Puntaje final del examen de admisión según el promedio de grado de los postulantes a la convocatoria de la Comisión Nacional de Residencias Médicas Paraguay 2019-2023

Introducción: La Comisión Nacional de Residencias Médicas (CONAREM) es el principal sistema de admisión para la tutoría clínica de residencias médicas en Paraguay, avalado por Ministerio de Salud Pública y Bienestar Social. Objetivos. Determinar la relación entre el puntaje final obtenido y el promedio de grado en postulantes a convocatorias CONAREM 2019-2023. Metodología: Estudio transversal con variables sociodemográficas, académicas, puntajes del examen y puntaje final. Se aplicaron métodos descriptivos y pruebas de Kolmogórov-Smirnov, t de Student, U de Mann-Whitney, Kruskal-Wallis y correlación de Spearman; utilizando software Stata© 17.0 de StataCorp LLC. Se consideraron significativos cuando p<0.05. Resultados: De 2019 a 2023, 4.768 médicos postularon examen CONAREM. 62,12 % eran mujeres, 34,51 % tenían entre 22 y 25 años y 95,30 % estaban solteros. El promedio de grado fue 3,56  0, 49. La mayoría (69,09 %) provenían de universidades privadas. En las especialidades preferidas, clínica médica fue más común (20,31 %), luego cirugía general y pediatría (ambas 14,30 %), 39,14 % pudo acceder a especialidad preferida. El puntaje final promedio fue 67,92 (RIC 60,78 - 76,76) con diferencias significativas según edad, universidad de procedencia y año de examen. Con modelo de regresión logística se demostró que promedio de grado, edad, universidad pública y primera participación en examen estaban asociados con mayor probabilidad de obtener mejores puntajes. El modelo tenía coeficiente de ajuste de 0, 318, indicando que solo predice el 32 % de resultados. La correlación fue moderada y significativa entre puntaje final y promedio general de grado. Según universidad, la correlación fue baja y no significativa para universidades extranjeras, mientras que universidades públicas y privadas mostraron correlación moderada pero significativa. Discusión. Los mejores promedios de grado se correlacionan moderadamente con mayor probabilidad de puntajes altos y acceder a especialidades de preferencia de los médicos recientemente graduados, provenientes de universidades públicas que hayan rendido por primera vez el examen de la CONAREM.

Introduction: The National Commission of Medical Residencies (CONAREM) is the main admission system for clinical tutoring of medical residencies in Paraguay, endorsed by the Ministry of Public Health and Social Welfare. Objectives: Determine the relationship between the final score obtained and the average degree in applicants to CONAREM calls 2019-2023. Methods: Cross-sectional study with sociodemographic and academic variables, exam scores and final score. Descriptive methods and tests of Kolmogorov-Smirnov, Student's t, Mann-Whitney U, Kruskal-Wallis and Spearman's correlation were applied; using Stata© 17.0 software from StataCorp LLC. They were considered significant when p<0.05. Results: From 2019 to 2023, 4,768 doctors applied for the CONAREM exam. 62.12% had a female female, 34.51% from 22 to 25, and 95.30% were single. The grade point average was 3.56(0.49. The majority (69.09%) came from private universities. As for preferred specialties, medical clinic was more common (20.31%), then general surgery and pediatrics (both 14.30%). 39.14% could access preferred specialty. The average final score was 67.92 and significant differences were found according to age, university of origin and year of examination. With logistic regression model, it was shown that average grade, age, public university and first participation in the exam were associated with a higher probability of obtaining better scores. The model had an adjustment coefficient of 0.318, indicating that it only predicts 32% of outcomes. The correlation was moderate and significant between final score and overall grade point average. By type of university, the correlation was low and not significant for foreign universities, while public and private universities showed moderate but significant correlation. Discussion: The best grade point averages correlate moderately with higher probability of high scores and access to specialties of preference and are associated with recently graduated doctors from public universities and took the exam for the first time.

Manejo de la vía aérea ante un caso de paro respiratorio en un escenario clínico simulado. Experiencia en una residencia de pediatría / Airway management during a respiratory arrest in a clinical simulation scenario. Experience at a pediatric residency program

Introducción. La insuficiencia respiratoria es la causa más común de paro cardíaco en pediatría; su reconocimiento y el manejo adecuado son cruciales. La simulación se utiliza para mejorar las habilidades médicas. El objetivo del trabajo fue determinar la proporción de residentes de pediatría que reconocieron un paro respiratorio (PR) pediátrico en un centro de simulación. Métodos. Se realizó un estudio observacional con 77 médicos residentes. Se utilizó un caso simulado de un paciente con dificultad respiratoria que progresa a PR. Resultados. De los 77 participantes, 48 reconocieron el paro respiratorio (62,3 %). El tiempo medio para reconocer el PR fue de 34,43 segundos. Conclusión. El 62,3 % de los participantes logró reconocer el paro respiratorio. Entre aquellos que lo identificaron, el tiempo promedio fue de 34,43 segundos. Se observaron graves deficiencias en algunas de las intervenciones esperadas.

Introduction. Respiratory failure is the most common cause of cardiac arrest in pediatrics. Recognizing and managing it adequately is critical. Simulation is used to improve medical skills. The objective of this study was to establish the proportion of pediatric residents who recognized a respiratory arrest in a child at a simulation center. Methods. This was an observational study in 77 residents. A simulation of a patient with respiratory distress that progressed to respiratory arrest was used. Results. Among the 77 participants, 48 recognized respiratory arrest (62.3%). The mean time to recognize respiratory arrest was 34.43 seconds. Conclusion. Respiratory arrest was recognized by 62.3% of participants. Among those who did so, the average time was 34.43 seconds. Severe failures were noted in some of the expected interventions.

