Medical interns' training in family medicine at a district hospital and primary health care clinics in Middelburg, Mpumalanga

Training of medical interns at the Middelburg district hospital has been introduced as part of the mandatory 6 months' rotation in Family Medicine department since 2021. This report provides an overview of what has been attained in 2021 and 2022. It covers various aspects of the activities medical interns have been exposed to in the Middelburg hospital and the surrounding primary health care clinics.Contribution: Sharing experiences of family medicine training for medical interns in district hospitals is essential because the 6 months' rotation is new for most family physician trainers, especially those in small hospitals and primary health care clinics. Taking into account the paucity of evidence on the topic, the report brings current information that supports that training medical interns in district hospitals and primary health care clinics prepares them to be comfortable and competent clinicians for the generalist work during the community service year ahead.

The exceptional potential in extending primary care exposure for South African medical interns

No abstract available.

South African medical interns' perspectives on the use of point of care ultrasound

BACKGROUND

 Point of care ultrasound (POCUS) has become such a part of patient care that it is included in undergraduate medical training in many high-income countries. In South Africa, despite the availability of ultrasound units, there is no information on the exposure or training required for medical interns to perform POCUS in their community service year. This study examines interns' self-reported POCUS training and competency, as well as their perceived readiness for their community service year.

METHODS

 In this cross-sectional web-based survey, 43 interns were invited to complete a self-administered questionnaire after completing their 6-month decentralised family medicine rotation in 2022.

RESULTS

 Thirty complete responses (69% response rate) were included for analysis. Eleven graduates from three medical schools reported undergraduate exposure to POCUS. Ten participants completed formal postgraduate ultrasound training. Eight participants felt confident to independently perform POCUS. Thirteen participants felt adequately prepared for their community service year, 10 of whom had received POCUS training. Nearly all the participants (29 of 30) felt that ultrasound training should be incorporated into both undergraduate and internship training.

CONCLUSION

 Medical interns expressed a need for more POCUS training. Most of the studied sample did not feel adequately prepared to perform POCUS independently. The high uptake of additional ultrasound courses highlights the need to include POCUS training. More research is needed to determine the extent and level at which POCUS training should be offered to medical interns in the South African setting.Contribution: This study looks at the perceived need of South African medical interns for formal POCUS training. It highlights a potential gap in training based on the expected clinical requirements of the community service year.

Using machine learning with intensive longitudinal data to predict depression and suicidal ideation among medical interns over time

BACKGROUND

Use of intensive longitudinal methods (e.g. ecological momentary assessment, passive sensing) and machine learning (ML) models to predict risk for depression and suicide has increased in recent years. However, these studies often vary considerably in length, ML methods used, and sources of data. The present study examined predictive accuracy for depression and suicidal ideation (SI) as a function of time, comparing different combinations of ML methods and data sources.

METHODS

Participants were 2459 first-year training physicians (55.1% female; 52.5% White) who were provided with Fitbit wearable devices and assessed daily for mood. Linear [elastic net regression (ENR)] and non-linear (random forest) ML algorithms were used to predict depression and SI at the first-quarter follow-up assessment, using two sets of variables (daily mood features only, daily mood features + passive-sensing features). To assess accuracy over time, models were estimated iteratively for each of the first 92 days of internship, using data available up to that point in time.

RESULTS

ENRs using only the daily mood features generally had the best accuracy for predicting mental health outcomes, and predictive accuracy within 1 standard error of the full 92 day models was attained by weeks 7-8. Depression at 92 days could be predicted accurately (area under the curve >0.70) after only 14 days of data collection.

CONCLUSIONS

Simpler ML methods may outperform more complex methods until passive-sensing features become better specified. For intensive longitudinal studies, there may be limited predictive value in collecting data for more than 2 months.

