply previous models of supervisory alliance to medical education, and explore associations between educational alliance and trainee self-esteem, burnout, and distress.Methods: Participants included 108 medical trainees (response rate = 81%). Medical trainees were recruited from a rural Pennsylvanian teaching hospital and asked to complete a voluntary and anonymous electronic survey. Multiple linear regression was used to examine the association between supervisory alliance and burnout and distress, while controlling for average hours worked and slept.Results: Results suggested that supervisory alliance was associated with burnout, distress, and self-esteem among medical trainees.Conclusion: Given the high rates of depression and burnout among medical providers, it may be helpful to understand the factors that may impact medical trainee’s distress and esteem. Future longitudinal research might examine the role of the supervisory alliance over time, and whether strong mentorship and guidance may serve to protect trainees from burnout throughout training and into their career.Keywords: medical residents, supervisory alliance, burnout

Abstract Background Workplace social capital (WSC), a social resource available within work or occupational environments, has been identified as an important factor for employees’ health in fields other than medical education. However, little is known about whether WSC is associated with well-being and work engagement among medical residents. The aim of this study was to examine the relationships between WSC, well-being, and work engagement specifically among medical residents. Methods This cross-sectional study was conducted at 32 hospitals in Japan, assessing WSC with the Japanese medical resident version of the Workplace Social Capital (JMR-WSC) scale. Well-being and work engagement were measured as the primary and secondary outcomes using the Subjective Well-Being Scale and the Japanese version of the Utrecht Work Engagement Scale. Results We analyzed data from 276 residents. Adjusting for possible confounders, the JMR-WSC Scale scores were associated with well-being in a dose-dependent manner (adjusted mean difference 6.55, 95% CI 4.96–8.15 for the WSC highest score quartile, compared with the lowest score quartile). The WSC Scale scores demonstrated a dose-dependent association with work engagement (adjusted mean difference 15.12, 95% CI 11.66–18.57 for the WSC highest score quartile, compared with the lowest score quartile). Conclusions This study showed that WSC was linked to enhanced well-being and work engagement among residents. Our findings offer insights for developing interventions to prevent resident burnout and create an environment conducive to residents’ well-being and engagement.

Abstract Background Leadership is a critical competency for medical professionals, yet it is often neglected in medical training. For ObGyn residents, leadership training is particularly crucial as it significantly impacts both maternal and newborn outcomes, as well as the operational efficiency of healthcare teams. The main objective of this study was to assess the perceptions of obstetrics and gynecology residents who served as group leaders in the emergency team at the Department of Gynecology, Ward 3, Dr. Ruth K.M. Pfau Civil Hospital Karachi. Methods A Cross-sectional survey was conducted with purposively sampled 28 year-4 residents who worked as group leaders during last 3 years (from 2018 to 2020) of their residency program at the emergency team in the department of Gynecology Ward 3 Dr Ruth KM Pfau Civil Hospital Karachi. The perceptions on leadership were assessed on 25 items scale sent through a questionnaire on email. Grading of responses was done using a 4-point ordinal scale where 1 meant little importance and 4 was regarded as having great importance. Data was summarized with relevant descriptive statistics and was analyzed on SPSS version 22. Results The mean age of residents was 30.36. The mean leadership scores of the group of residents were calculated to be 77.50 (SD ± 9.57) while 14(50%) residents showed good and 14 (50%) showed excellent leadership skills based on cumulative scores. Of the 25 traits examined in this study, the highest reported trait was humility 3.82 (± 0.39) followed by empowerment 3.68 (± 0.77) and effective communication 3.68 (± 0.77). While responding about learning experiences, 89.3% of participants felt that the experience enhanced their decision-making skills and boosted their confidence in dealing with emergencies. Conclusion Our study highlights the critical importance of leadership development in the training of ObGyn residents, particularly in high-pressure emergency settings. The findings reveal that residents value leadership traits such as humility, empowerment, and effective communication, which are essential for building teamwork and ensuring optimal patient outcomes and patient satisfaction.

Abstract Background Burnout is a syndrome that result from chronic workplace stress and it characterized by emotional exhaustion, depersonalization and low personal accomplishments. Studies report higher burnout levels in medical personnel compared to the general population. Workplace burnout has been directly linked to medical errors and negative coping strategies such as substance abuse. The aims of this study were to assess the level of burnout in medical residents, evaluate their impressions about coping mechanisms and assess perceived impact on patient care in a low/ middle income country setting. Methods This was a cross sectional, mixed methods survey carried out at Aga Khan University, Nairobi Kenya. The Maslach Burnout Inventory - Human Services Survey was used to assess the level of burnout. High-risk scores for each subscale are defined as > 27 in emotional exhaustion, > 10 in depersonalization, and

Background: Leadership is a critical competency for medical professionals, yet it is often neglected in medical training. For ObGyn residents, leadership training is particularly crucial as it significantly impacts both maternal and newborn outcomes, as well as the operational efficiency of healthcare teams. The main objective of this study was to assess the perceptions of obstetrics and gynecology residents who served as group leaders in the emergency team at the Department of Gynecology, Ward 3, Dr. Ruth K.M. Pfau Civil Hospital Karachi. Methods: A Cross-sectional survey was conducted with purposively sampled 28 year-4 residents who worked as group leaders during last 3 years (from 2018 to 2020) of their residency program at the emergency team in the department of Gynecology Ward 3 Dr Ruth KM Pfau Civil Hospital Karachi. The perceptions on leadership were assessed on 25 items scale sent through a questionnaire on email. Grading of responses was done using a 4-point ordinal scale where 1 meant little importance and 4 was regarded as having great importance. Data was summarized with relevant descriptive statistics and was analyzed on SPSS version 22. Results: The mean age of residents was 30.36. The mean leadership scores of the group of residents were calculated to be 77.50 (SD ± 9.57) while 14(50%) residents showed good and 14 (50%) showed excellent leadership skills based on cumulative scores. Of the 25 traits examined in this study, the highest reported trait was humility 3.82 (± 0.39) followed by empowerment 3.68 (± 0.77) and effective communication 3.68 (± 0.77). While responding about learning experiences, 89.3% of participants felt that the experience enhanced their decision-making skills and boosted their confidence in dealing with emergencies. Conclusion: Our study highlights the critical importance of leadership development in the training of ObGyn residents, particularly in high-pressure emergency settings. The findings reveal that residents value leadership traits such as humility, empowerment, and effective communication, which are essential for building teamwork and ensuring optimal patient outcomes and patient satisfaction. [ABSTRACT FROM AUTHOR]

