Una mirada crítica a los Trabajos de Terminación de la Especialidad en Medicina General Integral

RESUMEN Introducción: El trabajo de terminación de la especialidad representa un poderoso instrumento en el proceso de formación docente- investigativo de los futuros especialistas. Objetivo: Realizar una revisión crítica de los trabajos de terminación de la especialidad de Medicina General Integral. Métodos: Se realizó un estudio observacional descriptivo, de corte transversal, en el Policlínico Docente Ernesto Guevara del municipio de Niquero, provincia Granma. Fueron sometidas a revisión 37 tesis pertenecientes a estudiantes de la especialidad médica durante los años 2019 y 2020. Se emplearon métodos teóricos (histórico-lógico, análisis-síntesis, inductivo-deductivo) y empíricos (revisión documental). Los datos fueron expresados en frecuencias absolutas y porcentajes. Resultados: Constituyeron mayoría los temas relacionados con el Programa Materno-Infantil, el 35,14 %. Existió franco predominio de las investigaciones de intervención educativa en salud, el 62,16 %. Entre las deficiencias en los aspectos metodológicos se señalaron la poca profundidad en la discusión, la comparación con estudios desactualizados y la carencia de posición autoral en el 75,67 % de los informes. Entre los aspectos formales se evidenció un predominio de la vaguedad en la redacción/uso repetitivo de palabras en el 64,86 %. Discusión: Se revisaron los trabajos de terminación de la especialidad de Medicina General Integral del Policlínico Docente "Ernesto Guevara". En ellos se identificaron los temas investigados y los tipos de estudios más frecuentes, así como las principales dificultades en el orden metodológico y formal.

ABSTRACT Introduction: The completion works of the specialty represents a powerful instrument in the teaching-research training process of future specialists. Objective: To carry out a critical review of the completion works in the specialty of Comprehensive General Medicine specialty. Methods: A descriptive, cross-sectional, observational study was conducted at the Ernesto Guevara Teaching Polyclinic in the municipality of Niquero, Granma province. 37 theses belonging to students of the medical specialty were submitted for review during the years 2019 and 2020.Theoretical and empirical methods were used. Data were expressed in absolute frequencies and percentages. Results: Topics related to the Maternal-Child Program constituted the majority, 35.14 %. There was a clear predominance of educational intervention research in health, 62.16 %. Among the deficiencies in the methodological aspects, the little depth in the discussion, the comparison with outdated studies and the lack of authorial position in 75.67 % of the reports were pointed out. Among the formal aspects, there is evidence of a predominance of vagueness in the writing/repetitive use of words in 64.86 %. Discussion: The topics investigated and the most frequent types of studies were identified, as well as the main methodological and formal insufficiencies, among which are difficulties in formulating the scientific problem and the scarcity of the epidemiological context; little depth in the discussion, the comparison with outdated studies and the lack of authorial position, in a total of 28 reports, which represents 75.67%.

Factores psicosociales en residentes de especialidades médicas en Barranquilla. Dimensiones demandas de trabajo / Psychosocial factors in residents of medical specialties in Barranquilla. Work demands dimensions

RESUMEN Objetivo Describir los factores psicosociales en las dimensiones demandas de trabajo en los residentes de especialidades médicas en Barranquilla. Métodos Estudio cualitativo con metodología fenomenológica en residentes de especialidades médicas adscritos a una institución de educación superior en Barranquilla. Mediante entrevistas en profundidad se recogieron las experiencias, vivencias y consideraciones manifestadas en su vida cotidiana y en su salud mental, frente a las situaciones que afrontan a diario en su formación en el contexto laboral en medio de la ejecución de sus responsabilidades operativas. Resultados En el dominio de demandas de trabajo se concentraron las cinco dimensiones más sobresalientes, con 266 testimonios-demandas de autocontrol emocional; seguidos de 237 en la dimensión demandas cuantitativa; 165, en demandas de carga mental; 152, en demandas ambientales y de esfuerzo físico; y 142, en exigencias de responsabilidad del cargo. Conclusiones Es importante revisar las cargas de las demandas de trabajo a lo largo del curso de la residencia de las especialidades medico quirúrgicas para disminuir los riesgos psicosociales en el desempeño de sus funciones.

