Using Skype as an Alternative for Residency Selection Interviews

Abstract Background Residency interviews can place significant time and financial burdens on applicants. Objective To determine whether the use of Skype as a screening tool during interview season in a family medicine residency is cost-effective and time-efficient for the applicant and the residency program. Methods We surveyed 2 groups of medical students during interviews for our family medicine program. Thirty-two students were interviewed via our face-to-face, traditional interview (TI) process, and 10 students, the second group, who did not meet the program's standard interview selection criteria for TI, underwent our Skype interview (SI) process. Results Using an unpaired t test, we found that the applicants' costs of an SI were significantly less than a TI, $566 (95% confidence interval [CI] $784–$349, P < .001). Direct cash savings plus indirect salary savings to the program were $5,864, with a time savings of 7 interview days. Three of the applicants who were participants in the SI limb of the study were in our final rank order list. Conclusions For interviewing in family medicine residencies, use of Skype may be a cost-effective and time-efficient screening tool for both the applicant and the program. Alternate uses of SI may include the time-sensitive, postmatch Supplemental Offer and Acceptance Program.

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Extended Routine Follow-up of Primary Uncomplicated Hip and Knee Arthroplasty is not Necessary

The Open Orthopaedics Journal ◽

10.2174/1874325001913010266 ◽

2019 ◽

Vol 13 (1) ◽

pp. 266-271

Author(s):

Georgina Kakra Wartemberg ◽

Thomas Goff ◽

Simon Jones ◽

James Newman

Keyword(s):

Aseptic Loosening ◽

Revision Surgery ◽

Revision Arthroplasty ◽

Cost Effective ◽

Face To Face ◽

Primary Surgery ◽

Effective System ◽

Knee Revision Surgery ◽

Knee Revision

Aims: To create a more effective system to identify patients in need of revision surgery. Background: There are over 160,000 total hip and knee replacements performed per year in England and Wales. Currently, most trusts review patients for up to 10 years or more. When we consider the cost of prolonged reviews, we cannot justify the expenditure within a limited budget. Study Design & Methods: We reviewed all patients' notes that underwent primary hip and knee revision surgery at our institution, noting age, gender, symptoms at presentation, referral source, details of the surgery, reason for revision and follow up history from primary surgery. Results: There were 145 revision arthroplasties (60 THR and 85 TKR) that met our inclusion criteria. Within the hip arthroplasty group, indications for revision included aseptic loosening (37), dislocation (10), and infection (3), periprosthetic fracture, acetabular liner wear and implant failure. All thirty-seven patients with aseptic loosening presented with pain. Twenty-five were referred from general practice with new symptoms. The remaining were clinic follow-ups. The most common reason for knee revision was aseptic loosening (37), followed by infection (21) and then progressive osteoarthritis (8). Most were referred from GP as a new referral or were clinic follow-ups. All patients were symptomatic. Conclusion: All the patients that underwent revision arthroplasty were symptomatic. Rather than yearly follow up, we recommend a cost-effective system. We are implementing a 'non face-to-face' system. Patients would be directly sent a questionnaire and x-ray form. The radiographs and forms will be reviewed by an experienced arthroplasty surgeon. The concerning cases will be seen urgently in a face-to-face clinic.

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Implementation of podiatry telephone appointments for people with rheumatic and musculoskeletal diseases

Journal of Foot and Ankle Research ◽

10.1186/s13047-020-00441-9 ◽

2021 ◽

Vol 14 (1) ◽

Author(s):

J. L. Palmer ◽

H. J. Siddle ◽

A. C. Redmond ◽

B. Alcacer-Pitarch

Keyword(s):