Burnout, stress and overwork are highly prevalent amongst junior training physicians worldwide, which explains the widespread phenomenon of physicians leaving the field and organised protests/strikes for better working conditions. Back in 2003, the mandatory duty hour restriction was a landmark intervention rolled out by the Accreditation Council for Graduate Medical Education that formally mandated limiting working hours of trainee residents to no more than 80 h per week, and not exceeding 24-h shifts with 6 added hours for education and handover. Nonetheless, 20 years later, this measure continues to be subject to multiple debates on its purported efficacy in achieving its intended objectives and fails to adequately prevent physician burnout and exodus. In our view, the current duty hour restriction model is, in and of itself, inadequate for combating burnout amongst medical residents for several reasons, including insignificant reduction in duty hours with suboptimal adherence/reporting, failure to account for off-site clinical and non-clinical duties, as well as nature of clinical work which typically involves high work intensity in less-than-optimal/unconducive work environments and significant psychoemotional stress. In this article, we offer our perspectives on pursuing a balanced approach towards both meaningful quantitative reduction in working hours as well as practical qualitative improvement in nature of clinical and non-clinical work that could collectively address resident burnout and improve work and training outcomes. [ABSTRACT FROM AUTHOR]

OBJECTIVES: The adverse effects of physician stress on health system performance are well documented. Financial stress is a notable cause of anxiety in medical residents; however, most residency programs lack formal, comprehensive financial education programs. Early single-center studies link financial education interventions to improved immediate fiscal well-being, but programs evaluating its long-term effects are lacking. METHODS: Fifty (50) Emergency Medicine and Internal Medicine resident physicians from CommonSpirit Health's St. Joseph's Medical Center in Stockton, CA and Mercy One Medical Center in Des Moines, IA participated in a virtual 8-hour financial education course in April 2022. Participants completed pre-, post-, and 18-month follow-up course surveys to measure financial confidence in seven financial domains and six markers of stress of financial origin (SOFO). RESULTS: Forty (40) of 50 residents (80%) completed the pre-and post-course surveys and 19 (38%) completed pre-, post-, and 18-month follow-up surveys. Immediately after the course, there was a statistically significant increase in financial confidence in all seven course domains (p < 0.01) and a significant reduction in SOFO markers (p < 0.01-0.02). At 18 months, financial confidence markers remained increased in most course domains, except related to debt and mortgage, passive income, and taxes. There was a strong association between financial confidence and SOFO immediately post course. Residents with low financial confidence were 15 times as likely to experience SOFO than those with higher financial confidence (p = 0.02). These associations did not persistent at 18 months. CONCLUSION: Financial stress is a major contributor to anxiety among physician trainees. Our financial education program demonstrated a significant impact on financial confidence and markers of SOFO, especially in the short term. This offers promising results for personal finance education to serve as a feasible intervention to address physician stress but suggests the need for longitudinal education to maintain its beneficial effects. [ABSTRACT FROM AUTHOR]

Background: Burnout is a syndrome that result from chronic workplace stress and it characterized by emotional exhaustion, depersonalization and low personal accomplishments. Studies report higher burnout levels in medical personnel compared to the general population. Workplace burnout has been directly linked to medical errors and negative coping strategies such as substance abuse. The aims of this study were to assess the level of burnout in medical residents, evaluate their impressions about coping mechanisms and assess perceived impact on patient care in a low/ middle income country setting. Methods: This was a cross sectional, mixed methods survey carried out at Aga Khan University, Nairobi Kenya. The Maslach Burnout Inventory - Human Services Survey was used to assess the level of burnout. High-risk scores for each subscale are defined as > 27 in emotional exhaustion, > 10 in depersonalization, and < 33 in personal accomplishment. Overall high risk of burnout was defined as high-risk scores in 2 or more of the 3 categories. Categorical variables were analysed using descriptive statistics and reported as frequency counts and corresponding percentages. Chi-square test was applied to test for association of burnout and the categorical variables. P value of < 0.05 was considered statistically significant. To assess the impressions on patient care and evaluate the coping mechanisms employed in the context of burnout residents participated in four focus group discussions reaching thematic saturation. Results: 95 out of 120 residents consented to participate in the study, 47.3% of whom had a high risk of burnout. A significant association was found between gender and burnout risk with more female residents having high risk of burnout compared to their male counterparts; 58.0% and 35.6% respectively (P value 0.029). Residents in paediatrics and child health had the greatest risk of burnout (8 out of 10) compared to those in other programmes (P value of 0.01). Thematic analysis from focus group discussions revealed that main sources of stress included departmental conflict and struggle to balance work and other aspects of life. All focus group discussions revealed that burnout and stress are associated with negative coping mechanisms. Respondents reported that when under stress, they felt more likely to make medical errors. Conclusion: This study reported high risk of burnout among post graduate residents which is consistent with other global studies. The sources of stress cited by residents were mostly related to the workplace and many perceived sub-optimal patients care resulted from burnout. This highlights a need for preventive measures such as wellness programs within the training programmes. Trial registration number: Not applicable. [ABSTRACT FROM AUTHOR]

Background & Objective: The coronavirus disease brought worldwide uncertainty, and Iran was affected by it as well as many other countries in the world. Halting face-to-face education due to social distancing and resident re-employment in clinical wards leads to defective education. The aim of this survey was to evaluate the advantages and disadvantages of modifications made in pathology residency education in Iran. Methods: This online survey was conducted on all pathology residents in Iran. An online 30-item questionnaire was developed and used in this study. Results: Sixty residents (88.3% female) participated in this survey. The majority (70%) of the residents were over 30 years old. Fifty percent of the responders reported that their personal life was influenced by the pandemic. Skyroom and Adobe Connect were the most common platforms for online education with overall satisfaction of 65%. The webinars were considered suitable by 51.7% of the responders. Concerns at work were reported by 48.3% of the residents, while 78.3% reported being exposed to the disease and 55% reported being infected. Concerns about transmission of the disease to family members were reported by 90% of the responders. Conclusion: This study showed that the pathology residency modifications were successful in providing education. However, their social and educational life characteristics might affect their satisfaction with online education. [ABSTRACT FROM AUTHOR]

Unhealthy behaviors (UBs) can affect mental health. The most impactful of these are alcohol abuse, sedentary behavior, and sleep disturbances. Since these UBs are not well explored in medical residents, this study aims to overcome this gap, focusing on outcomes such as depression and anxiety. The Public Health Residents' Anonymous Survey in Italy (PHRASI) is a nationwide cross-sectional study based on an 88-item questionnaire. UBs were explored through validated questionnaires: the Alcohol Use Disorders Identification Test-c (AUDIT-C), the International Physical Activity Questionnaire (IPAQ), and the Insomnia Severity Index (ISI). Depressive symptoms and anxiety were detected by Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), respectively. Hierarchical cluster analysis described clusters using responses from the AUDIT-C, IPAQ, and ISI. A total of 375 participants were included in this study. Three distinct clusters (CL) were identified: CL1 was characterized by a moderate risk for alcohol abuse and high insomnia dissatisfaction, with a significantly higher frequency of depressive symptoms (46%, p < 0.001) and anxiety (53%, p < 0.001); CL2 had no risk for alcohol abuse, high sleep satisfaction, and better mental health profile, with the lowest prevalence of depressive symptoms (15%, p < 0.001); CL3 had the highest risk of alcohol abuse, the highest rate of physical activity (40%, p = 0.013), and the lowest prevalence of anxiety (27%, p < 0.001). Subjects belonging to CL1 required much more attention to prevent the worsening of mental outcomes. Interventions for promoting mental health should be addressed in all Public Health schools to create more sustainable working conditions. [ABSTRACT FROM AUTHOR]

This article provides structure to developing, implementing, and evaluating a successful coaching program that effectively meets the needs of learners. We highlight the benefits of coaching in medical education and recognize that many educators desiring to build coaching programs seek resources to guide this process. We align 12 tips with Kern’s Six Steps for Curriculum Development and integrate theoretical frameworks from the literature to inform the process. Our tips include defining the reasons a coaching program is needed, learning from existing programs and prior literature, conducting a needs assessment of key stakeholders, identifying and obtaining resources, developing program goals, objectives, and approach, identifying coaching tools, recruiting and training coaches, orienting learners, and evaluating program outcomes for continuous program improvement. These tips can serve as a framework for initial program development as well as iterative program improvement.