ABSTRACT Objective To describe the psychosocial factors in the dimensions of work demands in the residents of medical specialties in Barranquilla. Methods A qualitative study with phenomenological methodology in residents of medical specialties assigned to an Institution of Higher Education in Barranquilla. Through the in-depth interviews, the experiences, experiences, and considerations manifested in their daily lives and mental health were collected, in the face of the situations, they face daily in their training in the work context amid the execution of their operational responsibilities. Results The five most outstanding dimensions were concentrated in the domain demands of work, with 266 testimonies demands of emotional self-control, followed by 237 in the dimension quantitative demands, 165 in demands of mental load, 152 in environmental demands and of physical effort, and 142 in demands of responsibility of the position. Conclusions It is important to review the burdens of work demands throughout the course of the residency of the medical-surgical specialties to reduce psychosocial risks in the performance of their functions.

Survey on application status of innovation and entrepreneurship training program in medical undergraduates / 中华医学教育探索杂志

Objective:To investigate the status and influencing factors of application, project approval and scientific research output of innovation and entrepreneurship training program in medical undergraduates.Methods:A self-made questionnaire was used to investigate the application reasons, topic selection sources, project initiation, project type, implementation, progress, scientific research output and conclusion status of full-time medical undergraduates from Batch 2016 to 2020 in West China School of Medicine of Sichuan University. They were divided into two groups according to the situation whether they applied, whether they were approved and whether they had scientific research output. And the differences between the two groups were compared by chi-square test or t- test. Results:A total of 316 valid questionnaires were collected, of which 68.04% (215/316) applied for the innovation projects, 76.28% (164/215) obtained approval and 32.93% (54/164) had research output. The main reason that hindered students from applying for projects was the lack of guidance (70/101, 69.31%), and the main reason that prompted students to apply for projects was to increase the opportunities for postgraduate recommendation (147/215, 68.37%) and evaluation and award (151/215, 70.23%, 70.23%). 62.79% (135/215) of the project topics were inspired by tutor assignment, while independent topic selection was more conducive to project initiation (68/164, 41.46% vs. 12/51, 23.53%, P=0.021). Conclusion:The medical undergraduates have relatively high application and approval rate of innovation training program, but less scientific research output. Strengthening project application and topic selection guidance and process management can further improve the quality of innovation and entrepreneurship education for college students.

Puntajes del Concurso Nacional de Ingreso al Sistema Nacional de Servicio de Salud por universidad. Periodo 2017 ­ 2020 / Scores of the National Entrance Contest to the National Health Service System by university. Period 2017 - 2020

INTRODUCCIÓN: El Concurso Nacional de Ingreso al Sistema Nacional de Servicio de Salud (CONISS) es una de las modalidades más conocidas para acceder a una especialización médica en Chile. Se basa en la evaluación de 5 rubros diferentes y en los últimos años no ha sido capaz de cubrir la demanda de los postulantes haciendo necesario un mejor conocimiento de este. El objetivo del estudio es describir los resultados del concurso CONISS de los últimos 4 años según las universidades de los participantes. Material y método: Estudio observacional, corte transversal, descriptivo. Asociación de puntajes obtenidos por los estudiantes con su respectiva universidad, obteniéndose datos de la página de superintendencia de Salud y utilizándose software Microsoft Excel® para su procesamiento. Resultados: El total de egresados fue de 6.092, provenientes de 22 universidades chilenas. Destaca la Pontificia Universidad Católica de Chile por liderar en el rubro 1 y el puntaje total durante los 4 años y la Universidad Pedro de Valdivia por encontrarse en el último puesto. Los rubros 4 y 5 fueron los que más se completaron. Las universidades con mejor desempeño en el rubro 1 fueron también las que obtuvieron mejor desempeño en el puntaje final. Discusión: El rubro 1 es el que posee mayor importancia en el resultado final del concurso y no se encuentra estandarizado entre universidades quedando sujeto al criterio de cada institución. No completar el resto de los rubros representa una desventaja comparativa pues la mayoría tiene buenos puntajes, pero estos resultados se ven limitados en gran medida por las calificaciones.

