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Background: As healthcare professional trainees, resident physicians are expected to help with COVID-19 care in various ways. Many resident physicians worldwide have cared for COVID-19 patients despite the increased risk of burnout. However, few studies have examined the experience with COVID-19 care among resident physicians and its effects on competency achievement regarding clinical basics and COVID-19 patient care. Method: This nationwide, cross-sectional Japanese study used a clinical training environment questionnaire for resident physicians (PGY-1 and − 2) in 593 teaching hospitals during the General Medicine In-Training Examination in January 2021. The General Medicine In-Training Examination questions comprised four categories (medical interviews and professionalism; symptomatology and clinical reasoning; physical examination and clinical procedures; and disease knowledge) and a COVID-19-related question. We examined the COVID-19 care experience and its relationship with the General Medicine In-Training Examination score, adjusting for resident and hospital variables. Results: Of the 6,049 resident physicians, 2,841 (47.0%) had no experience caring for patients with COVID-19 during 2020. Total and categorical General Medicine In-Training Examination scores were not different irrespective of the experience with COVID-19 patient care. For the COVID-19-related question, residents with experience in COVID-19 care showed a significant increase in correct response by 2.6% (95% confidence interval, 0.3–4.9%; p = 0.028). Conclusions: The resident physicians' COVID-19 care experience was associated with better achievement of COVID-19-related competency without reducing clinical basics. However, approximately half of the residents missed the critical experience of caring for patients during this unparalleled pandemic in Japan. [ABSTRACT FROM AUTHOR]

Abstract Background As healthcare professional trainees, resident physicians are expected to help with COVID-19 care in various ways. Many resident physicians worldwide have cared for COVID-19 patients despite the increased risk of burnout. However, few studies have examined the experience with COVID-19 care among resident physicians and its effects on competency achievement regarding clinical basics and COVID-19 patient care. Method This nationwide, cross-sectional Japanese study used a clinical training environment questionnaire for resident physicians (PGY-1 and − 2) in 593 teaching hospitals during the General Medicine In-Training Examination in January 2021. The General Medicine In-Training Examination questions comprised four categories (medical interviews and professionalism; symptomatology and clinical reasoning; physical examination and clinical procedures; and disease knowledge) and a COVID-19-related question. We examined the COVID-19 care experience and its relationship with the General Medicine In-Training Examination score, adjusting for resident and hospital variables. Results Of the 6,049 resident physicians, 2,841 (47.0%) had no experience caring for patients with COVID-19 during 2020. Total and categorical General Medicine In-Training Examination scores were not different irrespective of the experience with COVID-19 patient care. For the COVID-19-related question, residents with experience in COVID-19 care showed a significant increase in correct response by 2.6% (95% confidence interval, 0.3–4.9%; p = 0.028). Conclusions The resident physicians’ COVID-19 care experience was associated with better achievement of COVID-19-related competency without reducing clinical basics. However, approximately half of the residents missed the critical experience of caring for patients during this unparalleled pandemic in Japan.

Abstract Background The COVID-19 pandemic had a significant impact on both the clinical practice and the psychological states of frontline physicians in the emergency department. Trainees, at the beginning of their careers and thus still developing their practice styles and identities as physicians, were uniquely affected. Objective In this qualitative study, we sought to explore how the pandemic environment shaped the experiences of emergency medicine resident physicians. Methods This was a qualitative study. We conducted in-depth interviews with emergency medicine faculty, resident physicians, and staff at a single emergency department based at an urban academic institution in the northeastern United States. Interviews were audio recorded and transcribed, and transcripts were then analyzed in an iterative process by our coding team for recurring themes related to the resident experience. Results We reached data saturation with 27 individuals. Of those who were interviewed, 10 were resident physicians [6 senior residents (PGY-3 or PGY-4) and 4 junior residents (PGY-1 or PGY-2)]. Three major recurring themes regarding resident physician experience emerged during our analysis of the interviews: (1) novel educational experiences dampened by negative structural forces from the pandemic, (2) fracturing of social interactions and mitigation through ad-hoc support systems and community of practice, and (3) development of negative emotions and psychological trauma including fear, resentment, and moral injury causing lasting harm. Conclusions Our results suggest that emergency medicine resident physicians training during the COVID-19 pandemic faced unique experiences concerning their education, social support systems, and emotional states. While the educational and social experiences were described as having both negative and positive impacts, the emotional experiences were largely negative. Residency program leadership may use these insights to improve resident preparation, wellness, and resilience in the face of future adverse events.

Background: The COVID-19 pandemic had a significant impact on both the clinical practice and the psychological states of frontline physicians in the emergency department. Trainees, at the beginning of their careers and thus still developing their practice styles and identities as physicians, were uniquely affected. Objective: In this qualitative study, we sought to explore how the pandemic environment shaped the experiences of emergency medicine resident physicians. Methods: This was a qualitative study. We conducted in-depth interviews with emergency medicine faculty, resident physicians, and staff at a single emergency department based at an urban academic institution in the northeastern United States. Interviews were audio recorded and transcribed, and transcripts were then analyzed in an iterative process by our coding team for recurring themes related to the resident experience. Results: We reached data saturation with 27 individuals. Of those who were interviewed, 10 were resident physicians [6 senior residents (PGY-3 or PGY-4) and 4 junior residents (PGY-1 or PGY-2)]. Three major recurring themes regarding resident physician experience emerged during our analysis of the interviews: (1) novel educational experiences dampened by negative structural forces from the pandemic, (2) fracturing of social interactions and mitigation through ad-hoc support systems and community of practice, and (3) development of negative emotions and psychological trauma including fear, resentment, and moral injury causing lasting harm. Conclusions: Our results suggest that emergency medicine resident physicians training during the COVID-19 pandemic faced unique experiences concerning their education, social support systems, and emotional states. While the educational and social experiences were described as having both negative and positive impacts, the emotional experiences were largely negative. Residency program leadership may use these insights to improve resident preparation, wellness, and resilience in the face of future adverse events. [ABSTRACT FROM AUTHOR]

Abstract Background In the context of standardized training for general practitioners, the emphasis is still primarily on clinical skills, which does not fully encompass the overall development of general practitioners. This study implemented a practice-based learning and improvement (PBLI) project among students and evaluated its effectiveness based on indicators such as learning outcomes, students’ subjective experiences, and annual grades. This study offers recommendations for optimizing general practitioners’ teaching and residential training programs. Methods 60 residents who participated in the regular training of general practitioners at the First Clinical College of Tongji Medical College of Huazhong University of Science and Technology from January 2019 to January 2022 were selected for this study. They were randomly divided into two groups, the PBLI group, and the control group, using a random number table method. Out of the 60 residents, 31 were assigned to the control group and 29 were assigned to the PBLI group. The participants in the PBLI group received additional PBLI training along with their daily residential training, while the participants in the control group only took part in the latter. The effectiveness of the PBLI program was analyzed by conducting a baseline survey, administering questionnaires, and evaluating examination results. Results After implementing the program, the PBLI group scored significantly higher than the control group (p

