High frequency of otolaryngology/ENT encounters in Canadian primary care despite low medical undergraduate

2021 ◽  
Author(s):  
Brendan Sorichetti ◽  
Julie Pauwels ◽  
Thomas Jacobs ◽  
Neil Chadha ◽  
Emelie Kozak ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Students ◽  
Primary Care Physicians ◽  
Pediatric Population ◽  
Adult Population ◽  
Care Facility ◽  
Symptom Presentation ◽  
Undergraduate Medical Students ◽  
Related Symptom ◽  
Medical Undergraduate

Otolaryngology involves the treatment of patients with diseases and disorders of the ear, nose, throat (ENT), and related structures of the head and neck. Many medical students in Canada have limited experiences in ENT and a vast majority of these students go on to pursue a career as primary care physicians. Physicians at a primary care facility classified patient’s visits as either being “ENT” related or not, to assess the amount of ENT related concerns they typically encounter. The data was collected separately in the summer and winter months to assess any seasonal variability. One in eight patient encounters presented with an ENT related concern. The percentage of ENT related symptom presentation visits in the pediatric population for both data collection periods (29%) was more than three times that of the adult population (9%). The rate of ENT symptom presentation in both adult and pediatric populations was not affected by seasonality. Primary care physicians will encounter new patients presenting with ENT related concerns quite frequently. This is especially true in the pediatric patient population. Increased ENT medical education is both necessary and essential for undergraduate medical students, residents, and primary care physicians.

Neuroscience education of undergraduate medical students. Part II: outcome improvement

2000 ◽  
Vol 92 (4) ◽  
pp. 642-645 ◽  
Author(s):  
Daniel K. Resnick ◽  
Lincoln F. Ramirez
Keyword(s):  
Primary Care ◽  
Medical Students ◽  
Student Performance ◽  
Primary Care Physicians ◽  
Pressure Head ◽  
Rehabilitation Medicine ◽  
Spine Injury ◽  
Undergraduate Medical Students ◽  
Content Type ◽  
Fine Print

Object. Because of political and economic pressures, primary care physicians are now charged with greater responsibility for the care of patients with disease processes definitively managed by neurosurgeons. The goal of this study was to establish the feasibility and efficacy of a neurosurgical curriculum designed to teach future primary care physicians about these diseases.Methods. A compact, seven-lecture curriculum was developed to teach 3rd-year medical students about degenerative spine disease, stroke, tumor- and hydrocephalus-related raised intracranial pressure, head and spine injury, and subarachnoid hemorrhage. This curriculum was given as part of a 6-week pilot course that included neurology, neurosurgery, ophthalmology, and rehabilitation medicine components. This course was administered to two groups of 18 medical students, and an examination was administered at the end of the pilot course. The same examination was administered to an additional 19 students immediately after their completion of the neurology course currently required.Students enrolled in the pilot neuroscience course performed significantly better (p < 0.001) on the examination than those who had completed the standard neurology course. Striking improvements were noted in the recognition and management of head injury, hydrocephalus, and radiculopathy.Conclusions. Inclusion of a short neurosurgery-related curriculum in a combined neuroscience course significantly improved student performance on an examination focusing on the recognition and management of common neurosurgical disorders. Because primary care physicians are responsible for the initial recognition and management of these disorders, the knowledge gained may lead to improved patient care.

scholarly journals Socioeconomic inequalities in primary-care and specialist physician visits: a systematic review

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Sara Lena Lueckmann ◽  
Jens Hoebel ◽  
Julia Roick ◽  
Jenny Markert ◽  
Jacob Spallek ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Primary Care Physicians ◽  
Web Of Science ◽  
Adult Population ◽  
Socioeconomic Inequalities ◽  
Eligibility Criteria ◽  
Physician Visits ◽  
General Adult Population ◽  
Registration Number

