Comparison of resident and intern salaries with the current living wage as a quantitative estimate of financial strain among postgraduate veterinary trainees

OBJECTIVE To compare resident and intern salaries with current regional living wages as a quantitative estimate of financial strain. SAMPLE 152 residency programs and 141 internship programs listed with the Veterinary Internship and Residency Matching Program for the 2021–2022 training year. PROCEDURES Data were collected for program annual salary and location. Regional living wage for each location was determined with the Massachusetts Institute of Technology Living Wage Calculator, and annual salary was compared with living wage to estimate income surplus before and after taxes. Results for programs in academia and private practice were compared. Spearman correlation was used to determine whether program annual salary was significantly associated with regional living wage. RESULTS Mean ± SD income surplus before taxes was $7,786 ± 9,426 for clinical residency programs, $16,672 ± 5,105 for laboratory animal programs, and $5,829 ± 8,119 for internships. Academic residencies and internships offered salaries significantly lower than those offered in private practice, and income surpluses before and after taxes were significantly lower for academic programs than for private practice programs. There were weak and moderate, respectively, correlations between program annual salary and regional living wage for residency (r = 0.369) and internship (r = 0.570) programs. CLINICAL RELEVANCE Postgraduate training prolongs financial instability, and annual salaries generally do not meet the minimum income standard of a living wage. Financial stress has implications for mental health and diversity, and these findings invite deeper consideration of current remuneration practices for veterinary residents and interns.

Contribution of a positive psychology-based conceptual framework in reducing physician burnout and improving well-being: a systematic review

Background The PERMA Model, as a positive psychology conceptual framework, has increased our understanding of the role of Positive emotion, Engagement, Relationships, Meaning, and Achievements in enhancing human potentials, performance and wellbeing. We aimed to assess the utility of PERMA as a multidimensional model of positive psychology in reducing physician burnout and improving their well-being. Methods Eligible studies include peer-reviewed English language studies of randomized control trials and non-randomized design. Attending physicians, residents, and fellows of any specialty in the primary, secondary, or intensive care setting comprised the study population. Eligible studies also involved positive psychology interventions designed to enhance physician well-being or reduce physician burnout. Using free text and the medical subject headings we searched CINAHL, Ovid PsychINFO, MEDLINE, and Google Scholar (GS) electronic bibliographic databases from 2000 until March 2020. We use keywords for a combination of three general or block of terms (Health Personnel OR Health Professionals OR Physician OR Internship and Residency OR Medical Staff Or Fellow) AND (Burnout) AND (Positive Psychology OR PERMA OR Wellbeing Intervention OR Well-being Model OR Wellbeing Theory). Results Our search retrieved 1886 results (1804 through CINAHL, Ovid PsychINFO, MEDLINE, and 82 through GS) before duplicates were removed and 1723 after duplicates were removed. The final review included 21 studies. Studies represented eight countries, with the majority conducted in Spain (n = 3), followed by the US (n = 8), and Australia (n = 3). Except for one study that used a bio-psychosocial approach to guide the intervention, none of the other interventions in this review were based on a conceptual model, including PERMA. However, retrospectively, ten studies used strategies that resonate with the PERMA components. Conclusion Consideration of the utility of PERMA as a multidimensional model of positive psychology to guide interventions to reduce burnout and enhance well-being among physicians is missing in the literature. Nevertheless, the majority of the studies reported some level of positive outcome regarding reducing burnout or improving well-being by using a physician or a system-directed intervention. Albeit, we found more favorable outcomes in the system-directed intervention. Future studies are needed to evaluate if PERMA as a framework can be used to guide system-directed interventions in reducing physician burnout and improving their well-being.