Anesthesia training: Are we doing enough in three years? Cross-sectional study

Introduction: The mínimum number of procedures required to be performed during anesthesia training has not been officially defined in Colombia. Although a number is no guarantee of acquired competencies, it does indicate the level of opportunity offered by the different programs. This study describes the practical training afforded to residents in a graduate anesthesia program in Colombia, and compares its results with international standards. Objective: Describe exposure to procedures performed by residents enrolled in a three-year anesthesia specialization program in Colombia between 2015 and 2020, and compare with the standards proposed by ASCOFAME and ACGME. Methods: Descriptive, cross-sectional study which included residents who did their specialization in a Colombian anesthesia program between 2015 and 2020. Complexity, anesthesia techniques, invasive monitoring and airway approach were described. Finally a descriptive comparison was made with the published references of the Colombian Association of Medical Schools (ASCOFAME) and the Accreditation Council for Graduate Medical Education (ACGME). Results: The results for 10 residents were included. Each resident had a median of 978 cases (IQR 942-1120), corresponding to 25 surgical specialties, the most frequent being general surgery (18%), orthopedics (16%), pediatric surgery (19%), and obstetrics (10.8%). According to the American Society of Anesthesiology (ASA) classification, the majority of patients were ASA II (39.63%) and ASA III (28.4%). Adequate exposure was achieved in 11 of the 15 categories proposed by ACGME and in 6 of the 15 proposed by ASCOFAME. Conclusions: A detailed description of the practice component acquired by the residents during their three years of training was obtained. This baseline provides insight into the national landscape and allows to describe the relationship with international standards.

Introducción: En Colombia no se encuentra oficialmente definido el número mínimo de procedimientos que se deben realizar durante el entrenamiento en anestesiología. Aunque el número no garantiza la adquisición de competencias de la especialidad, sí es un indicador de la oportunidad ofertada por parte de los programas. Este estudio describe el entrenamiento práctico que tienen los médicos residentes en un programa de posgrado de anestesiología en Colombia y compara sus resultados con estándares internacionales. Objetivo: Describir la exposición a procedimientos realizados por los médicos residentes de un programa de especialización en anestesiología de tres años en Colombia, entre 2015 y 2020, y compararlo con los estándares propuestos por ASCOFAME y el ACGME. Métodos: Estudio descriptivo de corte transversal; se incluyeron los residentes que cursaron su programa de especialidad en un programa colombiano de anestesiología entre 2015 y 2020. Se describieron la complejidad, técnicas anestésicas, monitoría invasiva y abordaje de la vía aérea. Finalmente, se compararon los resultados de manera descriptiva con lo referenciado por la Asociación Colombiana de Facultades de Medicina y el Accreditation Council for Graduate Medical Education (ACGME). Resultados: Se incluyeron los resultados de 10 médicos residentes. El número de casos por residente tuvo una mediana de 978 casos (RIQ942-1120), correspondientes a 25 especialidades quirúrgicas; cirugía general (18 %), ortopedia (16 %), cirugía pediátrica (19 %) y obstetricia (10,8 %) fueron las más frecuentes. Según la clasificación de la Sociedad Americana de Anestesiología (ASA), la mayoría de los pacientes tenían ASA 2 (39,63 %), ASA 3 (28,4 %). Se alcanzó una exposición adecuada en 11 de las 15 categorías propuestas por el ACGME y en 6 de las 15 propuestas por la Asociación Colombiana de Facultades de Medicina. Conclusiones: Se obtuvo una descripción detallada del aspecto práctico de los residentes de anestesiología durante sus tres años de formación. Esta línea de base permite ampliar el panorama a escala nacional y describir la relación con estándares internacionales.

Percepción de los médicos residentes de Pediatría sobre el impacto de la pandemia por COVID-19 en su proceso formativo / Pediatric residents' perceptions about the impact of the COVID-19 pandemic on their training

Introducción. Las residencias médicas experimentaron modificaciones que pudieron afectar la formación académica durante la pandemia por COVID-19. Objetivos. Describir la percepción de residentes de Pediatría en relación con el impacto de la pandemia en su formación. Efectuar la adaptación transcultural y validación al idioma español del instrumento "COVID-19 Resident Education and Experience Survey". Materiales y métodos. Estudio observacional, transversal. Participaron residentes de Pediatría de distintos hospitales del país. Se utilizó la encuesta de Ostapenko y col. modificada. Se realizó el análisis descriptivo utilizando SPSS vs. 21. El proyecto fue aprobado por el Comité de Ética institucional. Resultados. Completaron la encuesta 127 residentes. La mayoría dedicaba más de 50 horas a actividades asistenciales antes y durante la pandemia. El 43,3 % (IC95% 35-52) dedicaba hasta 1 hora diaria al estudio individual previo a la pandemia, y un 63 % (IC95% 54,3-70,9) dedicaba ese tiempo durante la pandemia. El 75,6 % (IC95% 67,4-82,2) reportó que el tiempo previo dedicado a actividades académicas era al menos de 4 horas semanales, descendiendo al 41,7 % (IC95% 33,5-50,4) en la pandemia. Más del 60 % (IC95% 54,3-70,1) percibió que la pandemia perjudicó su formación para convertirse en especialista y el 93,7 % (IC95% 88,1-96,8), que su nivel de estrés se incrementó. Conclusiones. La cantidad de horas destinadas a actividades académicas fue percibida como menor durante la pandemia. La mayoría de los encuestados refirió que su nivel de estrés aumentó y que la pandemia perjudicó su formación para convertirse en especialista.

Introduction. Medical residency programs suffered changes that may have affected academic training during the COVID-19 pandemic. Objectives. To describe the perceptions of pediatric residents about the pandemic's impact on their education. To transculturally adapt and validate the COVID-19 Resident Education and Experience Survey into Spanish. Materials and methods. Observational, cross-sectional study. Participants were pediatric residents from hospitals across the country. The survey by Ostapenko et al. was used. A descriptive analysis was done using the SPSS software, version 21. The project was approved by the Institutional Ethics Committee. Results. The survey was completed by 127 residents. Most did more than 50 hours of health care activities before and during the pandemic. Also, 43.3% (95% CI: 35­52) spent at least 1 hour a day studying individually before the pandemic, while 63% (95% CI: 54.3­70.9) did so during the pandemic. In relation to the time spent doing academic work, 75.6% (95% CI: 67.4­82.2) reported that, before the pandemic, they spent at least 4 hours a week doing academic activities, dropping to 41.7% (95% CI: 33.5­50.4) during the pandemic. More than 60% (95% CI: 54.3­70.1) perceived that the pandemic impaired their training to become a specialist and 93.7% (95% CI: 88.1­96.8), that their stress levels increased. Conclusions. The perception was that participants spent less hours doing academic activities during the pandemic. Most surveyed participants mentioned that their stress levels increased and that the pandemic impaired their training to become a specialist.