Abstract Background Utilization of primary-care and specialist physicians seems to be associated differently with socioeconomic status (SES). This review aims to summarize and compare the evidence on socioeconomic inequalities in consulting primary-care or specialist physicians in the general adult population in high-income countries. Methods We carried out a systematic search across the most relevant databases (Web of Science, Medline) and included all studies, published since 2004, reporting associations between SES and utilization of primary-care and/or specialist physicians. In total, 57 studies fulfilled the eligibility criteria. Results Many studies found socioeconomic inequalities in physician utilization, but inequalities were more pronounced in visiting specialists than primary-care physicians. The results of the studies varied strongly according to the operationalization of utilization, namely whether a physician was visited (probability) or how often a physician was visited (frequency). For probabilities of visiting primary-care physicians predominantly no association with SES was found, but frequencies of visits were higher in the most disadvantaged. The most disadvantaged often had lower probabilities of visiting specialists, but in many studies no link was found between the number of visits and SES. Conclusion This systematic review emphasizes that inequalities to the detriment of the most deprived is primarily a problem in the probability of visiting specialist physicians. Healthcare policy should focus first off on effective access to specialist physicians in order to tackle inequalities in healthcare. PROSPERO registration number CRD42019123222.

scholarly journals Searching for the erosion of empathy in medical undergraduate students: a longitudinal study

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e041810
Author(s):  
José Manuel Blanco ◽  
Fernando Caballero ◽  
Santiago Álvarez ◽  
Mercedes Plans ◽  
Diana Monge
Keyword(s):  
Medical Students ◽  
Undergraduate Students ◽  
Cognitive Empathy ◽  
Primary Outcome Measure ◽  
Undergraduate Medical Students ◽  
School Settings ◽  
School Year ◽  
School Of Medicine ◽  
Medical Undergraduate ◽  
Sociocultural Differences

ObjectiveTo analyse the trajectory of empathy throughout the degree programme of medicine in a Spanish school of medicine.DesignLongitudinal, prospective 5-year study, between October 2014 and June 2019.SettingStudents from a Spanish university of medicine.ParticipantsTwo voluntary cohorts of undergraduate medical students from two different school years were invited to participate (n=135 (cohort 1, C1) and 106 (cohort 2, C2) per school year). Finally, a total number of 174 students (102 (C1, 71.6% women) and 72 (C2, 70.8% women) students, respectively) were monitored for 5 years. Each cohort was divided in two subcohorts of paired and unpaired students that were analysed to check possible social desirability bias.Primary outcome measureThe Jefferson Scale of Empathy (JSE).ResultsThe cohort of 102 students (C1) monitored between their first and fifth years of study (71.6% women) showed an improvement among paired women of 2.15 points in total JSE score (p=0.01) and 2.39 points in cognitive empathy (p=0.01); in the unpaired female cohort the increase was of 2.32 points (cognitive empathy) (p=0.02). The cohort of 72 students (C2) monitored between their second and sixth years of study (70.8% women) displayed a cognitive empathy increase of 2.32 points (p=0.04) in the paired group of women. There were no significant differences between paired and unpaired results for either cohort. Empathy scores among men did not decrease.ConclusionsThe empathy of medical students at our school did not decline along grade years. In fact, it improved slightly, particularly cognitive empathy, among women. This paper contributes to enlarge data from Europe, where longitudinal studies are scarce. It supports the idea that there may be global geo-sociocultural differences; however, more studies comparing different school settings are needed.

Assessment of Pattern, Determinants and Treatment Practices of Menstrual Disorders among Medical Undergraduate Students

2021 ◽  
Vol 17 ◽  
Author(s):  
Nitin Joseph ◽  
Ayisha Alfiya ◽  
Megha Khurana ◽  
Maheshwari Divya ◽  
Kritika Gupta ◽  
...  
Keyword(s):  
Medical Students ◽  
Multivariable Analysis ◽  
Menstrual Disorders ◽  
Undergraduate Medical Students ◽  
Or Education ◽  
Self Medication ◽  
Cross Sectional ◽  
Treatment Practices ◽  
Medical Undergraduate ◽  
Excessive Consumption