Abstract Background Feedback is a critical component of the learning process in a clinical setting. This study aims to explore medical residents’ perspectives on feedback delivery and identify potential barriers to feedback-seeking in clinical training. Methods This cross-sectional study involved 180 medical residents across seventeen specialties. We employed the validated Residency Education Feedback Level Evaluation in Clinical Training (REFLECT) tool to assess residents’ perspectives on their attitude toward feedback, quality of feedback, perceived importance, and reaction to feedback. Additionally, we explored barriers to feedback-seeking behavior among medical residents. Results The majority of medical residents held positive attitudes toward feedback. They agreed that feedback improves their clinical performance (77.7%), professional behavior (67.2%), and academic motivation (56.7%), while also influencing them to become a better specialist in their future career (72.8%). However, the study revealed critical deficiencies in the feedback process. Only 25.6% of residents reported receiving regular feedback and less than half reported that feedback was consistently delivered at suitable times and locations, was sufficiently clear or included actionable plans for improvement. A minority (32.2%) agreed that faculty had sufficient skills to deliver feedback effectively. Moreover, peer-to-peer feedback appeared to be a primary source of feedback among residents. Negative feedback, though necessary, often triggered feelings of stress, embarrassment, or humiliation. Notably, there were no significant differences in feedback perceptions among different specialties. The absence of a feedback-seeking culture emerged as a central barrier to feedback-seeking behavior in the clinical setting. Conclusions Establishing shared expectations and promoting a culture of feedback-seeking could bridge the gap between residents’ perceptions and faculty feedback delivery. Furthermore, recognizing the role of senior and peer residents as valuable feedback sources can contribute to more effective feedback processes in clinical training, ultimately benefiting resident development and patient care.

Introduction: Medical training has been reported to be stressful. Clinical branch residents were found to be more anxious when compared to other than clinical branch residents. Heavy workloads and long working hours usually contribute to stress, resulting in fatigue, depression, and anxiety. Aim: To compare depression, anxiety, and Quality of Life (QoL) between clinical and other than clinical branch postgraduate medical students. Materials and Methods: The present cross-sectional study was conducted in the Department of Psychiatry at the Institute of Medical Sciences (IMS), Banaras Hindu University (BHU), in Varanasi, Uttar Pradesh, India. The data were collected from 150 residents through face-to-face interviews and by applying the Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HDRS), and World Health Organisation Quality of Life Brief Version (WHOQOL-BREF). The data were analysed using International Business Machines (IBM) Statistical Package for the Social Sciences (SPSS) Statistics 23.0 software. Results: The present study found that the majority of residents were male 108 (72%), belonged to the Hindu religion (134, 89.33%), were unmarried (150, 83.33%), and resided in the hostel (118, 78.67%) during their residency tenure. The prevalence of depression among clinical branch residents was 52 (50.0%), and in other than clinical branch residents, it was 17 (36.96%) (p=0.633). The prevalence of anxiety among clinical branch residents was 65 (62.5%), and in other than clinical branch residents, it was 18 (39.14%) (p=0.002). QoL was better in other than clinical branch residents compared to clinical branch residents in physical health, social, and environmental domains (p

OBJECTIVES: Coronavirus disease 2019 (COVID-19) has profoundly impacted residency and fellowship training and education. However, how and to what extent the COVID-19 pandemic in Lebanon compromised the daily involvement of trainees on the clinical and ethical levels is currently unknown, which this study will shed light on. METHODS: We conducted a cross-sectional survey (30 questions) targeting medical residents delivering healthcare services in Lebanon. Residents from different specialties were included in the study to assess the effect of the pandemic on their education and the ethical obstacles they faced when dealing with patients. RESULTS: A total of 221 postgraduate medical students participated in our study. Results showed that about half of the residents (52.1%) were only able to do a basic physical examination rather than a full examination as a mandatory requirement in the residency curriculum. The majority (60%) agreed that the doctor–patient relationship is contravened. In addition, almost all residents suffered from fear and emotional distress that affected their education (83.7%). CONCLUSION: The findings of this study identify the effect of COVID-19 on residents' training, which affects treatment outcomes and greatly impacts the mental well-being of both healthcare workers and patients. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusions Medical residency training is associated with a range of sociodemographic, lifestyle and mental health factors that may confer higher risk for psychotic‐like experiences (PLEs) in residents, yet little research has examined this question. Thus, we aimed to document the prevalence and associated factors of PLEs among resident physicians.Physicians enrolled in residency programmes in the Province of Québec, Canada (four universities) were recruited in Fall 2022 via their programme coordinators and social media. They completed an online questionnaire assessing PLEs in the past 3 months (the 15‐item Community Assessment of Psychic Experiences), as well as sociodemographic characteristics, lifestyle and mental health. Analyses included survey weights and gamma regressions.The sample included 502 residents (mean age, 27.6 years; 65.9% women). Only 1.3% (95% CI: 0.5%, 4.0%) of residents met the screening cut‐off for psychotic disorder. Factors associated with higher scores for PLEs included racialised minority status (relative difference: +7.5%; 95% CI: +2.2%, +13.2%) and English versus French as preferred language (relative difference: +7.9% 95% CI: +3.1%, +12.9%), as well as each additional point on scales of depression (relative difference: +0.8%; 95% CI: +0.3%, +1.3%) and anxiety (relative difference: +1.3%; 95% CI: +0.8%, +1.7%). In secondary analyses, racialised minority status was associated with persecutory items, but not with other PLEs. Gender, residency programmes and lifestyle variables were not associated with PLEs.This study found low reports of PLEs in a sample of resident physicians. Associations of PLEs with minoritised status may reflect experiences of discrimination. [ABSTRACT FROM AUTHOR]