INTRODUCTION: The National Entrance Contest to the National Health Service System (CONISS) is one of the best known modalities to access a medical specialization in Chile. It is based on the evaluation of 5 different areas (items) and in recent years it has not been able to meet the demand of the applicants, making it necessary to know more about the subject. The objective of the study is to describe the results of the CONISS by university for the last 4 years. Material and method: Observational, cross-sectional, descriptive study. Association of scores obtained by students with their respective university, obtaining data from the Superintendency of Health page and using Microsoft Excel® software for processing. Results: The total number of graduates was 6,092, from 22 Chilean universities. The Pontificia Universidad Católica de Chile stands out for leading in item 1 and the total score during the 4 years and "Pedro de Valdivia" University for being in the last position. Items 4 and 5 were the most completed. The universities with the best performance in item 1 were also the ones that obtained the best performance in the final score. Discussion: Item 1 is the one that has the greatest importance in the final result of the contest and is not standardized among universities, being subject to the criteria of each institution. Not achieving the other items implies a comparative disadvantage as most participants have good scores, but these results are largely limited by grades.

O PERFIL DO MÉDICO APROVADO NA RESIDÊNCIA MÉDICA DE MINAS GERAIS EM 2019 / Minas Gerais 2019's medical residency: The approved physician's profile

Introdução: Os processos seletivos de residência médica (PSRM) estão progressivamente mais concorridos e carecem de análises do seu perfil de candidatos aprovados. Objetivos: Analisar o desempenho e perfil do aprovado no Processo Seletivo de Residência Médica do Estado de Minas Gerais (PSU-MG) nas quatro especialidades médicas mais comuns no Brasil. Métodos: Analisamos candidatos aprovados ou selecionados nos três hospitais de Belo Horizonte com maior oferta de vagas em Cirurgia Geral (CIR), Clínica Médica (CLM), Ginecologia e Obstetrícia (GOB) e Pediatria (PED). Utilizamos a publicação da primeira chamada do PSU-MG 2019 e a Plataforma Lattes para análise do currículo quanto à especialidade e hospital pretendidos, notas de prova e de currículo, sexo e instituições cursadas. Resultados: Foram analisados 1087 candidatos. Candidatos de escolas médicas públicas apresentaram maiores medianas de notas de prova e de currículo (63,9 e 8,42 versus 60,3 e 7,00 respectivamente; p<0,05), foram mais aprovados no PSU-MG (p < 0,05) e tiveram mais inscrições em CIR e CLM e menos em PED (p<0,05) do que alunos de escolas médicas pagas. Não houve associação significativa entre o sexo e aprovação no concurso, porém, encontrouse associação positiva entre sexo feminino e as especialidades de GOB e PED, e sexo masculino e CIR e CLM. Conclusões: A relação Candidato/vaga e a escola de graduação parecem influenciar o desempenho dos candidatos em PSRM. Estudos adicionais e mais amplos são necessários para elucidação dos fatores que interferem no desempenho nos PSRM.

Introduction: Medical Residency Selection Processes (MRSP) are increasingly competitive and lack of objective analysis concerning approved candidates. Objective: Analyze the profile of physicians approved in the largest MRSP in the state of Minas Gerais - Brazil in 2019 (PSU-MG) in each of the four most common Brazilian specialties. Methods: Our sample consisted of approved or selected candidates for the hospitals in Belo Horizonte which offered more vacancies in the Internal Medicine (INTMED), Gynecology and Obstetrics (OB/ GYN), Pediatrics (PEDS) and General Surgery (GS) specialties in the PSU-MG. We used the PSU-MG approved candidates list and the Lattes curriculum for data regarding specialty, selected hospital, test and curriculum grades, gender, and attended institutions. Results: A total of 1087 candidates were analyzed. Physicians who graduated at public medical colleges had higher test and curriculum scores medians (63.9 and 8.42 versus 60.3 and 7.00 respectively; p<0.05), were more approved at the MRSP (p<0.05) and were more enrolled in GS and INTMED (p<0.05) and less enrolled in PEDS than candidates from private schools. There was no significant association between gender and approval. Female candidates were more enrolled in OB/GYN and PEDS, and male candidates in GS and INTMED. Conclusion: Both the ratio between candidate and vacancy for medical residency and the medical school graduation funding type seem to influence the approved candidate's performance on MRSP. Further studies are needed to better elucidate factors that interfere on the performance in MRSP.