The effect of rural placements on future rural general practice

Background: Providing health care to rural populations is a major issue in Australia. Disease burdenand health risk factorsincrease with remoteness, but the access to appropriate service decrease. The introduction of Rural Clinical Schools, rural locations for internship and residency, and decentralisation of the Australian General Practitioner Training Programaim to address this disparity. This systematic review aimed at determining if rural placements throughout medical training are associated with future rural general practice in Australia.Methods: Medline (Ovid), Pubmed, CINAHL and Science Direct were searched for the period January 2000 to July 2019. Included studies related specifically to rural general practitioners in Australia and studies were excluded if they reported only on intention to practice rurally. Evidence was assessed using the Standards for Quality Improvement Reporting Excellence Guidelines.Results: Eleven articles met the inclusion criteria. Three studies examined the effect of rural placements in medical school on future rural general practice. Three studies looked at placements as a junior doctor on future rural general practice. Four studies looked at the effect of rural general practitioner training on future rural general practice. One study reported on the effect of rural placements during both medical school and junior doctor years on future rural general practice. The studies supported an association between rural placements and future rural general practice, particularly for Australian born doctors, Australian graduates and individuals from rural backgrounds.Discussion: This review suggests that rural placements during medical training increase the likelihood of future rural general practice. The interplay of personal and professional life influence whether rural intention is sufficient to result in rural practice. Addressing human factors that influence rural practice will contribute to achieving equitable rural health care.

Pre-Hospital Care: The New Perspective in the International Rotational Program of Emergency Medicine Residents

Background: Cooperation between Japan (Tsukuba University), Laos (The University of Health Sciences), and Thailand (Khon Kaen University) had been established in order that the teaching of doctors in the Emergency Medicine Training Program in Laos could be developed so that these doctors could have the opportunity to be the observers of EMS in Thailand. However, as of this time, no studies related to the pre-hospital care perspective in the International Rotational Program for residents of Emergency Medicine have been conducted. Objective: To survey the perspectives of pre-hospital care for residents from Laos, who were participating in the International Rotational Program of Emergency Medicine. Materials and Methods: This was a retrospective cross-sectional study conducted between January and March 2020 with thirdyear residents in Emergency Medicine from Laos, who had come to gain practice at the EMS of Srinagarind Hospital in Thailand. Before starting the session, data was collected from all participants, which consisted of responses to a multiple-choice test, demographic data, and satisfaction surveys. Results: A total of eight emergency medicine residents were enrolled and were then divided into three groups. Under normal conditions, the EMS duration time was thirty-two hours for each group. During the first week of the course, knowledge was disseminated through lectures. During the second week, the participants were placed on duty. After that, they received calls from the 1669 center and were dispatched with the EMS operation team. Finally, over the duration of a two-week period, they were placed in the role of being observers on ambulance duty. When comparing the Pre-test and Post-test assessment of their EMS knowledge, a significant increase in their scores from 3.4 to 8.5 (p = 0.010) was found. In addition, the medical oversight had increased from 2.4 to 8.4 (p = 0.005), while the EMS systems had significantly increased from 4.2 to 8.6 (p = 0.014). Conclusion: The International Rotational Program for Emergency Medicine residents, which had focused on the EMS aspects with EMS knowledge, Medical Oversight, and on the EMS systems, was found to be successful for the doctors from Laos. Keywords: Emergency medicine, Internship and Residency, Emergency Medical Services, Learning

Learning Outcomes of an International Training Course on Mechanical Cardiopulmonary Resuscitation Device Use for Emergency Medicine Residents