Background: Feedback is a critical component of the learning process in a clinical setting. This study aims to explore medical residents' perspectives on feedback delivery and identify potential barriers to feedback-seeking in clinical training. Methods: This cross-sectional study involved 180 medical residents across seventeen specialties. We employed the validated Residency Education Feedback Level Evaluation in Clinical Training (REFLECT) tool to assess residents' perspectives on their attitude toward feedback, quality of feedback, perceived importance, and reaction to feedback. Additionally, we explored barriers to feedback-seeking behavior among medical residents. Results: The majority of medical residents held positive attitudes toward feedback. They agreed that feedback improves their clinical performance (77.7%), professional behavior (67.2%), and academic motivation (56.7%), while also influencing them to become a better specialist in their future career (72.8%). However, the study revealed critical deficiencies in the feedback process. Only 25.6% of residents reported receiving regular feedback and less than half reported that feedback was consistently delivered at suitable times and locations, was sufficiently clear or included actionable plans for improvement. A minority (32.2%) agreed that faculty had sufficient skills to deliver feedback effectively. Moreover, peer-to-peer feedback appeared to be a primary source of feedback among residents. Negative feedback, though necessary, often triggered feelings of stress, embarrassment, or humiliation. Notably, there were no significant differences in feedback perceptions among different specialties. The absence of a feedback-seeking culture emerged as a central barrier to feedback-seeking behavior in the clinical setting. Conclusions: Establishing shared expectations and promoting a culture of feedback-seeking could bridge the gap between residents' perceptions and faculty feedback delivery. Furthermore, recognizing the role of senior and peer residents as valuable feedback sources can contribute to more effective feedback processes in clinical training, ultimately benefiting resident development and patient care. [ABSTRACT FROM AUTHOR]

Recent protests staged by medical residents in the Israeli healthcare system to shorten their 26-hour shifts revealed a complex intergenerational relationship between senior physicians and residents. This qualitative study examines this intergenerational gap, which could create ageist attitudes and a hostile work environment. The findings reveal differences in the perception of the medical profession: the older generation prioritize the practice of medicine over other aspects of life, while the younger residents seek a better work–life balance. Furthermore, the findings also reveal a mutual respect and appreciation which illustrates the ambivalence of the complex intergenerational relationship. [ABSTRACT FROM AUTHOR]

Introduction: Medical training has been reported to be stressful. Clinical branch residents were found to be more anxious when compared to other than clinical branch residents. Heavy workloads and long working hours usually contribute to stress, resulting in fatigue, depression, and anxiety. Aim: To compare depression, anxiety, and Quality of Life (QoL) between clinical and other than clinical branch postgraduate medical students. Materials and Methods: The present cross-sectional study was conducted in the Department of Psychiatry at the Institute of Medical Sciences (IMS), Banaras Hindu University (BHU), in Varanasi, Uttar Pradesh, India. The data were collected from 150 residents through face-to-face interviews and by applying the Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HDRS), and World Health Organisation Quality of Life Brief Version (WHOQOL-BREF). The data were analysed using International Business Machines (IBM) Statistical Package for the Social Sciences (SPSS) Statistics 23.0 software. Results: The present study found that the majority of residents were male 108 (72%), belonged to the Hindu religion (134, 89.33%), were unmarried (150, 83.33%), and resided in the hostel (118, 78.67%) during their residency tenure. The prevalence of depression among clinical branch residents was 52 (50.0%), and in other than clinical branch residents, it was 17 (36.96%) (p=0.633). The prevalence of anxiety among clinical branch residents was 65 (62.5%), and in other than clinical branch residents, it was 18 (39.14%) (p=0.002). QoL was better in other than clinical branch residents compared to clinical branch residents in physical health, social, and environmental domains (p<0.04). Conclusion: The study concluded that clinical branch residents were experiencing significantly higher levels of anxiety. Overall, the QoL of residents in other than clinical branches was better than their counterparts in clinical branches. [ABSTRACT FROM AUTHOR]

Background: Burnout is a common psychological state among medical residents, which may affect their training, safety, and clinical performance. This study aimed to examine burnout, and its associated factors among the medical residents in university hospitals of Ahvaz Jundishapur University of Medical Sciences, Iran. Material and Methods: This was a cross-sectional study conducted on 300 medical residents from teaching hospitals in March 2021, using a web-based questionnaire. The validated Persian version of Maslach Burnout Questionnaire was used to collect the data. Multivariate linear regression analysis was used to identify factors significantly associated with burnout. Results: From 300 medical residents, 291(97%) responded. The participants' mean age was 32.9± 4.4, and over half (60.1%) were females, and 140(48.1%) were married. Burnout was reported by 77.3% of the medical residents. As far as emotional exhaustion (EE) was concerned, 25.1% reported high levels of burnout. In addition, high levels of depersonalization (DP) were reported by 19.9% of the participants, and 32.3% indicated a sense of low professional accomplishment (PA). There were notable differences in burnout and its dimensions among medical residents specializing in various fields, with surgical-specialty residents reporting the highest levels (p=0.000). Moreover, burnout was significantly associated with age (p=0.036), residency year (p=0.001), and specialty type (p=0.000). Based on multiple linear regression model, higher burnout scores were predicted by age (p=0.001), and specialty type (p=0.001). Conclusions: Based on our findings, there is a relatively high rate of burnout among medical residents. Therefore, it is essential that stakeholders urgently take effective measures to protect medical residents' mental health. [ABSTRACT FROM AUTHOR]

Purpose: Emotional intelligence (EI) can improve patient–doctor relationships, foster empathy, develop teamwork in the workplace, and boost communication skills. This study aims to determine whether a cohort of residents has different profiles to their demographic and EI. Design/methodology/approach: A cross-sectional survey was conducted in 2017–2018 (n = 440). The Trait Emotional Intelligence Questionnaire was used to measure EI. Cluster analysis was used to identify different profile groups. Findings: Cluster analysis identified three clusters with different profiles. The residents in cluster A (n = 146, 33.2%) were older, more males, studying in their final year, and perceived lower EI. Cluster B (n = 184, 41.8%) were predominantly young females, more single, studying in year one, and perceived moderate EI. Cluster C (n = 110, 25.0%) were predominantly married females studying their year 1 in surgical and perceived higher EI. Research limitations/implications: Study limitations include respondent honesty, cross-sectional design, and lack of a comparison site. Including EI education can improve emotional regulation, well-being, and sociability and should be assessed as part of residents' development. Practical implications: Medical residents differ in emotional profiles, with higher EI improving coping and problem-solving skills. EI training should be integrated into the medical curriculum, particularly given the high-stress levels and unique stressors of hospital practicums. Originality/value: The study suggested that three groups of residents exist, and they differ in demographic, EI, and subscale levels. This study recommended that residents be taught EI-related concepts to help them develop their EI through training on emotionality, self-control, well-being, and sociability. [ABSTRACT FROM AUTHOR]

BackgroundAntimicrobial resistance (AMR) is one of the biggest threats to global public health systems. This study aimed to assess the knowledge, attitudes and practice about AMR, antimicrobial stewardship programs (ASPs) and multidrug-resistant (MDR) bacteria.MethodsA web-based questionnaire survey was conducted among the residents of Isfahan University of Medical Sciences from May to November 2023. Data analysis was done using SPSS version 24.0 software.ResultsOverall, 400 out of 450 medical residents responded to the questionnaire, giving a response rate of 88.9%. The participants’ ages ranged from 26 to 54 years, and the majority were female (227/400 56.8%). Average scores for knowledge, attitudes, and practices were 53.70 ± 15.88, 36.97 ± 5.89 and 24.69 ± 4.24, respectively. In terms of knowledge, only 26.8% had heard the term “ASPs” and knew what it was. Most incorrect answers appeared to the treatment of infection caused by MDR bacteria including ESBL-producing Escherichia coli (27.8%) and carbapenem-resistant Klebsiella pneumoniae (30.8%), as well as the atypical bacteria (45.5%). Approximately, 50 and 71.7% said they had received no specific training in the fields of microbiological sampling methods and the appropriate time to prescribe antibiotics, respectively. Surprisingly, regarding practice, 81.8% of the respondents stated that antibiotics are used to treat flu or the common cold.ConclusionResidents considered their training on important issues including ASPs, MDR bacteria and the spectrum of antibiotics insufficient. This result highlights the need for targeted training interventions about antibiotic prescription in the curriculum at the university with more emphasis on ASPs to limit the development of resistance.