Fatores Associados à Escolha da Especialidade de Medicina de Família e Comunidade / Factors Associated with the Choice of Specializing in Family Medicine

Resumo: Introdução: A Medicina de Família e Comunidade (MFC) é considerada a especialidade mais relacionada com os princípios de longitudinalidade, integralidade e coordenação do cuidado da atenção primária à saúde (APS). A escolha da especialidade de MFC pode ser considerada por aspectos pessoais, profissionais e do currículo médico. O objetivo deste estudo foi analisar o perfil dos médicos residentes e egressos dos programas de residência de MFC de Pernambuco e os fatores associados à escolha da especialidade. Método: Realizou-se um estudo de corte transversal envolvendo 129 médicos ingressantes nas residências de MFC de Pernambuco, de 2012 a 2017. A coleta de dados foi feita com a aplicação de questionário eletrônico do LimeSurvey em escala tipo Likert de cinco pontos, com perguntas sobre fatores que contribuíram para a escolha da especialidade. Fizeram-se análises descritivas das variáveis do estudo no Epi Info 7.0, apresentadas em distribuição de frequência e medidas de tendência central e dispersão. Avaliou-se a consistência interna dos dados pelo alfa de Cronbach. O estudo foi aprovado pelo Comitê de Ética em Pesquisa da Faculdade Pernambucana de Saúde. Resultados: Responderam ao questionário 104 médicos, com média de idade de 31 + 6,1 anos. Do total de participantes, 58,6% eram mulheres, 70% eram egressos de faculdades públicas e 66,3% escolheram a MFC após a conclusão da faculdade. Os aspectos pessoais analisados como influenciadores na escolha da especialidade de MFC foram: compromisso social, aptidão e afinidade com a especialidade, e circunstâncias da vida pessoal. Em relação às características da residência, a duração e a disponibilidade de vagas favoreceram a escolha. A maior parte dos aspectos relacionados com as caraterísticas próprias da especialidade exerceu influência positiva na escolha dos participantes. Os fatores do currículo da graduação que favoreceram a escolha da especialidade foram: influência de preceptores modelos e atividades práticas no contexto da MFC. O coeficiente alfa de Cronbach foi de 0,847. Conclusões: Entre os fatores referidos pelos residentes como influenciadores na escolha da especialidade de MFC, incluem-se os aspectos pessoais e as características do programa de residência e da especialidade. Por sua vez, os aspectos do currículo da graduação, de forma geral, não contribuíram para a essa escolha, entretanto houve concordância de que a vivência em cenário de prática de MFC e o exemplo de preceptores modelos influenciaram na decisão.

Abstract: Introduction: Family Medicine (FM) is considered the specialty which is most closely related to the primary health care (PHC) principles of longitudinality, comprehensiveness and coordination. The choice to specialize in FM can be related to personal, professional and curricular aspects. Objective: To analyze the profile of family medicine residents in Pernambuco and the factors associated with the choice of this specialty. Method: Cross-sectional study, involving 129 physicians entering FM residency in Pernambuco from 2012 to 2017. Data collection was performed by applying an electronic LimeSurvey questionnaire using a five-point Likert scale with questions about factors that may have contributed to their choice of the specialty. Descriptive analyses of the study variables were performed in EpiInfo® 7.0, presented in frequency distribution and measures of central tendency and dispersion. The internal consistency of the data was assessed using Alpha Cronbach. The study was approved by the Research Ethics Committee of the Faculdade Pernambucana de Saúde. Results: 104 physicians answered the questionnaire, with a mean age of 31 + 6.1 years, 58.6% women, 70% were graduates from public universities and 66.3% of the medics decided to specialize in FM after graduating. Personal aspects analysed in relation to influence on the physician's choice to specialize in FM are social commitment, aptitude, affinity with the specialty and personal life circumstances. In terms of the characteristics of medical residency, both the duration and the availability of places in the state's FM programs played a part in the choice. Most aspects related to the choice of following a career in FM were classed as a positive influence on that choice. Factors related to the undergraduate curriculum included model preceptors and practical activities in the family medicine setting. Cronbach's alpha coefficient was 0.847. Conclusion: The factors cited by residents as influencing their choice to specialize in FM include personal aspects, characteristics of the residency program as well as characteristics of the specialty itself. On the other hand, aspects related to the undergraduate curriculum in general did not contribute to this choice. There was, however, agreement that practical experience in a FM setting and the example of model tutors influenced the decision.