Effect of the COVID-19 pandemic on cataract surgery by residents who had routine surgical simulator training during residency

ABSTRACT Purpose: To assess the effect of the coronavirus disease 2019 (COVID-19) pandemic on cataract surgery by residents who had mandatory surgical simulator training during residency. Methods: In this retrospective, observational analytical study, the total number of cataract surgeries and surgical complications by all senior residents of 2019 (2019 class; prepandemic) and 2020 (2020 class; affected by the reduced number of elective surgeries due to the COVID-19 pandemic) were collected and compared. All residents had routine mandatory cataract surgery training on a virtual surgical simulator during residency. The total score obtained by these residents on cataract challenges of the surgical simulator was also evaluated. Results: The 2020 and 2019 classes performed 1275 and 2561 cataract surgeries, respectively. This revealed a reduction of 50.2% in the total number of procedures performed by the 2020 class because of the pandemic. The incidence of surgical complications was not statistically different between the two groups (4.2% in the 2019 class and 4.9% in the 2020 class; p=0.314). Both groups also did not differ in their mean scores on the simulator's cataract challenges (p<0.696). Conclusion: Despite the reduction of 50.2% in the total number of cataract surgeries performed by senior residents of 2020 during the COVID-19 pandemic, the incidence of surgical complications did not increase. This suggests that surgical simulator training during residency mitigated the negative effects of the reduced surgical volume during the pandemic.

Modelos de preceptoria de residência em medicina de família e comunidade: um estudo Delphi / Models of preceptorship in family and community medicine residence: a Delphi study

Resumo Introdução: A preceptoria na atenção primária à saúde desempenha papel central na formação do residente, já que 70%-80% da carga horária dos programas de residência de medicina de família e comunidade (PRMFC) acontece na unidade de saúde da família. Como preceptor entende-se o professor que ensina na prática clínica. O cenário atual de expansão dos PRMFC, associado a poucos profissionais especializados em preceptoria, fez com que vários modelos fossem praticados. Uma revisão de literatura feita em estágio anterior a este trabalho, além das contribuições da Sociedade Brasileira de Medicina de Família e Comunidade, identificou quatro modelos de preceptoria em MFC: ombro a ombro, preceptor da equipe ao lado, preceptor de unidade e preceptor de campo. Objetivo: Este estudo teve como objetivos validar esses quatro modelos e identificar outros, determinar, sob a ótica da qualidade de formação dos residentes, a aceitabilidade e o grau de recomendação dos modelos, e reconhecer os pontos positivos e negativos. Método: Utilizou-se a técnica Delphi modificada por questionários on-line. O estudo começou com 24 participantes de todo o Brasil na primeira rodada e terminou com 18. Aplicaram-se a técnica de estatística descritiva e a análise de conteúdo. O estudo foi realizado entre fevereiro e abril de 2022. Resultado: Validaram-se os quatro modelos apresentados, e nenhum outro foi identificado. Os modelos ombro a ombro, preceptor da equipe ao lado e preceptor de unidade foram considerados aceitáveis; e o modelo preceptor de campo, inaceitável. Os modelos ombro a ombro e preceptor de unidade foram recomendados. Reconheceram-se 92 aspectos como pontos positivos e negativos, dos quais 81 atingiram consenso. Conclusão: Obteve-se a validação dos quatro tipos de modelos de preceptoria para PRMFC. Como os modelos ombro a ombro e preceptor de unidade foram elencados como aceitáveis e recomendáveis, é importante que sejam priorizados na implantação e manutenção dos PRMFC. Os modelos preceptor da equipe ao lado e preceptor de campo foram julgados como não recomendados e, portanto, devem ser evitados. O conhecimento das fortalezas e fraquezas de cada modelo prepara os PRMFC para as possíveis dificuldades e os auxilia na escolha do modelo adequado às diversas realidades existentes no país.

Abstract Introduction: Medical residency preceptorship in primary healthcare plays a major role in the professional qualification of medical residents, since 70-80% of the workload of the Family and Community Medical Residency Program (PRMFC) takes place in primary care clinics. A preceptor is understood as an experienced practitioner who teaches during clinical practice. The current scenario of expansion of PRMFCs in Brazil, associated with the limited number of professionals specialized in preceptorship, has resulted in the practice of different preceptorship models. A literature review performed in the previous stage of this study, added to the contributions of the Brazilian Society of Family and Community Medicine, pointed out four models of preceptorship in family practice: shoulder-to-shoulder, next-door team, clinic preceptor and field preceptor. Objective: To validate these four models of preceptorship and identify if there are others models; to determine, from the perspective of the quality of training residents, the acceptability and degree of recommendation of the models and recognize the positive and negative points. Method: The Delphi technique modified by online questionnaires was used. It was initiated with 24 participants from all over Brazil in the first round and ended with 18. Descriptive statistics and content analysis method was applied. The study was conducted between February and April 2022. Result: The four models presented were validated and no others were identified. The shoulder-to-shoulder, nextdoor team preceptor and clinic preceptor models were considered acceptable and the field preceptor model, unacceptable. The shoulder-to-shoulder and clinic preceptor models were recommended. Ninety-two aspects were recognized as positive and negative points. Of these, 81 achieved consensus. Conclusion: The shoulder-to-shoulder preceptor and clinic preceptor models were validated as acceptable and recommended, so it is important to prioritize these models in the implementation and maintenance of PRMFCs. The next-door team preceptor and field preceptor models were deemed as not recommended and, therefore, should be avoided. Information about the strengths and weaknesses of each model prepares the PRMFCs for possible implementation difficulties and helps them to select the appropriate model for the different realities existing in the country.

