Engaging healthcare providers and patients on climate action through physical, emotional and social wellness

According to the World Health Organization, the health challenges from climate change are many and varied including: Malnutrition due to lack of quality food access. Mental health challenges in addition to severe socioeconomic challenges, through the loss of homes, jobs and needed social connections due to extreme events. Acute illness and the risk of water-borne diseases associated with lack of access to clean water. The increased risk of vector-borne diseases with warmer temperatures. Chronic illnesses associated with heat stress and pollution. Death from cardiovascular and respiratory disease, particularly among vulnerable people as temperatures rise to extreme levels. Both healthcare providers and patients must be engaged on climate change and action. While several medical training institutions are exploring opportunities to embed climate change and health education into their curricula, of importance are the holistic strategies to engage patients on climate action. The challenges are complex, and the data is overwhelming. Patients may not fully comprehend the personal implications of climate change and as citizens, may not understand their role in climate action. We suggest through the creation of a sustainable living mindset based on wellness, it is possible for healthcare providers to create a personal and emotional connection to climate action. The results from workshops with older adults are shared in this paper, demonstrating how the link to physical, emotional and social wellness, can encourage behavior change with respect to dietary and consumption practices as well as increased connection to and protection of greenspaces for health and well-being.

Knowledge and Attitudes for the Management of Behavioral Variant of Frontotemporal Dementia

Background: The diagnosis of the behavioral variant of frontotemporal dementia (bvFTD) can be especially challenging and is relatively underdiagnosed. There is scarce information on training and attitudes from care providers facing bvFTD in settings with limited resources. We aim to describe clinical knowledge and attitudes facing bvFTD from neurologists, psychiatrists, and residents in Peru.Methods: Potential participants received invitations by email to complete an online questionnaire. In addition, we reviewed 21 curricula from undergraduate medical schools' programs offered by the main schools of medicine in Peru during 2020 and 2021.Results: A total of 145 participants completed the survey. The responders were neurologists (51%), psychiatrists (25%), and residents in neurology or psychiatry (24%). Only 26% of the respondents acknowledged receiving at least one class on bvFTD in undergraduate medical training, but 66.6% received at least some training during postgraduate study. Participants identified isolated supportive symptoms for bvFTD; however, only 25% identified the possible criteria and 18% the probable bvFTD criteria. They identified MoCA in 44% and Frontal Assessment Battery (39%) as the most frequently used screening test to assess bvFTD patients. Memantine and Acetylcholinesterase inhibitors were incorrectly indicated by 40.8% of participants. Seventy six percentage of participants indicated that they did not provide education and support to the caregiver. The dementia topic was available on 95.2%, but FTD in only 19%.Conclusion: Neuropsychiatry medical specialists in Peru receive limited training in FTD. Their clinical attitudes for treating bvFTD require appropriate training focused on diagnostic criteria, assessment tools, and pharmacological and non-pharmacological management.

Impact of COVID-19 on Hematology-Oncology Fellowship Programs: A Quantitative and Qualitative Survey Assessment of Fellowship Program Directors

PURPOSE: The COVID-19 pandemic led to unprecedented challenges in medical training, and we sought to assess the specific impact of COVID-19 on hematology-oncology (HO) fellowship programs. METHODS: We conducted a cross-sectional anonymous online survey of 103 HO program directors (PDs) in conjunction with the American Society of Hematology (ASH) and ASCO. We sought to assess the specific impact of COVID-19 on HO fellowship programs' clinical, educational, and research activities, evaluate perceptions regarding PD and trainee emotional and mental health, and identify ways to support programs. Data were analyzed using descriptive statistics, parametric and nonparametric tests, and multivariable logistic regression models. Responses to open-ended questions were analyzed with thematic analysis. RESULTS: Significant changes to fellowship activities included transitioning fellow training from outpatient clinics to telehealth (77.7%), shifting to virtual education (94.2%), and moving to remote research work (63.1%). A minority (21.4%) of PDs reported that their fellows were redeployed to cover non-HO services. Most PDs (54.4%) believed COVID-19 had a slight negative impact on fellowship training. PD self-reported burnout increased significantly from 15.5% prepandemic to 44.7% during the pandemic, and most PDs witnessed minor signs of fellow burnout (52.4%). Common PD concerns included inadequate supervision for telehealth activities, reduced opportunities for fellow advancement and promotion, lack of professional development activities, limited research operations and funding, program financial constraints, and virtual recruitment. CONCLUSION: We encourage institutions and national societies to allocate resources and develop programs that can support fellowships and mitigate the potential negative effects of COVID-19 on trainee and PD career development.

