A Practical Approach for Residency Programs to Revive Graduate Medical Education during the Novel Coronavirus Disease 2019 (COVID-19) Pandemic: A Battle Proven Concept

The Novel Coronavirus Disease 2019 (COVID-19) Pandemic impacted the educational environment of Internal Medicine residency programs tremendously, shifting the focus from continued medical education to being the first line of defense while taking care of patients with COVID-19. Our article discusses an approach to reestablish medical education in the midst of a pandemic.

“…we were like tourists in the theatre, the interns assisted almost all procedures…” Challenges facing the training of Assistant Medical Officers in Tanzania

Background: Training of mid-level providers is a task sharing strategy that has gained popularity in the recent past for addressing critical shortage of health workforce. In Tanzania, training of mid-level providers has existed for over five decades, however, concerns are upon the quality of the mid-level cadres amidst the growing number of medical universities. This study sought to explore the challenges facing the training of the Assistant Medical Offices in Tanzania.Methods: An exploratory qualitative case study was carried out in four regions to include one rural district in each of the selected regions and two AMOs Training Colleges in Tanzania. A semi-structured interview guide was used to interview 29 Key informants from the district hospitals, district management, regional management, AMOs training college and one retired AMO. In addition, four focus group discussions were conducted with 35 AMO trainees.Results: Training of AMOs in Tanzania faces many challenges. The challenges include; use of outdated and static curriculum, inadequate tutors (lack of teaching skills and experience of teaching adults), Inadequate teaching infrastructure in existence of many other trainees to include interns, and limited or lack of scholarships and sponsorship for the AMO trainees. Conclusions: The findings of this study underscore that the challenges facing AMO training have the potentials to negatively impact the quality of care rendered by this cadre. Holistic approach is needed in addressing these challenges. The solutions should focus on reviewing the curriculum, deploying qualified tutors and improving the competencies of the available tutors through continued medical education programmes. Furthermore, the government in collaboration with other stakeholders should work together to address the challenges on teaching infrastructure and financial support to this cadre that has continued to be the backbone of the primary health care in Tanzania. Long term solution should consider to deploy the medical officers at the primary facilities and phase out the AMOs. Finally, challenges facing mid-level providers in Tanzania and similar settings are similar, thus these findings can be used as a starting pointing in addressing them.

Discharging sinus from the eyelid following accidental impaction of wood fragment

Injury to the eyelid is one of the most common emergencies at eye hospitals. Injuries to the eye and its surrounding tissues may result from several types of foreign bodies. The injured eye must be carefully and gently examined to prevent missed injuries and to avoid putting pressure on the globe, which might cause prolapse of intraocular contents. We report an unsightly upper eyelid discharging sinus with wood fragment impaction that was incompletely removed by the first attending physician for a period of eleven months. The wood fragments were carefully and completely removed under local anaesthesia, and debridement and dressing of the wound were done by an ophthalmic plastic surgeon when the patient was eventually referred to the tertiary institution. The need to include basic eye care courses in continued medical education for all general practitioners is advocated to reduce resultant ocular morbidity from such ocular injuries. This will aid this group of physicians in decision-making while providing care to patients with eye injuries.

Internal Medicine Physicians and Social Media: Knowledge, Skills, and Attitudes (Preprint)

UNSTRUCTURED This research study was designed to understand physician awareness and engagement with social media (sometimes referred to as #SoMe) within the digital landscape of healthcare delivery. An audience-response survey focused on social media “Social media in Healthcare: Physician Survey”, was administered during the “A Systematic Approach to Medically Unexplained Symptoms” continuing medical education conference. The Conference took place between August 22, 2019 and August 24, 2019. Data was collected on August 23, 2019. A range of 103 (59.5%) to 112 (64.7%) of the total 173 attendees participated in this cross-sectional audience-response survey, depending on the questions answered. Most responders were between the ages of 35 and 65 years (79.6%) and female (60.2%). A majority of responders were aware of social media terminology (88.7%), and many had used it personally (46.7%), but only 12% knew how to use social media to search medical topics, 18% used it to network professionally and most (68.9%) had a distrust of social media when it came to the protection of their privacy or their patients’ privacy. Overall, about 29.6% indicated an interest in future continued medical education focused on social media (and 27.4% were neutral). Awareness of social media’s role in healthcare has increased among physicians in practice, however their participation and knowledge of opportunities remains limited. Distance from academic institutions and concerns about privacy play the largest roles in the aversion towards professional use of social media.

Knowledge about epidemiological determinants of obesity and its management amongst medical professionals of Marathwada region of Maharashtra, India

Background: Obesity has become a challenge in medical care worldwide. Medical professionals have a significant role to play in preventing and diagnosing weight problems and in providing initial counseling. Health professionals are poorly prepared in weight management, which has an effect on their knowledge and management skills with regard to overweight and obese patients. Hence the present study was carried out to assess the knowledge about epidemiological determinants of obesity and its management amongst medical professionals of Marathwada region of Maharashtra, India.Methods: A cross-sectional study was carried out during the period of March to April 2019 amongst 110 medical professionals at Department of Community Medicine of IIMSR Medical College, Badnapur, Jalna, Maharashtra, who were actively participated in continued medical education (CME) on obesity and its management where the knowledge of medical professionals were assessed. Data was analysed by using appropriate statistical test whenever necessary.Results: In this study, the pre-test good knowledge score was 14 (12.7%), which increased to 61 (55.5%) post CME. The pre-test mean score of level of knowledge was 7.41±4.12 and after CME, it was 12.90±5.21 and the mean difference was 5.49, which was statistically highly significant.Conclusions: As obesity is a public health problem globally, there was marked improvement in the knowledge amongst medical professionals after CME on epidemiological determinants of obesity and its management.

Internal Medicine Physicians and Social media: Knowledge, Skills, and Attitudes

Objective Increasing adoption of social media have revolutionized communications between individuals, groups, and organizations This research study was designed to assess the knowledge, skills, and attitudes of internal medicine physicians’ awareness and engagement with social media (sometimes referred to as #SoMe) within the digital landscape of healthcare delivery. Methods An audience-response survey focused on social media “ Social media in Healthcare: Physician Survey,” was administered during the “A Systematic Approach to Medically Unexplained Symptoms” continuing medical education conference. The Conference took place between August 22, 2019 and August 24, 2019. Data was collected on August 23, 2019. A range of 103 (59.5%) to 112 (64.7%) of the total 173 attendees participated in this cross-sectional audience-response survey, depending on the questions answered. Results Most responders were between the ages of 35 and 65 years (79.6%) and female (60.2%). A majority of responders were aware of social media terminology (88.7%), and many had used it personally (46.7%), but only 12% knew how to use social media to search medical topics, 18% used it to network professionally and most (68.9%) had a distrust of social media when it came to the protection of their privacy or their patients’ privacy. Overall, about 29.6% indicated an interest in future continued medical education focused on social media (and 27.4% were neutral). Conclusions Approximately half of the responders used social media but far less engaged its platforms for professional use likely due to privacy related concerns. Distance from academic institutions, where professional social media use is more common likely, played a role in aversion. Awareness of social media’s role in healthcare has increased among physicians in practice, however their participation and knowledge of opportunities remains limited.