Preferences, Career Aspects, and Factors Influencing the Choice of Specialty by Medical Students and Interns in Saudi Arabia: A Cross-Sectional Study

Background and objective Choosing a medical specialty is one of the most critical career decisions medical students and interns make. However, little is known about the factors these graduates consider when choosing their specialty. Our study assessed factors that medical students and interns consider when determining their specialty. Methods This is a cross-sectional survey-based study, conducted from November to December 2022. We utilized a previously published questionnaire for 1074 participants, including 837 medical students and 237 interns from Saudi Arabian universities. Results The majority of female participants (80.4%), compared with only 19.6% of male participants, considered interest in specific procedures and techniques typical of the specialty an important factor in choosing a specialty (p = 0.036). Dissertation research experience was an important factor for 83.5% of female participants and 16.5% of male participants (p = 0.024). Additionally, good quality teaching within the study program framework was important for 81.2% of female participants and 18.8% of male participants (p = 0.033), suggesting that male and female participants viewed the importance of good quality teaching differently. Female participants accounted for 80% of those who considered the overseas experience a factor in their specialty choice. Also, 74.4% of female and 25.6% of male participants considered friends, relatives, or other connections in the healthcare field a factor that affects their choice. Furthermore, 79.6% of female and 20.4% of male participants reported having good experiences with physician role models as an impactful factor in their specialty choice. Conclusion Female participants were most interested in obstetrics and gynecology (12.1%,), internal medicine (11.8%), and family medicine (10.8%). Male participants, on the other hand, showed more interest in family medicine (12.7%,), internal medicine (11.0%), and emergency medicine (10.1%). Medical schools and healthcare institutions must provide students and interns with enough information and resources to help them explore different specialties and make well-informed decisions about their careers.

Peak-end bias in retrospective recall of depressive symptoms on the PHQ-9

Mental health care is built around patient recall and report of clinical symptoms. However, memories of events and experiences rely on cognitive heuristics that influence our recall. The peak-end bias, which refers to the tendency for the most intense and proximate aspects of an experience to disproportionately influence our memory, has been understudied in the context of mental health symptoms and may unduly influence self-reported symptoms, even in the context of standardized assessments. To determine whether the peak-end bias applies to the report of depressive symptoms on the standardized Patient Health Questionnaire-9 (PHQ-9) assessment, we compared two scores from daily mood assessments collected over a 2-week period from 4,322 medical interns (56% women; 60% non-Hispanic White). The peak-end-mood score, which averaged the single lowest and most recent mood scores over 2 weeks had a significantly stronger correlation with the PHQ-9 than the mean-mood score, which averaged all mood scores during the 2 weeks. Likelihood ratio tests and fit statistics provided further support that the peak-end-mood score was a significantly better predictor of depression than the mean-mood score. Results were consistent when limiting the sample to those with mild-to-severe depressive symptoms, and when only examining the two primary mood items as the dependent variable. These findings provide evidence for a modest peak-end recall bias for mood and depressive symptoms. There may be benefits to implementing intermittent assessment strategies to support clinical decision-making. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Assessment of training of general practice interns in motivational interviews about vaccination

The effectiveness of motivational interviewing (MI) for reducing vaccine hesitancy (VH) has been demonstrated in Quebec. We conducted a study to evaluate the acquisition of MI skills after MI training via videoconferencing for interns training as general practitioners (GPs) in southeastern France. A vaccination-specific MI training workshop was offered to interns in 2021, consisting of two separate Zoom videoconference sessions. Participants completed the Motivational Interviewing Skills in Immunization questionnaire before and after the training to measure skills acquisition. We used pairwise exact Wilcoxon-Pratt signed rank tests for the analysis. Among 45 GP interns enrolled in the first MI session, 34 (75.6%) attended both sessions and completed the questionnaire at 3 different time points. After the first session, MI knowledge scores improved significantly (+21.1 ± 21.6; P < .0001), as did application of MI skills (+36.8 ± 36.7; P < .0001), and MI practice confidence (+21.2 ± 11.1; P < .0001). The second MI session maintained the skills developed after the first session without further improvement. Participant satisfaction was high. This is the first study in France assessing the impact of a vaccination-specific MI training for GP interns. It shows a substantial improvement in knowledge, application of MI skills, and self-confidence in the practice of MI. GP interns were highly satisfied with the training despite the videoconference format. These promising results will allow the integration of MI training in GP medical curricula in order to prepare future GPs for communication in the field of vaccination.