Because of the well documented burnout and stress experienced by medical residents, the Accreditation Council for Graduate Education (ACGME) has directed training programs to address these issues in their residents. The current study describes a resiliency enhancement program administered to residents from differing residencies. Method: Residents received group-based sessions focusing on awareness of stress reactions, mindfulness, cognitive coping skills and balancing life and work. All sessions were interactive. The training occurred over a 9-month time span. Residents provided informed consent so that data could be collected. The percentage of burnout was calculated based on one indicator (high emotional exhaustion, high depersonalization, or low personal accomplishment using the Maslach Burnout Scale). Standardized assessment instruments were administered at the beginning (September) and the end of the program (May) to assess the impact of the intervention. Residents were in training at a medium-sized academic medical center. They came from urology, internal medicine, emergency medicine and neurology training programs. Eighteen female and 51 male residents participated. Results: Baseline rates of burnout were as follows: urology residents, 89%; internal medicine, 73%; neurology, 50%; emergency medicine, 22%. There was a significant decrease in perceived stress for the overall group following the intervention. Residents who significantly improved on mindfulness measures also showed significant improvement on resiliency, stress, and personal accomplishment scores. Residents who significantly lowered perceived stress also lowered emotional exhaustion, depersonalization, and increased resiliency and compassion satisfaction. Discussion: This study demonstrated that a resiliency enhancement program and data collection after IRB approval is feasible and effective during medical residency. Based on our analysis, mindfulness, and cognitive skills to reduce perceptions of stress seem to be critical components. Future research is necessary to identify elements of the program most relevant to specific residencies.

Introduction: Given the importance of empathy in the process of caring for patients, this study investigated the level of empathy and its associated factors among medical residents at Ahvaz Jundishapur University of Medical Sciences (AJUMS). Method: This cross-sectional study was conducted at AJUMS in 2022. All 473 medical residents who were studying at AJUMS were included in the study using census method. Participants completed the Jefferson Scale of Physician Empathy. This scale has 20 items that are scored based on a 7-point Likert scale. Data were analyzed using independent t-test, ANOVA, and Pearson's correlation coefficient. Results: The number of medical residents who completed the questionnaires was 290 (response rate 61.3%). These medical residents' mean score of empathy was 102.81±12.75 (out of a total of 140 points). Empathy scores had no statistically significant relationship with sex, marital status, and entry year (p˃ 0.05). Pearson's correlation coefficient showed that there is a significant relationship between the level of empathy and age (r=0.223, p=0.001). Also, there was a significant difference between the empathy scores of medical residents of different specialties (p=0.0001, F=5.249), with the psychiatry residents having the highest mean empathy score (118.31±6.1) and the ophthalmology residents having the lowest (92.85±14.2). Conclusion: The findings showed that the empathy score of the residents is at a moderate level, and given the significant difference between the empathy scores of residents of different specialties, it can be argued that empathy changes under the influence of the clinical education environment and is a teachable skill.

Abstract Background Workplace factors are important predictors of occurrence of musculoskeletal pain among different occupational populations. In healthcare, a psychologically unsafe work environment can negatively affect the emotional, physical and psychological well-being of physicians. This study aimed to examine the relationship between workplace violence, sexual harassment and musculoskeletal pain among Egyptian physicians in their years of residency. Methods We distributed an online self-administered questionnaire to 101 residents working in various healthcare sectors in Egypt. It included sections on demographic data, working conditions, widespread pain index (WPI), pain interference short-form, workplace violence and harassment questionnaire, psychosocial safety climate questionnaire (PSC) and sexual harassment climate questionnaire. Results All residents had at least one painful site on the WPI (range 1–11). The mean WPI was 3.5 ± 2.4, and 39.6% satisfied the criteria of having widespread pain by having at least 4 pain sites. Widespread pain index showed a weak statistically significant negative correlation with workplace PSC score (rho = − 0.272, p = 0.006), and a statistically significant weak positive correlation with the calculated total abuse index (rho = 0.305, p = 0.002). Workplace violence and abuse, as measured by a calculated abuse index was the only significant predictors of widespread pain among residents. Conclusion WPV was found to be a predictor of musculoskeletal pain among medical residents. Healthcare organizations need to address WPV by employing preventive strategies to minimize its hazardous effects and ensure a safe working environment for physicians.

AbstractPurposeMaterials and methodsResultsConclusionsThe clinical learning environment (CLE) affects resident physician well-being. This study assessed how aspects of the learning environment affected the level of resident job stress and burnout.Three institutions surveyed residents assessing aspects of the CLE and well-being via anonymous survey in fall of 2020 during COVID. Psychological safety (PS) and perceived organizational support (POS) were used to capture the CLE, and the Mini-Z Scale was used to assess resident job stress and burnout. A total of 2,196 residents received a survey link; 889 responded (40% response rate). Path analysis explored both direct and indirect relationships between PS, POS, resident stress, and resident burnout.Both POS and PS had significant negative relationships with experiencing a great deal of job stress; the relationship between PS and stress was noticeably stronger than POS and stress (POS: B= −0.12, p=.025; PS: B= −0.37, p<.001). The relationship between stress and residents’ level of burnout was also significant (B = 0.38, p<.001). The overall model explained 25% of the variance in resident burnout.Organizational support and psychological safety of the learning environment is associated with resident burnout. It is important for educational leaders to recognize and mitigate these factors. [ABSTRACT FROM AUTHOR]