Introduction: Horizontal violence (HV) is defined as “persistent exposure to interpersonal aggression and mistreatment from colleagues.” Our objective in this pilot, single-site study was to identify sources of HV toward emergency medicine (EM) residents, using the Negative Acts Questionnaire-Revised (NAQ-R). Methods: In this investigation we used a descriptive cross-sectional survey design to categorize HV. All voluntary participants were residents in an Accreditation Council for Graduate Medical Education- approved, three-year academic EM residency. Data were collected via electronic survey and occurred six months into an academic year. We collected demographic information and responses to the NAQ-R in 2020. Horizontal violence is subdivided into three categories: work-related; person-related; and physical intimidation. Emergency medicine residents answered questions as they related to their interactions with residents and support staff, which included nursing. Results: A total of 23 of 26 residents responded (89%). Participants were 56% women, 78% white, 11% Hispanic, and 89% heterosexual. Participant clinical year was 39% first-, 39% second-, and 22% third-year residents. Women reported a higher frequency of HV compared to men (1.3 vs 1.1, P =.01). By category, women indicated higher incidence of work-related violence from other residents (P = .05) and staff (P =.02). There was no difference in reported frequency of violence for interns compared to senior residents.  Conclusion: Our pilot study demonstrated horizontal violence toward EM residents exists and is more prevalent in women.

Background: Medical residents commonly face compassion fatigue, burnout, anxiety, and depression. Studies of nature-based interventions show improved mental and physical health; few focus on healthcare providers. Objective: To explore potential benefits of forest bathing for medical residents' wellbeing. Methods: Using the Association of Nature and Forest Therapy's framework, we piloted a forest bathing intervention among medical residents with pre/post-participation surveys assessing perceptions of mindfulness and psychological wellbeing. Responses were analyzed using a Fisher's exact test and Student's t-test for independent samples. Results: Fourteen of fifteen participants completed both surveys. We observed significantly improved mindfulness scores and expressions of feeling calm, vital, or creative, as well as a decreased sense of anxiety and depression. Nonsignificant trends towards decreased burnout and irritability were seen. Conclusion: This quality improvement pilot demonstrates trends that forest bathing can improve medical residents' psychological wellbeing and mindfulness. Further exploration of this intervention for healthcare providers is warranted. [ABSTRACT FROM AUTHOR]

Objective: This research aims to reveal the mental fatigue experiences of resident physicians while practicing their profession. Material and Method: The study was earned out with the phenomenology design, which is considered within the scope of qualitative research. Participants were reached using the homogeneous sampling technique, which is one of the purposive sampling techniques. In this context, in-depth interviews were conducted using semi-structured forms with 10 resident physicians continuing their residency training in Turkey. The data obtained by transcribing the interviews were subjected to interpretive phenomenological analysis. The data obtained were coded and gathered under themes to make the phenomenon of mental fatigue meaningful. Results: In this study, which examines the mental fatigue experienced by assistant physicians while performing their profession as a whole, it has been determined that the causes of mental fatigue are related to working life, academic life, professional life, psychological, systemic and physiological reasons. At the same time, it has been determined that the mental fatigue experienced by assistant physicians causes some individual consequences such as stress, anxiety, focusing problems, and burnout, and some social consequences such as social adaptation problems, negative effects on the patient, and difficulty in the diagnosis process. Conclusion: This study, which reveals the causes and consequences of mental fatigue experienced by resident physicians, has concluded that this situation not only has individual consequences on the physician but also causes some social consequences such as difficulty in the diagnosis process, social adaptation problem and the negative effects of this situation on the patients. To minimize this effect, it is recommended to clarify the job description of resident physicians, reduce the patient burden by shortening long working hours, and make necessary legal and systemic regulations on the subject. [ABSTRACT FROM AUTHOR]

Abstract Background Standardized training for resident physicians is the primary form of postgraduate medical education, and it plays a pivotal role in healthcare safety and industry stability. Currently, it has garnered significant attention from healthcare institutions. Methods By conducting a comprehensive literature review and a Delphi consultation in June 2022 for which 40 experts in clinical medicine, public health, and other related fields in China were invited. The indicators were adjusted according to the results of the consultation, and the final indicator weights were determined through an analytic hierarchy process. Results The response rate was 100%, and the expert authority coefficient was 0.879. The consistency among the experts on the tertiary indicators, as measured by Kendall’s W, was 0.675 (χ2 = 42.516, p

Standardized training for resident physicians is currently a recognized way to cultivate qualified clinical physicians. As an important routine examination in clinical practice, ECG is one of the basic skills that clinical physicians must master, and it is also an important content required to be mastered in standardized training for resident physicians. The Department of Cardiac Function in the Second Affiliated Hospital of Kunming Medical University has explored a teaching method more suitable for resident physicians through continuous improvement. By utilizing diverse teaching forms, the Department of Cardiac Function has devoted to enhancing students' interest in learning and ensuring learning quality so as to help them to apply the knowledge and techniques learned to clinical practice. [ABSTRACT FROM AUTHOR]

Introduction: Depression is an increasingly common disorder around the world. General practitioners are the most frequently consulted health professionals by depressed patients. More than 70% of all depressed patients receive treatment by general practitioners and not by psychiatric specialists. According to studies conducted in Buenos Aires, more than 25% of all patients admitted to the Clinical Services in public hospitals present depression. These patients are usually under the care and follow-up of clinical trainee physicians, residents, or interns. This study aimed to analyze the knowledge about selective serotonin reuptake inhibitors (SSRIs) of clinical trainee residents and interns in five hospitals in the Ciudad Autónoma de Buenos Aires (CABA) and to describe their treatment of a depressive patient. Material and methods: We conducted a descriptive cross-sectional study with a non-probabilistic sampling. We used a semi-structured questionnaire arranged into two sections as a measuring tool. One, with demographic data to describe the sample. The other, with 15 items, explores respondents' knowledge of SSRIs and the treatment of depression. Four experts reviewed the questionnaire, which was anonymous. We applied it to 59 clinical medical trainees, residents, and interns from five CABA hospitals who volunteered to participate during August-September 2022. Results: Most clinical trainees do not treat depressive conditions and, when confronted with a depressed patient, request an assessment by a Mental Health specialist. Only 6.8% medicate the patient with an antidepressant. More than 75% of the sample reported remembering their knowledge of SSRIs from the Pharmacology course and 13.6% from the Psychiatry course at the School of Medicine. Conclusion: There is a deficient knowledge about SSRIs in trainee residents and interns of Clínica Médica. We believe it is necessary to reinforce training on depression and management of antidepressants during residency/internship practice in Clínica Médica.