Medical interns' views on the strategies for reducing antibiotic misuse in the hospitals-what guidelines do they follow?

Objectives

Although the topic of antibiotic misuse is taught in medical schools, interns (fresh medical graduates) still encounter barriers to appropriate antibiotic prescription when they practice in hospitals under supervision. The impact of teaching in medical school, antibiotics stewardship program (ASP), and prescription guidelines was uncertain. This study explored the medical interns' views on antibiotic use and resistance, and their perceived enablers to appropriate antibiotic prescription.

Methods

Two focus groups were conducted among medical interns with rotation experiences in different public hospitals of Hong Kong. The identified themes about attitudes to antibiotic resistance and enablers to appropriate antibiotic prescription were further examined by a questionnaire survey with 77 respondents.

Results

The interns had lower preferences for tackling antibiotic resistance as they feared of delayed prescriptions. Guidelines provided by international evidence-based clinical resources and the interns' working hospitals were stronger enablers to appropriate antibiotic use than education materials from schools and the government. Qualitative findings revealed that the interns were aware of the existing ASP but doubted its effectiveness as it failed to get the prescribers' attention. They followed guidelines in their wards but perceived guidelines from local health authorities user-unfriendly. Knowledge from medical school was not very applicable. Varying prescribing practices between hospitals and the densely placed hospital beds made it difficult to prevent the spread of antimicrobial resistance.

Conclusions

Minimizing delayed prescription is of a higher priority than tackling antibiotic resistance in medical interns' perspective. Interventions should target guidelines in hospitals and simplify the interface of local guidelines.

The Impact of the COVID-19 Pandemic on Medical Interns' Education, Training, and Mental Health: A Cross-Sectional Study

Background and objectives

The novel coronavirus disease 2019 (COVID-19) pandemic has challenged healthcare systems worldwide. Various studies have revealed the negative impact of the pandemic on the education and mental health of medical students and residents. In this study, we aimed to explore the effects of the COVID-19 pandemic on medical interns’ educational experience, clinical practice, and mental health. We also engage in a discussion on the compensatory methods that have been adopted to improve medical interns’ learning processes during the ongoing pandemic.

Methods

This cross-sectional survey-based study was conducted at the King Saud University Medical City (KSUMC) in Riyadh, Kingdom of Saudi Arabia (KSA) from March to October 2020. The participants consisted of medical interns. The survey collected information on participants’ demographics, training, and the educational and psychological impact of the pandemic.

Results

The survey was distributed to 480 medical interns, of whom 345 (71.8%) participated. Most of our sample (75.6%) believed that the COVID-19 pandemic has negatively impacted their cumulative experience. Regarding the pandemic’s impact on training and education, it was found that the emergency department rotation was the most affected rotation (60.3%). The majority of the participants (55.9%) believed that all tracks have received equal education and the volume of patients seen by interns decreased by 91.9%. As for the compensatory methods, 73.3% reported the utilization of remote platforms. Regarding the pandemic’s mental health impact, 36% believed that it has affected their mental health, where increased stress levels were noticed in 47.8% of participants. Statistical significance was found in both Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) scores, which indicated that during the pandemic, 20.6% of the participants suffered from depression, and 13.9% had moderate to severe anxiety.

Conclusions

This study highlights the negative educational and psychological impact of COVID-19 on medical interns. With emerging infectious diseases on the rise, recognizing the impact of COVID-19 on medical interns is vital to improving interns’ educational experiences and mental health during future crises.