Uso do Mini-Clinical Evaluation Exercise (Mini-CEX) na residência médica: uma revisão de escopo / Use of Mini-Clinical Evaluation Exercise (Mini-CEX) in medical residency: a scoping review

Resumo Introdução: Com a evolução do ensino médico para currículos baseados em competências, fez-se necessária uma readequação dos currículos e dos métodos de avaliação, com maior enfoque sobre o cenário de prática profissional e, portanto, na utilização de ferramentas como o Mini-Clinical Evaluation Exercise (Mini-CEX). Objetivo: Este estudo teve como objetivo avaliar o uso da estratégia Mini-CEX como método de avaliação nos programas de residência médica. Método: Trata-se de uma revisão de escopo, cuja estratégia de busca realizada no PubMed resultou em 578 artigos. Após aplicar a metodologia do Instituto Joanna Briggs para inclusão e exclusão, foram selecionados 24 estudos transversais. Resultado: Selecionaram-se artigos referentes a estudos realizados entre 1995 e 2021, em diversos continentes, diferentes programas de residência, e cenários ambulatorial, internação e de emergência. O Mini-CEX mostrou-se aplicável no contexto da residência médica, pois trata-se de uma avaliação observacional direta do atendimento realizado pelo médico residente nos diversos cenários de atuação, como ambulatórios, internações e emergências. Trata-se de uma avaliação com tempo de observação variando de dez a 40 minutos e que permite a abordagem de vários aspectos do atendimento médico, como anamnese, exame físico, raciocínio clínico e aconselhamento, além de possibilitar a realização de um feedback sobre o desempenho dos residentes. Conclusão: O Mini-CEX constitui uma ferramenta de fácil aplicabilidade e promove alto grau de satisfação dos envolvidos, podendo ser utilizada de forma rotineira nos programas de residência médica.

Abstract Introduction: With the evolution of medical education towards competency-based curriculum, the need has emerged to reconfigure curriculum and assessment methods, with increased focus on the professional practice setting, thus leading to the utilization of tools such as the mini-CEX (mini-Clinical Evaluation Exam). Objective: To evaluate the use of the mini-CEX strategy as an assessment method in medical residency programs. Method: This is a scoping review, and the search performed on PubMed resulted in 578 articles. After applying the Joanna Briggs Institute methodology for inclusion and exclusion, 24 cross-sectional studies were selected. Results: The selected articles were based on studies conducted between 1995 and 2021, in various continents and in both clinical and surgical residency programs, including outpatient, inpatient, and emergency settings. The Mini-CEX was shown to be applicable in the context of medical residency, as it is an observational assessment of the care provided by the resident physician in various practice settings such as outpatient clinics, inpatient wards, and emergency departments. It involves a variable observation time ranging from 10 to 40 minutes and allows for the evaluation of various aspects of medical care, including history taking, physical examination, clinical reasoning, counseling, and provides an opportunity for providing feedback on the residents' performance. Conclusion: The mini-CEX is a tool that is easy to implement and promotes a high degree of satisfaction among stakeholders. It could be used more routinely in medical residency programs.

Egressos de um programa de residência multiprofissional em cardiopneumologia e inserção no mercado de trabalho / Egresses from a multiprofessional residency program in cardiopneumology and insertion in the labor market / Egresos de un programa de residencia multiprofesional en cardiopneumología e inserción en el mercado de trabajo

A Residência Multiprofissional é uma importante estratégia de Educação Permanente (EPS) no Sistema Único de Saúde (SUS), sendo a primeira oportunidade para muitos recém-graduados de exercer sua profissão e adquirir experiência. O objetivo do presente estudo foi conhecer o perfil de profissionais egressos de um programa de Residência Multiprofissional em Cardiopneumologia no Ceará e sua inserção no mercado de trabalho. No estudo, transversal e quantitativo, coletaram-se dados socioeconômicos, sociodemográficos e sobre histórico no mercado de trabalho, entre junho e outubro de 2022, via formulário eletrônico enviado aos egressos. A grande maioria estava empregada, atuando no SUS como terceirizados, vinculados como celetistas ou cooperados, em áreas de atuação diversas, destacando o potencial de contribuição na saúde, na educação e na gestão pública. Estudos com profissionais egressos de outros programas hospitalares são necessários para melhor elucidar as potencialidades, contribuições e lacunas do processo formativo à inserção dos profissionais no mercado de trabalho.

Multiprofessional Residency is an important strategy for Continuing Education (PDE) in the Unified Health System (SUS), being the first opportunity for many recent graduates to exercise their profession and acquire experience. The aim of this study was to know the profile of professionals graduating from a Multiprofessional Residency in Cardiopneumology program in Ceará and their insertion in the labor market. In this cross-sectional and quantitative study, socioeconomic, sociodemographic and labor market history data were collected between June and October 2022, via an electronic form sent to the graduates. The vast majority were employed, working in the SUS as outsourced, contracted, or cooperative workers, in diverse areas, highlighting the potential to contribute to health, education, and public management. Studies with professionals graduating from other hospital programs are necessary to better elucidate the potentialities, contributions, and gaps of the formative process to the insertion of the professionals in the labor market.

La Residencia Multiprofesional es una importante estrategia de Educación Continuada (PDE) en el Sistema Único de Salud (SUS), siendo la primera oportunidad para muchos recién graduados de ejercer su profesión y adquirir experiencia. El objetivo de este estudio fue conocer el perfil de los profesionales egresados de un programa de Residencia Multiprofesional en Cardoneumología en Ceará y su inserción en el mercado de trabajo. En este estudio transversal y cuantitativo, se recogieron datos socioeconómicos, sociodemográficos y de historia laboral entre junio y octubre de 2022, a través de un formulario electrónico enviado a los graduados. La gran mayoría estaba empleada, trabajando en el SUS como tercerizados, contratados o cooperativistas, en diversas áreas, destacando el potencial de contribución a la salud, educación y gestión pública. Estudios con profesionales egresados de otros programas hospitalarios son necesarios para dilucidar mejor las potencialidades, contribuciones y lagunas del proceso formativo para la inserción de los profesionales en el mercado de trabajo.

