Methods: We adopted a comparative cross-sectional study on pre-clinical medical students who appeared in two different admission tests. The stress, anxiety, and depression levels of students were measured by the depression, anxiety, stress scale (DASS-21), and their burnout level was measured by the Copenhagen Burnout Inventory.
Results: The stress, anxiety, and depression scores between MMI and PI were not significantly different (p-value > 0.05). The personal, work and client burnout scores between MMI and PI were not significantly different (p-value > 0.05). The prevalence of stress (MMI = 39%, PI = 36.9%), anxiety (MMI = 78%, PI = 67.4%), depression (MMI = 41%, PI = 36.2%) and burnout (MMI = 29%, PI = 31.9%) between MMI and PI cohorts was not significantly different (p-value > 0.05). These results showed similar levels of stress, anxiety, depression, and burnout in students at the end of the pre-clinical phase.
Conclusions: This study showed similar psychological health status of the pre-clinical students who were enrolled by two different admission tests. The prevalence of stress, anxiety, burnout, and depression among the pre-clinical medical students was comparable to the global prevalence. The results indicate that medical schools can consider implementing either MMI or PI to recruit suitable candidates for medical training.
Aim: To consolidate the literature regarding the barriers faced by primary care physicians in making house calls.
Design of the study: Literature review.
Method: Studies were sourced from PubMed and Embase.
Results: 7 studies were selected to be in the literature review. Barriers to making house calls by primary care physicians include inadequate remuneration, lack of time and training, unconducive home environment, concerns with professional liability and safety, and perceived low value-added in the patient's quality of care.
Conclusion: While primary care physicians do recognize the value of house calls in patient care, the perceived limited standard of care that can be achieved in the home setting, busy clinic practice (large patient loads), coupled with inadequate remuneration make house calls unrealistic for many doctors. These barriers must be addressed to ensure accessibility to primary health care services for the immobile, frail, and sick is not being compromised. One of the solutions may be to expose medical students and residents to house calls early through mentorship.
METHOD: A hyperlink to an online, anonymised questionnaire was distributed to medical students in 3rd, 4th and final year at three RCSI campuses. Basic descriptive statistics were used to describe the responses to individual questions and appropriate statistical tests used to compare male and female responses to questions.
RESULTS: A total of 464 completed questionnaires were analysed. Almost 40% (n=185) were male and 60% (n=279) were female. Males were significantly more influenced by remuneration than females (p<0.001) towards a choice of surgical career. Females were significantly more influenced in their choice of surgical career by part-time work (p<0.001), parental leave (p<0.001), working hours (p<0.001) and length of residency (p=0.003). During surgical attachments, females were significantly more likely to admit feeling intimidated than males (p=0.002) and males more likely to report feeling confident (p<0.001). Ninety-six per cent of students felt they would be more likely to pursue a career in which they had identified a positive role model, with female medical students three times more likely to have identified a female role model than males.
CONCLUSION: According to our study, preference for a career in surgery declines with advancing years in medical school for both males and females. Medical students report high levels of feeling intimidated or ignored during their surgical placements, and enthusiasm for surgery reduces during medical school with exposure to this. These findings, along with the importance of role modelling, add further urgency to the need to address factors which make surgery less appealing to female medical graduates.