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Kumar M, Ali K, Sharma N, Sharma A, Jain M, Vats S, Kapoor G, Chahal A. Evaluation of Mental Health and Quality of Life among Indian Professionals Embarked as COVID-19 Survivors. J Lifestyle Med 2023; 13:66-72. [PMID: 37250276 PMCID: PMC10210969 DOI: 10.15280/jlm.2023.13.1.66] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/11/2023] [Accepted: 02/17/2023] [Indexed: 05/31/2023] Open
Abstract
Background Government guidelines for lockdown and quarantine measures impacted the daily lives and health of individuals amid the coronavirus disease 2019 (COVID-19) pandemic. The pandemic caused significant changes in the daily routine and lifestyles of individuals worldwide with the simultaneous emergence of mental health disorders. Stress caused by COVID-19 pandemic outbreaks and consequent social isolation significantly influenced the mental health and quality of life of professionals among Indian population. This study aimed to evaluate the mental health and quality of life among Indian professionals embarked as COVID-19 survivors. Methods A 20-item self-administered questionnaire was developed and circulated among the participants with the following domains: helplessness, apprehension, mood swing, physical activity, restlessness, insomnia, irritation, mental stress, and emotional instability to assess their mental health and quality of life. Results Of the total 322 participants, 73.6% of individuals experienced helplessness, 56.2% felt the need for counseling, 65.5% reported feeling irritated even over minor issues, 62.1% experienced negative thoughts during isolation, 76.5% experienced difficulty in falling asleep, and 71.9% felt restless during their course of illness. Conclusion The study concludes that mental health and quality of life among COVID-19 survivors was affected by sleep, physical activities, emotional instability, and job profile, as well as support from others, mood swings, and the need for counseling.
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Affiliation(s)
- Mohit Kumar
- Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana-Ambala, Haryana, India
| | - Kamran Ali
- Department of Physiotherapy, School of Medical and Allied Sciences, GD Goenka University, Sohna, Haryana, India
| | - Nidhi Sharma
- Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana-Ambala, Haryana, India
| | - Abhishek Sharma
- Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana-Ambala, Haryana, India
| | - Mansi Jain
- Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana-Ambala, Haryana, India
| | - Sakshi Vats
- Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana-Ambala, Haryana, India
| | - Gaurav Kapoor
- Department of Physiotherapy, NIMS College of Physiotherapy and Occupational Therapy, NIMS University, Jaipur, Rajasthan, India
| | - Aksh Chahal
- Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana-Ambala, Haryana, India
- Department of Physiotherapy, School of Medical and Allied Health Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
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McFarland DC, Holland J, Holcombe RF. Inpatient Hematology-Oncology Rotation Is Associated With a Decreased Interest in Pursuing an Oncology Career Among Internal Medicine Residents. J Oncol Pract 2015; 11:289-95. [DOI: 10.1200/jop.2015.003798] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
An inpatient hematology-oncology ward rotation does not lead to increased interest and, for some residents, may lead to decreased interest in the field.
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Affiliation(s)
- Daniel C. McFarland
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai; and Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Jimmie Holland
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai; and Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Randall F. Holcombe
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai; and Memorial Sloan-Kettering Cancer Center, New York, NY
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Daniels VJ, Kassam N. Impact of personal goals on the internal medicine R4 subspecialty match: a Q methodology study. BMC MEDICAL EDUCATION 2013; 13:171. [PMID: 24359484 PMCID: PMC3879426 DOI: 10.1186/1472-6920-13-171] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Accepted: 12/18/2013] [Indexed: 06/03/2023]
Abstract
BACKGROUND There has been a decline in interest in general internal medicine that has resulted in a discrepancy between internal medicine residents' choice in the R4 subspecialty match and societal need. Few studies have focused on the relative importance of personal goals and their impact on residents' choice. The purpose of this study was to assess if internal medicine residents can be grouped based on their personal goals and how each group prioritizes these goals compared to each other. A secondary objective was to explore whether we could predict a resident's desired subspecialty choice based on their constellation of personal goals. METHODS We used Q methodology to examine how postgraduate year 1-3 internal medicine residents could be grouped based on their rankings of 36 statements (derived from our previous qualitative study). Using each groups' defining and distinguishing statements, we predicted their subspecialties of interest. We also collected the residents' first choice in the subspecialty match and used a kappa test to compare our predicted subspecialty group to the residents' self-reported first choice. RESULTS Fifty-nine internal medicine residents at the University of Alberta participated between 2009 and 2010 with 46 Q sorts suitable for analysis. The residents loaded onto four factors (groups) based on how they ranked statements. Our prediction of each groups' desired subspecialties with their defining and/or distinguishing statements are as follows: group 1 - general internal medicine (variety in practice); group 2 - gastroenterology, nephrology, and respirology (higher income); group 3 - cardiology and critical care (procedural, willing to entertain longer training); group 4 - rest of subspecialties (non-procedural, focused practice, and valuing more time for personal life). There was moderate agreement (kappa = 0.57) between our predicted desired subspecialty group and residents' self-reported first choice (p < 0.001). CONCLUSION This study suggests that most residents fall into four groups based on a constellation of personal goals when choosing an internal medicine subspecialty. The key goals that define and/or distinguish between these groups are breadth of practice, lifestyle, desire to do procedures, length of training, and future income potential. Using these groups, we were able to predict residents' first subspecialty group with moderate success.
