Career Choices and Career Progression of Junior Doctors in Dermatology: Surveys of UK Medical Graduates.

Science.gov (United States)

Barat, Atena; Goldacre, Michael J; Lambert, Trevor W

2018-01-01

To report UK-trained doctors' career choices for dermatology, career destinations, and factors influencing career pathways. Multicohort multipurpose longitudinal surveys of UK-trained doctors who graduated between 1974 and 2015. In all, 40,412 doctors (58% of graduates) responded in year 1, 31,466 (64%) in year 3, and 24,970 (67%) in year 5. One year after graduation, 1.7% of women and 0.6% of men made dermatology their first choice but by five years after graduation the respective figures were 1.0% and 0.7%. Compared to their predecessors, its popularity fell more substantially from years 1 to 5 among recent graduates (2005-15), particularly for women (from 2.1% in year 1 to 0.8% in year 5) compared with a fall from 0.8% to 0.5% among men. The most important factor influencing dermatology choice was "hours/working conditions": in year one, 69% regarded this as important compared with 31% of those choosing other hospital physician specialties. Only 18% of respondents who chose dermatology at year 1 eventually worked in it; however, almost all practising dermatologists (94%), 10 years after qualifying, had made their future career decision by year 5. Dermatology is popular among female UK graduates. Most dermatologists made their career decision late but decisively.

Why doctors consider leaving UK medicine: qualitative analysis of comments from questionnaire surveys three years after graduation.

Science.gov (United States)

Lambert, Trevor W; Smith, Fay; Goldacre, Michael J

2018-01-01

Objective To report the reasons why doctors are considering leaving medicine or the UK. Design Questionnaire survey. Setting UK. Participants Questionnaires were sent three years after graduation to all UK medical graduates of 2008 and 2012. Main outcome measures Comments from doctors about their main reasons for considering leaving medicine or the UK (or both). Results The response rate was 46.2% (5291/11,461). Among the 60% of respondents who were not definitely intent on remaining in UK medicine, 50% were considering working in medicine outside the UK and 10% were considering leaving medicine. Among those considering working in medicine outside the UK, the most commonly cited reasons were to gain wider experience, that things would be 'better' elsewhere and a negative view of the National Health Service and its culture, state and politics. Other reasons included better training or job opportunities, better pay and conditions, family reasons and higher expectations. Three years after graduation, doctors surveyed in 2015 were significantly more likely than doctors surveyed in 2011 to cite factors related to the National Health Service, to pay and conditions, to their expectations and to effects on work-life balance and patient care. Among those considering leaving medicine, the dominant reason for leaving medicine was a negative view of the National Health Service (mentioned by half of those in this group who commented). Three years after graduation, doctors surveyed in 2015 were more likely than doctors surveyed in 2011 to cite this reason, as well as excessive hours and workload, and financial reasons. Conclusions An increasingly negative view is held by many doctors of many aspects of the experience of being a junior doctor in the National Health Service, and the difficulty of delivering high-quality patient care within what many see as an under-funded system. Policy changes designed to encourage more doctors to remain should be motivated by a desire to address

Training for the future NHS: training junior doctors in the United Kingdom within the 48-hour European working time directive.

Science.gov (United States)

Datta, Shreelatta T; Davies, Sally J

2014-01-01

Since August 2009, the National Health Service of the United Kingdom has faced the challenge of delivering training for junior doctors within a 48-hour working week, as stipulated by the European Working Time Directive and legislated in the UK by the Working Time Regulations 1998. Since that time, widespread concern has been expressed about the impact of restricted duty hours on the quality of postgraduate medical training in the UK, particularly in the "craft" specialties--that is, those disciplines in which trainees develop practical skills that are best learned through direct experience with patients. At the same time, specialist training in the UK has experienced considerable change since 2007 with the introduction of competency-based specialty curricula, workplace-based assessment, and the annual review of competency progression. The challenges presented by the reduction of duty hours include increased pressure on doctors-in-training to provide service during evening and overnight hours, reduced interaction with supervisors, and reduced opportunities for learning. This paper explores these challenges and proposes potential responses with respect to the reorganization of training and service provision.

Professional values and reported behaviours of doctors in the USA and UK: quantitative survey

Science.gov (United States)

Rao, Sowmya R; Sibbald, Bonnie; Hann, Mark; Harrison, Stephen; Walter, Alex; Guthrie, Bruce; Desroches, Catherine; Ferris, Timothy G; Campbell, Eric G

2011-01-01

Background The authors aimed to determine US and UK doctors' professional values and reported behaviours, and the extent to which these vary with the context of care. Method 1891 US and 1078 UK doctors completed the survey (64.4% and 40.3% response rate respectively). Multivariate logistic regression was used to compare responses to identical questions in the two surveys. Results UK doctors were more likely to have developed practice guidelines (82.8% UK vs 49.6% US, pretribution. UK doctors were more likely than US doctors to agree that significant medical errors should always be disclosed to patients. More US doctors reported that they had not disclosed an error to a patient because they were afraid of being sued. Discussion The context of care may influence both how professional values are expressed and the extent to which behaviours are in line with stated values. Doctors have an important responsibility to develop their healthcare systems in ways which will support good professional behaviour. PMID:21383386

Selecting, training and assessing new general practice community teachers in UK medical schools.

Science.gov (United States)

Hydes, Ciaran; Ajjawi, Rola

2015-09-01

Standards for undergraduate medical education in the UK, published in Tomorrow's Doctors, include the criterion 'everyone involved in educating medical students will be appropriately selected, trained, supported and appraised'. To establish how new general practice (GP) community teachers of medical students are selected, initially trained and assessed by UK medical schools and establish the extent to which Tomorrow's Doctors standards are being met. A mixed-methods study with questionnaire data collected from 24 lead GPs at UK medical schools, 23 new GP teachers from two medical schools plus a semi-structured telephone interview with two GP leads. Quantitative data were analysed descriptively and qualitative data were analysed informed by framework analysis. GP teachers' selection is non-standardised. One hundred per cent of GP leads provide initial training courses for new GP teachers; 50% are mandatory. The content and length of courses varies. All GP leads use student feedback to assess teaching, but other required methods (peer review and patient feedback) are not universally used. To meet General Medical Council standards, medical schools need to include equality and diversity in initial training and use more than one method to assess new GP teachers. Wider debate about the selection, training and assessment of new GP teachers is needed to agree minimum standards.

Career Choices and Career Progression of Junior Doctors in Dermatology: Surveys of UK Medical Graduates

Directory of Open Access Journals (Sweden)

Atena Barat

2018-01-01

Full Text Available Objective. To report UK-trained doctors’ career choices for dermatology, career destinations, and factors influencing career pathways. Methods. Multicohort multipurpose longitudinal surveys of UK-trained doctors who graduated between 1974 and 2015. Results. In all, 40,412 doctors (58% of graduates responded in year 1, 31,466 (64% in year 3, and 24,970 (67% in year 5. One year after graduation, 1.7% of women and 0.6% of men made dermatology their first choice but by five years after graduation the respective figures were 1.0% and 0.7%. Compared to their predecessors, its popularity fell more substantially from years 1 to 5 among recent graduates (2005–15, particularly for women (from 2.1% in year 1 to 0.8% in year 5 compared with a fall from 0.8% to 0.5% among men. The most important factor influencing dermatology choice was “hours/working conditions”: in year one, 69% regarded this as important compared with 31% of those choosing other hospital physician specialties. Only 18% of respondents who chose dermatology at year 1 eventually worked in it; however, almost all practising dermatologists (94%, 10 years after qualifying, had made their future career decision by year 5. Conclusion. Dermatology is popular among female UK graduates. Most dermatologists made their career decision late but decisively.

University strategy for doctoral training: the Ghent University Doctoral Schools.

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Bracke, N; Moens, L

2010-01-01

The Doctoral Schools at Ghent University have a three-fold mission: (1) to provide support to doctoral students during their doctoral research, (2) to foster a quality culture in (doctoral) research, (3) to promote the international and social stature and prestige of the doctorate vis-a-vis potential researchers and the potential labour market. The Doctoral Schools offer top-level specialized courses and transferable skills training to doctoral students as part of their doctoral training programme. They establish mechanisms of quality assurance in doctoral research. The Doctoral Schools initialize and support initiatives of internationalization. They also organize information sessions, promotional events and interaction with the labour market, and as such keep a finger on the pulse of external stakeholders.

The TROJAN Project: Creating a Customized International Orthopedic Training Program for Junior Doctors.

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Kalraiya, Ashish; Buddhdev, Pranai

2015-03-03

Musculoskeletal problems account for a vast proportion of presentations encountered by doctors globally, with figures ranging from 15-36%. However, the time medical schools allocate to learning orthopedics is by no means proportional to this. This study aims to bridge this gap by developing an international orthopedic teaching program tailored to the specific knowledge and skills required by junior doctors in different countries. This prospective study asked fifty junior doctors, who had recently completed an orthopedics job, what three orthopedic teaching topics taught retrospectively would have benefitted their clinical practice. The most requested topics were used to design educational workshops for junior doctors and these consequently comprised the TROJAN (Teaching Requested by Orthopaedic Juniors And Novices) training program. Data was collected from twenty-five junior doctors in KwaZulu-Natale State, South Africa, and twenty-five in London, UK. It is therefore in these two countries that the TROJAN program was subsequently made available. Participants who selected topics were within two years of graduating medical school and had worked an orthopedic or Accident and Emergency job within the last year. 49% of topics chosen by SA doctors were practical skills such as wrist and ankle fracture reduction techniques, and management of open fractures. The most requested topic by UK doctors (11 out of 25) was management of neck of femur fractures. This is rationalized by the fact South African doctors require more hands-on responsibility in their daily practice whereas in the UK greater emphasis is placed on optimizing patients for theatre and making sound management plans. TROJAN currently develops orthopedic skills and knowledge in junior doctors in South Africa and United Kingdom with teaching customized based upon location. Feedback has been exceptionally positive with every candidate thus far rating the usefulness of TROJAN as the highest option, very useful.

Foundation Year 2 doctors' reasons for leaving UK medicine: an in-depth analysis of decision-making using semistructured interviews.

Science.gov (United States)

Smith, Samantha E; Tallentire, Victoria R; Pope, Lindsey M; Laidlaw, Anita H; Morrison, Jill

2018-03-02

To explore the reasons that doctors choose to leave UK medicine after their foundation year two posts. All four regions of Scotland. Foundation year two doctors (F2s) working throughout Scotland who were considering leaving UK medicine after foundation training were recruited on a volunteer basis. Maximum variation between participants was sought. Semistructured interviews were coded using template analysis. Six perspectives, described by Feldman and Ng, were used as the initial coding template. The codes were then configured to form a framework that explores the interplay of factors influencing Foundation Year 2 (F2) doctors' decisions to leave UK medicine. Seventeen participants were interviewed. Six perspectives were explored. Structural influences (countrywide and worldwide issues) included visas, economic and political considerations, structure of healthcare systems and availability of junior doctor jobs worldwide. Organisational influences (the National Health Service (NHS) and other healthcare providers) included staffing and compensation policies, the working environment and the learning environment. Occupational influences (specific to being a junior doctor) comprised the junior doctor contract, role and workload, pursuit of career interests and the structure of training. Work group influences (relationships with colleagues) included support at work, task interdependence and use of locums. Personal life influences consisted of work-life balance, and support in resolving work-life conflict. The underlying theme of 'taking a break' recurred through multiple narratives. F2s give reasons similar to those given by any professional considering a change in their job. However, working within the NHS as an F2 doctor brought specific challenges, such as a need to make a choice of specialty within the F2 year, exposure to workplace bullying and difficulties in raising concerns. Despite these challenges, most F2s did not view their decision to leave as a permanent job

'You can't be a person and a doctor': the work-life balance of doctors in training-a qualitative study.

Science.gov (United States)

Rich, Antonia; Viney, Rowena; Needleman, Sarah; Griffin, Ann; Woolf, Katherine

2016-12-02

Investigate the work-life balance of doctors in training in the UK from the perspectives of trainers and trainees. Qualitative semistructured focus groups and interviews with trainees and trainers. Postgraduate medical training in London, Yorkshire and Humber, Kent, Surrey and Sussex, and Wales during the junior doctor contract dispute at the end of 2015. Part of a larger General Medical Council study about the fairness of postgraduate medical training. 96 trainees and 41 trainers. Trainees comprised UK graduates and International Medical Graduates, across all stages of training in 6 specialties (General Practice, Medicine, Obstetrics and Gynaecology, Psychiatry, Radiology, Surgery) and Foundation. Postgraduate training was characterised by work-life imbalance. Long hours at work were typically supplemented with revision and completion of the e-portfolio. Trainees regularly moved workplaces which could disrupt their personal lives and sometimes led to separation from friends and family. This made it challenging to cope with personal pressures, the stresses of which could then impinge on learning and training, while also leaving trainees with a lack of social support outside work to buffer against the considerable stresses of training. Low morale and harm to well-being resulted in some trainees feeling dehumanised. Work-life imbalance was particularly severe for those with children and especially women who faced a lack of less-than-full-time positions and discriminatory attitudes. Female trainees frequently talked about having to choose a specialty they felt was more conducive to a work-life balance such as General Practice. The proposed junior doctor contract was felt to exacerbate existing problems. A lack of work-life balance in postgraduate medical training negatively impacted on trainees' learning and well-being. Women with children were particularly affected, suggesting this group would benefit the greatest from changes to improve the work-life balance of

Exploring provision of Innovative Community Education Placements (ICEPs) for junior doctors in training: a qualitative study.

Science.gov (United States)

Griffin, Ann; Jones, Melvyn M; Khan, Nada; Park, Sophie; Rosenthal, Joe; Chrysikou, Vasiliki

2016-02-09

Medical education in community settings is an essential ingredient of doctors' training and a key factor in recruiting general practitioners (GP). Health Education England's report 'Broadening the Foundation' recommends foundation doctors complete 4-month community placements. While Foundation GP schemes exist; other community settings, are not yet used for postgraduate training. The objective of this study was to explore how community-based training of junior doctors might be expanded into possible 'innovative community education placements' (ICEPs), examining opportunities and barriers to these developments. A qualitative study where semistructured interviews were undertaken and themes were generated deductively from the research questions, and iteratively from transcripts. UK community healthcare. Stakeholders from UK Community healthcare providers and undergraduate GP and community educators. Nine participants were interviewed; those experienced in delivering community-based undergraduate education, and others working in community settings that had not previously trained doctors. Themes identified were practicalities such as 'finance and governance', 'communication and interaction', 'delivery of training' and 'perceptions of community'. ICEPs were willing to train Foundation doctors. However, concerns were raised that large numbers and inadequate resources could undermine the quality of educational opportunities, and even cause reputational damage. Organisation was seen as a challenge, which might be best met by placing some responsibility with trainees to manage their placements. ICEP providers agreed that defined service contribution by trainees was required to make placements sustainable, and enhance learning. ICEPs stated the need for positive articulation of the learning value of placements to learners and stakeholders. This study highlighted the opportunities for foundation doctors to gain specialist and generalist knowledge in ICEPs from diverse clinical

Making clinical academic careers more attractive: views from questionnaire surveys of senior UK doctors.

Science.gov (United States)

Lambert, Trevor W; Smith, Fay; Goldacre, Michael J

2015-08-01

To report on doctors' reasons, as expressed to our research group, for choosing academic careers and on factors that would make a career in clinical academic medicine more attractive to them. Postal, email and web questionnaires. UK. A total of 6936 UK-trained doctors who graduated in 1996, 1999 and 2000. Open-ended comments about a career in clinical academic medicine. Of doctors who provided reasons for pursuing a long-term career in clinical academic medicine, the main reasons were enjoyment of academic work and personal satisfaction, whether expressed directly in those terms, or in terms of intellectual stimulation, enjoyment of research, teaching and the advancement of medicine, and the job being more varied than and preferable to clinical work alone. Doctors' suggestions for making clinical academic medicine more attractive included improved pay and job security, better funding of research, greater availability of academic posts, more dedicated time for research (and less service work) and more support and mentoring. Women were more likely than men to prioritise flexible working hours and part-time posts. Medical schools could provide more information, as part of student teaching, about the opportunities for and realities of a career in clinical academic medicine. Women, in particular, commented that they lacked the role models and information which would encourage them to consider seriously an academic career. Employers could increase academic opportunities by allowing more time for teaching, research and study and should assess whether job plans make adequate allowance for academic work.

Professional values and reported behaviours of doctors in the USA and UK: quantitative survey.

NARCIS (Netherlands)

Roland, M.; Rao, S.R.; Sibbald, B.S.; Hann, M.; Harrison, S.; Walter, A.; Guthrie, B.; Desroches, C.; Ferris, T.G.; Campbell, E.G.

2011-01-01

BACKGROUND The authors aimed to determine US and UK doctors' professional values and reported behaviours, and the extent to which these vary with the context of care. METHOD 1891 US and 1078 UK doctors completed the survey (64.4% and 40.3% response rate respectively). Multivariate logistic

What factors are critical to attracting NHS foundation doctors into specialty or core training? A discrete choice experiment.

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Scanlan, Gillian Marion; Cleland, Jennifer; Johnston, Peter; Walker, Kim; Krucien, Nicolas; Skåtun, Diane

2018-03-12

Multiple personal and work-related factors influence medical trainees' career decision-making. The relative value of these diverse factors is under-researched, yet this intelligence is crucially important for informing medical workforce planning and retention and recruitment policies. Our aim was to investigate the relative value of UK doctors' preferences for different training post characteristics during the time period when they either apply for specialty or core training or take time out. We developed a discrete choice experiment (DCE) specifically for this population. The DCE was distributed to all Foundation Programme Year 2 (F2) doctors across Scotland as part of the National Career Destination Survey in June 2016. The main outcome measure was the monetary value of training post characteristics, based on willingness to forgo additional potential income and willingness to accept extra income for a change in each job characteristic calculated from regression coefficients. 677/798 F2 doctors provided usable DCE responses. Location was the most influential characteristic of a training position, followed closely by supportive culture and then working conditions. F2 doctors would need to be compensated by an additional 45.75% above potential earnings to move from a post in a desirable location to one in an undesirable location. Doctors who applied for a training post placed less value on supportive culture and excellent working conditions than those who did not apply. Male F2s valued location and a supportive culture less than female F2s. This is the first study focusing on the career decision-making of UK doctors at a critical careers decision-making point. Both location and specific job-related attributes are highly valued by F2 doctors when deciding their future. This intelligence can inform workforce policy to focus their efforts in terms of making training posts attractive to this group of doctors to enhance recruitment and retention. © Article author

“You can’t be a person and a doctor”. The work-life balance of doctors in training: a qualitative study

OpenAIRE

Rich, A.; Viney, R.; Needleman, S.; Griffin, A.; Woolf, K. V. M.

2016-01-01

Objectives Investigate the work–life balance of doctors in training in the UK from the perspectives of trainers and trainees. Design Qualitative semistructured focus groups and interviews with trainees and trainers. Setting Postgraduate medical training in London, Yorkshire and Humber, Kent, Surrey and Sussex, and Wales during the junior doctor contract dispute at the end of 2015. Part of a larger General Medical Council study about the fairness of postgraduate medical training. Part...

Attitudes of UK doctors towards euthanasia and physician-assisted suicide: a systematic literature review.

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McCormack, Ruaidhri; Clifford, Margaret; Conroy, Marian

2012-01-01

To review studies over a 20-year period that assess the attitudes of UK doctors concerning active, voluntary euthanasia (AVE) and physician-assisted suicide (PAS), assess efforts to minimise bias in included studies, determine the effect of subgroup variables (e.g. age, gender) on doctors' attitudes, and make recommendations for future research. Three electronic databases, four pertinent journals, reference lists of included studies. Literature search of English articles between January 1990 and April 2010. Studies were excluded if they did not present independent data (e.g. commentaries) or if they related to doctors outside the UK, patients younger than 18 years old, terminal sedation, withdrawing or withholding treatment, or double-effect. Quantitative and qualitative data were extracted. Following study selection and data extraction, 15 studies were included. UK doctors oppose the introduction of both AVE and PAS in the majority of studies. Degree of religiosity appeared as a statistically significant factor in influencing doctors' attitudes. The top three themes in the qualitative analysis were the provision of palliative care, adequate safeguards in the event of AVE or PAS being introduced, and a profession to facilitate AVE or PAS that does not include doctors. UK doctors appear to oppose the introduction of AVE and PAS, even when one considers the methodological limitations of included studies. Attempts to minimise bias in included studies varied. Further studies are necessary to establish if subgroup variables other than degree of religiosity influence attitudes, and to thoroughly explore the qualitative themes that appeared.

Bias against foreign-born or foreign-trained doctors: experimental evidence.

Science.gov (United States)

Louis, Winnifred R; Lalonde, Richard N; Esses, Victoria M

2010-12-01

Bias against foreign-born or -trained medical students and doctors is not well understood, despite its documented impact on recruitment, integration and retention. This research experimentally examines the interaction of location of medical education and nationality in evaluations of doctors' competence and trustworthiness. A convenience sample of prospective patients evaluated fictitious candidates for a position as a doctor in community practice at a new local health clinic. All applicants were described as having the same personality profile, legal qualifications to practise, a multi-degree education and relevant work experience. The location of medical education (the candidate's home country or the UK) and national background (Australia or Pakistan) of the applicants were independently experimentally manipulated. Consistent with previous research on skills discounting and bias, foreign-born candidates were evaluated less favourably than native-born candidates, despite their comparable education level, work experience and personality. However, overseas medical education obtained in the First World both boosted evaluations (of competence and trustworthiness) and attenuated bias based on nationality. The present findings demonstrate the selective discounting of foreign-born doctors' credentials. The data show an interaction of location of medical education and birth nationality in bias against foreign doctors. On an applied level, the data document that the benefits of medical education obtained in the First World can extend beyond its direct outcomes (high-quality training and institutional recognition) to the indirect benefit of the attenuation of patient bias based on nationality. © Blackwell Publishing Ltd 2010.

What motivates doctors to leave the UK NHS for a “life in the sun” in New Zealand; and, once there, why don’t they stay?

OpenAIRE

Gauld, Robin; Horsburgh, Simon

2015-01-01

Background At 44%, New Zealand has the highest proportion of international medical graduates (IMGs) in its workforce amongst OECD member countries. Around half of New Zealand’s IMGs come from the UK NHS, yet only around 50% stay longer than 1 year post-registration with significant costs to the New Zealand health care system. Why these doctors go to New Zealand and do not stay for long is an important question. Methods UK-trained doctors who had gained registration with the Medical Council of...

Training tomorrow's doctors to explain 'medically unexplained' physical symptoms: An examination of UK medical educators' views of barriers and solutions.

Science.gov (United States)

Joyce, Emmeline; Cowing, Jennifer; Lazarus, Candice; Smith, Charlotte; Zenzuck, Victoria; Peters, Sarah

2018-05-01

Co-occuring physical symptoms, unexplained by organic pathology (known as Functional Syndromes, FS), are common and disabling presentations. However, FS is absent or inconsistently taught within undergraduate medical training. This study investigates the reasons for this and identifies potential solutions to improved implementation. Twenty-eight medical educators from thirteen different UK medical schools participated in semi-structured interviews. Thematic analysis proceeded iteratively, and in parallel with data production. Barriers to implementing FS training are beliefs about the complexity of FS, tutors' negative attitudes towards FS, and FS being perceived as a low priority for the curriculum. In parallel participants recognised FS as ubiquitous within medical practice and erroneously assumed it must be taught by someone. They recommended that students should learn about FS through managed exposure, but only if tutors' negative attitudes and behaviour are also addressed. Negative attitudes towards FS by educators prevents designing and delivering effective education on this common medical presentation. Whilst there is recognition of the need to implement FS training, recommendations are multifaceted. Increased liaison between students, patients and educators is necessary to develop more informed and effective teaching methods for trainee doctors about FS and in order to minimise the impact of the hidden curriculum. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

Perceived causes of differential attainment in UK postgraduate medical training: a national qualitative study.

Science.gov (United States)

Woolf, Katherine; Rich, Antonia; Viney, Rowena; Needleman, Sarah; Griffin, Ann

2016-11-25

Explore trainee doctors' experiences of postgraduate training and perceptions of fairness in relation to ethnicity and country of primary medical qualification. Qualitative semistructured focus group and interview study. Postgraduate training in England (London, Yorkshire and Humber, Kent Surrey and Sussex) and Wales. 137 participants (96 trainees, 41 trainers) were purposively sampled from a framework comprising: doctors from all stages of training in general practice, medicine, obstetrics and gynaecology, psychiatry, radiology, surgery or foundation, in 4 geographical areas, from white and black and minority ethnic (BME) backgrounds, who qualified in the UK and abroad. Most trainees described difficult experiences, but BME UK graduates (UKGs) and international medical graduates (IMGs) could face additional difficulties that affected their learning and performance. Relationships with senior doctors were crucial to learning but bias was perceived to make these relationships more problematic for BME UKGs and IMGs. IMGs also had to deal with cultural differences and lack of trust from seniors, often looking to IMG peers for support instead. Workplace-based assessment and recruitment were considered vulnerable to bias whereas examinations were typically considered more rigorous. In a system where success in recruitment and assessments determines where in the country you can get a job, and where work-life balance is often poor, UK BME and international graduates in our sample were more likely to face separation from family and support outside of work, and reported more stress, anxiety or burnout that hindered their learning and performance. A culture in which difficulties are a sign of weakness made seeking support and additional training stigmatising. BME UKGs and IMGs can face additional difficulties in training which may impede learning and performance. Non-stigmatising interventions should focus on trainee-trainer relationships at work and organisational changes to

The future of UK/Irish surgery: A European solution.

Science.gov (United States)

Varzgalis, M; Kerin, M J; Sweeney, K J

2015-11-01

The United Kingdom (UK) and Republic of Ireland (ROI) hospital systems are dependent on junior doctors for their functionality however it is increasingly difficult to recruit UK/ROI trained doctors to fill these posts. Directive 2005/36/EC, which came into force in 2007, is the principal European legislation on the recognition of equivalence of professional qualifications across Europe. European trained doctors are therefore attractive candidates for junior doctor posts. However, although their training is recognised as equivalent by the Irish Medical Council (IMC) and General Medical Council (GMC) they are not being appointed to equivalent posts by the Health Service Executive (HSE) or National Health Service (NHS). With the influence of European Union (EU) centralisation, modification of UK/ROI consultant grade is imminent, possibly to pyramidal structure of the Continental European model with clearer lines of corporate responsibility. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

UK doctors' views on the implementation of the European Working Time Directive as applied to medical practice: a qualitative analysis.

Science.gov (United States)

Clarke, Rachel T; Pitcher, Alex; Lambert, Trevor W; Goldacre, Michael J

2014-02-06

To report on what doctors at very different levels of seniority wrote, in their own words, about their concerns about the European Working Time Directive (EWTD) and its implementation in the National Health Service (NHS). All medical school graduates from 1993, 2005 and 2009 were surveyed by post and email in 2010. The UK. Using qualitative methods, we analysed free-text responses made in 2010, towards the end of the first year of full EWTD implementation, of three cohorts of the UK medical graduates (graduates of 1993, 2005 and 2009), surveyed as part of the UK Medical Careers Research Group's schedule of multipurpose longitudinal surveys of doctors. Of 2459 respondents who gave free-text comments, 279 (11%) made unprompted reference to the EWTD; 270 of the 279 comments were broadly critical. Key themes to emerge included frequent dissociation between rotas and actual hours worked, adverse effects on training opportunities and quality, concerns about patient safety, lowering of morale and job satisfaction, and attempts reportedly made in some hospitals to persuade junior doctors to collude in the inaccurate reporting of compliance. Further work is needed to determine whether problems perceived with the EWTD, when they occur, are attributable to the EWTD itself, and shortened working hours, or to the way that it has been implemented in some hospitals.

Attitudes of UK doctors towards euthanasia and physician-assisted suicide: a systematic literature review.

LENUS (Irish Health Repository)

McCormack, Ruaidhri

2012-01-01

To review studies over a 20-year period that assess the attitudes of UK doctors concerning active, voluntary euthanasia (AVE) and physician-assisted suicide (PAS), assess efforts to minimise bias in included studies, determine the effect of subgroup variables (e.g. age, gender) on doctors\\' attitudes, and make recommendations for future research. Data sources: Three electronic databases, four pertinent journals, reference lists of included studies. Review methods: Literature search of English articles between January 1990 and April 2010. Studies were excluded if they did not present independent data (e.g. commentaries) or if they related to doctors outside the UK, patients younger than 18 years old, terminal sedation, withdrawing or withholding treatment, or double-effect. Quantitative and qualitative data were extracted.

Doctorate Program Trains Industrial Chemists.

Science.gov (United States)

Chemical and Engineering News, 1982

1982-01-01

The University of Texas (Dallas) has initiated a new Ph.D. program specifically to train chemists for doctoral level work in industry (Doctor of Chemistry). Participants will complete three research practica (at an industrial site and in two laboratory settings) instead of the traditional dissertation, emphasizing breadth and flexibility in…

Core competencies in teaching and training for doctors in Scotland: a review of the literature and stakeholder survey.

Science.gov (United States)

Ross, Michael T; Macrae, Claire; Scott, Jayne; Renwick, Lynne; Moffat, Mandy; Needham, Gillian; Scott, Hazel; Shippey, Ben; Jackson, Catherine; Edgar, Simon; Aitken, Debbie; Evans, Phillip; Irvine, Stewart

2014-06-01

The UK General Medical Council requires all registered doctors to be competent in all areas of their work, including teaching and training. The current research sought consensus on core competencies for all consultants and GPs involved in teaching and training in Scotland. A draft list of 80 competencies was developed from the literature and made available as a survey to all consultants and GPs with teaching roles and all final year speciality trainees working in Scotland. Respondents rated the importance of each competency and provided free text comments. There were 1026 responses. Eighteen competencies were rated as "high priority", and are recommended as a baseline for all doctors involved in teaching and training; 55 were rated as "medium priority", and are recommended in relation to specific teaching and training roles; and 7 were rated as "low priority". Free text responses suggested the topic was controversial and emotive, and emphasised the importance of further work to engage trainers. The findings appeared to have face validity, and it was felt these could be used as the basis for developing a "Scottish Trainer Framework" for doctors and others involved in teaching and training in Scotland.

Factors influencing junior doctors' choices of future specialty: trends over time and demographics based on results from UK national surveys.

Science.gov (United States)

Smith, Fay; Lambert, Trevor W; Goldacre, Michael J

2015-10-01

To study trends in factors influencing junior doctors' choice of future specialty. Respondents were asked whether each of 15 factors had a great deal of influence on their career choice, a little influence or no influence on it. Percentages are reported of those who specified that a factor had a great deal of influence on their career choice. UK. A total of 15,765 UK-trained doctors who graduated between 1999 and 2012. Questions about career choices and factors which may have influenced those choices, in particular comparing doctors who qualified in 2008-2012 with those who qualified in 1999-2002. Enthusiasm for and commitment to the specialty was a greater influence on career choice in the 2008-2012 qualifiers (81%) than those of 1999-2002 (64%), as was consideration of their domestic circumstances (43% compared with 20%). Prospects for promotion were less important to recent cohorts (16%) than older cohorts (21%), as were financial prospects (respectively, 10% and 14%). Domestic circumstances and working hours were considered more important, and financial prospects less important, by women than men. Inclination before medical school was rated as important by 41% of doctors who were over 30 years old, compared with 13% of doctors who were under 21, at the time of starting medical school. The increasing importance of both domestic circumstances and enthusiasm for their specialty choice in recent cohorts suggest that today's young doctors prize both work-life balance and personal fulfilment at work more highly than did their predecessors. The differences in motivations of older and younger generations of doctors, men and women, and doctors who start medical school relatively late are worthy of note. © The Royal Society of Medicine.

Cultural dimensions in the transition of overseas medical graduates to the UK workplace.

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Morrow, Gill; Rothwell, Charlotte; Burford, Bryan; Illing, Jan

2013-10-01

Historically, overseas-qualified doctors have been essential for meeting service needs in the UK National Health Service (NHS). However, these doctors encounter many cultural differences, in relation to training, the healthcare system and the doctor-patient relationship and training. To examine whether Hofstede's cultural model may help us understand the changes doctors from other countries experience on coming to work in the UK, and to identify implications for supervisors and clinical teams. Telephone interviews were conducted with overseas medical graduates before starting work as a Foundation Year One (F1) doctor, followed up after four months and 12 months; and with educational supervisors. Data were analysed using a confirmatory thematic approach. Sixty-four initial interviews were conducted with overseas doctors, 56 after four months, and 32 after 12 months. Twelve interviews were conducted with educational supervisors. The changes doctors experienced related particularly to Hofstede's dimensions of power distance (e.g. in relation to workplace hierarchies and inter-professional relationships), uncertainty avoidance (e.g. regarding ways of interacting) and individualism-collectivism (e.g., regarding doctor-patient/family relationship; assertiveness of individuals). Hofstede's cultural dimensions may help us understand the adaptations some doctors have to make in adjusting to working in the UK NHS. This may promote awareness and understanding and greater 'cultural competence' amongst those working with them or supervising them in their training.

Clinical leadership development in postgraduate medical education and training: policy, strategy, and delivery in the UK National Health Service

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Aggarwal R

2015-11-01

Full Text Available Reena Aggarwal,1,2 Tim Swanwick2 1Women's Health, Whittington Health, London, UK; 2Health Education England, North Central and East London, London, UK Abstract: Achieving high quality health care against a background of continual change, increasing demand, and shrinking financial resource is a major challenge. However, there is significant international evidence that when clinicians use their voices and values to engage with system delivery, operational efficiency and care outcomes are improved. In the UK National Health Service, the traditional divide between doctors and managers is being bridged, as clinical leadership is now foregrounded as an important organizational priority. There are 60,000 doctors in postgraduate training (junior doctors in the UK who provide the majority of front-line patient care and form an "operating core" of most health care organizations. This group of doctors is therefore seen as an important resource in initiating, championing, and delivering improvement in the quality of patient care. This paper provides a brief overview of leadership theories and constructs that have been used to develop a raft of interventions to develop leadership capability among junior doctors. We explore some of the approaches used, including competency frameworks, talent management, shared learning, clinical fellowships, and quality improvement. A new paradigm is identified as necessary to make a difference at a local level, which moves learning and leadership away from developing "leaders", to a more inclusive model of developing relationships between individuals within organizations. This shifts the emphasis from the development of a "heroic" individual leader to a more distributed model, where organizations are "leader-ful" and not just "well led" and leadership is centered on a shared vision owned by whole teams working on the frontline. Keywords: National Health Service, junior doctors, quality improvement, management, health care

Doctors' enjoyment of their work and satisfaction with time available for leisure: UK time trend questionnaire-based study.

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Surman, Geraldine; Lambert, Trevor W; Goldacre, Michael

2016-04-01

Doctors' job satisfaction is important to the health service to ensure commitment, effective training, service provision and retention. Job satisfaction matters to doctors for their personal happiness, fulfilment, service to patients and duty to employers. Monitoring job satisfaction trends informs workforce planning. We surveyed UK-trained doctors up to 5 years after graduation for six graduation year cohorts: 1996, 1999, 2002, 2005, 2008, 2012. Doctors scored their job enjoyment (Enjoyment) and satisfaction with time outside work (Leisure) on a scale from 1 (lowest enjoyment/satisfaction) to 10 (highest). Overall, 47% had a high level of Enjoyment (scores 8-10) 1 year after graduation and 56% after 5 years. For Leisure, the corresponding figures were 19% and 37% at 1 and 5 years, respectively. For Leisure at 1 year, high scores were given by about 10% in the 1990s, rising to about 25% in the mid-2000s. Low scores (1-3) for Enjoyment were given by 15% of qualifiers of 1996, falling to 5% by 2008; corresponding figures for Leisure were 42% and 19%. At 5 years, the corresponding figures were 6% and 4%, and 23% and 17%. Enjoyment and Leisure were scored higher by general practitioners than doctors in other specialties. Both measures varied little by sex, ethnicity or medical school attended. Scores for Enjoyment were generally high; those for Leisure were lower. Policy initiatives should address why this aspect of satisfaction is low, particularly in the first year after graduation but also among hospital doctors 5 years after graduation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Making clinical academic careers more attractive: views from questionnaire surveys of senior UK doctors

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Lambert, Trevor W; Goldacre, Michael J

2015-01-01

Summary Objectives To report on doctors’ reasons, as expressed to our research group, for choosing academic careers and on factors that would make a career in clinical academic medicine more attractive to them. Design Postal, email and web questionnaires. Setting UK. Participants A total of 6936 UK-trained doctors who graduated in 1996, 1999 and 2000. Main outcome measures Open-ended comments about a career in clinical academic medicine. Results Of doctors who provided reasons for pursuing a long-term career in clinical academic medicine, the main reasons were enjoyment of academic work and personal satisfaction, whether expressed directly in those terms, or in terms of intellectual stimulation, enjoyment of research, teaching and the advancement of medicine, and the job being more varied than and preferable to clinical work alone. Doctors’ suggestions for making clinical academic medicine more attractive included improved pay and job security, better funding of research, greater availability of academic posts, more dedicated time for research (and less service work) and more support and mentoring. Women were more likely than men to prioritise flexible working hours and part-time posts. Conclusions Medical schools could provide more information, as part of student teaching, about the opportunities for and realities of a career in clinical academic medicine. Women, in particular, commented that they lacked the role models and information which would encourage them to consider seriously an academic career. Employers could increase academic opportunities by allowing more time for teaching, research and study and should assess whether job plans make adequate allowance for academic work. PMID:26380103

UK military doctors; stigma, mental health and help-seeking: a comparative cohort study.

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Jones, Norman; Whybrow, D; Coetzee, R

2018-03-09

Studies suggest that medical doctors can suffer from substantial levels of mental ill-health. Little is known about military doctors' mental health and well-being; we therefore assessed attitudes to mental health, self-stigma, psychological distress and help-seeking among UK Armed Forces doctors. Six hundred and seventy-eight military doctors (response rate 59%) completed an anonymous online survey. Comparisons were made with serving and ex-military personnel (n=1448, response rate 84.5%) participating in a mental health-related help-seeking survey. Basic sociodemographic data were gathered, and participants completed measures of mental health-related stigmatisation, perceived barriers to care and the 12-Item General Health Questionnaire. All participants were asked if in the last three years they had experienced stress, emotional, mental health, alcohol, family or relationship problems, and whether they had sought help from formal sources. Military doctors reported fewer mental disorder symptoms than the comparison groups. They endorsed higher levels of stigmatising beliefs, negative attitudes to mental healthcare, desire to self-manage and self-stigmatisation than each of the comparison groups. They were most concerned about potential negative effects of and peer perceptions about receiving a mental disorder diagnosis. Military doctors reporting historical and current relationship, and alcohol or mental health problems were significantly and substantially less likely to seek help than the comparison groups. Although there are a number of study limitations, outcomes suggest that UK military doctors report lower levels of mental disorder symptoms, higher levels of stigmatising beliefs and a lower propensity to seek formal support than other military reference groups. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

UK doctors and equal opportunities in the NHS: national questionnaire surveys of views on gender, ethnicity and disability.

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Lambert, Trevor; Surman, Geraldine; Goldacre, Michael

2014-10-01

To seek doctors' views about the NHS as an employer, our surveys about doctors' career intentions and progression, undertaken between 1999 and 2013, also asked whether the NHS was, in their view, a good 'equal opportunities' employer for women doctors, doctors from ethnic minority groups and doctors with disabilities. Surveys undertaken in the UK by mail and Internet. UK medical graduates in selected graduation years between 1993 and 2012. Respondents were asked to rate their level of agreement with three statements starting 'The NHS is a good equal opportunities employer for…' and ending 'women doctors', 'doctors from ethnic minorities' and 'doctors with disabilities'. Of first-year doctors surveyed in 2013, 3.6% (78/2158) disagreed that the NHS is a good equal opportunities employer for women doctors (1.7% of the men and 4.7% of the women); 2.2% (44/1968) disagreed for doctors from ethnic minorities (0.9% of white doctors and 5.8% of non-white doctors) and 12.6% (175/1387) disagreed for doctors with disabilities. Favourable perceptions of the NHS in these respects improved substantially between 1999 and 2013; among first-year doctors of 2000-2003, combined, the corresponding percentages of disagreement were 23.5% for women doctors, 23.1% for doctors from ethnic minorities and 50.6% for doctors with disabilities. Positive views about the NHS as an equal opportunities employer have increased in recent years, but the remaining gap in perception of this between women and men, and between ethnic minority and white doctors, is a concern. © The Royal Society of Medicine.

Encouraging formative assessments of leadership for foundation doctors.

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Hadley, Lindsay; Black, David; Welch, Jan; Reynolds, Peter; Penlington, Clare

2015-08-01

Clinical leadership is considered essential for maintaining and improving patient care and safety in the UK, and is incorporated in the curriculum for all trainee doctors. Despite the growing focus on the importance of leadership, and the introduction of the Medical Leadership Competency Framework (MLCF) in the UK, leadership education for doctors in training is still in its infancy. Assessment is focused on clinical skills, and trainee doctors receive very little formal feedback on their leadership competencies. In this article we describe the approach taken by Health Education Kent, Sussex and Surrey (HEKSS) to raise the profile of leadership amongst doctors in training in the South Thames Foundation School (STFS). An annual structured formative assessment in leadership for each trainee has been introduced, supported by leadership education for both trainees and their supervisors in HEKSS trusts. We analysed over 500 of these assessments from the academic year 2012/13 for foundation doctors in HEKSS trusts, in order to assess the quality of the feedback. From the analysis, potential indicators of more effective formative assessments were identified. These may be helpful in improving the leadership education programme for future years. There is a wealth of evidence to highlight the importance and value of formative assessments; however, particularly for foundation doctors, these have typically been focused on assessing clinical capabilities. This HEKSS initiative encourages doctors to recognise leadership opportunities at the beginning of their careers, seeks to help them understand the importance of acquiring leadership skills and provides structured feedback to help them improve. Leadership education for doctors in training is still in its infancy. © 2015 John Wiley & Sons Ltd.

Surgical simulators in urological training--views of UK Training Programme Directors.

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Forster, James A; Browning, Anthony J; Paul, Alan B; Biyani, C Shekhar

2012-09-01

What's known on the subject? and What does the study add? The role of surgical simulators is currently being debated in urological and other surgical specialties. Simulators are not presently implemented in the UK urology training curriculum. The availability of simulators and the opinions of Training Programme Directors' (TPD) on their role have not been described. In the present questionnaire-based survey, the trainees of most, but not all, UK TPDs had access to laparoscopic simulators, and that all responding TPDs thought that simulators improved laparoscopic training. We hope that the present study will be a positive step towards making an agreement to formally introduce simulators into the UK urology training curriculum. To discuss the current situation on the use of simulators in surgical training. To determine the views of UK Urology Training Programme Directors (TPDs) on the availability and use of simulators in Urology at present, and to discuss the role that simulators may have in future training. An online-questionnaire survey was distributed to all UK Urology TPDs. In all, 16 of 21 TPDs responded. All 16 thought that laparoscopic simulators improved the quality of laparoscopic training. The trainees of 13 TPDs had access to a laparoscopic simulator (either in their own hospital or another hospital in the deanery). Most TPDs thought that trainees should use simulators in their free time, in quiet time during work hours, or in teaching sessions (rather than incorporated into the weekly timetable). We feel that the current apprentice-style method of training in urological surgery is out-dated. We think that all TPDs and trainees should have access to a simulator, and that a formal competency based simulation training programme should be incorporated into the urology training curriculum, with trainees reaching a minimum proficiency on a simulator before undertaking surgical procedures. © 2012 THE AUTHORS. BJU INTERNATIONAL © 2012 BJU INTERNATIONAL.

Non-European Union doctors in the National Health Service: why, when and how do they come to the United Kingdom of Great Britain and Northern Ireland?

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Jude Edward B

2007-02-01

Full Text Available Abstract Background As many as 30% of doctors working for the National Health System (NHS of the United Kingdom of Great Britain and Northern Ireland (UK have obtained their primary qualifications from a country outside the European Union. However, factors driving this migration of doctors to the UK merit continuing exploration. Our objective was to obtain training and employment profile of UK doctors who obtained their primary medical qualification outside the European Union (non-European doctors and to assess self-reported reasons for their migration. Methods We conducted an online survey of non-European doctors using a pre-validated questionnaire. Results One thousand six hundred and nineteen doctors of 26 different nationalities completed the survey. Of the respondents, 90.1% were from India and over three-quarters migrated to the UK mainly for 'training'. Other reasons cited were 'better pay' (7.2%, 'better work environment' (7.1% and 'having family and friends in the UK' (2.8%. Many of the respondents have been in the UK for more than a year (88.8%, with 31.3% having spent more than 3 years gaining experience of working in the NHS. Most respondents believe they will be affected by recent changes to UK immigration policy (86.6%, few report that they would be unaffected (3.7% and the rest are unsure (9.8%. Conclusion The primary reason for many non-European doctors to migrate to the UK is for training within the NHS. Secondary reasons like better pay, better work environment and having friends and family in the UK also play a role in attracting these doctors, predominantly from the Indian subcontinent and other British Commonwealth countries.

Disorganized junior doctors fail the MRCP (UK).

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Stanley, Adrian G; Khan, Khalid M; Hussain, Walayat; Tweed, Michael

2006-02-01

Career progression during undergraduate and early postgraduate years is currently determined by successfully passing examinations. Both academic factors (secondary school examination results, learning style and training opportunities) and non-academic factors (maturity, ethnic origin, gender and motivation) have been identified as predicting examination outcome. Few studies have examined organization skills. Disorganized medical students are more likely to perform poorly in end-of-year examinations but this observation has not been examined in junior doctors. This study asked whether organization skills relate to examination outcome amongst junior doctors taking the clinical Part II examination for the Membership of the Royal College of Physicians (Practical Assessment of Clinical Examination Skills). The study was conducted prospectively at four consecutive clinical courses that provided clinical teaching and practice to prepare trainees for the examination. Arrival time at registration for the course was the chosen surrogate for organization skills. Trainees were advised that they should arrive promptly at 8.00 a.m. for registration and it was explained that the course would start at 8.30 a.m. Recorded arrival times were compared with the pass lists published by the Royal College of Physicians. The mean arrival time was 8.17 a.m. A total of 81 doctors (53.3%) passed the examination with a mean arrival time of 8.14 a.m. However, 71 doctors failed the exam and arrived, on average, six minutes later than doctors who passed (p?=?0.006). Better-prepared junior doctors were more likely to pass the final examination. Arriving on time represents a composite of several skills involved in the planning of appropriate travel arrangements and is therefore a valid marker of organization skills and preparation. This novel study has shown that good time-keeping skills are positively associated with examination outcome.

What motivates doctors to leave the UK NHS for a "life in the sun" in New Zealand; and, once there, why don't they stay?

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Gauld, Robin; Horsburgh, Simon

2015-09-08

At 44%, New Zealand has the highest proportion of international medical graduates (IMGs) in its workforce amongst OECD member countries. Around half of New Zealand's IMGs come from the UK NHS, yet only around 50% stay longer than 1 year post-registration with significant costs to the New Zealand health care system. Why these doctors go to New Zealand and do not stay for long is an important question. UK-trained doctors who had gained registration with the Medical Council of New Zealand and currently practising in New Zealand were surveyed (n = 1357) on the motivation for their move to New Zealand, experiences once there and what was prompting any intentions to move away from New Zealand. Multivariate proportional odds models (POM) were used to quantify various associations. The survey had a 47% response (n = 632). Quality of life considerations motivated 96% of respondents to move to New Zealand, although 65% indicated they were pushed by a desire to leave the NHS. POM analyses revealed older respondents were significantly less likely than younger respondents to be motivated by quality of life considerations. Younger doctors were significantly more likely to be seeking to leave the NHS. Seventy-six per cent of respondents signalling an intention to leave New Zealand indicated that the desire to return to the UK was the primary reason for this. There is a long history of medical migration from the UK to New Zealand. However, the 65% of respondents in this study seeking to leave the NHS was much higher than found elsewhere, perhaps reflecting increasing workplace and funding pressures in recent years. Of concern to policy makers were the higher odds of seeking to leave the NHS motivating younger doctors. Various changes "down under", in New Zealand as well as Australia, mean their IMG markets may well be tightening up.

Does money or the law reduce doctors' working hours in the UK?

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Moreton, Adam; Collier, Andrew

2015-08-01

What can be learned from a 45-year journey to reduced junior doctors' working hours? The authors investigated the impact of financially punitive measures (the 2001 New Deal contract) and legislation (Working Time Regulations) on the average working week for doctors-in-training.

What factors influence UK medical students’ choice of foundation school?

Directory of Open Access Journals (Sweden)

Miah S

2017-04-01

Full Text Available Saiful Miah,1,2 Karl H Pang,3 Wayne Rebello,4 Zoe Rubakumar,4 Victoria Fung,5 Suresh Venugopal,6 Hena Begum4 1Division of Surgery and Interventional science, University College London, London, UK; 2Department of Urology, Charing Cross Hospital Imperial College Healthcare NHS Trust, London, UK; 3Academic Urology Unit, University of Sheffield, Sheffield, UK; 4Medical School, University of Sheffield, Sheffield, UK; 5Department of Plastic Surgery, Royal Hallamshire Hospital, Sheffield, UK; 6Department of Urology, Chesterfield Royal Infirmary, Chesterfield, UK Background: We aimed to identify the factors influencing UK medical student applicants’ choice of foundation school. We also explored the factors that doctors currently approaching the end of their 2-year program believe should be considered. Methods: A cross-sectional study was conducted during the 2013–2014 academic year. An online questionnaire was distributed to 2092 final-year medical students from nine UK medical schools and 84 foundation year-2 (FY2 doctors from eight foundation schools. Participants were asked to rank their top 3 from a list of 12 factors that could potentially influence choice of foundation school on a 5-point Likert scale. Collated categorical data from the two groups were compared using a chi-square test with Yates correction. Results: Geographic location was overwhelmingly the most important factor for medical students and FY2 doctors with 97.2% and 98.8% in agreement, respectively. Social relationships played a pivotal role for medical student applicants. Clinical specialties within the rotations were of less importance to medical students, in comparison to location and social relationships. In contrast, FY2 doctors placed a significantly greater importance on the specialties undertaken in their 2-year training program, when compared to medical students (chi-square; p=0.0001. Conclusion: UK medical schools should make their foundation program applicants aware

Making Social Scientists, or Not?: Glimpses of the Unmentionable in Doctoral Education

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Mills, David; Paulson, Julia

2014-01-01

Recent research on doctoral education in the U.K. has revealed the increasing number and diversity of academic relationships that shape the lives of research students, and students' own role in activating, mobilising and maintaining these relationships. Higher education policy reforms promoting doctoral "skills training",…

Psychological Assessment Training in Clinical Psychology Doctoral Programs.

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Mihura, Joni L; Roy, Manali; Graceffo, Robert A

2017-01-01

We surveyed American Psychological Association-accredited clinical psychology doctoral programs' (n = 83) training in psychological assessment-specifically, their coverage of various assessment topics and tests in courses and practica, and whether the training was optional or required. We report results overall and separately per training model (clinical science, scientist-practitioner, and practitioner-focused). Overall, our results suggest that psychological assessment training is as active, or even more active, than in previous years. Areas of increased emphasis include clinical interviewing and psychometrics; multimethod, outcomes, health, and collaborative or therapeutic assessment; and different types of cognitive and self-report personality tests. All or almost all practice-focused programs offered training with the Thematic Apperception Test and Rorschach compared to about half of the scientist-practitioner programs and a third of the clinical science programs. Although almost all programs reported teaching multimethod assessment, what constitutes different methods of assessing psychopathology should be clarified in future studies because many programs appear to rely on one method-self-report (especially clinical science programs). Although doctoral programs covered many assessment topics and tests in didactic courses, there appears to be a shortage of program-run opportunities for students to obtain applied assessment training. Finally, we encourage doctoral programs to be familiar with (a) internships' assessment expectations and opportunities, (b) the professional guidelines for assessment training, and (c) the American Psychological Association's requirements for preinternship assessment competencies.

Doctors applying for Danish postgraduate medical specialist training are getting younger

DEFF Research Database (Denmark)

Kjaer, N. K.; Clausen, L. W.; Qvesel, D.

2012-01-01

was 58 months. 6% of the recruited doctors had a PhD. 61% of the doctors were graduates from the University of Southern Denmark. 14% graduated from the University of Copenhagen and 12% from Aarhus University. Finally, 13% graduated from a foreign university. CONCLUSION: Applicants accepted for specialist......INTRODUCTION: It was previously shown that applicants for postgraduate medical specialist training in Denmark were old. In order to prevent potential shortage of specialists, the Danish health authorities have passed legislation to speed up the output of new specialists. The aim of this study...... was to highlight the present characteristics of young doctors who entered specialist training. MATERIAL AND METHODS: Data include 443 doctors who were enrolled in a formalized postgraduate medical training programme in the Region of Southern Denmark from 2009 to 2011. RESULTS: 41% of the recruited young doctors...

Struggling doctors in specialist training: a case control study

DEFF Research Database (Denmark)

O'Neill, Lotte; Norberg, Karen; Thomsen, Maria

), or transferred (i.e. had unplanned changes in place of training/ward due to failure to thrive or due to inadequate development of competences), or dropped out (i.e. were dismissed from, had resigned from, or changed their speciality). Controls were a random sample of doctors in the source population, who were......Abstract summary The aim of this cummulative incidence case-control study was to examine: if struggling trainees in medical specialist training (cases) tended to struggle already in medical school or not compared to non-struggling controls, and which performance indicators during medical school...... seemed to predict struggling in postgraduate education if any. The study design is rooted in epidemiological methodology. Struggling doctors in specialist training: a case-control study. It has been reported in the international literature, that around 3-10% of doctors in post-garduate specialist...

Smart strategies for doctors and doctors-in-training: heuristics in medicine.

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Wegwarth, Odette; Gaissmaier, Wolfgang; Gigerenzer, Gerd

2009-08-01

How do doctors make sound decisions when confronted with probabilistic data, time pressures and a heavy workload? One theory that has been embraced by many researchers is based on optimisation, which emphasises the need to integrate all information in order to arrive at sound decisions. This notion makes heuristics, which use less than complete information, appear as second-best strategies. In this article, we challenge this pessimistic view of heuristics. We introduce two medical problems that involve decision making to the reader: one concerns coronary care issues and the other macrolide prescriptions. In both settings, decision-making tools grounded in the principles of optimisation and heuristics, respectively, have been developed to assist doctors in making decisions. We explain the structure of each of these tools and compare their performance in terms of their facilitation of correct predictions. For decisions concerning both the coronary care unit and the prescribing of macrolides, we demonstrate that sacrificing information does not necessarily imply a forfeiting of predictive accuracy, but can sometimes even lead to better decisions. Subsequently, we discuss common misconceptions about heuristics and explain when and why ignoring parts of the available information can lead to the making of more robust predictions. Heuristics are neither good nor bad per se, but, if applied in situations to which they have been adapted, can be helpful companions for doctors and doctors-in-training. This, however, requires that heuristics in medicine be openly discussed, criticised, refined and then taught to doctors-in-training rather than being simply dismissed as harmful or irrelevant. A more uniform use of explicit and accepted heuristics has the potential to reduce variations in diagnoses and to improve medical care for patients.

ELIXIR-UK role in bioinformatics training at the national level and across ELIXIR.

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Larcombe, L; Hendricusdottir, R; Attwood, T K; Bacall, F; Beard, N; Bellis, L J; Dunn, W B; Hancock, J M; Nenadic, A; Orengo, C; Overduin, B; Sansone, S-A; Thurston, M; Viant, M R; Winder, C L; Goble, C A; Ponting, C P; Rustici, G

2017-01-01

ELIXIR-UK is the UK node of ELIXIR, the European infrastructure for life science data. Since its foundation in 2014, ELIXIR-UK has played a leading role in training both within the UK and in the ELIXIR Training Platform, which coordinates and delivers training across all ELIXIR members. ELIXIR-UK contributes to the Training Platform's coordination and supports the development of training to address key skill gaps amongst UK scientists. As part of this work it acts as a conduit for nationally-important bioinformatics training resources to promote their activities to the ELIXIR community. ELIXIR-UK also leads ELIXIR's flagship Training Portal, TeSS, which collects information about a diverse range of training and makes it easily accessible to the community. ELIXIR-UK also works with others to provide key digital skills training, partnering with the Software Sustainability Institute to provide Software Carpentry training to the ELIXIR community and to establish the Data Carpentry initiative, and taking a lead role amongst national stakeholders to deliver the StaTS project - a coordinated effort to drive engagement with training in statistics.