Factores asociados a la elección de psiquiatría como especialidad en internos de medicina de dos universidades privadas del Perú / Factors associated with choosing psychiatry among medical interns in two private universities in Peru

Objetivo: Determinar los factores asociados a la elección de psiquiatría como especialidad médica en internos de medicina de dos universidades privadas del Perú. Material y métodos: Estudio transversal realizado en internos de medicina de las universidades Ricardo Palma y San Juan Bautista. Se les administró tres instrumentos: El Inventario de Personalidad - Eysenck para adultos (EPI), la Escala de Valoración del Proceso Enseñanza - Aprendizaje, y el Cuestionario General de Salud Mental de Goldberg (QHG-12), para el estudio de las variables personalidad, percepción del proceso enseñanza - aprendizaje del curso de psiquiatría y psicopatología respectivamente. Se utilizó la prueba estadística X2 cuadrado para determinar la existencia de asociación entre las variables. Resultados: De los 223 internos de medicina estudiados, 35 (15,7%) manifestaron que elegirán psiquiatría como especialidad. La elección de psiquiatría como especialidad se asoció con: personalidad sanguínea (p=0,001); extroversión (p=0,02) y ser emocionalmente estable (p=0,03). Por otro lado, el estudio no evidenció asociación significativa entre las variables sexo, parientes con carreras afines al área de la salud mental y psicopatología con la elección de psiquiatría. Conclusiones: Existe asociación estadísticamente significativa entre el tipo de personalidad y la elección de psiquiatría. Los internos de medicina que les interesa especializarse en psiquiatría, por lo general tienen una personalidad tipo sanguínea, además son extrovertidos y emocionalmente estables.

Objective: To determine the factors associated with choosing psychiatry as a specialty among medical interns in two private universities in Peru. Methods: A cross-sectional study was carried-out among medical interns of Ricardo Palma and San Juan Bautista Universities. Three instruments were applied: personality inventory-Eysenck for adults, scale to evaluate the teaching-learning process and the Goldberg´s general survey of mental health to evaluate personality, perception of the teaching-learning process of the psychiatry and psychology courses. The X2 test was used to determine associations. Results: out of 233 medical interns evaluated, 35 (15.7%) said that would elect psychiatry as a specialty. The election of psychiatry was associated with a blood personality (p=0.001); extroversion (p=0.02) and being emotionally stable (p=0.039). On the other hand, the study did not reveal and association with sex, relatives with specialties closed to mental health and psychopathology. Conclusions: there is an association between type of personality and choosing psychiatry as a) specialty. Medical interns interested in becoming psychiatrist have a blood type of personality, are extroverted and emotionally stable.

Fatores que Influenciam a Escolha da Especialização Médica pelos Estudantes de Medicina em uma Instituição de Ensino de Curitiba (PR) / Factors that Influence the Choice of Medical Specialty by Medical Students of an Educational Institution in Curitiba (PR)

RESUMO A escolha da especialidade médica é de suma importância para o estudante de Medicina, uma vez que representa a escolha da sua prática diária. Embora a realização acadêmica, considerações financeiras e preferências de estilo de vida influenciem a escolha, os aspectos intrapessoais têm impacto na decisão do médico. Objetivos Avaliar os principais fatores que influenciam o acadêmico de Medicina na escolha da especialidade médica e identificar as áreas de atuação preferidas pelos estudantes dos quatro primeiros anos de uma instituição de ensino superior de Curitiba (PR). Resultados Dos 397 estudantes, 307 responderam a um questionário previamente elaborado para este estudo, sendo que 291 foram considerados válidos. Duzentos e quatro estudantes são do sexo feminino e 87 do sexo masculino. Os fatores de influência foram comparados entre os estudantes dos diferentes anos e com resultados publicados na literatura. Os principais fatores considerados pelos estudantes nesta decisão foram: conhecimento mais amplo ou específico, contato com o paciente, local de atuação profissional e estilo de vida após a residência médica. Para as mulheres, a pressão do dia a dia durante o exercício da especialidade, a relação a longo prazo com o paciente e a facilidade de emprego foram significativamente mais relevantes na escolha da especialidade do que para os homens. Pai ou mãe médicos influenciam os estudantes na decisão da escolha da especialidade. O perfil financeiro do estudante influenciou a escolha quando relacionado a retorno financeiro a longo prazo, sendo mais relevante para os estudantes com renda familiar mensal entre 6 mil e 15 mil reais ou maior que 20 mil reais. A especialidade de Cirurgia Geral foi a preferida pelos estudantes, com predominância no sexo masculino, seguida de Pediatria, Clínica Médica e Psiquiatria. Conclusões Estilo de vida, local de atuação e retorno financeiro precoce foram considerados igualmente importantes por estudantes de todos os anos avaliados. Devido à grande quantidade de variáveis avaliadas e de fatores que influenciam esta decisão, estudos adicionais são necessários para comparações mais significativas com a literatura disponível.