Mini entrevistas múltiples para la selección de residentes y fellows en un centro cardiovascular. Experiencia a 5 años / Multiple Mini Interviews for Selection of Residents and Fellows in a Cardiovascular Center. A 5-year Experience

RESUMEN Introducción las mini entrevistas múltiples (MME) son un modelo para evaluar las habilidades no cognitivas en la selección de profesionales ingresantes a instituciones médicas. Objetivo el objetivo de este trabajo fue evaluar la factibilidad, confiabilidad y la aceptabilidad de las MME para la selección de residentes y fellows en un centro cardiovascular en los últimos 5 años. Material y métodos se realizó un estudio observacional, en el cual se incluyeron consecutivamente postulantes a la residencia de Cardiología y a las especialidades de Medicina Nuclear y Ultrasonido en los años 2018, 2019 y 2022. Se desarrollaron diez estaciones para evaluar diferentes dominios no cognitivos. La confiabilidad se evaluó mediante el coeficiente G de generalización. Además, se encuestó a postulantes y entrevistadores para evaluar la aceptabilidad de las MME, y se evaluó la factibilidad en términos de tiempo dedicado al proceso. Resultados un total de 75 postulantes participaron de las MME. A partir del estudio G se obtuvieron coeficientes de confiabilidad de 0,62 y 0,61 acorde al diseño. Fue factible su implementación y el 92% de los postulantes valoró de manera muy positiva a las MME. El 90% de los entrevistadores refirió tener suficiente tiempo para evaluar a los participantes y que el proceso no era excesivamente agotador Conclusiones las MME son un método novedoso en nuestro medio. Demostraron ser confiables y con un elevado nivel de aceptabilidad para la evaluación de habilidades no cognitivas en el proceso de selección de postulantes a residencia de Cardiología y de subespecialidades en un centro cardiovascular.

ABSTRACT Background Multiple mini-interviews (MMIs) serve as a model to evaluate non-cognitive skills in the admission process of health care professionals. Objective The aim of this study was to evaluate the feasibility, reliability and acceptability of the MMI model for the selection of residents and fellows in a cardiovascular center in the past 5 years. Methods We conducted an observational study including applicants to the cardiology residency program and to the fellowship in Nuclear Medicine and Cardiovascular Ultrasound in 2018, 2019 and 2022. Ten stations were developed to evaluate different non-cognitive domains. Reliability was assessed using G-coefficient. Applicants and interviewers were also surveyed to assess the acceptability of the MMI model and its feasibility in terms of the time required for the process. Results A total of 75 applicants participated in the MMIs. The G study showed reliability coefficients of 0.62 and 0.61 according to the design. Implementation was feasible; 92% of applicants gave positive reviews to the MMI model, and 90% of interviewers reported they had sufficient time to assess the participants and that the process was not an excessively exhausting. Conclusion MMIs are a novel method in our setting, demonstrating reliability and a high level of acceptability for evaluating non-cognitive skills in the selection process of applicants to the cardiology residency program and fellowships in a cardiovascular center.

Residencia de Medicina Física y Rehabilitación en el Perú: número de vacantes y análisis de los planes de estudios

Introducción. En el Perú existe un déficit de médicos fisiatras y los estándares para la formación de especialistas en Medicina Física y Rehabilitación (MFyR) no han sido actualizados desde el 2002. No existen estudios que aborden esta problemática. Objetivos. Describir el número de vacantes y analizar los planes de estudios de los programas de residencia de MFyR. Métodos. Estudio observacional descriptivo. Revisamos el número de vacantes para MFyR ofertadas en el período 2017-2022. Asimismo, recolectamos las variables de interés de los planes de estudios de los programas de residencia, incluyendo el abordaje de 30 competencias básicas recomendadas por la Sociedad Internacional de MFyR (ISPRM). Resultados. Durante el periodo 2017-2022, 11 universidades ofertaron 283 vacantes para MFyR, de las cuales 89,4% correspondieron a la ciudad de Lima. El número de vacantes mostró una tendencia a la baja desde el 2018 hasta el 2021. 7 de 11 planes de estudios abordaron por lo menos el 75% de las competencias básicas recomendadas por la ISPRM, y ninguno abordó el 100% de estas competencias. Además, encontramos heterogeneidad respecto a los cursos teóricos, el número de créditos académicos y las rotaciones externas permitidas. Conclusiones. En el Perú, el número de vacantes para MFyR disminuyó durante la pandemia por COVID-19, a pesar de su rol fundamental en la atención de la población afectada por la enfermedad y del déficit de médicos fisiatras. Ningún plan de estudios incluye todas las competencias básicas recomendadas por la ISPRM, lo cual alerta sobre la necesidad de actualizarlos y reestructurarlos.

Introduction. In Peru there is a shortage of physiatrists, and the standards for the training of specialists in Physical Medicine and Rehabilitation (PM&R) have not been updated since 2002. There are no studies that have focused on this problem. Objectives. To describe the number of PM&R positions and analyze the PM&R residency programs' curriculums. Methods. Descriptive observational study. We reviewed the number of PM&R positions offered in the 2017-2022 period. Likewise, we collected the variables of interest from the curriculums that offer this residency program, including the approach of 30 basic competencies recommended by the International Society of PM&R (ISPRM). Results. During the 2017-2022 period, 11 universities offered 283 PM&R positions, of which 89.4% corresponded to the city of Lima. The number of positions showed a downward trend from 2018 to 2021. 7/11 curriculums addressed at least 75% of the basic competencies recommended by the ISPRM, and none of them addressed 100% of these competencies. In addition, we found heterogeneity between universities respect to the theoretical courses taught, the number of academic credits and the external rotations allowed. Conclusions. In Peru, the number of PM&R positions decreased during the COVID-19 pandemic, despite its crucial role in caring for the affected population and the shortage of physiatrists. No curriculum includes all the basic competencies recommended by ISPRM, highlighting the need to update and restructure them.