Epistaxis management: current understanding amongst junior doctors.

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Fox, R; Nash, R; Liu, Z-W; Singh, A

2016-03-01

Epistaxis is a common and potentially life-threatening emergency. This survey assesses understanding and confidence in epistaxis management amongst current junior doctors. A cross-sectional study was conducted of foundation year one and two doctors based at three National Health Service trusts within a single region of the UK, assessing basic understanding and procedural confidence. A total of 111 foundation doctors completed this survey. The average duration of undergraduate exposure to otolaryngology was 8.1 days. Forty-one per cent of respondents stated that they would apply pressure to the nasal bones to control epistaxis. Seventy-five per cent lacked confidence in their ability to manage epistaxis. Those with two weeks or more of undergraduate exposure to otolaryngology were more confident than those with one week or less of exposure (p epistaxis management, with patient safety implications. Confidence is associated with the duration of undergraduate exposure to otolaryngology. A minimum emergency safe competency should be a priority during foundation training if not achieved in UK medical schools.

Vocation and avocation: leisure activities correlate with professional engagement, but not burnout, in a cross-sectional survey of UK doctors.

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McManus, I C; Jonvik, Hallgeir; Richards, Peter; Paice, Elisabeth

2011-08-30

Sir William Osler suggested in 1899 that avocations (leisure activities) in doctors are related to an increased sense of vocation (professional engagement) and a decreased level of burnout. This study evaluated those claims in a large group of doctors practicing in the UK while taking into account a wide range of background variables. A follow-up questionnaire was sent to 4,457 UK-qualified doctors who had been included in four previous studies of medical school selection and training, beginning in 1980, 1985, 1990 and 1989/1991. A total of 2,845 (63.8%) doctors returned the questionnaire. Questions particularly asked about work engagement, satisfaction with medicine as a career, and personal achievement (Vocation/engagement), stress, emotional exhaustion, and depersonalization (BurnedOut), and 29 different leisure activities (Avocation/Leisure), as well as questions on personality, empathy, work experience, and demography. Doctors reporting more Avocation/Leisure activities tended to be women, to have older children, to be less surface-rational, more extravert, more open to experience, less agreeable, and to fantasize more. Doctors who were more BurnedOut tended to be men, to be more sleep-deprived, to report a greater workload and less choice and independence in their work, to have higher neuroticism, lower extraversion and lower agreeableness scores, and to have lower self-esteem. In contrast, doctors with a greater sense of Vocation/engagement, tended to see more patients, to have greater choice and independence at work, to have a deep approach to work, to have a more supportive-receptive work environment, to be more extravert and more conscientious, and to report greater self-esteem.Avocation/Leisure activities correlated significantly with Vocation/engagement, even after taking into account 25 background variables describing demography, work, and personality, whereas BurnedOut showed no significant correlation with Avocation/Leisure activities. Popular

Vocation and avocation: leisure activities correlate with professional engagement, but not burnout, in a cross-sectional survey of UK doctors

Directory of Open Access Journals (Sweden)

Jonvik Hallgeir

2011-08-01

Full Text Available Abstract Background Sir William Osler suggested in 1899 that avocations (leisure activities in doctors are related to an increased sense of vocation (professional engagement and a decreased level of burnout. This study evaluated those claims in a large group of doctors practicing in the UK while taking into account a wide range of background variables. Methods A follow-up questionnaire was sent to 4,457 UK-qualified doctors who had been included in four previous studies of medical school selection and training, beginning in 1980, 1985, 1990 and 1989/1991. A total of 2,845 (63.8% doctors returned the questionnaire. Questions particularly asked about work engagement, satisfaction with medicine as a career, and personal achievement (Vocation/engagement, stress, emotional exhaustion, and depersonalization (BurnedOut, and 29 different leisure activities (Avocation/Leisure, as well as questions on personality, empathy, work experience, and demography. Results Doctors reporting more Avocation/Leisure activities tended to be women, to have older children, to be less surface-rational, more extravert, more open to experience, less agreeable, and to fantasize more. Doctors who were more BurnedOut tended to be men, to be more sleep-deprived, to report a greater workload and less choice and independence in their work, to have higher neuroticism, lower extraversion and lower agreeableness scores, and to have lower self-esteem. In contrast, doctors with a greater sense of Vocation/engagement, tended to see more patients, to have greater choice and independence at work, to have a deep approach to work, to have a more supportive-receptive work environment, to be more extravert and more conscientious, and to report greater self-esteem. Avocation/Leisure activities correlated significantly with Vocation/engagement, even after taking into account 25 background variables describing demography, work, and personality, whereas BurnedOut showed no significant

Vocation and avocation: leisure activities correlate with professional engagement, but not burnout, in a cross-sectional survey of UK doctors

Science.gov (United States)

2011-01-01

Background Sir William Osler suggested in 1899 that avocations (leisure activities) in doctors are related to an increased sense of vocation (professional engagement) and a decreased level of burnout. This study evaluated those claims in a large group of doctors practicing in the UK while taking into account a wide range of background variables. Methods A follow-up questionnaire was sent to 4,457 UK-qualified doctors who had been included in four previous studies of medical school selection and training, beginning in 1980, 1985, 1990 and 1989/1991. A total of 2,845 (63.8%) doctors returned the questionnaire. Questions particularly asked about work engagement, satisfaction with medicine as a career, and personal achievement (Vocation/engagement), stress, emotional exhaustion, and depersonalization (BurnedOut), and 29 different leisure activities (Avocation/Leisure), as well as questions on personality, empathy, work experience, and demography. Results Doctors reporting more Avocation/Leisure activities tended to be women, to have older children, to be less surface-rational, more extravert, more open to experience, less agreeable, and to fantasize more. Doctors who were more BurnedOut tended to be men, to be more sleep-deprived, to report a greater workload and less choice and independence in their work, to have higher neuroticism, lower extraversion and lower agreeableness scores, and to have lower self-esteem. In contrast, doctors with a greater sense of Vocation/engagement, tended to see more patients, to have greater choice and independence at work, to have a deep approach to work, to have a more supportive-receptive work environment, to be more extravert and more conscientious, and to report greater self-esteem. Avocation/Leisure activities correlated significantly with Vocation/engagement, even after taking into account 25 background variables describing demography, work, and personality, whereas BurnedOut showed no significant correlation with Avocation

Professional paradox: identity formation in qualified doctors pursuing further training.

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Chan, Mercedes; Pratt, Dan; Poole, Gary; Sidhu, Ravi

2018-03-01

Many newly qualified specialists and subspecialists pursue additional training. Although their motivations are many, the pursuit of further training as an alternative to unemployment is an emerging trend. Paradoxically, doctors continue as trainees with a consultant's credentials, and without the guarantee of eventual employment. This study explores seven doctors' experiences, the effects of further training on their professional identity formation (PIF), and how these effects are reconciled on a personal and professional level. This phenomenological study involved interviews with seven qualified Canadian specialists (three were female) who pursued additional training in response to a lack of available positions in their respective specialties. Template analysis generated theoretical constructs of influences on their PIF, and characteristics of their lived experiences. Four themes shaped PIF: setting and context; language and communication; responsibilities and privileges; and participants' visions of their future selves. Professional identity formation (PIF) continued to develop in further training, but was inconsistently affirmed by participants' communities of practice. Four major themes characterised training experiences: prescription; managing multiple masters; limiting access to others and community ties; and constantly questioning the value of extra training. Qualified doctors traverse professional paradoxes as they seek further education with no guarantee of employment and provide consultant-level care as 'trainees'. An identity dissonance emerges that may continue until a clear identity is prescribed for them. Although disruptive to these doctors' PIF and personal and professional lives, the long-term effects of additional training are unknown. Its utility and influence on securing employment and future job satisfaction are areas for further research. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

Clinical leadership development in postgraduate medical education and training: policy, strategy, and delivery in the UK National Health Service.

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Aggarwal, Reena; Swanwick, Tim

2015-01-01

Achieving high quality health care against a background of continual change, increasing demand, and shrinking financial resource is a major challenge. However, there is significant international evidence that when clinicians use their voices and values to engage with system delivery, operational efficiency and care outcomes are improved. In the UK National Health Service, the traditional divide between doctors and managers is being bridged, as clinical leadership is now foregrounded as an important organizational priority. There are 60,000 doctors in postgraduate training (junior doctors) in the UK who provide the majority of front-line patient care and form an "operating core" of most health care organizations. This group of doctors is therefore seen as an important resource in initiating, championing, and delivering improvement in the quality of patient care. This paper provides a brief overview of leadership theories and constructs that have been used to develop a raft of interventions to develop leadership capability among junior doctors. We explore some of the approaches used, including competency frameworks, talent management, shared learning, clinical fellowships, and quality improvement. A new paradigm is identified as necessary to make a difference at a local level, which moves learning and leadership away from developing "leaders", to a more inclusive model of developing relationships between individuals within organizations. This shifts the emphasis from the development of a "heroic" individual leader to a more distributed model, where organizations are "leader-ful" and not just "well led" and leadership is centered on a shared vision owned by whole teams working on the frontline.

Clinical leadership development in postgraduate medical education and training: policy, strategy, and delivery in the UK National Health Service

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Aggarwal, Reena; Swanwick, Tim

2015-01-01

Achieving high quality health care against a background of continual change, increasing demand, and shrinking financial resource is a major challenge. However, there is significant international evidence that when clinicians use their voices and values to engage with system delivery, operational efficiency and care outcomes are improved. In the UK National Health Service, the traditional divide between doctors and managers is being bridged, as clinical leadership is now foregrounded as an important organizational priority. There are 60,000 doctors in postgraduate training (junior doctors) in the UK who provide the majority of front-line patient care and form an “operating core” of most health care organizations. This group of doctors is therefore seen as an important resource in initiating, championing, and delivering improvement in the quality of patient care. This paper provides a brief overview of leadership theories and constructs that have been used to develop a raft of interventions to develop leadership capability among junior doctors. We explore some of the approaches used, including competency frameworks, talent management, shared learning, clinical fellowships, and quality improvement. A new paradigm is identified as necessary to make a difference at a local level, which moves learning and leadership away from developing “leaders”, to a more inclusive model of developing relationships between individuals within organizations. This shifts the emphasis from the development of a “heroic” individual leader to a more distributed model, where organizations are “leader-ful” and not just “well led” and leadership is centered on a shared vision owned by whole teams working on the frontline. PMID:29355184

Employment experiences of vocationally trained doctors.

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Osler, K

1991-09-28

To investigate the expectations and employment experiences of male and female doctors who completed vocational training in East Anglia during 1981-7 and to examine the factors which had influenced those who had changed direction early in their careers. Survey conducted by confidential postal questionnaire. Britain. 281 doctors, 233 (83%) of whom responded. Ideal choice of work on completion of vocational training; present employment; factors which had restricted present choice of work; factors associated with reported satisfaction with job. 77/83 (93%) men and 130/150 (87%) women had hoped to work in general practice (p = 0.75). A smaller proportion of women (71%; 106) than men (89%; 74) were in general practice posts (p less than 0.01); only 6% (nine) of women were on maternity leave or caring for children without paid employment. More women than men were working in medical jobs other than general practice (18% (27) women v 4% (three) men; p less than 0.01). 44/91 (49%) women with children had achieved their employment goals compared with 47/59 (80%) women without children and 55/71 (78%) men with children. 87% (72/83) of men and 65% (98/150) of women had achieved the status of principal (p less than 0.01). 162/193 (84%) doctors who had worked in general practice reported satisfaction with their jobs. Dissatisfaction was linked with doing a job different from that hoped for and with perceiving that the share of practice income did not accurately reflect their share of the practice workload. Steps need to be taken to retain women in general practice, including a statutory part time pay allowance and incentives for practices to allow flexible working hours for doctors with young children.

Junior doctors' experiences of managing patients with medically unexplained symptoms: a qualitative study.

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Yon, Katherine; Nettleton, Sarah; Walters, Kate; Lamahewa, Kethakie; Buszewicz, Marta

2015-12-01

To explore junior doctors' knowledge about and experiences of managing patients with medically unexplained symptoms (MUS) and to seek their recommendations for improved future training on this important topic about which they currently receive little education. Qualitative study using in-depth interviews analysed using the framework method. Participants were recruited from three North Thames London hospitals within the UK. Twenty-two junior doctors undertaking the UK foundation two-year training programme (FY1/FY2). The junior doctors interviewed identified a significant gap in their training on the topic of MUS, particularly in relation to their awareness of the topic, the appropriate level of investigations, possible psychological comorbidities, the formulation of suitable explanations for patients' symptoms and longer term management strategies. Many junior doctors expressed feelings of anxiety, frustration and a self-perceived lack of competency in this area, and spoke of over-investigating patients or avoiding patient contact altogether due to the challenging nature of MUS and a difficulty in managing the accompanying uncertainty. They also identified the negative attitudes of some senior clinicians and potential role models towards patients with MUS as a factor contributing to their own attitudes and management choices. Most reported a need for more training during the foundation years, and recommended interactive case-based group discussions with a focus on providing meaningful explanations to patients for their symptoms. There is an urgent need to improve postgraduate training about the topics of MUS and avoiding over-investigation, as current training does not equip junior doctors with the necessary knowledge and skills to effectively and confidently manage patients in these areas. Training needs to focus on practical skill development to increase clinical knowledge in areas such as delivering suitable explanations, and to incorporate individual management

Workplace-based assessments of junior doctors: do scores predict training difficulties?

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Mitchell, Colin; Bhat, Sarita; Herbert, Anne; Baker, Paul

2011-12-01

Workplace-based assessment (WPBA) is an increasingly important part of postgraduate medical training and its results may be used as evidence of professional competence. This study evaluates the ability of WPBA to distinguish UK Foundation Programme (FP) doctors with training difficulties and its effectiveness as a surrogate marker for deficiencies in professional competence. We conducted a retrospective observational study using anonymised records for 1646 trainees in a single UK postgraduate deanery. Data for WPBAs conducted from August 2005 to April 2009 were extracted from the e-portfolio database. These data included all scores submitted by trainees in FP years 1 and 2 on mini-clinical evaluation exercise (mini-CEX), case-based discussion (CbD), direct observation of procedural skills (DOPS) and mini-peer assessment tool (mini-PAT) assessments. Records of trainees in difficulty, as identified by their educational supervisors, were tagged as index cases. Main outcome measures were odds ratios (ORs) for associations between mean WPBA scores and training difficulties. Further analyses by the reported aetiology of the training difficulty (health-, conduct- or performance-related) were performed. Of the 1646 trainees, 92 had been identified as being in difficulty. Mean CbD and mini-CEX scores were lower for trainees in difficulty and an association was found between identified training difficulties and average scores on the mini-CEX (OR = 0.54; p = 0.034) and CbD (OR = 0.39; p = 0.002). A receiver operator characteristic curve analysis of mean WPBA scores for diagnosing 'in difficulty' status yielded an area under the curve of 0.64, indicating weak predictive value. There was no statistical evidence that mean scores on DOPS and mini-PAT assessments differed between the two groups. Analysis of a large dataset of WPBA scores revealed significant associations between training difficulties and lower mean scores on both the mini-CEX and CbD. Models show that using WPBA

Emotional Labour, Training Stress, Burnout, and Depressive Symptoms in Junior Doctors

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Rogers, Mary E.; Creed, Peter A.; Searle, Judy

2014-01-01

Junior doctors are at risk of work-related burnout and mental health problems due to training workload demands and responsibilities. This study investigated the predictors of work-related burnout and depressive symptoms in junior doctors. Participants were 349 Australian doctors in postgraduate years 1-4, who completed a web-based survey assessing…

Stick or twist? Career decision-making during contractual uncertainty for NHS junior doctors.

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Spooner, S; Gibson, Jon; Rigby, Dan; Sutton, Matt; Pearson, Emma; Checkland, Kath

2017-01-25

To examine the extent, and nature, of impact on junior doctors' career decisions, of a proposed new contract and the uncertainty surrounding it. Mixed methods. Online survey exploring: doctors' future training intentions; their preferred specialty training (ST) programmes; whether they intended to proceed immediately to ST; and other plans. Linked qualitative interviews to explore more fully how and why decisions were affected. Doctors (F2s) in second year of Foundation School (FS) Programmes in England. Invitations sent by FSs. Open to all F2s November 2015-February 2016. All FSs represented. Survey completed by 816 F2s. Sample characteristics broadly similar to national F2 cohort. Proportions of doctors intending to proceed to ST posts in the UK, to defer or to exit UK medicine. Proportion of doctors indicating changes in training and career plans as a result of the contract and/or resulting uncertainty. Distribution of changes across training programmes. Explanations of these intentions from interviews and free text comments. Among the responding junior doctors, 20% indicated that issues related to the contract had prompted them to switch specialty and a further 20% had become uncertain about switching specialty. Switching specialty choice was more prevalent among those now choosing a community-based, rather than hospital-based specialty. 30% selecting general practice had switched choice because of the new contract. Interview data suggests that doctors felt they had become less valued or appreciated in the National Health Service and in society more broadly. Doctors reported that contract-related issues have affected their career plans. The most notable effect is a move away from acute to community-based specialities, with the former perceived as more negatively affected by the proposed changes. It is concerning that young doctors feel undervalued, and this requires further investigation. Published by the BMJ Publishing Group Limited. For permission to use

Rheumatology training in Poland vs. United Kingdom

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Karina Lazarewicz

2017-07-01

Full Text Available When evaluating the quality of Rheumatology specialty training, it can be useful to explore similarities and differences between countries. In this article we compare the training in the UK and Poland. The two training programmes are similar in length and in the competencies that must be achieved, although they do have significant differences in the way the training is structured. The UK-based system is more out-patient based, which can be advantageous, as after completion of training the doctor is more confident in treating common rheumatological problems. On the other hand, having exposure to paediatric rheumatology and orthopaedics like one has in Polish-based training, despite a short placement time, is definitely beneficial for the trainee in gaining all-round knowledge. In conclusion, each system has its merits and can be further enhanced by observing how junior doctors are sub-speciality trained in different countries.

Training doctors for primary care in China: Transformation of general practice education.

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Li, Donald

2016-01-01

China is known for developing a cadre of "Barefoot Doctors" to address her rural healthcare needs in past. The tradition of barefoot doctors has inspired similar developments in several other countries across world. Recently China has embarked upon an ambitious new mission to create a primary care workforce consisting of trained general practitioners having international standard skillsets. This editorial provides an insight into the current status of policy deliberations with regards to training of primary care doctors and a new surge in general practice education in China.

A new tool to evaluate postgraduate training posts: the Job Evaluation Survey Tool (JEST).

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Wall, David; Goodyear, Helen; Singh, Baldev; Whitehouse, Andrew; Hughes, Elizabeth; Howes, Jonathan

2014-10-02

Three reports in 2013 about healthcare and patient safety in the UK, namely Berwick, Francis and Keogh have highlighted the need for junior doctors' views about their training experience to be heard. In the UK, the General Medical Council (GMC) quality assures medical training programmes and requires postgraduate deaneries to undertake quality management and monitoring of all training posts in their area. The aim of this study was to develop a simple trainee questionnaire for evaluation of postgraduate training posts based on the GMC, UK standards and to look at the reliability and validity including comparison with a well-established and internationally validated tool, the Postgraduate Hospital Educational Environment Measure (PHEEM). The Job Evaluation Survey Tool (JEST), a fifteen item job evaluation questionnaire was drawn up in 2006, piloted with Foundation doctors (2007), field tested with specialist paediatric registrars (2008) and used over a three year period (2008-11) by Foundation Doctors. Statistical analyses including descriptives, reliability, correlation and factor analysis were undertaken and JEST compared with PHEEM. The JEST had a reliability of 0.91 in the pilot study of 76 Foundation doctors, 0.88 in field testing of 173 Paediatric specialist registrars and 0.91 in three years of general use in foundation training with 3367 doctors completing JEST. Correlation of JEST with PHEEM was 0.80 (p training posts.

Acute care simulation training for foundation doctors: the perceived impact on practice in the workplace.

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Patel, P; Sockalingam, I

2013-01-01

High fidelity simulation allows training of foundation doctors in a safe, structured environment. We explored the perceived impact of such training on subsequent clinical practice. 82 doctors attended and 52% responded to a follow up questionnaire sent two months after their training. 88% felt better able to manage the acutely ill patient than they did before their training. All cited simulation training as a reason for this and 44% felt simulation training was the main contributor. The remainder cited clinical experience as the main contributor. 53% gave real clinical examples where they applied skills attributed to simulation training. Doctors reflected positively on simulation training sometime after the experience, demonstrated transference of learnt skills and felt more confident at work.

Get a Life? The Impact of the European Working Time Directive: The Case of UK Senior Doctors.

Science.gov (United States)

Dolton, Peter J; Kidd, Michael P; Fooken, Jonas

2015-10-01

This paper seeks to identify the effect of the implementation of the European Working Time Directive on the working hours of UK doctors. The Labour Force Survey is used to compare the working hours of doctors with a variety of control groups before and after the implementation of the directive. The controls include those unconstrained by the directive and doctor counterparts working in Europe. We use differences-in-differences and matching methods to estimate the impact of this natural experiment, distinguishing between the anticipation and enactment of the European Working Time Directive. We find that the legislation reduced the hours of senior doctors by around 8 hours in total including the component attributable to anticipation effects and allowing for (exogenously set) rising wages. Copyright © 2014 John Wiley & Sons, Ltd. Copyright © 2014 John Wiley & Sons, Ltd.

Career choices for radiology: national surveys of graduates of 1974-2002 from UK medical schools

International Nuclear Information System (INIS)

Turner, G.; Lambert, T.W.; Goldacre, M.J.

2006-01-01

Aim: To report on trends in career choices for radiology among UK medical graduates. Materials and methods: One and 3 years after graduation, and at longer time intervals thereafter, postal questionnaire surveys were sent to all doctors who graduated from UK medical schools in 1974, 1977, 1980, 1983, 1993, 1996, 1999, 2000 and 2002. Doctors were asked to specify their choice of long-term career and to identify factors influencing their choice. Employment details were also collected. Results were analysed using χ 2 statistics and binary logistic regression. Results: Seventy-four percent (24,621/33,412) and 73% (20,720/28,459) of doctors responded 1 and 3 years after graduation. Choices for radiology in year 1 increased significantly over time (1.7% of 1974 graduates to 3.2% of 2002 graduates; χ 2 test for trend = 15.3, p < 0.001). In particular, there has been a steady increase from the cohorts of 1993 onwards. Thirty-eight percent of those who chose radiology in year 1, and 80% who chose radiology in year 3, were still working in radiology 10 years after graduation. Hours and working conditions influenced long-term career choices more for radiology than for other careers. Conclusions: The proportion of UK trained junior doctors who want to become radiologists has increased in recent years. However, although medical school intake and the numbers making an early choice for radiology have risen, it is unclear whether sufficient UK graduates will be attracted to radiology to fulfil future service requirements from UK trained graduates alone

Appropriate training and retention of community doctors in rural areas: a case study from Mali

Directory of Open Access Journals (Sweden)

Coulibaly Seydou

2008-11-01

Full Text Available Abstract Background While attraction of doctors to rural settings is increasing in Mali, there is concern for their retention. An orientation course for young practicing rural doctors was set up in 2003 by a professional association and a NGO. The underlying assumption was that rurally relevant training would strengthen doctors' competences and self-confidence, improve job satisfaction, and consequently contribute to retention. Methods Programme evaluation distinguished trainees' opinions, competences and behaviour. Data were collected through participant observation, group discussions, satisfaction questionnaires, a monitoring tool of learning progress, and follow up visits. Retention was assessed for all 65 trainees between 2003 and 2007. Results and discussion The programme consisted of four classroom modules – clinical skills, community health, practice management and communication skills – and a practicum supervised by an experienced rural doctor. Out of the 65 trained doctors between 2003 and 2007, 55 were still engaged in rural practice end of 2007, suggesting high retention for the Malian context. Participants viewed the training as crucial to face technical and social problems related to rural practice. Discussing professional experience with senior rural doctors contributed to socialisation to novel professional roles. Mechanisms underlying training effects on retention include increased self confidence, self esteem as rural doctor, and sense of belonging to a professional group sharing a common professional identity. Retention can however not be attributed solely to the training intervention, as rural doctors benefit from other incentives and support mechanisms (follow up visits, continuing training, mentoring... affecting job satisfaction. Conclusion Training increasing self confidence and self esteem of rural practitioners may contribute to retention of skilled professionals in rural areas. While reorientations of curricula in

Appropriate training and retention of community doctors in rural areas: a case study from Mali.

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Van Dormael, Monique; Dugas, Sylvie; Kone, Yacouba; Coulibaly, Seydou; Sy, Mansour; Marchal, Bruno; Desplats, Dominique

2008-11-18

While attraction of doctors to rural settings is increasing in Mali, there is concern for their retention. An orientation course for young practicing rural doctors was set up in 2003 by a professional association and a NGO. The underlying assumption was that rurally relevant training would strengthen doctors' competences and self-confidence, improve job satisfaction, and consequently contribute to retention. Programme evaluation distinguished trainees' opinions, competences and behaviour. Data were collected through participant observation, group discussions, satisfaction questionnaires, a monitoring tool of learning progress, and follow up visits. Retention was assessed for all 65 trainees between 2003 and 2007. The programme consisted of four classroom modules--clinical skills, community health, practice management and communication skills--and a practicum supervised by an experienced rural doctor. Out of the 65 trained doctors between 2003 and 2007, 55 were still engaged in rural practice end of 2007, suggesting high retention for the Malian context. Participants viewed the training as crucial to face technical and social problems related to rural practice. Discussing professional experience with senior rural doctors contributed to socialisation to novel professional roles. Mechanisms underlying training effects on retention include increased self confidence, self esteem as rural doctor, and sense of belonging to a professional group sharing a common professional identity. Retention can however not be attributed solely to the training intervention, as rural doctors benefit from other incentives and support mechanisms (follow up visits, continuing training, mentoring...) affecting job satisfaction. Training increasing self confidence and self esteem of rural practitioners may contribute to retention of skilled professionals in rural areas. While reorientations of curricula in training institutions are necessary, other types of professional support are needed

Physician-assisted suicide: a review of the literature concerning practical and clinical implications for UK doctors

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Hicks Madelyn

2006-06-01

Full Text Available Abstract Background A bill to legalize physician-assisted suicide in the UK recently made significant progress in the British House of Lords and will be reintroduced in the future. Until now there has been little discussion of the clinical implications of physician-assisted suicide for the UK. This paper describes problematical issues that became apparent from a review of the medical and psychiatric literature as to the potential effects of legalized physician-assisted suicide. Discussion Most deaths by physician-assisted suicide are likely to occur for the illness of cancer and in the elderly. GPs will deal with most requests for assisted suicide. The UK is likely to have proportionately more PAS deaths than Oregon due to the bill's wider application to individuals with more severe physical disabilities. Evidence from other countries has shown that coercion and unconscious motivations on the part of patients and doctors in the form of transference and countertransference contribute to the misapplication of physician-assisted suicide. Depression influences requests for hastened death in terminally ill patients, but is often under-recognized or dismissed by doctors, some of whom proceed with assisted death anyway. Psychiatric evaluations, though helpful, do not solve these problems. Safeguards that are incorporated into physician-assisted suicide criteria probably decrease but do not prevent its misapplication. Summary The UK is likely to face significant clinical problems arising from physician-assisted suicide if it is legalized. Terminally ill patients with mental illness, especially depression, are particularly vulnerable to the misapplication of physician-assisted suicide despite guidelines and safeguards.

Foundation Year 2 doctors’ reasons for leaving UK medicine: an in-depth analysis of decision-making using semistructured interviews

OpenAIRE

Smith, Samantha E.; Tallentire, Victoria R.; Pope, Lindsey M.; Laidlaw, Anita H.; Morrison, Jill

2018-01-01

This work was funded by a Scottish Medical Education Research Consortium grant. Objectives:  To explore the reasons that doctors choose to leave UK medicine after their foundation year two posts. Setting : All four regions of Scotland. Participants:  Foundation year two doctors (F2s) working throughout Scotland who were considering leaving UK medicine after foundation training were recruited on a volunteer basis. Maximum variation between participants was sought. Primary and secondary outc...

The development of Radiation Protection Training courses in the UK

International Nuclear Information System (INIS)

Paynter, R. A.

2003-01-01

This paper considers use of modern training materials and aids in radiation protection training activities. The development in the UK of training courses to satisfy the training requirements for Radiation Protection Advisers is also discussed. (Author)

A levels and intelligence as predictors of medical careers in UK doctors: 20 year prospective study

Science.gov (United States)

McManus, I C; Smithers, Eleni; Partridge, Philippa; Keeling, A; Fleming, Peter R

2003-01-01

Objective To assess whether A level grades (achievement) and intelligence (ability) predict doctors' careers. Design Prospective cohort study with follow up after 20 years by postal questionnaire. Setting A UK medical school in London. Participants 511 doctors who had entered Westminster Medical School as clinical students between 1975 and 1982 were followed up in January 2002. Main outcome measures Time taken to reach different career grades in hospital or general practice, postgraduate qualifications obtained (membership/fellowships, diplomas, higher academic degrees), number of research publications, and measures of stress and burnout related to A level grades and intelligence (result of AH5 intelligence test) at entry to clinical school. General health questionnaire, Maslach burnout inventory, and questionnaire on satisfaction with career at follow up. Results 47 (9%) doctors were no longer on the Medical Register. They had lower A level grades than those who were still on the register (P < 0.001). A levels also predicted performance in undergraduate training, performance in postregistration house officer posts, and time to achieve membership qualifications (Cox regression, P < 0.001; b=0.376, SE=0.098, exp(b)=1.457). Intelligence did not independently predict dropping off the register, career outcome, or other measures. A levels did not predict diploma or higher academic qualifications, research publications, or stress or burnout. Diplomas, higher academic degrees, and research publications did, however, significantly correlate with personality measures. Conclusions Results of achievement tests, in this case A level grades, which are particularly used for selection of students in the United Kingdom, have long term predictive validity for undergraduate and postgraduate careers. In contrast, a test of ability or aptitude (AH5) was of little predictive validity for subsequent medical careers. PMID:12869457

An analysis of the current educational status and future training needs of China's rural doctors in 2011.

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Li, Xingming; Liu, Juyuan; Huang, Jianshi; Qian, Yunliang; Che, Lu

2013-04-01

To analyse the educational status and future training needs of China's rural doctors and provide a basis to improve their future training. A cross-sectional epidemiological survey was used for the analysis, and 17 954 rural doctors chosen randomly from the eastern, central and western regions of China in 2009-2010 were surveyed to ascertain their average training time and the methods used for and content of their training. In general, 8671/17 778 (48.77%) of respondents received less than 12 days of training in a year. Conference sessions seemed to be the major route of training, with 10 150/17 925 respondents (56.62%). Clinical skills, with a response rate of 14 441/17 926 (80.56%), seemed to be the most popular training content. With regard to the general needs for training time received, 6547/18 255 (35.86%) of respondents hoped the average training time received a year would be less than 12 days; on-site guidance from a senior doctor was the most popular training method with response rate of 10 109/17 976 (56.24%), and clinical skills was what rural doctors wished to study the most, with a positive response of 16 744/17 962 (93.22%). Statistically significant differences existed in the current status and training time, training method and training content needs of China's rural doctors. Our results suggest that the training status and needs of China's rural doctors are still disjointed; measures including the introduction of remote education and clinical further education, extended training time and more clinical skills training should be adopted.

Adverse effects on health and wellbeing of working as a doctor: views of the UK medical graduates of 1974 and 1977 surveyed in 2014.

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Smith, Fay; Goldacre, Michael J; Lambert, Trevor W

2017-05-01

Objective To report on any adverse effects on health and wellbeing of working as a doctor, as described by senior doctors. Design Questionnaires sent in 2014 to all medical graduates of 1974 and 1977. Participants 3695 UK medical graduates. Setting United Kingdom. Main outcome measures Statements about adverse effects upon health, wellbeing and career. Results The aggregated response rate from contactable doctors was 84.6% (3695/4369). In response to the question 'Do you feel that working as a doctor has had any adverse effects on your own health or wellbeing?', 44% of doctors answered 'yes'. More GPs (47%) than hospital doctors (42%) specified that this was the case. Three-quarters of doctors who answered 'yes' cited 'stress/work-life balance/workload' as an adverse effect, and 45% mentioned illness. In response to the statement 'The NHS of today is a good employer when doctors become ill themselves', 28% of doctors agreed, 29% neither agreed nor disagreed and 43% disagreed. More women doctors (49%) than men doctors (40%) disagreed with this statement. More general practitioners (49%) disagreed than hospital doctors (37%). Conclusions Chronic stress and illness, which these doctors attributed to their work, were widely reported. Although recent changes may have alleviated some of these issues, there are lessons for the present and future if the NHS is to ensure that its medical workforce receives the support which enables current doctors to enjoy a full and satisfying career and to contribute fully to health service provision in the UK. Older doctors, in particular, need support to be able to continue successfully in their careers.

Re-visioning the doctoral research degree in nursing in the United Kingdom.

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Burton, Christopher R; Duxbury, Joy; French, Beverley; Monks, Rob; Carter, Bernie

2009-05-01

In the light of concerns about the wider social and economic value of the PhD training programme, this article discusses the challenges being directed primarily at the traditional doctoral programme of study. While the PhD is primarily concerned with the student making an original contribution to knowledge, the value-added component of the doctoral research degree needs to respond to the needs of a wider market of purchasers, and to meet practice and policy requirements for research leadership. The United Kingdom Research Councils (UK GRAD, 2001. Joint Skills Statement of Skills Training Requirements. Available at http://www.grad.ac.uk/downloads/documents/general/Joint%20Skills%20Statementpdf. (last accessed 1st April 2008.) suggest a range of seven skill domains over and above research design and management that should be offered to students. The seven domains are research skills and techniques, participation in the research environment, research management, personal effectiveness, communication, networking and team working, and career management. This article develops and extends these skill domains for the current healthcare context and considers how these should guide the development and evaluation of the value-added components of doctoral research degree programmes in nursing. The challenges that these issues present to academic departments are also discussed. Our conclusion is that PhD research training needs re-visioning and broadening so that the students' experience includes these value-added components.

Problems and perspectives of family doctors training on the undergraduate stage

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Yu. M. Kolesnik

2013-04-01

Full Text Available Introduction. Under healthcare reform activities of all medical schools and post-graduate education institutions are directed to improvement of the effectiveness of high-qualified family doctors training. Today, scientific and methodological approaches of undergraduate training in family medicine are discussed in a limited number of publications. The main part. Among the priorities on undergraduate stage of family physician preparation it should be noted the following: integrating of undergraduate and postgraduate phases of family doctors training, the widespread use of outpatient primary health care as a clinical divisions of family medicine departments, modern equipment of clinical bases of ambulatories in accordance to the report sheet; to provide in programs of clinical disciplines on 4th, 5th courses practical classes for students acquiring diagnostics, emergency care skills, prevention, health center, sanatorium, resort screening and treatment of patients based on primary health care; fully use elective courses in the discipline, to provide teaching discipline "Family medicine" textbooks and other educational publications sufficiency. Clinical bases for training students in Zaporozhye State Medical University are Communal Institution "4th Clinical Hospital" and Communal Institution "Polyclinic behalf March 8th." In the educational process teaching materials consist of the work program on the subject, methodological recommendations for independent work and workshops, for practical skills and algorithms for their implementation, tests of initial, current and final knowledge control, samples of basic records of general practice - family medicine, education and qualification characteristics of family doctor, a list of basic regulatory documents, educational literature. During the program, students are introduced to the structure of the family doctor clinics, day care, fundamentals of dispensary supervision, perform patient reception with

Physical activity education in the undergraduate curricula of all UK medical schools: are tomorrow's doctors equipped to follow clinical guidelines?

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Weiler, Richard; Chew, Stephen; Coombs, Ngaire; Hamer, Mark; Stamatakis, Emmanuel

2012-11-01

Physical activity (PA) is a cornerstone of disease prevention and treatment. There is, however, a considerable disparity between public health policy, clinical guidelines and the delivery of physical activity promotion within the National Health Service in the UK. If this is to be addressed in the battle against non-communicable diseases, it is vital that tomorrow's doctors understand the basic science and health benefits of physical activity. The aim of this study was to assess the provision of physical activity teaching content in the curricula of all medical schools in the UK. Our results, with responses from all UK medical schools, uncovered some alarming findings, showing that there is widespread omission of basic teaching elements, such as the Chief Medical Officer recommendations and guidance on physical activity. There is an urgent need for physical activity teaching to have dedicated time at medical schools, to equip tomorrow's doctors with the basic knowledge, confidence and skills to promote physical activity and follow numerous clinical guidelines that support physical activity promotion.

SPECIALITY TRAINING IN ABROAD – UNITED KINGDOM

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Maja Pakiž

2018-02-01

Full Text Available Backgroud. According to the Rules on types and curriculum of specialization of doctors in Slovenia part of the specialization can be conducted in abroad after conformation of Medical Chambers. Specialization abroad enables us to learn about different therapeutic approaches, organization of work, educational systems, new methods of treatment, etc. Content In the article organization of work at the Liverpool Women’s Hospital, the greatest European hospital for women’s diseases is presented. Furthermore, specialty training for obstetrics and gynecology according to the rules of the Royal College of Obstetricians and Gynecologists in the UK is described. The specialty training and education programme last seven years in the UK. The specialty trainees attend specific modules besides working at gynaecological and obstetrics departments. The exam is divided in two parts and performed after the second and fifth year of training. During the last two years of the specialty training the doctor is able to roughly determine the subspeciality. The education programme is adjusted for those who are interested in research and academic fields. Conclusions. My experiences as foreign visiting doctor, as well as differences towards our system, are shared.

How many doctors should we train for Sri Lanka? System dynamics modelling for training needs

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De Silva, D

2017-12-26

Over the years, Sri Lanka has achieved remarkable health gains for the money spent on health. Currently about 1450 doctors enter the health system annually. While some advocate opening up of new medical schools to address an apparent shortage of doctors in the country, others argue against it. To identify the number of doctors Sri Lanka need. System dynamics, an analytical modelling approach and a methodology for studying complex feedback systems was used. Two sub models of “need” and “supply” were developed and simulated for a period of 15 years from 2017 to 2032 At present the doctor to population ratio is 1:671 and 91% of the need has been met. This study shows that currently there is a shortage of doctors in the country. However, the supply will match the need by 2025/26. Increasing the number of doctors, will result in oversupply of doctors towards the latter part of the next decade. There is no acute necessity to open up new Medical Schools. However comprehensive health workforce analysis needs to be done once in 5 years and the number of doctors to be trained, decided accordingly.

Junior doctor psychiatry placements in hospital and community settings: a phenomenological study.

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Beattie, Sharon; Crampton, Paul E S; Schwarzlose, Cathleen; Kumar, Namita; Cornwall, Peter L

2017-09-27

The proportion of junior doctors required to complete psychiatry placements in the UK has increased, due in part to vacant training posts and psychiatry career workforce shortages, as can be seen across the world. The aim of this study was to understand the lived experience of a Foundation Year 1 junior doctor psychiatry placement and to understand how job components influence attitudes. The study was conducted using a cross-sectional qualitative phenomenological approach. Hospital and community psychiatry department settings in the North East of England, UK. In total, 14 Foundation Year 1 junior doctors were interviewed including seven men and seven women aged between 23 and 34 years. The majority had completed their medical degree in the UK and were White British. The lived experience of a junior doctor psychiatry placement was understood by three core themes: exposure to patient recovery, connectedness with others in the healthcare team and subjective interpretations of psychiatry. The experiences were moderated by instances of role definition, reaction to the specialty and the organisational fit of the junior doctor capacity in the specialty. The study reinforces and adds to the literature by identifying connectedness as being important for both job satisfaction and morale, which is currently damaged within the junior doctor population. The study provides in-depth insights into the lived experience of psychiatry placements and can be taken forward by educationalists to ensure the placements are meaningful experiences for junior doctors by developing role definition, belonging, structure and psychiatric care responsibility. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Reframing European Doctoral Training for the New ERA

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Repeckaite, Daiva

2016-01-01

In 2014 the institutionalization of European higher education and training, as well as research and innovation, policy entered a new phase: a number of financial instruments were simplified and merged. The Erasmus Mundus programme, wherein consortia of European and overseas universities built joint master's or doctoral degrees, was split into two…

"I am not frustrated anymore". Family doctors' evaluation of a comprehensive training on partner abuse.

NARCIS (Netherlands)

Lo Fo Wong, S.H.; Wester, F.; Mol, S.; Lagro-Janssen, A.L.M.

2007-01-01

OBJECTIVE: The aim of this study was to discover the ways in which a training program on intimate partner abuse affected a doctor's daily practice. METHODS: Eighteen family doctors who participated in a training program on partner abuse were interviewed. RESULTS: The interviewees evaluated the

Procedural confidence in hospital based practitioners: implications for the training and practice of doctors at all grades

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Tsagkaraki Petroula A

2009-01-01

Full Text Available Abstract Background Medical doctors routinely undertake a number of practical procedures and these should be performed competently. The UK Postgraduate Medical Education and Training Board (PMETB curriculum lists the procedures trainees should be competent in. We aimed to describe medical practitioner's confidence in their procedural skills, and to define which practical procedures are important in current medical practice. Methods A cross sectional observational study was performed measuring procedural confidence in 181 hospital practitioners at all grades from 2 centres in East Anglia, England. Results Both trainees and consultants provide significant service provision. SpR level doctors perform the widest range and the highest median number of procedures per year. Most consultants perform few if any procedures, however some perform a narrow range at high volume. Cumulative confidence for the procedures tested peaks in the SpR grade. Five key procedures (central line insertion, lumbar puncture, pleural aspiration, ascitic aspiration, and intercostal drain insertion are the most commonly performed, are seen as important generic skills, and correspond to the total number of procedures for which confidence can be maintained. Key determinants of confidence are gender, number of procedures performed in the previous year and total number of procedures performed. Conclusion The highest volume of service requirement is for six procedures. The procedural confidence is dependent upon gender, number of procedures performed in the previous year and total number of procedures performed. This has implications for those designing the training curriculum and with regards the move to shorten the duration of training.

The roles and training of primary care doctors: China, India, Brazil and South Africa.

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Mash, Robert; Almeida, Magda; Wong, William C W; Kumar, Raman; von Pressentin, Klaus B

2015-12-04

China, India, Brazil and South Africa contain 40% of the global population and are key emerging economies. All these countries have a policy commitment to universal health coverage with an emphasis on primary health care. The primary care doctor is a key part of the health workforce, and this article, which is based on two workshops at the 2014 Towards Unity For Health Conference in Fortaleza, Brazil, compares and reflects on the roles and training of primary care doctors in these four countries. Key themes to emerge were the need for the primary care doctor to function in support of a primary care team that provides community-orientated and first-contact care. This necessitates task-shifting and an openness to adapt one's role in line with the needs of the team and community. Beyond clinical competence, the primary care doctor may need to be a change agent, critical thinker, capability builder, collaborator and community advocate. Postgraduate training is important as well as up-skilling the existing workforce. There is a tension between training doctors to be community-orientated versus filling the procedural skills gaps at the facility level. In training, there is a need to plan postgraduate education at scale and reform the system to provide suitable incentives for doctors to choose this as a career path. Exposure should start at the undergraduate level. Learning outcomes should be socially accountable to the needs of the country and local communities, and graduates should be person-centred comprehensive generalists.

A UK perspective on smartphone use amongst doctors within the surgical profession.

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Patel, Rikesh K; Sayers, Adele E; Patrick, Nina L; Hughes, Kaylie; Armitage, Jonathan; Hunter, Iain Andrew

2015-06-01

Hospitals are increasingly looking for mobile solutions to meet their information technology needs. Medical professionals are using personal mobile devices to support their work, because of limitations in both time and space. Our aims were to assess smartphone use amongst UK surgical doctors, the prevalence of medical app use and online activity. A thirteen-item questionnaire was derived to identify the proportion of surgical doctors of all grades using smartphones within the workplace. The following factors were evaluated: use of medical apps; use of online medical resources and if users were willing to use their own smartphone for clinical use. A total of 341 participants were surveyed with a complete response rate: 93.5% of which owned a smartphone, with 54.2% of those owning medical apps and 86.2% using their device to access online medical resources. Junior doctors were more likely to use medical apps over their senior colleagues (p = 0.001) as well as access the Internet on their smartphone for medical information (p smartphone for clinical use, which was found not to be dependent on seniority (p = 0.922). Online resources contribute significantly to clinical activities with the majority of smartphone users willing to use their own device. The information gathered from this study can aid developers to create software dedicated to the smartphone operating systems in greatest use and to potentially increase the use of a bring your own device (BYOD) scheme.

Quantitative Preparation in Doctoral Education Programs: A Mixed-Methods Study of Doctoral Student Perspectives on their Quantitative Training

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Sarah L Ferguson

2017-07-01

Full Text Available Aim/Purpose: The purpose of the current study is to explore student perceptions of their own doctoral-level education and quantitative proficiency. Background: The challenges of preparing doctoral students in education have been discussed in the literature, but largely from the perspective of university faculty and program administrators. The current study directly explores the student voice on this issue. Methodology: Utilizing a sequential explanatory mixed-methods research design, the present study seeks to better understand doctoral-level education students’ perceptions of their quantitative methods training at a large public university in the southwestern United States. Findings: Results from both phases present the need for more application and consistency in doctoral-level quantitative courses. Additionally, there was a consistent theme of internal motivation in the responses, suggesting students perceive their quantitative training to be valuable beyond their personal interest in the topic. Recommendations for Practitioners: Quantitative methods instructors should emphasize practice in their quantitative courses and consider providing additional support for students through the inclusion of lab sections, tutoring, and/or differentiation. Pre-testing statistical ability at the start of a course is also suggested to better meet student needs. Impact on Society: The ultimate goal of quantitative methods in doctoral education is to produce high-quality educational researchers who are prepared to apply their knowledge to problems and research in education. Results of the present study can inform faculty and administrator decisions in doctoral education to best support this goal. Future Research: Using the student perspectives presented in the present study, future researchers should continue to explore effective instructional strategies and curriculum design within education doctoral programs. The inclusion of student voice can strengthen

Counseling Psychology Doctoral Trainees' Satisfaction with Clinical Methods Training

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Menke, Kristen Ann

2015-01-01

Counseling psychology doctoral trainees' satisfaction with their clinical methods training is an important predictor of their self-efficacy as counselors, persistence in graduate programs, and probability of practicing psychotherapy in their careers (Fernando & Hulse-Killacky, 2005; Hadjipavlou & Ogrodniczuk, 2007; Morton & Worthley,…

A comparison of best practices for doctoral training in Europe and North America

DEFF Research Database (Denmark)

Barnett, Joey, V.; Harris, Robert. A; Mulvany, Michael J.

2017-01-01

The PhD degree was established in Berlin 200 years ago and has since spread across the whole world. While there is general agreement that the degree is awarded in recognition of successfully completed research training, there have been significant differences in the way doctoral training programs......D theses. These differences are analyzed in detail in order to provide a foundation for discussion of their relative advantages and disadvantages, with a view to providing a platform for discussion of best practices. The results will be of importance in the continued development of global discussion about...... development of doctoral training....

Undergraduate Training in Human Sexuality?Evaluation of the Impact on Medical Doctors' Practice Ten Years After Graduation

OpenAIRE

Clegg, Mary; Pye, Joanne; Wylie, Kevan R.

2016-01-01

Introduction: It has been suggested that an indicator of a doctor's ability to assess patients' sexual function relates to the level of earlier training. The amount and quality of training the doctor receives at the undergraduate level and beyond could contribute to the doctor's confidence and competence. Aims: To evaluate whether doctors found that the teaching in human sexuality received at medical school was sufficient for their future practice and whether their chosen medical specialty...

Perceived causes of differential attainment in UK postgraduate medical training: a national qualitative study

OpenAIRE

Woolf, Katherine; Rich, Antonia; Viney, Rowena; Needleman, Sarah; Griffin, Ann

2016-01-01

Objectives Explore trainee doctors? experiences of postgraduate training and perceptions of fairness in relation to ethnicity and country of primary medical qualification. Design Qualitative semistructured focus group and interview study. Setting Postgraduate training in England (London, Yorkshire and Humber, Kent Surrey and Sussex) and Wales. Participants 137 participants (96 trainees, 41 trainers) were purposively sampled from a framework comprising: doctors from all stages of training in g...

A survey of UK optometry trainees' smoking cessation training.

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Lorencatto, Fabiana; Harper, Alice M; Francis, Jill J; Lawrenson, John G

2016-07-01

Smoking is a risk factor for a number of eye conditions, including age-related macular degeneration, cataracts and thyroid eye disease. Smoking cessation interventions have been shown to be highly cost-effective when delivered by a range of healthcare professionals. Optometrists are well placed to deliver smoking cessation advice to a wide population of otherwise healthy smokers. Yet optometrists remain a relatively neglected healthcare professional group in smoking cessation research and policy. Surveys of UK medical/nursing schools and of optometrists' training internationally demonstrate significant deficits in current curricular coverage regarding smoking cessation. This study aimed to identify the extent of smoking cessation training in UK optometry trainees' undergraduate and pre-registration training. All undergraduate optometry schools in the UK (n = 9) were invited to participate in a web-based survey of their curricular coverage and assessment related to smoking cessation, and of perceived barriers to delivering smoking cessation training. A content analysis of the College of Optometrists Scheme for Registration Trainee Handbook 2014 was conducted to identify competence indicators related to smoking cessation. Nine undergraduate optometry schools (100%) responded to the survey. The majority reported dedicating limited hours (0-3) to teaching smoking cessation, and predominantly focused on teaching the harmful effects of smoking (89%). Only one school provides practical skills training for delivering evidence-based smoking cessation interventions, including very brief advice. The majority of schools (78%) reported that they did not formally examine students on their knowledge or skills for supporting smoking cessation, and rated confidence in their graduates' abilities to deliver smoking cessation interventions as 'poor' (78%). Lack of knowledge amongst staff was identified as the key barrier to teaching about smoking cessation support. The pre

Developing an e-induction passport for doctors in training in the South West of England

OpenAIRE

Gaskell, N.; Malin, A.; Gray, S.

2016-01-01

Background\\ud Doctors in training rotate round different organisations, sometimes for short periods of times. Face to face induction and requirements for statutory and mandatory training can be very time-consuming, Streamlining these processes has potential to increase the amount of times junior doctors can spend on direct patient care, particularly important at the key times when new cohorts of doctors start work.\\ud \\ud Summary of work\\ud In 2012, the hospital in Bath developed an on line e...

Legalisation of euthanasia or physician-assisted suicide: survey of doctors' attitudes.

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Seale, C

2009-04-01

This study reports UK doctors' opinions about legalisation of medically assisted dying (euthanasia and physician-assisted suicide), comparing this with the UK general public. A postal survey of 3733 UK medical practitioners was done. The majority of UK doctors are opposed to legalisation, contrasting with the UK general public. Palliative medicine specialists are particularly opposed. A strong religious belief is independently associated with opposition to assisted dying. Frequency of treating patients who die is not independently associated with attitudes. Many doctors supporting legalisation also express reservations and advocate safeguards; many doctors opposing legalisation believe and accept that treatment and nontreatment decisions may shorten life. It is hoped that future debates about legalisation can proceed with this evidence in mind.

Clinician-scientist MB/PhD training in the UK: a nationwide survey of medical school policy.

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Barnett-Vanes, Ashton; Ho, Guiyi; Cox, Timothy M

2015-12-30

This study surveyed all UK medical schools regarding their Bachelor of Medicine (MB), Doctor of Philosophy (PhD) (MB/PhD) training policy in order to map the current training landscape and to provide evidence for further research and policy development. Deans of all UK medical schools registered with the Medical Schools Council were invited to participate in this survey electronically. The number of medical schools that operate institutional MB/PhD programmes or permit self-directed student PhD intercalation. Medical school recruitment procedures and attitudes to policy guidance. 27 of 33 (81%) registered UK medical schools responded. Four (14%) offer an institutional MB/PhD programme. However, of those without institutional programmes, 17 (73%) permit study interruption and PhD intercalation: two do not (one of whom had discontinued their programme in 2013), three were unsure and one failed to answer the question. Regarding student eligibility, respondents cited high academic achievement in medical studies and a bachelor's or master's degree. Of the Medical schools without institutional MB/PhD programmes, 5 (21%) have intentions to establish a programme, 8 (34%) do not and 3 were unsure, seven did not answer. 19 medical schools (70%) considered national guidelines are needed for future MB/PhD programme development. We report the first national survey of MB/PhD training in the UK. Four medical schools have operational institutional MB/PhD programmes, with a further five intending to establish one. Most medical schools permit study interruption and PhD intercalation. The total number MB/PhD students yet to graduate from medical school could exceed 150, with 30 graduating per year. A majority of medical school respondents to this survey believe national guidelines are required for MB/PhD programme development and implementation. Further research should focus on the MB/PhD student experience. Discussion regarding local and national MB/PhD policies between medical

Guidelines for cognitive behavioral training within doctoral psychology programs in the United States: report of the Inter-organizational Task Force on Cognitive and Behavioral Psychology Doctoral Education.

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Klepac, Robert K; Ronan, George F; Andrasik, Frank; Arnold, Kevin D; Belar, Cynthia D; Berry, Sharon L; Christofff, Karen A; Craighead, Linda W; Dougher, Michael J; Dowd, E Thomas; Herbert, James D; McFarr, Lynn M; Rizvi, Shireen L; Sauer, Eric M; Strauman, Timothy J

2012-12-01

The Association for Behavioral and Cognitive Therapies initiated an interorganizational task force to develop guidelines for integrated education and training in cognitive and behavioral psychology at the doctoral level in the United States. Fifteen task force members representing 16 professional associations participated in a year-long series of conferences, and developed a consensus on optimal doctoral education and training in cognitive and behavioral psychology. The recommendations assume solid foundational training that is typical within applied psychology areas such as clinical and counseling psychology programs located in the United States. This article details the background, assumptions, and resulting recommendations specific to doctoral education and training in cognitive and behavioral psychology, including competencies expected in the areas of ethics, research, and practice. Copyright © 2012. Published by Elsevier Ltd.

Training Humanities Doctoral Students in Collaborative and Digital Multimedia

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Ensslin, Astrid; Slocombe, Will

2012-01-01

This study reports on the pedagogic rationale, didactic design and implications of an AHRC-funded doctoral training scheme in collaborative and digital multimedia in the humanities. In the second part of this article we discuss three areas of provision that were identified as particularly significant and/or controversial. These include (1) desktop…

Cultural diversity training for UK healthcare professionals: a comprehensive nationwide cross-sectional survey.

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Bentley, Paul; Jovanovic, Ana; Sharma, Pankaj

2008-10-01

Healthcare inequalities within the UK based on patients' ethnicity have been found over the last five years in a large number of medical specialties. One possible explanation for this lies in ignorance of ethnic minority healthcare needs among professionals. Cultural diversity programmes have been shown to improve patient outcomes including compliance, yet these are not as yet requirements for any UK healthcare professionals with the exception of psychiatrists. This paper documents the frequency, regional variation, characteristics and motivations for cultural diversity training through a questionnaire survey of the educational leads of every UK medical school, postgraduate deanery and schools of nursing, physiotherapy, occupational therapy, speech and language therapy, and pharmacy. The results showed a wide variation in teaching practices between healthcare professions and geographical regions. This study provides evidence for the need for national guidelines to incorporate cultural competency training by all UK healthcare professional training bodies.

Barriers to education of overseas doctors in paediatrics: a qualitative study in South Yorkshire.