Background: The present study was conducted to assess the learning outcomes of mechanical cardiopulmonary resuscitation device training course for emergency medicine residents from Laos. The course was part of a collaborative project among Tsukuba University in Japan, the University of Health Sciences in Laos, and Khon Kaen University in Thailand. Objective: To evaluate the learning outcomes a mechanical cardiopulmonary resuscitation device course for emergency medicine residents. Materials and Methods: The cross-sectional study was conducted in emergency medicine residents from Laos who participated in a training course on the use of mechanical cardiopulmonary resuscitation devices, which took place between January and March 2020 at the Srinagarind Hospital emergency department (ED). Assessment exams for individually with standard checklists for Thais’ emergency medicine residents. Results: A total of eight emergency medicine residents from Laos were enrolled. The mean age was 33.7+3.5 years, and 62.5% (n = 5) of the participants were female. We found that participants’ mean score had increased from 4 to 8 points after the training course (p = 0.010). Participants rated the ease of the procedure as 8 out of 10 (1: very difficult). Conclusion: The mechanical cardiopulmonary resuscitation device training course was successful in terms of sharing both medical knowledge and equipment management techniques. Keywords: Internship and Residency, Laos, Cardiopulmonary resuscitation, Emergency medicine

Matriz de competência relacionada à Covid-19: contribuições de estudantes e residentes

Introduction: Competency-based education has been discussed under the new perspective of the COVID-19 pandemic. The need for social distancing had effects on student activities and educational institutions needed to reflect and redesign the teaching-learning process. It was necessary to incorporate contents related to COVID-19 into the medical training programs and to adapt the teaching tools. Therefore, it is necessary that training be mediated by a collective construction of the competency matrix with the participation of the subjects involved in the process. Objective: This project aims to present the reconstruction of the curriculum in cardiology by observing the collaboration of the students and residents. Method: Exploratory study, involving 13 undergraduate medical students and eight medical residents from the institution’s cardiology program, who comprised the “Students and residents’ panel”. Consensus was reached among the panelists through the Delphi methodology. The first version of the matrix was prepared by the research team and sent, together with the FICF, containing 16 items aimed at COVID-19 content to be achieved at the cardiology internship and residency. The participants attributed their degree of agreement for each proposed item and after returning them, the data were tabulated, stored in an Excel spreadsheet and percentages for each item were calculated and presented in a descriptive manner. Result: The panel consisted of 19 participants. Of the 21 invited, 02 participants did not answer the online questionnaire and were excluded. The initial version of the matrix reached a consensus in the first round, with the lowest agreement rate being 71% in the internship matrix and 89.5% in the residency matrix. Both matrices showed high levels of agreement. There were no disagreements or suggestions for new items for the matrix. Conclusion: The students and residents’ engagement in the pedagogical process may contribute to a better understanding of the competencies for their training and bring sustainable changes to the curriculum.

Competency matrix related to Covid-19: contributions from students and residents

Introduction: Competency-based education has been discussed under the new perspective of the COVID-19 pandemic. The need for social distancing had effects on student activities and educational institutions needed to reflect and redesign the teaching-learning process. It was necessary to incorporate contents related to COVID-19 into the medical training programs and to adapt the teaching tools. Therefore, it is necessary that training be mediated by a collective construction of the competency matrix with the participation of the subjects involved in the process. Objective: This project aims to present the reconstruction of the curriculum in cardiology by observing the collaboration of the students and residents. Method: Exploratory study, involving 13 undergraduate medical students and eight medical residents from the institution’s cardiology program, who comprised the “Students and residents’ panel”. Consensus was reached among the panelists through the Delphi methodology. The first version of the matrix was prepared by the research team and sent, together with the FICF, containing 16 items aimed at COVID-19 content to be achieved at the cardiology internship and residency. The participants attributed their degree of agreement for each proposed item and after returning them, the data were tabulated, stored in an Excel spreadsheet and percentages for each item were calculated and presented in a descriptive manner. Result: The panel consisted of 19 participants. Of the 21 invited, 02 participants did not answer the online questionnaire and were excluded. The initial version of the matrix reached a consensus in the first round, with the lowest agreement rate being 71% in the internship matrix and 89.5% in the residency matrix. Both matrices showed high levels of agreement. There were no disagreements or suggestions for new items for the matrix. Conclusion: The students and residents’ engagement in the pedagogical process may contribute to a better understanding of the competencies for their training and bring sustainable changes to the curriculum.