Musculoskeletal Diseases ◽

Cost Effective ◽

Time Frame ◽

Teaching Hospitals ◽

Potential Cost ◽

Foot Health ◽

Telephone Consultation ◽

Face To Face ◽

Initial Intervention

Abstract Background Foot health problems are common in the general population, and particularly so in people with rheumatic and musculoskeletal disorders (RMD). Several clinical guidelines state that people with RMDs should have access to foot health services, although service capacity is often limited. The current COVID-19 pandemic has increased the need for alternative ways to provide patient care. The aim of this clinical audit was to review a newly implemented telephone follow-up appointment service conducted within the Rheumatology Podiatry Department in Leeds, UK. Methods Fifty-eight patients attending the Rheumatology Podiatry Department at Leeds Teaching Hospitals NHS Trust were contacted by telephone approximately 6–8 weeks following initial intervention. During the telephone consultation, all patients were asked pre-defined questions relating to their symptoms, intervention efficacy, the need for further appointments and their preference for the type of consultation. To assess the cost of the telephone consultation the number of attempts needed in order to make successful contact, the duration of the call and the number of telephone follow-up appointments completed in a working day were also recorded. Results Twenty-five patients (43%) were successfully contacted within the 6–8 weeks stipulated time frame and were included in the analysis. Of the 25 contacted, twelve (48%) patients were successfully contacted on the first attempt. Ten (40%) were successfully contacted on the second attempt. The remaining three patients (12%) required 3 or more attempts to make successful contact. Telephone consultations were estimated not to last longer than 10 min, including notes screening and documentation. Eleven patients (44%) reported an improvement in their symptoms, thirteen (52%) reported no change and one patient (4%) reported their symptoms to be worse. Conclusion Telephone follow-up consultations may be a potentially cost-effective alternative to face-to-face appointments when implemented in a Rheumatology Podiatry Department, and provide an alternative way of providing care, especially when capacity for face-to-face contact is limited. The potential cost saving and efficiency benefits of this service are likely to be enhanced when telephone consultations are pre-arranged with patients.

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NESTROFT—A Cost-Effective Mass Screening Tool for the Detection of β-Thalassemia Carrier Status in Anemic Pregnant Women: A Step Toward Reducing the National Disease Burden

Journal of Laboratory Physicians ◽

10.1055/s-0041-1732493 ◽

2021 ◽

Author(s):

Manasi Gosavi ◽

Ramesh Chavan ◽

M. B. Bellad

Keyword(s):

Pregnant Women ◽

Effective Mass ◽

Mass Screening ◽

Predictive Value ◽

Screening Tool ◽

Hematological Parameters ◽

False Negative ◽

Cost Effective ◽

Mean Corpuscular Hemoglobin ◽

Carrier Status

Abstract Introduction β-Thalassemias are inherited hemoglobinopathies commonly encountered in practice. With chances of a promising cure being rare, the prevention of births with this disorder should assume priority, especially in low-resource countries. This can be achieved by the implementation of a mass screening program that is reliable and, at the same time, cost-effective. Objectives This study focuses on the utility of Naked Eye Single Tube Red Cell Osmotic Fragility Test (NESTROFT) as a mass screening tool to detect thalassemia carriers. Hematological parameters that may predict carrier status were also evaluated. Materials and Methods Hemoglobin estimation was performed on all consented pregnant women. If the patient was found to have hemoglobin < 11 g/dL, the blood sample was subjected to other routine hematological tests along with peripheral smear examination. NESTROFT was performed using 0.36% saline solution. Confirmation was done using high-performance liquid chromatography (HPLC). Statistical Analysis Data obtained were tabulated using version 21 of the Statistical Package for Social Sciences. Means, standard deviations, and percentages were used to describe the sample. Chi-square test and Students’ “t” test were used to identify differences between the groups. Results Of 441 pregnant women enrolled, 206 were found to be anemic. Nineteen (9.2%) of the anemic pregnant women were detected to be carriers of hemoglobinopathies. Among the hematological parameters, mean red blood cell count and reticulocyte count were higher, while mean corpuscular hemoglobin concentration was lower in carriers. Also, carriers were more likely to present with microcytic hypochromic anemia. NESTROFT showed a sensitivity of 84.21%, specificity of 96.25%, a positive predictive value of 69.56%, and a negative predictive value of 98.36%. A false-positive result was seen in 3.74% of the tests, while a false negative result was seen in 15.78% of the tests. Conclusions NESTROFT (0.36%) can be used as a simple and cost-effective mass screening tool for the detection of carrier status. This should be followed by confirmation using HPLC or hemoglobin electrophoresis.

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A virtual multi-disciplinary meeting is a cost-effective method of triaging referrals to a regional musculoskeletal oncology service

Scottish Medical Journal ◽

10.1177/00369330211008598 ◽

2021 ◽

pp. 003693302110085

Author(s):

Omer MHF Alanie ◽

Ashish Mahendra ◽

Mairi Mackinnon ◽

Mark McCleery ◽

Christopher Nicholas ◽

...