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Mahajan, J; Stark, P

2007-03-01

To explore the factors that may influence the progress of doctors who come from the Indian subcontinent to train in paediatrics in the UK. Overseas doctors training in paediatrics in Rotherham, Sheffield and Doncaster participated in the study. Focus groups were used to collect data; two focus groups, each with 4-5 participants, were conducted at 6-week intervals. Semistructured, one-to-one interviews were conducted to add more understanding and depth to issues highlighted in the focus groups. The focus groups and interviews were audiotaped; the tapes were transcribed and data were analysed using the Grounded Theory; open codes were formed and concepts identified using microanalysis, and initial theories were built. Lack of information about the National Health Service (NHS)/Royal Colleges, inappropriate communication skills, difficulties in team working, difficulties in preparing for Royal College examinations, visa and job hunting, and social and cultural isolation were identified as major barriers. Problems arose not only from difficulties with language but also from use of local and colloquial words, different accents and difficulty in communicating sensitive issues. Lack of understanding of role in teams and difficulties in working in multiprofessional setting all contributed to the problems. Cultural differences inside and outside the workplace, and social isolation were also highlighted. Induction programmes, mentoring, awareness of the issues within the teams, and courses in communication specifically directed at overseas doctors were identified as means to overcome these barriers. Several intercultural factors were identified that could act as barriers to the progress of overseas doctors training in paediatrics in the UK. Increased awareness of these factors within the teams would be the first step in resolving some of the issues.

Utilizing doctors' attitudes toward staff training to inform a chiropractic technology curriculum.

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Eberhart, Catherine A; Martel, Stacie S

2015-03-01

The purpose of this study is to determine attitudes of doctors of chiropractic regarding the importance of staff training in specific skill areas to inform the curriculum management process of a chiropractic technology program. A survey was distributed to registrants of a chiropractic homecoming event. On a 5-point Likert scale, respondents were asked to rate the degree of importance that staff members be trained in specific skills. Descriptive statistics were derived, and a 1-way analysis of variance (ANOVA) was used to test differences between groups based on years in practice and level of staff training. Doctors place a high level of importance on oral communication skills and low importance on nutrition and physical examinations. Comparing groups based on years in practice revealed differences in the areas of passive physiotherapies (F = 3.61, p = .015), legal issues/regulations (F = 3.01, p = .032), occupational safety and health regulation (F = 4.27, p = .006), and marketing (F = 2.67, p = .049). Comparing groups based on level of staff training revealed differences in the areas of occupational safety and health regulations (F = 4.56, p = .005) and cardiopulmonary resuscitation (F = 4.91, p = .003). With regard to their assistants, doctors of chiropractic tend to place high importance on office skills requiring effective communication and place less importance on clinical skills such as physical examinations and physiotherapy.

Career choices for public health: cohort studies of graduates from UK medical schools.

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Goldacre, Michael J; Laxton, Louise; Lambert, Trevor W; Webster, Premila

2011-12-01

The aim of this paper is to describe UK-trained doctors' early intentions about seeking careers in public health and their eventual speciality destinations. Analysis of longitudinal studies of medical graduates from all UK medical schools in selected year-of-qualification cohorts from 1974 to 2008; data collected by postal questionnaires at various times after qualifying; and selection, for this paper, of doctors who expressed an early preference for a career in public health and/or who eventually practised in it. Of all doctors eventually practising in public health, for whom we had early choices, public health had been the unreserved first choice of 8% (10/125) in their first post-qualification year, 27% (33/122) in their third year and 59% (51/86) in their fifth year. Including first choices for public health 'tied' with an equal preference for a different speciality, and doctors' second and third choices for public health, 19% (24/125) of practising public health doctors had considered public health as a possible career in their first post-graduation year, 41% (50/122) in the third and 83% (71/86) in the fifth year. Comparisons with other specialities show that doctors in public health chose their speciality relatively late after qualification.

The Relevance of Doctoral Training in Different Labour Markets

Science.gov (United States)

Kyvik, Svein; Olsen, Terje Bruen

2012-01-01

This study examines the relevance of doctoral training (thesis, coursework and generic skills) for a career in three types of labour market: academia, applied research institutes and industrial laboratories, and non-research workplaces. Data are drawn from a mail survey among PhD holders in Norway. In total, more than 40% of the respondents had…

Counseling Psychology Doctoral Students' Training Experiences in Primary Care Psychology

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Cox, Jared

2011-01-01

This qualitative study focused on counseling psychology doctoral students' perspectives regarding their practicum training experience in primary care psychology. The four participants included three females and one male. Semi-structured individual and focus group interviews were used to explore participants' experiences. The participants described…

An Exploration of the Relationship between Training Grants and Profitability of UK Construction Companies

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Abdel-Wahab, Mohamed; Dainty, Andrew R. J.; Ison, Stephen G.; Hazlehurst, Guy

2008-01-01

A levy/grant system exists in the UK construction industry to provide financial support for companies undertaking training activities. With the current UK government skills policy, there is an emphasis on ensuring that training support provided to employers is aimed at enhancing companies' profitability. This paper explores the profitability of…

Leading the asset : Resilience training efficacy in UK policing

OpenAIRE

Hesketh, Ian George; Cooper, Cary Lynn; Ivy, Jonathan Peter

2018-01-01

This paper examines and reports on the efficacy of work-based personal resilience training in a provincial police force in the north of UK. Taking a contextual view, data is modelled from an ASSET survey (n ¼ 350) that provides evidence of the manifestations and consequences of providing such input, in comparison with respondents who had no training and were in the same organisation. The findings support the use of such training programmes (Hesketh et al., 2015) for improving employee well-be...

What factors influence UK medical students' choice of foundation school?

Science.gov (United States)

Miah, Saiful; Pang, Karl H; Rebello, Wayne; Rubakumar, Zoe; Fung, Victoria; Venugopal, Suresh; Begum, Hena

2017-01-01

We aimed to identify the factors influencing UK medical student applicants' choice of foundation school. We also explored the factors that doctors currently approaching the end of their 2-year program believe should be considered. A cross-sectional study was conducted during the 2013-2014 academic year. An online questionnaire was distributed to 2092 final-year medical students from nine UK medical schools and 84 foundation year-2 (FY2) doctors from eight foundation schools. Participants were asked to rank their top 3 from a list of 12 factors that could potentially influence choice of foundation school on a 5-point Likert scale. Collated categorical data from the two groups were compared using a chi-square test with Yates correction. Geographic location was overwhelmingly the most important factor for medical students and FY2 doctors with 97.2% and 98.8% in agreement, respectively. Social relationships played a pivotal role for medical student applicants. Clinical specialties within the rotations were of less importance to medical students, in comparison to location and social relationships. In contrast, FY2 doctors placed a significantly greater importance on the specialties undertaken in their 2-year training program, when compared to medical students (chi-square; p =0.0001). UK medical schools should make their foundation program applicants aware of the importance of choosing rotations based on specialties that will be undertaken. Individual foundation schools could provide a more favorable linked application system and greater choice and flexibility of specialties within their 2-year program, potentially making their institution more attractive to future applicants.

UK doctors' views on the implementation of the European Working Time Directive as applied to medical practice: a quantitative analysis.

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Maisonneuve, Jenny J; Lambert, Trevor W; Goldacre, Michael J

2014-02-06

To report on doctors' views, from all specialty backgrounds, about the European Working Time Directive (EWTD) and its impact on the National Health Service (NHS), senior doctors and junior doctors. All medical school graduates from 1999 to 2000 were surveyed by post and email in 2012. The UK. Among other questions, in a multipurpose survey on medical careers and career intentions, doctors were asked to respond to three statements about the EWTD on a five-point scale (from strongly agree to strongly disagree): 'The implementation of the EWTD has benefited the NHS', 'The implementation of the EWTD has benefited senior doctors' and 'The implementation of the EWTD has benefited junior doctors'. The response rate was 54.4% overall (4486/8252), 55.8% (2256/4042) of the 1999 cohort and 53% (2230/4210) of the 2000 cohort. 54.1% (2427) of all respondents were women. Only 12% (498/4136 doctors) agreed that the EWTD has benefited the NHS, 9% (377) that it has benefited senior doctors and 31% (1289) that it has benefited junior doctors. Doctors' views on EWTD differed significantly by specialty groups: 'craft' specialties such as surgery, requiring extensive experience in performing operations, were particularly critical. These cohorts have experience of working in the NHS before and after the implementation of EWTD. Their lack of support for the EWTD 4 years after its implementation should be a concern. However, it is unclear whether problems rest with the current ceiling on hours worked or with the ways in which EWTD has been implemented.

Improved interobserver variation after training of doctors in the Neer system. A randomised trial

DEFF Research Database (Denmark)

Brorson, S; Bagger, J; Sylvest, A

2002-01-01

We investigated whether training doctors to classify proximal fractures of the humerus according to the Neer system could improve interobserver agreement. Fourteen doctors were randomised to two training sessions, or to no training, and asked to categorise 42 unselected pairs of plain radiographs...... of fractures of the proximal humerus according to the Neer system. The mean kappa difference between the training and control groups was 0.30 (95% CI 0.10 to 0.50, p = 0.006). In the training group the mean kappa value for interobserver variation improved from 0.27 (95% CI 0.24 to 0.31) to 0.62 (95% CI 0.......57 to 0.67). The improvement was particularly notable for specialists in whom kappa increased from 0.30 (95% CI 0.23 to 0.37) to 0.79 (95% CI 0.70 to 0.88). These results suggest that formal training in the Neer system is a prerequisite for its use in clinical practice and research....

Food hygiene training in the UK: time for a radical re-think?

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MacAuslan, E

2001-12-01

Training food handlers in the hospitality industry has been recommended by various organisations as a means of improving food handling practices and thus the safety of food for consumers. It is nearly 20 years since the first examinations for basic level food hygiene certificates were made available to food handlers in the UK. Since then little has changed in the syllabuses and in the way the questions are worded. However, the range of languages spoken by food handlers working in the UK has increased substantially since more employers are recruiting those who speak English as a second language. Training can be an unwelcome expense for managers where there is a high turnover of employees, especially amongst those for whom English is not a first language. To improve practical implementation of food hygiene theory it is time to develop a radical strategy concerning the way training is targeted and delivered in the UK, and perhaps Europe.

TRAINING COURSES AND PROFESSIONAL INTEGRATION OF DOCTORS IN EDUCATION: PATHS AND DESTINATION OF GRADUATES

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Altair Alberto Fávero

2016-12-01

Full Text Available This study aimed to investigate the trajectories and institutional destinations of graduates of doctoral programs in Education from Brazilian public universities in the last twelve years (2000-2012. The research is characterized as Mixed Methods (CRESWELL and CLARK, 2013 and was developed from data available in the electronic site of the CAPES, referring to graduate programs and Lattes Platform. Of the 3,598 graduates surveyed, a small number represents researchers who went straight to masters and doctorate degrees shortly after undergraduate studies. Almost one-third of respondents obtained doctorate degrees in between 10 and 15 years after graduation. About 15% held a doctorate between 20 and 25 years after graduation. We found that less than 25% of respondents were master's degree students in 2013 and less than 10% have contributed to the training of young doctors. We believe that the development of this research, unprecedented on this scale in the area of education, can contribute to the evaluation of expansion conditions and qualification programs and courses. In addition to taking a look at the activities and the working arrangements of the young doctors in Education in Brazil and prepare analytical frameworks that can contribute to the proposition of strategic funding policies and the setting of teachers in disadvantaged regions. Keywords: Postgraduate studies. Education. Graduate student training. Employability.

High-intensity interval training versus moderate-intensity steady-state training in UK cardiac rehabilitation programmes (HIIT or MISS UK): study protocol for a multicentre randomised controlled trial and economic evaluation.

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McGregor, Gordon; Nichols, Simon; Hamborg, Thomas; Bryning, Lucy; Tudor-Edwards, Rhiannon; Markland, David; Mercer, Jenny; Birkett, Stefan; Ennis, Stuart; Powell, Richard; Begg, Brian; Haykowsky, Mark J; Banerjee, Prithwish; Ingle, Lee; Shave, Rob; Backx, Karianne

2016-11-16

Current international guidelines for cardiac rehabilitation (CR) advocate moderate-intensity exercise training (MISS, moderate-intensity steady state). This recommendation predates significant advances in medical therapy for coronary heart disease (CHD) and may not be the most appropriate strategy for the 'modern' patient with CHD. High-intensity interval training (HIIT) appears to be a safe and effective alternative, resulting in greater improvements in peak oxygen uptake (VO 2 peak ). To date, HIIT trials have predominantly been proof-of-concept studies in the laboratory setting and conducted outside the UK. The purpose of this multicentre randomised controlled trial is to compare the effects of HIIT and MISS training in patients with CHD attending UK CR programmes. This pragmatic study will randomly allocate 510 patients with CHD to 8 weeks of twice weekly HIIT or MISS training at 3 centres in the UK. HIIT will consist of 10 high-intensity (85-90% peak power output (PPO)) and 10 low-intensity (20-25% PPO) intervals, each lasting 1 min. MISS training will follow usual care recommendations, adhering to currently accepted UK guidelines (ie, >20 min continuous exercise at 40-70% heart rate reserve). Outcome measures will be assessed at baseline, 8 weeks and 12 months. The primary outcome for the trial will be change in VO 2 peak as determined by maximal cardiopulmonary exercise testing. Secondary measures will assess physiological, psychosocial and economic outcomes. The study protocol V.1.0, dated 1 February 2016, was approved by the NHS Health Research Authority, East Midlands-Leicester South Research Ethics Committee (16/EM/0079). Recruitment will start in August 2016 and will be completed in June 2018. Results will be published in peer-reviewed journals, presented at national and international scientific meetings and are expected to inform future national guidelines for exercise training in UK CR. NCT02784873; pre-results. Published by the BMJ

Practical advice on how to prevent and manage poorly performing doctors under postgraduate training - acceptance of a one day training course in Denmark

DEFF Research Database (Denmark)

Kodal, Troels

2009-01-01

was prevention, early detection and action plan. Summary of work: Since February 2008 32 senior doctors have attended the course. Questionnaires assessing the acceptance and usefulness of the course were answered by 29 participants. Summary of results: A positive evaluation was reported by 27. The most important...... ( http://www.nact.org.uk/pdf_documents/ trainees_in_difficulty_jan08.pdf). In order to test the acceptance and usefulness of this guide in a Danish setting a one day adjusted course, was offered to senior doctors being clinical supervisor in Region of Southern Denmark. The main focus of the course...

ELIXIR-UK role in bioinformatics training at the national level and across ELIXIR [version 1; referees: 2 approved, 1 approved with reservations

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L. Larcombe

2017-06-01

Full Text Available ELIXIR-UK is the UK node of ELIXIR, the European infrastructure for life science data. Since its foundation in 2014, ELIXIR-UK has played a leading role in training both within the UK and in the ELIXIR Training Platform, which coordinates and delivers training across all ELIXIR members. ELIXIR-UK contributes to the Training Platform’s coordination and supports the development of training to address key skill gaps amongst UK scientists. As part of this work it acts as a conduit for nationally-important bioinformatics training resources to promote their activities to the ELIXIR community. ELIXIR-UK also leads ELIXIR’s flagship Training Portal, TeSS, which collects information about a diverse range of training and makes it easily accessible to the community. ELIXIR-UK also works with others to provide key digital skills training, partnering with the Software Sustainability Institute to provide Software Carpentry training to the ELIXIR community and to establish the Data Carpentry initiative, and taking a lead role amongst national stakeholders to deliver the StaTS project – a coordinated effort to drive engagement with training in statistics.

What factors influence UK medical students’ choice of foundation school?

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Miah, Saiful; Pang, Karl H; Rebello, Wayne; Rubakumar, Zoe; Fung, Victoria; Venugopal, Suresh; Begum, Hena

2017-01-01

Background We aimed to identify the factors influencing UK medical student applicants’ choice of foundation school. We also explored the factors that doctors currently approaching the end of their 2-year program believe should be considered. Methods A cross-sectional study was conducted during the 2013–2014 academic year. An online questionnaire was distributed to 2092 final-year medical students from nine UK medical schools and 84 foundation year-2 (FY2) doctors from eight foundation schools. Participants were asked to rank their top 3 from a list of 12 factors that could potentially influence choice of foundation school on a 5-point Likert scale. Collated categorical data from the two groups were compared using a chi-square test with Yates correction. Results Geographic location was overwhelmingly the most important factor for medical students and FY2 doctors with 97.2% and 98.8% in agreement, respectively. Social relationships played a pivotal role for medical student applicants. Clinical specialties within the rotations were of less importance to medical students, in comparison to location and social relationships. In contrast, FY2 doctors placed a significantly greater importance on the specialties undertaken in their 2-year training program, when compared to medical students (chi-square; p=0.0001). Conclusion UK medical schools should make their foundation program applicants aware of the importance of choosing rotations based on specialties that will be undertaken. Individual foundation schools could provide a more favorable linked application system and greater choice and flexibility of specialties within their 2-year program, potentially making their institution more attractive to future applicants. PMID:28458589

Associations between perceived institutional support, job enjoyment, and intentions to work in the United Kingdom: national questionnaire survey of first year doctors.

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Lachish, Shelly; Goldacre, Michael J; Lambert, Trevor

2016-05-23

Identifying factors that improve job satisfaction of new doctors and ease the difficult transition from student to doctor is of great interest to public health agencies. Studies to date have focused primarily on the value of changes to medical school curricula and induction processes in this regard, but have overlooked the extent to which institutional support can influence new doctors' enjoyment of and attitude to work. Here, we examine variation in the perceived level of support received by new medical graduates in the United Kingdom (UK) from their employer and whether this influences enjoyment of and attitudes to the first postgraduate year, and whether doctors who perceived a lower level of support were less inclined to intend a long term career in medicine in the UK. All UK medical graduates of 2012 were surveyed in 2013 in a cross-sectional study, towards the end of their first post-graduate year (the 'F1' year of the 2-year Foundation Training Programme for new UK doctors). We used linear regression to assess whether the level of support doctors reported receiving from their employing Trust (Very Good, Good, Adequate, Poor, or Very Poor) was associated with the extent to which they enjoyed their F1 year. Similarly, we assessed the strength of associations between self-reported level of Trust support and doctors' responses to 12 statements about fundamental aspects of their working lives, each assessed on a 5-point scale of agreement. Using χ (2) tests we examined whether doctors' intentions to practise medicine in the UK varied with the level of support they reported receiving from their Trust. The response rate was 45 % (2324/5171). Of 2324 responding junior doctors, 63.8 % reported receiving 'Very Good' (23.6 %) or 'Good' (40.2 %) initial support from their Trust, while a further 27.4 % stated they received 'Adequate' support. 'Poor' support was reported by 5.8 % and 'Very Poor' support by 2.2 %. We found very strong positive associations between

The interpretability of doctor identification badges in UK hospitals: a survey of nurses and patients.

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Hickerton, Bethan C; Fitzgerald, Daniel John; Perry, Elizabeth; De Bolla, Alan R

2014-07-01

Hospital badges have multiple important purposes, but their essential role remains the clear identification of the bearer, including their professional status. The modernisation of medical careers in the National Health Service has changed terminology dramatically, resulting in a plethora of new job titles emerging among both doctors and nurses. To determine whether the new or old terminology allowed clearer identification of medical doctors by patients and nurses. We replicated 11 identification badges used in the Royal Cornwall Hospital and Wrexham Maelor Hospital, both current and before the introduction of new medical training terminology. Data were collected from 114 patients and 67 nurses, by asking them to (1) identify which name badges represented doctors and (2) rank them in order of seniority. Only 11% of patients and 60% of nurses identified a 'Foundation Year 1 Trainee' as a qualified medical doctor. Indeed, only 'General Practice Vocational Trainee' and 'Consultant' were both readily identifiable as qualified doctors to both patients and nurses. Ranking was also a problem, with only 19% of patients and 45% of nurses able to correctly grade medical doctors using the current terminology. The old terminology allowed more accurate identification by nurses, with over 80% successfully ranking and marking the title appropriately. Current terminology is a source of confusion to both patients and members of the immediate medical care team, with nurses unable to correctly identify medical doctors. Our study indicates that a review of terminology is necessary to ensure patients, and staff, are able to communicate effectively. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Attitudes towards attrition among UK trainees in obstetrics and gynaecology

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Gafson, I.; Currie, J.; O Dwyer, S.; Woolf, K.; Griffin, A.

2017-01-01

Physician dissatisfaction in the workplace has consequences for patient safety. Currently in the UK, 1 in 5 doctors who enter specialist training in obstetrics and gynaecology leave the programme before completion. Trainee attrition has implications for workforce planning, organization of health-care services and patient care. The authors conducted a survey of current trainees' and former trainees' views concerning attrition and ‘peri-attrition’ – a term coined to describe the trainee who has...

Stress and training satisfaction among resident doctors in Nigeria: Any justification for a change in training policy?

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Oluseun Peter Ogunnubi

2018-01-01

Full Text Available Background: There are pointers in existing literature to the stressful nature of residency program, thereby placing training physicians at increased risk of psychological distress. Objectives: The study identified perceived stress, its sources, training satisfaction, and the associated sociodemographic characteristics among resident doctors. Materials and Methods: A total of 405 self-administered questionnaires were given to all attendees of the National Postgraduate Medical College Revision Course. The questionnaires sought information on sociodemographic variables, sources of stress, and training satisfaction. Only 20 questionnaires were not returned. Data were collated and analyzed. Results: A majority of the respondents were male (69.1%, mostly between 31 and 35 years of age. Most (80% of the respondents were married while 51.4% had over 4 dependents. All the respondents reported a significant level of stress, and different sources of stress were identified. Only 12 (3.1% of the respondents were satisfied with the quality of training being received in their institutions. Conclusion: Our study found residency training to be stressful for doctors and often compounded by identifiable variables as shown in this study. Such stressful experience can, in turn, have negative impacts on their physical along with mental well-being and the patient care. Thus, there is a need for relevant stakeholders to review the structure of residency program with the view of addressing “modifiable risks” of stress among would-be specialists.

What shape do UK trainees want their training to be? Results of a cross-sectional study.

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Harries, Rhiannon L; Rashid, Mustafa; Smitham, Peter; Vesey, Alex; McGregor, Richard; Scheeres, Karl; Bailey, Jon; Sohaib, Syed Mohammed Afzal; Prior, Matthew; Frost, Jonathan; Al-Deeb, Walid; Kugathasan, Gana; Gokani, Vimal J

2016-10-07

The British Government is acting on recommendations to overhaul postgraduate training to meet the needs of the changing population, to produce generalist doctors undergoing shorter broad-based training (Greenaway Review). Only 45 doctors in training were involved in the consultation process. This study aims to obtain a focused perspective on the proposed reforms by doctors in training from across specialities. Prospective, questionnaire-based cross-sectional study. Following validation, a 31-item electronic questionnaire was distributed via trainee organisations and Postgraduate Local Education and Training Board (LETB) mailing lists. Throughout the 10-week study period, the survey was publicised on several social media platforms. Of the 3603 demographically representative respondents, 69% knew about proposed changes. Of the respondents, 73% expressed a desire to specialise, with 54% keen to provide general emergency cover. A small proportion (12%) stated that current training pathway length is too long, although 86% felt that it is impossible to achieve independent practitioner-level proficiency in a shorter period of time than is currently required. Opinions regarding credentialing were mixed, but tended towards disagreement. The vast majority (97%) felt credentialing should not be funded by doctors in training. Respondents preferred longer placement lengths with increasing career progression. Doctors in training value early generalised training (65%), with suggestions for further improvement. This is the first large-scale cross-specialty study regarding the Shape of Training Review. Although there are recommendations which trainees support, it is clear that one size does not fit all. Most trainees are keen to provide a specialist service on an emergency generalist background. Credentialing is a contentious issue; however, we believe removing aspects from curricula into post-Certificate of Completion of Training (CCT) credentialing programmes with shortened

WorldSkills UK Training Managers: Midas Touch or Fool’s Gold?

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Stephanie Wilde

2015-08-01

Full Text Available This article focuses on the role of training managers (TMs in UK participation in WorldSkills Competitions (WSC. The TM role is outlined, according to the perceptions of the TMs, and there is analysis of the benefits to them of participation, as well as the barriers they face, and the benefits and barriers available to participating further education colleges and employers. The article is based on analysis of semi-structured interviews with almost the full cohort of UK TMs preparing competitors for WorldSkills Brazil 2015, and concludes with reflections on the vision and purposes of UK WorldSkills participation.

A rehabilitation training partnership in Madagascar.

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Andrianabela, Sonia; Hariharan, Ram; Ford, Helen L; Chamberlain, M Anne

2015-09-01

We describe here the development of a mid-level training programme for doctors in Madagascar to direct regional and national rehabilitation services. Eight doctors enrolled and all gained their diplomas and have gone on to form the Association of Physical and Rehabilitation Medicine of Madagascar, which is leading further training and service developments. The course was specific to Madagascar's needs, and was devised according to the vision of the senior rehabilitation specialist in the Ministry of Health in Madagascar with support from the University of Antananarivo. The syllabus was developed with a senior Rehabilitation Medicine consultant responsible for setting up a comprehensive range of services and teaching in a University teaching hospital in the UK. Major barriers to success include the economic and political situation in Madagascar, which worsened steadily over the period of the training, the lack of resources for health, rehabilitation and rehabilitation workshops, and the withdrawal of aid. The sustainability of the training and the improved services that have been initiated will be evaluated, but these will be influenced by the situation of the country. It is hoped that this description of a highly practical training using modern teaching methods will be of use in other low-resource countries. Much of the teaching input was given by clinicians from a UK teaching hospital, and this resource will continue to be needed.

International Doctoral Students in Counselor Education: Coping Strategies in Supervision Training

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Woo, Hongryun; Jang, Yoo Jin; Henfield, Malik S.

2015-01-01

This study explores 8 international doctoral students' perceptions of coping strategies used in supervision training in counselor education programs. Using human agency as a conceptual framework, the authors found 3 categories: (a) personal and professional self-directed strategies as personal agency, (b) support and care from mentors as proxy…

8 years of experience in international, interdisciplinary and structured doctoral training in Earth system modelling

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Weitz, Antje; Stevens, Bjorn; Marotzke, Jochem

2010-05-01

The mission of the International Max Planck Research School on Earth System Modelling (IMPRS-ESM) is to provide a high quality, modern and structured graduate education to students pursuing a doctoral degree in Earth system modelling. In so doing, the IMPRS-ESM also strives to advance the emerging discipline (or cross-discipline) of Earth system modelling; to provide a framework for attracting the most talented and creative young women and men from around the world to pursue their doctoral education in Germany; to provide advanced as well as specialized academic training and scientific guidance to doctoral students; to encourage academic networking and publication of research results; to better integrate doctoral research at the Max Planck Institute for Meteorology (MPI-M) with education and research at the University of Hamburg and other cooperating institutions. Core elements are rigorous selection of doctoral students, effective academic supervision, advanced academic training opportunities and interdisciplinary communication as well as administrative support. IMPRS-ESM graduates have been recognized with a variety of awards. 85% of our alumni continue a career in research. In this presentation we review the challenges for an interdisciplinary PhD program in Earth system sciences and the types of routines we have implemented to surmount them as well as key elements that we believe contribute to the success of our doctoral program.

Learning the law: practical proposals for UK medical education.

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Margetts, J K

2016-02-01

Ongoing serious breaches in medical professionalism might be avoided if UK doctors rethink their approach to law. UK medical education has a role in creating a climate of change by re-examining how law is taught to medical students. Adopting a more insightful approach in the UK to the impact of The Human Rights Act and learning to manipulate legal concepts, such as conflict of interest, need to be taught to medical students now if UK doctors are to manage complex decision-making in the NHS of the future. The literature is reviewed from a unique personal perspective of a doctor and lawyer, and practical proposals for developing medical education in law in the UK are suggested. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

How do workplaces, working practices and colleagues affect UK doctors’ career decisions? A qualitative study of junior doctors’ career decision making in the UK

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Pearson, Emma; Gibson, Jonathan; Checkland, Kath

2017-01-01

Objectives This study draws on an in-depth investigation of factors that influenced the career decisions of junior doctors. Setting Junior doctors in the UK can choose to enter specialty training (ST) programmes within 2 years of becoming doctors. Their specialty choices contribute to shaping the balance of the future medical workforce, with views on general practice (GP) careers of particular interest because of current recruitment difficulties. This paper examines how experiences of medical work and perceptions about specialty training shape junior doctors’ career decisions. Participants Twenty doctors in the second year of a Foundation Training Programme in England were recruited. Purposive sampling was used to achieve a diverse sample from respondents to an online survey. Results Narrative interviewing techniques encouraged doctors to reflect on how experiences during medical school and in medical workplaces had influenced their preferences and perceptions of different specialties. They also spoke about personal aspirations, work priorities and their wider future. Junior doctors’ decisions were informed by knowledge about the requirements of ST programmes and direct observation of the pressures under which ST doctors worked. When they encountered negative attitudes towards a specialty they had intended to choose, some became defensive while others kept silent. Achievement of an acceptable work-life balance was a central objective that could override other preferences. Events linked with specific specialties influenced doctors’ attitudes towards them. For example, findings confirmed that while early, positive experiences of GP work could increase its attractiveness, negative experiences in GP settings had the opposite effect. Conclusions Junior doctors’ preferences and perceptions about medical work are influenced by multiple intrinsic and extrinsic factors and experiences. This paper highlights the importance of understanding how perceptions are formed

Student assistantships: bridging the gap between student and doctor

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Crossley JGM

2015-06-01

Full Text Available James GM Crossley,1,2 Pirashanthie Vivekananda-Schmidt1 1University of Sheffield School of Medicine, Sheffield, 2Chesterfield Royal Hospital NHS Foundation Trust, Chesterfield, UK Abstract: In 2009, the General Medical Council UK (GMC published its updated guidance on medical education for the UK medical schools – Tomorrow's Doctors 2009. The Council recommended that the UK medical schools introduce, for the first time, a clinical placement in which a senior medical student, “assisting a junior doctor and under supervision, undertakes most of the duties of an F1 doctor”. In the UK, an F1 doctor is a postgraduation year 1 (PGY1 doctor. This new kind of placement was called a student assistantship. The recommendation was considered necessary because conventional UK clinical placements rarely provided medical students with opportunities to take responsibility for patients – even under supervision. This is in spite of good evidence that higher levels of learning, and the acquisition of essential clinical and nontechnical skills, depend on students participating in health care delivery and gradually assuming responsibility under supervision. This review discusses the gap between student and doctor, and the impact of the student assistantship policy. Early evaluation indicates substantial variation in the clarity of purpose, setting, length, and scope of existing assistantships. In particular, few models are explicit on the most critical issue: exactly how the student participates in care and how supervision is deployed to optimize learning and patient safety. Surveys indicate that these issues are central to students' perceptions of the assistantship. They know when they have experienced real responsibility and when they have not. This lack of clarity and variation has limited the impact of student assistantships. We also consider other important approaches to bridging the gap between student and doctor. These include supporting the

Early career choices and successful career progression in surgery in the UK: prospective cohort studies

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Richards Jennifer MJ

2010-11-01

Full Text Available Abstract Background Changes to the structure of medical training worldwide require doctors to decide on their career specialty at an increasingly early stage after graduation. We studied trends in career choices for surgery, and the eventual career destinations, of UK graduates who declared an early preference for surgery. Methods Postal questionnaires were sent, at regular time intervals after qualification, to all medical qualifiers from all UK medical schools in selected qualification years between 1974 and 2005. They were sent in the first year after qualification, at year three and five years after qualification, and at longer time intervals thereafter. Results Responses were received from 27 749 of 38 280 doctors (73% at year one, 23 468 of 33151 (71% at year three, and 17 689 of 24 870 (71% at year five. Early career preferences showed that surgery has become more popular over the past two decades. Looking forward from early career choice, 60% of respondents (64% of men, 48% of women with a first preference for a surgical specialty at year one eventually worked in surgery (p Conclusions Surgery is a popular specialty choice in the UK. The great majority of doctors who progressed in a surgical career made an early and definitive decision to do so.

‘You can't be a person and a doctor’: the work–life balance of doctors in training—a qualitative study

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Viney, Rowena; Needleman, Sarah; Griffin, Ann

2016-01-01

Objectives Investigate the work–life balance of doctors in training in the UK from the perspectives of trainers and trainees. Design Qualitative semistructured focus groups and interviews with trainees and trainers. Setting Postgraduate medical training in London, Yorkshire and Humber, Kent, Surrey and Sussex, and Wales during the junior doctor contract dispute at the end of 2015. Part of a larger General Medical Council study about the fairness of postgraduate medical training. Participants 96 trainees and 41 trainers. Trainees comprised UK graduates and International Medical Graduates, across all stages of training in 6 specialties (General Practice, Medicine, Obstetrics and Gynaecology, Psychiatry, Radiology, Surgery) and Foundation. Results Postgraduate training was characterised by work–life imbalance. Long hours at work were typically supplemented with revision and completion of the e-portfolio. Trainees regularly moved workplaces which could disrupt their personal lives and sometimes led to separation from friends and family. This made it challenging to cope with personal pressures, the stresses of which could then impinge on learning and training, while also leaving trainees with a lack of social support outside work to buffer against the considerable stresses of training. Low morale and harm to well-being resulted in some trainees feeling dehumanised. Work–life imbalance was particularly severe for those with children and especially women who faced a lack of less-than-full-time positions and discriminatory attitudes. Female trainees frequently talked about having to choose a specialty they felt was more conducive to a work–life balance such as General Practice. The proposed junior doctor contract was felt to exacerbate existing problems. Conclusions A lack of work–life balance in postgraduate medical training negatively impacted on trainees' learning and well-being. Women with children were particularly affected, suggesting this group would

A comparative study of vocational education and occupational safety and health training in China and the UK.

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Nie, Baisheng; Huang, Xin; Xue, Fei; Chen, Jiang; Liu, Xiaobing; Meng, Yangyang; Huang, Jinxin

2018-06-01

In order to enhance Chinese workers' occupational safety awareness, it is essential to learn from developed countries' experiences. This article investigates thoroughly occupational safety and health (OSH) in China and the UK; moreover, the article performs a comparison of Chinese and British OSH training-related laws, regulations and education system. The following conclusions are drawn: China's work safety continues to improve, but there is still a large gap compared with the UK. In China a relatively complete vocational education and training (VET) system has been established. However, there exist some defects in OSH. In the UK, the employer will not only pay attention to employees' physiological health, but also to their mental health. The UK's VET is characterized by classification and grading management, which helps integrate OSH into the whole education system. China can learn from the UK in the development of policies, VET and OSH training.

Career destinations, views and future plans of the UK medical qualifiers of 1988.

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Taylor, Kathryn; Lambert, Trevor; Goldacre, Michael

2010-01-01

To report the career destinations, views and future plans of a cohort of senior doctors who qualified in the 1980s. Postal questionnaire survey of all doctors who qualified from all UK medical schools in 1988. The response rate was 69%. We estimated that 81% of the total cohort was working in the NHS, 16 years after qualification; and that at least 94% of graduates who, when students, were from UK homes, were working in medicine. Of NHS doctors, 30% worked part-time. NHS doctors rated their job satisfaction highly (median score 19.9, scale 5-25) but were less satisfied with the amount of leisure time available to them (median score 5.4, scale 1-10). NHS doctors were very positive about their careers, but were less positive about working hours and some other aspects of the NHS. Women were more positive than men about working conditions; general practitioners were more positive than hospital doctors. Twenty-five percent reported unmet needs for further training or career-related advice, particularly about career development. Twenty-nine percent intended to reduce their hours in future, while 6%, mainly part-time women, planned to increase their hours. Overall, 10% of NHS doctors planned to do more service work in future and 24% planned to do less; among part-time women, 18% planned to do more and only 14% less. These NHS doctors, now in their 40s, had a high level of satisfaction with their jobs and their careers but were less satisfied with some other aspects of their working environment. A substantial percentage had expectations about future career development and change.

PLAB and UK graduates’ performance on MRCP(UK) and MRCGP examinations: data linkage study

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Wakeford, Richard

2014-01-01

Objectives To assess whether international medical graduates passing the two examinations set by the Professional and Linguistic Assessments Board (PLAB1 and PLAB2) of the General Medical Council (GMC) are equivalent to UK graduates at the end of the first foundation year of medical training (F1), as the GMC requires, and if not, to assess what changes in the PLAB pass marks might produce equivalence. Design Data linkage of GMC PLAB performance data with data from the Royal Colleges of Physicians and the Royal College of General Practitioners on performance of PLAB graduates and UK graduates at the MRCP(UK) and MRCGP examinations. Setting Doctors in training for internal medicine or general practice in the United Kingdom. Participants 7829, 5135, and 4387 PLAB graduates on their first attempt at MRCP(UK) Part 1, Part 2, and PACES assessments from 2001 to 2012 compared with 18 532, 14 094, and 14 376 UK graduates taking the same assessments; 3160 PLAB1 graduates making their first attempt at the MRCGP AKT during 2007-12 compared with 14 235 UK graduates; and 1411 PLAB2 graduates making their first attempt at the MRCGP CSA during 2010-12 compared with 6935 UK graduates. Main outcome measures Performance at MRCP(UK) Part 1, Part 2, and PACES assessments, and MRCGP AKT and CSA assessments in relation to performance on PLAB1 and PLAB2 assessments, as well as to International English Language Testing System (IELTS) scores. MRCP(UK), MRCGP, and PLAB results were analysed as marks relative to the pass mark at the first attempt. Results PLAB1 marks were a valid predictor of MRCP(UK) Part 1, MRCP(UK) Part 2, and MRCGP AKT (r=0.521, 0.390, and 0.490; all PIELTS scores correlated significantly with later performance, multiple regression showing that the effect of PLAB1 (β=0.496) was much stronger than the effect of IELTS (β=0.086). Changes to PLAB pass marks that would result in international medical graduate and UK medical graduate equivalence were assessed in two

PLAB and UK graduates' performance on MRCP(UK) and MRCGP examinations: data linkage study.

Science.gov (United States)

McManus, I C; Wakeford, Richard

2014-04-17

To assess whether international medical graduates passing the two examinations set by the Professional and Linguistic Assessments Board (PLAB1 and PLAB2) of the General Medical Council (GMC) are equivalent to UK graduates at the end of the first foundation year of medical training (F1), as the GMC requires, and if not, to assess what changes in the PLAB pass marks might produce equivalence. Data linkage of GMC PLAB performance data with data from the Royal Colleges of Physicians and the Royal College of General Practitioners on performance of PLAB graduates and UK graduates at the MRCP(UK) and MRCGP examinations. Doctors in training for internal medicine or general practice in the United Kingdom. 7829, 5135, and 4387 PLAB graduates on their first attempt at MRCP(UK) Part 1, Part 2, and PACES assessments from 2001 to 2012 compared with 18,532, 14,094, and 14,376 UK graduates taking the same assessments; 3160 PLAB1 graduates making their first attempt at the MRCGP AKT during 2007-12 compared with 14,235 UK graduates; and 1411 PLAB2 graduates making their first attempt at the MRCGP CSA during 2010-12 compared with 6935 UK graduates. Performance at MRCP(UK) Part 1, Part 2, and PACES assessments, and MRCGP AKT and CSA assessments in relation to performance on PLAB1 and PLAB2 assessments, as well as to International English Language Testing System (IELTS) scores. MRCP(UK), MRCGP, and PLAB results were analysed as marks relative to the pass mark at the first attempt. PLAB1 marks were a valid predictor of MRCP(UK) Part 1, MRCP(UK) Part 2, and MRCGP AKT (r=0.521, 0.390, and 0.490; all PIELTS scores correlated significantly with later performance, multiple regression showing that the effect of PLAB1 (β=0.496) was much stronger than the effect of IELTS (β=0.086). Changes to PLAB pass marks that would result in international medical graduate and UK medical graduate equivalence were assessed in two ways. Method 1 adjusted PLAB pass marks to equate median performance of PLAB

How international medical graduates view their learning needs for UK GP training.

Science.gov (United States)

Warwick, Christopher

2014-03-01

International medical graduates (IMGs) form a vital group of general practitioners (GPs) in the NHS. They are known to face additional challenges above and beyond those faced by UK medical graduates in the course of their GP training. Whilst they are a heterogeneous group of professionals, their views on what they need to learn, and how they are supported, are often distant from those of the educators responsible for planning their education. This study was undertaken, through narrative-based focus groups, to explore the issues which matter to the IMGs, in an attempt to empower their voices about their experiences in GP training, and to see what lessons could be drawn from these views. The findings confirmed the central importance, and considerable challenge involved, in making an effective transition into the culture of the NHS and UK general practice. The IMGs felt that induction needed to be an on-going, iterative process of learning which continued throughout training, with a more effective individualised learning needs analysis at the start of GP training. Lack of sophisticated language skills was highlighted as a real concern. Recognition that their lack of knowledge about the NHS at the start of training should not be seen as an indicator of deficiency, but a clue to what they needed to learn were also key messages. IMGs also felt the earlier in their training they undertook a GP placement, the quicker they would start to understand the culture of general practice in the UK. Further work following on from this research should include how to manage change in the educational network for these barriers to be overcome.

New UK graduates' knowledge of training and service provision within restorative dentistry - a survey.

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Kalsi, A S; Kochhar, S; Lewis, N J; Hemmings, K W

2017-06-09

Objective To assess new UK graduates' knowledge of training and service provision within restorative dentistry.Design A national descriptive cross-sectional survey.Subjects and methods An online survey assessing clinicians' knowledge of restorative dentistry, who had graduated within the last four years in the UK, was distributed across the UK via postgraduate dental deaneries. One-hundred responses were accepted as a sample of a potential population of 4,000.Main outcome measure How well respondents understood the service provision and training aspects of the specialty of restorative dentistry.Results The responses were received from graduates from a variety of dental schools across the UK. Of those respondents, 41 reported receiving career guidance within restorative dentistry. 45 new graduates were confident in their understanding of the specialty, while 53 were confident in the differences between restorative dentistry and monospecialty training. The respondents appeared unaware regarding treatment priorities within restorative dentistry departments. Most respondents felt that receiving teaching on restorative dentistry as a specialty and career pathway would be beneficial.Conclusion The results suggest that new graduates may benefit from clarification regarding the specialty of restorative dentistry, however, caution must be taken due to the limitations of the study.

Counseling Health Psychology: Assessing Health Psychology Training within Counseling Psychology Doctoral Programs

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Raque-Bogdan, Trisha L.; Torrey, Carrie L.; Lewis, Brian L.; Borges, Nicole J.

2013-01-01

Training directors of American Psychological Association-approved counseling psychology doctoral programs completed a questionnaire assessing (a) student and faculty involvement in health-related research, practice, and teaching; (b) health-related research conducted by students and faculty; and (c) programs' expectations and ability to…

Use of structured musculoskeletal examination routines in undergraduate medical education and postgraduate clinical practice - a UK survey.

Science.gov (United States)

Baker, Kenneth F; Jandial, Sharmila; Thompson, Ben; Walker, David; Taylor, Ken; Foster, Helen E

2016-10-21

Structured examination routines have been developed as educational resources for musculoskeletal clinical skills teaching, including Gait-Arms-Legs-Spine (GALS), Regional Examination of the Musculoskeletal System (REMS) and paediatric GALS (pGALS). In this study, we aimed to assess the awareness and use of these examination routines in undergraduate medical teaching in UK medical schools and UK postgraduate clinical practice. Electronic questionnaires were distributed to adult and paediatric musculoskeletal teaching leads at UK medical schools and current UK doctors in training. Responses were received from 67 tutors representing teaching at 22/33 [67 %] of all UK medical schools, and 70 trainee doctors across a range of postgraduate training specialities. There was widespread adoption, at responding medical schools, of the adult examination routines within musculoskeletal teaching (GALS: 14/16 [88 %]; REMS: 12/16 [75 %]) and assessment (GALS: 13/16 [81 %]; REMS: 12/16 [75 %]). More trainees were aware of GALS (64/70 [91 %]) than REMS (14/67 [21 %]). Of the 39 trainees who used GALS in their clinical practice, 35/39 [90 %] reported that it had improved their confidence in musculoskeletal examination. Of the 17/22 responding medical schools that included paediatric musculoskeletal examination within their curricula, 15/17 [88 %] used the pGALS approach and this was included within student assessment at 4 medical schools. We demonstrate the widespread adoption of these examination routines in undergraduate education and significant uptake in postgraduate clinical practice. Further study is required to understand their impact upon clinical performance.

GPs' job satisfaction: doctors who chose general practice early or late.

Science.gov (United States)

Lambert, Trevor; Smith, Fay; Goldacre, Michael

2013-11-01

In the UK many practising GPs did not choose general practice as their first choice of career when they originally graduated as doctors. To compare job satisfaction of GPs who chose general practice early or later in their career. Questionnaires were sent to all UK-trained doctors who graduated in selected years between 1993 and 2000. Questionnaires were sent to the doctors 1, 3, 7 and 10 years after graduation. Of all 3082 responders working in general practice in years 7 and 10, 38% had first specified general practice as their preferred career when responding 1 year after graduation, 19% by year 3, 21% by year 5, and 22% after year 5. Job satisfaction was high and, generally, there was little difference between the first three groups (although, when different, the most positive responses were from the earliest choosers); but there were slightly lower levels of job satisfaction in the 'more than 5 years' group. For example, in response to the statement 'I find enjoyment in my current post', the percentages agreeing in the four groups, respectively, were 91.5%, 91.1%, 91.0% and 88.2%. In response to 'I am doing interesting and challenging work' the respective percentages were 90.2%, 88.0%, 86.6% and 82.6%. Job satisfaction levels were generally high among the late choosers as well as the early choosers. On this evidence, most doctors who turn to general practice, after preferring another specialty in their early career, are likely to have a satisfying career.

Conflict management: a primer for doctors in training

Science.gov (United States)

Saltman, D C; O'Dea, N A; Kidd, M R

2006-01-01

Conflict in the health arena is a growing concern and is well recognised for doctors in training. Its most extreme expression, workplace violence is on the increase. There is evidence that many conflicts remain unsatisfactorily resolved or unresolved, and result in ongoing issues for staff morale. This paper describes the nature of conflict in the health care system and identifies the difference between conflict and disagreement. Using a conflict resolution model, strategies for dealing with conflict as it arises are explored and tips are provided on how to effectively manage conflict to a satisfactory resolution for all parties. PMID:16397073

Conflict management: a primer for doctors in training.

Science.gov (United States)

Saltman, D C; O'Dea, N A; Kidd, M R

2006-01-01

Conflict in the health arena is a growing concern and is well recognised for doctors in training. Its most extreme expression, workplace violence is on the increase. There is evidence that many conflicts remain unsatisfactorily resolved or unresolved, and result in ongoing issues for staff morale. This paper describes the nature of conflict in the health care system and identifies the difference between conflict and disagreement. Using a conflict resolution model, strategies for dealing with conflict as it arises are explored and tips are provided on how to effectively manage conflict to a satisfactory resolution for all parties.

Integrated surgical academic training in the UK: a cross-sectional survey.

Science.gov (United States)

Blencowe, Natalie S; Glasbey, James C; McElnay, Philip J; Bhangu, Aneel; Gokani, Vimal J; Harries, Rhiannon L

2017-10-01

This study aimed to explore variations in the provision of integrated academic surgical training across the UK. This is an online cross-sectional survey (consisting of 44 items with a range of free-text, binomial and 5-point Likert scale responses) developed by the Association of Surgeons in Training. A self-reported survey instrument was distributed to academic surgical trainees across the UK (n=276). 143 (51.9%) responses were received (81% male, median age: 34 years), spanning all UK regions and surgical specialties. Of the 143 trainees, 29 were core trainees (20.3%), 99 were specialty trainees (69.2%) and 15 (10.5%) described themselves as research fellows. The structure of academic training varied considerably, with under a third of trainees receiving guaranteed protected time for research. Despite this, however, 53.1% of the respondents reported to be satisfied with how their academic training was organised. Covering clinical duties during academic time occurred commonly (72.7%). Although most trainees (n=88, 61.5%) met with their academic supervisor at least once a month, six (4.2%) never had an academic supervisory meeting. Most trainees (n=90, 62.9%) occupied a full-time rota slot and only 9.1% (n=13) described their role as 'supernumerary'. Although 58.7% (n=84) of the trainees were satisfied with their clinical competence, 37.8% (n=54) felt that clinical time focused more on service provision than the acquisition of technical skills. 58 (40.6%) had experienced some form of negative sentiment relating to their status as an academic trainee. Integrated academic training presents unique challenges and opportunities within surgery. This survey has identified variation in the quality of current programmes, meaning that the future provision of integrated surgical academic training should be carefully considered. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is

How policy can help develop and sustain workforce capacity in UK dementia research: insights from a career tracking analysis and stakeholder interviews.

Science.gov (United States)

Marjanovic, Sonja; Lichten, Catherine A; Robin, Enora; Parks, Sarah; Harte, Emma; MacLure, Calum; Walton, Clare; Pickett, James

2016-08-31

To identify research support strategies likely to be effective for strengthening the UK's dementia research landscape and ensuring a sustainable and competitive workforce. Interviews and qualitative analysis; systematic internet search to track the careers of 1500 holders of UK doctoral degrees in dementia, awarded during 1970-2013, to examine retention in this research field and provide a proxy profile of the research workforce. 40 interviewees based in the UK, whose primary role is or has been in dementia research (34 individuals), health or social care (3) or research funding (3). Interviewees represented diverse fields, career stages and sectors. While the UK has diverse strengths in dementia research, needs persist for multidisciplinary collaboration, investment in care-related research, supporting research-active clinicians and translation of research findings. There is also a need to better support junior and midlevel career opportunities to ensure a sustainable research pipeline and future leadership. From a sample of 1500 UK doctorate holders who completed a dementia-related thesis in 1970-2013, we identified current positions for 829 (55%). 651 (43% of 1500) could be traced and identified as still active in research (any field) and 315 (21%) as active in dementia research. Among recent doctoral graduates, nearly 70% left dementia research within 4-6 years of graduation. A dementia research workforce blueprint should consider support for individuals, institutions and networks. A mix of policy interventions are needed, aiming to attract and retain researchers; tackle bottlenecks in career pathways, particularly at early and midcareer stages (eg, scaling-up fellowship opportunities, rising star programmes, bridge-funding, flexible clinical fellowships, leadership training); and encourage research networks (eg, doctoral training centres, succession and sustainability planning). Interventions should also address the need for coordinated investment to improve

The impact of mentoring during postgraduate training on doctors' career success.

Science.gov (United States)

Stamm, Martina; Buddeberg-Fischer, Barbara

2011-05-01

Although mentoring is perceived as key to a successful and satisfying career in medicine, there is a lack of methodologically sound studies to support this view. This study made use of a longitudinal design to investigate the impact of mentoring during postgraduate specialist training on the career success of doctors. We analysed data pertaining to 326 doctors (172 women, 52.8%; 154 men, 47.2%) from a cohort of medical school graduates participating in the prospective SwissMedCareer Study, assessing personal characteristics, the possession of a mentor, mentoring support provided by the development network, and career success. The impact of personal characteristics on having a mentor was investigated using multiple linear regression analysis. The impacts of having a mentor and of having development network mentoring support on career success were analysed using hierarchical multiple regression analysis. Up to 50% of doctors reported having a mentor. A significant gender difference was found, with fewer female than male doctors having a mentor (40.7% versus 60.4% at the fifth assessment; p ≤ 0.001). Apart from gender, significant predictors of having a mentor were instrumentality (β = 0.24, p ≤ 0.01) and extraprofessional concerns (β = -0.15, p ≤ 0.05). Both having a mentor and having career support from the development network were significant predictors of both objective (β = 0.15, p ≤ 0.01; β = 0.17, p ≤ 0.01) and subjective (β = 0.17, p ≤ 0.01; β = 0.14, p ≤ 0.05) career success, but not of career satisfaction. This study confirmed the positive impact of mentoring on career success in a cohort of Swiss doctors in a longitudinal design. However, female doctors, who are mentored less frequently than male doctors, appear to be disadvantaged in this respect. Formal mentoring programmes could reduce barriers to mentorship and promote the career advancement of female doctors in particular. © Blackwell Publishing Ltd 2011.

Influence of training changes on the stability of specialty choices of UK medical graduates: surveys of the graduates of 2002 and 2008.

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Svirko, Elena; Lambert, Trevor W; Goldacre, Michael J

2015-01-01

To explore the impact of Modernising Medical Careers (MMC) training on the stability of medical career choices in the UK. Graduates of 2002 and 2008 from all UK medical schools, 1 and 3 years postgraduation. Questionnaire surveys were conducted of 2002 and 2008 graduates from all UK medical schools 1 and 3 years post graduation. Doctors gave their specialty choice(s) and rated the influence of each of 11 factors on their career choice. 2008 graduates were a little more likely than graduates of 2002 to retain their year 1 choice in year 3 (77.3% vs. 73.3%; p = 0.002). Among 2008 graduates, the percentage retaining their year 1 choice varied between 42% (clinical oncology) and 79% (general practice). Enthusiasm for a specialty, student experience and inclinations before medical school were associated with choice retention; consideration of domestic circumstances and hours/working conditions were associated with changes of choice. 2008 graduates were more likely than 2002s to be influenced by enthusiasm for a specialty, self-appraisal of their skills, working hours and their domestic circumstances; and less likely to be influenced by their experience of jobs, a particular teacher/department or eventual financial prospects. Post-MMC, graduates were less likely to change their career choice and more likely to be motivated by personal factors and self-assessment of their suitability to a particular area of work. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Physical activity education in the undergraduate curricula of all UK medical schools. Are tomorrow's doctors equipped to follow clinical guidelines?

OpenAIRE

Weiler, Richard; Chew, Stephen; Coombs, Ngaire; Hamer, Mark; Stamatakis, Emmanuel

2012-01-01

Physical activity (PA) is a cornerstone of disease prevention and treatment. There is, however, a considerable disparity between public health policy, clinical guidelines and the delivery of physical activity promotion within the National Health Service in the UK. If this is to be addressed in the battle against non-communicable diseases, it is vital that tomorrow's doctors understand the basic science and health benefits of physical activity. The aim of this study was to assess the provision...

Results of a psychosomatic training program in China, Vietnam and Laos: successful cross-cultural transfer of a postgraduate training program for medical doctors.

Science.gov (United States)

Fritzsche, Kurt; Scheib, Peter; Ko, Nayeong; Wirsching, Michael; Kuhnert, Andrea; Hick, Jie; Schüßler, Gerhard; Wu, Wenyuan; Yuan, Shen; Cat, Nguyen Huu; Vongphrachanh, Sisouk; Linh, Ngo Tich; Viet, Ngyuen Kim

2012-08-29

With the "ASIA-LINK" program, the European Community has supported the development and implementation of a curriculum of postgraduate psychosomatic training for medical doctors in China, Vietnam and Laos. Currently, these three countries are undergoing great social, economic and cultural changes. The associated psychosocial stress has led to increases in psychological and psychosomatic problems, as well as disorders for which no adequate medical or psychological care is available, even in cities. Health care in these three countries is characterized by the coexistence of Western medicine and traditional medicine. Psychological and psychosomatic disorders and problems are insufficiently recognized and treated, and there is a need for biopsychosocially orientated medical care. Little is known about the transferability of Western-oriented psychosomatic training programs in the Southeast Asian cultural context. The curriculum was developed and implemented in three steps: 1) an experimental phase to build a future teacher group; 2) a joint training program for future teachers and German teachers; and 3) training by Asian trainers that was supervised by German teachers. The didactic elements included live patient interviews, lectures, communication skills training and Balint groups. The training was evaluated using questionnaires for the participants and interviews of the German teachers and the future teachers. Regional training centers were formed in China (Shanghai), Vietnam (Ho Chi Minh City and Hue) and Laos (Vientiane). A total of 200 physicians completed the training, and 30 physicians acquired the status of future teacher. The acceptance of the training was high, and feelings of competence increased during the courses. The interactive training methods were greatly appreciated, with the skills training and self-experience ranked as the most important topics. Adaptations to the cultural background of the participants were necessary for the topics of "breaking bad

Results of a psychosomatic training program in China, Vietnam and Laos: successful cross-cultural transfer of a postgraduate training program for medical doctors

Directory of Open Access Journals (Sweden)

Fritzsche Kurt

2012-08-01

Full Text Available Abstract Background With the “ASIA-LINK” program, the European Community has supported the development and implementation of a curriculum of postgraduate psychosomatic training for medical doctors in China, Vietnam and Laos. Currently, these three countries are undergoing great social, economic and cultural changes. The associated psychosocial stress has led to increases in psychological and psychosomatic problems, as well as disorders for which no adequate medical or psychological care is available, even in cities. Health care in these three countries is characterized by the coexistence of Western medicine and traditional medicine. Psychological and psychosomatic disorders and problems are insufficiently recognized and treated, and there is a need for biopsychosocially orientated medical care. Little is known about the transferability of Western-oriented psychosomatic training programs in the Southeast Asian cultural context. Methods The curriculum was developed and implemented in three steps: 1 an experimental phase to build a future teacher group; 2 a joint training program for future teachers and German teachers; and 3 training by Asian trainers that was supervised by German teachers. The didactic elements included live patient interviews, lectures, communication skills training and Balint groups. The training was evaluated using questionnaires for the participants and interviews of the German teachers and the future teachers. Results Regional training centers were formed in China (Shanghai, Vietnam (Ho Chi Minh City and Hue and Laos (Vientiane. A total of 200 physicians completed the training, and 30 physicians acquired the status of future teacher. The acceptance of the training was high, and feelings of competence increased during the courses. The interactive training methods were greatly appreciated, with the skills training and self-experience ranked as the most important topics. Adaptations to the cultural background of the

Impact of reduction in working hours for doctors in training on postgraduate medical education and patients' outcomes: systematic review.

