The value of medical shadowing for high school students: A three-dimensional view

Medical shadowing helps provide clinical exposure to aspiring and current medical students, mainly at the college level. This paper makes a case for making medical shadowing opportunities more widely available for high school students. Through the perspective of a high school student who got such an opportunity, we demonstrate that high school students can gain valuable clinical knowledge and exposure to the ethics involved in patient care, inspiring them to explore further pathways that will help them make better-informed academic and career choices. This high school student provides pointers on preparing for medical shadowing encounters through background research and developing a note-taking template. We also offer early-career and experienced physicians' perspectives on how providing medical shadowing opportunities to high school students benefits practicing physicians by energizing their motivation, reaffirming their commitment to the profession, and gaining a fresh perspective on their work. We believe that medical shadowing for high school students can open channels to attract and motivate a young and diverse talent pool to the medical profession that will help mitigate the projected shortfall of physicians in the next decade.

Depression in Final-Year Medical Students in Ho Chi Minh City, Vietnam: The Role of Career-Choice Motivation

OBJECTIVES

Depression in medical students is concerning, potentially fueled by many stressors including career choice-relating stress. Choosing Medicine is a life-long commitment, and low intrinsic motivation or excessive dependence on family can complicate this decision and adding stress throughout their training. This stress intensifies in the final year, as students lacking personal drive struggle to see themselves continuing the career. Given limited studies on this crucial topic in Asia and Vietnam, we explored direct linkage between career choice motivation and depression in final-year medical students.

METHODS

A cross-sectional study was conducted with 569 final-year students between June and July 2020. The Vietnamese Patient Health Questionnaire 9 (PHQ-9) and 16-item CCM questionnaire were used as survey tools. Univariate analysis was used for descriptive statistics (absolute and relative frequency, mean (M), standard deviation (SD). Multinomial logistic regression models were used to explore the relationship between variables using STATA 5.1.

RESULTS

The depression among participants was about 24.6% (PHQ-9 cut-off ≥ 12). No difference in gender was found regarding depression. The most acknowledged motivator is securing employment (M = 4.14, SD = 1.02) and the least is parental wishes (M = 3.17, SD = 1.32). Familial influence on career choice significantly increased odds of having "moderately-severe depression" (OR = 1.17, 95% CI 1.04-1.32) and "severe depression" (OR = 1.36, 95% CI 1.10-1.68), whereas, career-choice motivators including satisfaction (OR = .76, 95% CI .60-.97), self-competence (OR = .80, 95% CI .66-.97) and career success (OR = .84, 95% CI .71-.99) were found to be protective factors for depression.

CONCLUSIONS

Roughly a quarter of final-year medical students encountered depression. Occupational security ranked as the primary motivator, with parental wish being the least. Familial influence heightened depression risk, while career prospects, satisfaction and self-efficacy acted as protective factors. Medical career paths should align with intrinsic motivations and personal interests for better mental health outcomes.

Career Trajectory of Physicians Following a Fellowship Program: A Descriptive Study

INTRODUCTION

A clinical and/or research fellowship abroad has become a prevalent choice among Israeli physicians. However, the influence of fellowship programs on the career path is unclear. We evaluated the role of physicians returning from fellowship in the organizational hierarchy and their professional and academic status.

METHODS

This was a retrospective, descriptive, cross-sectional study of physicians who completed a survey after accomplishing a fellowship. The survey included questions about the physicians' attitudes toward the program, programs' details, and the physicians' current academic, professional, and administrative status. Information about scientific publications was also collected.

RESULTS

Of the 106 physicians receiving the questionnaire, 101 responded. The majority completed a two-year fellowship in North America. Forty percent participated in an integrated program (research and clinical), and 40% participated in clinical programs. Subjectively, the physicians attributed a significant value to the fellowship and positively recommend it. Most of the physicians held managerial positions, academic appointments, and had generated significant research.

DISCUSSION

The subjective perspective of all physicians participating in the study was that attending a fellowship program had a positive impact on their careers. Objectively, the accomplishment of a fellowship program empowered the studied physicians to become scholars, senior executives, and opinion leaders in their professional field.