Impact of the COVID-19 pandemic on the clinical training of last year medical students in Mexico: a cross-sectional nationwide study

Background The COVID-19 pandemic has brought unprecedented changes to medical education. However, no data are available regarding the impact the pandemic may have on medical training in Mexico. The aim of our study was to evaluate and identify the medical school students’ perceptions of the changes in their clinical training due to the pandemic in Mexico. Methods This was a cross-sectional study where a previous validated online survey was translated and adapted by medical education experts and applied to senior medical students from March to April of 2021. The 16-item questionnaire was distributed online combining dichotomous, multiple-choice, and 5-point Likert response scale questions. Descriptive and multivariate analyses were performed to compare the student’s perceptions between public and private schools. Results A total of 671 responses were included in the study period. Most participants were from public schools (81%) and female (61%). Almost every respondent (94%) indicated it was necessary to obtain COVID-19 education, yet only half (54%) received such training. Students in private schools were less likely to have their clinical instruction canceled (53% vs. 77%, p = 0.001) and more likely to have access to virtual instruction (46% vs. 22%, p = 0.001) when compared to students from public schools. Four out of every five students considered their training inferior to that of previous generations, and most students (82%) would consider repeating their final year of clinical training. Conclusions The impact of the COVID-19 on medical education in Mexico has been significant. Most final-year medical students have been affected by the cancellation of their in-person clinical instruction, for which the majority would consider repeating their final year of training. Efforts to counterbalance this lack of clinical experience with virtual or simulation instruction are needed.

Prevalence and risk factors associated with mental health disorders among medical students

The mental health care of medical students is a complex process influenced by various innate or personal characteristics of the student, stressors related to medical training, social, economic, demographic and many other factors. Therefore, it is important to identify both the prevalence and the main risk factors that can trigger mental disorders in medical students, such as stress, burnout, anxiety, depression, suicidal ideation, suicide, among others. Specifically in these students, the prevalence of depression ranges between 2.9% and 38.2% respectively; likewise, exhaustion ("burnout") prevails in 28-45% of them. Most students do not seek the necessary support to solve such problems, which leads to serious consequences, such as the abuse of substances harmful to health, in addition to environments, situations or actions that lead to mental destabilization. The following paper is a review that emphasizes the prevalence and risk factors that can trigger these mental disorders, in order to make an early detection and timely intervention, such as attending psychiatric therapy and/or receiving support from the educational system itself.

Commentary and Opinions: The Utilization of Social Media by Medical Residency Programs During COVID-19 Pandemic and Beyond

As a result of COVID-19 pandemic, medical training has been greatly impacted globally. In Canada, out-of-province visiting clinical electives were cancelled. In addition, the Canadian Resident Matching Service (CaRMS) interviews were transitioned to being virtual since 2020. As residency programs are exploring new ways to overcome the challenges of elective cancellation, there has been a surge of residency program social media accounts on Instagram, Twitter, and Facebook. Social media serves as a platform for residency programs to promote themselves in addition to posting interactive educational materials. Moreover, social media residency accounts provide a platform for medical students to learn about the programs and network virtually with fellow applicants, residents, program directors, and faculty members. Overall, social media is becoming a popular and valuable tool for residency programs to connect with the applicants during COVID-19 pandemic and beyond. Among the different social media platforms, Instagram seems to be more appealing to both residency programs and the graduating medical students. We report our observations regarding selected Canadian residency program Instagram accounts. To maximize the success of using social media, it is important for the residency programs to consider the attitudes of applicants towards the residency social media accounts. Future studies are needed to assess the effectiveness of the Canadian residency program social media accounts for the final year students applying for these programs.