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Moonesinghe, S R; Lowery, J; Shahi, N; Millen, A; Beard, J D

2011-03-22

To determine whether a reduction in working hours of doctors in postgraduate medical training has had an effect on objective measures of medical education and clinical outcome. Systematic review. Medline, Embase, ISI Web of Science, Google Scholar, ERIC, and SIGLE were searched without language restriction for articles published between 1990 and December 2010. Reference lists and citations of selected articles. Studies that assessed the impact of a change in duty hours using any objective measure of outcome related to postgraduate medical training, patient safety, or clinical outcome. Any study design was eligible for inclusion. 72 studies were eligible for inclusion: 38 reporting training outcomes, 31 reporting outcomes in patients, and three reporting both. A reduction in working hours from greater than 80 hours a week (in accordance with US recommendations) does not seem to have adversely affected patient safety and has had limited effect on postgraduate training. Reports on the impact of European legislation limiting working hours to less than 56 or 48 a week are of poor quality and have conflicting results, meaning that firm conclusions cannot be made. Reducing working hours to less than 80 a week has not adversely affected outcomes in patient or postgraduate training in the US. The impact of reducing hours to less than 56 or 48 a week in the UK has not yet been sufficiently evaluated in high quality studies. Further work is required, particularly in the European Union, using large multicentre evaluations of the impact of duty hours' legislation on objective educational and clinical outcomes.

Training needs in adolescent medicine of practising doctors: a Swiss national survey of six disciplines.

Science.gov (United States)

Kraus, Barbara; Stronski, Susanne; Michaud, Pierre-André

2003-08-01

To assess and compare the training needs in adolescent medicine of doctors within 6 specialties as a basis for the development of pre/postgraduate and continuing medical education (CME) training curricula. Cross-sectional postal survey. Switzerland. National, representative, random sample of 1857 practising doctors in 6 disciplines (general practitioners, paediatricians, gynaecologists, internists, psychiatrists, child psychiatrists) registered with the Swiss Medical Association. Perceived importance of and training interest in 35 topics related to adolescent medicine listed in a self-administered, anonymous questionnaire. A total of 1367 questionnaires were returned, representing a response rate of 73.9%. Clear interest in adolescent medicine was reported by 62.1% of respondents. Topics perceived to be the most important in everyday practice were functional symptoms (71.4%), acne (67.1%), obesity (64.6%), depression-anxiety (68.1%) and communication with adolescents (61.7%). Differences between disciplines were especially marked for gynaecologists, who expressed interest almost exclusively in medical topics specific to their field. In contrast, other disciplines commonly reported a keen interest in psychosocial problems. Accordingly, interest in further training was expressed mostly for functional symptoms (62.4%), eating disorders (56.3%), depression-anxiety (53.7%) and obesity (52.6%). Issues related to injury prevention, chronic disease and confidentiality were rated as low priorities. Regardless of discipline, Swiss primary care doctors expressed a strong interest in adolescent medicine. Continuing medical education courses should include both interdisciplinary courses and discipline-specific sessions. Further training should address epidemiological and legal/ethical issues (e.g. injury prevention, confidentiality, impact of chronic conditions).

Training at the masters degree level in physics and technology of nuclear reactors in the uk

International Nuclear Information System (INIS)

Weaver, D.R.

2000-01-01

This paper discusses the current situation of university-based training for the nuclear power industry in the UK, drawing on information gathered as part of the survey for a review currently being undertaken by the Committee for Technical and Economic Studies on Nuclear Energy Development and Fuel Cycle (NDC) of the Nuclear Energy Agency (NEA) of the OECD. A particular focus will be the Physics and Technology of Nuclear Reactors MSc course at the University of Birmingham. In the past there were other similar MSc courses in the UK, but through the evolution of time the Birmingham course is now unique in its role of providing masters level training so specifically aimed at the commercial nuclear programme. Mention will, however, be made of other training at the postgraduate level elsewhere in the UK. A description is given of the need to consider a new form of relationship between industry and university in order to provide optimise the provision of masters level training. (author)

Stress, burnout and doctors' attitudes to work are determined by personality and learning style: a twelve year longitudinal study of UK medical graduates.

Science.gov (United States)

McManus, I C; Keeling, A; Paice, E

2004-08-18

The study investigated the extent to which approaches to work, workplace climate, stress, burnout and satisfaction with medicine as a career in doctors aged about thirty are predicted by measures of learning style and personality measured five to twelve years earlier when the doctors were applicants to medical school or were medical students. Prospective study of a large cohort of doctors. The participants were first studied when they applied to any of five UK medical schools in 1990. Postal questionnaires were sent to all doctors with a traceable address on the current or a previous Medical Register. The current questionnaire included measures of Approaches to Work, Workplace Climate, stress (General Health Questionnaire), burnout (Maslach Burnout Inventory), and satisfaction with medicine as a career and personality (Big Five). Previous questionnaires had included measures of learning style (Study Process Questionnaire) and personality. Doctors' approaches to work were predicted by study habits and learning styles, both at application to medical school and in the final year. How doctors perceive their workplace climate and workload is predicted both by approaches to work and by measures of stress, burnout and satisfaction with medicine. These characteristics are partially predicted by trait measures of personality taken five years earlier. Stress, burnout and satisfaction also correlate with trait measures of personality taken five years earlier. Differences in approach to work and perceived workplace climate seem mainly to reflect stable, long-term individual differences in doctors themselves, reflected in measures of personality and learning style.

Learning From The Past and Planning For The Future: The Challenges Of And Solutions For Integrating Aging Into Doctoral Psychology Training

Science.gov (United States)

Holtzer, Roee; Zweig, Richard A.; Siegel, Lawrence J.

2013-01-01

The long forecast “elder boom” has begun. Beginning in 2011, ten thousand members of the “baby boom” generation began turning 65 each day. This demographic shift in our society mandates that pre-doctoral programs in clinical psychology incorporate aging as an integral component of their core and elective training. While fully supporting the concept of broad and general training for predoctoral professional psychology programs, we maintain that the infusion of aging into doctoral psychology training curricula has been inadequate. In this manuscript we provide an overview of geropsychology training models and discuss the challenges involved in incorporating aging to the curriculum of pre-doctoral training in clinical psychology. Potential solutions and examples for accelerating infusion of aging knowledge base are discussed in the context of different geropsychology training models. We conclude that providing services to this rapidly growing segment of our population presents both an employment opportunity to broaden the reach of our profession as well as an ethical responsibility to train future professionals who will practice within their area of knowledge and expertise. PMID:23483705

Improving core medical training--innovative and feasible ideas to better training.

Science.gov (United States)

Tasker, Fiona; Dacombe, Peter; Goddard, Andrew F; Burr, Bill

2014-12-01

A recent survey of UK core medical training (CMT) training conducted jointly by the Royal College of Physicians (RCP) and Joint Royal College of Physicians Training Board (JRCPTB) identified that trainees perceived major problems with their training. Service work dominated and compromised training opportunities, and of great concern, almost half the respondents felt that they had not been adequately prepared to take on the role of medical registrar. Importantly, the survey not only gathered CMT trainees' views of their current training, it also asked them for their 'innovative and feasible ways to improve CMT'. This article draws together some of these excellent ideas on how the quality of training and the experience of trainees could be improved. It presents a vision for how CMT trainees, consultant supervisors, training programme directors, clinical directors and managers can work together to implement relevant, feasible and affordable ways to improve training for doctors and deliver the best possible care for patients. © 2014 Royal College of Physicians.

Patient-doctor relationship: the practice orientation of doctors in Kano.

Science.gov (United States)

Abiola, T; Udofia, O; Abdullahi, A T

2014-01-01

Attitude and orientation of doctors to the doctor-patient relationship has a direct influence on delivery of high quality health- care. No study to the knowledge of these researchers has so far examined the practice orientation of doctors in Nigeria to this phenomenon. The aims of this study were to determine the orientation of Kano doctors to the practice of doctor-patient relationship and physicians' related-factors. Participants were doctors working in four major hospitals (i.e., two federal-owned and two state-owned) servicing Kano State and its environs. The Patient-Practitioner Orientation Scale (PPOS) and a socio-demographic questionnaire were completed by the 214 participants. The PPOS has 18 items and measures three parameters of a total score and two dimension of "sharing" and "caring". The mean age of participants was 31.72 years (standard deviation = 0.87), with 22% being females, 40.7% have been practicing for ≥ 6 years and about two-third working in federal-owned health institution. The Cronbach's alpha of total PPOS scores was 0.733 and that of two sub-scale scores of "sharing" and "caring" were 0.659 and 0.546 respectively. Most of the doctors' orientation (92.5%) was towards doctor-centered (i.e., paternalistic) care, majority (75.2%) upheld the view of not sharing much information and control with patients, and showing little interest in psychosocial concerns of patients (i.e., 'caring'=93.0%). Respondents' characteristics that were significantly associated with high doctor 'caring' relationship orientation were being ≥ 30-year-old and practicing for ≥ 6 years. Working in State-owned hospitals was also significantly associated with high doctor "sharing" orientation. This paper demonstrated why patient-centered medical interviewing should be given top priority in medical training in Nigeria, and particularly for federal health institutions saddled with production of new doctors and further training for practicing doctors.

Grade of a doctor does not influence acquisition of knowledge and skill during CPR training in a developing country

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Olufemi B Bankole

2014-01-01

Full Text Available Background: Our teaching hospitals have different grades of doctors with varied exposure to cardiac arrest settings and their resuscitation skills are often inadequate. Objectives: We investigated whether the grade of a doctor influenced acquisition of knowledge and skill during cardiopulmonary resuscitation (CPR training in Nigeria. Materials and Methods: Doctors who attended a two-day resuscitation training program between December 2007 and April 2009 were scored on their knowledge of Basic Life Support, Advanced Life Support, and performance at five skill stations. A pass mark was awarded for a post-test score ≥ 75% and a pass in all skill stations. Results: A total of 130 doctors were studied with a mean of 10.99 ± 6.51 years since medical qualification (range, 2-28 years. The mean pre-test score was 54.43 ± 16.10% (range 30.5-91.8% while the mean post-test score was 88.48 ± 6.8% (range, 54.6-94%, (P < 0.001. Mean post-test scores were not significantly different between grades. Mean scores for questions on Basic Life Support, defibrillator use, and drug therapy and in performance at skill stations were not significantly different between grades. A significant difference however existed in questions on cardiac arrest rhythms (P = 0.031. Sixty-five participants (50% passed the post-test at first attempt. Consultants, senior registrars, and registrars had pass rates of 59.2%, 53.6%, and 43.5% respectively (P = 0.336. After re-training at performance stations, 124 doctors (95.4% passed the test with no significant difference in overall pass in the various grades (P = 0.605. Conclusion : Grade of doctor did not affect the acquisition of knowledge and skill during resuscitation training.

WorldSkills UK Training Managers: Midas Touch or Fool's Gold?

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Wilde, Stephanie; Relly, Susan James

2015-01-01

This article focuses on the role of training managers (TMs) in UK participation in WorldSkills Competitions (WSC). The TM role is outlined, according to the perceptions of the TMs, and there is analysis of the benefits to them of participation, as well as the barriers they face, and the benefits and barriers available to participating further…

Preparation to care for confused older patients in general hospitals: a study of UK health professionals.

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Griffiths, Amanda; Knight, Alec; Harwood, Rowan; Gladman, John R F

2014-07-01

in the UK, two-thirds of patients in general hospitals are older than 70, of whom half have dementia or delirium or both. Our objective was to explore doctors, nurses and allied health professionals' perceptions of their preparation to care for confused older patients on general hospital wards. : using a quota sampling strategy across 11 medical, geriatric and orthopaedic wards in a British teaching hospital, we conducted 60 semi-structured interviews with doctors, nurses and allied healthcare professionals and analysed the data using the Consensual Qualitative Research approach. : there was consensus among participants that education, induction and in-service training left them inadequately prepared and under-confident to care for confused older patients. Many doctors reported initial assessments of confused older patients as difficult. They admitted inadequate knowledge of mental health disorders, including the diagnostic features of delirium and dementia. Handling agitation and aggression were considered top priorities for training, particularly for nurses. Multidisciplinary team meetings were highly valued but were reported as too infrequent. Participants valued specialist input but reported difficulties gaining such support. Communication with confused patients was regarded as particularly challenging, both in terms of patients making their needs known, and staff conveying information to patients. Participants reported emotional and behavioural responses including frustration, stress, empathy, avoidance and low job satisfaction. : our findings indicate that a revision of training across healthcare professions in the UK is required, and that increased specialist support should be provided, so that the workforce is properly prepared to care for older patients with cognitive problems. © The Author 2013. Published by Oxford University Press on behalf of the British Geriatrics Society.

Doctor-patient communication skills training in mainland China: a systematic review of the literature.

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Liu, Xinchun; Rohrer, Wesley; Luo, Aijing; Fang, Zhou; He, TianHua; Xie, Wenzhao

2015-01-01

To conduct a systematic review of studies on doctor-patient communication skills training (CST) for medical students and physicians in mainland China. We retrieved articles from six electronic databases, and searched additional eligible papers by checking reference lists. Chinese or English-language studies focused on CST and implemented in mainland China were applied to the pre-determined criteria. Articles included were further reviewed under the following categories: participant; training strategy; assessment; and outcome. 20 studies met the inclusion criteria. 90% of the CST improved trainees' communication skills using a strategy which included a didactic component combined with practical rehearsal and feedback. The duration of training varied substantially. A lack of enhancement in empathy, and the use of open-ended questions were reported. 83% of the assessment instruments were self-designed and most lacked reliability and validity testing. Only two of the included studies evaluated patient satisfaction. The majority of included studies attained statistically significant improvements. Chinese doctors and medical students' communication skills can be enhanced through CST. Future studies in China should place stronger emphasis on the development of training strategies, validation of the assessment instruments, and evaluation of patient satisfaction affected by CST. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

A survey-based cross-sectional study of doctors' expectations and experiences of non-technical skills for Out of Hours work.

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Brown, Michael; Shaw, Dominick; Sharples, Sarah; Jeune, Ivan Le; Blakey, John

2015-02-16

The skill set required for junior doctors to work efficiently and safely Out of Hours (OoH) in hospitals has not been established. This is despite the OoH period representing 75% of the year and it being the time of highest mortality. We set out to explore the expectations of medical students and experiences of junior doctors of the non-technical skills needed to work OoH. Survey-based cross-sectional study informed by focus groups. Online survey with participants from five large teaching hospitals across the UK. 300 Medical Students and Doctors Participants ranked the importance of non-technical skills, as identified by literature review and focus groups, needed for OoH care. The focus groups revealed a total of eight non-technical skills deemed to be important. In the survey 'Task Prioritisation' (mean rank 1.617) was consistently identified as the most important non-technical skill. Stage of training affected the ranking of skills, with significant differences for 'Communication with Senior Doctors', 'Dealing with Clinical Isolation', 'Task Prioritisation' and 'Communication with Patients'. Importantly, there was a significant discrepancy between the medical student expectations and experiences of doctors undertaking work. Our findings suggest that medical staff particularly value task prioritisation skills; however, these are not routinely taught in medical schools. The discrepancy between expectations of students and experience of doctors reinforces the idea that there is a gap in training. Doctors of different grades place different importance on specific non-technical skills with implications for postgraduate training. There is a pressing need for medical schools and deaneries to review non-technical training to include more than communication skills. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Stress, burnout and doctors' attitudes to work are determined by personality and learning style: A twelve year longitudinal study of UK medical graduates

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Paice E

2004-08-01

Full Text Available Abstract Background The study investigated the extent to which approaches to work, workplace climate, stress, burnout and satisfaction with medicine as a career in doctors aged about thirty are predicted by measures of learning style and personality measured five to twelve years earlier when the doctors were applicants to medical school or were medical students. Methods Prospective study of a large cohort of doctors. The participants were first studied when they applied to any of five UK medical schools in 1990. Postal questionnaires were sent to all doctors with a traceable address on the current or a previous Medical Register. The current questionnaire included measures of Approaches to Work, Workplace Climate, stress (General Health Questionnaire, burnout (Maslach Burnout Inventory, and satisfaction with medicine as a career and personality (Big Five. Previous questionnaires had included measures of learning style (Study Process Questionnaire and personality. Results Doctors' approaches to work were predicted by study habits and learning styles, both at application to medical school and in the final year. How doctors perceive their workplace climate and workload is predicted both by approaches to work and by measures of stress, burnout and satisfaction with medicine. These characteristics are partially predicted by trait measures of personality taken five years earlier. Stress, burnout and satisfaction also correlate with trait measures of personality taken five years earlier. Conclusions Differences in approach to work and perceived workplace climate seem mainly to reflect stable, long-term individual differences in doctors themselves, reflected in measures of personality and learning style.

Stress, burnout and doctors' attitudes to work are determined by personality and learning style: A twelve year longitudinal study of UK medical graduates

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McManus, IC; Keeling, A; Paice, E

2004-01-01

Background The study investigated the extent to which approaches to work, workplace climate, stress, burnout and satisfaction with medicine as a career in doctors aged about thirty are predicted by measures of learning style and personality measured five to twelve years earlier when the doctors were applicants to medical school or were medical students. Methods Prospective study of a large cohort of doctors. The participants were first studied when they applied to any of five UK medical schools in 1990. Postal questionnaires were sent to all doctors with a traceable address on the current or a previous Medical Register. The current questionnaire included measures of Approaches to Work, Workplace Climate, stress (General Health Questionnaire), burnout (Maslach Burnout Inventory), and satisfaction with medicine as a career and personality (Big Five). Previous questionnaires had included measures of learning style (Study Process Questionnaire) and personality. Results Doctors' approaches to work were predicted by study habits and learning styles, both at application to medical school and in the final year. How doctors perceive their workplace climate and workload is predicted both by approaches to work and by measures of stress, burnout and satisfaction with medicine. These characteristics are partially predicted by trait measures of personality taken five years earlier. Stress, burnout and satisfaction also correlate with trait measures of personality taken five years earlier. Conclusions Differences in approach to work and perceived workplace climate seem mainly to reflect stable, long-term individual differences in doctors themselves, reflected in measures of personality and learning style. PMID:15317650

Faculty of health sciences, walter sisulu university: training doctors from and for rural South african communities.

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Iputo, Jehu E

2008-10-01

Introduction The South African health system has disturbing inequalities, namely few black doctors, a wide divide between urban and rural sectors, and also between private and public services. Most medical training programs in the country consider only applicants with higher-grade preparation in mathematics and physical science, while most secondary schools in black communities have limited capacity to teach these subjects and offer them at standard grade level. The Faculty of Health Sciences at Walter Sisulu University (WSU) was established in 1985 to help address these inequities and to produce physicians capable of providing quality health care in rural South African communities. Intervention Access to the physician training program was broadened by admitting students who obtained at least Grade C (60%) in mathematics and physical science at standard grade, and who demonstrated appropriate personal attributes. An innovative curriculum, combining problem-based learning with community-based education (PBL/CBE) in small tutorial group settings, was also adopted. This approach was aimed at educating and graduating a broader cohort of students, while training future doctors to identify, analyze, and treat health problems in the rural South African context. Outcomes To date, 745 doctors (72% black Africans) have graduated from the program, and 511 students (83% black Africans) are currently enrolled. After the PBL/CBE curriculum was adopted, the attrition rate for black students dropped from 23% to 80%, and the proportion of students graduating within the minimum period rose from 55% to >70%. Many graduates are still completing internships or post-graduate training, but preliminary research shows that 36% percent of graduates practice in small towns and rural settings. Further research is underway to evaluate the impact of their training on health services in rural Eastern Cape Province and elsewhere in South Africa. Conclusions The WSU program increased access to

Summer research training provides effective tools for underrepresented minorities to obtain doctoral level degrees

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The ethnic, racial, and cultural diversity of the USA is not reflected in its healthcare and biomedical workforce. Undergraduate research programs are used to encourage underrepresented minorities to pursue training for biomedical careers, but there is limited published data on doctoral degree compl...

Cardiopulmonary resuscitation standards for clinical practice and training in the UK.

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Gabbott, David; Smith, Gary; Mitchell, Sarah; Colquhoun, Michael; Nolan, Jerry; Soar, Jasmeet; Pitcher, David; Perkins, Gavin; Phillips, Barbara; King, Ben; Spearpoint, Ken

2005-07-01

The Royal College of Anaesthetists, the Royal College of Physicians, the Intensive Care Society and the Resuscitation Council (UK) have published new resuscitation standards. The document provides advice to UK healthcare organisations, resuscitation committees and resuscitation officers on all aspects of the resuscitation service. It includes sections on resuscitation training, resuscitation equipment, the cardiac arrest team, cardiac arrest prevention, patient transfer, post-resuscitation care, audit and research. The document makes several recommendations. Healthcare institutions should have, or be represented on, a resuscitation committee that is responsible for all resuscitation issues. Every institution should have at least one resuscitation officer responsible for teaching and conducting training in resuscitation techniques. Staff with patient contact should be given regular resuscitation training appropriate to their expected abilities and roles. Clinical staff should receive regular training in the recognition of patients at risk of cardiopulmonary arrest and the measures required for the prevention of cardiopulmonary arrest. Healthcare institutions admitting acutely ill patients should have a resuscitation team, or its equivalent, available at all times. Clear guidelines should be available indicating how and when to call for the resuscitation team. Cardiopulmonary arrest should be managed according to current national guidelines. Resuscitation equipment should be available throughout the institution for clinical use and for training. The practice of resuscitation should be audited to maintain and improve standards of care. A do not attempt resuscitation (DNAR) policy should be compiled, communicated to relevant members of staff, used and audited regularly. Funding must be provided to support an effective resuscitation service.

Surgical and procedural skills training at medical school - a national review.

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Davis, Christopher R; Toll, Edward C; Bates, Anthony S; Cole, Matthew D; Smith, Frank C T

2014-01-01

This national study quantifies procedural and surgical skills training at medical schools in the United Kingdom (UK), a stipulated requirement of all graduates by the General Medical Council (GMC). A questionnaire recorded basic procedural and surgical skills training provided by medical schools and surgical societies in the UK. Skills were extracted from (1) GMC Tomorrows Doctors and (2) The Royal College of Surgeons Intercollegiate Basic Surgical Skills (BSS) course. Data from medical school curricula and extra-curricular student surgical societies were compared against the national GMC guidelines and BSS course content. Data were analysed using Mann-Whitney U tests. Representatives from 23 medical schools completed the survey (71.9% response). Thirty one skills extracted from the BSS course were split into 5 categories, with skills content cross referenced against GMC documentation. Training of surgical skills by medical schools was as follows: Gowning and gloving (72.8%), handling instruments (29.4%), knot tying (17.4%), suturing (24.7%), other surgical techniques (4.3%). Surgical societies provided significantly more training of knot tying (64.4%, P = 0.0013) and suturing (64.5%, P = 0.0325) than medical schools. Medical schools provide minimal basic surgical skills training, partially supplemented by extracurricular student surgical societies. Our findings suggest senior medical students do not possess simple surgical and procedural skills. Newly qualified doctors are at risk of being unable to safely perform practical procedures, contradicting GMC Guidelines. We propose a National Undergraduate Curriculum in Surgery and Surgical Skills to equip newly qualified doctors with basic procedural skills to maximise patient safety. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

Perceived causes of differential attainment in UK postgraduate medical training: a national qualitative study

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Woolf, K. V. M.; Rich, A.; Viney, R.; Needleman, S.; Griffin, A.

2016-01-01

Objectives: Explore trainee doctors’ experiences of postgraduate training and perceptions of fairness in relation to ethnicity and country of primary medical qualification. Design: Qualitative semistructured focus group and interview study. Setting: Postgraduate training in England (London, Yorkshire and Humber, Kent Surrey and Sussex) and Wales. Participants: 137 participants (96 trainees, 41 trainers) were purposively sampled from a framework comprising: doctors ...

Evaluation of a novel individualised communication-skills training intervention to improve doctors' confidence and skills in end-of-life communication.

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Clayton, Josephine M; Butow, Phyllis N; Waters, Amy; Laidsaar-Powell, Rebekah C; O'Brien, Angela; Boyle, Frances; Back, Anthony L; Arnold, Robert M; Tulsky, James A; Tattersall, Martin H N

2013-03-01

We developed a novel individualised training program regarding end-of-life communication, designed to be time effective for busy junior-doctors working in hospital settings. We aimed to pilot this brief individualised training program with junior-doctors to explore its acceptability, feasibility and effect on the doctors' confidence, communication skills, attitudes towards psychosocial care and burnout. The content of the training intervention was informed by a systematic literature review and evidence-based clinical practice guidelines regarding end-of-life communication. The intervention was based on sound educational principles and involved three one-hour teaching sessions over a three-week period, including two individual sessions with an expert facilitator and simulated patient/caregiver. In addition, participants received written and audiovisual take-home learning materials. PARTICIPANTS were videotaped consulting with a simulated patient/caregiver pre/post training to assess the impact of the course on their communication behaviours. PARTICIPANTS completed de-identified questionnaires pre/post training, including self-assessed confidence, attitudes to psychosocial care, and the Maslach Burnout inventory. PARTICIPANTS included 22 junior-doctors from a large teaching hospital in Sydney, Australia. All participants reported that the training was useful, had been helpful for their communication with patients and that they would recommend the training to others. Significant improvements were found in participants' communication skills (in seven out of 21 specific and all three global communication behaviours assessed, range P=0.02 to confidence in communicating about relevant topics (P<0.001), attitudes towards psychosocial care (P=0.03) and sense of personal accomplishment (P=0.043). There were no overall differences in participants' burnout levels. This intervention shows promise and warrants further formal evaluation.

What do UK medical students value most in their careers? A discrete choice experiment.

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Cleland, Jennifer A; Johnston, Peter; Watson, Verity; Krucien, Nicolas; Skåtun, Diane

2017-08-01

Many individual- and job-related factors are known to influence medical careers decision making. Previous research has extensively studied medical trainees' (residents') and students' views of the factors that are important. However, how trainees and students trade off these factors at times of important careers-related decision making is under-researched. Information about trade-offs is crucial to the development of effective policies to enhance the recruitment and retention of junior doctors. Our aim was to investigate the strength of UK medical students' preferences for the characteristics of training posts in terms of monetary value. We distributed a paper questionnaire that included a discrete choice experiment (DCE) to final-year medical students in six diverse medical schools across the UK. The main outcome measure was the monetary value of training post characteristics, based on willingness to forgo and willingness to accept extra income for a change in each job characteristic calculated from regression coefficients. A total of 810 medical students answered the questionnaire. The presence of good working conditions was by far the most influential characteristic of a training position. Medical students consider that, as newly graduated doctors, they will require compensation of an additional 43.68% above average earnings to move from a post with excellent working conditions to one with poor working conditions. Female students value excellent working conditions more highly than male students, whereas older medical students value them less highly than younger students. Students on the point of completing medical school and starting postgraduate training value good working conditions significantly more than they value desirable geographical location, unit reputation, familiarity with the unit or opportunities for partners or spouses. This intelligence can be used to address the crisis in workforce staffing that has developed in the UK and opens up fruitful

EXPERIENCE OF USING ADVANCED INFORMATION TECHNOLOGIES IN TRAINING FUTURE TRANSLATORS IN UK UNIVERSITIES

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E.V. Dolinskyi

2013-08-01

Full Text Available The quality of teaching is not only to use the Internet or e-learning. The novelty of the information and communication technology is to change the orientation of training, the transition to the creation of online and e-learning systems, but also remains an unsolved problem of adaptation of new materials. With IT students develop creativity, independence, professionalism. Interactive technologies provide various kinds of user interaction (sound, images, animations, etc. and is a basic tool for the creation of computer training programs. The synthesis of traditional and modern information technology is based on the activity- when learning activities are the subject of training and help to create an overview of the professional activities of an interpreter as a purposeful, active, long-term process of learning. Using an interdisciplinary approach makes it possible to seamlessly integrate the knowledge of linguistics and computer science, linguistics and psychology. The purpose of this paper is the analysis of experience in the use of new information technologies in the training of future translators in UK universities. In this research we identified the most common programs used in the preparation of translators, substantiated the possibility of their application, named the city and universities in the UK where such training is carried out.

Guidelines for Education and Training at the Doctoral and Postdoctoral Levels in Consulting Psychology/Organizational Consulting Psychology

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American Psychologist, 2007

2007-01-01

The purpose of these "Guidelines for Education and Training at the Doctoral and Postdoctoral Levels in Consulting Psychology/Organizational Consulting Psychology" is to provide a common framework for use in the development, evaluation, and review of education and training in consulting psychology/organizational consulting psychology (CP/OCP). The…

Purist or Pragmatist? UK Doctoral Scientists' Moral Positions on the Knowledge Economy

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Hancock, Sally; Hughes, Gwyneth; Walsh, Elaine

2017-01-01

Doctoral scientists increasingly forge non-academic careers after completing the doctorate. Governments and industry in advanced economies welcome this trend, since it complements the "knowledge economy" vision that has come to dominate higher education globally. Knowledge economy stakeholders consider doctoral scientists to constitute…

What am I going to say here? The experiences of doctors and nurses communicating with patients in a cancer unit

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Margaret eMcLean

2011-11-01

Full Text Available This paper describes a study investigating the provider-patient communication perceptions, experiences, needs and strategies of doctors and nurses working together in a UK cancer setting. This was a qualitative study using individual interviews and focus group discussions. Interpretative Phenomenological analysis (IPA was used to underpin data collection and analysis. Twenty-six staff participated in the project (18 nurses and 8 doctors. Both professional groups identified an inherent emotional strain in their daily interactions with patients. The strategies they adopted to reduce this strain fell into two main categories: 1 Handling or managing the patient to keep negative emotion at bay; and 2 Managing self to keep negative emotion at bay. These strategies allowed staff to maintain a sense of control in an emotionally-stressful environment. Most believed that their communication skills were sufficient. In conclusion, communicating with and caring for cancer patients causes considerable psycho-social burden for doctors and nurses. Managing this burden influences their communication with patients. Without recognition of the need for staff to protect their own emotional well-being, communication skills training programmes, emphasised in current UK cancer care guidelines, may have little impact on practice.

Can the transition process from foundation doctor to neurosurgical specialty trainee be improved through “learner-centered induction programs”?

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Acharya V

2015-10-01

Full Text Available Vikas Acharya,1 Sami Mansour,2 Samuel M Amis,3 Amir Reyahi3 1Department of Neurosurgery, University Hospitals Coventry and Warwickshire, 2Warwick Medical School, University of Warwick, Coventry, 3Luton and Dunstable University Hospital, Luton, UK Abstract: The transition period from foundation program doctor to specialty trainee can be difficult for junior doctors. This difficult period often acts as a major obstacle for learning in the workplace. Existing induction programs are commonly seen as inadequate at easing this transition, and therefore, a pilot study intervention was undertaken to assess if the initiation of “learner-centered induction programs” could help improve the confidence, knowledge acquisition, and satisfaction of junior doctors as they begin specialty training in neurosurgery. Ethnographic and anecdotal evidences were collated from junior doctors, specialty trainees, and consultants in order to investigate if further work on this subject would be beneficial. All participants were working in the Department of Neurosurgery at University Hospital Coventry and Warwickshire, Coventry, UK, over a 4-week period in March/April 2015. A review of the relevant literature was also undertaken. This report found that despite the reservations around the increased organizational demands of induction programs of this nature, as well as concerns around a single junior doctor covering the ward alone during the induction period, feedback following the intervention was largely positive. Junior doctors appreciated being taught about their roles and responsibilities from their predecessors as well as deciding among themselves what topics they wanted covering. As a result, the induction sessions tended to focus on clinical skills rather than theoretical knowledge, which most of the junior doctors believed they could cover adequately in their own time. The junior doctors felt that they benefited from learning/refreshing their relevant practical

Training Professional Archaeologists in the UK - meeting the crisis of success

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Kenneth Aitchison

2002-09-01

Full Text Available In the UK, increased levels of developer funding has led to increased demand for archaeological fieldworkers, the producers of the primary data upon which all archaeological work and research depends. But archaeologists entering the profession are underskilled – while increasing numbers of students are receiving archaeological degrees, recent graduates do not have the levels of practical knowledge that are required to work on major projects. This skills shortage is not restricted to junior fieldstaff. Throughout the profession there is a lack of structured vocational learning, and training is undervalued both by organisations and individuals. This article discusses archaeologists' engagement with the challenge of creating a skilled archaeological profession in the UK.

Skill set development of doctoral and post-doctoral graduates in life sciences.

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Kanwar, R S

2010-01-01

Doctoral and post-doctoral training programs at leading research universities in the USA are highly important in generating the much needed knowledge in science, technology, engineering, and mathematics for keeping rural and urban economies strong and societies healthy and prosperous. In addition, innovative graduate and post doctoral research programs are the driving engines of the success of U.S. economy and have made the U.S. the most successful model of generating new knowledge in the broader areas of life sciences (and agricultural education, research, and extension). We need to do everything in our power to make these training programs innovative, collaborative, independent, and resourceful so that students are trained in different disciplines making them more flexible within a range of challenges and opportunities. The training programs must empower students to solve complex and interdisciplinary problems of the society in 21st century and make our students competitive within a global economic system, to improve the health of the nation's economy. If our land grant schools and institutions of higher learning are not preparing doctoral students to be globally competitive scientists to create new knowledge and technologies to solve complex and interdisciplinary problems of the 21st century, then either we need to redefine the mission of our land grant system or we risk losing our role to serve the public and industry effectively. Doctoral and post doctoral students should be given the needed skills and experiences to prepare them for tenure track faculty jobs at leading US Universities in the 21st century as well as prepare them for the world outside of academia. I would say minimum competency skills are needed as "bare survival skills" for all doctoral students to become successful after obtaining PhD degrees. Today's PhD students will be working in a global but highly competitive, rapidly changing, and complex world. It is no longer enough to be a good

Newly qualified doctors' views on the significance and accessibility of career advice during medical training in Saudi Arabia.

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Mehmood, Syed Imran; Norcini, John J; Borleffs, Jan C C

2013-01-01

Career advice is an important instrument to help students with the proper specialty selection. The study aims (1) to explore the views of newly graduated doctors in Saudi Arabia about their experience with the current status of career support system during medical training and (2) to identify cross-cultural similarities and differences. A cross-sectional design study was conducted using a questionnaire to elicit the responses of participants from newly qualified doctors concerning the availability and significance of career advice. SPSS (version 11.0; Chicago, IL) was used to analyze the data and statistical tests, such as chi-square and unpaired t tests, were used to analyze the observations. A response rate of 94.7% was obtained. Among this group, 102 were males and 78 were females. Only 53% did receive career advice. The majority of men felt that career advice during medical studies was inadequate, while women were less negative (69% versus 32%; p = 0.0001). Furthermore, men were more disappointed about the possibilities for career advice after graduating than women (34% versus 13%, p = 0.0001). The results show that only half of newly graduated doctors had received any career advice during medical training. As the health care system cannot afford the potential waste of time and resources for doctors, career guidance should begin in undergraduate training so that the process of thinking about their future career starts longtime before they make their career choice.

Synthetic biology in the UK - An outline of plans and progress.

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Clarke, L J; Kitney, R I

2016-12-01

Synthetic biology is capable of delivering new solutions to key challenges spanning the bioeconomy, both nationally and internationally. Recognising this significant potential and the associated need to facilitate its translation and commercialisation the UK government commissioned the production of a national Synthetic Biology Roadmap in 2011, and subsequently provided crucial support to assist its implementation. Critical infrastructural investments have been made, and important strides made towards the development of an effectively connected community of practitioners and interest groups. A number of Synthetic Biology Research Centres, DNA Synthesis Foundries, a Centre for Doctoral Training, and an Innovation Knowledge Centre have been established, creating a nationally distributed and integrated network of complementary facilities and expertise. The UK Synthetic Biology Leadership Council published a UK Synthetic Biology Strategic Plan in 2016, increasing focus on the processes of translation and commercialisation. Over 50 start-ups, SMEs and larger companies are actively engaged in synthetic biology in the UK, and inward investments are starting to flow. Together these initiatives provide an important foundation for stimulating innovation, actively contributing to international research and development partnerships, and helping deliver useful benefits from synthetic biology in response to local and global needs and challenges.

Doctoral education in the nuclear sector; La formacion de doctores en el sector nuclear

Energy Technology Data Exchange (ETDEWEB)

Minguez, E.

2013-03-01

Doctoral aducation is a major priority for European universities. In the context of the Bologna Process the importance of doctoral education as the third cycle of higher education and the first stage of a young researchers career, and thus in linking the European Higher Education and Research Areas, was first highlighted in the 2003 Berlin Report. The core component of doctoral training is the advancement of knowledge through original research. considering the need for structured doctoral programs and the need for transparent supervision and assessment, we note that the normal workload of the third cycle in most countries would correspond 3-4 years full time. This is spirit of the new Spanish Doctoral Law. Then, universities should ensure that their doctoral programmes promote interdisciplinary training and the development of transferable skills, thus meeting the needs of the wider employment market. We need to achieve and overall increase in the numbers of doctoral candidates taking up research careers as early stage researchers and also increase the employability as a normal way as it is the case of other advance countries. In Spain, universities with doctoral nuclear programmes and the CIEMAT, with the sponsorship of the nuclear sector, a doctoral school in nuclear science and engineering should be created to enhance the research careers of Young students for the future of nuclear activities in Spain. (Author)

Attitudes towards attrition among UK trainees in obstetrics and gynaecology.

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Gafson, Irene; Currie, Jane; O'Dwyer, Sabrina; Woolf, Katherine; Griffin, Ann

2017-06-02

Physician dissatisfaction in the workplace has consequences for patient safety. Currently in the UK, 1 in 5 doctors who enter specialist training in obstetrics and gynaecology leave the programme before completion. Trainee attrition has implications for workforce planning, organization of health-care services and patient care. The authors conducted a survey of current trainees' and former trainees' views concerning attrition and 'peri-attrition' - a term coined to describe the trainee who has seriously considered leaving the specialty. The authors identified six key themes which describe trainees' feelings about attrition in obstetrics and gynaecology: morale and undermining; training processes and paperwork; support and supervision; work-life balance and realities of life; NHS environment; and job satisfaction. This article discusses themes of an under-resourced health service, bullying, lack of work-life balance and poor personal support.

UK doctors’ views on the implementation of the European Working Time Directive as applied to medical practice: a qualitative analysis

Science.gov (United States)

Clarke, Rachel T; Pitcher, Alex; Lambert, Trevor W; Goldacre, Michael J

2014-01-01

Objectives To report on what doctors at very different levels of seniority wrote, in their own words, about their concerns about the European Working Time Directive (EWTD) and its implementation in the National Health Service (NHS). Design All medical school graduates from 1993, 2005 and 2009 were surveyed by post and email in 2010. Setting The UK. Methods Using qualitative methods, we analysed free-text responses made in 2010, towards the end of the first year of full EWTD implementation, of three cohorts of the UK medical graduates (graduates of 1993, 2005 and 2009), surveyed as part of the UK Medical Careers Research Group's schedule of multipurpose longitudinal surveys of doctors. Results Of 2459 respondents who gave free-text comments, 279 (11%) made unprompted reference to the EWTD; 270 of the 279 comments were broadly critical. Key themes to emerge included frequent dissociation between rotas and actual hours worked, adverse effects on training opportunities and quality, concerns about patient safety, lowering of morale and job satisfaction, and attempts reportedly made in some hospitals to persuade junior doctors to collude in the inaccurate reporting of compliance. Conclusions Further work is needed to determine whether problems perceived with the EWTD, when they occur, are attributable to the EWTD itself, and shortened working hours, or to the way that it has been implemented in some hospitals. PMID:24503304

Have restricted working hours reduced junior doctors' experience of fatigue? A focus group and telephone interview study.

Science.gov (United States)

Morrow, Gill; Burford, Bryan; Carter, Madeline; Illing, Jan

2014-03-06

To explore the effects of the UK Working Time Regulations (WTR) on trainee doctors' experience of fatigue. Qualitative study involving focus groups and telephone interviews, conducted in Spring 2012 with doctors purposively selected from Foundation and specialty training. Final compliance with a 48 h/week limit had been required for trainee doctors since August 2009. Framework analysis of data. 9 deaneries in all four UK nations; secondary care. 82 doctors: 53 Foundation trainees and 29 specialty trainees. 36 participants were male and 46 female. Specialty trainees were from a wide range of medical and surgical specialties, and psychiatry. Implementation of the WTR, while acknowledged as an improvement to the earlier situation of prolonged excessive hours, has not wholly overcome experience of long working hours and fatigue. Fatigue did not only arise from the hours that were scheduled, but also from an unpredictable mixture of shifts, work intensity (which often resulted in educational tasks being taken home) and inadequate rest. Fatigue was also caused by trainees working beyond their scheduled hours, for reasons such as task completion, accessing additional educational opportunities beyond scheduled hours and staffing shortages. There were also organisational, professional and cultural drivers, such as a sense of responsibility to patients and colleagues and the expectations of seniors. Fatigue was perceived to affect efficiency of skills and judgement, mood and learning capacity. Long-term risks of continued stress and fatigue, for doctors and for the effective delivery of a healthcare service, should not be ignored. Current monitoring processes do not reflect doctors' true working patterns. The effectiveness of the WTR cannot be considered in isolation from the culture and context of the workplace. On-going attention needs to be paid to broader cultural issues, including the relationship between trainees and seniors.

Doctors Today

LENUS (Irish Health Repository)

Murphy, JFA

2012-03-01

Doctors’ relationship with patients and their role in society is changing. Until the 1960s doctors concentrated on the welfare of patients with less emphasis placed on patients’ rights1. Over recent decades there has been increasing empowerment of the individual across all facets of society including health care. Doctors continue to be perceived as having expertise and authority over medical science. Patients, however, now hold sway over questions of values or preferences. We all must be aware of this change in the doctor- patient interaction. We need to be more aware of the outcomes that patients view as important. The concept of shared decision-making with the patient is now widely appreciated. The process involves a change in mind set particularly for doctors who trained in an earlier era.

A national survey exploring UK trainees' perceptions, core training experience, and decisions to pursue advanced training in breast radiology.

Science.gov (United States)

Lowes, S; Bydder, M; Sinnatamby, R

2017-11-01

To investigate UK radiology trainees' perceptions of breast radiology and the factors that influenced their decision whether or not to choose breast radiology as an area of special interest. An online survey was compiled and distributed to all UK specialty trainees in clinical radiology via the Royal College of Radiologists Junior Radiologists' Forum (JRF) regional representatives. There were 275 respondents, representing 22% of all UK radiology trainees. Responses were received from all regions. A significant factor identified in influencing whether or not trainees decide to pursue advanced training in breast radiology is the timing and quality of their initial core training experience. Specific positive aspects of breast radiology that were repeatedly identified included the high level of patient contact and frequent use of interventional procedures. Recurring negative aspects of breast radiology included isolation from general radiology and finding the subject matter boring. Breast radiology faces a significant workforce shortfall that is predicted to worsen in the coming years. There has never been a greater need to recruit specialty trainees into this field, and action is urgently needed to help ensure the sustainability of breast services and drive further improvements to patient care. The findings from this survey should be regarded as a challenge to all breast radiologists to engage with trainees from an early stage in their training and to enthuse them with the many positive aspects of a career in breast radiology. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Undergraduate Training in Human Sexuality-Evaluation of the Impact on Medical Doctors' Practice Ten Years After Graduation.

Science.gov (United States)

Clegg, Mary; Pye, Joanne; Wylie, Kevan R

2016-09-01

It has been suggested that an indicator of a doctor's ability to assess patients' sexual function relates to the level of earlier training. The amount and quality of training the doctor receives at the undergraduate level and beyond could contribute to the doctor's confidence and competence. To evaluate whether doctors found that the teaching in human sexuality received at medical school was sufficient for their future practice and whether their chosen medical specialty and exposure to issues related to sexual health affected this opinion. One hundred seventy doctors maintaining contact with the University of Sheffield Medical School Alumni Office after qualifying in 2004 were sent self-completion postal questionnaires. Space was allocated for supplementary comments to their answers. Self-completion postal questionnaire. Although the response rate was low, there appeared to be an impact of the teaching of human sexuality on the clinical practice of doctors. More than two-thirds of respondents rated the teaching as useful and more than 70% felt more confident in diagnosing and managing male and female sexual issues. The results show a link between the undergraduate teaching of sexual medicine and education and a subsequent proactive approach to sexuality issues; unfortunately, the study does not provide any information about the level of skills or ability in this field of medicine. We have confirmed that the Sheffield model might be suitable for teaching sexual medicine issues in the United Kingdom but cannot confirm that the current format is suitable for international undergraduate audiences. Future study could include other medical schools and a comparison of sexual medicine practice among physicians who received undergraduate medical education and overall numbers could be increased to compare current practice with the number of hours of sexual medicine education as a key parameter. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

The impact of shift patterns on junior doctors' perceptions of fatigue, training, work/life balance and the role of social support.

Science.gov (United States)

Brown, M; Tucker, P; Rapport, F; Hutchings, H; Dahlgren, A; Davies, G; Ebden, P

2010-12-01

The organisation of junior doctors' work hours has been radically altered following the partial implementation of the European Working Time Directive. Poorly designed shift schedules cause excessive disruption to shift workers' circadian rhythms. Interviews and focus groups were used to explore perceptions among junior doctors and hospital managers regarding the impact of the European Working Time Directive on patient care and doctors' well-being. Four main themes were identified. Under "Doctors shift rotas", doctors deliberated the merits and demerits of working seven nights in row. They also discussed the impact on fatigue of long sequences of day shifts. "Education and training" focused on concerns about reduced on-the-job learning opportunities under the new working time arrangements and also about the difficulties of finding time and energy to study. "Work/life balance" reflected the conflict between the positive aspects of working on-call or at night and the impact on life outside work. "Social support structures" focused on the role of morale and team spirit. Good support structures in the work place counteracted and compensated for the effects of negative role stressors, and arduous and unsocial work schedules. The impact of junior doctors' work schedules is influenced by the nature of specific shift sequences, educational considerations, issues of work/life balance and by social support systems. Poorly designed shift rotas can have negative impacts on junior doctors' professional performance and educational training, with implications for clinical practice, patient care and the welfare of junior doctors.

Safe working hours--doctors in training a best practice issue.

Science.gov (United States)

Lewis, Andrew

2002-01-01

In 1995, the Australian Medical Association launched its Safe Working Hours campaign. By 1998, this had been developed into a National Code of Conduct that continues to resonate in the Australian public health system. However, and particularly in respect of Doctors in Training (DITs) who continue to work long hours, there are levels of resistance to proposals that seek to re-organise work or change prevailing professional and cultural expectations. Long working hours have substantial impacts on a DIT's capacity to consistently deliver high quality patient care, dilute the effectiveness of their training regime and have negative consequences on their health, social life and family responsibilities. While public hospitals often maintain the view that minimal budget flexibility restricts their capacity to affect change in a positive way, in fact devisable productivity and efficiency gains can be achieved by reducing working hours. Further, the medical profession needs to consider whether long hours provide an optimal environment for quality learning and performance.

A comparison of best practices for doctoral training in Europe and North America.

Science.gov (United States)

Barnett, Joey V; Harris, Robert A; Mulvany, Michael J

2017-10-01

The PhD degree was established in Berlin 200 years ago and has since spread across the whole world. While there is general agreement that the degree is awarded in recognition of successfully completed research training, there have been significant differences in the way doctoral training programs have developed in particular countries. There is, however, a clear global tendency to follow the programs currently used either in the United States or in Europe. To determine more clearly how US and European PhD programs are both similar and different, we have used a validated questionnaire to analyze biomedical PhD programs in four representative institutions at Vanderbilt University, University of Manitoba, Karolinska Institutet, and Graz Medical University. The analysis is based on 63 detailed questions concerning the research environment, outcomes, admission criteria, content of programs, mentoring (or supervising), the PhD thesis, assessment of the thesis, and PhD school structure. The results reveal that while there is considerable overlap in the aims and content of PhD programs, there are also considerable differences regarding the structure of PhD programs, mentoring and assessment of PhD theses. These differences are analyzed in detail in order to provide a foundation for discussion of their relative advantages and disadvantages, with a view to providing a platform for discussion of best practices. The results will be of importance in the continued development of global discussion about development of doctoral training.

Educational challenges faced by international medical graduates in the UK

Directory of Open Access Journals (Sweden)

Hashim A

2017-06-01

Full Text Available Ahmed Hashim Gastroenterology Department, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK Introduction: International medical graduates (IMGs in the UK constitute approximately one-quarter of the total number of doctors registered in the General Medical Council (GMC. The transition of IMGs into the health care system in the UK is accompanied by significant sociocultural and educational challenges. This study aims to explore the views of IMGs in medical training on the educational challenges they face.Methods: This study was conducted in the Kent, Surrey and Sussex region in 2015. All IMGs who work in medical (physicianly training programs were included. Data were collected through a questionnaire and semi-structured interviews. Thematic approach was used to analyze the qualitative data.Results: Of the total 61 IMGs included, 17 responded to the survey and 3 were interviewed. The common educational barriers faced by IMGs were related to lack of appreciation of the values and structure of the National Health Service (NHS, ethical and medicolegal issues, receiving feedback from colleagues and the different learning strategies in the UK. IMGs suggested introduction of a mandatory dedicated induction program in the form of formal teaching sessions. They also believed that a supervised shadowing period prior in the first job in the UK would be beneficial. Further assessment areas should be incorporated into the prequalifying examinations to address specific educational needs such as NHS structure and hospital policies. Other measures such as buddying schemes with senior IMGs and educating NHS staff on different needs of IMGs should also be considered.Conclusion: This study highlighted important educational challenges faced by IMGs and generated relevant solutions. However, the opinions of the supervisors and other health care professionals need to be explored. Keywords: international medical graduates, IMG, educational barriers

Expert consensus statement 'Neonatologist-performed Echocardiography (NoPE)'-training and accreditation in UK.

Science.gov (United States)

Singh, Yogen; Gupta, Samir; Groves, Alan M; Gandhi, Anjum; Thomson, John; Qureshi, Shakeel; Simpson, John M

2016-02-01

Targeted echocardiographic assessments of haemodynamic status are increasingly utilised in many settings. Application in the neonatal intensive care units (NICU) is increasingly demanded but challenging given the risk of underlying structural lesions. This statement follows discussions in UK led by the Neonatologists with an Interest in Cardiology and Haemodynamics (NICHe) group in collaboration with the British Congenital Cardiac Association (BCCA) and the Paediatricians with Expertise in Cardiology Special Interest Group (PECSIG). Clear consensus was agreed on multiple aspects of best practice for neonatologist-performed echocardiogram (NoPE)-rigorous attention to infection control and cardiorespiratory/thermal stability, early referral to paediatric cardiology with suspicion of structural disease, reporting on standardised templates, reliable image storage, regular skills maintenance, collaboration with a designated paediatric cardiologist, and regular scan audit/review. It was agreed that NoPE assessments should confidently exclude structural lesions at first scan. Practitioners would be expected to screen and establish gross normality of structure at first scan and obtain confirmation from paediatric cardiologist if required, and subsequently, functional echocardiography can be performed for haemodynamic assessment to guide management of newborn babies. To achieve training, NICHe group suggested that mandatory placements could be undertaken during core registrar training or neonatal subspecialty grid training with a paediatric cardiology placement for 6 months and a neonatology placement for a minimum of 6 months. In the future, we hope to define a precise curriculum for assessments. Technological advances may provide solutions-improvements in telemedicine may have neonatologists assessing haemodynamic status with paediatric cardiologists excluding structural lesions and neonatal echocardiography simulators could increase exposure to multiple pathologies and

Interventions for improving patients' trust in doctors and groups of doctors.

Science.gov (United States)

Rolfe, Alix; Cash-Gibson, Lucinda; Car, Josip; Sheikh, Aziz; McKinstry, Brian

2014-03-04

the studies.  Interventions were of three main types; three employed additional physician training, four were education for patients and three provided additional information about doctors in terms of financial incentives or consulting style. Additionally, several different measures of trust were employed.The studies gave conflicting results. Trials showing a small but statistically-significant increase in trust included: a trial of physician disclosure of financial incentives; a trial of providing choice of physician based on concordance between patient and physician beliefs about care; a trial of group visits for new inductees into a Health Maintenance Organisation; a trial of training oncologists in communication skills; and a trial of group visits for diabetic patients. However, trust was not affected in a subsequent larger trial of group visits for uninsured people with diabetes, nor with a decision aid for helping choose statins, another trial of disclosure of financial incentives or specifically training doctors to increase trust or cultural competence. There was no evidence of harm from any of the studies. Overall, there remains insufficient evidence to conclude that any intervention may increase or decrease trust in doctors. This may be due in part to the sensitivity of trust instruments, and a ceiling effect, as trust in doctors is generally high. It may be that current measures of trust are insufficiently sensitive. Further trials are required to explore the impact of doctors' specific training or the use of a patient-centred or decision-sharing approach on patients' trust, especially in the areas of healthcare provider choice, and induction into healthcare organisation. International trials would be of particular benefit. The review was constrained by the lack of consistency between trust measurements, timeframes and populations.

Talking to Your Doctor

Medline Plus

Full Text Available ... Trials and You Talking to Your Doctor Science Education Resources Community Resources Clear Health A–Z Publications ... Research & Training Medical Research Initiatives Science Highlights Science Education Research in NIH Labs & Clinics Training Opportunities Library ...

The efficiency of training for doctors of general practice — family medicine concerning to features work of teenagers at risk

Directory of Open Access Journals (Sweden)

Bobkova O.V.

