Malaysian private general practitioners’ views and experiences on continuous professional development: A qualitative study

Introduction: Continuous professional development (CPD) is an important aspect of a medical practitioner’s career. Aiming to be at par with other developed countries for high quality of professional practice, Malaysia is planning to implement compulsory CPD for the doctors. Aim: The aim of the study was to explore the private general practitioners’ (GPs) views, experiences and needs regarding CPD programme in the primary care service. Methods: This study used a qualitative methodology. Seven semi-structured interviews and three focus group discussions were conducted with private general practitioners from an urban area of Malaysia between January and December 2012. An interview topic guide was developed based on literature review and researchers’ discussions and it was used to guide the interviews. All the interviews were audio-recorded, transcribed verbatim and the transcripts formed the data for analysis using the thematic approach. Results: GPs undertook a wide range of CPD programmes to keep up with medical advances, meet patients’ expectations and improve financial rewards. Conferences, lectures and online recourses were the most mentioned methods of keeping updated. Some of the GPs felt that peer motivation and networking seem to motivate and facilitate participation in CPD programmes. However, they were wary of the validity and relevance of some CPD programmes, particularly those related to pharmaceutical industry. Although the participants agreed to the new mandatory CPD regulation, they voiced concerns on how it would be implemented and wished for a more effective method of monitoring. Conclusions: Organised peer support and relevant CPD content may improve GP participation in CPD but adequate regulatory measure should be in place to monitor the CPD activities.

Retinopathy of prematurity; a study of frequency and risk factors

Retinopathy of prematurity [ROP] is a serious complication of prematurity treatment and extension of survival in premature infants and can lead to blindness unless recognized and treated early. The aim of this prospective study was to estimate the incidence of ROP in our country and to identify the risk factors which predispose to ROP in the Neonatal Intensive Care Unit [NICU] graduates. An ROP prospective screening survey was performed enrolling all premature admitted to the NICU from 1st September 2007 to 31st August 2008, with a gestational age [GA]of 32 weeks or less at birth and those of birth weight [BW] of 1500gm or less. Infants whom GA was>32 week or BW was>1500 gm were included if they were exposed to high oxygen [FiO2>21%].A total of 175 infants had retinal evaluation by indirect ophthalmoscopy at 4 weeks of gestation and followed up periodically. All clinical and epidemiological data were statistically analyzed. ROP was diagnosed in 34 [19.4%] infants; one of whom was diagnosed as threshold ROP and underwent Laser Ablative therapy. Out of the 175 neonate, 86 [49.1%] were males and 89 [50.9%] were females. The mean gestational age was 33.01 +/- 1.73 weeks; 25 were less than 32 weeks and 150 were>32 weeks. The birth weight ranged from 0.67 to 2 kg with a mean of 1.5 +/- 0.24 Kg. Using univariate comparison between the risk factors in neonates who developed ROP and those who didn't we found a statistically significant correlation between the occurrence of ROP and gestational age, supplemental oxygen therapy and frequency of packed RBC transfusions. However insignificant correlation was found with sepsis, respiratory distress syndrome [RDS], intraventricular hemorrhage [IVH], patent ductus arteriosus [PDA] and the use of phototherapy. The incidence of ROP in our study was 19.4%.Short gestation, supplemental oxygen administration and frequency of packed RBC transfusions were significant risk factors for ROP. Laser was effective in regressing ROP