Keyword(s):

Screening Tool ◽

Discharge Rate ◽

Cost Effective ◽

Risk Environment ◽

Potential Cost ◽

Patient Journey ◽

Cost Effective Method ◽

Diagnosis Of Cancer ◽

Musculoskeletal Oncology ◽

Prospective Database

Background and aims In 2010, a virtual sarcoma referral model was implemented, which aims to provide a centralised multidisciplinary team (MDT) to provide rapid advice, avoiding unnecessary appointments and providing a streamlined service. The aim of this study is to examine the feasibility of this screening tool in reducing the service burden and expediting patient journey. Methods and results All referrals made to a single tertiary referral sarcoma unit from January 2010 to December 2018 were extracted from a prospective database. Only 26.0% events discussed required review directly. 30.3% were discharged back to referrer. 16.5% required further investigations. 22.5% required a biopsy prior to review. There was a reduction in the rate of patients reviewed at the sarcoma clinic, and a higher discharge rate from the MDT in 2018 versus 2010 (p < 0.001). This gives a potential cost saving of 670,700 GBP over the 9 year period. Conclusion An MDT meeting which triages referrals is cost-effective at reducing unnecessary referrals. This can limit unnecessary exposure of patients who may have an underlying diagnosis of cancer to a high-risk environment, and reduces burden on services as it copes with increasing demands during the COVID-19 pandemic.

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SPECIAL TUTORIAL CLASSES TO UPGRADE LEARNING ACHIEVEMENT OF STUDENTS ENROLLED IN MATHEMATICS FOR SOCIAL SCIENCE AT STOU

Asian Association of Open Universities Journal ◽

10.1108/aaouj-03-02-2008-b005 ◽

2008 ◽

Vol 3 (2) ◽

pp. 122-133

Author(s):

Sakorn Boondao

Keyword(s):

Social Science ◽

Cost Effective ◽

Developed Countries ◽

Pass Rate ◽

Final Exam ◽

Face To Face ◽

Tutorial Program ◽

Significant Difference ◽

Level Scale ◽

Teaching Programs

Unlike distance education institutions in developed countries Sukhothai Thammathirat Open University makes very limited use of assignments in its teaching programs. The main means of interaction between tutors and students consists of free face-to-face tutorials conducted three times per semester in provincial centers throughout the country. In courses with low enrolments (less than 1000 students) such tutorials have recently been deemed not to be cost effective. Alternative regional or central intensive programs have been developed. These involve 20 hours of tutorial classes and assignment work over two weekends in the final month of the semester and count for 30% of the assessment. A small charge is made for registration. The Mathematics for Social Science course was affected by this change. Since mathematics is a difficult subject for students, (only about 30% normally passed the course) the special tutorial program was used to help students in the second semester of 2006. Students were more interested in this approach than in the regular face-to-face tutorials. After the project was advertised, 98 students applied. While this was more than three times the number who had attended the free tutorials in the previous semester, it was not sufficient to justify tutorials in the four regions. Instead, three classes were conducted in Bangkok. Only 71 of the original applicants attended. During the program the better students were asked to assist those who needed help. Student questionnaires indicated that more than half identified themselves as weak in mathematics, most had completed year 12 and just over three-quarters had never attended regular face-to-face tutorials. They were asked to rank items about the classes on a five-level scale. The availability of up to 30% of the marks for the course was the major attraction. Most indicated that they were pleased with the classes, and gained more knowledge; while assignments, as well as the solutions given after submission, helped them understand the contents. Having classmates help them with learning also encouraged them with their study. They felt that they needed more time to study and do assignment work, and would like more marks to be allocated for the assignments. It was found that the achievement of students who attended the special tutorial classes was significantly higher than that of those who did not. The pass rate in this semester dramatically increased compared to the previous semester, 50.72% and 30.34% respectively. But when comparing students' final exam scores for both groups, it was found that there was no significant difference in the scores. However students were satisfied with these special tutorial classes.