2016-05-01

Full Text Available Medical personnel provide assistance to teenagers and young people because of understanding their problems and a common search for ways to resolve them to change risky behavior and health. A major problem for doctors of general practice — family medicine is the condition of adolescent morbidity diseases that are transmitted mainly through sexual contact, HIV infection, which requires the formation of the teenagers responsible attitude to their own health. Doctor of general practice — family medicine should actively influence on health status, including reproductive health specified target group of patients. The aim of the study was analysis of the effectiveness of educational training on( monitoring and evaluation M & E within the scientific support project «HIV prevention among young women of sex business, people who inject drugs and young people who live or work on the street» and development of an effective system of improving professional qualification of doctors of general practice — family medicine relative characteristics of health care among risk adolescents. During 2015 there were trainings for doctors, psychologists, social workers and nurses. Investigation of the effectiveness of the activities performed on a specially designed questionnaire monitoring and evaluation (M & E. 53 respondents were interviewed — doctors of general practice — family medicine of the Zaporozhye region and the city. Zaporozhye. Questioning was conducted before and after training exercises investigated by experts of department of medical care teenagers and youth KU «Zaporozhye Regional Children Clinical Hospital.» The rating was given on a 5-point scale. The study made the following findings: therapeutic and preventive work with teenagers and young people, is one of the major problems of medical and social work in Ukraine and practice of general practitioner — family medicine; training on the basis of a single M & E system is an effective means

An evaluation of the utilisation of the virtual environment for radiotherapy training (VERT) in clinical radiotherapy centres across the UK

International Nuclear Information System (INIS)

James, Sarah; Dumbleton, Claire

2013-01-01

Aim: The purpose of the survey was to evaluate the utilisation of the Virtual Environment for Radiotherapy Training (VERT) in clinical radiotherapy centres across the UK. Methods: A survey questionnaire was constructed using the Survey Monkey™ tool to evaluate the utilisation of the Virtual Environment for Radiotherapy Training. Once constructed, an online link to the survey questionnaire was emailed to all radiotherapy centre managers in the UK (n = 67) who were invited to provide one response per centre. The survey comprised forty-five questions which were grouped into eleven sections. Key results: The results indicate that 61% of UK radiotherapy centres have VERT installed, twenty centres are currently without a VERT installation and only 1 centre is intending to install a system in the near future. The results also indicate that the use of VERT varies considerably in differing radiotherapy centres with the most frequent use of VERT being for the training of staff, specifically for the training of pre-registration therapeutic radiographers and preparation time for trainers. The majority of centres using VERT for any of the purposes investigated feel it provides benefits. Conclusions and recommendations: The survey highlighted the varied use of VERT in radiotherapy centres across the UK and indicated that when VERT is used in clinical radiotherapy centres, a wide variety of benefits are experienced. Because of the variation in use, it is concluded that the benefits of the VERT installations in radiotherapy centres across the UK are not being fully realised. It is recommended that all radiotherapy service managers commit adequate resources to develop and implement VERT fully and effectively so that its full potential is realised in all radiotherapy centres across the UK

The experience of international nursing students studying for a PhD in the U.K: A qualitative study.

Science.gov (United States)

Evans, Catrin; Stevenson, Keith

2011-06-13

Educating nurses to doctoral level is an important means of developing nursing capacity globally. There is an international shortage of doctoral nursing programmes, hence many nurses seek their doctorates overseas. The UK is a key provider of doctoral education for international nursing students, however, very little is known about international doctoral nursing students' learning experiences during their doctoral study. This paper reports on a national study that sought to investigate the learning expectations and experiences of overseas doctoral nursing students in the UK. Semi-structured qualitative interviews were conducted in 2008/09 with 17 international doctoral nursing students representing 9 different countries from 6 different UK universities. Data were analysed thematically. All 17 interviewees were enrolled on 'traditional' 3 year PhD programmes and the majority (15/17) planned to work in higher education institutions back in their home country upon graduation. Studying for a UK PhD involved a number of significant transitions, including adjusting to a new country/culture, to new pedagogical approaches and, in some cases, to learning in a second language. Many students had expected a more structured programme of study, with a stronger emphasis on professional nursing issues as well as research - akin to the professional doctorate. Students did not always feel well integrated into their department's wider research environment, and wanted more opportunities to network with their UK peers. A good supervision relationship was perceived as the most critical element of support in a doctoral programme, but good relationships were sometimes difficult to attain due to differences in student/supervisor expectations and in approaches to supervision. The PhD was perceived as a difficult and stressful journey, but those nearing the end reflected positively on it as a life changing experience in which they had developed key professional and personal skills. Doctoral

The experience of international nursing students studying for a PhD in the U.K: A qualitative study

Directory of Open Access Journals (Sweden)

Stevenson Keith

2011-06-01

Full Text Available Abstract Background Educating nurses to doctoral level is an important means of developing nursing capacity globally. There is an international shortage of doctoral nursing programmes, hence many nurses seek their doctorates overseas. The UK is a key provider of doctoral education for international nursing students, however, very little is known about international doctoral nursing students' learning experiences during their doctoral study. This paper reports on a national study that sought to investigate the learning expectations and experiences of overseas doctoral nursing students in the UK. Methods Semi-structured qualitative interviews were conducted in 2008/09 with 17 international doctoral nursing students representing 9 different countries from 6 different UK universities. Data were analysed thematically. All 17 interviewees were enrolled on 'traditional' 3 year PhD programmes and the majority (15/17 planned to work in higher education institutions back in their home country upon graduation. Results Studying for a UK PhD involved a number of significant transitions, including adjusting to a new country/culture, to new pedagogical approaches and, in some cases, to learning in a second language. Many students had expected a more structured programme of study, with a stronger emphasis on professional nursing issues as well as research - akin to the professional doctorate. Students did not always feel well integrated into their department's wider research environment, and wanted more opportunities to network with their UK peers. A good supervision relationship was perceived as the most critical element of support in a doctoral programme, but good relationships were sometimes difficult to attain due to differences in student/supervisor expectations and in approaches to supervision. The PhD was perceived as a difficult and stressful journey, but those nearing the end reflected positively on it as a life changing experience in which they had

'How do they want to know?' Doctors' perspectives on making and communicating a diagnosis of dementia.

Science.gov (United States)

Bailey, Cate; Dooley, Jemima; McCabe, Rose

2018-01-01

Recent drives to facilitate earlier identification of dementia have led to increased memory clinic referrals and diagnoses. This study explored the perspectives of memory clinic doctors on making and delivering diagnoses. Four focus groups were conducted with 13 psychiatrists and two geriatricians in the UK. Transcripts were coded line by line using NVIVO. Thematic analysis identified 39 categories, 18 sub-themes and eight overarching themes. Inter-rater reliability on 31% of the data was 0.89. Increased public awareness of dementia was viewed positively in facilitating access to diagnosis and treatment. Doctors viewed diagnosis as a process and expressed concerns about limited pre-diagnostic counselling and post-diagnostic support. In diagnostic delivery doctors sought to develop a narrative drawing on the patient's report of symptoms and adjust explanations to patient preferences and awareness. However, tailoring the delivery to the individual patient was challenging when meeting for the first time. These consultations often involved three participants (doctor, patient and relative), who were felt to have differing needs and expectations. Doctors emphasized that delicacy was required in deciding in what could be discussed in front of both parties, however also stressed the importance of explicitly naming 'dementia'. Efforts were made to balance honesty and hope when discussing prognosis and medication. The work was sometimes emotionally distressing, with limited supervision. Existing communication training was felt to be inadequate for consultations involving triads or people with cognitive impairment. Delivering a dementia diagnosis is a nuanced and challenging task. Negotiating honest descriptions of a life-limiting condition whilst instilling hope is further complicated when cognitive impairment affects comprehension. Misunderstandings at the time of feedback may limit patient opportunities for informed future planning afforded by early diagnosis. Doctors in

A Descriptive Analysis of the Use of Workplace-Based Assessments in UK Surgical Training.

Science.gov (United States)

Shalhoub, Joseph; Santos, Cristel; Bussey, Maria; Eardley, Ian; Allum, William

2015-01-01

Workplace-based assessments (WBAs) were introduced formally in the UK in 2007. The aim of the study was to describe the use of WBAs by UK surgical trainees and examine variations by training region, specialty, and level of training. The database of the Intercollegiate Surgical Curriculum Programme was examined for WBAs between August 2007 and July 2013, with in-depth analysis of 2 periods: August 2011 to July 2012 and August 2012 to July 2013. The numbers of validated WBAs per trainee per year increased more than 7-fold, from median 6 per trainee in 2007 to 2008, to 39 in 2011 to 2012, and 44 in 2012 to 2013. In the period 2011 to 2012, 58.4% of core trainees completed the recommended 40 WBAs, with only 38.1% of specialty trainees achieving 40 validated WBAs. In the period 2012 to 2013, these proportions increased to 67.7% and 57.0% for core and specialty trainees, respectively. Core trainees completed more WBAs per year than specialty trainees in the same training region. London core trainees completed the highest numbers of WBAs in both the periods 2011 to 2012 (median 67) and 2012 to 2013 (median 74). There was a peak in WBAs completed by London specialty trainees in the period 2012 to 2013 (median 63). The most validated WBAs were completed by ST1/CT1 (specialty surgical training year, core surgical training year), with a gradual decrease in median WBAs to ST4, followed by a plateau; in the period 2012 to 2013, there was an increase in WBAs at ST8. Core surgical trainees complete ~50% "operative" (procedure-based assessment/direct observation of procedural skills) and ~50% "nonoperative" assessments (case-based discussion/clinical evaluation exercise). During specialty training, procedure-based assessments represented ~46% of WBAs, direct observation of procedural skills 11.2%, case-based discussion ~23%, and clinical evaluation exercise ~15%. UK surgical trainees are, on an average, undertaking 1 WBA per week. Variation exists in use of WBAs between training

Aspirations to become an anaesthetist: longitudinal study of historical trends and trajectories of UK-qualified doctors' early career choices and of factors that have influenced their choices.

Science.gov (United States)

Emmanouil, Beatrice; Goldacre, Michael J; Lambert, Trevor W

2017-07-25

It is important to inform medical educators and workforce planners in Anaesthesia about early career choices for the specialty, factors that influence them and to elucidate how recent choices of men and women doctors relate to the overall historical trends in the specialty's popularity. We analysed longitudinal data on career choice, based on self-completed questionnaires, from national year-of-qualification cohorts of UK-trained doctors from 1974 to 2012 surveyed one, three and 5 years post-qualification. Career destination data 10 years post-qualification were used for qualifiers between 1993 and 2002, to investigate the association between early choice and later destinations. In years 1, 3 and 5 post-qualification, respectively, 59.9% (37,385), 64.6% (31,473), and 67.2% (24,971) of contactable doctors responded. There was an overall increase, from the early to the later cohorts, in the percentage of medical graduates who wished to enter anaesthesia: for instance year 1 choices rose from 4.6 to 9.4%, comparing the 1974 and 2012 cohorts. Men were more likely than women to express an early preference for a career in anaesthesia: for example, at year 3 after qualification anaesthesia was the choice of 10.1% of men and 7.9% of women. There was a striking increase in the certainty with which women chose anaesthesia as their future career specialty in recent compared to earlier cohorts, not reflected in any trends observed in men choosing anaesthesia. Sixty percent of doctors who were anaesthetists, 10 years after qualifying, had specified anaesthesia as their preferred specialty when surveyed in year 1, 80% in year 3, and 92% in year 5. Doctors working as anaesthetists were less likely than those working in other hospital specialties to have specified, as strong influences on specialty choice, 'experience of the subject' as students, 'inclinations before medical school', and 'what I really want to do'. Men anaesthetists were more influenced in their specialty

Doctoral e-Theses; experiences in harvesting on a national and European level

CERN Multimedia

CERN. Geneva

2007-01-01

In many countries in Europe doctoral e-theses are an integrated part of institutional repositories, which have been set up in recent years. In some countries they have been harvested on a national level, like in the Netherlands with the ‘Promise of Science’ portal (http://www.darenet.nl/promiseofscience) . In October 2006 SURFfoundation (The Netherlands), JISC (UK) and DIVA (funded through BIBSAM in Sweden) started a common project to harvest repositories with e-theses on an international scale and to set up a freely accessible European portal and test in practice the interoperability. The project, which aims at creating a value added service for doctoral e-Theses, will finish in June 2007. In the presentation we will show some lessons learned and the first results of the Demonstrator, an interoperable portal of European doctoral e-theses in five countries: Denmark, Germany, the Netherlands, Sweden and the UK. Furthermore, we will present the developments regarding the European coordination of doctoral...

Guidelines for Cognitive Behavioral Training within Doctoral Psychology Programs in the United States: Report of the Inter-Organizational Task Force on Cognitive and Behavioral Psychology Doctoral Education

Science.gov (United States)

Klepac, Robert K.; Ronan, George F.; Andrasik, Frank; Arnold, Kevin D.; Belar, Cynthia D.; Berry, Sharon L.; Christofff, Karen A.; Craighead, Linda W.; Dougher, Michael J.; Dowd, E. Thomas; Herbert, James D.; McFarr, Lynn M.; Rizvi, Shireen L.; Sauer, Eric M.; Strauman, Timothy J.

2012-01-01

The Association for Behavioral and Cognitive Therapies initiated an interorganizational task force to develop guidelines for integrated education and training in cognitive and behavioral psychology at the doctoral level in the United States. Fifteen task force members representing 16 professional associations participated in a yearlong series of…

Attitudes of newly qualified doctors towards a career in general practice: a qualitative focus group study.

Science.gov (United States)

Merrett, Alexandra; Jones, Daniel; Sein, Kim; Green, Trish; Macleod, Una

2017-04-01

A key element of the NHS is universal access to a GP. Recently, UK general practice has been described as being in crisis, with training places unfilled and multiple practices reporting vacancies or facing closure. The recruitment of GPs continues to be a key focus for both the Royal College of General Practitioners (RCGP) and the government. To understand the attitudes of newly qualified doctors towards a career in general practice, to appreciate potential reasons for the crisis in GP recruitment, and to recommend ways to improve recruitment. A qualitative study comprising five focus groups with 74 Foundation Year 1 (FY1) doctors from one Yorkshire deanery. Audio recordings were transcribed verbatim and thematic analysis undertaken. Foundation Year 1 doctors' thoughts towards a career in general practice were summarised in four themes: quality of life, job satisfaction, uncertainty surrounding the future of general practice, and the lack of respect for GPs among both doctors and the public. Participants felt that general practice could provide a good work-life balance, fair pay, and job stability. Job satisfaction, with the ability to provide care from the cradle to the grave, and to work within a community, was viewed positively. Uncertainties around future training, skill levels, pay, and workload, together with a perceived stigma experienced in medical schools and hospitals, were viewed as a deterrent to a career in general practice. This study has gathered the opinions of doctors at a critical point in their careers, before they choose a future specialty. Findings highlight areas of concern and potential deterrents to a career in general practice, together with recommendations to address these issues. © British Journal of General Practice 2017.

Doctoral education in the nuclear sector

International Nuclear Information System (INIS)

Minguez, E.

2013-01-01

Doctoral education is a major priority for European universities. In the context of the Bologna Process the importance of doctoral education as the third cycle of higher education and the first stage of a young researchers career, and thus in linking the European Higher Education and Research Areas, was first highlighted in the 2003 Berlin Report. The core component of doctoral training is the advancement of knowledge through original research. considering the need for structured doctoral programs and the need for transparent supervision and assessment, we note that the normal workload of the third cycle in most countries would correspond 3-4 years full time. This is spirit of the new Spanish Doctoral Law. Then, universities should ensure that their doctoral programmes promote interdisciplinary training and the development of transferable skills, thus meeting the needs of the wider employment market. We need to achieve and overall increase in the numbers of doctoral candidates taking up research careers as early stage researchers and also increase the employability as a normal way as it is the case of other advance countries. In Spain, universities with doctoral nuclear programmes and the CIEMAT, with the sponsorship of the nuclear sector, a doctoral school in nuclear science and engineering should be created to enhance the research careers of Young students for the future of nuclear activities in Spain. (Author)

Choose your doctorate.

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Jolley, Jeremy

2007-02-01

The development of education options for nurses has been inexorable and it is increasingly the case that senior nurses are considering a doctorate as the logical next step in their educational career. Such individuals need to make important decisions as to whether they should embark on a taught doctorate, professional doctorate or a traditional PhD. Each of these options will necessitate a considerable investment in time and money as well as the sacrifice of quality time and spare time over a significant number of years. A doctorate is not for everyone. Those still reading this text may be asking 'could this possibly be for me'? This paper will try to help the reader decide which if any option to take. It is suggested that nurses will now turn to the doctoral degree as their next adventure in academic study. It is argued that this development is not being controlled by management forces and indeed cannot be controlled by them. This last is chiefly because the move towards doctoral education is led by individuals who choose to study for a doctorate simply because they can. The paper considers what choices are available to nurses who wish to pursue a doctoral programme of study. In particular, this paper considers what new developments in doctoral courses are becoming available and what advantage there may be in studying for one of the newer professional doctorates rather than a traditional PhD. The material here is the result of a review of the literature on recent developments in doctoral education for nurses. The existing provision by UK and other universities was also reviewed, the data being collected by an informal review of universities' advertising material. It is inevitable that some nurses who are already qualified to degree and masters degree will take advantage of the doctoral degree opportunities which now newly present themselves. For nurses in practice, the advantages of the professional doctorate is that it is more structured, enables more peer and

Career choices for cardiology: cohort studies of UK medical graduates

Science.gov (United States)

2013-01-01

Background Cardiology is one of the most popular of the hospital medical specialties in the UK. It is also a highly competitive specialty in respect of the availability of higher specialty training posts. Our aims are to describe doctors’ early intentions about seeking careers in cardiology, to report on when decisions about seeking a career in cardiology are made, to compare differences between men and women doctors in the choice of cardiology, and to compare early career choices with later specialty destinations. Methods Questionnaire surveys were sent to all UK medical graduates in selected qualification years from 1974–2009, at 1, 3, 5, 7 and 10 years after graduation. Results One year after graduation, the percentage of doctors specifying cardiology as their first choice of long-term career rose from the mid-1990s from 2.4% (1993 cohort) to 4.2% (2005 cohort) but then fell back to 2.7% (2009 cohort). Men were more likely to give cardiology as their first choice than women (eg 4.1% of men and 1.9% of women in the 2009 cohort). The percentage of doctors who gave cardiology as their first choice of career declined between years one and five after qualification: the fall was more marked for women. 34% of respondents who specified cardiology as their sole first choice of career one year post-graduation were later working in cardiology. 24% of doctors practising as cardiologists several years after qualification had given cardiology as their sole first choice in year one. The doctors’ ‘domestic circumstances’ were a relatively unimportant influence on specialty choice for aspiring cardiologists, while ‘enthusiasm/commitment’, ‘financial prospects’, ‘experiences of the job so far’ and ‘a particular teacher/department’ were important. Conclusions Cardiology grew as a first preference one year after graduation to 2005 but is now falling. It consistently attracts a higher percentage of men than women doctors. The correspondence between early

Organisational perspectives on addressing differential attainment in postgraduate medical education: a qualitative study in the UK.

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Woolf, Katherine; Viney, Rowena; Rich, Antonia; Jayaweera, Hirosha; Griffin, Ann

2018-03-09

To explore how representatives from organisations with responsibility for doctors in training perceive risks to the educational progression of UK medical graduates from black and minority ethnic groups (BME UKGs), and graduates of non-UK medical schools (international medical graduates (IMGs)). To identify the barriers to and facilitators of change. Qualitative semistructured individual and group interview study. Postgraduate medical education in the UK. Individuals with roles in examinations and/or curriculum design from UK medical Royal Colleges. Employees of NHS Employers. Representatives from 11 medical Royal Colleges (n=29) and NHS Employers (n=2) took part (55% medically qualified, 61% male, 71% white British/Irish, 23% Asian/Asian British, 6% missing ethnicity). Risks were perceived as significant, although more so for IMGs than for BME UKGs. Participants based significance ratings on evidence obtained largely through personal experience. A lack of evidence led to downgrading of significance. Participants were pessimistic about effecting change, two main barriers being sensitivities around race and the isolation of interventions. Participants felt that organisations should acknowledge problems, but felt concerned about being transparent without a solution; and talking about race with trainees was felt to be difficult. Participants mentioned 63 schemes aiming to address differential attainment, but these were typically local or specialty-specific, were not aimed at BME UKGs and were largely unevaluated. Participants felt that national change was needed, but only felt empowered to effect change locally or within their specialty. Representatives from organisations responsible for training doctors perceived the risks faced by BME UKGs and IMGs as significant but difficult to change. Strategies to help organisations address these risks include: increased openness to discussing race (including ethnic differences in attainment among UKGs); better sharing of

A survey of doctors at a UK teaching hospital to assess understanding of recent changes to consent law.

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O'Brien, J W; Natarajan, M; Shaikh, I

2017-06-01

The UK Supreme Court recently ruled that when consenting patients for treatments or procedures, clinicians must also discuss any associated material risks. We surveyed medical staff at a large UK teaching hospital in order to ascertain knowledge of consent law and current understanding of this change. Email survey sent to medical staff in all specialities at Norfolk and Norwich University Hospital in February 2016. 245 responses (141 Consultants and 104 junior doctors, response rate 32%). 82% consent patients for procedures at least monthly and 23% daily. 31% were not familiar with the concept of material risk. 35% were familiar with the recent change in consent law, 41% were not. 18% were "very uncertain" and 64% "a little uncertain" that their consenting process meets current legal requirements. >92% think that landmark cases and changes in law should be discussed through professional bodies and circulated better locally. The majority were not familiar with the concept of material risk and recent legal changes. A majority were not confident that their practice meets current requirements, suggesting that recent changes in consent law may not be widely understood at this hospital. We suggest more guidance and education may be necessary than is currently available. Increased understanding of recent changes to consent law will reduce the risk taken by NHS trusts and offer patients a service compliant with Supreme Court guidance.

Prevalence of GMC performance assessments in the United Kingdom: a retrospective cohort analysis by country of medical qualification.

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Mehdizadeh, L; Potts, H W W; Sturrock, A; Dacre, J

2017-04-04

The demographics of doctors working in the UK are changing. The United Kingdom (UK) has voted to leave the European Union (EU) and there is heightened political discourse around the world about the impact of migration on healthcare services. Previous work suggests that foreign trained doctors perform worse than UK graduates in postgraduate medical examinations. We analysed the prevalence by country of primary medical qualification of doctors who were required to take an assessment by the General Medical Council (GMC) because of performance concerns. This was a retrospective cohort analysis of data routinely collected by the GMC. We compared doctors who had a GMC performance assessment between 1996 and 2013 with the medical register in the same period. The outcome measures were numbers experiencing performance assessments by country or region of medical qualification. The rate of performance assessment varied significantly by place of medical qualification and by year; χ 2 (17) = 188, p Economic Area (EEA), were more likely to have a performance assessment than UK trained doctors, with the exception of South African trained doctors. The rate of performance assessment varies significantly by place of medical qualification. This is the first study to explore the risk of performance assessment by individual places of medical qualification. While concern has largely focused on the competence of non-EEA, International Medical Graduates, we discuss implications for how to ensure European trained doctors are fit to practise before their medical licence in the UK is granted. Further research is needed to investigate whether these country effects hold true when controlling for factors like doctors' sex, age, length of time working in the UK, and English language skills. This will allow evidence-based decisions to be made around the regulatory environment the UK should adopt once it leaves the EU. Patients should be reassured that the vast majority of all doctors

Through doctors' eyes: A qualitative study of hospital doctor perspectives on their working conditions.

LENUS (Irish Health Repository)

McGowan, Yvonne

2013-03-11

BACKGROUND: Hospital doctors face significant challenges in the current health care environment, working with staff shortages and cutbacks to health care expenditure, alongside increased demand for health care and increased public expectations. OBJECTIVE: This article analyses challenges faced by junior hospital doctors, providing insight into the experiences of these frontline staff in delivering health services in recessionary times. DESIGN: A qualitative methodology was chosen. METHODS: Semi-structured in-depth interviews were conducted with 20 doctors from urban Irish hospitals. Interviews were recorded via note taking. Full transcripts were analysed thematically using NVivo software. RESULTS: Dominant themes included the following: (1) unrealistic workloads: characterised by staff shortages, extended working hours, irregular and frequently interrupted breaks; (2) fatigue and its impact: the quality of care provided to patients while doctors were sleep-deprived was questioned; however, little reflection was given to any impact this may have had on junior doctors own health; (3) undervalued and disillusioned: insufficient training, intensive workloads and a perceived lack of power to influence change resulted in a sense of detachment among junior doctors. They appeared immune to their surroundings. CONCLUSION: Respondents ascribed little importance to the impact of current working conditions on their own health. They felt their roles were underappreciated and undervalued by policy makers and hospital management. Respondents were concerned with the lack of time and opportunity for training. This study highlighted several \\'red flags\\

Unhappiness and dissatisfaction in doctors cannot be predicted by selectors from medical school application forms: A prospective, longitudinal study

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Ferguson E

2005-12-01

Full Text Available Abstract Background Personal statements and referees' reports are widely used on medical school application forms, particularly in the UK, to assess the suitability of candidates for a career in medicine. However there are few studies which assess the validity of such information for predicting unhappiness or dissatisfaction with a career in medicine. Here we combine data from a long-term prospective study of medical student selection and training, with an experimental approach in which a large number of assessors used a paired comparison technique to predict outcome. Methods Data from a large-scale prospective study of students applying to UK medical schools in 1990 were used to identify 40 pairs of doctors, matched by sex, for whom personal statements and referees' reports were available, and who in a 2002/3 follow-up study, one pair member was very satisfied and the other very dissatisfied with medicine as a career. In 2005, 96 assessors, who were experienced medical school selectors, doctors, medical students or psychology students, used information from the doctors' original applications to judge which member of each pair of doctors was the happier, more satisfied doctor. Results None of the groups of assessors were significantly different from chance expectations in using applicants' personal statements and the referees' reports to predict actual future satisfaction or dissatisfaction, the distribution being similar to binomial expectations. However judgements of pairs of application forms from pairs of doctors showed a non-binomial distribution, indicating consensus among assessors as to which doctor would be the happy doctor (although the consensus was wrong in half the cases. Assessors taking longer to do the task concurred more. Consensus judgements seem mainly to be based on referees' predictions of academic achievement (even though academic achievement is not actually a valid predictor of happiness or satisfaction. Conclusion

Communication Skills in Patient-Doctor Interactions: Learning from Patient Complaints

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Janine W.Y. Kee

2018-06-01

Full Text Available Purpose: Despite communication skills training in medical school, junior doctors continue to demonstrate poor patient-doctor communication skills, where patient unhappiness from the encounter often manifests as patient complaints. We sought to identify crucial communication skills that should be incorporated in the communications curriculum by learning from patient complaints, to explore how the communication lapses occur. Method: 38 cases of anonymized negative patient feedback about junior doctors were analysed using qualitative content analysis. A two-step fine-coding system involving four researchers was employed. Results: Four main themes of communication errors were identified, namely: non-verbal (eye contact, facial expression and paralanguage, verbal (active listening and inappropriate choice of words, and content (poor quantity and quality of information provided; and poor attitudes (lack of respect and empathy. Discussion: Patient-doctor communication is a complex interpersonal interaction that requires an understanding of each party׳s emotional state. We identified important but overlooked communication lapses such as non-verbal paralinguistic elements that should be incorporated into communications curriculum, with an emphasis on dialectical learning. These include integrating these findings into a simulation-based communications module for training doctors at a post-graduate level as well as monitoring and analyzing patient complaints regularly to iteratively update the content of the training module. Beyond these skills training, there is also a need to highlight negative emotions of doctors in future research, as it influences their communication patterns and attitudes towards patients, ultimately shaping how patients perceive them. Keywords: Communication skills training, Patient complaints, Patient negative feedback, Patient-Doctor communication, Residency training

A Qualitative Evaluation of Clinical Audit in UK Dental Foundation Training.

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Thornley, Peter; Quinn, Alyson

2017-11-10

Clinical Audit (CA) has been recognized as a useful tool for tool for improving service delivery, clinical governance, and the education and performance of the dental team. This study develops the discussion by investigating its use as an educational tool within UK Dental Foundation Training (DFT). The aim was to investigate the views of Foundation Dentists (FDs) and Training Programme Directors (TPDs) on the CA module in their FD training schemes, to provide insight and recommendations for those supervising and undertaking CA. A literature review was conducted followed by a qualitative research methodology, using group interviews. The interviews were transcribed and thematically analyzed using NVIVO, a Computer-Assisted Qualitative Data Analysis tool. CA was found to be a useful tool for teaching management and professionalism and can bring some improvement to clinical practice, but TPDs have doubts about the long-term effects on service delivery. The role of the Educational Supervisor (ES) is discussed and recommendations are given for those supervising and conducting CA.

A Qualitative Evaluation of Clinical Audit in UK Dental Foundation Training

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Peter Thornley

2017-11-01

Full Text Available Clinical Audit (CA has been recognized as a useful tool for tool for improving service delivery, clinical governance, and the education and performance of the dental team. This study develops the discussion by investigating its use as an educational tool within UK Dental Foundation Training (DFT. The aim was to investigate the views of Foundation Dentists (FDs and Training Programme Directors (TPDs on the CA module in their FD training schemes, to provide insight and recommendations for those supervising and undertaking CA. A literature review was conducted followed by a qualitative research methodology, using group interviews. The interviews were transcribed and thematically analyzed using NVIVO, a Computer-Assisted Qualitative Data Analysis tool. CA was found to be a useful tool for teaching management and professionalism and can bring some improvement to clinical practice, but TPDs have doubts about the long-term effects on service delivery. The role of the Educational Supervisor (ES is discussed and recommendations are given for those supervising and conducting CA.

Agency and Social Capital in Chinese International Doctoral Students' Conversion to Christianity

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Ding, Qun; Devine, Nesta

2017-01-01

Chinese international students constitute the largest proportion of overseas students in several English-speaking countries such as the UK and New Zealand. Little research has been done concerning those undertaking doctoral study. This qualitative study explores how Chinese overseas doctoral students become involved in church communities and how…

The Making of Careers, the Making of a Discipline: Luck and Chance in Migrant Careers in Geriatric Medicine

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Bornat, Joanna; Henry, Leroi; Raghuram, Parvati

2011-01-01

The geriatric specialty, unpopular among most UK born and trained medical graduates, provided an opportunity for career development and achievement for those doctors whose training had been non-standard for a variety of reasons. Migrant doctors who have played a substantive role in the UK National Health Service since its inception made an…

A new chapter in doctoral candidate training: The Helmholtz Space Life Sciences Research School (SpaceLife)

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Hellweg, C. E.; Gerzer, R.; Reitz, G.

2011-05-01

In the field of space life sciences, the demand of an interdisciplinary and specific training of young researchers is high due to the complex interaction of medical, biological, physical, technical and other questions. The Helmholtz Space Life Sciences Research School (SpaceLife) offers an excellent interdisciplinary training for doctoral students from different fields (biology, biochemistry, biotechnology, physics, psychology, nutrition or sports sciences and related fields) and any country. SpaceLife is coordinated by the Institute of Aerospace Medicine at the German Aerospace Center (DLR) in Cologne. The German Universities in Kiel, Bonn, Aachen, Regensburg, Magdeburg and Berlin, and the German Sports University (DSHS) in Cologne are members of SpaceLife. The Universities of Erlangen-Nürnberg, Frankfurt, Hohenheim, and the Beihang University in Beijing are associated partners. In each generation, up to 25 students can participate in the three-year program. Students learn to develop integrated concepts to solve health issues in human spaceflight and in related disease patterns on Earth, and to further explore the requirements for life in extreme environments, enabling a better understanding of the ecosystem Earth and the search for life on other planets in unmanned and manned missions. The doctoral candidates are coached by two specialist supervisors from DLR and the partner university, and a mentor. All students attend lectures in different subfields of space life sciences to attain an overview of the field: radiation and gravitational biology, astrobiology and space physiology, including psychological aspects of short and long term space missions. Seminars, advanced lectures, laboratory courses and stays at labs at the partner institutions or abroad are offered as elective course and will provide in-depth knowledge of the chosen subfield or allow to appropriate innovative methods. In Journal Clubs of the participating working groups, doctoral students learn

The communicative dimension in medical training: A proposal to strengthen the doctor-patient relationship

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Jacinto Sánchez-Angarita

2017-10-01

Based on these approaches, a proposal is made to promote education considering the PBL teaching strategy that favors training in the communicative dimension, in order to promote the integration of disciplines, the construction of meaningful learning, interdisciplinary work, and problem solving with a holistic vision. Additionally, obtaining information to solve learning situations, making decisions and finding ways of communicating with patients is intended with the purpose of strengthening the doctor-patient relationship.

Drivers and Interpretations of Doctoral Education Today: National Comparisons

DEFF Research Database (Denmark)

Andres, Lesley; Bengtsen, Søren Smedegaard; Castano, Liliana Del Pilar Gallego

2015-01-01

In the last decade, doctoral education has undergone a sea change with several global trends increasingly apparent. Drivers of change include massification and professionalization of doctoral education and the introduction of quality assurance systems. The impact of these drivers, and the forms...... that they take, however, are dependent on doctoral education within a given national context. This paper is frontline in that it contributes to the literature on doctoral education by examining the ways in which these global trends and drivers are being taken up in policies and practices by various countries. We...... do so by comparing recent changes in each of the following countries: Canada, Colombia, Denmark, Finland, the UK, and the USA. Each country case is based on national education policies, policy reports on doctoral education (e.g., OECD and EU policy texts), and related materials. We use the same...

Training Teachers to Deliver Mindfulness-Based Interventions: Learning from the UK Experience.

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Crane, Rebecca S; Kuyken, Willem; Hastings, Richard P; Rothwell, Neil; Williams, J Mark G

2010-06-01

Several randomised controlled trials suggest that mindfulness-based approaches are helpful in preventing depressive relapse and recurrence, and the UK Government's National Institute for Health and Clinical Excellence has recommended these interventions for use in the National Health Service. There are good grounds to suggest that mindfulness-based approaches are also helpful with anxiety disorders and a range of chronic physical health problems, and there is much clinical and research interest in applying mindfulness approaches to other populations and problems such as people with personality disorders, substance abuse, and eating disorders. We review the UK context for developments in mindfulness-based approaches and set out criteria for mindfulness teacher competence and training steps, as well as some of the challenges and future directions that can be anticipated in ensuring that evidence-based mindfulness approaches are available in health care and other settings.

Foundation doctors and dyslexia: a qualitative study of their experiences and coping strategies.

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Newlands, Freda; Shrewsbury, Duncan; Robson, Jean

2015-03-01

Dyslexia is the most common form of specific learning difficulty affecting approximately 6% of the general UK population and believed to affect approximately 2% of UK medical students. The impact of dyslexia on early practice has not been studied. To develop an understanding of the challenges faced by doctors with dyslexia in the first year of practice and their support requirements. Semistructured telephone interviews were conducted with seven foundation year 1 doctors with dyslexia from Scottish hospitals between March 2013 and August 2013. Foundation doctors indicated that due to their dyslexia, they experience difficulty with all forms of communication, time management and anxiety. There were concerns about disclosure of their dyslexia to colleagues and supervisors. Coping strategies used frequently were safety-netting and planning; technology solutions did offer some assistance. Although technological interventions have the potential to offer benefits to foundation doctors with dyslexia, increased openness about a diagnosis of dyslexia with discussion between doctor and supervisors about the challenges and anxieties is likely to provide the most benefit. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The national and international implications of a decade of doctor migration in the Irish context.

LENUS (Irish Health Repository)

Bidwell, Posy

2012-12-17

BACKGROUND: Between 2000 and 2010, Ireland became increasingly dependent on foreign-trained doctors to staff its health system. An inability to train and retain sufficient doctors to meet demand is the primary reason for the dependence on foreign-trained doctors. By 2008 the proportion of foreign-trained doctors was the second highest in the OECD. This increased dependence on international medical migration has both national and international policy implications. METHODS: Registration data were obtained from the Medical Council of Ireland (MCI) for a 10-year period: 2000-2010. Data indicate country of qualification but not nationality. The total number of registrants and entrants (n) was determined for each year. Immigration data were also obtained on the number of work visas issued to doctors. Registration and visa data were then compared in order to estimate doctor migration to Ireland 2000-2010. RESULTS: The proportion of foreign-trained doctors rose from 13.4% of all registered doctors in 2000 to 33.4% by 2010. The largest increase was in foreign-trained doctors from outside the EU, rising from 972 (7.4%) in 2000 to 4740 (25.3%) of registered doctors in 2010. The biggest source country in 2000 was Pakistan. By 2010, South Africa had become the biggest source country. The number of foreign-trained doctors from other EU countries doubled from 780 in 2000 to 1521 in 2010. CONCLUSIONS: Registration data are likely to over-estimate and visa data under-estimate the numbers of doctors actively working in Ireland. However, they serve to illustrate Ireland\\'s rapidly increasing and potentially unsustainable reliance on foreign-trained doctors; and to highlight the need for better data to measure migratory flows. Improved measurement of health worker migration is necessary both for national workforce planning and to fulfil the requirements of the WHO Global Code on the International Recruitment of Health Personnel.

Weekly working hours for Norwegian hospital doctors since 1994 with special attention to postgraduate training, work–home balance and the European Working Time Directive: a panel study

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Rosta, Judith; Aasland, Olaf G

2014-01-01

Objectives To examine the weekly working hours of Norwegian hospital doctors from 1994 to 2012 with special emphasis on the quality of postgraduate training and work–home balance, and in relation to the requirements of the European Working Time Directive (EWTD). Design Panel study based on postal questionnaires. Setting Norway. Participants Unbalanced cohort of 1300–1600 doctors in 1994, 1995, 1996, 1997, 2000, 2002, 2004, 2006, 2008, 2010 and 2012. Outcome measures Self-reported total weekly working hours and whether 45 weekly working hours are too short, sufficient, or too long to meet the quality requirements of obligatory postgraduate training for junior doctors. Results From 1994 to 2012, the number of weekly working hours was stable for senior (46–47 h) and junior (45–46 h) hospital doctors. In 2012, significantly more senior (27–35%) than junior (11–20%) doctors reported suboptimal work–home balance, defined as working more than 48 h a week. The majority perceived the present situation with an average of 45 h per week for juniors as sufficient for obligatory postgraduate specialist training, but doctors of higher age (OR 1.04, 95% CI 1.01 to 1.08), senior doctors (1.07, 1.04 to 1.11) and doctors working in surgical specialties (OR 1 vs laboratory medicine 0.03, 0.01 to 0.25, internal medicine 0.31, 0.17 to 0.58, psychiatry 0.12, 0.04 to 0.36, paediatrics 0.36, 0.12 to 1.07, anaesthesiology 0.08, 0.02 to 0.39, gynaecology 0.07, 0.01 to 0.56 and others 0.39, 0.04 to 3.56) were more likely to want the work-week to be longer. Conclusions The weekly working hours of Norwegian hospital doctors were always below the EWTD requirements. A significant growth of hospital doctor density over the past two decades, national regulations and cultural values might be important factors. Specialty differences in perception of sufficient training time may call for more flexibility in working time regulations. PMID:25311038

Weekly working hours for Norwegian hospital doctors since 1994 with special attention to postgraduate training, work-home balance and the European working time directive: a panel study.

Science.gov (United States)

Rosta, Judith; Aasland, Olaf G

2014-10-13

To examine the weekly working hours of Norwegian hospital doctors from 1994 to 2012 with special emphasis on the quality of postgraduate training and work-home balance, and in relation to the requirements of the European Working Time Directive (EWTD). Panel study based on postal questionnaires. Norway. Unbalanced cohort of 1300-1600 doctors in 1994, 1995, 1996, 1997, 2000, 2002, 2004, 2006, 2008, 2010 and 2012. Self-reported total weekly working hours and whether 45 weekly working hours are too short, sufficient, or too long to meet the quality requirements of obligatory postgraduate training for junior doctors. From 1994 to 2012, the number of weekly working hours was stable for senior (46-47 h) and junior (45-46 h) hospital doctors. In 2012, significantly more senior (27-35%) than junior (11-20%) doctors reported suboptimal work-home balance, defined as working more than 48 h a week. The majority perceived the present situation with an average of 45 h per week for juniors as sufficient for obligatory postgraduate specialist training, but doctors of higher age (OR 1.04, 95% CI 1.01 to 1.08), senior doctors (1.07, 1.04 to 1.11) and doctors working in surgical specialties (OR 1 vs laboratory medicine 0.03, 0.01 to 0.25, internal medicine 0.31, 0.17 to 0.58, psychiatry 0.12, 0.04 to 0.36, paediatrics 0.36, 0.12 to 1.07, anaesthesiology 0.08, 0.02 to 0.39, gynaecology 0.07, 0.01 to 0.56 and others 0.39, 0.04 to 3.56) were more likely to want the work-week to be longer. The weekly working hours of Norwegian hospital doctors were always below the EWTD requirements. A significant growth of hospital doctor density over the past two decades, national regulations and cultural values might be important factors. Specialty differences in perception of sufficient training time may call for more flexibility in working time regulations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Beyond Knowledge and Skills: Rethinking the Development of Professional Identity during the STEM Doctorate

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Hancock, Sally; Walsh, Elaine

2016-01-01

The science, technology, engineering, mathematics (STEM) doctorate is the established entry qualification for a scientific research career. However, contemporary STEM doctoral graduates assume increasingly diverse professional paths, with many forging non-academic careers. Using the UK as an example, the authors suggest that the STEM PhD fails to…

Critical Autobiography in the Professional Doctorate: Improving Students' Writing through the Device of Literature

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Eastman, Christine; Maguire, Kate

2016-01-01

This paper argues for a pedagogic practice to overcome the challenges that many professional practitioners face in undertaking a professional doctorate. Recent examination feedback on a professional doctoral programme of 300 candidates in the UK highlighted that a number of candidates often struggle to write persuasively, critically and…

Newly qualified doctors' views on the significance and accessibility of career advice during medical training in Saudi Arabia

NARCIS (Netherlands)

Mehmood, Syed Imran; Norcini, John J.; Borleffs, Jan C. C.

2013-01-01

Background: Career advice is an important instrument to help students with the proper specialty selection. The study aims (1) to explore the views of newly graduated doctors in Saudi Arabia about their experience with the current status of career support system during medical training and (2) to

The Nuclear Engineering Doctorate and NTEC CPD and Masters programmes: education, training and research for the decommissioning skills-base - 16395

International Nuclear Information System (INIS)

Roberts, John W.

2009-01-01

Since its establishment in 2005 the Nuclear Decommissioning Authority (NDA) has a remit to maintain the skills-base for safe, secure and cost effective decommissioning of the existing UK civil nuclear power plants and associated facilities. With an aging workforce and a competitive tender process for each project a number of new companies are realising the potential of the UK decommissioning market. The Nuclear Engineering Doctorate and NTEC Masters Programmes have been designed to provide the nuclear workforce of the future. The doctorate is a partnership between industry, a university partner and the research engineer with the benefit to industry that the research engineer is based with the industrial partner. Technical and management modules are studied at the university whilst the research project is carried out in the industrial environment. The Masters programme draws on the expertise of 11 Higher Education Institutes and offers over 20 modules that are delivered in a short-fat format either as standalone CPD courses or, by taking further modules, a certificate, diploma or on completion of a research project an M.Sc. Modules are available that cover the technical aspects of decommissioning as well as management of the decommissioning process. The availability of modules in a Distance Learning format now enables students based around the world to benefit from this programme. This paper will describe the two programmes in detail and provide examples of current projects that are delivering the research and workforce required for a successful decommissioning programme. (author)

Creating better doctors: exploring the value of learning medicine in primary care.

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Newbronner, Elizabeth; Borthwick, Rachel; Finn, Gabrielle; Scales, Michael; Pearson, David

2017-07-01

Across the UK, 13% of undergraduate medical education is undertaken in primary care (PC). Students value their experiences in this setting but uncertainty remains about the extent to which these placements influence their future practice. To explore the impact of PC based undergraduate medical education on the development of medical students and new doctors as clinicians, and on students' preparedness for practice. Mixed method study across two UK medical schools. Focus groups and individual interviews with Year 5 medical students, Foundation Year 2 doctors and GP Specialty Trainees; online surveys of Year 5 medical students and Foundation Year 2 doctors. PC placements play an important part in the development of all 'apprentice' doctors, not just those wanting to become GPs. They provide a high quality learning environment, where students can: gradually take on responsibility; build confidence; develop empathy in their approach to patient care; and gain understanding of the social context of health and illness. The study suggests that for these results to be achieved, PC placements have to be high quality, with strong links between practice-based learning and teaching/assessment in medical school. GP tutors need to be enthusiastic and students actively involved in consultations.

Innovative UK Approaches to Acquisition Management

Science.gov (United States)

2009-05-01

Financial and Operational Imperatives Size of UK armed forces UK Industry ? Political influence PFI / PPP Increased Scrutiny - NAO “ Commercialisation “ of the...acquisition KNOWLEDGE (EXPERIENCE – Lessons learned) KNOWLEDGE (Training) KNOWLEDGE ( Education ) OPTIMAL OPERATIONAL PERFORMANCE Operational Capability UK

Induction Based Training leads to Highly Significant Improvements of Objective and Subjective Suturing Ability in Junior Doctors

Directory of Open Access Journals (Sweden)

Kevin Garry

2018-03-01

Full Text Available Background: Simulation based training has shown to be of benefit in the education of medical students. However, the impact of induction based clinical simulation on surgical ability of qualified doctors remains unclear.The aim of this study was to establish if a 60 minute teaching session integrated into an Emergency Medicine speciality induction program produces statistically significant improvements in objective and subjective suturing abilities of junior doctors commencing an Emergency Medicine rotation.Methods: The objective suturing abilities of 16 Foundation Year Two doctors were analysed using a validated OSATs scale prior to a novel teaching intervention. The doctors then undertook an intensive hour long workshop receiving one to one feedback before undergoing repeat OSATs assessment.Subjective ability was measured using a 5 point likert scale and self-assessed competency reporting interrupted suturing before and after the intervention. Photographs of wound closure before and after the intervention were recorded for further blinded assessment of impact of intervention. A survey regarding continued ability was repeated at four months following the intervention. The study took place on 7/12/16 during the Belfast Health and Social Care Trust Emergency Medicine induction in the Royal Victoria Hospital Belfast. The hospital is a regional level 1 trauma centre that has annual departmental attendances in excess of 200,000.All new junior doctors commencing the Emergency Medicine rotation were invited to partake in the study. All 16 agreed. The group consisted of a mixture of undergraduate and postgraduate medicaldoctors who all had 16 months experience working in a variety of medical or surgical jobs previously.Results: Following the teaching intervention objective and subjective abilities in interrupted suturing showed statistically significant improvement (P>0.005. Self-reporting of competency of independently suturingwounds improved from 50

Exploring a shared leadership perspective for NHS doctors.

Science.gov (United States)

Willcocks, Stephen George; Wibberley, Gemma

2015-01-01

The purpose of this paper is to explore involving doctors in shared leadership. It examines the policies that have led to the focus on shared leadership and the implications for practice. This is a conceptual paper, examining policy developments and key literature to understand the move towards shared leadership. It focuses on UK NHS, and in particular doctors, although the concepts will be relevant to other disciplines in healthcare, and healthcare systems in other countries. This paper suggests that the shared-leadership approach for doctors has potential given the nature of clinical practice, the inherently collaborative nature of healthcare and the demands of new healthcare organisations. Health policy reform, generally, will mean that all doctors need to be engaged with leadership, albeit, perhaps, at different levels, and with different degrees of formality. Leadership will remain an important precondition for the success of the reforms. This is likely to be the case for other countries involved in healthcare reform. To highlight the benefits and barriers to shared leadership for doctors. Offers an alternative to traditional approaches to leadership.

IDRC Doctoral Research Awards 2018 | IDRC - International ...

International Development Research Centre (IDRC) Digital Library (Canada)

2018-05-30

May 30, 2018 ... You must be enrolled at a Canadian university at the doctoral level ... IDRC Doctoral Research Awards are intended to promote the capacity and growth of ... including academic training, local language capacity, professional ... funding opportunity to support Canadian-African research teams studying Ebola.

Differential growth in doctor-patient communications skills

NARCIS (Netherlands)

M van Es, Judith; Wieringa-de Waard, Margreet; Visser, Mechteld R. M.

2013-01-01

Although doctor-patient communication is considered a core competency for medical doctors, the effect of training has not been unequivocally established. Moreover, knowledge about the variance in the growth of different skills and whether certain patterns in growth can be detected could help us to

Nuclear skills and education training in the UK through the Dalton nuclear institute

International Nuclear Information System (INIS)

Richard Clegg

2006-01-01

-level nuclear training called NTEC (Nuclear Technology Education Consortium). The consortium has received funding from the UK research councils and industry. Its first student intake was in October 2005 and eventually the modules on offer will cover the broad spectrum from reactor systems and fuel cycles through to decommissioning and clean-up, with modules also on offer covering fusion, nuclear medicine and socio-economics. A key aim of NTEC is to forge international teaching collaborations to share material as well as student exchanges. (author)

Training in the Public Sector in a Period of Austerity: The Case of the UK

Science.gov (United States)

Jewson, Nick; Felstead, Alan; Green, Francis

2015-01-01

This article examines what has happened to training in public sector organisations in the UK in a period of austerity. It draws on individual-level data collected over the period 2000-2012 and establishment-level data collected from employer surveys carried out between 2005 and 2012. To understand these data further, 75 qualitative interviews with…

Prevalence of GMC performance assessments in the United Kingdom: a retrospective cohort analysis by country of medical qualification

OpenAIRE

Mehdizadeh, L.; Potts, H. W. W.; Sturrock, A.; Dacre, J.

2017-01-01

Background The demographics of doctors working in the UK are changing. The United Kingdom (UK) has voted to leave the European Union (EU) and there is heightened political discourse around the world about the impact of migration on healthcare services. Previous work suggests that foreign trained doctors perform worse than UK graduates in postgraduate medical examinations. We analysed the prevalence by country of primary medical qualification of doctors who were required to take an assessment ...

Provision of undergraduate otorhinolaryngology teaching within General Medical Council approved UK medical schools: what is current practice?

Science.gov (United States)

Khan, M M; Saeed, S R

2012-04-01

Despite longstanding concern, provision of undergraduate ENT teaching has not improved in response to the aims of the UK General Medical Council's initiative Tomorrow's Doctors. Previous studies have demonstrated poor representation of ENT within the undergraduate curriculum. We aimed to identify current practice in order to establish undergraduate ENT experience across UK medical schools, a timely endeavour in light of the General Medical Council's new 2011-2013 education strategy. Questionnaires were sent to ENT consultants, medical school deans and students. All schools with a clinical curriculum were anonymously represented. Our outcome measures were the provision of mandatory or optional ENT placements, and their duration and content. A compulsory ENT placement was available to over half (53 per cent) of the students. Ten of the 26 participating schools did not offer an ENT attachment. The mean mandatory placement was 8 days. Overall, 38 per cent of students reported a satisfactory compulsory ENT placement. Most ENT consultants questioned considered that newly qualified doctors were not proficient in managing common ENT problems that did not require specialist referral. Little improvement in the provision of undergraduate ENT teaching was demonstrated. An increase in the proportion of students undertaking ENT training is necessary. Time and curriculum constraints on medical schools mean that optimisation of available resources is required.

THE EFFICACY OF MOTORCYCLE TRAINING TO REDUCE SELF-REPORTED NEGATIVE BEHAVIOUR AND ATTITUDE (CASE STUDY IN UK AND INDONESIA

Directory of Open Access Journals (Sweden)

Winna Justiana Sirait

2014-01-01

Full Text Available Motorcyclists are vulnerable road users because of their particular combination of physical vulnerability. Motorcyclists’ training and licensing system have already implemented in so many countries in the world particularly developed countries. In the other hand, there are countries, particularly developing countries, where motorcyclists are less regulated in term of licensing, enforcement, and insurance. Therefore the objective of this research are to analyses the behavior and attitude of motorcyclists in Yorkshire and Humber Region (UK and Jakarta (Indonesia, and to analyses the efficacy of motorcycle training in UK to influence the self-reported negative behavior and attitude of motorcyclists. Motorcycle Rider Behavior Questionnaire (MRBQ and Motorcyclists Attitude Questionnaire (MAQ are used to conduct this study. The Mann Whitney test is used to evaluate the significance different of the mean score, which obtained from the survey in each country (UK and Indonesia. Mean score computation showed that Yorkshire and Humber Region’s respondents have better mean score than Jakarta’s respondents. However Mann Whitney test showed that the mean score different is not significant for speed violation factor in MRBQ and drink driving and speeding factor in MAQ. Keywords: motorcyclist, motorcycle training, Motorcycle Rider Behavior Questionnaire (MRBQ, Motorcyclist Attitude Questionnaire (MAQ.

Why is U.K. medicine no longer a self-regulating profession? The role of scandals involving "bad apple" doctors.

Science.gov (United States)

Dixon-Woods, Mary; Yeung, Karen; Bosk, Charles L

2011-11-01

This article identifies the role played by a series of medical scandals in the U.K., occurring from the mid-1990s onwards, in ending a collegial model of self-regulation of the medical profession that had endured for 150 years. The state's original motive in endorsing professional self-regulation was to resolve the principal-agent problem inherent in the doctor-patient relationship. The profession, in return for its self-regulating privileges, undertook to act as a reliable guarantor for the competence and conduct of each of its members. Though sufficient to ensure that most doctors were "good", the collegial model adopted by the profession left it fatally vulnerable to the problem of "bad apples": those unwilling, incapable or indifferent to delivering on their professional commitments and who betrayed the trust of both patients and peers. Weak administrative systems in the NHS failed to compensate for the defects of the collegium in controlling these individuals. The scandals both provoked and legitimised erosion of the profession's self-regulatory power. Though its vulnerability to bad apples had been present since the founding of the 19th century profession, it was the convergence of social and political conditions at a particular historical moment that transformed the scandals into an unstoppable imperative for reform. Huge public anger, the voice permitted to a coalition of critics, shifts in social attitudes, the opportunity presented for imposing standards for accountability, and the increasing ascendancy of pro-interventionist managerialist and political agendas from the early 1990s onwards were all implicated in the response made to scandals and the shape the reforms took. Scandals need to be understood not as simple determinants of change, but as one performative element in a constellation of socially contingent forces and contexts. The new rebalancing of the "countervailing powers" has dislodged the profession as the senior partner in the regulation of

Talking to Your Doctor

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Initial Results of the Master's Degree Programme in "Leadership in Medicine" – Impact on hospital-based follow-on training of doctors

Directory of Open Access Journals (Sweden)

Wulfert, Chris-Henrik

2017-11-01

Full Text Available Objective: This pilot project, which was jointly conducted by a hospital and a university, describes the development of the Master's Degree Programme in Leadership in Medicine, a course designed to supplement medical specialty training. The aim of the pilot project is to demonstrate how hospital-based projects on personnel and organisational development undertaken under academic supervision can be used to increase leadership responsibility among doctors whose duties include providing initial and follow-on training and to professionalise medical specialty training as a leadership task. This need arose from the nationwide requirements and an internal audit regarding follow-on training. The version of the degree programme described below aims to further the personnel development of the participants in the field of didactics. Method: Each of the nine modules is made up of two classroom-based phases and one distance learning phase. The distance learning phase involves undertaking hospital-based projects on personnel and organisational development under academic supervision. The pilot phase participants were hospital doctors who, as part of their duties, hold leadership responsibility or are involved in the follow-on training of doctors.Results: The 17 participants successfully implemented more than 30 hospital-based projects during the distance learning phases of the nine modules. These projects included the development of medical specialty curricula, relevant didactic methods and evaluation design and were subsequently presented and subjected to reflection in interdisciplinary groups. The project presentation together with the project report were regarded as proof of competency. Conclusion: In addition to enhancing participant competency, the degree model described, which interlinks theory and practice, promotes organisational development through the implementation of projects undertaken under academic supervision. This has a double impact on the

UK medical education on human trafficking: assessing uptake of the opportunity to shape awareness, safeguarding and referral in the curriculum.

Science.gov (United States)

Arulrajah, Poojani; Steele, Sarah

2018-06-13

Human trafficking is a serious violation of human rights, with numerous consequences for health and wellbeing. Recent law and policy reforms mean that clinicians now hold a crucial role in national strategies. 2015 research, however, indicates a serious shortfall in knowledge and confidence among healthcare professionals in the UK, leading potentially to failures in safeguarding and appropriate referral. Medical education is a central point for trafficking training. We ascertain the extent of such training in UK Medical Schools, and current curricular design. We sent Freedom of Information requests to the 34 public UK medical schools, which included a preliminary question on education provision, supplemented with follow-up questions exploring the nature, delivery and format of any education, as well as future curriculum development. There was a response rate of 97%. A majority (72%) of the schools did not provide trafficking education. 13% of these did, however, offer opportunities outside the formal curriculum. 70% had no plans to implement any education opportunities. Among the 28% of schools providing teaching, 56% integrated this within the core curriculum. 56% only delivered this within a single year of the degree. 67% provided some form of teaching in-person, while 78% used a combination of methods. Medical education on trafficking in the UK is variable and often absent. To produce future clinicians who are competent and capable, there is a need for expanded education on trafficking and research into optimal curriculum design. The UK's new Independent Anti-Slavery Commissioner should work with medical schools to develop an educational strategy urgently to fulfil the UK Government's plans and commitments. Both in the UK and around the world, human trafficking education presents a critical opportunity to address human rights and safeguarding to a generation of new doctors.