Background: Menstruation-related symptoms (MRSs) have been observed to result in absenteeism from either work or education, more commonly among women below 21 years than women of any other age group. Despite its high prevalence and associated ill effects, it is generally ignored even by medical students. Objectives: This study was conducted to assess the pattern, determinants, and treatment practices of menstrual disorders among undergraduate medical students. Methods: This was a cross-sectional study conducted among 215 female medical students from first to final year. Data were collected by using a self-administered questionnaire. The height and weight of participants were measured using standard procedures. Results: The most common menstrual disorders reported by participants over the past six months were dysmenorrhoea [191(88.8%)] followed by irregular cycles [43(20.0%)]. In multivariable analysis, the presence of polycystic ovarian syndrome (PCOS) and excessive consumption of coffee was associated with irregular menstrual cycles; the presence of anaemia was associated with menorrhagia, the presence of fibroids and age of participants ≤18 years were associated with polymenorrhoea, excessive chocolate consumption was related to intermenstrual bleeding, excessive chocolate consumption, presence of anaemia, and low body mass index (BMI) were associated with premenstrual syndrome. Self-medication was reported by 15 (42.9%) out of the 35 participants on treatment. Conclusion: Dysmenorrhea, menstrual irregularities, and premenstrual symptoms were common among participants. They need to limit potential risk factors like excessive consumption of coffee and chocolates. Additionally, screening for anaemia, PCOS, fibroids and low BMI needs to be done. Self-medication practices need to be also dissuaded in the setting.

scholarly journals Community diagnosis for a slum population under the field practice area of a government medical college, New Delhi: community-oriented primary care exercise for undergraduate students

2018 ◽  
Vol 5 (12) ◽  
pp. 5404
Author(s):  
P. Aravind Gandhi ◽  
U. Venkatesh ◽  
Poornima Tiwari ◽  
Preety Doley
Keyword(s):  
Primary Care ◽  
Medical Students ◽  
Urban Poor ◽  
Unmet Need ◽  
Drainage System ◽  
Income Poverty ◽  
New Delhi ◽  
Undergraduate Medical Students ◽  
Rapid Urbanization ◽  
Awareness Campaigns

Background: Rapid urbanization has led to the increase in a group of people called ‘Urban poor’ dwelling as a community in ‘Slums’, worldwide. Slums manifest deprivation that transcends income poverty. Hence, we conducted this Community-oriented primary care (COPC) exercise, to give medical students a greater understanding of the situation of individual patients in the slum and to formulate a community diagnosis.Methods: The current study was done at Tyagaraj Nagar Jhuggi in the South district of New Delhi, during Community-oriented primary care (COPC) exercise of undergraduate medical students in their 4th semester over a period of 20 days, using a predesigned proforma for collecting data on health events and determinants of health, from families. 35 households were chosen by systematic random sampling.Results: Out of 179 community members studied, 33 (18.43%) were afflicted with morbidity, which consists of common cold with cough, generalized body pain and joint pain. The sex ratio was found to be 826, literacy rate was 76.9% in the study area, 44.11% of the households were having sanitary latrines owned by them, 68.6% had a closed drainage system 63% of the families used clean fuel for cooking and unmet need of contraception was 85% among eligible couples.Conclusions: Investments in women’s access to various contraceptive preferences are urgently needed to help increase the contraceptive prevalence rate. Health Education and awareness campaigns on prevention of potential mosquito, fly breeding sites, hand hygiene, avoidance of firewood as fuel, establishing smoke outlet and solid waste management should be arranged.

scholarly journals Primary Care Tracks in Medical Schools

PRiMER ◽  
2019 ◽  
Vol 3 ◽  
Author(s):  
Maribeth P. Williams ◽  
Denny Fe Agana ◽  
Benjamin J. Rooks ◽  
Grant Harrell ◽  
Rosemary A. Klassen ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Students ◽  
Family Medicine ◽  
Primary Care Physicians ◽  
Response Rate ◽  
Positive Impact ◽  
Medical Schools ◽  
Clerkship Director ◽  
Medicine Clerkship ◽  
Faculty Mentorship

