Factors associated with the choice of a second specialty among internal medicine residency graduates

Abstract: Introduction: After the residency in Internal Medicine, most graduates choose to undergo a new selection process to obtain a second specialty. The phenomenon of early specialization is encouraged as early as in the undergraduate course. Despite this, the demand for general practitioners is growing. Objective: To investigate the factors that lead the newly graduated clinician to undertake a new residency. Method: This is a cross-sectional study that analyzes the responses of Internal Medicine residency graduates from the state of Pernambuco in 2020, through a questionnaire available online by Google Forms, containing questions about social aspects, undergraduate medical course, Medical Residency and intentions for the future career. Results: There were 81 responses of the 104 possible participants (77.88%). Most of these were female (66.67%), graduated from public universities (69.14%) and had already started the Internal Medicine residency shortly after graduation (50.62%). Regarding the specialty choice, 51.85% answered they had decided in the second year of residency, and 80.25% stated that they had undergone the selection process for the second specialty shortly after completing the Internal Medicine residency. The most often chosen career was Cardiology (20%). The factors most often associated with the choice of specialty were, according to the means on the Likert scale, “work in an outpatient setting”, “long-term patient follow-up”, and “more contact with patients”. Conclusion: As far as it could be investigated in the literature, this was the first Brazilian study on specialty choices after the Internal Medicine residency. It was possible to identify the most important reasons for choosing a second specialty among the graduates of this Medical Residency program in Pernambuco in 2020. More studies are needed to establish correlations between the factors of choice with the chosen specialty.

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The effects on patient retention after opioid weaning in an internal medicine residency clinic

Journal of Opioid Management ◽

10.5055/jom.2018.0438 ◽

2018 ◽

Vol 14 (2) ◽

pp. 117

Author(s):

Charles P. Opperman, MD ◽

Melissa M. Butler, MD ◽

Andrew K. Stroud, MD ◽

Michael R. Sun, MD

Keyword(s):

Internal Medicine ◽

Chronic Pain ◽

Cross Sectional Study ◽

Internal Medicine Residency ◽

Dramatic Reduction ◽

Patient Volume ◽

Opioid Misuse ◽

Sectional Study ◽

Cross Sectional ◽

Patient Retention

A retrospective, cross-sectional study was completed on 220 patients to determine the effects of implementation of an aggressive policy to curb opioid misuse/abuse in an internal medicine residency clinic. Our findings suggest that the development of a clear and consistent protocol for approaching patients on chronic controlled substances, as well as the initiation of regular didactic sessions addressing chronic pain and pain management, led to a dramatic reduction in the number or opioid prescriptions written by our resident providers without much reduction in patient volume.

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Medical student preferences for the internal medicine residency interview day: A cross-sectional study

PLoS ONE ◽

10.1371/journal.pone.0199382 ◽

2018 ◽

Vol 13 (7) ◽

pp. e0199382 ◽

Cited By ~ 1

Author(s):

Amar R. Chadaga ◽

Dana Villines ◽

Armand Krikorian

Keyword(s):

Internal Medicine ◽

Medical Student ◽

Cross Sectional Study ◽

Internal Medicine Residency ◽

Sectional Study ◽

Cross Sectional ◽

Student Preferences

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Long-term metabolic and socio educational outcomes of transient neonatal diabetes: A longitudinal and cross-sectional study

Yearbook of Paediatric Endocrinology ◽

10.1530/ey.17.2.9 ◽

2020 ◽

Author(s):

Le Bourgeois F ◽

B Beltrand J Baz ◽

JP Julla JB Riveline ◽

Simon A ◽

Flechtner I ◽

...

Keyword(s):

Educational Outcomes ◽

Neonatal Diabetes ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Transient Neonatal Diabetes

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Learning Electrocardiogram Interpretation: Insights from Residents and a Proposed Solution in an Observational Study (Preprint)

10.2196/preprints.19645 ◽

2020 ◽

Author(s):

Mohammad Alakchar ◽

Abdisamad M. Ibrahim ◽

Mohsin Salih ◽

Mukul Bhattarai ◽

Nitin Tandan ◽

...