Training on handover of patient care within UK medical schools

Directory of Open Access Journals (Sweden)

Morris Gordon

2013-01-01

Full Text Available Background: Much evidence exists to demonstrate that poor handover can directly impact patient safety. There have been calls for formal education on handover, but evidence to guide intervention design and implementation is limited. It is unclear how undergraduate medical schools are tackling this issue and what barrier or facilitators exist to handover education. We set out to determine curriculum objectives, teaching and assessment methods, as well as institutional attitudes towards handover within UK medical schools. Methods: A descriptive, non-experimental, cross-sectional study design was used. A locally developed online questionnaire survey was sent to all UK Medical Schools, after piloting. Descriptive statistics were calculated for closed-ended responses, and free text responses were analysed using a grounded theory approach, with constant comparison taking place through several stages of analysis. Results: Fifty percent of UK medical schools took part in the study. Nine schools (56% reported having curriculum outcomes for handover. Significant variations in the teaching and assessments employed were found. Qualitative analysis yielded four key themes: the importance of handover as an education issue, when to educate on handover, the need for further provision of teaching and the need for validated assessment tools to support handover education. Conclusions: Whilst undergraduate medical schools recognised handover as an important education issue, they do not feel they should have the ultimate responsibility for training in this area and as such are responding in varying ways. Undergraduate medical educators should seek to reach consensus as to the extent of provision they will offer. Weaknesses in the literature regarding how to design such education have exacerbated the problem, but the contemporaneous and growing published evidence base should be employed by educators to address this issue.

Talking to Your Doctor

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[The importance of master's degree and doctorate degree in general surgery].

Science.gov (United States)

Montalvo-Javé, Eduardo Esteban; Mendoza-Barrera, Germán Eduardo; Valderrama-Treviño, Alan Isaac; Alcántara-Medina, Stefany; Macías-Huerta, Nain Abraham; Tapia-Jurado, Jesús

2016-01-01

The Doctor of Philosophy is the highest academic degree that can be obtained in universities. Graduate Education Program in Medicine in Mexico is divided into 2 major categories: Medical Specialty and Master studies/Doctor of Philosophy. The objective of this study was to demonstrate the importance of master's degrees and Doctor of Philosophy in general surgery. A literature search in PubMed and Medline among others, from 1970 to 2015 with subsequent analysis of the literature reviews found. The physicians who conducted doctoral studies stand out as leaders in research, teaching and academic activities. Dual training with a doctorate medical specialty is a significant predictor for active participation in research projects within the best educational institutions. It is important to study a PhD in the education of doctors specialising in surgery, who show more training in teaching, research and development of academic activities. Currently, although there is a little proportion of students who do not finish the doctoral program, the ones who do are expected to play an important role in the future of medical scientific staff. It has been shown that most doctors with Doctor of Philosophy have wide range of career options. The importance of doctoral studies in the formation of general surgery is due to various reasons; the main one being comprehensively training physician scientists who can develop in clinical, teaching and research. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

Talking to Your Doctor

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Exploring the impact of workplace cyberbullying on trainee doctors.

Science.gov (United States)

Farley, Samuel; Coyne, Iain; Sprigg, Christine; Axtell, Carolyn; Subramanian, Ganesh

2015-04-01

Workplace bullying is an occupational hazard for trainee doctors. However, little is known about their experiences of cyberbullying at work. This study examines the impact of cyberbullying among trainee doctors, and how attributions of blame for cyberbullying influence individual and work-related outcomes. Doctors at over 6 months into training were asked to complete an online survey that included measures of cyberbullying, blame attribution, negative emotion, job satisfaction, interactional justice and mental strain. A total of 158 trainee doctors (104 women, 54 men) completed the survey. Overall, 73 (46.2%) respondents had experienced at least one act of cyberbullying. Cyberbullying adversely impacted on job satisfaction (β = - 0.19; p cyberbullying influenced its impact and the path of mediation. Negative emotion mediated the relationship between self-blame for a cyber-bullying act and mental strain, whereas interactional injustice mediated the association between blaming the perpetrator and job dissatisfaction. Acts of cyberbullying had been experienced by nearly half of the sample during their training and were found to significantly relate to ill health and job dissatisfaction. The deleterious impact of cyberbullying can be addressed through both workplace policies, and training for trainee doctors and experienced medical professionals. © 2015 John Wiley & Sons Ltd.

A role for doctors in assisted dying? An analysis of legal regulations and medical professional positions in six European countries.

Science.gov (United States)

Bosshard, G; Broeckaert, B; Clark, D; Materstvedt, L J; Gordijn, B; Müller-Busch, H C

2008-01-01

To analyse legislation and medical professional positions concerning the doctor's role in assisted dying in western Europe, and to discuss their implications for doctors. This paper is based on country-specific reports by experts from European countries where assisted dying is legalised (Belgium, The Netherlands), or openly practiced (Switzerland), or where it is illegal (Germany, Norway, UK). Laws on assisted dying in The Netherlands and Belgium are restricted to doctors. In principle, assisted suicide (but not euthanasia) is not illegal in either Germany or Switzerland, but a doctor's participation in Germany would violate the code of professional medical conduct and might contravene of a doctor's legal duty to save life. The Assisted Dying for the Terminally Ill Bill proposed in the UK in 2005 focused on doctors, whereas the Proposal on Assisted Dying of the Norwegian Penal Code Commission minority in 2002 did not. Professional medical organisations in all these countries except The Netherlands maintain the position that medical assistance in dying conflicts with the basic role of doctors. However, in Belgium and Switzerland, and for a time in the UK, these organisations dropped their opposition to new legislation. Today, they regard the issue as primarily a matter for society and politics. This "neutral" stance differs from the official position of the Royal Dutch Medical Association which has played a key role in developing the Dutch practice of euthanasia as a "medical end-of-life decision" since the 1970s. A society moving towards an open approach to assisted dying should carefully identify tasks to assign exclusively to medical doctors, and distinguish those possibly better performed by other professions.

DOCTORAL STUDIES IN THE HOMELAND HIGHER EDUCATION: EXPERIENCE AND PROSPECTS OF THE EUROPEAN DIMENSION

Directory of Open Access Journals (Sweden)

Svitlana Holovko

2017-11-01

Full Text Available Purpose: Ensuring compliance of doctoral training in Ukraine with the European standards is an objective condition for the complete integration of our state into the united educational and scientific environment. In order to ensure the effectiveness of this process, the necessity of research conducted on the European experience as well as the first achievements and difficulties in the national high school, the determining factors, in particular, the state and prospects of the legal area development for the implementation of the new model appears to be urgent. Methods: general and specific scientific (special methods were used to achieve the research target. Applying the methods of the first group made it possible to outline the tendencies of the doctoral training transformation in European countries and in Ukraine. By means of the comparative legal method, the peculiarities of the development of the normative-legal field of doctoral training in the national high school were analyzed, and the areas of its improvement were determined. Results: The features of development of doctoral training in the European educational space and the prospects of its introduction in the national higher education were considered. The formation of the legal area of doctoral training in Ukraine was argued, and the ways of its improvement were outlined. Exemplified on the National Aviation University, as one of the leading research institutions, the first experience of introducing a European model for training scientific staff is summarized. Discussion: In doctoral training, one of the leading trends is the issue of ensuring the quality of the implementation of curricula of the Doctor of Philosophy, enhancing the autonomy and responsibility of postgraduate students and academic leaders, improving the academic and geographical mobility of scholars, increasing funding for research and enhancing its innovation. In the projection of this issue on the national university

The Content Analysis on Doctoral Thesies in Geomatic Engineering in Turkey

Directory of Open Access Journals (Sweden)

Tahsin BOZTOPRAK

2016-10-01

Full Text Available The purpose of this study is to reach a conclusion based on the synthesis of doctoral dissertations published about surveying (geomatic engineering by using content analysis. For this purpose, 325 doctoral dissertations published in Turkey were analyzed using content analysis technique. As a result of performed analysis, it has been determined that 70.46's% of doctoral dissertations have been published in the last fifteen years. It has been shown that most doctoral dissertations were published by Istanbul Technical University, Yıldız Technical University, Selçuk University and Karadeniz Technical University. Most of the doctorate studies have been carried out in the discipline of public measurements/ land management with the rate of %32.62. 89.54% of the publishing language of the PhD thesis is Turkish, the average number of pages is 156. 68.45% of the PhD thesis advisors have professor doctor title. The most covered subjects are geographic information systems (15.46%, GPS/GNSS (12.36% and satellite image analysis (11.24%.

Basic life support knowledge, self-reported skills and fears in Danish high school students and effect of a single 45-min training session run by junior doctors; a prospective cohort study

DEFF Research Database (Denmark)

Aaberg, Anne Marie Roust; Larsen, Caroline Emilie Brenner; Rasmussen, Bodil Steen

2014-01-01

BACKGROUND: Early recognition and immediate bystander cardiopulmonary resuscitation are critical determinants of survival after out-of-hospital cardiac arrest (OHCA). Our aim was to evaluate current knowledge on basic life support (BLS) in Danish high school students and benefits of a single...... training session run by junior doctors. METHODS: Six-hundred-fifty-one students were included. They underwent one 45-minute BLS training session including theoretical aspects and hands-on training with mannequins. The students completed a baseline questionnaire before the training session and a follow...... areas of BLS is poor among high school students. One hands-on training session run by junior doctors seems to be efficient to empower the students to be first responders to OHCA....

How appropriate are the English language test requirements for non-UK-trained nurses? A qualitative study of spoken communication in UK hospitals.

Science.gov (United States)

Sedgwick, Carole; Garner, Mark

2017-06-01

Non-native speakers of English who hold nursing qualifications from outside the UK are required to provide evidence of English language competence by achieving a minimum overall score of Band 7 on the International English Language Testing System (IELTS) academic test. To describe the English language required to deal with the daily demands of nursing in the UK. To compare these abilities with the stipulated levels on the language test. A tracking study was conducted with 4 nurses, and focus groups with 11 further nurses. The transcripts of the interviews and focus groups were analysed thematically for recurrent themes. These findings were then compared with the requirements of the IELTS spoken test. The study was conducted outside the participants' working shifts in busy London hospitals. The participants in the tracking study were selected opportunistically;all were trained in non-English speaking countries. Snowball sampling was used for the focus groups, of whom 4 were non-native and 7 native speakers of English. In the tracking study, each of the 4 nurses was interviewed on four occasions, outside the workplace, and as close to the end of a shift as possible. They were asked to recount their spoken interactions during the course of their shift. The participants in the focus groups were asked to describe their typical interactions with patients, family members, doctors, and nursing colleagues. They were prompted to recall specific instances of frequently-occurring communication problems. All interactions were audio-recorded, with the participants' permission,and transcribed. Nurses are at the centre of communication for patient care. They have to use appropriate registers to communicate with a range of health professionals, patients and their families. They must elicit information, calm and reassure, instruct, check procedures, ask for and give opinions,agree and disagree. Politeness strategies are needed to avoid threats to face. They participate in medical

[Assessing bioethics education: Teaching to be virtuous doctors or just doctors with practical ethical skills].

Science.gov (United States)

Esquerda, Montse; Pifarré, Josep; Roig, Helena; Busquets, Ester; Yuguero, Oriol; Viñas, Joan

2018-04-04

In the last decades, bioethics has been incorporated into the academic training of the Medical Schools. Some studies analyze the ethical-moral development of medical students and the effect of ethical education in other countries. This evaluation is done by measuring Kohlberg's moral reasoning (virtuous doctors), or ethical sensitivity to resolve clinical cases (physicians with ethical skills). The following study is proposed to assess the impact of bioethics training on these two variables, in Spanish medical students. Observational cross-sectional study. SITE: Faculty of Medicine, University of Lleida. 175 students from third year of medicine (78 before bioethics and 97 after bioethics, in different courses) were conducted. Bioethics course. A socio-demographic questionnaire, the Rest Defining Issue test scale, and Problem Identification Test with clinical vignettes were administered. A consistent and significant correlation has been found between moral reasoning and ethical sensitivity. Women presented greater post-conventional reasoning. There were no changes in Kohlberg's stage of global moral reasoning with ethical training. There were changes in ethical sensitivity with bioethical training, with a significantly and globally improvement. In our study, training in bioethics does not improve moral development but rather the ethical problem solving skills. It is asked if this improvement is enough to train doctors prepared for the new challenges. Copyright © 2018 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.

Factors influencing intercultural doctor-patient communication: a realist review.

NARCIS (Netherlands)

Paternotte, E.; Dulmen, S. van; Lee, N. van der; Scherpbier, A.J.J.A.; Scheele, F.

2015-01-01

Objective: Due to migration, doctors see patients from different ethnic backgrounds. This causes challenges for the communication. To develop training programs for doctors in intercultural communication (ICC), it is important to know which barriers and facilitators determine the quality of ICC. This

[Effect of doctor-patient communication education on oral clinical practice].

Science.gov (United States)

Wang, Yi; Tang, Yu; He, Yan; Zhu, Ya-qin

2012-08-01

To evaluate the effect of doctor-patient communication education on dental clinical practice. The process of 61 dental interns' clinical practice was divided into two stages. The dental interns were taught with traditional teaching method in the first stage. Doctor-patient communication and communication skill training were added to the second stage. Scale of medical student's doctor-patient communication behavior was used to evaluate the dental interns' behavior by themselves after two stages. The SEGUE frame work was used to evaluate the dental interns' behavior by teachers after two stages. All statistical analysis was performed using SPSS 13.0 software package. The result of scale of medical student's doctor-patient communication behavior was analyzed using Fisher exact test or Chi-square test. The score of the SEGUE frame work was analyzed using Student's t test. The result of Scale of medical student's doctor-patient communication behavior showed only 37.71% of dental interns could establish good doctor-patient relationship in the first stage. After doctor-patient communication and communication skill training, the percentage became 75.4%. The result of the SEGUE frame work showed the score was raised from 16.066±3.308 to 21.867±2.456, and a significant difference was found between the two stages. Doctor-Patient communication education can improve dental interns' communication skills and help to establish a good doctor-patient relationship.

What advice is given to newly qualified doctors on Twitter? An analysis of #TipsForNewDocs tweets.

Science.gov (United States)

Rashid, Mohammed Ahmed; McKechnie, Doug; Gill, Deborah

2018-07-01

Twitter is a social media platform on which users post very brief messages that can be rapidly communicated across wide geographical areas and audiences. Many doctors use Twitter for personal as well as professional communications and networking. The #TipsForNewDocs hashtag is used on Twitter to give advice to newly qualified doctors as they commence their careers. This study explores the nature and focus of such advice. An analysis of Twitter activity containing the #TipsForNewDocs hashtag was performed using Symplur health care analytics software. Tweets sent during a peak 48-hour period in 2016 (immediately preceding the first day of work for newly qualified UK doctors) were studied. The geographical locations and professional backgrounds of participants were categorised and the content of tweets was subjected to thematic analysis. During 1 and 2 August 2016, 661 unique #TipsForNewDocs tweets were posted. A total of 621 (94.0%) were posted by people in the UK; 522 (79.0%) were posted by doctors, and the remainder by allied health care professionals and patients. The majority of included tweets focused on aspects of professional development, improving personal or professional knowledge, particularly tacit knowledge, and developing 'know-how'. These aspects of professional knowledge have previously been described as fundamental to professional education and training. However, a significant subset of tweets focused on accelerating socialisation into the profession, an essential step in joining a professional community. The tweets relating to socialisation were often humorous and colloquial in nature. Despite their brief and often jocular nature, #TipsForNewDocs tweets provided meaningful advice for newcomers to the profession, often focusing on tacit learning and professional socialisation. Hashtag-driven enquiries can be a valuable and time-efficient way of accessing and sharing tacitly held knowledge. Social media content analysis can provide valuable insights

Training and experience of doctors administering obstetric ...

African Journals Online (AJOL)

Background All the published Saving Mothers Reports generated by the National Committee of the Confidential Enquiries into Maternal Deaths in South Africa have associated anaesthesia-related maternal deaths with the lack of skills of the doctors administering the anaesthesia. The Reports have shown the Free State to ...

Becoming a caregiver: attachment theory and poorly performing doctors.

Science.gov (United States)

Adshead, Gwen

2010-02-01

In this paper, I review a theoretical paradigm (attachment theory) which facilitates an understanding of how human care-giving and care-eliciting behaviours develop and are maintained over the lifespan. I argue that this paradigm has particular utility in: (i) the training of doctors; (ii) understanding why some doctors and medical students experience high levels of stress, and (iii) developing interventions to help those who struggle to manage high levels of work-related stress. I carried out a review of key texts and previously published studies of attachment styles in caregivers. Large-scale epidemiological studies, using valid and reliable measures, show that insecure attachment styles are found in a proportion of normal populations of both males and females. Insecure attachment is associated with impaired stress management and subtle deficits in care-giving sensitivity. It is reasonable to assume that a proportion of students entering medical training and doctors with performance problems may have insecure attachment styles which influence how they approach their training experience and how they manage occupational stress. Attachment theory is a useful paradigm for thinking about training as a professional caregiver. Insecure early attachment experiences may be a risk factor for poor stress management in some medical students and doctors who are exposed to increasing demands as carers. These findings lead to suggestions for possible research and support interventions.

A national survey of the effects of fatigue on trainees in anaesthesia in the UK.

Science.gov (United States)

McClelland, L; Holland, J; Lomas, J-P; Redfern, N; Plunkett, E

2017-09-01

Long daytime and overnight shifts remain a major feature of working life for trainees in anaesthesia. Over the past 10 years, there has been an increase in awareness and understanding of the potential effects of fatigue on both the doctor and the patient. The Working Time Regulations (1998) implemented the European Working Time Directive into UK law, and in August 2009 it was applied to junior doctors, reducing the maximum hours worked from an average of 56 per week to 48. Despite this, there is evidence that problems with inadequate rest and fatigue persist. There is no official guidance regarding provision of a minimum standard of rest facilities for doctors in the National Health Service, and the way in which rest is achieved by trainee anaesthetists during their on-call shift depends on rota staffing and workload. We conducted a national survey to assess the incidence and effects of fatigue among the 3772 anaesthetists in training within the UK. We achieved a response rate of 59% (2231/3772 responses), with data from 100% of NHS trusts. Fatigue remains prevalent among junior anaesthetists, with reports that it has effects on physical health (73.6% [95%CI 71.8-75.5]), psychological wellbeing (71.2% [69.2-73.1]) and personal relationships (67.9% [65.9-70.0]). The most problematic factor remains night shift work, with many respondents commenting on the absence of breaks, inadequate rest facilities and 57.0% (55.0-59.1) stating they had experienced an accident or near-miss when travelling home from night shifts. We discuss potential explanations for the results, and present a plan to address the issues raised by this survey, aiming to change the culture around fatigue for the better. © 2017 The Association of Anaesthetists of Great Britain and Ireland.

Attracting and retaining doctors in rural Nepal.

Science.gov (United States)

Shankar, P R

2010-01-01

In Nepal, a number of private sector medical schools have opened recently; although sufficient numbers of doctors are graduating there continues to be a doctor shortage in rural areas. This article analysed the rural doctor shortage in Nepal and reviewed the international literature for strategies that may be suitable for use in Nepal. Original research articles, reviews, magazine articles and project reports dealing with Nepal and other developing countries during the period 1995 to 2010 were sourced via Google, Google Scholar and Pubmed. Full text access was obtained via WHO's HINARI database. The health workforce in Nepal is unevenly distributed resulting in doctor shortages in rural areas. The recent introduction of mandatory rural service for scholarship students was aimed to reduce the loss of medical graduates to developed nations. High tuition fees in private medical schools and low Government wages prevent recent graduates from taking up rural positions, and those who do face many challenges. Potential corrective strategies include community-based medical education, selecting rural-background medical students, and providing a partial or complete tuition fee waiver for medical students who commit to rural service. Traditional healers and paramedical staff can also be trained for and authorized to provide rural health care. A range of strategies developed elsewhere could be used in Nepal, especially community-oriented medical education that involves rural doctors in training medical students. The reimbursement of tuition fees, assistance with relocation, and provision of opportunities for academic and professional advancement for rural doctors should also be considered. Government investment in improving working conditions in rural Nepal would assist rural communities to attract and retain doctors.

Doctoral Education

DEFF Research Database (Denmark)

Ridder, Hanne Mette Ochsner

2015-01-01

Doctoral education covers the “third cycle” of degrees following the bachelor’s and the master’s degree. The education of researchers is necessary for developing music therapy as a scientific discipline and calls for a certain research culture that not only brings knowledge on research...... with an integration of science and practice. This leads to a description of the principles of problem-based learning as a social constructive approach, problematization, self-directed learning and learning community. The chapter is concluded with an example of a model of doctoral education, the Aalborg model, where...... the coursework, supervision, and curriculum is based on problem-based learning. About the book: 'International Perspectives in Music Therapy Education and Training: Adapting to a Changing World,' the first anthology of its kind, edited by Professor Karen Goodman, brings noted educators from Brazil, Canada...

Failing to retain a new generation of doctors: qualitative insights from a high-income country.

Science.gov (United States)

Humphries, Niamh; Crowe, Sophie; Brugha, Ruairí

2018-02-27

The failure of high-income countries, such as Ireland, to achieve a self-sufficient medical workforce has global implications, particularly for low-income, source countries. In the past decade, Ireland has doubled the number of doctors it trains annually, but because of its failure to retain doctors, it remains heavily reliant on internationally trained doctors to staff its health system. To halve its dependence on internationally trained doctors by 2030, in line with World Health Organisation (WHO) recommendations, Ireland must become more adept at retaining doctors. This paper presents findings from in-depth interviews conducted with 50 early career doctors between May and July 2015. The paper explores the generational component of Ireland's failure to retain doctors and makes recommendations for retention policy and practice. Interviews revealed that a new generation of doctors differ from previous generations in several distinct ways. Their early experiences of training and practice have been in an over-stretched, under-staffed health system and this shapes their decision to remain in Ireland, or to leave. Perhaps as a result of the distinct challenges they have faced in an austerity-constrained health system and their awareness of the working conditions available globally, they challenge the traditional view of medicine as a vocation that should be prioritised before family and other commitments. A new generation of doctors have career options that are also strongly shaped by globalisation and by the opportunities presented by emigration. Understanding the medical workforce from a generational perspective requires that the health system address the issues of concern to a new generation of doctors, in terms of working conditions and training structures and also in terms of their desire for a more acceptable balance between work and life. This will be an important step towards future-proofing the medical workforce and is essential to achieving medical workforce

Attitude of nigerian resident doctors towards clinical autopsy.

Science.gov (United States)

Ekanem, V J; Gerry, I E

2007-03-01

It is to the disadvantage of the doctors in training that there is a decline in the rate of clinical autopsy world wide. This decline may to an extent depend on the attitude of the physicians. To evaluate the attitude of resident doctors towards the practice of clinical autopsy and to determine their role in the decline of clinical autopsy. We carried out a survey of the attitude of resident doctors undergoing training in the various clinical departments of our teaching hospital towards clinical autopsy practice. This survey was by means of a structured randomly distributed questionnaire. Questions were asked on their willingness to request for autopsy, the number of autopsies that they have requested for so far, what hinders them from requesting for autopsy, the level of participation at autopsy and the importance of autopsies in the health care delivery system Eighteen (30%) out of 60 resident doctors attributed their inability to request for autopsy on their not being in direct control of the patients, while 16 (26.7%) found it difficult to get consent from the relatives. Seventeen per cent of them gave reason of not being able to obtain report from the pathologist, 13.3% said it was difficult to get pathologist to perform autopsy on time while only 11% said they knew the diagnosis in most of their cases. Almost all the resident doctors (98.5%) agreed that autopsy is a necessary procedure and is important for their training and health care delivery system Autopsy rate can increase if the resident doctors receive more blessings to request for autopsy from their consultants. Increased exposure to autopsies and education with regards to the benefits of autopsies at both the undergraduate and post graduate level will contribute to improvement in the rate of clinical autopsy.

A Handbook for Doctoral Supervisors Stan Taylor and Nigel Beasley A Handbook for Doctoral Supervisors Routledge 256 £24.99 0415335450 0415335450 [Formula: see text].

Science.gov (United States)

2006-07-01

It can often be an enlightening affair to be made aware of the limitations of one's knowledge on a subject in which one is gainfully employed - having read this book, I am grateful for such a salutary experience. As a doctoral supervisor, I feel justified in considering myself better informed and equipped to perform a role for which, there is very little contemporary literature available. The manner in which Taylor and Beasley have comprehensively tackled this omission, going beyond the usual checklist for supervisors, is a huge strength of the book, bringing to life the real world of doctoral supervision. This text is a timely publication given the momentous changes of the past decade in terms of the doctorate, modes and methods of study, the candidate population and new demands upon supervisors. Although the book appears to be primarily written for a UK audience it is relevant to all those involved in helping the doctoral candidate achieve their goal.

Examining the Doctoral Viva: Perspectives from a Sample of UK Academics

Science.gov (United States)

Poole, Brian

2015-01-01

The doctoral viva voce examination has existed in Britain since the PhD (or DPhil) was introduced at Oxford University almost a hundred years ago. However, despite some recent research studies, it seems that the viva remains somewhat under-researched and that viva voce examinations continue to take place according to largely unchanged and…

Choice and rejection of psychiatry as a career: surveys of UK medical graduates from 1974 to 2009.

Science.gov (United States)

Goldacre, Michael J; Fazel, Seena; Smith, Fay; Lambert, Trevor

2013-03-01

Recruitment of adequate numbers of doctors to psychiatry is difficult. To report on career choice for psychiatry, comparing intending psychiatrists with doctors who chose other clinical careers. Questionnaire studies of all newly qualified doctors from all UK medical schools in 12 qualification years between 1974 and 2009 (33 974 respondent doctors). One, three and five years after graduation, 4-5% of doctors specified psychiatry as their first choice of future career. This was largely unchanged across the 35 years. Comparing intending psychiatrists with doctors who chose other careers, factors with a greater influence on psychiatrists' choice included their experience of the subject at medical school, self-appraisal of their own skills, and inclinations before medical school. In a substudy of doctors who initially considered but then did not pursue specialty choices, 72% of those who did not pursue psychiatry gave 'job content' as their reason compared with 33% of doctors who considered but did not pursue other specialties. Historically, more women than men have chosen psychiatry, but the gap has closed over the past decade. Junior doctors' views about psychiatry as a possible career range from high levels of enthusiasm to antipathy, and are more polarised than views about other specialties. Shortening of working hours and improvements to working practices in other hospital-based specialties in the UK may have reduced the relative attractiveness of psychiatry to women doctors. The extent to which views of newly qualified doctors about psychiatry can be modified by medical school education, and by greater exposure to psychiatry during student and early postgraduate years, needs investigation.

The impact of the European Working Time Directive 10 years on: views of the UK medical graduates of 2002 surveyed in 2013-2014.

Science.gov (United States)

Lambert, Trevor W; Smith, Fay; Goldacre, Michael J

2016-03-01

To report doctors' views about the European Working Time Directive ('the Directive'). Survey of the medical graduates of 2002 (surveyed in 2013-2014). Medical graduates. UK. Questions on views about the Directive. The response rate was 64% (2056/3196). Twelve per cent of respondents agreed that the Directive had benefited senior doctors, 39% that it benefited junior doctors, and 17% that it had benefited the NHS. More women (41%) than men (35%) agreed that the Directive had benefited junior doctors. Surgeons (6%) and adult medical specialists (8%) were least likely to agree that the Directive had benefited senior doctors. Surgeons (20%) were less likely than others to agree that the Directive had benefited junior doctors, whilst specialists in emergency medicine (57%) and psychiatry (52%) were more likely to agree. Surgeons (7%) were least likely to agree that the Directive had benefited the NHS. Most respondents (62%) reported a positive effect upon work-life balance. With regard to quality of patient care, 45% reported a neutral effect, 40% reported a negative effect, and 15% a positive effect. Most respondents (71%) reported a negative effect of the Directive on continuity of patient care, and 71% felt that the Directive had a negative effect upon junior doctors' training opportunities. Fifty-two per cent reported a negative effect on efficiency in managing patient care. Senior doctors agreed that the Directive benefited doctors' work-life balance. In other respects, they were more negative about it. Surgeons were the least positive about aspects of the Directive.

Factors influencing intercultural doctor-patient communication: a realist review.

Science.gov (United States)

Paternotte, Emma; van Dulmen, Sandra; van der Lee, Nadine; Scherpbier, Albert J J A; Scheele, Fedde

2015-04-01

Due to migration, doctors see patients from different ethnic backgrounds. This causes challenges for the communication. To develop training programs for doctors in intercultural communication (ICC), it is important to know which barriers and facilitators determine the quality of ICC. This study aimed to provide an overview of the literature and to explore how ICC works. A systematic search was performed to find literature published before October 2012. The search terms used were cultural, communication, healthcare worker. A realist synthesis allowed us to use an explanatory focus to understand the interplay of communication. In total, 145 articles met the inclusion criteria. We found ICC challenges due to language, cultural and social differences, and doctors' assumptions. The mechanisms were described as factors influencing the process of ICC and divided into objectives, core skills and specific skills. The results were synthesized in a framework for the development of training. The quality of ICC is influenced by the context and by the mechanisms. These mechanisms translate into practical points for training, which seem to have similarities with patient-centered communication. Training for improving ICC can be developed as an extension of the existing training for patient-centered communication. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Perceptions of doctors on being treated by a doctor just completing the house job.

Science.gov (United States)

Ahmad, Amina; Haque Shaikh, Siraj Ul; Tayyab, Muhammad; Gardezi, Javed Raza

2014-12-01

To determine the percentage of medical teachers and fresh doctors who feel that graduating doctors are competent or incompetent to handle common ailments and to evaluate the reasons for their perceptions. Sequential mixed method. First phase extending from December 2010 to December 2011 and second phase was conducted in March 2014. First phase comprised electronic distribution of questionnaire to 100 medical teachers and fresh doctors working in hospitals attached with 5 private and 5 public sector medical colleges of Lahore and Karachi to rate an average house officer on a frequency scale of 1 - 6 and do self-assessment, in case of a fresh doctor. The second phase included interviews of 20 medical teachers to explore justification for their rating in the survey questionnaire and for triangulation of data. Quantitative data was analyzed through SPSS version 15 to calculate frequencies and percentages and interviews were analyzed through quasi-statistical approach. In survey, 38.36% out of 73 medical teachers and 30% out of 20 medical teachers in interviews confirmed their confidence on consulting fresh doctors for common ailments as opposed to 61.64% and 70% respectively, expressing their dissatisfaction. Self-assessment of fresh doctors indicated that 40% are confident in handling common medical conditions as opposed to 33.3% out of 75 respondents, who are not confident about their clinical skills. Faculty and self-assessment of fresh doctors has a fair overlap, indicating room for further improvement in the house job training program.

From student to steward: the Interdisciplinary Program in Neuroscience at Georgetown University as a case study in professional development during doctoral training.

Science.gov (United States)

Ullrich, Lauren; Dumanis, Sonya B; Evans, Tanya M; Jeannotte, Alexis M; Leonard, Carrie; Rozzi, Summer J; Taylor, Caitlin M; Gale, Karen; Kanwal, Jagmeet S; Maguire-Zeiss, Kathleen A; Wolfe, Barry B; Forcelli, Patrick A

2014-01-01

A key facet of professional development is the formation of professional identity. At its most basic level, professional identity for a scientist centers on mastery of a discipline and the development of research skills during doctoral training. To develop a broader understanding of professional identity in the context of doctoral training, the Carnegie Initiative on the Doctorate (CID) ran a multi-institutional study from 2001 to 2005. A key outcome of the CID was the development of the concept of 'stewards of the discipline'. The Interdisciplinary Program in Neuroscience (IPN) at Georgetown University participated in CID from 2003 to 2005. Here, we describe the IPN and highlight the programmatic developments resulting from participation in the CID. In particular, we emphasize programmatic activities that are designed to promote professional skills in parallel with scientific development. We describe activities in the domains of leadership, communication, teaching, public outreach, ethics, collaboration, and mentorship. Finally, we provide data that demonstrate that traditional metrics of academic success are not adversely affected by the inclusion of professional development activities in the curricula. By incorporating these seven 'professional development' activities into the required coursework and dissertation research experience, the IPN motivates students to become stewards of the discipline.

Doctors who considered but did not pursue specific clinical specialties as careers: questionnaire surveys.

Science.gov (United States)

Goldacre, Michael J; Goldacre, Raph; Lambert, Trevor W

2012-04-01

To report doctors' rejection of specialties as long-term careers and reasons for rejection. Postal questionnaires. United Kingdom. Graduates of 2002, 2005 and 2008 from all UK medical schools, surveyed one year after qualification. Current specialty choice; any choice that had been seriously considered but not pursued (termed 'rejected' choices) with reasons for rejection. 2573 of 9155 respondents (28%) had seriously considered but then not pursued a specialty choice. By comparison with positive choices, general practice was under-represented among rejected choices: it was the actual choice of 27% of respondents and the rejected choice of only 6% of those who had rejected a specialty. Consideration of 'job content' was important in not pursuing general practice (cited by 78% of those who considered but rejected a career in general practice), psychiatry (72%), radiology (69%) and pathology (68%). The surgical specialties were the current choice of 20% of respondents and had been considered but rejected by 32% of doctors who rejected a specialty. Issues of work-life balance were the single most common factor, particularly for women, in not pursuing the surgical specialties, emergency medicine, the medical hospital specialties, paediatrics, and obstetrics and gynaecology. Competition for posts, difficult examinations, stressful working conditions, and poor training were mentioned but were mainly minority concerns. There is considerable diversity between doctors in their reasons for finding specialties attractive or unattractive. This underlines the importance of recruitment strategies to medical school that recognize diversity of students' interests and aptitudes.

Investigating the feasibility and acceptability of health psychology-informed obesity training for medical students.

Science.gov (United States)

Chisholm, Anna; Hart, Jo; Mann, Karen; Perry, Mark; Duthie, Harriet; Rezvani, Leila; Peters, Sarah

2016-01-01

Health psychologists have succeeded in identifying theory-congruent behaviour change techniques (BCTs) to prevent and reduce lifestyle-related illnesses, such as cardiovascular disease, cancers and diabetes. Obesity management discussions between doctors and patients can be challenging and are often avoided. Despite a clear training need, it is unknown how best to tailor BCT research findings to inform obesity-management training for future healthcare professionals. The primary objective of this descriptive study was to gather information on the feasibility and acceptability of delivering and evaluating health psychology-informed obesity training to UK medical students. Medical students (n = 41) attended an obesity management session delivered by GP tutors. Sessions were audio-recorded to enable fidelity checks. Acceptability of training was explored qualitatively. Tutors consistently delivered training according to the intervention protocol; and students and tutors found the training highly acceptable. This psychology-informed training can be delivered successfully by GP tutors and further research is warranted to explore its efficacy.

[The ski camp doctor's role in the the prevention of winter sport accidents].

Science.gov (United States)

Felkai, Péter

2007-08-26

Skiing is a risky sport for many, even for children and beginners. When the ski-group is escorted by doctors who are able to provide advanced life support on the scene and are trained either in the field of emergency medicine or in travel medicine, a good possibility is given for the prevention of ski-accidents and for decreasing the number of travel related illnesses. This fact has led to the basic idea of training ski-camp doctors in Hungary. There is no similar initiative in the Hungarian literature. Therefore the article tries to summarise the medical knowledge and requirements of a ski-camp doctor, and analyses the prevention tasks of the doctor as well. The camp doctor must be well informed and highly trained in the field of emergency and travel medicine. The main tasks are: pre-travel advice, treatment of the common (travel-related) diseases, providing basic and advanced life-support on the scene, and to organise the hospitalisation and repatriation of patient, in cooperation with the hospital and insurance doctor. Moreover, the prevention should start before departure: the estimation of the physical and health condition of the skiers, a continuous care of the chronic people, and supervision of the place (hygienic circumstances, rescue forces available, the condition of the ski slopes, etc.) are vital--as for the primary prevention. The secondary level of the prevention is the treatment of the injured/sick persons, and assistance in the medical evacuation. During the training, not only postgraduate medical, mountain and alpine medicine lessons have been provided, but basic legal and insurance information as well. Moreover, the doctors received ski-course from professional ski-trainers in order to improve their ski-technique and skills on different slopes and off-piste places. In the future the local mountain rescue and air-rescue forces have to be involved in postgraduate training. Hopefully different travel-insurance companies and travel offices will use

Women Doctors and Lady Nurses: Class, Education, and the Professional Victorian Woman.

Science.gov (United States)

Heggie, Vanessa

2015-01-01

The lives of the first women doctors in Britain have been well studied by historians, as have the many debates about the right of women to train and practice as doctors. Yet the relationship between these women and their most obvious comparators and competitors-the newly professionalized hospital nurses-has not been explored. This article makes use of a wide range of sources to explore the ways in which the first lady doctors created "clear water" between themselves and the nurses with whom they worked and trained. In doing so, it reveals an identity that may seem at odds with some of the clichés of Victorian femininity, namely that of the intelligent and ambitious lady doctor.

Doctors as managers of healthcare resources in Nigeria: Evolving roles and current challenges.

Science.gov (United States)

Ojo, Temitope Olumuyiwa; Akinwumi, Adebowale Femi

2015-01-01

Over the years, medical practice in Nigeria has evolved in scope and practice, in terms of changing disease patterns, patients' needs, and social expectations. In addition, there is a growing sentiment especially among the general public and some health workers that most doctors are bad managers. Besides drawing examples from some doctors in top management positions that have performed less creditably, critics also harp on the fact that more needs to be done to improve the training of doctors in health management. This article describes the role of doctors in this changing scene of practice and highlights the core areas where doctors' managerial competencies are required to improve the quality of healthcare delivery. Areas such as health care financing, essential drugs and supplies management, and human resource management are emphasized. Resources to be managed and various skills needed to function effectively at the different levels of management are also discussed. To ensure that doctors are well-skilled in managerial competencies, the article concludes by suggesting a curriculum review at undergraduate and postgraduate levels of medical training to include newer but relevant courses on health management in addition to the existing ones, whereas also advocating that doctors be incentivized to go for professional training in health management and not only in the core clinical specialties.

Barriers facing junior doctors in rural practice.

Science.gov (United States)

Smith, Deborah M

2005-01-01

Early postgraduate, or junior doctors, are still required to practise in rural and remote communities, and they continue to face numerous issues and difficulties. Within the hospital setting, exposure to rural practice appears to be very limited during internship, and also to some extent, during the second postgraduate year and beyond. This is a major issue for those required to undertake country relieving, rural terms or who will be bonded to rural and remote practice for several years after internship. This research investigated the current issues and difficulties faced by junior doctors, required to undertake rural and remote practice in Queensland, Australia. An exploratory study was undertaken. Primary data were collected through semi-structured interviews held with key stakeholders. Stakeholders included: directors of clinical training; medical educators; junior doctors; rural practitioners; academic rural practitioners; and medical administrators. Of the 23 people approached, a total of 19 agreed to be interviewed. The response rate was 82.6%. Similar to the issues identified in the literature, there are currently a number of barriers influencing the ability of junior doctors to practise competently and confidently when undertaking practice in rural and remote communities. Minimal clinical experience, lack of supervision and on-site support, inadequate orientation and uninformed expectations, limited access to relevant education, and the influence of isolation, results in an overall lack of preparation both professionally and personally. When asked, respondents supported the identification of core skills and knowledge, and integration of these and other issues affecting rural practice, into their hospital-based programs. Current hospital-based education and training programs were not adequately preparing junior doctors for rural and remote practice. It was commented that orientation and education, with a rural emphasis, could assist junior doctors in their

A National Study of Wellbeing of Hospital Doctors in Ireland

OpenAIRE

Hayes, Blanaid

2016-01-01

The working environment for hospital doctors in Ireland has undergone radical change in recent years with hospital posts becoming unattractive to doctors in training and to consultants. For young medical graduates, the tensions between training requirements and service demands have contributed to a ‘brain drain’ with over half leaving to work abroad after graduation. Many consultant posts are vacant or are filled on a temporary basis, impacting on the quality of patient care. This study se...

Professional Doctorates: A Pathway to Legitimacy for Non-Academic HE Professionals?

Science.gov (United States)

Moran, Eamonn; Misra, Debananda

2018-01-01

This article discusses the current challenges faced by the two authors--both participants on a professional doctorate (PD) programme in education at a leading UK university--in gaining legitimacy as higher education (HE) professionals. By: (1) reflecting upon their own professional experiences in HE and as PD students; (2) utilizing…

Equipping tomorrow's doctors for the patients of today.

Science.gov (United States)

Oakley, Rachel; Pattinson, Joanne; Goldberg, Sarah; Daunt, Laura; Samra, Rajvinder; Masud, Tahir; Gladman, John R F; Blundell, Adrian G; Gordon, Adam L

2014-07-01

As the proportion of older patients with frailty presenting to health services increases, so does the need for doctors to be adequately trained to meet their needs. The presentations seen in such patients, the evidence-based models of care and skillsets required to deliver them are different than for younger patient groups-so specific training is required. Several research programmes have used detailed and explicit methods to establish evidence-based expert-validated curricula outlining learning outcomes for undergraduates in geriatric medicine-there is now broad-consensus on what newly qualified doctors need to know. There are, despite this, shortcomings in the teaching of undergraduates about geriatric medicine. National and international surveys from the UK, EU, USA, Canada, Austria and the Netherlands have all shown shortcomings in the content and amount of undergraduate teaching. Mechanisms to improve this situation, aside from specifying curricula, include developing academic departments and professorships in geriatric medicine, providing grants to develop teaching in geriatric medicine and developing novel teaching interventions to make the best of existing resources. Under the last of these headings, innovations have been shown to improve outcomes by: using technology to ensure the most effective allocation of teaching time and resources; using inter-professional education as a means of improving attitudes towards care of older patients; focusing teaching specifically on attitudes towards older patients and those who work with them; and trying to engage patients in teaching. Research areas going forward include how to incentivise medical schools to deliver specified curricula, how to choose from an ever-expanding array of teaching technologies, how to implement interprofessional education in a sustainable way and how to design teaching interventions using a qualitative understanding of attitudes towards older patients and the teams that care for them. �

Best practices in doctoral retention: Mentoring

Directory of Open Access Journals (Sweden)

Judie L. Brill

2014-06-01

Full Text Available  The aim of this critical literature review is to outline best practices in doctoral retention and the successful approach of one university to improve graduation success by providing effective mentorship for faculty and students alike. The focus of this literature review is on distance learning relationships between faculty and doctoral students, regarding retention, persistence, and mentoring models. Key phrases and words used in the search and focusing on mentoring resulted in over 20,000 sources. The search was narrowed to include only doctoral study and mentoring. Research questions of interest were: Why do high attrition rates exist for doctoral students? What are the barriers to retention? What are the benefits of doctoral mentoring? What programs do institutions have in place to reduce attrition? The researchers found a key factor influencing doctoral student retention and success is effective faculty mentorship. In particular, the design of a mentoring and faculty training program to increase retention and provide for success after graduation is important. This research represents a key area of interest in the retention literature, as institutions continue to search for ways to better support students during their doctoral programs and post-graduation. DOI: 10.18870/hlrc.v4i2.186

Undergraduate Origins of Recent Science and Engineering Doctorate Recipients.

Science.gov (United States)

Hill, Susan T.; And Others

Because undergraduate education is the foundation for graduate studies, it is important to know where our Nation's science and engineering (S&E) doctorate recipients are receiving their undergraduate training. Specifically, this report addresses the following broad questions: (1) What are the undergraduate origins of S&E doctorate holders? (2)…

Content and Process in a Teaching Workshop for Faculty and Doctoral Students

Science.gov (United States)

Rinfrette, Elaine S.; Maccio, Elaine M.; Coyle, James P.; Jackson, Kelly F.; Hartinger-Saunders, Robin M.; Rine, Christine M.; Shulman, Lawrence

2015-01-01

Teaching in higher education is often not addressed in doctoral education, even though many doctoral graduates will eventually teach. This article describes a biweekly teaching workshop, presents pitfalls and challenges that beginning instructors face, and advocates pedagogical training for doctoral students. Led by a well-known social work…

Learning needs in clinical biochemistry for doctors in foundation years.

Science.gov (United States)

Khromova, Victoria; Gray, Trevor A

2008-01-01

Most medical school curricula have reduced the amount of time available for teaching in pathology despite the fact that junior staff in the early stages of their training were responsible for requesting the majority of pathology tests on acutely ill hospital patients. So, the lack of specific training in this area means that test requesting may be poorly performed and the results ill understood by these staff. This paper describes a questionnaire, which was designed to assist laboratory staff providing targeted teaching in this area. Doctors in Foundation year 1 (F1) and Foundation year 2 (F2) in Sheffield teaching hospitals were given a questionnaire to ascertain how confident they were in requesting and interpreting the results of clinical biochemistry tests. The doctors were also asked about which areas of laboratory medicine they would like to be taught. Responses were received from 82 doctors, about half those in F1 and F2. The survey revealed areas where juniors are less confident in requesting tests and interpreting results. Despite lack of confidence in interpreting the result, 18% were confident about requesting tests. Doctors were also unsure of the effects of common problems like haemolysis on the interpretation of results. More than 70% of the doctors requested specific teaching in these areas. Foundation doctors have learning needs in clinical biochemistry, addressing which would assist them in patient care. While better training in medical school may help in future, there are specific needs for those on the wards now that require targeted teaching.

Investigating the influence of African American and African Caribbean race on primary care doctors' decision making about depression.

Science.gov (United States)

Adams, A; Vail, L; Buckingham, C D; Kidd, J; Weich, S; Roter, D

2014-09-01

This paper explores differences in how primary care doctors process the clinical presentation of depression by African American and African-Caribbean patients compared with white patients in the US and the UK. The aim is to gain a better understanding of possible pathways by which racial disparities arise in depression care. One hundred and eight doctors described their thought processes after viewing video recorded simulated patients presenting with identical symptoms strongly suggestive of depression. These descriptions were analysed using the CliniClass system, which captures information about micro-components of clinical decision making and permits a systematic, structured and detailed analysis of how doctors arrive at diagnostic, intervention and management decisions. Video recordings of actors portraying black (both African American and African-Caribbean) and white (both White American and White British) male and female patients (aged 55 years and 75 years) were presented to doctors randomly selected from the Massachusetts Medical Society list and from Surrey/South West London and West Midlands National Health Service lists, stratified by country (US v.UK), gender, and years of clinical experience (less v. very experienced). Findings demonstrated little evidence of bias affecting doctors' decision making processes, with the exception of less attention being paid to the potential outcomes associated with different treatment options for African American compared with White American patients in the US. Instead, findings suggest greater clinical uncertainty in diagnosing depression amongst black compared with white patients, particularly in the UK. This was evident in more potential diagnoses. There was also a tendency for doctors in both countries to focus more on black patients' physical rather than psychological symptoms and to identify endocrine problems, most often diabetes, as a presenting complaint for them. This suggests that doctors in both countries

Effectiveness and efficiency of training in digital healthcare packages: training doctors to use digital medical record keeping software.

Science.gov (United States)

Benwell, Nicola; Hird, Kathryn; Thomas, Nicholas; Furness, Erin; Fear, Mark; Sweetman, Greg

2017-10-01

Objective Fiona Stanley Hospital (FSH) is the first hospital in Western Australia to implement a digital medical record (BOSSnet, Core Medical Solutions, Australia). Formal training in the use of the digital medical record is provided to all staff as part of the induction program. The aim of the present study was to evaluate whether the current training program facilitates efficient and accurate use of the digital medical record in clinical practice. Methods Participants were selected from the cohort of junior doctors employed at FSH in 2015. An e-Learning package of clinically relevant tasks from the digital medical record was created and, along with a questionnaire, completed by participants on two separate occasions. The time taken to complete all tasks and the number of incorrect mouse clicks used to complete each task were recorded and used as measures of efficiency and accuracy respectively. Results Most participants used BOSSnet more than 10 times per day in their clinical roles and self-rated their baseline overall computer proficiency level as high. There was a significant increase in the self-rating of proficiency levels in successive tests. In addition, a significant improvement in both efficiency and accuracy for all participants was measured between the two tests. Interestingly, both groups ended up with similar accuracy on the second trial, despite the second group of participants starting with significantly poorer accuracy. Conclusions Overall, the greatest improvements in task performance followed daily ward-based experience using BOSSnet rather than formalised training. The greatest benefits of training were noted when training was delivered in close proximity to the onset of employment. What is known about the topic? Formalised training in the use of information and communications technology (ICT) is widespread in the health service. However, there is limited evidence to support the modes of learning typically used. Formalised training is often

UK Transfusion Laboratory Collaborative: minimum standards for staff qualifications, training, competency and the use of information technology in hospital transfusion laboratories 2014.

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Chaffe, B; Glencross, H; Jones, J; Staves, J; Capps-Jenner, A; Mistry, H; Bolton-Maggs, P; McQuade, M; Asher, D

2014-12-01

The SHOT Adverse Incident Reporting Scheme has consistently reported an unacceptably high level of errors originating in the laboratory setting. In 2006 an initiative was launched in conjunction with the IBMS, SHOT, RCPath, BBTS, UK NEQAS, the NHSE NBTC and the equivalents in Scotland, Wales and Northern Ireland that led to the formation of the UK TLC. The UK TLC in considering the nature and spread of the errors documented by SHOT concluded that a significant proportion of these errors were most likely to be related to either the use of information technology or staff education, staffing levels, skill mix, training and competency issues. In the absence of any formal guidance on these matters, the UK TLC developed a series of recommendations using the results of two laboratory surveys conducted in 2007 and 2008.

Patient perception of smartphone usage by doctors

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Kerry G

2017-03-01

Full Text Available Georgina Kerry,1 Shyam Gokani,2 Dara Rasasingam,2 Alexander Zargaran,3 Javier Ash,2 Aaina Mittal2 1College of Medical and Dental Sciences, University of Birmingham, Birmingham, 2Faculty of Medicine, Imperial College London, London, 3Faculty of Medicine, St George’s University of London, London, UK Abstract: Technological advancements have revolutionized modern medicine and smartphones are now ubiquitous among health care professionals. The ability to look up information promptly is invaluable to doctors and medical students alike, but there is an additional contiguous benefit to patients. Queries can be answered more accurately through fingertip access to evidence-based medicine, and physicians have instant access to emergency care protocols. However, is consideration always extended to the patient’s perception of the use of smartphones by doctors? Do patients know why we use smartphones to assist us in their care? What do they think when they see a doctor using a smartphone?An independent question, conducted within a wider service evaluation (ethical approval not required, full verbal and written electronic consent provided by all patients at St. Mary’s Hospital, London, indicated that although the majority (91.0% of patients owned a smartphone, many (61.6% did not agree that the use of smartphones at work by doctors is professional. This highlights the potential for damage to the doctor–patient relationship. There is a risk that these patients will disconnect with care services with possible detriment to their health. Additionally, it is notable that a larger proportion of those patients aged >70 years found the use of smartphones by doctors at work unprofessional, compared with patients aged <70 years.Adequate communication between the doctor and patient is critical in ensuring that doctors can make use of modern technology to provide the best possible care and that patients are comfortable with this and do not feel isolated or

A summative, Objective, Structured, Clinical Examination in ENT used to assess postgraduate doctors after one year of ENT training, as part of the Diploma of Otorhinolaryngology, Head and Neck Surgery.

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Drake-Lee, A B; Skinner, D; Hawthorne, M; Clarke, R

2009-10-01

'High stakes' postgraduate medical examinations should conform to current educational standards. In the UK and Ireland, national assessments in surgery are devised and managed through the examination structure of the Royal Colleges of Surgeons. Their efforts are not reported in the medical education literature. In the current paper, we aim to clarify this process. To replace the clinical section of the Diploma of Otorhinolaryngology with an Objective, Structured, Clinical Examination, and to set the level of the assessment at one year of postgraduate training in the specialty. After 'blueprinting' against the whole curriculum, an Objective, Structured, Clinical Examination comprising 25 stations was divided into six clinical stations and 19 other stations exploring written case histories, instruments, test results, written communication skills and interpretation skills. The pass mark was set using a modified borderline method and other methods, and statistical analysis of the results was performed. The results of nine examinations between May 2004 and May 2008 are presented. The pass mark varied between 68 and 82 per cent. Internal consistency was good, with a Cronbach's alpha value of 0.99 for all examinations and split-half statistics varying from 0.96 to 0.99. Different standard settings gave similar pass marks. We have developed a summative, Objective, Structured, Clinical Examination for doctors training in otorhinolaryngology, reported herein. The objectives and standards of setting a high quality assessment were met.

Intercultural doctor-patient communication in daily outpatient care: relevant communication skills.

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Paternotte, Emma; Scheele, Fedde; Seeleman, Conny M; Bank, Lindsay; Scherpbier, Albert J J A; van Dulmen, Sandra

2016-10-01

Intercultural communication (ICC) between doctors and patients is often associated with misunderstandings and dissatisfaction. To develop ICC-specific medical education, it is important to find out which ICC skills medical specialists currently apply in daily clinical consultations. Doctor-patient consultations of Dutch doctors with non-Dutch patients were videotaped in a multi-ethnic hospital in the Netherlands. The consultations were analyzed using the validated MAAS-Global assessment list in combination with factors influencing ICC, as described in the literature. In total, 39 videotaped consultations were analyzed. The doctors proved to be capable of practising many communication skills, such as listening and empathic communication behaviour. Other skills were not practised, such as being culturally aware and checking the patient's language ability. We showed that doctors did practice some but not all the relevant ICC skills and that the ICC style of the doctors was mainly biomedically centred. Furthermore, we discussed the possible overlap between intercultural and patient-centred communication. Implications for practice could be to implement the relevant ICC skills in the existing communication training or develop a communication training with a patient-centred approach including ICC skills.

Challenges in Doctoral Research Project Management: A Comparative Study

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Reuven Katz

2016-03-01

Full Text Available This paper presents quantitative results of a comparative study evaluating the management skills of doctoral candidates working toward a PhD and additional information related to their lifestyles. We conducted a survey among enrolled doctoral candidates at five universities in Israel and three technological universities in Western Europe. 1013 Israeli candidates and 457 Western European candidates replied to our survey. In our analysis, we compared the answers of Israeli Science and Engineering candidates to those of Social Sciences and Humanities candidates; in addition, we compared the answers of Israeli Science and Engineering students to their Western European peers. Our analysis focused on finding significant patterns by comparing these groups of students. In order to identify such patterns, we analyzed each question using the Pearson chi-square test. The current study’s main finding is that the majority of candidates, regardless of their chosen academic field or the region where they study, have no training or expertise in managing a doctoral research project. Based on these findings, we suggest that all doctoral candidates be taught basic research-project management. We believe that such training will provide them with a powerful tool for better managing their research as they advance towards successful completion of their doctorate.

EHR adoption among doctors who treat the elderly.