Background: Standardized training for resident physicians is the primary form of postgraduate medical education, and it plays a pivotal role in healthcare safety and industry stability. Currently, it has garnered significant attention from healthcare institutions. Methods: By conducting a comprehensive literature review and a Delphi consultation in June 2022 for which 40 experts in clinical medicine, public health, and other related fields in China were invited. The indicators were adjusted according to the results of the consultation, and the final indicator weights were determined through an analytic hierarchy process. Results: The response rate was 100%, and the expert authority coefficient was 0.879. The consistency among the experts on the tertiary indicators, as measured by Kendall's W, was 0.675 (χ2 = 42.516, p < 0.001). Based on the results of the expert consultation, a job competence evaluation system for resident physicians (including integrated postgraduates) receiving standardized training was established, which included 6 primary indicators, 18 secondary indicators, and 116 tertiary indicators. The weights for the primary indicators, namely professional quality, skills and knowledge, patient care, communication and collaboration, teaching skills, and lifelong learning, were 0.313, 0.248, 0.181, 0.083, 0.066, and 0.110, respectively. The top three secondary indicators in terms of combined weights were clinical skills (0.122), professional ethics (0.120), and professional dedication (0.109). The three tertiary indicators with the highest scores were "maintains collaboration with peers and colleagues in patient treatment," "has clinical thinking skills, makes diagnosis and treatment decisions based on analysis of evidence, and has the ability to administer suitable treatments," and "abides by laws and discipline and refuses to seek personal gains in medical practice"; their combined weights were 0.035, 0.028, and 0.027, respectively. Conclusion: This study has established a concrete, objective, and quantifiable competency assessment index system for standardized training of clinical resident physicians (including integrated postgraduates). This system provides a foundation for the quantitative evaluation of the competency of clinical resident physicians (including integrated postgraduates) undergoing standardized training. [ABSTRACT FROM AUTHOR]

Background/objectiveBurnout is common among resident physicians, which has the potential to translate into diagnostic and management errors. Our study investigates the relationship between sleepiness, depression, anxiety, burnout, and lack of professional fulfillment with clinical performance during a critically ill patient simulation. Methods/Approach: Emergency medicine residents were recruited to participate in a high-fidelity simulation case of a critically ill patient. A survey with validated wellbeing measures (National Institutes of Health Patient-Reported Outcomes Measurement Information System (NIH PROMIS), Linzer burnout measure, and professional fulfillment index) was administered prior to the simulation. Each encounter was video-recorded and analyzed by two blinded raters based on a binary critical-actions checklist. Time-to-intubation, management errors, and misdiagnosis rates were assessed.ResultsTwenty residents participated, with most subjects endorsing sleepiness (70%) and less than half reporting depression (40%) and anxiety (45%). Burnout was identified to be in 50% of participants by the Linzer measure and 85% by the professional fulfillment index. No significant difference was found between mean performance scores in sleepy, depressed, and anxious cohorts in comparison to groups without those symptoms. Similarly, burnout and professional fulfillment did not yield any significant difference, nor did comparisons with time to intubation, management errors, and frequency of misdiagnosis.ConclusionResident burnout, depression, anxiety, sleepiness, and lack of professional fulfillment did not appear to have a measurable impact on clinical performance in managing a critically ill patient. There is no evidence from this study that the lack of resident physician well-being adversely impacts patient care by increasing errors in management or misdiagnoses during this high-fidelity simulation.

Abstract Background Workflow interruptions are common for emergency physicians and are shown to have downstream consequences such as patient dissatisfaction, delay in clinical response, and increase in medical error. However, the impact of passive interruptions on physician productivity is unclear and has not been well studied. We sought to evaluate if the number of pages received per hour significantly affects the number of patients seen per hour. Methods Retrospective data was collected on resident physician (RP) emergency department shifts from July 1st, 2021 to June 30th, 2022 at an academic medical center with an annual census of 55,000 patients. A total of 2865 RP shifts were collected among the 26 postgraduate year (PGY) 1 and PGY2 residents. For each RP shift, we identified the number of pages received per hour and the number of new patients seen per hour. Pages consist of any transmitted message that was sent to the RP's personal pager, which includes both automatic (eg, bed assignments, abnormal lab values) and personalized pages from other healthcare practicioners (eg, nursing, consultants). Data were analyzed using Poisson regression controlling for clustering at the physician level to determine if the number of patients seen per hour is significantly affected by the number of pages (divided into quartiles) received. Results We found the number of pages received per hour did not decrease the number of patients seen per hour. Contrary to our hypothesis, there was a strong positive relationship between the number of pages received per hour and the number of patients seen by RPs in that hour and subsequent hours. During the middle of a shift (hours 3, 4, and 5), RPs receiving pages in the third and fourth quartile (top 50% of pages) saw significantly more patients during that same hour and the next hour (p

In the context of the particular importance of residency in medicine, aimed at ensuring the selection of the best candidates for specialization programs and guaranteeing the existence of an optimal number of medical specialists to provide quality medical services, we will insist in this paper on the particular dynamics of the resources of human and financial order, amplified in the last period, referring to the normative framework applicable to this matter. The system under discussion is a vast one, only if we think only of the number of resident doctors and pharmacists in training in 2022, which is 30,250, of which 21,882 in the field of Medicine. Also, the institutional framework applicable to it is one of the most complex. The structure of this paper includes, following this introductory part (1): Theoretical background (2), Research methodology (3), Approach regarding the status of the resident doctor based on the legislation applicable to medical residency (4), Dynamics of the number of places and resources of a financial-budgetary nature allocated annually to medical residency in the recent period. Effects obtained (5) and Conclusions (6). [ABSTRACT FROM AUTHOR]

Introduction: Extensive studies regarding the COVID-19 pandemic have shown negative effects on physicians-in-training. Besides a high workload, their learning environment has been affected. A quality learning environment is vital for residents' physician's clinical development and also their health. Nevertheless, few studies have explored this. The aim of this study was to explore resident physicians' experiences of transition to pandemic care during the first wave of the COVID-19 pandemic in Sweden. Method: In this qualitative study, 12 Swedish resident physicians were interviewed using a semi-structured interview guide. They were interviewed between June and October of 2020 and asked to reflect on the pandemic and, more specifically, the first wave. The empirical material was analysed using qualitative content analysis. The analysis resulted in one theme and four categories. Results: The theme identified was An impaired learning environment which signifies the disruptions the resident physicians experienced during the first wave of the pandemic. The four categories, Professional role insecurity, High expectations but little influence, Stagnant clinical development, and Professional growth through experience, describe in what way the learning environment was impacted. [ABSTRACT FROM AUTHOR]

BackgroundResidents in training have high rates of depression and are reluctant to seek treatment. The goal of the study was to conduct a survey with a high response rate to better understand resident attitudes about mental health.MethodsA multi-site study of residents from three teaching hospitals in the USA completed a 21-item anonymous questionnaire, on their smartphones, during mandatory lecture sessions.ResultsThree-hundred and sixteen resident surveys were completed during 24 didactic sessions. The overall response rate from resident-only presentations was 87.8% and ranged from 76.9% to 100% in presentations that included both residents and other attendees. A significant majority of residents indicated that physicians who seek treatment for medical conditions would not seek treatment for depression (87.7%), physicians do not see acceptance of mental health treatment as a sign of strength (80.1%), and most residents with depression cope with it alone (69.0%). Factors that would encourage residents to seek treatment, including easy access to mental healthcare and acceptance of treatment in the workplace environment, varied significantly when residents were grouped by age and gender.ConclusionsWhile residents believe that physicians are highly resistant to mental health treatment, targeted strategies may increase the acceptance of treatment. Administration of surveys to physicians on smartphones at the time of lecture or presentation may improve the response rate.