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Affiliation(s)
- Vijay J Daniels
- Department of Medicine, University of Alberta, Edmonton, Canada
| | - Narmin Kassam
- Department of Medicine, University of Alberta, Edmonton, Canada
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Daniels VJ, Kassam N. Determinants of internal medicine residents' choice in the Canadian R4 fellowship match: a qualitative study. BMC MEDICAL EDUCATION 2011; 11:44. [PMID: 21714921 PMCID: PMC3146947 DOI: 10.1186/1472-6920-11-44] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2010] [Accepted: 06/29/2011] [Indexed: 05/31/2023]
Abstract
BACKGROUND There is currently a discrepancy between Internal Medicine residents' decisions in the Canadian subspecialty fellowship match (known as the R4 match) and societal need. Some studies have been published examining factors that influence career choices. However, these were either demographic factors or factors pre-determined by the authors' opinion as possibly being important to incorporate into a survey. METHODS A qualitative study was undertaken to identify factors that determine the residents choice in the subspecialty (R4) fellowship match using focus group discussions involving third and fourth year internal medicine residents RESULTS Based on content analysis of the discussion data, we identified five themes:1) Practice environment including acuity of practice, ability to do procedures, lifestyle, job prospects and income 2) Exposure in rotations and to role models 3) Interest in subspecialty's patient population and common diseases 4) Prestige and respect of subspecialty 5) Fellowship training environment including fellowship program resources and length of training CONCLUSIONS There are a variety of factors that contribute to Internal Medicine residents' fellowship choice in Canada, many of which have been identified in previous survey studies. However, we found additional factors such as the resources available in a fellowship program, the prestige and respect of a subspecialty/career, and the recent trend towards a two-year General Internal Medicine fellowship in our country.
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Affiliation(s)
- Vijay J Daniels
- Department of Medicine, University of Alberta, 2F1.13 WMC 8440 - 112 Street, Edmonton, T6G 2B7, Canada
| | - Narmin Kassam
- Department of Medicine, University of Alberta, 2F1.13 WMC 8440 - 112 Street, Edmonton, T6G 2B7, Canada
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Prislin MD, Saultz JW, Geyman JP. The generalist disciplines in American medicine one hundred years following the Flexner Report: a case study of unintended consequences and some proposals for post-Flexnerian reform. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2010; 85:228-235. [PMID: 20107347 DOI: 10.1097/acm.0b013e3181c877bf] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Abraham Flexner's analysis of U.S. medical education at the turn of the 20th century transformed the processes of student selection and instruction, the roles and responsibilities of faculty members, and the provision of resources to support medical education. Flexner's report also led to the nearly universal adoption of the academic medical center as the focal point of medical school teaching, research, and clinical activities. In this article, the authors describe the effects of the dissemination of this model and how the subsequent introduction of public funding for research and patient care transformed academic health centers and altered the composition of the physician workforce, resulting in the proliferation of specialties. They also describe how these workforce changes, along with the evolution of health care financing during the late 20th century, have led to a system that affords the most scientifically advanced and potentially efficacious care in the world, yet so profoundly fails to ensure affordability and equitable access and quality, that the system is no longer sustainable. The authors propose that both health care system reform and medical education reform are needed now to restore economic viability and moral integrity, and that a key element of this process will be to rebalance the generalist and specialist composition of the physician workforce. They conclude by suggesting that post-Flexnerian reform of medical education should include broadening the scope of criteria used to select medical students and reshaping the curriculum to address the evolving needs of patient care during the 21st century.
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Affiliation(s)
- Michael D Prislin
- Department of Family Medicine, University of California, Irvine School of Medicine, Irvine, California 92697, USA.
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McDonald FS, West CP, Popkave C, Kolars JC. Educational debt and reported career plans among internal medicine residents. Ann Intern Med 2008; 149:416-20. [PMID: 18794561 DOI: 10.7326/0003-4819-149-6-200809160-00008] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Physicians often enter the workplace with substantial debt. The relationship between debt and reported career plans among internal medicine residents is unknown. OBJECTIVE To determine distributions of educational debt among internal medicine residents and associations of debt with reported career plans. DESIGN Cross-sectional survey using data from the annual Internal Medicine In-Training Examination Residents Questionnaire completed by U.S. categorical internal medicine residents. SETTING Categorical internal medicine residencies in the United States. PARTICIPANTS 22,563 residents in their third (final) year of residency, representing 74.1% of all eligible U.S. categorical internal medicine residents from 2003 through 2007. MEASUREMENTS Distributions of educational debt were tabulated. Proportions of residents choosing career plans were calculated for various levels of debt. RESULTS International medical graduates represented 48.7% of the cross section and had considerably less debt than U.S. medical graduates: 53.8% of U.S. medical graduates had debt of 100,000 dollars or greater and 60.2% of international medical graduates had none. U.S. medical graduates with debt of 100,000 dollars to 150,000 dollars were less likely than those with no debt to choose a subspecialty career (57.5% vs. 63.5%). U.S. medical graduates with debt of 50,000 dollars to 99,999 dollars were more likely than those with no debt to choose a hospitalist career (8.5% vs. 6.2%), and this preference increased with increasing debt level (10.0% for those with >150,000 dollars debt). These associations are more pronounced for U.S. medical graduates than for international medical graduates. LIMITATION The study addressed total educational debt, but not when it was incurred, and did not allow inferences related to causality. CONCLUSION Educational debt is associated with differences in reported career plans among internal medicine residents.