The Impact of the SARS-COV-2 Pandemic on the Mental Health and Employment Decisions of Medical Students in North China

Background: The outbreak of severe respiratory syndrome coronavirus 2 (SARS-COV-2) has led to long periods of social isolation for individuals across the world. Although medical students generally have a high prevalence of mental health problems, they have received less attention than other groups concerning the impact of SARS-COV-2. Therefore, the present study investigated the mental health status, risk factors, and protective factors for mental health problems in medical students in North China during the SARS-COV-2 pandemic. Methods: A WeChat-based survey, which included the Depression Anxiety Stress Scale-21 and measures of social demographics, was performed twice. Risk and protective factors were identified by binary logistic regression analysis. Results: A total of 702 effective questionnaires were collected in two separate surveys. In total, 24.55% of medical students were suffering anxiety to different degrees of severity, 13.18% were suffering depression in the first survey, and 3.71% wanted to give up working in primary medical care during the SARS-COV-2 pandemic in the second survey. In contrast, during the SARS-COV-2 pandemic, a risk factor for anxiety and depression was gender which is male, while being knowledgeable about the SARS-COV-2 pandemic and having a lower academic burden were both protective factors. Conclusions: Measures are required to prevent increases in mental health problems in medical students. Our findings suggest that increasing knowledge about the SARS-COV-2 pandemic and reducing academic burden in medical students is extremely important during the SARS-COV-2 pandemic.

Parental influences on medical students' self-efficacy and career exploration in collectivist culture

INTRODUCTION

Families, especially parents, play an important role in identifying their children's talents and directing their educational journey. The role of parents in their children career applies both to collectivist and to noncollectivist culture.

AIM

To examine the correlation between parental influences on medical students' self-efficacy and career exploration in collectivist culture.

METHODS

This research was a quantitative study. The study involved 1017 medical students of medical faculties in four faculties of medicine in Indonesia. All data were collected online in August 2018. The study was conducted using an online survey questionnaire and analyzed to finally form a model that displays the determinants of career exploration behavior. The data were analyzed using the maximum likelihood estimation in IBM AMOS 24.

RESULTS

The results found a model that has various routes toward career exploration in collectivist culture. Path analysis revealed both direct and direct effect toward the variable studied. Parents' expectations had influence on self-efficacy.

CONCLUSION

The findings show the important role between the influence of parents expectations for self-efficacy and career exploration in children.

From 'neurotic' to 'managing' mother: The 'medical career' experienced by mothers of a child diagnosed with Juvenile Idiopathic Arthritis

Objective Despite increased research into how caring for a child diagnosed with juvenile idiopathic arthritis (JIA) affects mothers, more needs to be known about ways in which such experiences transform their lives. Insight into the experiences of such mothers was sought through analysis of interviews with eight mothers and one father caring for a child with JIA. Design The study is situated within a larger project involving families with a child with JIA. A social constructionist approach was adopted and grounded theory including a 'negative case,' guided gathering and analysing data. Individual, semi-structured interviews were conducted based on the research question: 'What is it like to be the mother of a child with juvenile idiopathic arthritis?' Results Findings suggest that mothers find difficulty living up to the 'ideal mother' expected within Western society when forced to provide competing demands of age-related, yet illness-relevant care. The unpredictable nature of JIA means mothers face a lack of understanding from professionals so become hyper-vigilant, 'battling' on behalf of their ill child. A self-perpetuating loop develops if this is misperceived as being overprotective, leaving mothers vulnerable to being judged 'neurotic'. However, with experience, often at an emotional cost, such mothers' confidence in managing the competing demands of caring for their ill child increases such they can navigate a positive journey from 'neurotic' to 'managing' mother. Conclusions Understanding this process could help health care professionals reduce stressful experiences faced by mothers when caring for a chronically ill child. Statement of contribution What is already known on this subject? Mothers of chronically ill children are often diagnosed with anxiety and depression. Such mothers will have taken over managing their child's condition, and this can include negative experiences within the health care system. Qualitative methods enable deeper understanding of the experiences of mothers of chronically ill children. What does the study add? Potentially gendered position of mothers of children with chronic conditions. Taken for granted assumptions implicitly underpin interactions between mothers and some professionals. Greater partnership between mothers and professionals ultimately improves the care of the ill child.

Impact of MiniMedJob as medical career intervention program

BACKGROUND AND AIM

Medical career exploration is a continuous process that one should invest on throughout their academic life. However, lack of resources and time are the main barriers in establishing suitable intervention. Therefore, the needs for flexible intervention are crucial, as it can improve medical career choices. This study aimed to improve career self-efficacy and to open the insight of medical students in choosing a variety of medical careers.