AIM: To investigate the application and effect of virtual-reality surgery exercise in minimally invasive cataract surgery training for ophthalmology residents.METHODS:Twenty ophthalmology residents with equal seniority who had completed 3a standardized residency training in the Affiliated Eye Hospital of Nanjing Medical University from 2019 to 2021 were prospectively enrolled. After passing the theoretical examination, residents were randomly divided into virtual surgery exercise(Dry-lab)group(n=10)and real animal surgery exercise(Wet-lab)group(n=10). Dry-lab and Wet-lab group residents performed training using the Eye SI surgical simulator and pig eye respectively. At the end of the training, the overall training effects of the residents in both groups were rated using the Eye SI surgical simulator and the real pig eye operation, and the module training effects of the residents in both groups were rated using the virtual surgical simulator. Furthermore, a questionnaire survey was used to objectively evaluate the two training methods.RESULTS:Residents in Dry-lab group had significantly higher total scores on both operation assessments,simulator assessment and real pig eye operation assessment than Wet-lab group(88.03±1.34 vs 80.35±2.87, 87.50±3.03 vs 77.60±5.62, 88.57±1.89 vs 83.10±3.22, all P

IntroductionExtensive studies regarding the COVID-19 pandemic have shown negative effects on physicians-in-training. Besides a high workload, their learning environment has been affected. A quality learning environment is vital for residents’ physician’s clinical development and also their health. Nevertheless, few studies have explored this. The aim of this study was to explore resident physicians’ experiences of transition to pandemic care during the first wave of the COVID-19 pandemic in Sweden.MethodIn this qualitative study, 12 Swedish resident physicians were interviewed using a semi-structured interview guide. They were interviewed between June and October of 2020 and asked to reflect on the pandemic and, more specifically, the first wave. The empirical material was analysed using qualitative content analysis. The analysis resulted in one theme and four categories.ResultsThe theme identified was An impaired learning environment which signifies the disruptions the resident physicians experienced during the first wave of the pandemic. The four categories, Professional role insecurity, High expectations but little influence, Stagnant clinical development, and Professional growth through experience, describe in what way the learning environment was impacted.

The purpose of this article is to clarify the importance of respecting the limits of the medical specialty, the consequences arising from this, in terms of the nature of medical expertise. Nowadays, forensic expertise continues to be approached from an obsolete perspective, without detecting its limits in medical or legal matters. This article aims to analyze the relevant legislation regarding the limits and implications of medical specialties. Despite the abundance of specialized works in the field, it is still difficult to clarify the object of forensic expertise. The purpose of our analysis is to reveal the nature of the expertise that is carried out in trials where medical malpractice is being examined, whether it is the negligence of the doctor or the fault of the medical or pharmaceutical unit. [ABSTRACT FROM AUTHOR]

PurposeMost physicians, including residents, experience significant emotional distress after making medical 11 errors. As high reliability organizations (HROs), hospitals must not only support physicians' emotional recovery but also promote their learning from errors. Self-disclosure is a process of communication in which individuals reveal information about themselves to others. While many previous studies have focused on investigating the effectiveness of self-disclosure, little is known about the process itself. Therefore, this study aims to explore residents' processes of coping with their emotional distress and learning through self-disclosure after making errors.MethodsSemi-structured interviews were conducted with 22 residents in their second year from two Japanese hospitals where informal error conferences guided by senior residents are implemented regularly. In the interview, four core questions were posed regarding the nature of the error/incident, their emotions and behavior after the error, ways of self-disclosure, and the results of error-sharing in the conference. Interview data were thematically analyzed, drawing upon disclosure decision model as the theoretical framework.ResultsFive phases emerged from the analysis: (1) emotional distress and reactions before self-disclosure; (2) self-disclosure to individuals to achieve social rewards; (3) emotional sublimation after self-disclosure to individuals; (4) sharing errors in groups for learning opportunities; and (5) transforming the perspectives on overcoming and learning from errors.ConclusionThis is the study to demonstrate that various types of self-disclosure were embedded in the processes of residents' recovery and learning from medical errors. The study suggests that a better understanding of the processes of residents' coping with their distress and learning from their errors through self-disclosure is fundamental to the creation of a “culture of sharing errors” in hospitals as HROs.

Background: During the COVID-19 containment, a decrease in physical activity, vigorous physical exercise and an increase in sedentary lifestyle were documented. Objective: To describe the physical activity, biochemical and somatometric profile of Rehabilitación resident physicians during the COVID-19 pandemic and to determine the correlations between these variables. Material and methods: A cross-sectional, analytical study of medical residents was carried out. Clinical, somatometric and biochemical data were taken; The average number of steps for one day was recorded. Correlations between these variables were sought. A p < 0.05 was considered significant. Results: 57 residents were recruited. The median number of steps was 3,187 (36 - 6,338) in men and 4,935 (2,139 - 7,731) in women. The median waist circumference was normal in women and men (77.5 (67.4 - 87.6) cm and 90 (74.5 - 105) cm); the waist/hip ratio remained within normal limits (0.84 (0.77 - 0.91) and 0.91 (0.78 - 1.04)) and the percentage of fat was high in both sexes (35.42 ± 7.41% and 29.82 ± 8.67). Significant correlations were found between the number of steps and serum triglycerides (-0.34), BMI (-0.49), waist circumference (-0.44), and fat percentage (-0.55). Conclusions: The physical activity of medical residents in the COVID-19 contingency was low. The percentage of fat was found to be increased in both sexes. Total cholesterol was found in the upper limits of normality. Significant correlations were found between the number of steps and serum triglycerides, BMI, waist circumference, and body fat percentage. [ABSTRACT FROM AUTHOR]

Abstract Background Residency training exposes young physicians to a challenging and high-stress environment, making them vulnerable to burnout. Burnout syndrome not only compromises the health and wellness of resident physicians but has also been linked to prescription errors, reduction in the quality of medical care, and decreased professionalism. This study explored burnout and factors influencing resilience among U.S. resident physicians. Methods A cross-sectional study was conducted through an online survey, which was distributed to all accredited residency programs by Accreditation Council of Graduate Medical Education (ACGME). The survey included the Connor-Davidson Resilience Scale (CD-RISC 25), Abbreviated Maslach Burnout Inventory, and socio-demographic characteristics questions. The association between burnout, resilience, and socio-demographic characteristics were examined. Results The 682 respondents had a mean CD-RISC score of 72.41 (Standard Deviation = 12.1), which was equivalent to the bottom 25th percentile of the general population. Males and upper-level trainees were more resilient than females and junior residents. No significant differences in resilience were found associated with age, race, marital status, or training program type. Resilience positively correlated with personal achievement, family, and institutional support (p