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Yeager, Valerie A; Menachemi, Nir; Brooks, Robert G

2010-12-01

The purpose of this study is to examine Electronic Health Record (EHR) adoption among Florida doctors who treat the elderly. This analysis contributes to the EHR adoption literature by determining if doctors who disproportionately treat the elderly differ from their counterparts with respect to the utilization of an important quality-enhancing health information technology application. This study is based on a primary survey of a large, statewide sample of doctors practising in outpatient settings in Florida. Logistic regression analysis was used to determine whether doctors who treat a high volume of elderly (HVE) patients were different with respect to EHR adoption. Our analyses included responses from 1724 doctors. In multivariate analyses controlling for doctor age, training, computer sophistication, practice size and practice setting, HVE doctors were significantly less likely to adopt EHR. Specifically, compared with their counterparts, HVE doctors were observed to be 26.7% less likely to be utilizing an EHR system (OR=0.733, 95% CI 0.547-0.982). We also found that doctor age is negatively related to EHR adoption, and practice size and doctor computer savvy-ness is positively associated. Despite the fact that EHR adoption has improved in recent years, doctors in Florida who serve the elderly are less likely to adopt EHRs. As long as HVE doctors are adopting EHR systems at slower rates, the elderly patients treated by these doctors will be at a disadvantage with respect to potential benefits offered by this technology. © 2010 Blackwell Publishing Ltd.

Procedural skills practice and training needs of doctors, nurses, midwives and paramedics in rural Victoria

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Campbell, David; Shepherd, Irwyn; McGrail, Matthew; Kassell, Lisa; Connolly, Marnie; Williams, Brett; Nestel, Debra

2015-01-01

Introduction Procedural skills are a significant component of clinical practice. Doctors, nurses, midwives and paramedics are trained to use a variety of procedural skills. Rural clinicians in particular are often required to maintain competence in some procedural skills that are used infrequently, and which may require regular and repeated rehearsal. This paper reports on a research project conducted in Gippsland, Victoria, to ascertain the frequency of use, and relevance to clinical practice, of a range of skills in the fields of medicine, nursing, midwifery, and paramedic practice. The project also gathered data on the attitudes of clinicians regarding how frequently and by what means they thought they needed to practice these skills with a particular focus on the use of simulation as an educational method. Methods The research was conducted following identification of a specific set of procedural skills for each professional group. Skills were identified by an expert steering committee. We developed online questionnaires that consisted of two parts: 1) demographic and professional characteristics, and 2) experience of procedural skills and perceived training needs. We sought to invite all practicing clinicians (doctors, nurses, midwives, paramedics) working in Gippsland. Online surveys were distributed between November 2011 and April 2012 with three follow-up attempts. The Monash University Human Research Ethics Committee approved the study. Results Valid responses were received from 58 doctors, 94 nurses, 46 midwives, and 30 paramedics, whom we estimate to represent not more than 20% of current clinicians within these professions. This response rate reflected some of the difficulties experienced in the conduct of the research. Results were tabulated for each professional group across the range of skills. There was significant correlation between the frequency of certain skills and confidence with maintenance of these skills. This did not necessarily correlate

Procedural skills practice and training needs of doctors, nurses, midwives and paramedics in rural Victoria.

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Campbell, David; Shepherd, Irwyn; McGrail, Matthew; Kassell, Lisa; Connolly, Marnie; Williams, Brett; Nestel, Debra

2015-01-01

Procedural skills are a significant component of clinical practice. Doctors, nurses, midwives and paramedics are trained to use a variety of procedural skills. Rural clinicians in particular are often required to maintain competence in some procedural skills that are used infrequently, and which may require regular and repeated rehearsal. This paper reports on a research project conducted in Gippsland, Victoria, to ascertain the frequency of use, and relevance to clinical practice, of a range of skills in the fields of medicine, nursing, midwifery, and paramedic practice. The project also gathered data on the attitudes of clinicians regarding how frequently and by what means they thought they needed to practice these skills with a particular focus on the use of simulation as an educational method. The research was conducted following identification of a specific set of procedural skills for each professional group. Skills were identified by an expert steering committee. We developed online questionnaires that consisted of two parts: 1) demographic and professional characteristics, and 2) experience of procedural skills and perceived training needs. We sought to invite all practicing clinicians (doctors, nurses, midwives, paramedics) working in Gippsland. Online surveys were distributed between November 2011 and April 2012 with three follow-up attempts. The Monash University Human Research Ethics Committee approved the study. Valid responses were received from 58 doctors, 94 nurses, 46 midwives, and 30 paramedics, whom we estimate to represent not more than 20% of current clinicians within these professions. This response rate reflected some of the difficulties experienced in the conduct of the research. Results were tabulated for each professional group across the range of skills. There was significant correlation between the frequency of certain skills and confidence with maintenance of these skills. This did not necessarily correlate with perceptions of

Making time for what's important: what elements should we value when planning practice-based professional training?

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Williams, J C; Clements, S

2016-08-12

Newly qualified professional healthcare graduates, whether training to become doctors, dentists, veterinary surgeons or nurses, tend to need some support as they take their first steps along that bumpy road from university to confident, competent practice. We identify some key features of the UK programme of dental practice-based training to acknowledge its strengths - 12 months of clinical practice within a well-established dental team, one-to-one weekly meetings with the same dedicated mentor, regular peer learning with the same group of peers over 12 months and the opportunity to observe role models from the profession including training programme directors and other general dental practitioners (GDPs). This educational programme is unique to dentistry and this article outlines why we believe it is important to value these features when designing postgraduate professional training in healthcare sciences.

The use of equipment and training practices and the prevalence of owner-reported ridden behaviour problems in UK leisure horses.

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Hockenhull, J; Creighton, E

2013-01-01

UK leisure horses are owned primarily for riding. Ridden behaviour problems may compromise the use of the horse in this role and lead to harsh redress or relinquishment of the horse. Despite the consequences of these problems little is known about their prevalence or the working lives of UK leisure horses. To generate data on the work undertaken by leisure horses, the equipment and training practices used with them and prevalence of ridden behaviour problems. An internet survey was used to generate horse-level data from a convenience sample of leisure horse carers. Respondents were asked to report on their practices in the week prior to the survey's completion to minimise recall bias. The survey was online for one year to allow for seasonal variation in practices. Data were collected on the tack and equipment used on the horse, the regularity that professional services (e.g. farriers) were used, type of training employed and frequency the owner reported that horse displayed 15 ridden behaviour problems. The survey generated data on 1326 individual horses. Data describing practices relating to the horse's working life are presented. Ridden behaviour problems were reported in 91% of horses in the week preceding data collection. Descriptive data on the working lives of UK leisure horses provides valuable baseline statistics for this largest section of the UK horse population. High prevalence of owner-reported ridden behaviour problems represents a concern in such leisure horses and may indicate significant rider safety and horse welfare concerns. © 2012 EVJ Ltd.

La formación actual del médico: fortalezas y debilidades The current training of doctors: strengths and weaknesses

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X. Clèries

2009-03-01

Full Text Available Las “Jornadas estatales de estudio y debate sobre el futuro de la formación integral del médico ¿bioingeniería o medicina?” que se realizaron en Barcelona el 8 y 9 de febrero de 2008 fueron el marco para que un grupo de trabajo abordara el tema de las fortalezas y debilidades de la formación actual del médico. Las principales aportaciones se estructuraron en los tres niveles educativos siguientes: pregrado, posgrado y formación continuada. Se destacó la necesidad de una formación integral y psicosocial en la enseñanza de pregrado, la conveniencia de una estructuración troncal de la formación de posgrado para conseguir una mayor transversalidad de la competencia del médico y la contextualización de la formación continuada en el desarrollo profesional de cada médico. El predominio de los conocimientos biomédicos y tecnológicos en la formación actual del médico contrastan con las demandas de carácter psicosocial de una gran parte de la población en el sistema sanitario.The “National Conference for study and debate on the future of the integral training of doctors: bioengineering or medicine?” that were realized in Barcelona on February 8-9th, 2008 it was the context so that a work group was carried out on the topic about strengths and weaknesses of the current training of physicians. The main contributions were structured around three educational levels: undergraduate, postgraduate and continuing education. In the undergraduate level was emphasized the need to achieve an integral and psychosocial education. The postgraduate education should have a core subject in order to acquire a better global understanding of doctors' competences. Continuing medical education in the context of professional development of every physician. The predominance of the biomedical and technological knowledge in the current training of doctors contrasts with psychosocial demands of the population of healthcare system.

Perceptions and Impact of Mandatory eLearning for Foundation Trainee Doctors: A Qualitative Evaluation.

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Brooks, Hannah L; Pontefract, Sarah K; Vallance, Hannah K; Hirsch, Christine A; Hughes, Elizabeth; Ferner, Robin E; Marriott, John F; Coleman, Jamie J

2016-01-01

Junior doctors in the UK must complete various educational components during their two year Foundation training programme. It is important that mandatory learning is informative and engaging. The aim of this study was to evaluate trainee doctors' perceptions of a Technology Enhanced Learning (TEL) programme developed to improve prescribing competency. Focus groups and interviews were conducted at three hospital sites in the West Midlands. Codes, sub-themes and themes were determined using deductive and inductive thematic analysis. Data were collected from 38 Foundation trainee doctors. Results revealed major themes relating to prescribing education, the user experience and user engagement. Key findings included the positive impact of preparedness following undergraduate education on the user experience of the TEL programme at the postgraduate level; the impact of content, structure, and individual learning needs and styles on the user experience; and the impact of motivation and time on engagement. Most trainees engaged with the programme owing to its mandatory nature; however, some trainees also used the programme voluntarily, for example, to acquire knowledge prior to starting a new placement. It is important to ensure that learners are willing to engage with mandatory TEL, and that they have the time and motivation to do so. It is also important to ensure that learners have a positive user experience and that in designing TEL individual differences in learning styles and needs are taken into account. These findings have implications for educators and system developers in the construction and design of mandatory eLearning programmes.

Imagined and Emerging Career Patterns: Perceptions of Doctoral Students and Research Staff

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McAlpine, Lynn; Turner, Gill

2012-01-01

Increasingly, research staff positions rather than lectureships are the reality for social sciences PhD graduates wishing academic work. Within this context, our longitudinal study examined how social science doctoral students and research staff in two UK universities imagined their futures in and out of academia. The variation over time in how…

Effect of UK policy on medical migration: a time series analysis of physician registration data.

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Blacklock, Claire; Heneghan, Carl; Mant, David; Ward, Alison M

2012-09-25

Economically developed countries have recruited large numbers of overseas health workers to fill domestic shortages. Recognition of the negative impact this can have on health care in developing countries led the United Kingdom Department of Health to issue a Code of Practice for National Health Service (NHS) employers in 1999 providing ethical guidance on international recruitment. Case reports suggest this guidance had limited influence in the context of other NHS policy priorities. The temporal association between trends in new professional registrations from doctors qualifying overseas and relevant United Kingdom government policy is reported. Government policy documents were identified by a literature review; further information was obtained, when appropriate, through requests made under the Freedom of Information Act. Data on new professional registration of doctors were obtained from the General Medical Council (GMC). New United Kingdom professional registrations by doctors trained in Africa and south Asia more than doubled from 3105 in 2001 to 7343 in 2003, as NHS Trusts sought to achieve recruitment targets specified in the 2000 NHS Plan; this occurred despite ethical guidance to avoid active recruitment of doctors from resource-poor countries. Registration of such doctors declined subsequently, but in response to other government policy initiatives. A fall in registration of South African-trained doctors from 3206 in 2003 to 4 in 2004 followed a Memorandum of Understanding with South Africa signed in 2003. Registrations from India and Pakistan fell from a peak of 4626 in 2004 to 1169 in 2007 following changes in United Kingdom immigration law in 2005 and 2006. Since 2007, registration of new doctors trained outside the European Economic Area has remained relatively stable, but in 2010 the United Kingdom still registered 722 new doctors trained in Africa and 1207 trained in India and Pakistan. Ethical guidance was ineffective in preventing mass

Audit on the Quality of Handovers of a Psychiatric Liaison Team in the UK: a Short Report.

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Koli, Trupti; Filippidou, Maria

2017-09-01

The importance of handovers has been recognised and proven in clinical practice. In liaison psychiatry, this is particularly important due to the high turnover of patients seen, the shift work pattern and the number of member staff engaging in this process. An Audit on the Quality of Handovers was carried out within a Psychiatric Liaison team of a General hospital in UK with an intention to review and improve this. Handovers were evaluated against the gold standard of the SBAR tool (Situation/Background/Assessment/Recommendations) over a period of 4 weeks. Handovers were assessed by 2 members of staff (a Consultant & a Specialty doctor). Data was analysed using Microsoft Excel. Results showed that the team's handover practice is mostly "Good" but there was also an amount of "Poor" under "Situation & Background", mostly presented by mid-grade doctors & trainees. Nurses scored higher than medics on overall rating, nearly 50%.This could be attributed to the fact that handovers form an essential & integral part of Nurse's training & culture. Also mid-grade (staff grade) doctors have had a significant amount of "excellent" scoring that other groups didn't have, mostly on the Assessment & Recommendations domains, which can be attributed to the fact that importance is stressed more on the assessment & treatment module by the doctors. The multi-disciplinary composition of the liaison psychiatry team has a positive impact on the patient care. This audit has revealed overall good communication amongst the members of the team, nevertheless one that needs some improvement, particularly amongst the doctors. Doctors tend to focus on the remedial (assessment & treatment) module rather than the holistic approach. SBAR remains an effective & handy tool to improve the handover quality. A re-audit will be carried out in 6 months time to assess the improvements observed following the implementation of this new tool.

Winter is Coming: Doctoral Supervision in the Neoliberal University

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Tara Brabazon

2017-01-01

Full Text Available : Doctoral Education Studies, particularly in its North American manifestations, emphasizes quantitative methods. The resulting research is empirical and occasionally empiricist. The challenges revealed through this mode of research is that the highly ideological, volatile environment of higher education is flattened, framed and justified. My research offers an alternative view and perspective of doctoral education through a post-empirical, theoretical article. Within my piece, the PhD and doctoral supervision are framed by the post-Global Financial Crisis to understand the very specific – and volatile – context for research and research training.

Choice and rejection of psychiatry as a career: surveys of UK medical graduates from 1974 to 2009†

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Goldacre, Michael J.; Fazel, Seena; Smith, Fay; Lambert, Trevor

2013-01-01

Background Recruitment of adequate numbers of doctors to psychiatry is difficult. Aims To report on career choice for psychiatry, comparing intending psychiatrists with doctors who chose other clinical careers. Method Questionnaire studies of all newly qualified doctors from all UK medical schools in 12 qualification years between 1974 and 2009 (33 974 respondent doctors). Results One, three and five years after graduation, 4–5% of doctors specified psychiatry as their first choice of future career. This was largely unchanged across the 35 years. Comparing intending psychiatrists with doctors who chose other careers, factors with a greater influence on psychiatrists’ choice included their experience of the subject at medical school, self-appraisal of their own skills, and inclinations before medical school. In a substudy of doctors who initially considered but then did not pursue specialty choices, 72% of those who did not pursue psychiatry gave ‘job content’ as their reason compared with 33% of doctors who considered but did not pursue other specialties. Historically, more women than men have chosen psychiatry, but the gap has closed over the past decade. Conclusions Junior doctors’ views about psychiatry as a possible career range from high levels of enthusiasm to antipathy, and are more polarised than views about other specialties. Shortening of working hours and improvements to working practices in other hospital-based specialties in the UK may have reduced the relative attractiveness of psychiatry to women doctors. The extent to which views of newly qualified doctors about psychiatry can be modified by medical school education, and by greater exposure to psychiatry during student and early postgraduate years, needs investigation. PMID:23099446

Doctors' experience with handheld computers in clinical practice: qualitative study.

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McAlearney, Ann Scheck; Schweikhart, Sharon B; Medow, Mitchell A

2004-05-15

To examine doctors' perspectives about their experiences with handheld computers in clinical practice. Qualitative study of eight focus groups consisting of doctors with diverse training and practice patterns. Six practice settings across the United States and two additional focus group sessions held at a national meeting of general internists. 54 doctors who did or did not use handheld computers. Doctors who used handheld computers in clinical practice seemed generally satisfied with them and reported diverse patterns of use. Users perceived that the devices helped them increase productivity and improve patient care. Barriers to use concerned the device itself and personal and perceptual constraints, with perceptual factors such as comfort with technology, preference for paper, and the impression that the devices are not easy to use somewhat difficult to overcome. Participants suggested that organisations can help promote handheld computers by providing advice on purchase, usage, training, and user support. Participants expressed concern about reliability and security of the device but were particularly concerned about dependency on the device and over-reliance as a substitute for clinical thinking. Doctors expect handheld computers to become more useful, and most seem interested in leveraging (getting the most value from) their use. Key opportunities with handheld computers included their use as a stepping stone to build doctors' comfort with other information technology and ehealth initiatives and providing point of care support that helps improve patient care.

Exploring the experiences of EU qualified doctors working in the United Kingdom: a qualitative study.

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Legido-Quigley, Helena; Saliba, Vanessa; McKee, Martin

2015-04-01

This qualitative study of 23 doctors from other EU member states working in the UK highlights that, contrary to media reports, doctors from other member states working in the UK were well prepared and their main motivation to migrate was to learn new skills and experience a new health care system. Interviewees highlighted some aspects of their employment that work well and others that need improving. Some interviewees reported initially having language problems, but most noted that this was resolved after a few months. These doctors overwhelmingly reported having very positive experiences with patients, enjoying a NHS structure that was less hierarchical structure than in their home systems, and appreciating the emphasis on evidence-based medicine. Interviewees mostly complained about the lack of cleanliness of hospitals and gave some examples of risk to patient safety. Interviewees did not experience discrimination other than some instances of patronising and snobbish behaviour. However, a few believed that their nationality was a block to achieving senior positions. Overall, interviewees reported having enjoyable experiences with patients and appreciating what the NHS had to offer. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Passing through - reasons why migrant doctors in Ireland plan to stay, return home or migrate onwards to new destination countries.

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Brugha, Ruairí; McAleese, Sara; Dicker, Pat; Tyrrell, Ella; Thomas, Steve; Normand, Charles; Humphries, Niamh

2016-06-30

International recruitment is a common strategy used by high-income countries to meet their medical workforce needs. Ireland, despite training sufficient doctors to meet its internal demand, continues to be heavily dependent on foreign-trained doctors, many of whom may migrate onwards to new destination countries. A cross-sectional study was conducted to measure and analyse the factors associated with the migratory intentions of foreign doctors in Ireland. A total of 366 non-European nationals registered as medical doctors in Ireland completed an online survey assessing their reasons for migrating to Ireland, their experiences whilst working and living in Ireland, and their future plans. Factors associated with future plans - whether to remain in Ireland, return home or migrate to a new destination country - were tested by bivariate and multivariate analyses, including discriminant analysis. Of the 345 foreign doctors who responded to the question regarding their future plans, 16 % of whom were Irish-trained, 30 % planned to remain in Ireland, 23 % planned to return home and 47 % to migrate onwards. Country of origin, personal and professional reasons for migrating, experiences of training and supervision, opportunities for career progression, type of employment contract, citizenship status, and satisfaction with life in Ireland were all factors statistically significantly associated with the three migratory outcomes. Reported plans may not result in enacted emigration. However, the findings support a growing body of evidence highlighting dissatisfaction with current career opportunities, contributing to the emigration of Irish doctors and onward migration of foreign doctors. Implementation of the WHO Global Code, which requires member states to train and retain their own health workforce, could also help reduce onward migration of foreign doctors to new destination countries. Ireland has initiated the provision of tailored postgraduate training to doctors from

Children and their parents assessing the doctor-patient interaction: a rating system for doctors' communication skills.

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Crossley, Jim; Eiser, Christine; Davies, Helena A

2005-08-01

Only a patient and his or her family can judge many of the most important aspects of the doctor-patient interaction. This study evaluates the feasibility and reliability of children and their families assessing the quality of paediatricians' interactions using a rating instrument developed specifically for this purpose. A reliability analysis using generalisability theory on the ratings from 352 doctor-patient interactions across different speciality clinics. Ratings were normally distributed. They were highest for 'overall' performance, and lowest for giving time to discuss the families' agenda. An appropriate sample of adults' ratings provided a reliable score (G = 0.7 with 15 raters), but children's ratings were too idiosyncratic to be reproducible (G = 0.36 with 15 raters). CONCLUSIONS AND FURTHER WORK: Accompanying adults can provide reliable ratings of doctors' interactions with children. Because an adult is usually present at the consultation their ratings provide a highly feasible and authentic approach. Sampling doctors' interactions from different clinics and with patients of both genders provides a universal picture of performance. The method is ideal to measure performance for in-training assessment or revalidation. Further work is in progress to evaluate the educational impact of feeding ratings back to the doctors being assessed, and their use in a range of clinical contexts.

[Added value of family practitioners' supervision of junior doctors in a walk-in clinic].

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Perdrix, J; Gubser, R; Gilgien, W; Bischoff, T

2011-05-18

The pending workforce crisis in family medicine has triggered various initiatives. This article describes the PMU-FLON walk-in clinic, a project of the Institute of General Medicine University of Lausanne. The working conditions in this clinic are close to that of a family practice. Doctors in training are supervised by family doctors who work part-time in the clinic. The objective is to improve training in the various fields of family medicine, from technical skills (improving optimal use of diagnostic tools), to integrating patients' requests in a more global patient-centered approach. This new educational model allows doctors in training to benefit from the specific approaches of different trainers. It will contribute to promoting quality family medicine in the future.

Identifying current training provision and future training needs in allergy available for UK general practice trainees: national cross-sectional survey of General Practitioner Specialist Training programme directors.

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Ellis, Jayne; Rafi, Imran; Smith, Helen; Sheikh, Aziz

2013-03-01

There are ongoing concerns about the quality of care provision for allergy in primary care. To identify current training provision in allergy to GP trainees and to understand how this could be enhanced. A cross-sectional survey of GP Speciality Training (GPST) programme directors was undertaken. Programme directors of the 174 GPST schemes were sent an online questionnaire which was informed by the content of the Royal College of General Practitioners curriculum. Quantitative data were descriptively analysed and a thematic analysis was undertaken of free text responses. We obtained responses from 146 directors representing 106 training programmes. Responses indicated that two-thirds (62%, 95% CI 53.1 to 71.5) of programmes were providing at least some allergy training, with the remaining third stating that they either provided no training or were unsure. Overall, one-third (33%, 95% CI 22.7 to 42.2) of programme directors believed that all the relevant allergy-related curriculum requirements were being met. Where provided, this training was believed to be best for organ-specific allergic disorders but was thought to be poorer for systemic allergic disorders, particularly food allergy where 67% (95% CI 57.5 to 76.5) of respondents indicated that training was poor. There was considerable interest in increasing the allergy training provided, preferably through eLearning modules and problem-based learning materials supported by those with relevant specialist knowledge. This UK-wide survey has identified important gaps in the training of GP trainees in relation to allergy care. Addressing these gaps, particularly in the management of systemic allergic disorders, should help to improve delivery of primary care-based allergy care.

Productivity, impact, and collaboration differences between transdisciplinary and traditionally trained doctoral students: A comparison of publication patterns

Science.gov (United States)

Sloane, Stephanie; Liechty, Janet M.; Fiese, Barbara H.; Donovan, Sharon M.

2017-01-01

Transdisciplinary (TD) approaches are increasingly used to address complex public health problems such as childhood obesity. Compared to traditional grant-funded scientific projects among established scientists, those designed around a TD, team-based approach yielded greater publication output after three to five years. However, little is known about how a TD focus throughout graduate school training may affect students’ publication-related productivity, impact, and collaboration. The objective of this study was to compare the publication patterns of students in traditional versus TD doctoral training programs. Productivity, impact, and collaboration of peer-reviewed publications were compared between traditional (n = 25) and TD (n = 11) students during the first five years of the TD program. Statistical differences were determined by t-test or chi square test at p students was 5.2 ± 10.1 (n = 56) compared to 3.6 ± 4.5 per traditional student (n = 82). Publication impact indicators were significantly higher for TD students vs. traditional students: 5.7 times more citations in Google Scholar, 6.1 times more citations in Scopus, 1.3 times higher journal impact factors, and a 1.4 times higher journal h-index. Collaboration indicators showed that publications by TD students had significantly more co-authors (1.3 times), and significantly more disciplines represented among co-authors (1.3 times), but not significantly more organizations represented per publication compared to traditional students. In conclusion, compared to doctoral students in traditional programs, TD students published works that were accepted into higher impact journals, were more frequently cited, and had more cross-disciplinary collaborations. PMID:29244832

[Academician Li Lianda talking about doctors doing scientific research].

Science.gov (United States)

He, Ping; Li, Yi-kui

2015-09-01

At present, Chinese medical field faces with an important problem of how to correctly handle the relationship between medical and scientific research. Academician Li Lianda advocates doctors doing scientific research under the premise of putting the medical work first. He points out that there are many problems in the process of doctors doing scientific research at present such as paying more attention to scientific research than medical care, excessively promoting building scientific research hospital, only paying attention to training scientific talents, research direction be flashy without substance, the medical evaluation system should be improved and so on. Medical, scientific research and teaching are inseparable because improving medical standards depends on scientific research and personnel training. But not all doctors need to take into account of medical treatment, scientific research and teaching in the same degree while not all hospitals need to turn into three-in-one hospital, scientific research hospital or teaching hospital. It must be treated differently according to the actual situation.

Job satisfaction among Australian doctors: the use of latent class analysis.

Science.gov (United States)

Joyce, Catherine; Wang, Wei Chun

2015-10-01

To identify patterns of job satisfaction among Australian doctors using latent class analysis, and to determine the relationships of these patterns to personal and professional characteristics so as to improve satisfaction and minimize medical wastage. MABEL (Medicine in Australia: Balancing Employment and Life) data in 2011 were used. The study collected information on 5764 doctors about their job satisfaction, demographic characteristics, their health, country of medical training, opportunities for professional development and social interaction, taking time off work, views of patients' expectations, unpredictable working hours, hours worked per week, preference to reduce hours and intention to leave the medical workforce. Four latent classes of job satisfaction were identified: 5.8% had high job satisfaction; 19.4% had low satisfaction with working hours; 16.1% had high satisfaction with working hours but felt undervalued; and 6.5% had low job satisfaction. Low job satisfaction was associated with reporting poor health, having trained outside Australia, having poor opportunities for professional development and working longer hours. Low satisfaction was associated with a preference to reduce work hours and an intention to leave the medical workforce. To improve job satisfaction and minimize medical wastage, policies need to address needs of overseas trained doctors, provide continuing professional development and provide good health care for doctors. © The Author(s) 2015.

Ethnic inequalities in doctor-patient communication regarding personal care plans: the mediating effects of positive mental wellbeing.

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Umeh, Kanayo F

2017-04-06

There is limited understanding of ethnic inequalities in doctor-patient communication regarding personal care plans (PCPs). This study investigated the mediating effects of positive mental wellbeing on differences in PCP-related doctor-patient communication amongst South Asian and Caucasian UK residents. Data from 10,980 respondents to the 2013 Health Survey for England was analysed using bootstrapping methods. Constructs from the WEMWBS (Warwick and Edinburgh Mental Wellbeing Scale) (Stewart-Brown, S., and K. Janmohamed. 2008. Warwick, UK) were assessed as mediators of relations between ethnicity and several doctor-patient communication variables, including PCP-related interactions; (a) had a PCP-related discussion about a long-term condition with a doctor/nurse, and (b) had this conversation within the past year, (c) agreed to a PCP with a health professional; and (d) talked to a doctor in the past 2 weeks. Bootstrapped mediation analysis (Hayes, A. F. 2013. Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-based Approach. New York, NY: The Guilford Press) showed that three positive mind-sets mediated associations between ethnicity and doctor-patient contact, including PCP-related communication. Being able to make up one's mind (ab = -0.05; BC a CI [-0.14, 0.01]) mediated the effect of ethnicity on agreeing to a PCP, while having energy to spare (ab = 0.07; BC a CI [-0.04, 0.12]), and feeling good about oneself (ab = 0.03; BC a CI [0.01, 0.07]), mediated ethnic effects on talking to a doctor during the past fortnight. The mediating effect of reported energy persisted after controlling for medical history, perceived health, and other covariates. Ethnic disparities in doctor-patient interaction, including PCP-related communication, are partly explained by positive mental wellbeing. Gauging positive psychological moods in patients, particularly self-worth, self-perceived vigour and decisiveness, are relevant to

Student Socialization in Interdisciplinary Doctoral Education

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Boden, Daniel; Borrego, Maura; Newswander, Lynita K.

2011-01-01

Interdisciplinary approaches are often seen as necessary for attacking the most critical challenges facing the world today, and doctoral students and their training programs are recognized as central to increasing interdisciplinary research capacity. However, the traditional culture and organization of higher education are ill-equipped to…

The complex thinking and prospect of actions of future doctors

Directory of Open Access Journals (Sweden)

Patrícia Segtowich

2011-12-01

Full Text Available This paper aims at discussing prospects of actions manifested by future doctors in the beginning of their doctoral training. The research started through my involvement in the ambit of doctoral education in the curriculum component Epistemological Basis of Research on Education in Science and Mathematics, offered in the Postgraduate Course in Science and Mathematics Education, at Federal University of Pori (UFPA in 2010 academic year. At these meetings, the teachers trainers requested the doctoral students, in pairs, to elaborate three questions about the following positioning: "HOW DO I SEE MYSELF AS A DOCTOR?" These questions were discussed by all the doctoral students and subsequently reduced to five to be answered by all individually. The responses to this questionnaire provided the data for this research. The answers revealed that doctoral students are not tied to methodologies or unique processes, this positioning being demonstrated through prospects of performance in ways that were diverse and interactive

Views of junior doctors about whether their medical school prepared them well for work: questionnaire surveys

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Taylor Kathryn

2010-11-01

Full Text Available Abstract Background The transition from medical student to junior doctor in postgraduate training is a critical stage in career progression. We report junior doctors' views about the extent to which their medical school prepared them for their work in clinical practice. Methods Postal questionnaires were used to survey the medical graduates of 1999, 2000, 2002 and 2005, from all UK medical schools, one year after graduation, and graduates of 2000, 2002 and 2005 three years after graduation. Summary statistics, chi-squared tests, and binary logistic regression were used to analyse the results. The main outcome measure was the level of agreement that medical school had prepared the responder well for work. Results Response rate was 63.7% (11610/18216 in year one and 60.2% (8427/13997 in year three. One year after graduation, 36.3% (95% CI: 34.6, 38.0 of 1999/2000 graduates, 50.3% (48.5, 52.2 of 2002 graduates, and 58.2% (56.5, 59.9 of 2005 graduates agreed their medical school had prepared them well. Conversely, in year three agreement fell from 48.9% (47.1, 50.7 to 38.0% (36.0, 40.0 to 28.0% (26.2, 29.7. Combining cohorts at year one, percentages who agreed that they had been well prepared ranged from 82% (95% CI: 79-87 at the medical school with the highest level of agreement to 30% (25-35 at the lowest. At year three the range was 70% to 27%. Ethnicity and sex were partial predictors of doctors' level of agreement; following adjustment for them, substantial differences between schools remained. In years one and three, 30% and 34% of doctors specified that feeling unprepared had been a serious or medium-sized problem for them (only 3% in each year regarded it as serious. Conclusions The vast knowledge base of clinical practice makes full preparation impossible. Our statement about feeling prepared is simple yet discriminating and identified some substantial differences between medical schools. Medical schools need feedback from graduates about

Development of village doctors in China: financial compensation and health system support.

Science.gov (United States)

Hu, Dan; Zhu, Weiming; Fu, Yaqun; Zhang, Minmin; Zhao, Yang; Hanson, Kara; Martinez-Alvarez, Melisa; Liu, Xiaoyun

2017-07-01

Since 1968, China has trained about 1.5 million barefoot doctors in a few years' time to provide basic health services to 0.8 billion rural population. China's Ministry of Health stopped using the term of barefoot doctor in 1985, and changed policy to develop village doctors. Since then, village doctors have kept on playing an irreplaceable role in China's rural health, even though the number of village doctors has fluctuated over the years and they face serious challenges. United Nations declared Sustainable Development Goals in 2015 to achieve universal health coverage by 2030. Under this context, development of Community Health workers (CHWs) has become an emerging policy priority in many resource-poor developing countries. China's experiences and lessons learnt in developing and maintaining village doctors may be useful for these developing countries. This paper aims to synthesis lessons learnt from the Chinese CHW experiences. It summarizes China's experiences in exploring and using strategic partnership between the community and the formal health system to develop CHWs in the two stages, the barefoot doctor stage (1968 -1985) and the village doctor stage (1985-now). Chinese and English literature were searched from PubMed, CNKI and Wanfang. The information extracted from the selected articles were synthesized according to the four partnership strategies for communities and health system to support CHW development, namely 1) joint ownership and design of CHW programmes; 2) collaborative supervision and constructive feedback; 3) a balanced package of incentives, both financial and non-financial; and 4) a practical monitoring system incorporating data from the health system and community. The study found that the townships and villages provided an institutional basis for barefoot doctor policy, while the formal health system, including urban hospitals, county health schools, township health centers, and mobile medical teams provided training to the barefoot

Workforce issues and training programmes - A UK perspective

International Nuclear Information System (INIS)

Richards, Warren

2007-01-01

Over the past 20 years under-investment has led to the UK's nuclear skills base being run down to the point where it is now very fragile and the cracks are showing. As a result a number of key nuclear science and engineering disciplines are now showing signs of shortages developing which is being reflected in both industry and academia. Fortunately, the skills gap has been recognised and the trend of under-investment is being reversed. Industry, Government and the Research Councils are starting to take steps to address the issue and new nuclear education and research initiatives are underway including the Dalton Nuclear Institute and the plans to create a National Nuclear Laboratory. The concern over a skills gap still exists but hopefully with the realisation of high profile projects such as new nuclear build, the establishment of a National Nuclear Laboratory and continued support from the UK's Research Councils, involvement in the nuclear field will prove to be an attractive career option for a greater number of people which will put the UK back in the position of having a vibrant and sustainable world class nuclear skills base. (author)

[RELATIONSHIP BETWEEN JUNIOR AND SENIOR DOCTORS: A BUBERIAN MODEL].

Science.gov (United States)

Pougnet, Richard; Pougnet, Laurence

2016-01-01

Doctors in training work in services under the supervision of senior doctors. These professional relationships may lead to frustrations, or ill-being at work. Indeed doctors are often very busy with care and can hardly communicate. The purpose of this article is to propose ways to think in its ethical dimension this relationship, by learning from Martin Buber's ideas. He thought a philosophy of relationship in two word pairs: I-Thou and I-It. This thought can be useful in the context of the médical relationship and mentorship. Indeed we can see our colleague as a person or only as a caregiver. We offer a relationship model according to buberian thought, between junior and senior doctor caring about the same patients.

Diagnosing the doctors' departure: survey on sources of dissatisfaction among Irish junior doctors.

LENUS (Irish Health Repository)

Bruce-Brand, R

2012-01-01

There has been a significant decline in the number of applications for non-consultant hospital doctor (NCHD) posts in Ireland over the last 18 months. We conducted an online, anonymous survey of Irish NCHDs to establish levels of satisfaction, sources of dissatisfaction and the major reasons for junior doctors seeking work abroad. 522 NCHDs took the survey, including 64 (12.3%) currently working outside of the Republic. 219 (45.8%) were slightly dissatisfied and 142 (29.7%) were extremely dissatisfied with practising medicine in Ireland. Major sources of dissatisfaction included the state of the health care system, staffing cover for leave and illness, the dearth of consultant posts and the need to move around Ireland. The most important reason for NCHDs wishing to leave was to seek better training and career opportunities abroad.

Doctor's perception of doctor-patient relationships in emergency departments: What roles do gender and ethnicity play?

Directory of Open Access Journals (Sweden)

Borde Theda

2008-04-01

Full Text Available Abstract Background Emergency departments continuously provide medical treatment on a walk-in basis. Several studies investigated the patient's perception of the doctor-patient relationship, but few have asked doctors about their views. Furthermore, the influence of the patient's ethnicity and gender on the doctor's perception remains largely unanswered. Methods Based on data collated in three gynaecology (GYN/internal medicine (INT emergency departments in Berlin, Germany, we evaluated the impact of the patient's gender and ethnicity on the doctors' satisfaction with the course of the treatment they provided. Information was gathered from 2.429 short questionnaires completed by doctors and the medical records of the corresponding patients. Results The patient's ethnicity had a significant impact on the doctors' satisfaction with the doctor-patient relationship. Logistic regression analysis showed that the odds ratio (OR for physician satisfaction was significantly lower for patients of Turkish origin (OR = 2.6 INT and 5.5 GYN than for those of German origin. The main reasons stated were problems with communication and a perceived lack of urgency for emergency treatment. The odds ratios for dissatisfaction due to a lack of language skills were 4.48 (INT and 6.22 (GYN, and those due to perceived lack of urgency for emergency treatment were 0.75 (INT and 0.63 (GYN. Sex differences caused minor variation. Conclusion The results show that good communication despite language barriers is crucial in providing medical care that is satisfactory to both patient and doctors, especially in emergency situations. Therefore the use of professional interpreters for improved communication and the training of medical staff for improved intercultural competence are essential for the provision of adequate health care in a multicultural setting.

A study of the relationship between resilience, burnout and coping strategies in doctors.

Science.gov (United States)

McCain, R Scott; McKinley, Nicola; Dempster, Martin; Campbell, W Jeffrey; Kirk, Stephen J

2017-08-09

The aim of this study was to measure resilience, coping and professional quality of life in doctors. A cross-sectional study using an online questionnaire in a single National Health Service trust, including both primary and secondary care doctors. 283 doctors were included. Mean resilience was 68.9, higher than population norms. 100 (37%) doctors had high burnout, 194 (72%) doctors had high secondary traumatic stress and 64 (24%) had low compassion satisfaction. Burnout was positively associated with low resilience, low compassion satisfaction, high secondary traumatic stress and more frequent use of maladaptive coping mechanisms, including self-blame, behavioural disengagement and substance use. Non-clinical issues in the workplace were the main factor perceived to cause low resilience in doctors. Despite high levels of resilience, doctors had high levels of burnout and secondary traumatic stress. Doctors suffering from burnout were more likely to use maladaptive coping mechanisms. As doctors already have high resilience, improving personal resilience further may not offer much benefit to professional quality of life. A national study of professional Quality of Life, Coping And REsilience, which we are proposing to undertake, will for the first time assess the UK and Ireland medical workforce in this regard and guide future targeted interventions to improve professional quality of life. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The Doctorate in the Nordic Countries.

Science.gov (United States)

Kyvik, Svein; Tvede, Olaf

1998-01-01

Overview of research training systems leading to doctoral degrees in Denmark, Finland, Norway, and Sweden emphasizes the structure of postgraduate education, administration and funding, number of students, time to degree, completion rates, labor market, and study abroad. Comparisons to U.S., British, German, and French systems suggests a trend…

Generating Benefits and Negotiating Tensions through an International Doctoral Forum: A Sociological Analysis

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Guanglun Michael Mu

2016-02-01

Full Text Available Workshops and seminars are widely-used forms of doctoral training. However, research with a particular focus on these forms of doctoral training is sporadic in the literature. There is little, if any, such research concerning the international context and participants’ own voices. Mindful of these lacunae in the literature, we write the current paper as a group of participants in one of a series of doctoral forums co-organised annually by Beijing Normal University, China and Queensland University of Technology, Australia. The paper voices our own experiences of participation in the doctoral forum. Data were drawn from reflections, journals, and group discussions of all 12 student and academic participants. These qualitative data were organised and analysed through Bourdieu’s notions of capital and field. Findings indicate that the doctoral forum created enabling and challenging social fields where participants accrued and exchanged various forms of capital and negotiated transient and complex power relations. In this respect, the sociological framework used provides a distinctive theoretical tool to conceptualise and analyse the benefits and tensions of participation in the doctoral forum. Knowledge built and lessons learned through our paper will provide implications and recommendations for future planning of, and participation in, the doctoral forum series and similar activities elsewhere.

UK medical students’ perceptions, attitudes, and interest toward medical leadership and clinician managers

Directory of Open Access Journals (Sweden)

Rouhani MJ

2018-02-01

Full Text Available Maral J Rouhani,1 Eleanor J Burleigh,2 Chloe Hobbis,2 Charlotte Dunford,1 Nadir I Osman,3 Christine Gan,1 Norma B Gibbons,1 Hashim U Ahmed,1,4 Saiful Miah1,5 1Department of Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK; 2Medical School, University of Sheffield, Sheffield, UK; 3Department of Urology, Royal Hallamshire Hospital, Sheffield, UK; 4Division of Surgery, Department of Surgery and Cancer, Imperial College London, London, UK; 5Division of Surgery and Interventional Science, University College London, London, UK Background: We aimed to determine UK medical students’ perceptions and attitudes and interest toward medical leadership and clinician managers. Methods: A cross-sectional study was conducted during the academic year 2015–2016. An online questionnaire was distributed to 2,349 final-year students from 10 UK medical schools. Participants were asked to complete a 5-point Likert scale on their current perceptions, attitudes, and interest toward medical leadership and clinician managers. They were also asked to self-rate their leadership competences set by the Medical Leadership Competency Framework and to rate the quality of management and leadership training they received from their medical school. Results: In total, we received 114 complete responses. Only 7.9% of respondents were in agreement (strongly agree or agree when asked whether they felt they were well informed about what a managerial position in medicine entails. When asked whether clinicians should influence managerial decisions within a clinical setting, 94.7% of respondents were in agreement with the statement. About 85% of respondents were in agreement that it is important for clinicians to have managerial or leadership responsibilities, with 63.2% of students in agreement that they would have liked more management or leadership training during medical school. Over half the respondents rated their management and leadership

Why are junior doctors deterred from choosing a surgical career?

Science.gov (United States)

Rogers, Mary E; Creed, Peter A; Searle, Judy

2012-05-01

To identify the reasons why interns would not choose a surgical career. This qualitative study used semi-structured telephone interviews to explore the future career choices of 41 junior doctors (14 men, 27 women). Doctors were asked to identify specialties they would not take up, and state why this was the case. Thirty (73.2%) of the 41 interns nominated surgery as a specialty they would not choose. Themes relating to reasons for not wanting to pursue a surgical career included the lifestyle associated with surgery (66.7%), the culture within the surgical work environment (53.3%), the lack of interest in performing surgical work (36.7%), and the training requirements associated with surgery (33.3%). Both sexes had similar reasons for not wanting to choose a surgical career; but additionally, women referred to the male domination of surgery, and the difficulty and inflexibility of the training program as deterrents. Efforts are needed to promote interest in surgery as a career especially for women, to improve the surgical work environment so that medical students and junior doctors have exposure to positive role models and surgical placements, and to provide a more flexible approach to surgical training.

The role of general practice in postgraduate basic training

DEFF Research Database (Denmark)

Kjaer, Niels Kristian; Kodal, Troels; Qvesel, Dorte

2010-01-01

BACKGROUND: In recent years, there has been growing interest in the role of primary care in postgraduate training. Relatively little has been published about benefits of early and sustained postgraduate basic training in general practice, especially for doctors with other ambitions than family...... scale and qualitative questions. We used a phenomenological approach. RESULTS: Almost all of the young Danish doctors responding felt that training in general practice is a necessary part of a postgraduate basic training programme. Early training in primary care not only gives doctors a broad...

Job satisfaction of village doctors during the new healthcare reforms in China.

Science.gov (United States)

Zhang, Xiaoyan; Fang, Pengqian

2016-04-01

Objective China launched new healthcare reforms in 2009 and several policies targeted village clinics, which affected village doctors' income, training and duties. The aim of the present study was to assess village doctors' job satisfaction during the reforms and to explore factors affecting job satisfaction. Methods Using a stratified multistage cluster sampling process, 935 village doctors in Jiangxi Province were surveyed with a self-administered questionnaire that collected demographic information and contained a job satisfaction scale and questions regarding their work situation and individual perceptions of the new healthcare reforms. Descriptive analysis, Pearson's Chi-squared test and binary logistic regression were used to identify village doctors' job satisfaction and the factors associated with their job satisfaction. Results Only 12.72% of village doctors were either satisfied or very satisfied with their jobs and the top three items leading to dissatisfaction were pay and the amount of work that had to be done, opportunities for job promotion and work conditions. Marriage, income, intention to leave, satisfaction with learning and training, social status, relationship with patients and satisfaction with the new healthcare reforms were significantly associated with job satisfaction (Pjob satisfaction. For future healthcare reforms, policy makers should pay more attention to appropriate remuneration and approaches that incentivise village doctors to achieve the goals of the health reforms. What is known about the topic? Village doctors act as gatekeepers at the bottom tier of the rural health system. However, the policies of the new healthcare reform initiatives in China were centred on improving the quality of care delivered to the rural population and reducing fast-growing medical costs. There have been limited studies on village doctors' reactions to these reforms. What does this paper add? The findings of the present study indicate that in the

The financial cost of doctors emigrating from sub-Saharan Africa: human capital analysis.

Science.gov (United States)

Mills, Edward J; Kanters, Steve; Hagopian, Amy; Bansback, Nick; Nachega, Jean; Alberton, Mark; Au-Yeung, Christopher G; Mtambo, Andy; Bourgeault, Ivy L; Luboga, Samuel; Hogg, Robert S; Ford, Nathan

2011-11-23

To estimate the lost investment of domestically educated doctors migrating from sub-Saharan African countries to Australia, Canada, the United Kingdom, and the United States. Human capital cost analysis using publicly accessible data. Sub-Saharan African countries. Nine sub-Saharan African countries with an HIV prevalence of 5% or greater or with more than one million people with HIV/AIDS and with at least one medical school (Ethiopia, Kenya, Malawi, Nigeria, South Africa, Tanzania, Uganda, Zambia, and Zimbabwe), and data available on the number of doctors practising in destination countries. The financial cost of educating a doctor (through primary, secondary, and medical school), assuming that migration occurred after graduation, using current country specific interest rates for savings converted to US dollars; cost according to the number of source country doctors currently working in the destination countries; and savings to destination countries of receiving trained doctors. In the nine source countries the estimated government subsidised cost of a doctor's education ranged from $21,000 (£13,000; €15,000) in Uganda to $58,700 in South Africa. The overall estimated loss of returns from investment for all doctors currently working in the destination countries was $2.17bn (95% confidence interval 2.13bn to 2.21bn), with costs for each country ranging from $2.16m (1.55m to 2.78m) for Malawi to $1.41bn (1.38bn to 1.44bn) for South Africa. The ratio of the estimated compounded lost investment over gross domestic product showed that Zimbabwe and South Africa had the largest losses. The benefit to destination countries of recruiting trained doctors was largest for the United Kingdom ($2.7bn) and United States ($846m). Among sub-Saharan African countries most affected by HIV/AIDS, lost investment from the emigration of doctors is considerable. Destination countries should consider investing in measurable training for source countries and strengthening of their

Reinventing The Doctor

Directory of Open Access Journals (Sweden)

Moyez Jiwa

2011-07-01

Full Text Available There has been a seismic shift in the lives of people because of technology. People are far better informed than they were in the 1980s and 1990s. Much of this information is available through the media but even more is available and archived on the internet. The forces pushing the internet into health and health care are strong and unstoppable, ensuring that the internet and the choices it offers must be part of the design of our future health care system. We are no longer content to wait in queues as we live at a faster pace than earlier generations — we don’t not have time to wait for appointments months, weeks or even days in advance. The internet offers the prospect of online consultations in the comfort of your own home. The physical examination will change as new devices are developed to allow the necessary sounds and signals emitted by our malfunctioning bodies to be recorded, interpreted and captured at a remote location. Meanwhile, for those who prefer to see a health care practitioner in person the options to consult practitioners other than doctors who can advise on our health is expanding. The reality is we can’t afford to train or pay for all the doctors we need under the current “doctor-knows-best” system of health care. Patients no longer believe the rhetoric and are already voting with their feet. Pharmacists, nurses and other allied health professionals are beginning to play a much greater role in offering relief from symptoms and monitoring of chronic diseases. Of course, the doctor of the future will still need to offer face-to-face consultations to some people most of the time or most people some of the time. The social role doctors play will continue to be important as humans will always need other humans to personally respond to their distress. As doctors reinvent themselves, the internet and the value of time with patients will be the driving forces that move us into a more sustainable future in health care.

Becoming a Woman Doctor in Iran: The Formation of Classed and Gendered Selves

Science.gov (United States)

Fathi, Mastoureh

2018-01-01

This paper analyses the pedagogical pathways of a group of first-generation Iranian migrant doctors in the UK. It explores the complex system of class production and growing up as a classed subject in Iran, a process that ties young women's educational aspirations to female independence on the one hand and to the modern feminine, heterosexual…

A peer-led teaching initiative for foundation doctors.

Science.gov (United States)

Ramsden, Sophie; Abidogun, Abiola; Stringer, Emma; Mahgoub, Sara; Kastrissianakis, Artemis; Baker, Paul

2015-08-01

Peer teaching has been used informally throughout the history of medical education. Formal studies within the medical student and allied health care professional communities have found it to be a popular, and highly effective, method of teaching. Newly qualified doctors are currently an underused resource in terms of teaching one another. A committee, made up of newly qualified doctors and postgraduate education staff, was established. Using only a few resources, this committee organised regular, peer-led tutorials and used educational needs assessment tools, such as questionnaires, to make improvements to early postgraduate training. A realistic and well-received intervention to improve the teaching of newly qualified doctors, which is feasible in the modern, busy health care setting. Other institutions may find this method and its resources valuable. Newly qualified doctors are currently an underused resource in terms of teaching one another. © 2015 John Wiley & Sons Ltd.

DOES GENDER IMPACT ON FEMALE DOCTORS' EXPERIENCES IN THE TRAINING AND PRACTICE OF SURGERY?

Science.gov (United States)

Umoetok, F; van Wyk, J; Madiba, T E

2017-06-01

Surgery has been a male-dominated speciality both in South Africa and abroad. This mixed methodology case study collected data from a purposive sample of female surgical registrars enrolled at one institution in South Africa. A self-administered questionnaire was used to explore whether or not female doctors perceived any benefits of being in a male-dominated specialty. It explored problems encountered due to gender, the participants' perceptions of the influence of gender on their surgical training, practice and challenges. Thirty-two female registrars participated in the study. The respondents were mainly South African (91%) and enrolled in seven surgical specialities. Twenty-seven (84%) respondents were satisfied with their practical training and skills development as surgeons. Twenty-four (75%) respondents had identified a mentor from the department and all respondents indicated that the gender of their mentor did not impact on the quality of their training. Seventeen (53%) respondents perceived having received differential treatment due to their gender and 25 (78.2%) thought that the gender of their mentor did not impact on the quality of the guidance in surgery. Challenges included physical threats to them as females from patients and disrespect, emotional threats and defaming statements from male registrars. Other challenges included time-constraints for family and academic work, poor work life balance and being treated differently due to their gender. Seventeen (53%) respondents would consider teaching in the Department of Surgery. Twenty-five respondents (78%) would recommended the specialty to young female students, as they were convinced that surgery had been the right choice for them. Seventeen respondents (53%) were also open to pursuing teaching posts in the Department of Surgery. Generally, females had positive perceptions of their training in Surgery. They expressed concern about finding a worklife balance. The gender of their mentor did not impact

Bullying and harassment – Are junior doctors always the victims?

International Nuclear Information System (INIS)

Nyhsen, C.M.; Patel, P.; O'Connell, J.E.

2016-01-01

Introduction: NHS staff have the right to work in an environment free from bullying, harassment and violence. There should be good team-working with colleagues from all disciplines. Reports of bullying experienced by junior doctors resulted in mandatory annual GMC surveys regarding the quality of training. This led to medical trainees being surveyed more than any other staff. Radiographers informally reported bullying and harassment (B&H) incidents involving trainees. This survey aims to quantify the issue. Methods: Online survey of general and CT radiographers at a large acute hospital in the North East of England addressing incidents involving junior doctors and occurring in the preceding 12 months. Results: The survey was completed by 86% (44/51) general and 5/7 CT radiographers. Overall 45% experienced bullying, 92% had their own/witnessed a colleague's opinion being ignored and 57% were the target of loud verbal abuse/anger or witnessed colleagues being treated in that way. Several radiographers reported 5 or more B&H incidents. 26 radiographers (51%) were shouted at/ridiculed in theatre, 4 feeling unsafe/physically threatened. Junior doctors regularly queried the need to supervise CT contrast injections on call. Free text comments highlighted that doctors rarely introduced themselves to radiology staff. Conclusion: Radiographers report significant incidents of B&H involving junior doctors, who do not always seem to appreciate radiation exposure legislation, patient safety protocols or respect the seniority of highly trained radiographers. Measures introduced subsequently include guidance for radiographers, a dedicated radiology e-learning package for trainees and classroom sessions for foundation doctors and final year undergraduate students. - Highlights: • Bullying and harassment of radiographers is a persistent problem. • Some radiographers reported feeling physically threatened in theatre. • Some junior doctors do not respect radiation exposure

A survey to determine the potential impact of foundation year career aims on surgical specialty training.

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Patel, Rikesh Kumar; Sayers, Adele Elizabeth; Akbar, Muhammad Jawaid; Hunter, Iain Andrew

2014-03-01

The competition for Core Surgical Training (CST) positions and subsequent Surgical Specialty Training (ST3) posts throughout the UK is fierce. Our aim was to conduct a pilot study to assess whether current foundation year doctors were considering pursuing a career in surgery and the reasons guiding their decisions. A ten-item questionnaire was voluntarily completed by foundation doctors at a large acute teaching trust. Factors evaluated included: experience working within a surgical rotation; previous consideration of a career in surgery; whether they found a career in surgery appealing; reasons guiding their decision and would they be applying to CST. All 67 foundation doctors approached agreed to participate: of which 56 (83.6%) had experience working within a surgical rotation. Males were significantly more likely to find a career in surgery appealing (p career, only 11 (16.4%) would be applying to CST. Reasons for finding a career in surgery appealing included: job satisfaction (84.2%), diversity of work (79.0%) and working environment/colleagues (47.4%). Of those that did not consider a career in surgery to be appealing, reasons included: working hours (75.0%), work/life balance (62.5%), working environment/colleagues (50%). Although only a small proportion of current foundation doctors were surveyed in our study, only 16.4% were considering applying for CST. These figures are lower than previously suggested and would indicate that there will be fewer applicants for CST in future years, which may potentially reduce the current bottleneck of applicants at ST3.

An evaluation of UK foundation trainee doctors' learning behaviours in a technology-enhanced learning environment.

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Brooks, Hannah L; Pontefract, Sarah K; Hodson, James; Blackwell, Nicholas; Hughes, Elizabeth; Marriott, John F; Coleman, Jamie J

2016-05-03

Technology-Enhanced Learning (TEL) can be used to educate Foundation Programme trainee (F1 and F2) doctors. Despite the advantages of TEL, learning behaviours may be exhibited that are not desired by system developers or educators. The aim of this evaluation was to investigate how learner behaviours (e.g. time spent on task) were affected by temporal (e.g. time of year), module (e.g. word count), and individual (e.g. knowledge) factors for 16 mandatory TEL modules related to prescribing and therapeutics. Data were extracted from the SCRIPT e-Learning platform for first year Foundation trainee (F1) doctors in the Health Education England's West Midland region from 1(st) August 2013 to 5(th) August 2014. Generalised Estimating Equation models were used to examine the relationship between time taken to complete modules, date modules were completed, pre- and post-test scores, and module factors. Over the time period examined, 688 F1 doctors interacted with the 16 compulsory modules 10,255 times. The geometric mean time taken to complete a module was 28.9 min (95% Confidence Interval: 28.4-29.5) and 1,075 (10.5%) modules were completed in less than 10 min. In February and June (prior to F1 progression reviews) peaks occurred in the number of modules completed and troughs in the time taken. Most modules were completed, and the greatest amount of time was spent on the learning on a Sunday. More time was taken by those doctors with greater pre-test scores and those with larger improvements in test scores. Foundation trainees are exhibiting unintended learning behaviours in this TEL environment, which may be attributed to several factors. These findings can help guide future developments of this TEL programme and the integration of other TEL programmes into curricula by raising awareness of potential behavioural issues that may arise.

Self-reported and employer-recorded sickness absence in doctors.