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Thomas KG, West CP, Popkave C, Weinberger SE, Kolars JC. Internal medicine resident perceptions of optimal training duration. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2007; 82:996-9. [PMID: 17895665 DOI: 10.1097/acm.0b013e31814a5192] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
PURPOSE To describe internal medicine residents' opinions regarding the optimal duration of internal medicine residency training, and to assess whether these opinions are associated with specific career interests. METHOD A national cohort study was conducted during the 2005 Internal Medicine In-Training Examination (IM-ITE), which involved 382 of 388 (98.5%) U.S. internal medicine programs. A sample of 14,579 residents enrolled in three-year categorical or primary care training programs in the United States reported their opinions regarding optimal residency training duration on the IM-ITE 2005 Residents Questionnaire. Reported optimal training duration was assessed by postgraduate training year, sex, medical school location, program type, and reported career plan. RESULTS Among the residents surveyed, 78.1% reported a three-year optimal length of internal medicine residency training, 15.3% preferred a two-year training duration, and 6.7% preferred a four-year duration. Residents planning careers in general medicine, hospital medicine, and subspecialty fields all preferred a three-year training duration (83.8%, 82.6%, and 75.9%, respectively). Residents planning subspecialty careers were more likely than those planning general or hospital medicine careers to prefer a two-year program (18.7% versus 7.4% and 8.3%). Residents planning generalist or hospitalist careers were more likely to favor a four-year program (8.9% and 9.1%, respectively) compared with residents planning subspecialty careers (5.4%). CONCLUSIONS Most internal medicine residents endorse a three-year optimal duration of internal medicine residency training. This perspective should be considered in further national discussions regarding the optimal duration of internal medicine training.
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Affiliation(s)
- Kris G Thomas
- Division of Primary Care Internal Medicine, Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA
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Boulet JR, Norcini JJ, Whelan GP, Hallock JA, Seeling SS. The international medical graduate pipeline: recent trends in certification and residency training. Health Aff (Millwood) 2006; 25:469-77. [PMID: 16522588 DOI: 10.1377/hlthaff.25.2.469] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
International medical graduates (IMGs) represent a large proportion of the population entering graduate medical education (GME) programs. Many of these internationally trained physicians go on to practice medicine in the United States. To be eligible for GME, IMGs must be certified by the Educational Commission for Foreign Medical Graduates (ECFMG). The number of certificates issued by the ECFMG has varied over time and historically has exceeded the number of available training positions. More detailed longitudinal analyses are required to better understand the interwoven issues of physician supply, consumers' needs, and the role of IMGs in the U.S. health care system.
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Affiliation(s)
- John R Boulet
- Educational Commission for Foreign Medical Graduates, Philadelphia, Pennsylvania, USA.
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Abstract
BACKGROUND Sociodemographic factors and personality attributes predict career decisions in medical students. Determinants of internal medicine residents' specialty choices have received little attention. OBJECTIVE To identify factors that predict the clinical practice of residents following their training. DESIGN Prospective cohort study. PARTICIPANTS Two hundred and four categorical residents from 2 university-based residency programs. MEASUREMENTS Sociodemographic and personality inventories performed during residency, and actual careers 4 to 9 years later. RESULTS International medical school graduates (IMGs) were less likely to practice general medicine than U.S. graduates (33.3% vs 70.6%, P < .001). Residents with higher loan indebtedness more often became generalists (P = .001). A corresponding trend favoring general internal medicine was observed among those who perceived General Internists to have lower potential incomes (69.0% vs 53.3%, P = .08). There was a trend for generalists to have lower scores on scales measuring authoritarianism, negative orientation to psychological problems, and Machiavellianism (0.05 < P < .10). In a logistic regression, graduation from a U.S. medical school (odds ratio [OR] 3.02; 95% confidence interval [CI], 1.00 to 9.10, P = .049) and perception of low future income (OR 1.65; 95% CI, 1.06 to 2.56, P = .03) predicted entry into general medicine, with trends apparent for higher debt (P = .05) and greater comfort caring for patients with psychological problems (P = .07). CONCLUSION Recruitment of IMGs may not increase the supply of General Internists. Prospects of lower income, even in the face of large debt, may not discourage residents from becoming generalists. If increasing generalist manpower is a goal, residencies should consider weighing applicants' personal attributes during the selection process.
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Affiliation(s)
- Andrew K Diehl
- Division of General Medicine, Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
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