Objective: To create an interdisciplinary curriculum to teach key topics at the intersection of women's health, gender-affirming care, and health disparities to internal medicine (IM) residents. Materials and Methods: A core team of faculty from IM, Obstetrics and Gynecology, and Surgery partnered with faculty and fellows from other disciplines and with community experts to design and deliver the curriculum. The resulting curriculum consisted of themed half-day modules, each consisting of three to four inter-related topics, updated and repeated on an ∼3-year cycle. Health equity was a focus of all topics. Module delivery used diverse interactive learning strategies. Modules have been presented to ∼175 residents annually, beginning in 2015. To assess the curriculum, we used formative evaluation methods, using primarily anonymous, electronic surveys, and collected quantitative and qualitative data. Most surveys assessed resident learning by quantifying residents' self-reported comfort with skills taught in the module pre- and postsession. Results: Of 131 residents who completed an evaluation in 2022/23, 121 (90%) "somewhat" or "strongly" agreed with their readiness to perform a range of skills taught in the module. In all previous years where pre- and postsurveys were used to evaluate modules, we observed a consistent meaningful increase in the proportion of residents reporting high levels of comfort with the material. Residents particularly valued interactive teaching methods, and direct learning from community members and peers. Conclusion: Our interdisciplinary curriculum was feasible, valued by trainees, and increased resident learning. The curriculum provides a template to address equity issues across a spectrum of women's and gender-affirming care conditions that can be used by other institutions in implementing similar curricula. [ABSTRACT FROM AUTHOR]

Introduction: Given the importance of empathy in the process of caring for patients, this study investigated the level of empathy and its associated factors among medical residents at Ahvaz Jundishapur University of Medical Sciences (AJUMS). Metho d: This cross -sectional study was conducted at AJUMS in 2022. All 473 medical residents who were studying at AJUMS were included in the study using census method. Participants completed the Jefferson Scale of Physician Empathy. This scale has 20 items that are scored based on a 7 -point Likert scale. Data were analyzed using independent t -test, ANOVA, and Pearson's correlation coefficient. Results: The number of medical residents who completed the questionnaires was 290 (response rate 61.3%). These medical residents' mean score of empathy was 102.81±12.75 (out of a total of 140 points). Empathy scores had no statistically significant relationship with sex, marital status, and entry year (p˃ 0.05). Pearson's correlation coefficient showed that there is a significant relationship between the level of empathy and age (r=0.223, p=0.001). Also, there was a significant difference between the empathy scores of medical residents of different specialties (p=0.0001, F=5.249), with the psychiatry residents having the highest mean empathy score (118.31±6.1) and the ophthalmology residents having the lowest (92.85±14.2). Conclusion: The findings showed that the empathy score of the residents is at a moderate level, and given the significant difference between the empathy scores of residents of different specialties, it can be argued that empathy changes under the influence of the clinical education environment and is a teachable skill. [ABSTRACT FROM AUTHOR]

Background and purpose: Role modeling is defined as "a purposeful activity that demonstrates the knowledge, skills, attitudes, and behaviors that students should acquire." This is an educational method suitable for the medical environment where students have the opportunity to observe their professors in action and behavior. All the teachers of medical sciences are diligent in training human resources, but developing a professional identity in medical students is a top priority which could help them to become good doctors. The purpose of this study was to explain the role modeling of teachers in professional identity formation of medical residents. Materials and methods: Sixteen medical residents, aged between 26 and 40 (male and female), participated in this qualitative content analysis study. The residents beloned to four major specialty groups including obstetrics and gynecology, surgery, internal medicine, and pediatric. Data were collected from four specialty hospitals of Tehran University of Medical Sciences through semi-structured in-depth interviews. Then the collected data were analyzed using conventional content analysis. Results: Data analysis showed four main categories of "access to the role of models" including ethical role modeling, professional role modeling, personality role modeling, and interpersonal interaction role modeling. These conceptualized categories explained that role modeling teachers created good opportunities for professional identity formation of medical residents. Conclusion: Based on the present study, role modeling is a combination of individual characteristics and professional patient care that is implicitly revealed in medical education. Excellence in role modeling requires showing superior clinical care, teaching skills, and strengthening the good personal characteristics of professors. More studies and effective interventions in empowering of medical teachers can help lifelong learning and create a positive learning environment in the formation of professional identity in medical students and residents.

Objective: To explore the reasons of unsuccessful attempt in examination during postgraduate clinical training in Pakistan. Method: The qualitative, exploratory study was conducted at the Allied Hospital, Faisalabad, Pakistan, from December 1, 2022, to February 25, 2023, and comprised postgraduate trainees from different departments who had at least one unsuccessful attempt in examination during their residency programme. Data was collected through direct interviews that were recorded. The data was subjected to thematic narrative analysis. Results: Of the 14 participants, 10(71.4%) were males and 4(28.5%) were females. The maximum number of unsuccessful attempts were 7(7%), followed by 6(14%), 4(7%), 3(14%), 2(42%) and 11(14%). There were 3 main themes; personal factors, training factors, and exam factors. All the themes had subthemes. Conclusion: At the start of the residency programme, postgraduate trainees must be provided with adequate guidance, and a support system must be present during the programme to help them cope with the stress during training. Key Words: Medical residents, Surgical residents, Training, Postgraduation, Reasons, Unsuccessful.

Objective The ubiquity of electronic health records (EHRs) has made incorporating EHRs into medical practice an essential component of resident's training. Patient encounters, an important element of practice, are impacted by EHRs through factors that include increasing documentation requirements. This research sheds light on the role of EHRs on resident clinical skills development with emphasis on their role in patient encounters. Materials and Methods We conducted qualitative semistructured interviews with 32 residents and 13 clinic personnel at an internal medicine residency program in a western US medical school focusing on the resident's clinic rotation. Results Residents were learning to use the EHR to support and enhance their patient encounters, but one factor making that more challenging for many was the need to address quality measures. Quality measures could shift attention away from the primary reason for the encounter and addressing them consumed time that could have been spent diagnosing and treating the patient's chief complaint. A willingness to learn on-the-job by asking questions was important for resident development in using the EHR to support their work and improve their clinical skills. Discussion Creating a culture where residents seek guidance on how to use the EHR and incorporate it into their work will support residents on their journey to become master clinicians. Shifting some documentation to the patient and other clinicians may also be necessary to keep from overburdening residents. Conclusion Residency programs must support residents as they develop their clinical skills to practice in a world where EHRs are ubiquitous. [ABSTRACT FROM AUTHOR]

Background and purpose: Role modeling is defined as "a purposeful activity that demonstrates the knowledge, skills, attitudes, and behaviors that students should acquire." This is an educational method suitable for the medical environment where students have the opportunity to observe their professors in action and behavior. All the teachers of medical sciences are diligent in training human resources, but developing a professional identity in medical students is a top priority which could help them to become good doctors. The purpose of this study was to explain the role modeling of teachers in professional identity formation of medical residents. Materials and methods: Sixteen medical residents, aged between 26 and 40 (male and female), participated in this qualitative content analysis study. The residents beloned to four major specialty groups including obstetrics and gynecology, surgery, internal medicine, and pediatric. Data were collected from four specialty hospitals of Tehran University of Medical Sciences through semi-structured in-depth interviews. Then the collected data were analyzed using conventional content analysis. Results: Data analysis showed four main categories of "access to the role of models" including ethical role modeling, professional role modeling, personality role modeling, and interpersonal interaction role modeling. These conceptualized categories explained that role modeling teachers created good opportunities for professional identity formation of medical residents. Conclusion: Based on the present study, role modeling is a combination of individual characteristics and professional patient care that is implicitly revealed in medical education. Excellence in role modeling requires showing superior clinical care, teaching skills, and strengthening the good personal characteristics of professors. More studies and effective interventions in empowering of medical teachers can help lifelong learning and create a positive learning environment in the formation of professional identity in medical students and residents. [ABSTRACT FROM AUTHOR]