Introduction: With the estimated future shortage of primary care physicians there is a need to recruit more medical students into family medicine. Longitudinal programs or primary care tracks in medical schools have been shown to successfully recruit students into primary care. The aim of this study was to examine the characteristics of primary care tracks in departments of family medicine.  Methods: Data were collected as part of the 2016 CERA Family Medicine Clerkship Director Survey. The survey included questions regarding the presence and description of available primary care tracks as well as the clerkship director’s perception of impact. The survey was distributed via email to 125 US and 16 Canadian family medicine clerkship directors.  Results: The response rate was 86%. Thirty-five respondents (29%) reported offering a longitudinal primary care track. The majority of tracks select students on a competitive basis, are directed by family medicine educators, and include a wide variety of activities. Longitudinal experience in primary care ambulatory settings and primary care faculty mentorship were the most common activities. Almost 70% of clerkship directors believe there is a positive impact on students entering primary care.  Conclusions: The current tracks are diverse in what they offer and could be tailored to the missions of individual medical schools. The majority of clerkship directors reported that they do have a positive impact on students entering primary care.

scholarly journals Teaching Skin Cancer Detection to Medical Students Using a Dermoscopic Algorithm

PRiMER ◽  
2021 ◽  
Vol 5 ◽  
Author(s):  
Peggy R. Cyr ◽  
Wendy Craig ◽  
Hadjh Ahrns ◽  
Kathryn Stevens ◽  
Caroline Wight ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Students ◽  
Skin Cancer ◽  
Primary Care Physicians ◽  
Survival Rates ◽  
Family Physicians ◽  
Skin Lesions ◽  
Posttest Score ◽  
Malignant Skin ◽  
Attending Physicians

Introduction: Early detection of melanoma skin cancer improves survival rates. Training family physicians in dermoscopy with the triage amalgamated dermoscopic algorithm (TADA) has high sensitivity and specificity for identifying malignant skin neoplasms. In this study we evaluated the effectiveness of TADA training among medical students, compared with practicing clinicians. Methods: We incorporated the TADA framework into 90-minute workshops that taught dermoscopy to family physicians, primary care residents, and first- and second-year medical students. The workshop reviewed the clinical and dermoscopic features of benign and malignant skin lesions and included a hands-on interactive session using a dermatoscope. All participants took a 30-image pretest and a different 30-image posttest. Results: Forty-six attending physicians, 25 residents, and 48 medical students participated in the workshop. Mean pretest scores were 20.1, 20.3, and 15.8 for attending physicians, resident physicians and students, respectively (P&lt;.001); mean posttest scores were 24.5, 25.9, and 24.1, respectively (P=.11). Pre/posttest score differences were significant (P&lt;.001) for all groups. The medical students showed the most gain in their pretest and posttest scores. Conclusion: After short dermoscopy workshop, medical students perform as well as trained physicians in identifying images of malignant skin lesions. Dermoscopy training may be a valuable addition to the medical school curriculum as this skill can be used by primary care physicians as well as multiple specialists including dermatologists, gynecologists, otolaryngologists, plastic surgeons, and ophthalmologists, who often encounter patients with concerning skin lesions.

Student Education in a University-Based General Pediatric Clinic

PEDIATRICS ◽  
1974 ◽  
Vol 54 (3) ◽  
pp. 384-385
Author(s):  
Jay E. Berkelhamer ◽  
Janis Mendelsohn ◽  
John D. Madden
Keyword(s):  
Primary Care ◽  
Child Care ◽  
Medical Students ◽  
Care Facility ◽  
University Of Chicago ◽  
Primary Care Facility ◽  
Well Child Care ◽  
Pediatric Clinic ◽  
The Subject ◽  
The University

Since effective education of medical students in general pediatric clinics has been the subject of much review lately,1-6 a survey of the General Pediatric Clinic of the University of Chicago was conducted. Medical students and patients appeared to be satisfied with their experience in our clinic. The clinic is a primary care facility where patients are seen on a nonreferral basis. Approximately 70% of the 12,000 patient visits per year are for continuous well child care.

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