Objective To evaluate the application effect of PDCA cycle method in the standardized training of residents. Methods China national knowledge infrastructure (CNKI), Chinese Biology Medical Literature Database (CBM), VIP and Wanfang Data database were used to retrieve the randomized controlled trials studies related to the application of the PDCA cycle in the standardized training of residents published or registered but not yet published before February 2021, including Chinese and English literature. Literature quality was evaluated, and meta-analysis was performed. Results A total of fourteen articles in Chinese were selected, including 950 subjects[470 in the observation group (the PDCA cycle method) and 460 in the control group (the traditional teaching method) ].Compared with the control group, the scores of doctors’ theory and skill tests in the observation group were higher, and the difference were statistically significant (WMD=5.39, 7.06;95%CI:3.59-7.18, 4.84-9.27;P<0.05) .Conclusion Compared with those of the traditional teaching methods, the PDCA cycle method was conducive to improving the theoretical scores and skills assessment scores of the resident doctors in the standardized training, so as to improve the teaching effect. Reset [ABSTRACT FROM AUTHOR]

Introduction: To investigate the effects and influencing factors of the COVID-19 epidemic on the employment intention of resident physicians in China. Methodology: 409 questionnaires were statistically analyzed after removing the missing values. We used the Chi-Square test for single-factor analysis and logistic regression analysis for multivariate analysis. The questions include the residents' employment intention and their willingness to engage in epidemic-related subspecialties and participate in epidemic-related work. Results: Residents of severe and high-risk epidemic regions had much lower employment intentions than those of stable epidemic regions (OR = 1.917, 95% CI: 1.024, 3.591, p = 0.042). The higher the Center for Epidemiologic Studies Depression Scale (CES-D) score, the more susceptible was the resident's employement intention (OR = 1.085, 95% CI: 1.044, 1.128, p < 0.001). Residents from severe and high-risk epidemic regions were more willing to participate in clinical work (OR = 4.263, 95% CI: 1.892, 9.604, p < 0.001), and the higher the CES-D score, the lower was the proportion of residents willing to choose clinical work (OR = 0.941, 95% CI: 0.893, 0.992, p = 0.023). Residents from severe epidemics and high-risk provinces were less willing to participate in respiratory medicine (X2 = 5.070, p = 0.027) and critical care medicine (X2 = 7.046, p = 0.011). Compared to residents with bachelor's degrees, residents with master's and doctoral degrees were less willing to participate in isolation wards (OR = 1.831, 95% CI: 1.122, 2.990, p = 0.016). Residents in epidemic-related current rotation departments were less willing to go to Wuhan as volunteers (OR = 2.197, 95% CI: 1.110, 4.347, p = 0.024). Conclusions: The COVID-19 outbreak had a negative impact on the job intentions of Chinese residents in general. [ABSTRACT FROM AUTHOR]

Rationale, aim and objectives Data on management of altered level of conscious (ALOC) is more consistent for industrialized countries, than in developing countries. The aim was to determine the current practice of pediatric physicians regarding the management of ALOC among children attending the emergency room, Alexandria University Children's Hospital. Patients and methods This is a descriptive cross-sectional survey. Situational analysis of current practice in the management of children presented with ALOC was done. Data were collected by a self-administered questionnaire designed for the pediatric residents, for medical records of emergency room. Results As regards history taking; the majority of pediatric residents mentioned that they took history related to the underlying disease (97.5%), history of trauma (95%), duration of medications (92.5%), and duration of symptoms (90%). All mentioned that they took history related to vomiting, headache, fever, and family history. The least percentage (55%) was related to the presence of automatism manifestations. Regarding treatment strategy, none of the physicians followed a treatment guideline for initiating treatment. The most frequently recorded items in the reviewed records were present history (100%) and family history (91%). The least recorded items were nutritional history (28%) and history of allergy (30%). Conclusion There is a big variation in practice regarding the management of ALOC in children among resident physicians at Alexandria University Children's Hospital. Regular audit is required to highlight the management gap and to improve the quality of services offered to the patients. Establishment of a local clinical practice guideline is required to standardize the practice and to narrow the management gap. [ABSTRACT FROM AUTHOR]

Introduction: Novel Corona Virus Disease 19 has created unforeseen burden on health care. New York city is one of the epicenters of pandemic and here we explore physical, mental and social impact of COVID 19 on Resident Physicians (RP) working within the center of this epicenter. Methods: This is a single-center cross-sectional web-based survey involving RP of a community hospital in Brooklyn, New York. Questionnaire was formulated in online platform. We used a convenient sampling method. Univariate analysis was conducted and presented the distribution of qualitative responses as frequency and percentages. Result: COVID19 related symptoms were reported by 39.8% RP. COVID19 IgG and IgM antibodies, both negative were reported by 34.9%, while only 6% RPs were IgG antibody positive. Symptomatic RP tested for COVID19-PCR was positive in 42.42%. Self-isolation from family during the pandemic was reported by only 14.5%. Financial constraints, lack of accommodation, and emotional reasons were main reasons of not being able to self isolate. Being bothered by ‘Anxiety’ and ‘Nervousness’ were reported by 8.5% on ‘Almost every day’ while 46.3% reported on ‘several days in the two weeks duration’. ‘Uncontrollable worrying’, ‘Feeling down’, ‘Depressed,’ or ‘Hopeless’ was reported as ‘Not at all’ by 78.8% and 3.7% reported it to ‘occur nearly every day for the last two weeks’. Conclusion: Aftermath of fight against pandemic has left RP with significant physical, mental, and social impact. Appropriate stress management and safety interventions are urgently needed. Further studies are needed to explore the detailed impact of COIV19 on RP.

Medical malpractice is an inevitable truth of being a practicing provider. Despite awareness of malpractice risk, education on understanding the legal landscape and protecting oneself from being named in a malpractice claim is sorely underrepresented in medical school and residency curricula. This review summarizes what is known about the legal risks to the resident in training and the attending physician supervisor. It also explores the legal landscape for physicians practicing and supervising telehealth encounters., Competing Interests: Disclosure The opinions expressed in this article are solely the author’s and do not represent the views of Troutman Pepper. This article is for informational purposes only and does not constitute legal advice. Please consult with a qualified legal professional for advice specific to your situation., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Introduction Resident physician’s working conditions are linked to poor health outcomes of professionals and patient’s safety. Previous studies suggest that residents in Spain have difficulties enjoying mandatory rest after on-call shifts. Objectives This study aims at describing the working conditions: working hours and the absence of mandatory rest periods after a 24h on-call shift in residents of psychiatry in the region of Madrid. Methods A descriptive observational cross-sectional study was carried out through an anonymous survey adapted from the available literature. Results Up to 24,1% of the surveyed residents could not enjoy mandatory resting periods after a 24 hour on-call shift and the mandatory weekly rest of at least 36 hours was not done in up to 17% of the cases with statistical significance (p