Accurate prediction of SARS-CoV-2 infection based on symptoms can be a cost-efficient tool for remote screening in healthcare settings with limited SARS-CoV-2 testing capacity. We used a machine learning approach to determine self-reported symptoms that best predict a positive SARS-CoV-2 test result in physician trainees from a large healthcare system in New York. We used survey data on symptoms history and SARS-CoV-2 testing results collected retrospectively from 328 physician trainees in the Mount Sinai Health System, over the period 1 February 2020 to 31 July 2020. Prospective data on symptoms reported prior to SARS-CoV-2 test results were available from the employee health service COVID-19 registry for 186 trainees and analyzed to confirm absence of recall bias. We estimated the associations between symptoms and IgG antibody and/or reverse transcriptase polymerase chain reaction test results using Bayesian generalized linear mixed effect regression models adjusted for confounders. We identified symptoms predicting a positive SARS-CoV-2 test result using extreme gradient boosting (XGBoost). Cough, chills, fever, fatigue, myalgia, headache, shortness of breath, diarrhea, nausea/vomiting, loss of smell, loss of taste, malaise and runny nose were associated with a positive SARS-CoV-2 test result. Loss of taste, myalgia, loss of smell, cough and fever were identified as key predictors for a positive SARS-CoV-2 test result in the XGBoost model. Inclusion of sociodemographic and occupational risk factors in the model improved prediction only slightly (from AUC = 0.822 to AUC = 0.838). Loss of taste, myalgia, loss of smell, cough and fever are key predictors for symptom-based screening of SARS-CoV-2 infection in healthcare settings with remote screening and/or limited testing capacity.

Zhiyuan Li,1 Dongmei Liu,1 Xiuping Liu,2 Hui Su,3 Song Bai1 1Department of Urology, Shengjing Hospital of China Medical University, Shenyang, People’s Republic of China; 2Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, People’s Republic of China; 3Department of Sleep Medical Center, Shengjing Hospital of China Medical University, Shenyang, People’s Republic of ChinaCorrespondence: Song Bai, Department of Urology, Shengjing Hospital of China Medical University, 36 Sanhao Street, Shenyang, Liaoning, 110004, People’s Republic of China, Tel +86-18940255568, Fax +86-024-83955092, Email baisongcmu81@163.comBackground: Long working hours are common among medical residents and may increase the risk of mental disorders. We aimed to investigate the association between experienced long working hours and depression, anxiety, and suicidal ideation among Chinese medical residents during the COVID-19 pandemic.Methods: This study was conducted in September 2022; 1343 residents from three center in Northeastern China were included in the final analysis (effective response rate: 87.61%). The data were collected from participants via online self-administered questionnaires. Depression and anxiety were measured by the Patient Health Questionnaire (PHQ-9) and the General Anxiety Disorder (GAD-7) scale, respectively. Adjusted odds ratios and 95% confidence intervals were determined after adjusting for potential confounders by binary unconditional logistic regression.Results: The effective response rate was 87.61%. Among the 1343 participants, 12.88% (173), 9.90% (133), and 9.68% (130) had experienced major depression, major anxiety, and suicidal ideation, respectively. We found that longer weekly worktime increased the risk of major depression, particularly in those who worked for more than 60 hours per week (≥ 61 hours vs ≤ 40 hours, OR=1.87, P for trend = 0.003). However, this trend was not observed for either major anxiety or suicidal ideation (P for trend > 0.05 for both).Conclusion: This study revealed that there was a considerable incidence of poor mental health among medical residents; furthermore, the longer weekly worktime was associated with a higher risk of major depression, especially for those who worked more than 60 hours per week, but this association was not observed in either major anxiety or suicidal ideation. This may help policymakers to develop targeted interventions.Keywords: long working hours, mental disorders, medical residents, depression, anxiety, COVID-19

Unhealthy behaviors (UBs) can affect mental health. The most impactful of these are alcohol abuse, sedentary behavior, and sleep disturbances. Since these UBs are not well explored in medical residents, this study aims to overcome this gap, focusing on outcomes such as depression and anxiety. The Public Health Residents’ Anonymous Survey in Italy (PHRASI) is a nationwide cross-sectional study based on an 88-item questionnaire. UBs were explored through validated questionnaires: the Alcohol Use Disorders Identification Test-c (AUDIT-C), the International Physical Activity Questionnaire (IPAQ), and the Insomnia Severity Index (ISI). Depressive symptoms and anxiety were detected by Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), respectively. Hierarchical cluster analysis described clusters using responses from the AUDIT-C, IPAQ, and ISI. A total of 375 participants were included in this study. Three distinct clusters (CL) were identified: CL1 was characterized by a moderate risk for alcohol abuse and high insomnia dissatisfaction, with a significantly higher frequency of depressive symptoms (46%, p < 0.001) and anxiety (53%, p < 0.001); CL2 had no risk for alcohol abuse, high sleep satisfaction, and better mental health profile, with the lowest prevalence of depressive symptoms (15%, p < 0.001); CL3 had the highest risk of alcohol abuse, the highest rate of physical activity (40%, p = 0.013), and the lowest prevalence of anxiety (27%, p < 0.001). Subjects belonging to CL1 required much more attention to prevent the worsening of mental outcomes. Interventions for promoting mental health should be addressed in all Public Health schools to create more sustainable working conditions.

Background: Burnout in medical profession can reduce the work output and affect the clinical decision making. Objectives: To estimate the proportion of medical residents experiencing burnout. Methodology: In this cross-sectional study, 172 medical residents working in the hospitals affiliated with Kasturba Medical College, Mangalore were assessed for presence of burnout. Permission was obtained from the Institutional Ethics Committee before the commencement of the study. Copenhagen Burnout Inventory scale was used to determine the presence of burnout syndrome among the participants. Results: The mean age of the participants was 27.6 years and a high proportion (n=93, 53.8%) of the participants were males. Forty-eight percent (n=83) of the participants in our study had burnout. A high proportion (n=35, 42.2%) of the participants with burnout were from first year of residency. Burnout was observed in the majority of unmarried males. Burnout was also seen to be highest in younger residents, and those who lacked adequate sleep. Conclusion: The proportion of occupational burnout among medical residents in our study was found to be very high. Early identification of the presence of burnout in the healthcare profession and initiating steps to reduce it can help them to provide uncompromised quality care to the patients.