Autonomía en actividades profesionales confiables luego de la pandemia por COVID-19: perspectivas de residentes y docentes / Autonomy in entrustable professional activities after the COVID-19 pandemic: the perspectives of residents and teachers

Introducción. Las actividades profesionales confiables (APROC) son 13 actividades que los médicos recién graduados deberían poder realizar sin supervisión directa. Nuestro objetivo fue evaluar la percepción de residentes y docentes acerca de la autonomía para realizar las APROC, luego de 2 años del inicio de la pandemia. Materiales y métodos. Estudio de corte transversal, que incluyó residentes de primer año de especialidades clínicas y quirúrgicas, y sus docentes. Se enviaron cuestionarios electrónicos y anónimos. Resultados. Se incluyeron 31 residentes y 20 docentes. La mayoría de los residentes creía que podía realizar en forma autónoma 8 de las 13 APROC. Para la mayoría de los docentes, los residentes requerían supervisión directa para 11 de las 13 actividades. Se observaron diferencias significativas entre la percepción de residentes y docentes en 8 de las 13 APROC. Conclusión. La percepción de autonomía para realizar las APROC al inicio de la residencia fue considerablemente mayor en residentes que en sus docentes.

Introduction. The entrustable professional activities (EPAs) are 13 activities that new medical graduates should be able to perform without direct supervision. Our objective was to assess the perceptions of residents and teachers regarding their autonomy to perform the EPAs 2 years after the onset of the COVID-19 pandemic. Materials and methods. Cross-sectional study of first-year residents of clinical and surgical specialties and their teachers. Electronic, anonymous questionnaires were used. Results. Subjects were 31 residents and 20 teachers. Most residents believed that they were able to perform 8 of the 13 EPAs independently. According to most teachers, residents required direct supervision to perform 11 of the 13 EPAs. Significant differences were observed between residents' and teachers' perceptions in 8 of the 13 EPAs. Conclusion. The perception of autonomy to perform the EPAs in the beginning of the residency program was considerably better among residents than their teachers.

Pensamiento suicida en médicos residentes con la escala de Plutchik en dos instituciones de salud en Ciudad Obregón, Sonora, México

Objetivo: Evaluar la incidencia y factores asociados al pensamiento suicida en una muestra de médicos residentes de dos instituciones. Materiales y métodos: Se realizó un estudio de tipo descriptivo, observacional, prospectivo y transversal, entre los meses de septiembre a octubre del 2022, para estimar el pensamiento suicida en los médicos residentes de dos hospitales con la escala de Plutchik, además de buscar factores asociados. Se aplicó la estadística descriptiva con medidas de tendencia central y de dispersión, frecuencias relativas y absolutas; las pruebas ji al cuadrado de Pearson y de bondad de ajuste, así como la prueba de Kruskal-Wallis se emplearon para examinar las diferencias entre especialidades, y la prueba post-hoc de Tukey para evaluar la especialidad diferente. Resultados: Se respondió un total de 225 encuestas, de las cuales se eliminaron 20 por inadecuado diligenciamiento, y quedaron 205. El promedio de edad fue de 28,66 años (DS ± 2,360) y el 71,2 % correspondió al sexo femenino. En cuanto a las especialidades, se encontró a pediatría con el 28,8 % y a anestesiología con el 20,5 %. Se evidenció asociación significativa entre especialidades, con un valor de p = 0,0000, y grado académico de p = 0,003 (p ≤ 0,05). Según la especialidad, se encontraron diferencias en cuanto al pensamiento suicida; la prueba de Kruskal-Wallis mostró un valor de p = 0,000 y la prueba post-hoc de Tukey reveló que la especialidad de ginecología fue la diferente. Conclusiones: De acuerdo con los resultados de la muestra, alrededor de una cuarta parte de los médicos residentes manifiesta pensamiento suicida. La prevalencia en dicha muestra no presenta diferencia significativa con respecto a la incidencia a nivel latinoamericano. Se encontró una asociación entre ideas suicidas, especialidades médicas y grado académico. En cuanto a comparación entre las especialidades, ginecología fue la que mostró mayor ideación suicida. Este trabajo presenta algunas limitaciones, por ejemplo, existe una gran heterogeneidad de grupos, no se empleó una técnica de selección probabilística y las pruebas estadísticas empleadas fueron no paramétricas.

Objective: To evaluate the incidence and factors associated with suicidal ideation in a sample of resident physicians from two institutions. Materials and methods: A descriptive, observational, prospective and cross-sectional study was carried out to estimate the suicidal ideation and associated factors with the Plutchik Suicide Risk Scale among resident physicians from two hospitals between September and October 2022. Descriptive statistics were used with measures of central tendency and dispersion, as well as relative and absolute frequencies. In addition, Pearson's chi-square goodness of fit test and Kruskal-Wallis H test were used to examine the differences between specialties, and Tukey's Honest Significant Difference test to determine which specialty was different. Results: A total of 225 surveys were answered, out of which 20 were eliminated due to inadequate completion, leaving 205 complete surveys for analysis. The average age was 28.66 years (SD ± 2.360) and 71.2 % were females. Concerning the specialties, pediatrics was found in 28.8 % of the respondents and anesthesiology in 20.5 %. A significant association between specialties with a value of p = 0.0000 and academic degrees with p = 0.003 (p ≤ 0.05) was evidenced. Differences regarding suicidal ideation were found by specialty: Kruskal-Wallis H test showed a value of p = 0.000 and Tukey's Honest Significant Difference test revealed that the specialty of gynecology was the different one. Conclusions: According to the results of the study sample, approximately one fourth of the resident physicians had suicidal ideation. Its prevalence in this sample showed no significant difference with respect to its incidence in Latin America. An association between suicidal ideation, medical specialties and academic degree was found. As for the comparison between specialties, gynecology was the one with the highest suicidal ideation rate. This work had some limitations; for example, the groups were very heterogeneous, a probabilistic selection technique was not used, and the statistical tests were nonparametric.