The knowledge and perceptions regarding antibiotic stewardship of the interns rotating at the Bloemfontein Academic Complex

BACKGROUND

Antibiotic resistance (ABR) is a global problem with the overuse of antibiotics accelerating this process. Antibiotic stewardship aims to optimise antibiotic treatment to enable cost-effective therapy and improve patients' outcome whilst limiting ABR. The study aimed to evaluate intern medical doctors' knowledge and perceptions about antibiotic stewardship and their perceptions regarding education on relevant topics.

METHODS

This was a cross-sectional study on interns rotating at Bloemfontein Academic Complex. An anonymous, self-administered questionnaire was completed. The questionnaire recorded demographic information, perception and knowledge of antibiotic stewardship, and the quality of education as perceived by the interns.

RESULTS

Of the 120 possible participants, 92 (76.7%) responded to all or part of the questionnaire. The median age of the respondents was 25 years, and 56.7% of the respondents were female. The mean score for the knowledge-based case scenarios was 5.4 out of 10. Only 4.4% participants could manage a drip site infection correctly, whilst 18.5% could treat Escherichia coli (E. coli) bacteraemia. The interns perceived that they have a lack of training and preparedness in certain areas of prescribing antibiotics. Though 77.2% of the interns had received education on starting antibiotic treatment, 29.3% claimed to be unsure when to start antibiotic therapy. Interns indicated that formal lectures (81.3%) and bedside tutorials (86.7%) have a high educational value.

CONCLUSION

Intern medical doctors do not have sufficient knowledge to establish antibiotic stewardship but have a desire for improvement. The results identified specific areas where better antibiotic training is required.

Internship orientation: An essential facilitatory bridging step for medical students

Background

Internship is a facilitatory period that hones skills and helps in the evolution of a qualified medical student to a competent doctor. The feeling of a final year student joining as a fresh intern after successfully completing the final professional examination will be directionless without a bridging initiative through a buffer program. Fresh interns need to be oriented to the fundamentals of working effectively with a patient as a whole and not as a separate discipline. This study was done to evaluate the effectiveness of the internship orientation program and to assess the feedback of participants about this program.

Methodology

This was a study conducted on 235 freshly joined medical interns. The process included evaluation of a well-structured seven-day orientation program by prevalidated structured Multiple Choice Questions (MCQs) and feedback.

Results

All interns performed satisfactorily in the post-test with a mean score of 74.13 ± 7.18. Post-test scores were highest for procedure skills and communication skills, including medical ethics. Overall, 232 (99%) of interns responded that the program was useful and it successfully enhanced their clinical skills; 221 (94%) of interns expressed that the content of the program was excellent to good; and 228 (97%) of interns felt that the method used for training was appropriate. Interns also documented that there were a few new skills that were acquired by attending this program.

Conclusion

There is an unmet need for an internship orientation program across all medical colleges to lay a strong foundation for naive interns. Based on the results, we recommend an internship orientation program for a smooth and swift transition from that of a medical student to professional life. It will orient the interns and lay the foundation for the next level of assignment in building their professional career.

Are the medical interns ready to deal with the treatment, prevention and control of Nipah virus infection at the tertiary care hospital?

Context:

Nipah virus infection is an emerging life threatening zoonotic disease. Health care workers are at the highest risk of getting the infection.

Objectives:

To assess the level of knowledge and attitude regarding Nipah virus infection among medical interns of a tertiary care hospital, Mangaluru and also to assess the readiness of medical interns dealing with cases of Nipah virus infection.

Setting and Design:

A cross-sectional study was conducted among 94 medical interns of a teaching hospital in Mangaluru.

Methods and Material:

Questionnaire comprising of 33 questions was used to assess the knowledge, attitude and practice behaviors of the medical interns.

Statistical Analysis Used:

Descriptive statistics as mean and standard deviation and Pearson correlation coefficient.