Keyword(s):

Internal Medicine ◽

Correlation Coefficient ◽

Online Survey ◽

Cross Sectional Study ◽

Cross Sectional ◽

Resident Attitudes ◽

Internal Medicine Residents ◽

Life Threatening ◽

Degree Of Participation ◽

Electrocardiogram Interpretation

BACKGROUND Interpretation of electrocardiograms (EKG) is an essential tool for every physician. Despite this, the diagnosis of life-threatening pathology on EKG remains suboptimal in trainees. The purpose of this study is to study resident attitudes and behaviours towards EKGs, and describe an innovative way to teach EKGs. OBJECTIVE Study attitudes and behaviours towards EKGs. Describe an innovative way to teach EKGs. METHODS Design: An observational cross-sectional study through an anonymous online survey of resident attitudes and comfort with EKG interpretation. This was followed by creation of a WhatsApp group for discussion and interpretation of EKGs with peers. At the end of the day, the official EKG interpretation was posted. Setting: Internal medicine residency at Southern Illinois University. Participants: Internal medicine residents Interventions: Creation of WhatsApp group to aid with EKG interpretation Measurements: A 17 item questionnaire, followed by detection of degree of participation in a WhatsApp group. RESULTS Forty-one out of 63 residents (65%) completed the survey. 85% of respondents thought that an interactive way to teach EKGs is the best method of teaching, and 73% did not feel confident interpreting EKGs. 30% often rely on automated EKG interpretation. Further analysis indicated that PGY-1 residents reported ordering fewer EKGs (correlation coefficient -0.399, p = 0.012) and were uncomfortable diagnosing QT prolongation on an EKG (correlation coefficient -0.310, p = 0.049). Residents in the third or greater year of training ordered more EKGs (correlation coefficient 0.379, p = 0.015), less frequently relied on the computer for EKG diagnosis (correlation coefficient 0.399, p = 0.010), and were comfortable diagnosing an acute myocardial infarction and atrial arrhythmias. CONCLUSIONS In conclusion, most IM trainees do not feel comfortable interpreting EKG, however, this does improve with PGY year. WhatsApp is a possible platform for teaching EKGs.

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Survey-Based Analysis of Current Trends for Prescribing Gastrointestinal Protectants among Small-Animal General Practitioners in Portugal

Veterinary Sciences ◽

10.3390/vetsci8050070 ◽

2021 ◽

Vol 8 (5) ◽

pp. 70

Author(s):

Rita Baptista ◽

Ryane Englar ◽

Berta São Braz ◽

Rodolfo Oliveira Leal

Keyword(s):

General Practitioners ◽

Healthcare Providers ◽

Small Animal ◽

Cross Sectional Study ◽

Online Forums ◽

Educational Strategies ◽

Cross Sectional ◽

Current Trends ◽

Therapeutic Value

In both human and veterinary healthcare, gastrointestinal protectants (GIPs) are considered a staple of clinical practice in that they are prescribed by general practitioners (GPs) and specialists alike. Concerning GIP use, overprescription of proton pump inhibitors (PPIs) has become a growing concern among human healthcare providers. This trend has also been documented within veterinary practice, prompting the American College of Veterinary Internal Medicine (ACVIM) to publish a consensus statement in 2018 concerning evidence-based indications for GIP use. This observational cross-sectional study evaluated self-reported prescribing protocols among Portuguese GPs to determine whether there is adherence to the consensus guidelines. Respondents were Portuguese GPs recruited by social media posts in veterinarian online forums. Data were collected from 124 respondents concerning their GIPs of choice and their rationales for prescribing them. Data were mined for prescription patterns and protocols. Among GIPs, PPIs were prescribed more often. Rationales for use included gastrointestinal ulceration and erosion (GUE), prophylactic management of nonerosive gastritis, pancreatitis, reflux esophagitis, and steroid-induced ulceration. Once-daily administration of PPIs was the most frequent dosing regime among respondents. Ninety-six percent of PPI prescribers advocated that the drug be administered either shortly before or at mealtime. Forty-nine percent of respondents supported long-term use of PPIs. Fifty-nine percent of respondents acknowledged discontinuing PPIs abruptly. This study supports that Portuguese GPs commonly prescribe GIPs in accordance with ACVIM recommendations to medically manage GUE. However, misuse of GIPs does occur, and they have been prescribed where their therapeutic value is debatable. Educational strategies should target GPs in an effort to reduce GIP misuse.

