Brief Report: Autism-Specific College Support Programs: Differences Across Geography and Institutional Type

Many postsecondary institutions have begun their own Autism-Specific College Support Programs (ASPs) to integrate the emergence of autistic students into college and offer supports aiding their success (Longtin in J Postsecond Educ Disabil 27(1):63–72, 2014), yet little is known about these programs. We conducted an exhaustive, year-long search of all postsecondary institutions in the United States to identify all ASPs. Although we identified a total of 74 programs located in 29 states, our analyses suggest these are unavailable to students in large portions of the country. When they are available, these programs appear to be disproportionately located at 4-year institutions, public institutions, and in the Mid-East. Our study highlights inequities based on institutional type and geography, as well as offers a complete public list of ASPs.

Worried, weary and worn out: mixed-method study of stress and well-being in final-year medical students

ObjectiveAlthough there is much focus on burnout and psychological distress among doctors, studies about stress and well-being in medical students are limited but could inform early intervention and prevention strategies.DesignThe primary aim of this mixed-method, cross-sectional survey was to compare objective and subjective levels of stress in final-year medical students (2017) and to explore their perspectives on the factors they considered relevant to their well-being.SettingUniversity College Dublin, the largest university in Ireland.Participants161 of 235 medical students participated in this study (response rate 69%).Results65.2% of students scored over accepted norms for the Perceived Stress Scale (34.8% low, 55.9% moderate and 9.3% high). 35% scored low, 28.7% moderate and 36.3% high on the Subjective Stress Scale. Thematic analysis identified worry about exams, relationships, concern about the future, work–life balance and finance; one in three students reported worry, irritability and hostility; many felt worn out. Cognitive impacts included overthinking, poor concentration, sense of failure, hopelessness and procrastination. Almost a third reported sleep and appetite disturbance, fatigue and weariness. A quarter reported a ‘positive reaction’ to stress. Positive strategies to manage stress included connection and talking, exercise, non-study activity and meditation. Unhelpful strategies included isolation and substance use. No student reported using the college support services or sought professional help.ConclusionMedical students experience high levels of psychological distress, similar to their more senior doctor colleagues. They are disinclined to avail of traditional college help services. Toxic effects of stress may impact their cognition, learning, engagement and empathy and may increase patient risk and adverse outcomes. The focus of well-being in doctors should be extended upstream and embedded in the curriculum where it could prevent future burnout, improve retention to the profession and deliver better outcomes for patients.

Growing research in geriatric medicine: a trainee perspective

Growing research in geriatric medicine is a priority area. Currently, involvement of geriatricians in research lags behind other specialties. The reasons for this are multifactorial, but a lack of training infrastructure within geriatric medicine higher specialist training is contributory. This is widespread across European countries and internationally. The Geriatric Medicine Research Collaborative (GeMRC) offers an opportunity to engage trainees in research, regardless of their previous individual research experiences. Utilising national trainee networks, GeMRC is able to conduct large-scale projects within short periods of time that can have real impact upon patient care. We consider that embedding GeMRC within higher specialist training with formal college support will assist to upskill trainee geriatricians in research methodology. Collaboratives are internationally recognised across disciplines. Expansion across European and international countries offers the opportunity for international collaboration in geriatric medicine. International trainee-led networks will enable the conduct of large-scale global projects in geriatric medicine.

Improvement of the Medical Education Situation in Sudan: Collegectomy is Not the Only Management Option

Sudan witnessed an increase in the number of colleges of medicine after the higher education revolution in the early 1990s. Many authors writing about medical education, both in Sudan and across the world, have described a negative correlation between the increased number of medical colleges and the quality of education provided by those colleges. Many educational leaders in Sudan are calling for action to deal with the issues arising from this great expansion of medical colleges, with opinions varying from collegectomies (closure of the colleges) to merging colleges. Several strategies have been implemented in Canada, Iran, the Philippines and South Africa to deal with similar situations. These have included college support such as funding or technical support, changing the colleges’ educational strategies, modifying the curriculum, integrating (rather than merging) colleges, and collegectomies. This paper outlines possible actions to be taken in response to the expansion of medical colleges in the Sudanese context. It explores the international experience with the situation in an attempt to augment the discussion with options that may help to improve medical education. Keywords: collegectomy, medical education, Sudan, social accountability