MATERIAL AND METHODS

This study was conducted using quasi-experimental study design with nonequivalent control groups design (pretest-posttest) using a modified model from a preexisting medical career intervention (MedJob™) labeled as MiniMedJob™. A total of 122 1^st-year medical students from Sriwijaya University, Indonesia, were voluntarily joining the study. The effectiveness of MiniMedJob™ in increasing students' self-efficacy was evaluated using Wilcoxon and Mann-Whitney statistical tests using IBM SPSS Statistics for Windows, Version 24.0, Armonk, New York.

RESULTS

MiniMedJob™ was proven effective to improve medical students' career self-efficacy (P = 0,000). The mean of the pretest and posttest for the intervention group was 77.79 ± 10.12 and 87 ± 8.36, respectively. While for the control group, the mean of pretest was 87.00 ± 8.36 and for the posttest group was 83.55 ± 7.96. Despite the higher score of the intervention group compared to control group, statistically, it was insignificantly different (P = 0,084).

CONCLUSIONS

MiniMedJob™ is proven effective in improving medical students career self-efficacy despite their shorter period and fewer activities compared to preexisting intervention model.

The system of values and styles of success in the medical career: A longitudinal study

OBJECTIVES

The purpose of the study was to investigate the relation between system values during medical education and styles of success in the medical career.

MATERIAL AND METHODS

The participants were first examined when they applied to the medical school. Questionnaires were given to these students each academic year. Medical doctors who had participated in the first phase of the study completed a questionnaire 4 years after their graduation, too. The baseline questionnaire measured the system values. The follow-up questionnaire included measures of quality of life, work stress and burnout, satisfaction with medicine as a career and professional competency.

RESULTS

The identified 3 groups of students representing 3 types of careers had been different regarding their preferred terminal values and instrumental values. Out of 3 groups, 2 presented a high risk of burnout. What is more the life goals (terminal values) are relatively stable, but preferable modes of behavior (instrumental values) are likely to change. The most important differences between students who may suffer from burnout later as doctors and those who are at a lower risk are e.g., family security, freedom, happiness, mature love, self-respect, social recognition and wisdom.

CONCLUSIONS

The Rokeach Value Survey may be applied to identify specific tendencies in the development of medical career. The obtained results may be used by the medical school admission officers as well as resident selection committees in order to identify candidates who may be at risk of professional difficulties. Authors can identify during medical education which student will be at risk of professional burnout after studies. Thus there could be a selection of interventions directed toward differentiated groups of students, e.g.: supplying them with proper coping vs. guiding them, to increase life satisfaction and productivity. Int J Occup Med Environ Health 2018;31(6):823-835.

The US pediatric nephrology workforce: a report commissioned by the American Academy of Pediatrics

The US pediatric nephrology workforce is poorly characterized. This report describes clinical and nonclinical activities, motivations and disincentives to a career in pediatric nephrology, future workforce needs, trainee recruitment, and possible explanations for personnel shortages. An e-mail survey was sent in 2013 to all identified US-trained or -practicing pediatric nephrologists. Of 504 respondents, 51% are men, 66% are US graduates, and 73% work in an academic setting. About 20% of trained pediatric nephrologists no longer practice pediatric nephrology. Among the 384 respondents practicing pediatric nephrology full or part-time in the United States, the mean work week was 56.1±14.3 hours, with time divided between patient care (59%), administration (13%), teaching (10%), clinical research (9%), basic research (6%), and other medical activities (3%). Most (>85%) care for dialysis and transplantation patients. The median number of weeks annually on call is 16, and 29% work with one or no partner. One-third of US pediatric nephrologists (n=126) plan to reduce or stop clinical nephrology practice in the next 5 years, and 53% plan to fully or partially retire. Almost half the division chiefs (47%) report inadequate physician staffing. Ongoing efforts to monitor and address pediatric nephrology workforce issues are needed.

Factors affecting the choice of health specialty by medical graduates

A specialty is the transition from the undifferentiated medical graduate phase to the final, fully-differentiated specialist who is almost restricted to one specialized area of medical work. The medical specialty chosen by the medical practitioner is important for both the practitioner and the society. It is an important determinant of the future supply of doctors in different specialties and the planning of the workforce for the health-care services.Many factors influence specialty choices of the medical student and medical practitioner. These range from individual characteristics to the features of the specialty itself, including specialty-related lifestyle.This article explores factors influencing specialty choices of medical students and young practitioners. The article also suggests some general and practical principles that junior doctors should follow in selecting a specialty to suit their personality bearing in mind the health needs of the society.