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980. Drexel Medicine Resident Knowledge, Practices and Attitudes Regarding Pre-exposure prophylaxis (PrEP)

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1166 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S518-S518

Author(s):

Jen E Mainville ◽

Ed Gracely ◽

Zsofia Szep

Keyword(s):

Internal Medicine ◽

Male Partner ◽

Healthcare Providers ◽

Cross Sectional Study ◽

Cross Sectional ◽

Major Barrier ◽

Medicine Resident ◽

Highly Effective ◽

Prevention Method ◽

Exposure Prophylaxis

Abstract Background Pre-exposure prophylaxis (PrEP) is a highly effective daily oral antiretroviral medication that was approved by the FDA in 2012 and has been shown to reduce the risk of HIV by 95% in real-world studies. Despite this, many healthcare providers are not offering PrEP to their patients who are at risk for HIV. Methods We performed a cross-sectional study among Drexel Internal Medicine, Family Medicine, and Obstetrics and Gynecology residents. The survey included questions about experience, knowledge, attitudes toward and barriers to using PrEP. The survey was adapted from previous studies regarding medical providers’ attitudes and knowledge about PrEP (Petroll, 2016; Seifman, 2016; Blumenthal, 2105). A Likert 5-point scale was used for attitude and barriers questions. Results Among 143 participants, 80% specialized in Internal Medicine. 43% of participants were in their first year of training and the mean age (+ SD) was 28.8 + 2. 76% reported never initiating a conversation about PrEP with a patient and only 18% reported ever prescribing PrEP to their patients. 92% reported being very or extremely willing to prescribe PrEP to a male with a current male partner known to be HIV positive. Only 43% of residents reported being moderately likely to prescribe PrEP to a patient coming in for a STI exposure. 68% of residents reported their knowledge about PrEP was a major barrier to prescribing PrEP. Conclusion We found that most residents have minimal experience with prescribing PrEP, and knowledge was identified as the largest barrier. Additional education and a better understanding of PrEP indications is necessary to ensure eligible PrEP patients have access to this highly effective HIV prevention method. Disclosures All Authors: No reported disclosures

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A Cross-Sectional Study on the Impacts of Perceived Job Value, Job Maintenance, and Social Support on Burnout among Long-Term Care Staff in Hawaii

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18020476 ◽

2021 ◽

Vol 18 (2) ◽

pp. 476

Author(s):

Bum Jung Kim ◽

Sun-young Lee

Keyword(s):

Social Support ◽

Long Term Care ◽

Cross Sectional Study ◽

Care Staff ◽

Hierarchical Regression ◽

Sectional Study ◽

Cross Sectional ◽

Term Care ◽

The Impact

Extensive research has demonstrated the factors that influence burnout among social service employees, yet few studies have explored burnout among long-term care staff in Hawaii. This study aimed to examine the impact of job value, job maintenance, and social support on burnout of staff in long-term care settings in Hawaii, USA. This cross-sectional study included 170 long-term care staff, aged 20 to 75 years, in Hawaii. Hierarchical regression was employed to explore the relationships between the key independent variables and burnout. The results indicate that staff with a higher level of perceived job value, those who expressed a willingness to continue working in the same job, and those with strong social support from supervisors or peers are less likely to experience burnout. Interventions aimed at decreasing the level of burnout among long-term care staff in Hawaii may be more effective through culturally tailored programs aimed to increase the levels of job value, job maintenance, and social support.

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