Purpose: To evaluate knowledge of age-related fertility decline and oocyte cryopreservation among resident physicians in obstetrics and gynecology (ob-gyn) compared to residents in other specialties. Methods: An online survey was sent to the US residency program directors for ob-gyn, internal medicine, emergency medicine, family medicine, general surgery, pediatrics, and psychiatry. They were asked to forward the survey to their respective residents. The survey consisted of three sections: fertility knowledge, oocyte cryopreservation knowledge, and attitudes toward family building and fertility preservation. Multivariable logistic regression models were used to compare outcomes between ob-gyn and non-ob-gyn residents. Results: Of the 2,828 completed surveys, 450 (15.9%) were by ob-gyn residents and 2,378 (84.1%) were by residents in other specialties. 66.3% of respondents were female. The median number of correct answers was 2 out of 5 on the fertility knowledge section and 1 out of 3 on the oocyte cryopreservation knowledge section among both ob-gyn and non-ob-gyn residents. After adjusting for covariates, residents in ob-gyn were no more likely to answer these questions correctly than residents in other specialties (fertility knowledge, adjusted OR.97, 95% CI.88–1.08; oocyte cryopreservation knowledge, adjusted OR 1.05, 95% CI.92–1.19). Ob-gyn residents were significantly more likely than non-ob-gyn residents to feel "somewhat supported" or "very supported" by their program to pursue family building goals (83.5% vs. 75.8%, OR 1.62, 95% CI 1.23–2.14). Conclusions: Resident physicians, regardless of specialty, have limited knowledge of natural fertility decline and the opportunity to cryopreserve oocytes. These data suggest need for improved fertility education. [ABSTRACT FROM AUTHOR]

The Agency of Health Care Research and Quality in assessing patient safety culture in hospitals have several aspects of dimensions that need to be considered, that is the expectations and actions of supervisors / managers in promoting patient safety, learning of continuous improvement, teamwork in units, open communication, feedback on errors, no-blame responses, adequate staffing, overall perception, hospital management support, inter-unit teamwork, patient submission and transfer and frequency of incident reporting .This study used a cross-sectional research design to obtain information about the relationship between the workplace environment and patient safety culture between resident physician and profession students. The sample (n = 105) consisted of 32 dental resident and 73 profession students. This questionnaire contained 34 questions that were distributed to subjects, data were collected and analyzed by SPSS software. The work environment of dental hygienist has a close relationship with patient safety. Dental hygienist with 1-2 years of work experience, 2-8 years and more than 9 years have a significant relationship to patient safety culture. There was no statistically significant difference in the amount of work per week to the patient safety culture (P> 0.05). Among the work environment in the oral and dental hospital of Hasanuddin University, only 1 aspect had a significant effect on patient safety culture variables, that is work experience. [ABSTRACT FROM AUTHOR]

Abstract Background Although general medicine (GM) faculty in Japanese medical schools have an important role in educating medical students, the importance of residents’ rotation training in GM in postgraduate education has not been sufficiently recognized in Japan. To evaluate the relationship between the rotation of resident physicians in the GM department and their In-Training Examination score. Methods This study is a nationwide multi-center cross-sectional study in Japan. Participants of this study are Japanese junior resident physicians [postgraduate year (PGY)-1 and PGY-2] who took the General Medicine In-Training Examination (GM-ITE) in fiscal years 2016 to 2018 at least once (n = 11,244). The numbers of participating hospitals in the GM-ITE were 381, 459, and 503 in 2016, 2017, and 2018.The GM-ITE score consisted of four categories (medical interview/professionalism, symptomatology/clinical reasoning, physical examination/procedure, and disease knowledge). We evaluated relationship between educational environment (including hospital information) and the GM-ITE score. Results A total of 4464 (39.7%) residents experienced GM department rotation training. Residents who rotated had higher total scores than residents who did not rotate (38.1 ± 12.1, 36.8 ± 11.7, and 36.5 ± 11.5 for residents who experienced GM rotation training, those who did not experience this training in hospitals with a GM department, and those who did not experience GM rotation training in hospitals without a GM department, p = 0.0038). The association between GM rotation and competency remained after multivariable adjustment in the multilevel model: the score difference between GM rotation training residents and non-GM rotation residents in hospitals without a GM department was estimated as 1.18 (standard error, 0.30, p = 0.0001), which was approximately half of the standard deviation of random effects due to hospital variation (estimated as 2.00). Conclusions GM rotation training improved the GM-ITE score of residents and should be considered mandatory for junior residents in Japan.

In the standardized training for resident physicians, trainees are required to master the operating and diagnosing skills of electrocardiogram (ECG). However, it is challenging to be skilled during the standardized training due to the abstractness of ECG diagnosis. Centered around how to complete the teaching task of standardized training within the prescribed time period, this paper shares a set of training programme and the related teaching methods, which could effectively improve the trainees ECG diagnostic and analytic abilities, and provide references for ECG teaching in the standardized training for resident physicians. [ABSTRACT FROM AUTHOR]

Objectives: To assess patient acceptance of resident involvement in otolaryngologic procedures and to evaluate the impact of a written preoperative educational pamphlet. Study Design: Prospective cohort study. Methods: This is a prospective survey study at a large tertiary care academic center. In addition to standard perioperative instructions and informed consent, 87 out of 183 patients received a pamphlet with information on the role of the otolaryngology resident. Results: Greater than 90% of all patients surveyed recognized that resident physicians are directly involved in delivering care at teaching hospitals and may have assisted in their surgical procedure. Ninety percent of patients receiving educational pamphlets were aware residents may have performed portions of their procedure versus 71% in the control group (P =.001). Ninety‐seven percent of patients receiving pamphlets wanted to know how much of their procedure was performed by a resident versus 71% of the control group (P <.001), and patients undergoing single‐surgeon procedures were less likely to want to know how much was performed by a resident (P <.05). Ninety‐six percent in the pamphlet group agreed that residents improved the quality of their care versus 79% of the control group (P =.001). Discussion: Resident surgeons are well received by the large majority of otolaryngology patients. Structured perioperative information regarding surgical training facilitates an honest and open informed consent discussion between the patient and surgeon and helps to establish a solid foundation of trust. Conclusion: Implementation of this practice is simple and inexpensive. It should be considered for any clinical practice with a focus on surgical education. Level of Evidence: 4 Laryngoscope, 131:2448–2454, 2021 [ABSTRACT FROM AUTHOR]

Background: Residency training exposes young physicians to a challenging and high-stress environment, making them vulnerable to burnout. Burnout syndrome not only compromises the health and wellness of resident physicians but has also been linked to prescription errors, reduction in the quality of medical care, and decreased professionalism. This study explored burnout and factors influencing resilience among U.S. resident physicians. Methods: A cross-sectional study was conducted through an online survey, which was distributed to all accredited residency programs by Accreditation Council of Graduate Medical Education (ACGME). The survey included the Connor-Davidson Resilience Scale (CD-RISC 25), Abbreviated Maslach Burnout Inventory, and socio-demographic characteristics questions. The association between burnout, resilience, and socio-demographic characteristics were examined. Results: The 682 respondents had a mean CD-RISC score of 72.41 (Standard Deviation = 12.1), which was equivalent to the bottom 25th percentile of the general population. Males and upper-level trainees were more resilient than females and junior residents. No significant differences in resilience were found associated with age, race, marital status, or training program type. Resilience positively correlated with personal achievement, family, and institutional support (p < 0.001) and negatively associated with emotional exhaustion and depersonalization (p < 0.001). Conclusions: High resilience, family, and institutional support were associated with a lower risk of burnout, supporting the need for developing a resilience training program to promote a lifetime of mental wellness for future physicians. [ABSTRACT FROM AUTHOR]