Background: Early medical residents are expected to have a higher prevalence of burnout due to physical and psychological stressors. However psychological distress associated with burnout has not been adequately investigated in a longitudinal manner. We therefore examined the longitudinal trajectory of depression and its associated factors among early medical residents. Methods: In this cohort study, medical residents (n = 215) who started rotation at the University of Yamanashi Hospital during 2012 to 2018 were recruited and asked to complete the Brief Job Stress Questionnaire (BJSQ), Center for Epidemiologic Studies Depression Scale (CESD), Brief Scale for Coping Profile (BSCP) and Athens Insomnia Scale (AIS) at the time of exit from each clinical department for up to two years over seven years. Factors associated with the CES-D scores were statistically explored, with a cutoff score of 16 to denote depression. Results: The CES-D was completed by 205 residents. The average CES-D score was 10.3 ± 8.0 and the scores were lower in the 2nd versus 1st year of residency (11.3 ± 6.7 versus 9.2 ± 7.0). Multiple regression analysis of BJSQ/BSCP/AIS on CES-D revealed that insomnia had a significant impact on the CES-D scores. Apart from insomnia, avoidance and suppression and peer support had significant effects. Resilient residents, who showed the maximum CES-D score of under 16 consistently throughout the residency, was better in terms of changing a point of view, active solution and changing mood. Women were more likely to express emotions to others, while they reported more job control in the first year. Conclusions: Our results have high clinical relevance to challenge psychological burnout among early medical residents, offering some possible clues for prevention such as reduced burden, more flexibility during the first year and strengthening coworker support. Insomnia exerted moderate to strong effects on depression and monitoring of sleep appears indispensable in this specific population.

Background: Different stages of a physician's career may be associated with different types of mental health impairment. Aims: This study aimed to compare symptoms of anxiety, depression, and stress and their associated factors among medical students, medical residents, and physicians. Methods: A cross-sectional study was conducted. Data collection included sociodemographic data, religiosity (Duke University Religion Index), and mental health (21-item Depression, Anxiety and Stress Scale – DASS-21) data. The comparison between the groups was performed using ANOVA, and the associated factors were evaluated via linear regression models. Results: The sample consisted of 1,417 participants: 778 medical students, 190 medical residents, and 468 established physicians. Medical students had significantly higher depression, anxiety, and stress scores as compared to medical residents and established physicians. However, regarding DASS 21 scores, no significant differences were found between established physicians and medical residents. The factors associated with mental health in the different groups showed that being married and male were associated with better mental health among physicians and medical residents, while the factors of male gender, being in later years of the course, and lower religious attendance were associated with better mental health in students. Conclusion: Medical students had worse mental health outcomes when compared to residents and established physicians. Interventions are needed to minimize suffering during medical education and career. [ABSTRACT FROM AUTHOR]

Background: A death certificate is an official certificate signed by a doctor that states the cause of a person’s death. In most teaching hospitals, resident physicians complete the filling out of death certificates. Materials and Methods: In this research study, we conducted a cross-sectional study on 300 resident physicians from subspecialties, such as internal medicine, emergency medicine, and surgery, at King Khalid University Hospital, Riyadh, Saudi Arabia. The residents responded to a self-administered questionnaire. Both male and female physicians voluntarily participated in the study upon providing electronic consent. The Statistical Package for the Social Sciences(SPSS) version 25 was used to measure the statistical significance of the retrieved responses. Results: The study conveys that in the last 12 months, 8% of the study participants had not filled out any death certificates. Moreover, in the last 3 years, 74.6% of the resident doctor participants had filled out a significant number of death certificates, while only 4.3% had not dealt with this document. Only 16% of the doctors filled out a death certificate for patients for whom they were the primary caregivers in most of the cases. Conclusion: The data generated through this study indicated the reasons why some inaccuracies occur in the process of filling out death certificates, which are based on the reasons accepted by the system, the language barrier, and the training received by the residents on the matter. Given these study results, we have made various recommendations for a training program based on the documented challenges and inaccuracies in filling out death certificates, irrespective of any prior training in the subject. [ABSTRACT FROM AUTHOR]

Background and Objective: Job burnout is one of the challenges of the health system and medical residents are among the most important pillars of service delivery, especially in epidemic conditions, and spiritual intelligence can be proposed as a way to relieve job burnout. The purpose of this study is to investigate the correlation between spiritual intelligence and job burnout in clinical teaching residents of Mazandaran University of Medical Sciences during the COVID-19 pandemic. Methods: This study is a questionnaire-based survey (cross-sectional study) that was conducted in 1400 with the participation of 36 residents from 3 educational groups of Mazandaran University of Medical Sciences. Maslach job burnout and King spiritual intelligence questionnaires were used for primary data collection and correlation analysis was done by calculating Pearson's coefficient (r) and statistical description and analysis was done using IBM SPSS version 25 software. Findings: The average burden of job burnout was 84.44 and the average burden of spiritual intelligence was 47.69. The production of personal meaning had a direct and significant correlation with job burnout, which was also observed in infectious residents. In emergency medicine residents; Job burnout has had a direct and significant correlation with spiritual intelligence and the subscales of critical existential thinking and the production of personal meaning and transcendental consciousness. Conclusion: According to the findings of the research, there is a need for more studies to examine the correlation between spiritual intelligence and burnout. [ABSTRACT FROM AUTHOR]

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Background and Objectives: The prevalence of COVID-19 significantly affected different aspects of the quality of life (QoL) in people, especially the medical staff, who are at the forefront of battle against the disease. This study aims to investigate the QoL of medical residents of hospitals affiliated to Kashan University of Medical Sciences (KUMS) during the COVID-19 pandemic. Methods: This cross-sectional study was conducted on 140 medical residents of hospitals affiliated to KUMS in 2021. Their QoL was assessed using World Health Organization quality of life (WHOQOL). The collected data were analyzed in SPSS software, version 22 using Chi-square, Mann-Whitney U test, t-test, one-way analysis of variance, Kolmogorov-Smirnov test, Pearson and Spearman correlation tests. Results: The physical health dimension had a statistically significant relationship with age, marital status, underlying disease, sports/arts activities, and year of residency (P

Abstract Background Methylphenidate (MPH) and other stimulants may be misused, mainly as cognitive enhancers and recreational drugs. Data regarding misuse among medical residents are scarce. This study aimed to evaluate the prevalence of and main reasons for methylphenidate (MPH) use and misuse among Israeli medical residents. Methods In this cross-sectional study, we sent an online questionnaire to medical residents who had completed their first residency exam and specialists with up to 2 years of experience. We asked about the use of MPH before and during residency and attitudes toward the use of MPH as a cognitive enhancer. We also added the Adult ADHD Self-Report Scale (ASRS) questionnaire, a validated tool used to screen for the presence of attention deficit hyperactivity disorder (ADHD). Users and misusers were classified based on self-report of use and formal ADHD diagnosis. Logistic regression analysis was used to evaluate factors associated with MPH misuse. Results From March 2021 to August 2021, 370 physicians responded to our questionnaire (response rate 26.4%). Twenty-eight met the exclusion criteria and were not included. The respondents’ average age was 36.5 years. Women comprised 63.5% of the respondents. Of the participants, 16.4% were classified as users and 35.1% as misusers. The prevalence of misusers was 45.6% among surgery and OB/GYN physicians, 39.4% among pediatricians and internists, and 24% among family physicians (P