ABSTRACT Choosing a medical specialty is extremely important for medical students as it represents the choice of their day-to-day practice. While this choice is influenced by academic achievement, financial considerations and lifestyle preferences, intrapersonal aspects also have an impact on the decision. Objectives To evaluate the main factors that influence medical students in their choice of medical specialty, and to identify the areas of practice preferred by students in the first four years of a Higher Education Institution. Results Out of a total of 397 students, 307 answered a questionnaire previously prepared for this study, and of these, 291 were considered valid. 204 female, and 87 male. Influencing factors were compared among students from different years, and with results published in the literature. The main factors considered by the students in this decision were: broader or specific knowledge, contact with the patient, place of professional activity, and lifestyle after medical residency. For the women, the factors day-to-day stress of the specialty, the long-term relationship with the patient, and the ease of finding a job were significantly more relevant in the choice of specialty than for the men. Parents who were doctors also influenced the choice of specialty. The student's financial profile influenced the choice when related to long-term financial returns, being more relevant for students with monthly family incomes at the higher or lower ends of spectrum, i.e., - between 6 and 15 thousand Brazilian reals, or more than 20 thousand Brazilian reals. The specialty General Surgery was the first choice , predominantly among the male students, followed by Pediatrics, Clinical Medicine and Psychiatry. Conclusions Lifestyle, place of professional activity and early financial returns were considered equally important by students across all the years evaluated. Due to the large number of variables evaluated, and the many factors that influence this decision, additional studies are needed, in order to make more significant comparisons with the literature.

Specialty Training System and Postgraduate Education in Japan / 医学教育

Medical education towards a specialty is a core stage of training for medical doctors. The specialty training system in Japan was initially organized by various academic societies and was recently integrated under Japan Medical Specialty Board, which was established in 2014. From April 2018, a revised specialty training system will begin and be based on new program guidelines. Its main concepts are professional autonomy, quality assurance of the medical specialty board and trustworthy medical consultation. As with undergraduate education, global standards are recently required in postgraduate education. Consistent outcome policy throughout undergraduate and postgraduate education and workplace-based assessment can hopefully be established.

Stop Discussing New Medical Specialty Boards

The Korean society is rapidly aging and the health care needs for aged people are increasing. In this context, some physicians claim to establish new medical specialty board (MSB) for geriatric medical experts but also MSB for primary medical care specialists, clinical pharmacologists, and public health experts. In Korea, basic concept for the specialty board system is still under debates and the legal support for the system is poor. At present, doctors with MSBs in private sectors supply 92.4% of primary medical care but the National Health Care System requires more primary care physicians than specialists in Korea. Therefore, the government must invest in the education of doctors more to improve the public health care system. The proposal of the new MSB for geriatric medicine must be gradually developed according to the national long-term health plan, social needs, and national budget for the public benefit. Please stop discussing unprepared new MSBs.

Specialty Training System and Postgraduate Education in Japan / 医学教育

Medical education towards a specialty is a core stage of training for medical doctors. The specialty training system in Japan was initially organized by various academic societies and was recently integrated under Japan Medical Specialty Board, which was established in 2014. From April 2018, a revised specialty training system will begin and be based on new program guidelines. Its main concepts are professional autonomy, quality assurance of the medical specialty board and trustworthy medical consultation. As with undergraduate education, global standards are recently required in postgraduate education. Consistent outcome policy throughout undergraduate and postgraduate education and workplace-based assessment can hopefully be established.