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Out-of-Match Residency Offers: The Possible Extent and Implications of Prematching in Graduate Medical Education

Journal of Graduate Medical Education ◽

10.4300/jgme-d-09-00053.1 ◽

2010 ◽

Vol 2 (3) ◽

pp. 327-333 ◽

Cited By ~ 12

Author(s):

Robert V. Wetz ◽

Charles B. Seelig ◽

Georges Khoueiry ◽

Kera F. Weiserbs

Keyword(s):

Internal Medicine ◽

United States ◽

Primary Care ◽

Medical Education ◽

Family Medicine ◽

Rank Order ◽

Medical Doctors ◽

Spearman Rank ◽

Fellowship Programs ◽

Career Preferences

Abstract Background When the data from the National Resident Matching Program (NRMP) are used to analyze trends in medical students' career preferences, positions offered outside the match are omitted. The purpose of the study was to evaluate the extent and nature of out-of-match residency offers. Methods We obtained total resident complements and postgraduate year-1 positions offered in 7 specialties in 2007 and compared these with the 2007 NRMP match data. We compared the percentage of positions offered outside the match to “success” in matching United States medical doctors (USMDs) and to the availability of fellowship positions, using the Spearman rank order test (SROT). Results A total of 18 030 postgraduate year-1 positions were offered in 9 specialty areas. Of 15 205 positions offered in the match, 54% were taken by USMDs. The percentage of outside-the-match offers was found to vary by specialty, from 7% in obstetrics-gynecology to 23% in internal medicine, and was inversely correlated with the specialty's “success” in matching USMDs (SROT = −0.87). The 3 nonprocedural primary care specialties (internal medicine, family medicine, and pediatrics) accounted for 10 091 (46.2%) of the 21 845 total positions offered in the match, with 4401 (43.6%) offered almost entirely to non-USMDs. Another 2467 positions were offered outside the match, resulting in 6868 positions offered to non-USMDs (55% of all primary care positions). In internal medicine, the percentage of outside-the-match offers was significantly and inversely associated with the availability of intrainstitutional fellowship programs (P < .0001). Prematching of independent applicants was significantly higher in primary care than in procedural-lifestyle programs (P < .0001). Conclusion The NRMP's match data do not account for positions filled outside the match, a finding that appears to be significant. In 2007, 1 in 5 positions in primary care was offered outside the match.

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Contact with treatment services among arrested drug users

Psychiatric Bulletin ◽

10.1192/pb.27.6.214 ◽

2003 ◽

Vol 27 (6) ◽

pp. 214-216 ◽

Cited By ~ 1

Author(s):

Mervyn London ◽

Juan Canitrot ◽

Adrian Dzialdowski ◽

Robert Bates ◽

Alan Gwynn

Keyword(s):

Drug Users ◽

Cost Effective ◽

Evidence Base ◽

Opiate Dependence ◽

Drug Misuse ◽

Police Custody ◽

Face To Face ◽

Treatment Services ◽

Previous Contact ◽

Local Research

Aims and MethodTo identify the proportion of arrested drug misusers with prior contact with treatment services, police surgeons' records were examined over a 12-month period and compared with the records of the local drug misuse services. Both referrals and those who attended with face-to-face contact were noted.ResultsSixty-seven per cent of drug-related cases had been referred to services prior to arrest and 58% had attended with face-to-face contact on at least one occasion. Homeless and male drug users were more likely to have had no past contact. Police surgeons treated three-quarters of the cases for opiate dependence. Drug misusers were much more likely to have had past contact with services than arrested alcohol misusers, and were more likely to reoffend.Clinical ImplicationsThe evidence base for motivational enhancement in the transient coercive setting of police custody is not established, and arrest referral schemes might not be cost-effective in areas where most cases have had previous contact with services. Local research may contribute to more informed decisions about these treatment-related criminal justice initiatives.