Results:

The mean knowledge, attitude and practice scores were 10.28 (± 2.31), 8 (± 2.9) and 15.85 (± 3.7). Three (3.2%) of the medical interns correctly knew the best modality of diagnosis of Nipah. All the interns correctly answered the samples to be collected for diagnosis and 72 (76.6%) correctly answered the lab where samples have to be sent. Majority i.e. 64 (68.1%) of the medical interns correctly enumerated the preventive measures to be employed. Eighty four (89.4%) of them were aware about the availability of vaccine. The correlation between the adequate facilities available with practice domain and training provided with practice domain were found to be statistically significant.

Conclusion:

In this study, the knowledge, attitude and practice regarding Nipah virus infection were found to be inadequate. There is an urgent need to address these gaps.

The Awareness of Patients' Bill of Rights among Medical Interns and Medical Students at Tabuk University

BACKGROUND

Incorporating patient priorities and preferences into their healthcare can improve desirable proximal outcomes related to communication such as the patient feeling heard, understood, respected and engaged in their care, which can soften the negative effects of the illness and can help clinicians in decision-making.

AIM

To determine the level of awareness and knowledge of Patients' Bill of Rights and factors affecting it among undergraduate students and medical interns.

METHODS

This is a cross-sectional study carried out in Tabuk city among all medical interns doing their clinical rotations at Tabuk city (n = 70) as well as the 4th, 5th and 6th-year medical students, Tabuk University (n = 219). An English self-administered valid and reliable questionnaire, based on patients` Bill of Rights (PBR) document published by the Ministry of Health (MOH), Kingdom of Saudi Arabia (KSA) was utilised for data collection.

RESULTS

The study included 205 medical students and interns out of invited 289, giving a response rate of 70.9%. All were Saudis. Almost two-thirds (69.3%) reported hearing about patients` bill of rights. Among those who have heard about these rights, 40.2% gained their information from lectures whereas 16.2% gained the information from hospital posters. The total knowledge score about Patients` Bill of Rights ranged between 0 and 32 (out of a possible maximum of 34) with a mean ± SD of 24.6 ± 4.6 and median (IQR) of 25 (23-27). There was a significant positive correlation between student`s age and total score of knowledge of patients` bill of rights, Spearman`s correlation coefficient (r) = 0.18, p = 0.014. The mean rank of the total knowledge score was 83.98 among 4th-grade medical students and reached to 125.07 among medical interns, p = 0.003.

CONCLUSION

Overall awareness and Knowledge of the senior medical students and interns in the College of Medicine, Tabuk University regarding patients` rights age acceptable. However, some deficient issue needs to be improved.

Sleep and Alertness in Medical Interns and Residents: An Observational Study on the Role of Extended Shifts

Study Objectives

Fatigue from sleep loss is a risk to physician and patient safety, but objective data on physician sleep and alertness on different duty hour schedules is scarce. This study objectively quantified differences in sleep duration and alertness between medical interns working extended overnight shifts and residents not or rarely working extended overnight shifts.

Methods

Sleep-wake activity of 137 interns and 87 PGY-2/3 residents on 2-week Internal Medicine and Oncology rotations was assessed with wrist-actigraphy. Alertness was assessed daily with a brief Psychomotor Vigilance Test (PVT) and the Karolinska Sleepiness Scale.

Results

Interns averaged 6.93 hours (95% confidence interval [CI] 6.84-7.03 hours) sleep per 24 hours across shifts, significantly less than residents not working overnight shifts (7.18 hours, 95% CI 7.06-7.30 hours, p = .007). Interns obtained on average 2.19 hours (95% CI 2.02-2.36 hours) sleep during on-call nights (17.5% obtained no sleep). Alertness was significantly lower on mornings after on-call nights compared to regular shifts (p < .001). Naps between 9 am and 6 pm on the first day post-call were frequent (90.8%) and averaged 2.84 hours (95% CI 2.69-3.00 hours), but interns still slept 1.66 hours less per 24 hours (95% CI 1.56-1.76 hours) compared to regular shift days (p < .001). Sleep inertia significantly affected alertness in the 60 minutes after waking on-call.