Residências em saúde: análise de uma política estadual de formação de profissionais para o SUS / Residencies in health: analysis of a state policy for training professionals for the SUS

RESUMO As residências em saúde constituem-se importante estratégia de Estado na regulação da formação de profissionais para o Sistema Único de Saúde (SUS) no âmbito da política de gestão do trabalho e educação na saúde. Foi realizada uma investigação que objetivou analisar como a política de residência em área profissional da saúde tem sido implementada no estado de Pernambuco, Brasil, no período de 2010 a 2021, nos aspectos gestão, características dos programas de residência e recursos investidos. O trabalho é uma pesquisa social, do tipo estudo de caso e abordagem de métodos mistos, com pesquisa documental e dados governamentais, que utilizou como referencial teórico-analítico a Abordagem do Ciclo de Políticas. Foi desenvolvida análise de conteúdo temática com base no que foi coletado, na teoria e na perspectiva dos pesquisadores, identificando as categorias: atores da política e governança; expansão da formação e financiamento; áreas temáticas prioritárias; formação nas residências multiprofissionais em saúde. Foram identificadas experiências de gestão com participação dos diversos atores locais, investimento incremental em bolsas de residência e ampliação das residências multiprofissionais em saúde. Persiste o desafio de implementar uma política de formação em saúde, que, pautada pelo ensino em serviço, atue como força motriz para fazer avançar o SUS.

ABSTRACT Health residencies constitute an important State strategy in regulating the training of professionals for the Unified Health System (SUS) within the scope of work management and health education policy. An investigation was carried out to analyze how the residency policy in the professional health area has been implemented in the state of Pernambuco, Brazil, from 2010 to 2021, in terms of management, characteristics of residency programs, and resources invested. The work is a social research, of the case study type and mixed methods approach, with documental research and government data, which used the Policy Cycle Approach as a theoretical-analytical framework. We developed thematic content analysis based on what was collected, on theory and on the researchers' perspective, identifying the categories: policy actors and governance; expansion of training and funding; priority thematic areas; training in multiprofessional health residencies. We identified management experiences with the participation of different local actors, incremental investment in residency grants, and expansion of multiprofessional residencies in health. The challenge of implementing a health training policy remains, which, based on in-service education, acts as a driving force to advance the SUS.

Burnout syndrome in nursing residents in COVID-19 pandemic / Burnout syndrome in nursing residents in COVID-19 pandemic

Introduction: The incidence of Burnout Syndrome (BS) among nurses is higher. For this group, nursing residents undergo periodic assessments regarding compliance with the care workload in closed sectors, such as Intensive Care and Emergency Care, that put them at higher risk for the syndrome. Objective: Identify the prevalence and related factors for BS in nursing residents. Material and Methods: Quantitative, analytical, cross-sectional study with 106 nurses enrolled in the Residency program in Rio de Janeiro, Brazil, based on the following instruments: Maslach Burnout Inventory-General Survey Scale and an occupational sociodemographic questionnaire. Non-parametric statistical tests for independent samples were applied and Mann-Whitney test 15 was used for quantitative variables. Results: The results show that variable changes in relationships indicates stage 4 of the BS when compared to the other stages. For the other variables, there were no statistically significant differences. Discussion: Studies reveal that work-family balance is closely related to how job satisfaction is affected and mitigates the negative effects of BS. Conclusions: Consequences on relation patterns are among the most affected symptoms in the lives of nursing residents. This study is expected to contribute to raising awareness of the problem in question and to improve the quality of work life of resident nurses, detecting and preventing their illness.

Introducción: La incidencia del síndrome de burnout en profesionales de enfermería es mayor. Los residentes de enfermería se someten a evaluaciones periódicas sobre el cumplimiento de la carga de trabajo asistencial en servicios cerrados, como unidades de cuidados intensivos y urgencias, que les exponen a un mayor riesgo de padecer este síndrome. Objetivo: Identificar la prevalencia y factores relacionados del síndrome de burnout en residentes de enfermería. Materiales y métodos: Estudio cuantitativo, analítico y transversal que incluyó 106 enfermeros residentes matriculados en el programa de residencia en Río de Janeiro, Brasil, y empleó el Inventario de Burnout de Maslach - Encuesta General y un cuestionario sociodemográfico y ocupacional. Se aplicaron pruebas estadísticas no paramétricas para muestras independientes y se utilizó la prueba de Mann-Whitney para las variables cuantitativas. Resultados: Los resultados muestran que la variable "cambios en las relaciones" se encuentra en etapa 4 del síndrome de burnout en comparación con las demás etapas. En cuanto a las demás variables, no hubo diferencias estadísticamente significativas. Discusión: Los estudios revelan que el equilibrio trabajo-familia está estrechamente relacionado con el modo en que se ve afectada la satisfacción laboral y mitiga los efectos negativos del síndrome de burnout. Conclusiones: Las consecuencias en los patrones de relación se encuentran entre los síntomas más afectados en la vida de los residentes de enfermería. Se espera que este estudio contribuya a concientizar sobre el problema en cuestión y a mejorar la calidad de vida laboral de las enfermeras residentes, detectando y previniendo esta enfermedad.

Introdução: A incidência da Síndrome de Burnout (SB) entre os enfermeiros é maior. Para esse grupo, os residentes de enfermagem são submetidos a avaliações periódicas quanto ao cumprimento da carga horária de cuidados em setores fechados, como Terapia Intensiva e Emergência, o que os coloca em maior risco para a síndrome. Objetivo: Identificar a prevalência e os fatores relacionados à SB em residentes de enfermagem. Material e métodos: Estudo quantitativo, analítico, transversal com 106 enfermeiros matriculados no programa de Residência no Rio de Janeiro, Brasil, com base nos seguintes instrumentos: Maslach Burnout Inventory-General Survey Scale e um questionário sociodemográfico ocupacional. Foram aplicados testes estatísticos não paramétricos para amostras independentes e o teste de Mann-Whitney 15 foi usado para variáveis quantitativas. Resultados: Os resultados mostram que as mudanças variáveis nos relacionamentos indicam o estágio 4 do BS quando comparado com os outros estágios. Para as outras variáveis, não houve diferenças estatisticamente significativas. Discussão: Estudos revelam que o equilíbrio entre trabalho e família está intimamente relacionado à forma como a satisfação no trabalho é afetada e atenua os efeitos negativos da SB. Conclusões: As consequências nos padrões de relacionamento estão entre os sintomas mais afetados na vida dos residentes de enfermagem. Espera-se que este estudo contribua para aumentar a conscientização sobre o problema em questão e para melhorar a qualidade de vida profissional dos enfermeiros residentes, detectando e prevenindo suas doenças.