The practice of combining humanistic education with professional education in the practice of gynecology and obstetrics / 中华医学教育探索杂志

Humanistic education is of great significance to medical personnel training.Based on the current situation of humanistic education in medical institutions,this article analyzes the necessity and feasibility of combining humanistic education with professional education,and lists the points where they can be precisely combined.Typical cases in gynecology and obstetrics are taken as examples to elucidate how to achieve such kind of combination by guiding students to love life and increasing their ability of frustration resistance The reflection of this precise integration is also involved in this article.

Review of Medical Training System in Japan / 医学教育

"The Ordinance of Ministry of Health, Labor and Welfare on Japanese Postgraduate Medical Training System" from 2020 was announced to each prefectural governor on July 3rd, 2018. This Medical Training system has been reviewed once every five years, and has been strongly aware of the consistency between the model core curriculum of the undergraduate medical education and the continuing professional development of Japan Medical Association. In this journal, Postgraduate Education Committee in Japan Society for Medical Education has published six installments of a series entitled "Japanese Medical Training System and Medical Education" . We reviewed the series and discussed medical education trends surrounding the postgraduate medical training system and issues in the committee. We will be reporting the information as part of the seventh installment of the series.

Non-medical students first aid awareness and training needs survey of Shiyan city / 重庆医学

Objective In order to know first aid awareness and training needs of non-medical college students in Shiyan city,and to provide the basis for an efficient first-aid training.Methods A total of 1063 non-medical colleges in Shiyan city were surveyed by random sampling method.Results 64.61％ of students awared of their own lack of knowledge of first aid,only 3.8 ％ feel rich;based on the first aid knowledge they obtained at present,46.92 ％ did not hesitate to rescue the stranger.After receiving systematic training,the rate rise to 78.9 ％,68.09 ％ of students worried about their lack of first aid skills were the biggest obstacle for them to implement of rescue;98.3％ of the students asked to undergo first aid training,92.27％ of students like approach first aid skills was hands-on model.33.03％ of students believe that medical schools were the best institutions to undertake emergency training,23.46％ of students chose the hospital.Conclusion Non-medical college students in Shiyan city have a bad awareness for firstaid knowledge and a strong desire for training.It is necessary that relevant departments will formulate targeted training programs to improve college students' first-aid response and improve regional emergency level.

Assessment of specialization preference among undergraduate medical students and its influencing factors

Background: Understanding the future career interests of medical graduates is important, as they are the future workforce of the healthcare profession. Aim: The aim of this study was to determine the career choices and the factors that influence undergraduate medical students to choose a particular medical specialty. Materials and methods: A cross sectional observational study was conducted among ‘300’ undergraduate medical students of Sardar Patel Medical College, Bikaner, Rajasthan between January to March 2014. A self-administered questionnaire was used to collect data and the association between different variables was tested using Chi-square test. Results: Out of total ‘300’ respondents, 84% (n=252) considered post-graduation very important for future career and majority of them (99%) wanted to pursue the same in clinical subject. The most preferred specialty expressed by male students was Medicine, followed by Surgery and Orthopedic, while the female students were more interested in Radiology, Paediatrics and Obstetrics and Gynecology. Little interest was shown in other specialities. Personal interest was found to be the most common factor that influenced the choice of specialization. Conclusion: A variety of factors appeared to inspire medical graduates to opt for a particular specialty. All the substantial factors that influence the medical graduates’ decision should be equally justified and addressed, so that the quantitative and qualitative inequality of specialists can be nullified.

Medical Specialist Training: Views from Stakeholders

In Malaysia, medical specialisation training is mainly carried out by the public universities. Methods: A survey was carried out to explore the views of medical specialists in the country on issues such as structure of medical specialty training, availability of human resource, public/private sector competition, competency and apprenticeship, and its impact on assurance and quality of medical specialty training. Results: Altogether 238 medical specialists from 30 hospitals and medical institutions in the country participated in the survey. Conclusion: Among the findings, competition for human resource between public and private sector and lack of uniformity on medical specialty training across universities in the country are among the issues found to be of concern. There is also a need to address governance issue which necessitates to clearly delineating what constitutes medical specialty and what constitutes a subspecialty so that an agreed uniformed nomenclature is exercised across all stakeholders. The respondents also strongly agreed on the need to ensure competence in medical specialist training.