Conclusions

Extended overnight shifts increase the likelihood of chronic sleep restriction in interns. Reduced levels of alertness after on-call nights need to be mitigated. A systematic comparison of sleep, alertness, and safety outcomes under current and past duty hour rules is encouraged.

Interns reflect: the effect of formative assessment with feedback during pre-internship

BACKGROUND

It is widely known that the opportunity for medical students to be observed and to receive feedback on their procedural skills performance is variable in the senior years. To address this problem, we provided our Pre-Intern (PrInt) students with "one-to-one" formative feedback on their ability to perform urethral catheterization (U/C) and hypothesized that their future practice of U/C as interns would benefit. This study sought to evaluate the performance and practice of interns in U/C 4-5 months after having received feedback on their performance of U/C as PrInt students.

METHODS

Between 2013 and 2014, two cohorts of interns, (total n=66) who had received recent formative feedback on their U/C performance as PrInt students at Central Clinical School, were invited to complete an anonymous survey. The survey contained nine closed unvalidated questions and one open-ended question, designed to allow interns to report on their current practice of U/C.

RESULTS

Forty-one out of 66 interns (62%) completed the survey. Thirty-five out of 41 respondents (85%) reported that the assessment with feedback during their PrInt term was beneficial to their practice. Thirty of 41 (73%) reported being confident to perform U/C independently. Eleven out of 41 respondents (27%) reported that they had received additional training at intern orientation. Nine of the 11 interns (82%) reported that they had a small, but a significant, increase in confidence to perform U/C when compared with the 30 of the 41 respondents (73%) who had not (p=0.03).

CONCLUSION

Our results substantiate our hypothesis that further education by assessment with feedback in U/C during PrInt was of benefit to interns' performance. Additional educational reinforcement in U/C during intern orientation further improved intern confidence. Our results indicate that extra pre- and post-graduation procedural skills training, with feedback, should be universal.

Coping, perceived stress, and job satisfaction among medical interns: The mediating effect of mindfulness

BACKGROUND

Past research studies on the exploration of attributes to the stress of doctors/medical interns were reported more often than the types of coping strategies, healthy practices to strengthen their internal resources to deal effectively with the stressful situations.

OBJECTIVES

The present study was conducted to find such internal resource - "mindfulness" as a mediator of coping, perceived stress, and job satisfaction among medical interns.

METHODS

A cross-sectional descriptive study comprised 120 medical interns forms from various medical colleges in Mangalore were recruited and completed the assessment on mindfulness, cognitive-emotive regulation, coping strategies, perceived stress, and job satisfaction from doctoral interns were collected.

RESULTS

Initial correlation analysis results indicate that adaptive coping strategies significantly associate with greater mindfulness and less perceived stress. In turn, mindfulness is negatively correlated with nonadaptive coping strategies and perceived. Job satisfaction showed no significant relationship with any of the other variables. Mediational models indicate that the relationship between adaptive coping strategies and perceived stress was significantly mediated by mindfulness. Furthermore, partial mediation between nonadaptive strategies and perceived stress through mindfulness indicates that respondents reported a high level of nonadaptive strategy experience and a lower level of mindfulness can be counterproductive as they encourage the ineffective way to deal with the stresses.

CONCLUSION

The implication of the results were discussed with suggesting a possible intervention to improve the adaptive strategies and mindfulness among the medical interns.

Job stress, satisfaction, and coping strategies among medical interns in a South Indian tertiary hospital

BACKGROUND

It has previously been demonstrated that there is a significant drop in all domains of quality of life among interns during internship.

AIMS

A modified version of the health consultant's job stress and satisfaction questionnaire (HCJSSQ) was used to assess and quantify aspects of internship that were perceived as stressful and satisfying. Methods used to cope with work place stress were explored.