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Murphy, I J

2014-09-01

Doctors' sickness absence reduces the quality and continuity of patient care and is financially costly. Doctors have lower rates of sickness absence than other healthcare workers. To compare self-reported with recorded sickness absence in doctors in a UK National Health Service hospital trust. A retrospective questionnaire study. The main outcome measures were self-reported and trust-recorded sickness absence episodes of 4 days or more in two consecutive 6-month periods. The response rate was 82% (607/736). Self-reported sickness absence rates were 1.2% compared with a rate of 0.6% from trust-recorded data. There were 38 matched pairs of self-reported (mean duration: 18 days, standard deviation: 22 days) and trust-recorded (mean duration: 10 days, standard deviation: 17 days) sickness absence episodes of 4 days or more in the 12 months studied. A matched pairs t-test determined that the difference between the two means was significant (t = 2.57, P sickness absence was significantly under-recorded in this study population. © The Author 2014. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The European Donor Hospital Education Programme (EDHEP): addressing the training needs of doctors and nurses who break bad news, care for the bereaved, and request donation

NARCIS (Netherlands)

Blok, G. A.; van Dalen, J.; Jager, K. J.; Ryan, M.; Wijnen, R. M.; Wight, C.; Morton, J. M.; Morley, M.; Cohen, B.

1999-01-01

The competence of critical care staff when it comes to death and organ donation can make the difference between a family's agreeing to or refusing the latter. Doctors and nurses often feel uncomfortable approaching relatives about donation and attribute this to a lack of training. Bereaved relatives

Factors influencing career intentions on completion of general practice vocational training in England: a cross-sectional study.

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Dale, Jeremy; Russell, Rachel; Scott, Emma; Owen, Katherine

2017-08-17

General practice is experiencing a growing crisis with the numbers of doctors who are training and then entering the profession in the UK failing to keep pace with workforce needs. This study investigated the immediate to medium term career intentions of those who are about to become general practitioners (GPs) and the factors that are influencing career plans. Online questionnaire survey, with quantitative answers analysed using descriptive statistics and free text data analysed using a thematic framework approach. Doctors approaching the end of 3-year GP vocational training in the West Midlands, England. 178 (57.2%) doctors completed the survey. Most participants planned to work as salaried GPs or locums rather than entering a general practice partnership for at least the first 5 years post-completion of training; others failed to express a career plan or planned to leave general practice completely or work overseas. Many were interested in developing portfolio careers.The quality of general practice experience across undergraduate, foundation and vocational training were reported as influencing personal career plans, and in particular perceptions about workload pressure and morale within the training practices in which they had been placed. Experience of a poor work-life balance as a trainee had a negative effect on career intentions, as did negative perceptions about how general practice is portrayed by politicians and the media. This study describes a number of potentially modifiable factors related to training programmes that are detrimentally influencing the career plans of newly trained GPs. In addition, there are sociodemographic factors, such as age, gender and having children, which are also influencing career plans and so need to be accommodated. With ever-increasing workload in general practice, there is an urgent need to understand and where possible address these issues at national and local level. © Article author(s) (or their employer(s) unless

Are doctor of pharmacy curricula in developing countries adequate to train graduates to provide pharmaceutical care?

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Ramalingam Peraman

2017-01-01

Full Text Available Doctor of Pharmacy (PharmD program is a new dimension of pharmacy education in developing countries. The PharmD graduates are expected to participate in patient health care by providing pharmaceutical care. The graduates should have enough necessary clinical knowledge, competitiveness and skills in community, hospital and clinical pharmacy related services. There is a need of curriculum that fit into the program outcome that helps to attain graduate competency. Programs in India, Pakistan, Iran and Nepal were reviewed based on the available literature. Even though it is evident that the PharmD curriculum in developing countries has made an attempt to provide patient-oriented approach for pharmacists, the existing curriculum, training and orientation have several pitfalls. It needs assessment, evaluation and improvement.

Innovations in Doctoral Training and Research on Tinnitus: The European School on Interdisciplinary Tinnitus Research (ESIT) Perspective.

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Schlee, Winfried; Hall, Deborah A; Canlon, Barbara; Cima, Rilana F F; de Kleine, Emile; Hauck, Franz; Huber, Alex; Gallus, Silvano; Kleinjung, Tobias; Kypraios, Theodore; Langguth, Berthold; Lopez-Escamez, José A; Lugo, Alessandra; Meyer, Martin; Mielczarek, Marzena; Norena, Arnaud; Pfiffner, Flurin; Pryss, Rüdiger C; Reichert, Manfred; Requena, Teresa; Schecklmann, Martin; van Dijk, Pim; van de Heyning, Paul; Weisz, Nathan; Cederroth, Christopher R

2017-01-01

Tinnitus is a common medical condition which interfaces many different disciplines, yet it is not a priority for any individual discipline. A change in its scientific understanding and clinical management requires a shift toward multidisciplinary cooperation, not only in research but also in training. The European School for Interdisciplinary Tinnitus research (ESIT) brings together a unique multidisciplinary consortium of clinical practitioners, academic researchers, commercial partners, patient organizations, and public health experts to conduct innovative research and train the next generation of tinnitus researchers. ESIT supports fundamental science and clinical research projects in order to: (1) advancing new treatment solutions for tinnitus, (2) improving existing treatment paradigms, (3) developing innovative research methods, (4) performing genetic studies on, (5) collecting epidemiological data to create new knowledge about prevalence and risk factors, (6) establishing a pan-European data resource. All research projects involve inter-sectoral partnerships through practical training, quite unlike anything that can be offered by any single university alone. Likewise, the postgraduate training curriculum fosters a deep knowledge about tinnitus whilst nurturing transferable competencies in personal qualities and approaches needed to be an effective researcher, knowledge of the standards, requirements and professionalism to do research, and skills to work with others and to ensure the wider impact of research. ESIT is the seed for future generations of creative, entrepreneurial, and innovative researchers, trained to master the upcoming challenges in the tinnitus field, to implement sustained changes in prevention and clinical management of tinnitus, and to shape doctoral education in tinnitus for the future.

Innovations in Doctoral Training and Research on Tinnitus: The European School on Interdisciplinary Tinnitus Research (ESIT Perspective

Directory of Open Access Journals (Sweden)

Winfried Schlee

2018-01-01

Full Text Available Tinnitus is a common medical condition which interfaces many different disciplines, yet it is not a priority for any individual discipline. A change in its scientific understanding and clinical management requires a shift toward multidisciplinary cooperation, not only in research but also in training. The European School for Interdisciplinary Tinnitus research (ESIT brings together a unique multidisciplinary consortium of clinical practitioners, academic researchers, commercial partners, patient organizations, and public health experts to conduct innovative research and train the next generation of tinnitus researchers. ESIT supports fundamental science and clinical research projects in order to: (1 advancing new treatment solutions for tinnitus, (2 improving existing treatment paradigms, (3 developing innovative research methods, (4 performing genetic studies on, (5 collecting epidemiological data to create new knowledge about prevalence and risk factors, (6 establishing a pan-European data resource. All research projects involve inter-sectoral partnerships through practical training, quite unlike anything that can be offered by any single university alone. Likewise, the postgraduate training curriculum fosters a deep knowledge about tinnitus whilst nurturing transferable competencies in personal qualities and approaches needed to be an effective researcher, knowledge of the standards, requirements and professionalism to do research, and skills to work with others and to ensure the wider impact of research. ESIT is the seed for future generations of creative, entrepreneurial, and innovative researchers, trained to master the upcoming challenges in the tinnitus field, to implement sustained changes in prevention and clinical management of tinnitus, and to shape doctoral education in tinnitus for the future.

Suicide in doctors and wives of doctors.

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Sakinofsky, I

1980-06-01

This paper re-examines the widespread belief that doctors have a proneness for suicide greater than the general population. The Standardized Mortality Ratio for male physicians is 335 and for single women doctors 257. Doctors' wives have an even greater risk: their SMR is 458. These rates for doctors are higher than for most other professional groups (except pharmacists) and the rate for doctors' wives far exceeds that for wives of other professionals. The intrinsic causes of the physician's high occupational mortality include his knowledge of toxicology and ready access to lethal drugs, so that impulsive suicide is more often successful. Professional stress and overwork, particularly the unrelenting responsibility for decisions upon which the lives of others may depend, have been inculpated. These stresses interact with the decline in the doctors' self-respect and with a personality that is prestige-oriented and independent. Some physicians turn in their frustration to alcohol/and or drugs, accelerating the process of deterioration. The high suicide rate in doctors' wives appears to be the result of unrequited needs for caring and dependency which the doctors' career demands and personality deny them.

Perceptions and culture of safety among helicopter emergency medical service personnel in the UK.

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Chesters, Adam; Grieve, Philip H; Hodgetts, Timothy J

2016-11-01

The use of helicopter emergency medical services (HEMS) has increased significantly in the UK since 1987. To date there has been no research that addresses HEMS pilots and medical crews' own ideas on the risks that they view as inherent in their line of work and how to mitigate these risks. The aim of this survey is to describe and compare the attitudes and perceptions towards risk in HEMS operations of these staff. A questionnaire was administered electronically to a representative selection of HEMS doctors, paramedics and pilots in the UK. A number of questions were grouped into common themes, and presented as Likert scales and ranking where appropriate. Descriptive and comparative results were presented and statistically analysed. The target sample of 100 consecutive respondents was achieved. All questionnaires were entirely completed. Respondents attributed the most risk to night HEMS operations without the use of night vision goggles, commercial pressure and mechanical aircraft failure. There was no statistical difference in overall perception of safety and years of experience (p=0.58) or between professions (p=0.08). Those who had experienced a crash were more likely to believe that HEMS operations are not inherently safe (p=0.05). We have surveyed a cross-section of the HEMS operational community in the UK in order to describe their perceptions of safety and risk within their professional life. Two-thirds of respondents believed that HEMS operations were inherently safe. Those who did not seemed to be influenced by personal experience of a crash or serious incident. We support increased operational training for clinical crewmembers, an increased emphasis on incident reporting and a culture of safety, and careful attention to minimum training and equipment requirements for all HEMS missions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Black doctors and discrimination under South Africa's apartheid regime.

Science.gov (United States)

Digby, Anne

2013-04-01

This article discusses an under-researched group and provides an analytical overview of the comparative experiences of African, Indian and Coloured doctors at South African universities during the apartheid era. It probes diversity of experience in training and practice as well as gendered differentiation amongst black students before going on to discuss the careers and political activism of black doctors as well as the impact of recent transformational change on their position. It briefly assesses how singular this South African experience was.

Masculinity in the doctor's office: Masculinity, gendered doctor preference and doctor-patient communication.

Science.gov (United States)

Himmelstein, Mary S; Sanchez, Diana T

2016-03-01

Mortality and morbidity data suggest that men have shorter life expectancies than women and outrank women on several leading causes of death. These gendered disparities may be influenced by psychosocial factors like masculinity. Three studies (Total N=546) examined the role of masculinity in men's doctor choices and doctor-patient interactions. In Studies 1 and 2, men completed measures of masculinity, gender bias, and doctor preference. Using structural equation modeling, we tested the direct relationship between masculinity and male doctor preference and the indirect relationship of masculinity on male doctor preference through an association with gendered competence stereotypes. Participants in Study 3 disclosed symptoms in private followed by disclosure to a male or female interviewer in a clinical setting. Using repeated measures analysis of variance (ANOVA), we examined the interaction among symptom reporting, masculinity and doctor gender, controlling for participant comfort. In Study 1, results suggested that masculinity encouraged choice of a male doctor directly and indirectly via beliefs that men make more competent doctors than women; Study 2 directly replicated the results of Study 1. In Study 3, independent of participant comfort, an interaction between interviewer gender and masculinity emerged such that men scoring higher on masculinity reported symptoms less consistently to male interviewers (relative to higher scoring men reporting to female interviewers); the reverse was found for men scoring low on masculinity. Taken together these studies suggest that masculinity may affect men's health by encouraging choice of a male doctor with whom doctor-patient communication may be impaired. Copyright © 2015 Elsevier Inc. All rights reserved.

Are UK radiologists satisfied with the training and support received in suspected child abuse?

International Nuclear Information System (INIS)

Leung, R.S.; Nwachuckwu, C.; Pervaiz, A.; Wallace, C.; Landes, C.; Offiah, A.C.

2009-01-01

Aim: To determine current practice and perceptions of the adequacy of training and support received for the reporting of skeletal surveys in suspected physical child abuse. Materials and methods: A list of telephone numbers of UK hospitals with a radiology department was obtained from Royal College of Radiologists. One hundred hospitals were then randomly selected for inclusion in the survey. An 18-item questionnaire was successfully administered to consultant radiologists from 84 departments. Results: Sixty-one percent of departments had a named radiologist to report their skeletal surveys, 16% assigned surveys to a random radiologist, and 23% referred them elsewhere. Only 52% of departments had a dedicated paediatric radiologist, thus in a significant proportion of departments (25%) initial reports on skeletal surveys for physical abuse were provided by non-paediatric radiologists. Fifteen percent did not have ready access to a paediatric radiology opinion. Sixty-one percent thought that the service could be improved. Expert evidence was provided by 5% of respondents. Seventy-three percent would never consider providing expert evidence, even if given adequate radiology and/or legal training. Conclusion: The survey shows significant dissatisfaction amongst consultant radiologists with the current service, confirms a low number of paediatric radiologists taking on this work, and suggests the potential to increase numbers of radiology child abuse experts by 27% if given improved training and support. Appropriate service and education strategies should be implemented.

Are UK radiologists satisfied with the training and support received in suspected child abuse?

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Leung, R.S. [Department of Radiology, Great Ormond Street Hospital for Children, London (United Kingdom); Nwachuckwu, C. [Department of Paediatrics, Whipps Cross Hospital, London (United Kingdom); Pervaiz, A. [Department of Radiology, Great Ormond Street Hospital for Children, London (United Kingdom); Wallace, C.; Landes, C. [Department of Radiology, Royal Liverpool Childrens NHS Trust, Liverpool (United Kingdom); Offiah, A.C. [Department of Radiology, Great Ormond Street Hospital for Children, London (United Kingdom)], E-mail: OffiaA@gosh.nhs.uk

2009-07-15

Aim: To determine current practice and perceptions of the adequacy of training and support received for the reporting of skeletal surveys in suspected physical child abuse. Materials and methods: A list of telephone numbers of UK hospitals with a radiology department was obtained from Royal College of Radiologists. One hundred hospitals were then randomly selected for inclusion in the survey. An 18-item questionnaire was successfully administered to consultant radiologists from 84 departments. Results: Sixty-one percent of departments had a named radiologist to report their skeletal surveys, 16% assigned surveys to a random radiologist, and 23% referred them elsewhere. Only 52% of departments had a dedicated paediatric radiologist, thus in a significant proportion of departments (25%) initial reports on skeletal surveys for physical abuse were provided by non-paediatric radiologists. Fifteen percent did not have ready access to a paediatric radiology opinion. Sixty-one percent thought that the service could be improved. Expert evidence was provided by 5% of respondents. Seventy-three percent would never consider providing expert evidence, even if given adequate radiology and/or legal training. Conclusion: The survey shows significant dissatisfaction amongst consultant radiologists with the current service, confirms a low number of paediatric radiologists taking on this work, and suggests the potential to increase numbers of radiology child abuse experts by 27% if given improved training and support. Appropriate service and education strategies should be implemented.

A critical review of the core medical training curriculum in the UK: A medical education perspective.

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Laskaratos, Faidon-Marios; Gkotsi, Despoina; Panteliou, Eleftheria

2014-01-01

This paper represents a systematic evaluation of the Core Medical Training Curriculum in the UK. The authors critically review the curriculum from a medical education perspective based mainly on the medical education literature as well as their personal experience of this curriculum. They conclude in practical recommendations and suggestions which, if adopted, could improve the design and implementation of this postgraduate curriculum. The systematic evaluation approach described in this paper is transferable to the evaluation of other undergraduate or postgraduate curricula, and could be a helpful guide for medical teachers involved in the delivery and evaluation of any medical curriculum.

The supervision of professional doctorates: experiences of the processes and ways forward.

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Carr, Susan M; Lhussier, Monique; Chandler, Colin

2010-05-01

The doctoral research terrain is changing, as new-styles, for example professional doctorates, are being developed (Park, C., 2005. New variant PhDL the changing nature of the doctorate in the UK. Journal of Higher Education Policy and Management 27(2), 189-207). There is a scarcity of literature aimed at supervisors (Gatfield, T., 2005, An investigation into PhD supervisory management styles: development of a dynamic conceptual model and its managerial implications. Journal of Higher Education Policy and Management 27(3), 311-325) and this is particularly so in relation to professional doctorates. In this position paper we argue that the supervisory approach required for a professional doctorate student is different than that required for a PhD. Professional doctorate students, like PhD students, are required to make an explicit contribution to knowledge. Their emphasis, however, needs to be in producing knowledge that is theoretically sound, original, and of relevance to their practice area. This is of increasing importance within healthcare with the growing emphasis on patient driven translational research. As such, the students and their supervisors face unique challenges of balancing academic requirements with praxis. We suggest this requires specific tools to make explicit the dialogical relationship between a particular project and the cultural, social, educational and political aspects of its environment. We expose the potential of soft systems methodology as a means to highlight the emergent aspects of a doctoral practice development project, their respective and evolving supervisory interactions. This focus of this paper is therefore not about guiding supervision in a managerial sense, but rather at offering methodological suggestions that could underpin applied research at doctoral level. Copyright 2009 Elsevier Ltd. All rights reserved.

[Psychological features of the motivation component in the training of doctors in the system of postgraduate education].

Science.gov (United States)

Koshova, Svitlana; Horachuk, Viktoriia; Pishchykov, Valerii

2018-01-01

Introduction: Тhe problem of motivating adult learning in postgraduate education has so far been the subject of study primarily in methodological and pedagogical studies. They focus on the analysis of the content side of the motivation of adult learning activities. As for the problem of the dynamics of motivation for adult learning activities, including for doctors in the system of postgraduate medical education with continuous professional development, it has not been sufficiently studied so far. The aim: This work is to analyze information and psychological features of the motivational sphere of doctors, which contribute to their successful training during continuous professional development in the system of postgraduate medical education. Materials and methods: In the work is used a range of methods: content analysis, bibliosemantic, systematic approach, analysis of products of activity. Review: At the present stage of social and economic transformations in Ukraine, the development of the general abilities of a person, his professional self-awareness, motivation for postgraduate education and obtaining a new specialization (E.О. Klimov, N.S. Glukhanyuk, I.V. Dubrovin, D.N. Zabrodin, T.V. Kudryavtsev, V.D. Shadrikov, etc.) The existing system of professional retraining does not pay enough attention to the study of conscious motives in adult learning activity. The practical relevance of this problem is determined, on the one hand, by the dynamic processes in the system of vocational training and retraining, the requirements for high efficiency of the results of the work of trained specialists. On the other hand, there is need to create conditions in the system of continuing education, the result of which is the effectiveness of adult learning activities. Conclusions: The study of the dynamics of motivation of adult learning activities is, in our opinion, relevant and has great theoretical as well as practical interest. It will allow to expand the idea of

Which doctors and with what problems contact a specialist service for doctors? A cross sectional investigation

Directory of Open Access Journals (Sweden)

von der Tann Matthias

2007-08-01

Full Text Available Abstract Background In the United Kingdom, specialist treatment and intervention services for doctors are underdeveloped. The MedNet programme, created in 1997 and funded by the London Deanery, aims to fill this gap by providing a self-referral, face-to-face, psychotherapeutic assessment service for doctors in London and South-East England. MedNet was designed to be a low-threshold service, targeting doctors without formal psychiatric problems. The aim of this study was to delineate the characteristics of doctors utilising the service, to describe their psychological morbidity, and to determine if early intervention is achieved. Methods A cross-sectional study including all consecutive self-referred doctors (n = 121, 50% male presenting in 2002–2004 was conducted. Measures included standardised and bespoke questionnaires both self-report and clinician completed. The multi-dimensional evaluation included: demographics, CORE (CORE-OM, CORE-Workplace and CORE-A an instrument designed to evaluate the psychological difficulties of patients referred to outpatient services, Brief Symptom Inventory to quantify caseness and formal psychiatric illness, and Maslach Burnout Inventory. Results The most prevalent presenting problems included depression, anxiety, interpersonal, self-esteem and work-related issues. However, only 9% of the cohort were identified as severely distressed psychiatrically using this measure. In approximately 50% of the sample, problems first presented in the preceding year. About 25% were on sick leave at the time of consultation, while 50% took little or no leave in the prior 12 months. A total of 42% were considered to be at some risk of suicide, with more than 25% considered to have a moderate to severe risk. There were no significant gender differences in type of morbidity, severity or days off sick. Conclusion Doctors displayed high levels of distress as reflected in the significant proportion of those who were at some risk of

Doctors' voices in patients' narratives: coping with emotions in storytelling.

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Lucius-Hoene, Gabriele; Thiele, Ulrike; Breuning, Martina; Haug, Stephanie

2012-09-01

To understand doctors' impacts on the emotional coping of patients, their stories about encounters with doctors are used. These accounts reflect meaning-making processes and biographically contextualized experiences. We investigate how patients characterize their doctors by voicing them in their stories, thus assigning them functions in their coping process. 394 narrated scenes with reported speech of doctors were extracted from interviews with 26 patients with type 2 diabetes and 30 with chronic pain. Constructed speech acts were investigated by means of positioning and narrative analysis, and assigned into thematic categories by a bottom-up coding procedure. Patients use narratives as coping strategies when confronted with illness and their encounters with doctors by constructing them in a supportive and face-saving way. In correspondence with the variance of illness conditions, differing moral problems in dealing with doctors arise. Different evaluative stances towards the same events within interviews show that positionings are not fixed, but vary according to contexts and purposes. Our narrative approach deepens the standardized and predominantly cognitive statements of questionnaires in research on doctor-patient relations by individualized emotional and biographical aspects of patients' perspective. Doctors should be trained to become aware of their impact in patients' coping processes.

Predicting fitness to practise events in international medical graduates who registered as UK doctors via the Professional and Linguistic Assessments Board (PLAB) system: a national cohort study.

Science.gov (United States)

Tiffin, Paul A; Paton, Lewis W; Mwandigha, Lazaro M; McLachlan, John C; Illing, Jan

2017-03-20

International medical graduates working in the UK are more likely to be censured in relation to fitness to practise compared to home graduates. Performance on the General Medical Council's (GMC's) Professional and Linguistic Assessments Board (PLAB) tests and English fluency have previously been shown to predict later educational performance in this group of doctors. It is unknown whether the PLAB system is also a valid predictor of unprofessional behaviour and malpractice. The findings would have implications for regulatory policy. This was an observational study linking data relating to fitness to practise events (referral or censure), PLAB performance, demographic variables and English language competence, as evaluated via the International English Language Test System (IELTS). Data from 27,330 international medical graduates registered with the GMC were analysed, including 210 doctors who had been sanctioned in relation to at least one fitness to practise issue. The main outcome was risk of eventual censure (including a warning). The significant univariable educational predictors of eventual censure (versus no censures or referrals) were lower PLAB part 1 (hazard ratio [HR], 0.99; 95% confidence interval, 0.98 to 1.00) and part 2 scores (HR, 0.94; 0.91 to 0.97) at first sitting, multiple attempts at both parts of the PLAB, lower IELTS reading (HR, 0.79; 0.65 to 0.94) and listening scores (HR, 0.76; 0.62 to 0.93) and higher IELTS speaking scores (HR, 1.28; 1.04 to 1.57). Multiple resits at either part of the PLAB and higher IELTS speaking score (HR, 1.49; 1.20 to 1.84) were also independent predictors of censure. We estimated that the proposed limit of four attempts at both parts of the PLAB would reduce the risk in this entire group by only approximately two censures per 5 years in this group of doctors. Making the PLAB, or any replacement assessment, more stringent and raising the required standards of English reading and listening may result in fewer fitness

Smartphone and medical related App use among medical students and junior doctors in the United Kingdom (UK: a regional survey

Directory of Open Access Journals (Sweden)

Payne Karl Frederick

2012-10-01

Full Text Available Abstract Background Smartphone usage has spread to many settings including that of healthcare with numerous potential and realised benefits. The ability to download custom-built software applications (apps has created a new wealth of clinical resources available to healthcare staff, providing evidence-based decisional tools to reduce medical errors. Previous literature has examined how smartphones can be utilised by both medical student and doctor populations, to enhance educational and workplace activities, with the potential to improve overall patient care. However, this literature has not examined smartphone acceptance and patterns of medical app usage within the student and junior doctor populations. Methods An online survey of medical student and foundation level junior doctor cohorts was undertaken within one United Kingdom healthcare region. Participants were asked whether they owned a Smartphone and if they used apps on their Smartphones to support their education and practice activities. Frequency of use and type of app used was also investigated. Open response questions explored participants’ views on apps that were desired or recommended and the characteristics of apps that were useful. Results 257 medical students and 131 junior doctors responded, equating to a response rate of 15.0% and 21.8% respectively. 79.0% (n=203/257 of medical students and 74.8% (n=98/131 of junior doctors owned a smartphone, with 56.6% (n=115/203 of students and 68.4% (n=67/98 of doctors owning an iPhone. The majority of students and doctors owned 1–5 medical related applications, with very few owning more than 10, and iPhone owners significantly more likely to own apps (Chi sq, p Conclusions This study found a high level of smartphone ownership and usage among medical students and junior doctors. Both groups endorse the development of more apps to support their education and clinical practice.

Virtual colonoscopy training and accreditation: a national survey of radiologist experience and attitudes in the UK

International Nuclear Information System (INIS)

Burling, D.; Moore, A.; Taylor, S.; La Porte, S.; Marshall, M.

2007-01-01

Aim: Expert consensus recommends directed training and possibly in the future, formal accreditation before independent virtual colonoscopy (VC) reporting. We surveyed radiologists' experience of VC training, compared with barium enema, and assessed attitudes towards accreditation. Materials and methods: A questionnaire was sent to 78 consultant radiologists from 72 centres (65 National Health Service hospitals; seven independent primary screening centres) offering a VC service. Results: Fifty-four (69%) eligible radiologists responded. They had interpreted 18,152 examinations (range 3-1500) in total versus 232,350 (13 times more) barium enemas. Twenty-two (41%) deemed their VC training as inadequate [including five (45%) of screening centre radiologists], and only 14 (26%) had attended a training workshop due to lack of availability (54%) or financial/study leave constraints (24%). Eleven (20%) radiologists routinely double-reported VC examinations versus 37 (69%) barium enemas, yet 21 (39%) considered requirements for VC training were greater than barium enema. Thirty-eight (70%) favoured accreditation beyond internal audit for VC versus 15(28%) for barium enema. Of these 38, seven (18%) favoured 'one-off,' and 18 (47%) periodic testing, with 16 (42%) favouring external audit alone or in combination with testing. Overall, 42 (78%) considered specific accreditation for reporting screening examinations appropriate and 45 (83%) respondents preferred a national radiological organization to regulate such a scheme. Conclusion: There is wide variability in reporting experience and recommendations for VC training have not been widely adopted, in part due to limited access to dedicated workshops. UK radiologists are generally in favour of VC accreditation, governed by a national radiology organization

The predictive validity of selection for entry into postgraduate training in general practice: evidence from three longitudinal studies.

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Patterson, Fiona; Lievens, Filip; Kerrin, Máire; Munro, Neil; Irish, Bill

2013-11-01

The selection methodology for UK general practice is designed to accommodate several thousand applicants per year and targets six core attributes identified in a multi-method job-analysis study To evaluate the predictive validity of selection methods for entry into postgraduate training, comprising a clinical problem-solving test, a situational judgement test, and a selection centre. A three-part longitudinal predictive validity study of selection into training for UK general practice. In sample 1, participants were junior doctors applying for training in general practice (n = 6824). In sample 2, participants were GP registrars 1 year into training (n = 196). In sample 3, participants were GP registrars sitting the licensing examination after 3 years, at the end of training (n = 2292). The outcome measures include: assessor ratings of performance in a selection centre comprising job simulation exercises (sample 1); supervisor ratings of trainee job performance 1 year into training (sample 2); and licensing examination results, including an applied knowledge examination and a 12-station clinical skills objective structured clinical examination (OSCE; sample 3). Performance ratings at selection predicted subsequent supervisor ratings of job performance 1 year later. Selection results also significantly predicted performance on both the clinical skills OSCE and applied knowledge examination for licensing at the end of training. In combination, these longitudinal findings provide good evidence of the predictive validity of the selection methods, and are the first reported for entry into postgraduate training. Results show that the best predictor of work performance and training outcomes is a combination of a clinical problem-solving test, a situational judgement test, and a selection centre. Implications for selection methods for all postgraduate specialties are considered.

Learning how to learn using simulation: Unpacking disguised feedback using a qualitative analysis of doctors' telephone talk.

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Eppich, Walter J; Rethans, Jan-Joost; Dornan, Timothy; Teunissen, Pim W

2018-05-04

Telephone talk between clinicians represents a substantial workplace activity in postgraduate clinical education, yet junior doctors receive little training in goal-directed, professional telephone communication. To assess educational needs for telephone talk and develop a simulation-based educational intervention. Thematic analysis of 17 semi-structured interviews with doctors-in-training from various training levels and specialties. We identified essential elements to incorporate into simulation-based telephone talk, including common challenging situations for junior doctors as well as explicit and informal aspects that promote learning. These elements have implications for both junior doctors and clinical supervisors, including: (a) explicit teaching and feedback practices and (b) informal conversational interruptions and questions. The latter serve as "disguised" feedback, which aligns with recent conceptualizations of feedback as "performance relevant information". In addition to preparing clinical supervisors to support learning through telephone talk, we propose several potential educational strategies: (a) embedding telephone communication skills throughout simulation activities and (b) developing stand-alone curricular elements to sensitize junior doctors to "disguised" feedback during telephone talk as a mechanism to augment future workplace learning, i.e. 'learning how to learn' through simulation.

Doctors discussing religion and spirituality: A systematic literature review.

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Best, Megan; Butow, Phyllis; Olver, Ian

2016-04-01

Discussion of religion and/or spirituality in the medical consultation is desired by patients and known to be beneficial. However, it is infrequent. We aimed to identify why this is so. We set out to answer the following research questions: Do doctors report that they ask their patients about religion and/or spirituality and how do they do it? According to doctors, how often do patients raise the issue of religion and/or spirituality in consultation and how do doctors respond when they do? What are the known facilitators and barriers to doctors asking their patients about religion and/or spirituality? A mixed qualitative/quantitative review was conducted to identify studies exploring the physician's perspective on discussion of religion and/or spirituality in the medical consultation. We searched nine databases from inception to January 2015 for original research papers reporting doctors' views on discussion of religion and/or spirituality in medical consultations. Papers were assessed for quality using QualSyst and results were reported using a measurement tool to assess systematic review guidelines. Overall, 61 eligible papers were identified, comprising over 20,044 physician reports. Religion and spirituality are discussed infrequently by physicians although frequency increases with terminal illness. Many physicians prefer chaplain referral to discussing religion and/or spirituality with patients themselves. Such discussions are facilitated by prior training and increased physician religiosity and spirituality. Insufficient time and training were the most frequently reported barriers. This review found that physician enquiry into the religion and/or spirituality of patients is inconsistent in frequency and nature and that in order to meet patient needs, barriers to discussion need to be overcome. © The Author(s) 2015.

A surgical career for New Zealand junior doctors? Factors influencing this choice.

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Du, Jason; Sathanathan, Janarthanan; Naden, Gill; Child, Stephen

2009-08-07

To discover the level of interest in a surgical career amongst junior doctors and trainee interns in the Auckland region. Secondary aims are to identify the factors that influence career choice as well as the timing of career choice. An anonymous and structured questionnaire was distributed to all trainee interns and junior doctors in their first to fifth postgraduate years in the Auckland region. Questions were based on basic demographics, level of training, career preference and factors from previous experiences in surgery that may have influenced their career choice. Total of 87 replies with 36% expressed interest in surgery whereas 64% were interested in non-surgical specialties. Top three factors influencing career choice were similar in both groups: Lifestyle, career ambitions and family. Personal interest, practical hands-on and positive previous experiences were the top reasons why junior doctors chose surgery. Poor lifestyle, lacking of interest, limited future part-time work and previous negative experiences were the top reasons why junior doctors did not choose surgery. A significantly (pcareers earlier. Career aspirations of New Zealand junior doctors were similar to findings reported overseas. To promote surgery amongst junior doctors and medical students, attention should be paid to the key factors which may influence career choice. By improving working conditions and have better surgical education with good mentoring, team atmosphere and opportunities for early exposure will hopefully allow better recruitment and training of future surgeons.

Knowledge and perception regarding clinical trials among doctors of government medical colleges: A questionnaire-based study

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Supriyo Choudhury

2016-01-01

Full Text Available Aims: By virtue of being a specialized field by itself, the science of clinical trials (CTs may not be well understood by doctors who are not specifically trained in it. A lack of knowledge may translate to a negative perception toward CT. With the idea of getting a situational snapshot, we estimated the knowledge and perception of CTs among doctors from government medical colleges of West Bengal who are not trained on CT in their postgraduate curriculum. Several determinants of knowledge and perception regarding CT were also evaluated. Methods: We have quantified the knowledge and perception of CTs by a structured validated questionnaire. Development and validation of the questionnaire was performed prior to the study. Results: Among 133 participants, 7.5% received focused training on CT and 16.5% participated in CTs as investigators. Majority of the doctors were unfamiliar with the basic terminologies such as, “adverse event” and “good clinical practice.” Encouragingly, 93.3% doctors advised that a detailed discussion of CT methodology should be incorporated in the under graduate medical science curriculum. They had an overall positive attitude toward CTs conducted in India, with a mean score that is 72.6% of the maximum positive score. However, a large number of the doctors were skeptical about the primary motivation and operations of pharmaceutical industry sponsored CTs, with 45% of them believing that patients are exploited in these sponsored CTs. Conclusion: Participant doctors had a basic knowledge of CT methodology. The study has revealed specific areas of deficient knowledge, which might be emphasized while designing focused training on CT methodology.

Experiences with maternal and perinatal death reviews in the UK--the MBRRACE-UK programme.

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Kurinczuk, J J; Draper, E S; Field, D J; Bevan, C; Brocklehurst, P; Gray, R; Kenyon, S; Manktelow, B N; Neilson, J P; Redshaw, M; Scott, J; Shakespeare, J; Smith, L K; Knight, M

2014-09-01

Established in 1952, the programme of surveillance and Confidential Enquiries into Maternal Deaths in the UK is the longest running such programme worldwide. Although more recently instituted, surveillance and confidential enquiries into perinatal deaths are also now well established nationally. Recent changes to funding and commissioning of the Enquiries have enabled both a reinvigoration of the processes and improvements to the methodology with an increased frequency of future reporting. Close engagement with stakeholders and a regulator requirement for doctors to participate have both supported the impetus for involvement of all professionals leading to greater potential for improved quality of care for women and babies. © 2014 Royal College of Obstetricians and Gynaecologists.

Identifying critical success factors for designing selection processes into postgraduate specialty training: the case of UK general practice.

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Plint, Simon; Patterson, Fiona

2010-06-01

The UK national recruitment process into general practice training has been developed over several years, with incremental introduction of stages which have been piloted and validated. Previously independent processes, which encouraged multiple applications and produced inconsistent outcomes, have been replaced by a robust national process which has high reliability and predictive validity, and is perceived to be fair by candidates and allocates applicants equitably across the country. Best selection practice involves a job analysis which identifies required competencies, then designs reliable assessment methods to measure them, and over the long term ensures that the process has predictive validity against future performance. The general practitioner recruitment process introduced machine markable short listing assessments for the first time in the UK postgraduate recruitment context, and also adopted selection centre workplace simulations. The key success factors have been identified as corporate commitment to the goal of a national process, with gradual convergence maintaining locus of control rather than the imposition of change without perceived legitimate authority.

Management Challenges for DevOps Adoption within UK SMEs

OpenAIRE

Jones, Stephen; Noppen, Joost; Lettice, Fiona

2016-01-01

The DevOps phenomenon is gathering pace as more UK organisations seek to leverage the benefits it can potentially bring to software engineering functions. However substantial organisational change is inherent to adopting DevOps, especially where there are prior and established methods. As part of a wider piece of doctoral research investigating the management challenges of DevOps adoption, we present early findings of a six month qualitative diary study following the adoption of DevOps within...

Digital reporting by small private companies in the UK

OpenAIRE

Alkhatib, Esraa

2016-01-01

This thesis was submitted for the award of Doctor of Philosophy and was awarded by Brunel University London. Abstract This thesis investigates the factors that affect the take-up of statutory digital reporting of statutory accounts and returns to the tax authority (HM Revenue and Customs) and voluntary digital reporting to the company registry (Companies House) by small private companies in the UK. In doing so, it identifies the costs and benefits of this innovation from the perspective...

Testing an empirically derived mental health training model featuring small groups, distributed practice and patient discussion.

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Murrihy, Rachael C; Byrne, Mitchell K; Gonsalvez, Craig J

2009-02-01

Internationally, family doctors seeking to enhance their skills in evidence-based mental health treatment are attending brief training workshops, despite clear evidence in the literature that short-term, massed formats are not likely to improve skills in this complex area. Reviews of the educational literature suggest that an optimal model of training would incorporate distributed practice techniques; repeated practice over a lengthy time period, small-group interactive learning, mentoring relationships, skills-based training and an ongoing discussion of actual patients. This study investigates the potential role of group-based training incorporating multiple aspects of good pedagogy for training doctors in basic competencies in brief cognitive behaviour therapy (BCBT). Six groups of family doctors (n = 32) completed eight 2-hour sessions of BCBT group training over a 6-month period. A baseline control design was utilised with pre- and post-training measures of doctors' BCBT skills, knowledge and engagement in BCBT treatment. Family doctors' knowledge, skills in and actual use of BCBT with patients improved significantly over the course of training compared with the control period. This research demonstrates preliminary support for the efficacy of an empirically derived group training model for family doctors. Brief CBT group-based training could prove to be an effective and viable model for future doctor training.

Mechanisms of formation of maladaptation states among internship doctors and approaches to their correction

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V. V. Vyun

2016-03-01

Full Text Available A doctor’s adaptation to medical activity has a great influence on the effectiveness of his professional activity. The objective: to explore individual psychological predictors of the formation of maladaptation states of internship doctors for the development of a system for their diagnosis, correction and psychoprophylaxis. A comprehensive clinical-psychological, psychodiagnostic and clinical-anamnestic examination of 213 internship doctors of the first year of training atKharkovNationalMedicalUniversity, 116 women and 97 men, aged 22-25 years old had been conducted. It had been established that internship doctors are characterized by feelings of internal tension and dissatisfaction, decreased mood, irritability, anxiety, long-term uncertain negative emotions, unmotivated fears, self-doubt, doubts about making decisions, decline in intellectual activityin conjunction with increased exhaustion and withdrawal mercurial attention. We have developed a system of medical and psychological support during the professional training period depending on the type of disadaptation. The psychotherapeutic complex in the internship doctors included the use of rational psychotherapy, autogenous training (psychotonic version of Shogham-Mirovsky, art therapy, progressive muscle relaxation by Jacobson, cognitive-behavioral therapy of Beck, autogenous training in the modification of Lebedinsky - Bortnik, etc. were used. The results of a three-year catamnestic study proved the effectiveness of the proposed system of psychotherapeutic correction of disorders of adaptation, positive dynamics of the mental state was noted, the maladaptive states were reduced; 92.6% of the examined recurrences of the violations of adaptation did not occur.

Educating doctors in the clinical workplace: unraveling the process of teaching and learning in the medical resident as teacher.

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Busari, J O; Arnold, Aer

2009-01-01

In recent years, higher medical education has witnessed major changes in the structure and content of postgraduate medical training. Seven professional competencies have been described that address the medical doctors' ability to effectively communicate and transfer medical information, interact effectively and professionally, and demonstrate a good grasp of clinical knowledge and skills. Proficiency in didactic skills, however, is an important competency that has not received prominent attention. In the clinical setting, attending-physicians and medical residents are responsible for teaching. Consequently, several medical institutions have proposed the need for teacher training programs to improve the teaching skills of attending doctors and medical residents. The supporters of these programs believe that through teaching, medical doctors improve their individual professional and clinical problem-solving abilities. Hence, it is logical to assume that didactic skills' training would contribute to the professional development of doctors. In this paper, we re-examine the underlying theory of the didactic proficiency, how it relates to the clinical setting, and why it may be beneficial for the professional training of medical residents.

Different approaches to the tasks of educating and training information systems professionals, within the National Health Service (UK).

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Grant, R M; Horkin, E J; Melhuish, P J; Norris, A C

1998-06-01

In 1994, La Sainte Union College of Higher Education (LSU) developed an MSc in Health Informatics course, in conjunction with Southampton University NHS Trust (SUHT). The original part-time, 1 day per week mode of delivery has since been broadened to include a distance leaning route and recently a block release mode, by which students combine usage of the distance learning materials with attendance in College for an intensive 2-day taught element. Because the course was designed in close co-operation with a major teaching hospital, it has always been 'market led' to meet the needs both of the individual students and of the organisations that they work for. At the same time, students acquire a quality-assured qualification from a premier UK university, a qualification that holds credence outside the National Health Service (NHS). At the same time as LSU and SUHT were developing the MSc in Health Informatics, the UK NHS Training Division (NHSTD) started to promote a professional qualification for health service professionals. the so-called 'Statement of Recognition' (SoR). In contrast to the academic format of an MSc, the SoR was not a formal course, but a combination of modules designed to help candidates demonstrate their competence and achievement at work by portfolio evidence. This approach has national standing throughout the UK in a set of qualifications known as NVQs (National Vocational Qualifications). The NHSTD, through its successor, the Institute of Health Care Development (IHCD), has further refined this competency based model, culminating in the launch in 1996 of the Diploma and Advanced Diploma in Information and Technology (Health). Professionals within the area of Information Management and Technology (IM&T) in the NHS now have the alternatives of an academic or a competency route to achieve their goals. This paper traces the development of and the relationship between, these two approaches to the educational and training of healthcare professionals

Performance in the FRCR (UK) Part 2B examination: Analysis of factors associated with success

International Nuclear Information System (INIS)

Hawtin, K.E.; Williams, H.R.T.; McKnight, L.; Booth, T.C.

2014-01-01

Aim: To assess factors that influence pass rates and examination scores in the Fellowship of the Royal College of Radiologists (FRCR) 2B examination. Materials and methods: 2238 attempts at the FRCR 2B examination were evaluated between Spring 2006 and Spring 2010. Pass rates and examination scores were analysed by gender and ethnicity, and the influence of factors such as radiology training (UK versus non-UK), sitting (Spring versus Autumn), and the presence of an undergraduate or postgraduate degree were examined. Results: 1571 candidates made 2238 examination attempts, with an overall pass rate of 59.4% (63.1% at first attempt). 66.2% entrants were male; 48.8% attempts were by candidates from a UK radiology training scheme. UK candidates were significantly more likely to pass than non-UK candidates (p < 0.0001). White candidates were more likely to pass at first or second attempt than non-white candidates (p < 0.0001), but when restricted to UK entrants ethnicity did not influence success at first attempt. Overall, females were more successful than males (p < 0.001). Presence of an undergraduate (p = 0.19) or postgraduate (p = 0.80) degree did not affect pass rate at first attempt for UK candidates. However, logistic regression demonstrated that the only significant factor influencing pass rates at first attempt was whether radiology training was undertaken in the UK (p < 0.0001). A trend towards increased pass rates in autumn sittings was seen (p = 0.06), but ethnicity (p = 0.99) and gender (p = 0.41) were not significant factors. Conclusion: The FRCR 2B examination is non-discriminatory for UK candidates with respect to gender and ethnicity. Poorer performance of non-UK trained candidates is a consistent outcome in the literature. - Highlights: • Factors influencing pass rates and scores in FRCR 2B examination were assessed. • UK candidates are more likely to pass than non-UK candidates. • There is no effect of gender or ethnicity on UK

Supervised Machine Learning Algorithms Can Classify Open-Text Feedback of Doctor Performance With Human-Level Accuracy.

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Gibbons, Chris; Richards, Suzanne; Valderas, Jose Maria; Campbell, John

2017-03-15

Machine learning techniques may be an effective and efficient way to classify open-text reports on doctor's activity for the purposes of quality assurance, safety, and continuing professional development. The objective of the study was to evaluate the accuracy of machine learning algorithms trained to classify open-text reports of doctor performance and to assess the potential for classifications to identify significant differences in doctors' professional performance in the United Kingdom. We used 1636 open-text comments (34,283 words) relating to the performance of 548 doctors collected from a survey of clinicians' colleagues using the General Medical Council Colleague Questionnaire (GMC-CQ). We coded 77.75% (1272/1636) of the comments into 5 global themes (innovation, interpersonal skills, popularity, professionalism, and respect) using a qualitative framework. We trained 8 machine learning algorithms to classify comments and assessed their performance using several training samples. We evaluated doctor performance using the GMC-CQ and compared scores between doctors with different classifications using t tests. Individual algorithm performance was high (range F score=.68 to .83). Interrater agreement between the algorithms and the human coder was highest for codes relating to "popular" (recall=.97), "innovator" (recall=.98), and "respected" (recall=.87) codes and was lower for the "interpersonal" (recall=.80) and "professional" (recall=.82) codes. A 10-fold cross-validation demonstrated similar performance in each analysis. When combined together into an ensemble of multiple algorithms, mean human-computer interrater agreement was .88. Comments that were classified as "respected," "professional," and "interpersonal" related to higher doctor scores on the GMC-CQ compared with comments that were not classified (P.05). Machine learning algorithms can classify open-text feedback of doctor performance into multiple themes derived by human raters with high

Brain drain: final year medical students' intentions of training abroad.

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Bojanic, Ana; Bojanic, Katarina; Likic, Robert

2015-06-01

In Croatia, a new European Union (EU) member state since July 2013, there is already a shortage of around 3280 doctors to reach the European average. To investigate the emigration intentions of the current cohort of final year medical students at Zabreb School of Medicine. An electronic questionnaire was used in June 2013 to assess the attitudes of 232 final year medical students towards working conditions abroad and expectations for career opportunities in Croatia following accession to the EU. With an overall response rate of 87%, more than half of the surveyed students (106/202, 53%) intended to travel abroad, either for specialty (52/202, 26%) or subspecialty (54/202, 27%) training. More female students (58/135, 43%) than male students (17/62, 27%) indicated they would not emigrate. Most attractive emigration destinations were: Germany (34/121, 28%), USA (19/121, 16%), the UK (19/121, 16%), Switzerland (16/121, 13%) and Canada (11/121, 9%). The most important goals that respondents aimed to achieve through training abroad were to excel professionally (45/120, 38%), to prosper financially (20/120, 17%) and to acquire new experiences and international exposure (31/120, 26%). Students' motivating factors, goals for and positive beliefs about training abroad, as well as negative expectations regarding career opportunities in Croatia, may point towards actions that could be taken to help make Croatia a country that facilitates medical education and professional career development of young doctors. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Clinical leadership training: an evaluation of the Welsh Fellowship programme.

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Phillips, Suzanne; Bullock, Alison

2018-05-08

Purpose UK fellowship schemes have been set up to address low-level engagement of doctors with leadership roles. Established in 2013, the Welsh Clinical Leadership Fellowship (WCLF) programme aims to recruit aspiring future clinical leaders and equip them with knowledge and skills to lead improvements in healthcare delivery. This paper aims to evaluate the 12-month WCLF programme in its first two years of operation. Design/methodology/approach Focused on the participants ( n = 8), the authors explored expectations of the programme, reactions to academic components (provided by Academi Wales) and learning from workplace projects and other opportunities. The authors adopted a qualitative approach, collecting data from four focus groups, 20 individual face-to-face or telephone interviews with fellows and project supervisors and observation of Academi Wales training days. Findings Although from diverse specialties and stages in training, all participants reported that the Fellowship met expectations. Fellows learned leadership theory, developing understanding of leadership and teamwork in complex organisations. Through workplace projects, they applied their knowledge, learning from both success and failure. The quality of communication with fellows distinguished the better supervisors and impacted on project success. Research limitations/implications Small participant numbers limit generalisability. The authors did not evaluate longer-term impact. Practical implications Doctors are required to be both clinically proficient and influence service delivery and improve patient care. The WCLF programme addresses both the need for leadership theory (through the Academi Wales training) and the application of learning through the performance of leadership roles in the projects. Originality/value This work represents an evaluation of the only leadership programme in Wales, and outcomes have led to improvements.

Palliative care education for medical students: Differences in course evolution, organisation, evaluation and funding: A survey of all UK medical schools.

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Walker, Steven; Gibbins, Jane; Paes, Paul; Adams, Astrid; Chandratilake, Madawa; Gishen, Faye; Lodge, Philip; Wee, Bee; Barclay, Stephen

2017-06-01

A proportion of newly qualified doctors report feeling unprepared to manage patients with palliative care and end-of-life needs. This may be related to barriers within their institution during undergraduate training. Information is limited regarding the current organisation of palliative care teaching across UK medical schools. To investigate the evolution and structure of palliative care teaching at UK medical schools. Anonymised, web-based questionnaire. Settings/participants: Results were obtained from palliative care course organisers at all 30 UK medical schools. The palliative care course was established through active planning (13/30, 43%), ad hoc development (10, 33%) or combination of approaches (7, 23%). The place of palliative care teaching within the curriculum varied. A student-selected palliative care component was offered by 29/30 (97%). All medical schools sought student feedback. The course was reviewed in 26/30 (87%) but not in 4. Similarly, a course organiser was responsible for the palliative care programme in 26/30 but not in 4. A total of 22 respondents spent a mean of 3.9 h (median 2.5)/week in supporting/delivering palliative care education (organisers received titular recognition in 18/27 (67%; no title 9 (33%); unknown 3 (11%)). An academic department of Palliative Medicine existed in 12/30 (40%) medical schools. Funding was not universally transparent. Palliative care teaching was associated with some form of funding in 20/30 (66%). Development, organisation, course evaluation and funding for palliative care teaching at UK medical schools are variable. This may have implications for delivery of effective palliative care education for medical students.

Early Mentoring of Medical Students and Junior Doctors on a Path to Academic Cardiothoracic Surgery.

Science.gov (United States)

Fricke, Tyson A; Lee, Melissa G Y; Brink, Johann; d'Udekem, Yves; Brizard, Christian P; Konstantinov, Igor E

2018-01-01

In 2005 the Department of Cardiothoracic Surgery at The Royal Children's Hospital started an early academic mentoring program for medical students and junior doctors with the aim of fostering an interest in academic surgery. Between 2005 and 2015, 37 medical students and junior doctors participated in research in the Department of Cardiothoracic Surgery at The Royal Children's Hospital. Each was given an initial project on which to obtain ethics approval, perform a literature review, data collection, statistical analysis, and prepare a manuscript for publication. A search of the names of these former students and doctors was conducted on PubMed to identify publications. A total of 113 journal articles were published in peer-reviewed journals with an average impact factor of 4.1 (range, 1.1 to 19.9). Thirty (30 of 37, 81%) published at least one article. A mean of 4.3 journal articles was published per student or junior doctor (range, 0 to 29). Eleven (11 of 37, 30%) received scholarships for their research. Nine (9 of 37, 24%) have completed or are enrolled in higher research degrees with a cardiothoracic surgery focus. Of these 9, 2 have completed doctoral degrees while in cardiothoracic surgery training. Five will complete their cardiothoracic surgery training with a doctoral degree and the other 2 are pursuing training in cardiology. A successful early academic mentoring program in a busy cardiothoracic surgery unit is feasible. Mentoring of motivated individuals in academic surgery benefits not only their medical career, but also helps maintain high academic output of the unit. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

[Doctor-Patient Communication Training in Simulated Situations: Emotions and Perceptions of Simulated Patients during Patient-Centered Conversations].

Science.gov (United States)

Butollo, Maria Asisa; Holzinger, Anita; Wagner-Menghin, Michaela

2018-04-13

The use of simulated patients (SPs) for doctor-patient communication training has been established in medical curricula as an important didactic method. The study addresses the question, if patients' emotions and perceptions are represented adequately in patient-centered communication. 22 of 37 SPs of the Medical University of Vienna (12 women, 10 men) were asked openly about their feelings after having acted as an SP in a semi-structured interview, which employed the Critical Incident Technique. The interviews were recorded, transcribed, separated into situational analysis units und analyzed deductively; we used the evidence based qualities of patient-centered communication and the "Nationaler Kompetenzbasierter Lernzielkatalog Medizin" as a guideline. Out of 192 analysis units, 67 were evaluated as positive and 125 as negative. The SPs reported positive feelings, such as perceiving "stability and trust in relationships" (22%), perception of congruence (15%), acceptance (27%) and empathy (36%). As to negative feelings, SPs reported "perceiving instability" (18%), "incongruence" (11%), "lack of acceptance" (40%) and "lack of empathy" (30%). Additionally, 50% of SPs were positively affected when observing students' learning success. When SPs perceived patient-centered communication, they reported positive emotions. A lack of patient centeredness, on the contrary, provoked negative emotions. An empathic attitude, as well as a "lack of acceptance" with contrary effects had the strongest influence on the SPs' mental state. The reaction of SPs to patient centeredness is sufficiently authentic to reach learning objectives, however it is also affected by reactions of SPs to the learning success of students, which is irrelevant for the real-life doctor-patient interaction. SP reactions are affected by students' attitudes. Students should therefore be prepared well before interacting with SPs in a roleplay setting. While SPs' behavior is authentic in patient

Learning Doctor-Patient Communication – Evaluating the effectiveness of the communication training course at Leipzig University from the students' point of view

Directory of Open Access Journals (Sweden)

Cämmerer, Jana

2016-05-01

Full Text Available Objective: At the University of Leipzig, the requirements of the Licensing Regulations for Doctors (Approbationsordnung für Ärzte for the practical training of communication skills are actively implemented by a two-semester communication course. During this course, student tutors impart the basics of interpersonal as well as selected aspects of doctor-patient communication using interactive training methods. This article reports on the effect the training has on the self-assessed communication skills of the medicine students.Methods: The students’ self-perceived communication skills were assessed, both at the beginning and after the completion of the first and second course semesters using questionnaires related to the course’s learning goals. Pre-post comparisons were then carried out. 142 students (of 163 students in total participated in the survey at the start of the course, of which 117 completed the T2-questionnaire at the end of the first course semester. Only the 84 students who also completed the questionnaires in the second course semester were included in the statistical analysis. These responses were analysed using both descriptive and inferential statistics.Results: The comparison of the self-assessments between the four measurement points showed that statistically significant learning progress for all assessed communication skills had taken place from the point of view of the students. The largest changes between measurements, and therefore the greatest learning progress, could be seen in knowledge related skills.Conclusion: From the students’ point of view the communication training contributes significantly to the acquisition of communication skills. The results suggest that this “hands-on” course concept is suited to successfully enhance the students’ communication skills. The course concept should therefore be retained for both the course in its current form as well as for any extension of the course into the

Significance of gender in the attitude towards doctor-patient communication in medical students and physicians.

Science.gov (United States)

Löffler-Stastka, Henriette; Seitz, Tamara; Billeth, Sabrina; Pastner, Barbara; Preusche, Ingrid; Seidman, Charles

2016-09-01

Gender-specific differences in the attitudes towards doctor-patient communication among medical students and physicians were assessed. A total of 150 medical students and 51 physicians from different departments took part in the study. The association, attitude and experiences regarding doctor-patient communication were assessed with a series of tools and questionnaires. Female doctors and students tended to describe the doctor-patient communication with positive attributes, such as "helpful", "sentimental", "voluble", "sociable", "gentle", "yielding" and "peaceful". Male students and physicians, on the other hand, described doctor-patient communication as "overbearing", "robust" and "inhibited". The most frequent associations females had with the term doctor-patient communication were "empathy", "confidence", "openess", while the most frequent association of the male colleagues was "medical history". Female doctors reported speaking about the psychosocial situation of the patient significantly more often and believed in higher patient satisfaction by sharing more information. Furthermore, they reported having longer conversations with a more equal partnership than their male colleagues. Compared to male students, female students were willing to take part in training their communication skills more often and had more interest in research about doctor-patient communication. Male medical students reported self-doubt during conversations with female patients, while one third of the male physicians talked about "the power over the patient". This study indicates a gender-dependent communication style influenced by stereotypes. At the establishment of communication training these differences should be taken into account, especially to strengthen male communication skills and improve their attitudes.

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