Introduction: Eligible residents during their fourth postgraduate year (PGY-4) of emergency medicine (EM) residency training who seek specialty board certification in emergency medicine may take the American Osteopathic Board of Emergency Medicine (AOBEM) Part 1 Board Certifying Examination (AOBEM Part 1). All residents enrolled in an osteopathic EM residency training program are required to take the EM Resident In-service Examination (RISE) annually. Our aim was to correlate resident performance on the RISE with performance on the AOBEM Part 1. The study group consisted of osteopathic EM residents in their PGY-4 year of training who took both examinations during that same year.Methods: We examined data from 2009 to 2012 from the National Board of Osteopathic Medical Examiners (NBOME). The NBOME grades and performs statistical analyses on both the RISE and the AOBEM Part 1. We used the RISE exam scores, as reported by percentile rank, and compared them to both the score on the AOBEM Part 1 and the dichotomous outcome of passing or failing. A receiver operating characteristic (ROC) curve was generated to depict the relationship.Results: We studied a total of 409 residents over the 4-year period. The RISE percentile score correlated strongly with the AOBEM Part 1 score for residents who took both exams in the same year (r¼0.61, 95% confidence interval [CI] 0.54 to 0.66). Pass percentage on the AOBEM Part 1 increased by resident percent decile on the RISE from 0% in the bottom decile to 100% in the top decile. ROC analysis also showed that the best cutoff for determining pass or fail on the AOBEM Part 1 was a 65th percentile score on the RISE.Conclusion: We have shown there is a strong correlation between a resident’s percentile score on the RISE during their PGY-4 year of residency training and first-time success on the AOBEM Part 1 taken during the same year. This information may be useful for osteopathic EM residents as an indicator as to how well prepared they are for the AOBEM Part 1 Board Certifying Examination. [West J Emerg Med. 2014;15(1):45–50.]

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Introduction: Our objective was to compare the effectiveness, speed, and complication rate of the traditional manually placed intraosseous (IO) catheter to a mechanical drill-assisted IO catheter by emergency medicine (EM) resident physicians in a training environment. Methods: Twenty-one EM residents participated in a randomized prospective crossover experiment placing 2 intraosseous needles (Cook® Intraosseous Needle, Cook Medical, Bloomington, IN; and EZ-IO® Infusion System, Vidacare, San Antonio, TX). IO needles were placed in anesthetized mixed breed swine (mass range: 25 kg to 27.2 kg). The order of IO placement and puncture location (proximal tibia or distal femur) were randomly assigned. IO placement time was recorded from skin puncture until the operator felt they had achieved successful placement. We used 3 verification criteria: aspiration of marrow blood, easy infusion of 10 mL saline mixed with methylene blue, and lack of stained soft tissue extravasation. Successful placement was defined as meeting 2 out of the 3 predetermined criteria. We surveyed participants regarding previous IO experience, device preferences, and comfort levels using multiple choice, Likert scale, and visual analog scale (VAS) questions. IO completion times, VAS, and mean Likert scales were compared using Student’s t-test and success rates were compared using Fisher’s exact test with p

Introduction: Novel Corona Virus Disease 19 has created unforeseen burden on health care. New York city is one of the epicenters of pandemic and here we explore physical, mental and social impact of COVID 19 on Resident Physicians (RP) working within the center of this epicenter. Methods: This is a single-center cross-sectional web-based survey involving RP of a community hospital in Brooklyn, New York. Questionnaire was formulated in online platform. We used a convenient sampling method. Univariate analysis was conducted and presented the distribution of qualitative responses as frequency and percentages. Result: COVID19 related symptoms were reported by 39.8% RP. COVID19 IgG and IgM antibodies, both negative were reported by 34.9%, while only 6% RPs were IgG antibody positive. Symptomatic RP tested for COVID19-PCR was positive in 42.42%. Self-isolation from family during the pandemic was reported by only 14.5%. Financial constraints, lack of accommodation, and emotional reasons were main reasons of not being able to self isolate. Being bothered by 'Anxiety' and 'Nervousness' were reported by 8.5% on 'Almost every day' while 46.3% reported on 'several days in the two weeks duration'. 'Uncontrollable worrying', 'Feeling down', 'Depressed,' or 'Hopeless' was reported as 'Not at all' by 78.8% and 3.7% reported it to 'occur nearly every day for the last two weeks'. Conclusion: Aftermath of fight against pandemic has left RP with significant physical, mental, and social impact. Appropriate stress management and safety interventions are urgently needed. Further studies are needed to explore the detailed impact of COIV19 on RP. [ABSTRACT FROM AUTHOR]

Background. There are some surveys documenting the lack of knowledge concerning cardiopulmonary resuscitation (CPR) among medical personnel. The aim of the study was to assess knowledge of residents of anaesthesiology about CPR of adults and children. Material and Methods. The survey was conducted on the residents of anaesthesiology who came to participate in obligatory courses recommended for their specialisation. Finally 146 physicians were evaluated. The first group (26 residents) was tested in 2009 and the second group (120 residents) during 2012-2018. The participants completed a written test with open questions which checked the knowledge of CPR of adult and child at basic and advanced level. They were tested at the beginning of the course. Results. The level of knowledge concerning CPR was variable among both tested groups. Whereas the residents possessed a knowledge about CPR of adults they lacked the knowledge about a child CPR. The most of incorrect answers concerned the borderline between adult and child and knowledge about recommended medications and their doses in children during resuscitation. Less than 30% of the respondents in 2009 and less than 40% in 2012-2018 were able to give all of the 8 possible causes of cardiac arrest reversal. Conclusion. There is a lack of knowledge about CPR among the residents of anaesthesiology especially about paediatric CPR. The trend in a level of knowledge among the tested groups did not change with the passage of time. To improve the knowledge of CPR, mandatory courses for the residents should be included into their specialization curriculum along with periodical tests at their work places. [ABSTRACT FROM AUTHOR]

Background: Medical residents are vulnerable to poor sleep quality due to intense work shifts and academic load. Studies objectively quantified with sleep quantity and quality among resident physicians are limited. Meditation techniques have been shown to improve sleep but are rarely studied in this population. The aim of the present study is to evaluate sleep patterns of internal medicine residents and the effect of a structured Heartfulness meditation program to improve sleep quality. Methods: A total of 36 residents participated in a pre–post cohort study from January 2019 through April 2019. Sleep was monitored during a one-week outpatient rotation with two validated assessment tools, namely consensus sleep diary and actigraphy. After four intervening weeks, when the residents returned to the same rotation, Heartfulness meditation was practiced and the same parameters were measured. At the end of the study period, an anonymous qualitative feedback survey was collected to assess the feasibility of the intervention. Results: All 36 residents participated in the study (mean age 31.09 years, SD 4.87); 34 residents (94.4%) had complete pre–post data. Consensus sleep diary data showed decreased sleep onset time from 21.03 to 14.84 min (P =.01); sleep quality and restfulness scores increased from 3.32 to 3.89 and 3.08 to 3.54, respectively (P <.001 for both). Actigraphy showed a change in sleep onset time from 20.9 min to 14.5 min (P =.003). Sleep efficiency improved from 83.5% to 85.6% (P =.019). Wakefulness after initial sleep onset changed from 38.8 to 39.9 min (P =.682). Sleep fragmentation index and the number of awakenings decreased from 6.16 to 5.46 (P =.004) and 41.71 to 36.37 (P =.013), respectively. Conclusions: Residents obtained nearly 7 h of sleep during outpatient rotation. Findings suggest a structured Heartfulness meditation practice to be a feasible program to improve subjective sleep onset time and several objective measures among resident physicians. [ABSTRACT FROM AUTHOR]