SETTINGS AND DESIGN

A prospective cohort study was undertaken among 93 medical interns doing a rotating internship at the Christian Medical College and Hospital, a tertiary-care hospital in southern India.

MATERIALS AND METHODS

After completion of 6 months of internship, the modified version of the HCJSSQ was administered to all participants.

STATISTICAL ANALYSIS

The data were entered into Statistical Package for the Social Sciences (SPSS) Version 9 by double data entry technique. Percentages of interns reporting high levels of stress, satisfaction were calculated.

RESULTS

While 63.4% of interns reported high levels of satisfaction, 45.2% of the interns experienced high levels of stress, 17.6% coped with work stress by using alcohol and nicotine, and 37% coped through unhealthy eating habits.

CONCLUSION

More people found internship satisfying than stressful. However, a high proportion found it stressful, and many reported unhealthy coping mechanisms.

Systematic review of new medics' clinical task experience by country

Objectives

There is a need for research which informs on the overall size and significance of clinical skills deficits among new medics, globally. There is also the need for a meta-review of the similarities and differences between countries in the clinical skills deficits of new medics.

Design

A systematic review of published literature produced 68 articles from Google/Google Scholar, of which nine met the inclusion criteria (quantitative clinical skills data about new medical doctors).

Participants

One thousand three hundred twenty-nine new medical doctors (e.g. foundation year-1s, interns, postgraduate year-1 doctors).

Setting

Ten countries/regions.

Main outcome measures

One hundred twenty-three data points and representation of a broad range of clinical procedures.

Results

The average rate of inexperience with a wide range of clinical procedures was 35.92% (lower confidence interval [CI] 30.84, upper CI 40.99). The preliminary meta-analysis showed that the overall deficit in experience is significantly different from 0 in all countries. Focusing on a smaller selection of clinical skills such as catheterisation, IV cannulation, nasogastric tubing and venepuncture, the average rate of inexperience was 26.75% (lower CI 18.55, upper CI 35.54) and also significant. England presented the lowest average deficit (9.15%), followed by New Zealand (18.33%), then South Africa (19.53%), Egypt, Kuwait, Gulf Cooperation Council countries and Ireland (21.07%), after which was Nigeria (37.99%), then USA (38.5%) and Iran (44.75%).

Conclusion

A meta-analysis is needed to include data not yet in the public domain from more countries. These results provide some support for the UK General Medical Council’s clear, detailed curriculum, which has been heralded by other countries as good practice.

Protecting health from climate change: preparedness of medical interns

CONTEXT

Climate change is a significant and emerging threat to public health and to meet the challenge, health systems require qualified staff.

AIMS

To study the preparedness of medical interns to meet the challenge of protecting health from climate change.

SETTINGS AND DESIGN

Medical colleges in a coastal town. Cross-sectional study.

MATERIALS AND METHODS

A proportionate number of medical interns from five medical colleges were included in the study. Level of awareness was used as a criterion to judge the preparedness. A self-administered, pretested, open-ended questionnaire was used. Responses were evaluated and graded.

STATISTICAL ANALYSIS USED

Proportions, percentage, Chi-test.

RESULTS

About 90% of the medical interns were aware of the climate change and human activities that were playing a major role. Ninety-four percent were aware of the direct health impacts due to higher temperature and depletion in ozone concentration, and about 78% of the respondents were aware about the change in frequency / distribution of vector-borne diseases, water borne / related diseases, malnutrition, and health impact of population displacement. Knowledge regarding health protection was limited to mitigation of climate change and training / education. Options like adaptation, establishing / strengthening climate and disease surveillance systems, and health action in emergency were known to only nine (7%), eight (6%), and 17 (13%), respectively. Collegewise difference was statistically insignificant. Extra / co-curricular activities were the major source of knowledge.

CONCLUSIONS

Majority of medical interns were aware of the causes and health impacts of climate change, but their knowledge regarding health protection measures was limited.