Manualising the induction of higher trainees in psychiatry for North Wales: The CiSGC Guide (“Croeso i Seiciatreg Gogledd Cymru”)

AimsThere is a significant period of adjustment for new higher trainees in psychiatry given the presence of inter-trust differences in the National Health Services (NHS). It may take some time for a trainee to become familiar with the new administrative system and workflow of the new environment, which may be even longer for an international medical graduate (IMG). Although there is an existing induction system, having a written structured manual will assist the trainees to get through this process more easily. Hence, this Quality Improvement Project (QIP) outlined the creation of an induction manual that serves as a starter pack to facilitate the settling-in process of new North Wales higher trainees in psychiatry, i.e. the “Croeso i Seiciatreg Gogledd Cymru” (CiSGC) guide (means Welcome to North Wales Psychiatry in Welsh).MethodThe induction manual was initially drafted by the authors based on the available printed policies and information online. Further input and from different stakeholders were obtained to triangulate and enrich the manual. Specific links and further references were included in the manual for the reference of prospective manual users. Authors’ contact details were included for any further clarification, suggestions or input.ResultThe manual consisted of four sections: A) General Process before, during and after Reporting Duty, B) Trainees’ Duty, 3) Speciality-specific Guidance, and 4) Health Board-related Information. The General Process section covered the visa-related information, post-acceptance paperwork process, access to email and hospital informative system, medical practice-related issues (including section 12(2) approval and medical indemnity). The Trainees’ Duty section briefed on time-tabling and clinical duty. The Specialty-specific Guide provided important information related to training. Lastly, the section of Health Board-related Information highlighted the administrative structure of the NHS Health Board, important contact numbers, link to information. Specialty specific sections were created for general adult psychiatry and old age psychiatry as there is no other higher training of psychiatry in North Wales at the moment. Further sections in the pipeline include substance misuse and liaison psychiatry.ConclusionThis induction manual is neither prescriptive nor exhaustive. It serves as a generic reference to facilitate new trainees in their adjustment process. Further review and revision will be conducted before every induction process to ensure the information is up-to-date and incorporating new input from the trainees.

Experiences of Negotiations for Improving Research Environment and Burnout among Young Physician Researchers in Japan

Physician scientists in Japan are often too busy to be sufficiently involved in research work. This cross-sectional study aimed to investigate their experiences negotiating with their superiors to improve their research environment and determine its relationship with psychological burnout. Among 1790 physician awardees of Grants-in-Aid for Young Scientists in 2014–2015, 490 responded (response rate 27.4%) and 408 were eligible for analysis. Outcome measures included two negotiation experiences: for reduction of clinical duty hours/promotion opportunities and for increased space or equipment/increased research budget. The main explanatory variables were personal, patient-related, and work-related burnout measured by the Copenhagen Burnout Inventory. The percentages of the above-mentioned two types of negotiations were 20–24% in women and 17–20% in men. Multivariable stepwise logistic regression analyses demonstrated that (1) the negotiation for reduction of clinical duty hours/promotion opportunities was significantly associated with physician scientists who had a short amount of weekly research time and high patient-related burnout score, and (2) the negotiation for increased space or equipment/increased research budget was significantly associated with older age, single status, and high personal and patient-related burnout scores. High burnout is related to negotiation experiences among physician researchers in Japan.

Brain-computer interfaces: military, neurosurgical, and ethical perspective

Brain-computer interfaces (BCIs) are devices that acquire and transform neural signals into actions intended by the user. These devices have been a rapidly developing area of research over the past 2 decades, and the military has made significant contributions to these efforts. Presently, BCIs can provide humans with rudimentary control over computer systems and robotic devices. Continued advances in BCI technology are especially pertinent in the military setting, given the potential for therapeutic applications to restore function after combat injury, and for the evolving use of BCI devices in military operations and performance enhancement. Neurosurgeons will play a central role in the further development and implementation of BCIs, but they will also have to navigate important ethical questions in the translation of this highly promising technology. In the following commentary the authors discuss realistic expectations for BCI use in the military and underscore the intersection of the neurosurgeon's civic and clinical duty to care for those who serve their country.

The Role of the Pharmacist in Palliative Care: Results of a Survey Conducted in Australia and Canada

A survey was conducted to determine what pharmaceutical services are provided to palliative care sites in Australia and Canada, and the pharmacist's role on the interdisciplinary team. Questionnaires were sent to 100 selected sites in each country. Questions pertained to demographics and the level of duties performed. Australian 42/76 (55.3%) and Canadian 59/69 (85.5%) sites employed palliative care pharmacists. Most Australians (83.3%) and Canadians (69.8%) worked under 20 hours/week on the palliative care service. Administrative duties and basic drug supply functions were more common in Australia, whilst Canadians had greater participation in team meetings and rounds. Medication review was the most common clinical duty; approximately 70% of respondents in each country provided specific advice on pharmacotherapy, administration, treatment, adverse effects, and incompatibilities. Education was universally important, but active participation in conferences, publication, and research was infrequent. Pharmacists in both Australia and Canada are important members of the palliative care team, and provide a similar high level of unique and valuable services to patients and their families.