Background: Resident physicians experience personal and professional stressors throughout training. These experiences may increase levels of burnout, depression, and grief. Understanding how these stressors impact trainees is essential for improving wellbeing during residency., Objective: We examined the prevalence and associations between burnout, depression, and grief among a national sample of psychiatry resident physicians., Methods: A survey including validated scales for burnout (Modified Maslach Burnout Inventory-Health Services Survey [MBI]), depression (Patient Health Questionnaire-9 [PHQ-9]), and grief (Traumatic Grief Inventory Self Report [TGSIR]) was distributed to 296 psychiatry program directors in January 2023 for dispersal to their respective residents., Results: Fifty-seven participants completed the survey out of 245 participants who opened and started the survey (23.3%). All participants were current psychiatry residents. MBI scores averaged 21.2 (SD 6.5, range 11-40); 11 participants reported high levels of burnout (scores >27; 19.3%). PHQ-9 scores averaged 3.42 (SD 3.0, range 0-14), with 8 responses meeting the criteria for moderate depressive symptoms (scores >10-14; 14.0%). Suicidal ideation was reported by 5 of 57 participants (8.7%). TGISR scores averaged 12.2 (SD 11, range 0-43); no participants met the criteria for pathologic grief. TGISR scores were correlated with MBI (r = .30; P = .02) and PHQ-9 scores (r = .53; P < .0001). MBI scores were also correlated with PHQ-9 scores (r = .54; P < .0001)., Conclusions: Non-pathological grief was correlated with burnout and depression. 14% to 20% of psychiatry residents reported clinically significant levels of burnout and depression. Future studies should aim to further characterize burnout, depression, and grief in larger samples of trainees., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Although general medicine (GM) faculty in Japanese medical schools have an important role in educating medical students, the importance of residents' rotation training in GM in postgraduate education has not been sufficiently recognized in Japan. To evaluate the relationship between the rotation of resident physicians in the GM department and their In-Training Examination score. Methods: This study is a nationwide multi-center cross-sectional study in Japan. Participants of this study are Japanese junior resident physicians [postgraduate year (PGY)-1 and PGY-2] who took the General Medicine In-Training Examination (GM-ITE) in fiscal years 2016 to 2018 at least once (n = 11,244). The numbers of participating hospitals in the GM-ITE were 381, 459, and 503 in 2016, 2017, and 2018.The GM-ITE score consisted of four categories (medical interview/professionalism, symptomatology/clinical reasoning, physical examination/procedure, and disease knowledge). We evaluated relationship between educational environment (including hospital information) and the GM-ITE score. Results: A total of 4464 (39.7%) residents experienced GM department rotation training. Residents who rotated had higher total scores than residents who did not rotate (38.1 ± 12.1, 36.8 ± 11.7, and 36.5 ± 11.5 for residents who experienced GM rotation training, those who did not experience this training in hospitals with a GM department, and those who did not experience GM rotation training in hospitals without a GM department, p = 0.0038). The association between GM rotation and competency remained after multivariable adjustment in the multilevel model: the score difference between GM rotation training residents and non-GM rotation residents in hospitals without a GM department was estimated as 1.18 (standard error, 0.30, p = 0.0001), which was approximately half of the standard deviation of random effects due to hospital variation (estimated as 2.00). Conclusions: GM rotation training improved the GM-ITE score of residents and should be considered mandatory for junior residents in Japan. [ABSTRACT FROM AUTHOR]

Background: In 2004, Japan introduced a mandatory 2‐year postgraduate training program for graduating medical students with a super‐rotation curriculum. A national matching system was established to determine the hospital residency programs best suited for the students. We examined the hospital characteristics preferred by applicants for residencies. Methods: A nationwide cross‐sectional study was conducted. Data on salaries, bonuses, and number of accepted ambulances were compiled from the Residency Electronic Information System. Information on the prefectural population, urban area, and number of senior residents (postgraduate years 3–5) for specialty training was extracted from data published on the web page. The ratio of the number of first‐choice applicants to recruitment capacity (matching ratio) for each program was compared between the characteristics of the hospitals and prefectures. Results: A strong linear relationship was observed between the number of first‐choice applications and the allocated number of resident positions (correlation coefficient,.72). The matching ratio was greater in community hospitals (2.10 times compared with university hospitals; 95% confidence interval [CI], 1.75–2.53), in hospitals with higher numbers of accepted ambulance cases (1.05 times per 1000 annually; 95% CI, 1.03–1.08), and in hospitals that served a larger prefectural population (1.05 times per million; 95% CI, 1.02–1.08). Conclusions: Financial incentives do not seem to attract residency applicants. Applicants prefer non‐university hospitals located in populous areas and those that accept larger number of ambulance cases. To recruit junior residents, an emergency department may need to have higher activity with larger numbers and variety of cases. [ABSTRACT FROM AUTHOR]

Objectives: Many resident physicians suffer from mental distress. This endangers the individual physician as well as the quality of patient care. This study tested the feasibility of a novel 8-week mindfulness program tailored to improve resident physicians' personal and work-related well-being. Methods: Participants were nine resident physicians from a major hospital in southern Germany. Feasibility was assessed in seven domains (demand, acceptability, implementation, practicality, adaptation, integration, and preliminary effectiveness), using self-reports, attrition, attendance, and daily home practice. Using a pre-post within-subjects design, changes were assessed in hair cortisol as a biomarker of stress as well as in self-reported personal and work-related well-being. Results: The program is feasible in all domains. Participants positively rated the program regarding satisfaction, helpfulness, usage, and personal and professional benefit. All participants indicated to recommend the program. There was no study attrition, high attendance, and an average daily home practice of 13.5 min. A medium reduction was observed with hair cortisol secretion (d = 0.64). In terms of personal well-being, medium-to-large improvements were observed with perceived stress (d = 0.58), mental health (d = 0.77), self-attributed mindfulness (d = 0.92), and self-compassion (d = 1.21). In terms of work-related well-being, small-to-medium improvements were observed with self-reported job strain (d = 0.58), effort-reward imbalance (d = 0.36), work-related burnout (d = 0.32), thriving at work (d = 0.24), and physician empathy (d = 0.21). Conclusions: This study provides evidence that a tailored mindfulness program is feasible and may be effective in reducing hair cortisol secretion and improving resident physicians' personal and work-related well-being. These promising findings warrant further investigation within a randomized controlled trial. [ABSTRACT FROM AUTHOR]