Outcome-based medical specialty training: Can it bridge the gap between theory and clinical practice? / 医学教育

　The Japanese Medical Specialty Board has been established with the collaboration of medical and medical care organizations. It ensures the quality of medical specialists and achieves accountability to the people by certifying medical specialists and authorizing training programs. Outcome-based education is characterized by an emphasis on the quality assurance of trained physicians. Therefore, the new medical specialty training system could be constructed through outcome-based education. I give a brief overview of the new medical specialty training system, and it is discussed in the context of the guideline for medical specialty training system published recently.

Médicos residentes en México: tradición o humillación / Resident physicians in Mexico: tradition or humiliation

México tiene una gran historia y tradición en la formación de médicos residentes. Pero ¿qué encontramos detrás de este proceso? Relaciones de poder implícitas y explícitas, inadvertidas o ignoradas por conveniencia por parte de las instituciones universitarias y de salud, con el agravante de olvidar su compromiso en la formación de mujeres y hombres profesionales. Los residentes son reducidos a un indicador más de recursos humanos para la salud. El médico residente en formación académico-científica está sumergido en esta vorágine deshumanizada y termina por convertirse en un individuo para el cual el dominio del conocimiento es un instrumento de poder. En este proceso olvida que su actuar y su razón de ser radican en el principio de primun non nocere y de servir. El artículo describe la realidad actual de los residentes en México y propone algunas medidas para mejorar las condiciones en las cuales se desempeñan.

Mexico has a great history and tradition in relation to the training of resident physicians, but what we find behind this process?, Power relations implied and not implied, unnoticed or ignored for convenience by the academic and health institutions, with the aggravation of forgetting its commitment to the training of men and women "professionals" and limited to meet another indicator of "human resources for health." The resident physician in academic and scientific training is immersed in this dehumanized maelstrom and ends up becoming a character for the domain of knowledge as power, forgetting that his act and its rationale lies in the principle of "primum non nocere" to that we would add: nor your person, nor your fellowman, much less whom you have the moral, ethical and civic responsibility to convey some of your knowledge and your experience, that is, part of your essence”.

Investigation and Analysis on Demand and Attitude of the Medical Engineering College Students' Mental Health Education Curriculum / 浙江中医药大学学报

[Objective]For more pertinently opening medical students mental health education course.[Methods]Through the issuance of 500 copies of ques-tionnaires, the current medical kind of col ege students' psychological health education curriculum requirements and attitude is researched. [Result] The medical specialty of college students ' psychological health status, with a certain degree of self adjustment ability, as wel as improvements to the curriculum and teaching methods are expected. [Conclusion]Recommended that through played curriculum, scientific curriculum, to strengthen the course construc-tion of improvements in areas such as mental health course.

Effects of Temperament and Character on the Specialty Interests of Medical Students

OBJECTIVES: In the previous studies, it has been suggested that temperament and character may affect specialty choice in medical students. The aim of this study is to investigate the effects of temperament and character on specialty interests in medical students. METHODS: A total 132 third-year medical students initially participated in this study. Among these participants, 128 students had filled out both demographic and Temperament and Character Inventory (TCI) questionnaires. Socio-demographic data, specialty interests and Cloninger's TCI scores were obtained. The specialty interests were categorized into surgical, medical and other departments. RESULTS: Among 128 students, 88 (68.7%), 29 (22.7%) and 22 (8.6%) students chose medical, surgical and other departments, respectively. Students choosing surgery departments showed lower Harm Avoidance scores (F = 4.39, df = 1, p = 0.04) and higher Self-Directedness scores (F = 4.30, df = 1, p = 0.04) than those who chose medical departments. There was no significant differences in Novelty Seeking, Reward dependence, Persistence, Cooperativeness, Self-Transcendence scores between groups. CONCLUSIONS: To the best of our knowledge, this is the first study that has demonstrated the relationship between TCI scores and specialty interests of medical students in Korea. The current study suggests that temperament and character influence specialty interests in medical students. These findings could have implications for medical education research and career counseling.