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A Clinician-Researcher Training Program for Family Medicine Residents

Clinical & Investigative Medicine ◽

10.25011/cim.v42i3.33090 ◽

2019 ◽

Vol 42 (3) ◽

pp. E35-E39

Author(s):

Gideon Koren ◽

Linoy Gabay ◽

Joseph Kuchnir

Keyword(s):

Family Medicine ◽

Health Services ◽

Training Program ◽

Research Training ◽

Research Question ◽

Steering Committee ◽

Research Proposal ◽

Community Based ◽

Community Based Research ◽

Face To Face

Purpose: Research training for clinicians is becoming relatively common for postdoctoral trainees in academic institutions. In contrast, there are relatively few such training programs for family physician residents. The purpose of this article is to describe a novel program for family medicine trainees in Maccabi Health Services, a large Israeli health fund. Methods: Following organizational approval and budget allocation, a call for family residents resulted in 18 applications, 15 of whom were selected for a two-year research training program. Each trainee submitted a research proposal, dealing with a community- based research question. Each protocol was allocated a budget. The Program, overseen by a steering committee of family physicians and scientists, has a designated clinical epidemiologist who coordinates all activities. The Project runs monthly face-to-face meetings where trainees present their research proposals. The group reviewed the protocols ahead of time, commented on them and criticized them. In parallel, the trainees participate in a detailed discussion of their research proposals face-to-face with the program director and clinical epidemiologist, and the revised research proposal is submitted to the Institution Review Board. Results: The Program received enthusiastic responses from the trainees and from Maccabi Health Services, which has already approved the budget for the second year of the Program with a new stream of trainees. The approved research proposals dealt with original and important community-based clinical questions. Conclusions: With the aim of developing clinician-researchers in the field of family medicine, this novel program will help change the research climate in a large organization, where community-based family practitioners were not typically involved in research.

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Study on prediction of type 2 diabetes mellitus in undergraduate MBBS students: a cross-section study in a tertiary health center, Kolkata

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20175717 ◽

2017 ◽

Vol 6 (1) ◽

pp. 184

Author(s):

Murari M. Mandal ◽

Shobhit Garg ◽

R. N. Mishra ◽

Swanya P. Maharana

Keyword(s):

Type 2 Diabetes ◽

Screening Tool ◽

Risk Group ◽

Cost Effective ◽

High Risk Group ◽

Hip Circumference ◽

Moderate Risk ◽

Cross Sectional ◽

Random Blood Sugar

Background: Diabetes, is now a leading cause of morbidity and mortality worldwide. Prevalence of type-2 diabetes in children and adolescents is rapidly increasing worldwide. Adolescence and early youth period has pivotal importance for young people with diabetes risk when they usually start learning about how to take responsibility. With this background, present study was done to find out the proportion of various risk factors and future risk of developing diabetes among MBBS undergraduates in Kolkata.Methods: This study was a cross-sectional institution based study done from 1st June to 18th June 2017. Data was collected by interviewing each respondent with the help of structured pre-designed pre-tested schedule, after which clinical examination for height, weight, waist and hip circumference, blood pressure and RBS were done. Out of 150 undergraduates, 130 agreed to participate. Data was analysed with R software.Results: Mean age of the students was 20.45years. 48.5% of them were either overweight or obese. Nearly half of them had waist circumference and waist hip ratio in risk group. Only 65 were normotensive and 7 had high random blood sugar (≥140 mg/dl). 6 students were in high risk group according to both IDRS (≥60) and ADA (≥5) risk score. 66 students were in moderate risk (30-50) group as per IDRS risk score.Conclusions: The simple and cost-effective IDRS could serve as a screening tool health worker to identify at risk individuals at the earliest and enable primary prevention by encouraging these students to modify their life-style.

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E-Learning versus Classroom Learning for Acquiring Knowledge about Precarity in Medicine

Journal of Family Medicine ◽

10.26420/jfammed.2021.1255 ◽

2021 ◽

Vol 8 (4) ◽

Author(s):

◽

Tanguy G ◽

Dessene P ◽

Rude M ◽

Doly L ◽

...

Keyword(s):

Online Learning ◽

Family Medicine ◽

Classroom Learning ◽

Face To Face ◽

Learning Group ◽

E Learning ◽

Knowledge Levels

The effect on knowledge levels immediately after a course on precarity in family medicine was assessed by comparing online learning against classroom learning, both followed by time for face-to-face discussion. Of 87 family medicine interns of the same class, 65 took part in the study and were evaluated, 34 being assigned to classroom learning and 31 to online learning. The increase in knowledge after the course was significantly higher in the online learning group (+27.8 points±11.2) than in the classroom group (+9.1 points±9.0) (p<0.0001).

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