Core Competencies Self-Assessment and Patient-Practitioner Orientation during the First Year of a Brazilian Orthopedic Residency / Autoavaliação de competências fundamentais e orientação médico durante o primeiro ano de residência ortopédica brasileira

Abstract Objective Training a competent physician requires to direct the resident profile of graduate students for practice activities. We sought to identify the doctor-patient relationship orientation and the self-assessment of the core competencies, which they pointed out needed to be developed. Methods All 56 orthopedic residents admitted between 2016 and 2019 participated in the present prospective observational study. The Patient Practitioner Orientation Scale (PPOS) and a self-assessment questionnaire were answered at the beginning and end of the first year of residency (R1) in Orthopedics and Traumatology. We calculated mean and standard deviation for PPOS items and scores and analyzed them through the paired t-test. Self-Assessment Questionnaire answer options were "yes" or "I need to improve it" and skills were classified in decreasing order of the frequency of "I need to improve it" responses with description of absolute number and percentage. We compared frequencies using Fisher Test. P-values < 0.05 were considered statistically significant. GraphPad Prism 8.4.3 (GraphPad Software, San Diego, CA, USA) and Microsoft Excel (Microsoft Corporation, Redmond, WA, USA) were used for statistical analysis. Results In the period between the beginning and the end of R1, the total PPOS mean score significantly decreased from 4.63 to 4.50 (p= 0.024), more biomedical-focused. Around one-third of the residents identified competencies of patient care, practice-based learning and improvement, and interpersonal and communication skills as needed to improve. Conclusions The PPOS and self-assessment activities could promote reflection practices and are possible tools for learner-centered competency assessment. Biomedical guidance tends to prevail as the training of physicians progresses, and periodic self-assessments can be worked on to build a growth mindset.

Resumo Objetivo A formação de um médico competente requer direcionar o perfil de pós-graduação residente para atividades práticas. Buscou-se identificar a orientação de relacionamento médico-paciente e a autoavaliação das competências fundamentais que eles apontaram que precisavam ser desenvolvidas. Métodos Todos os 56 residentes em ortopedia admitidos entre 2016 e 2019 participaram do presente estudo observacional prospectivo. A Escala de Orientação Médico-Paciente (Patient Practitioner Orientation Scale [PPOS, na sigla em inglês]) e um questionário de autoavaliação foram respondidos no início e no final do primeiro ano de residência (R1) em Ortopedia e Traumatologia. Calculamos o desvio médio e padrão para itens e pontuações de PPOS e os analisamos através do teste t emparelhado. As opções de resposta do Questionário de Autoavaliação foram "sim" ou "preciso melhorar" e as habilidades foram classificadas na ordem decrescente da frequência das respostas "preciso melhorar" com descrição de número absoluto e percentual. Comparamos frequências usando o teste de Fisher. Consideramos significativos valores-p < 0,05. Os programas GraphPad Prism 8.4.3 (GraphPad Software, San Diego, CA, EUA) e Microsoft Excel (Microsoft Corporation, Redmond, WA, EUA) foram utilizados para análise estatística. Resultados No período entre o início e o final do R1, a média total de PPOS diminuiu significativamente, de 4,63 para 4,50 (p= 0,024), mais focada em biomédica. Cerca de um terço dos residentes identificou competências do cuidado ao paciente, aprendizagem e melhoria baseadas na prática e habilidades interpessoais e de comunicação, como necessitando melhorar. Conclusões As atividades de PPOS e autoavaliação podem promover práticas de reflexão e são possíveis ferramentas para avaliação de competência centrada no aluno. A orientação biomédica tende a prevalecer à medida que a formação dos médicos progride e as autoavaliações periódicas podem ser trabalhadas para construir uma mentalidade de crescimento.

Desarrollo e implementación de un programa de investigación durante la residencia de ortopedia y traumatología

Introducción: Dentro de las recomendaciones internacionales para la formación de médicos expertos, se encuentra el integrar la mejor evidencia disponible a la práctica clínica y contribuir a la creación del conocimiento científico. El objetivo de este trabajo es describir la implementación de un programa formal de investigación en residentes de ortopedia y traumatología. Metodología: Se desarrolló un programa de investigación para residentes de ortopedia y traumatología, coordinado por un equipo con formación en metodología y bioestadística. El objetivo principal fue que los residentes lograran adquirir herramientas en el desarrollo del método científico e integrar la medicina basada en la evidencia en la práctica profesional. Para ello, se enfocó en tres ejes: 1. formación general 2. análisis crítico de la literatura y 3. desarrollo de investigación científica. Resultados: El año 2015 se implementó el programa. Comenzó con el módulo de formación general a través de seminarios de investigación y una rotación mensual obligatoria. De forma semanal se implementaron reuniones de revisiones críticas de la literatura a partir de casos clínicos y cada dos o tres meses sesiones de journal club. Se han formulado 30 proyectos de investigación, 22 de ellos se han presentado en congresos y ha habido un total de 27 publicaciones con coautoría de residentes (6 de primer autor). Conclusión: A través del programa de investigación, los residentes han adquirido herramientas para poder integrar la medicina basada en la evidencia a su práctica profesional y desarrollar proyectos científicos.

Introduction: In the international recommendations for resident education, there is integrating the best available evidence into clinical practice and contributing to the creation of scientific knowledge. This research aims to describe implementing a formal research program for orthopedic residents. Methodology: We developed a research program for orthopedic residents coordinated by a team trained in methodology and biostatistics. The main objective for residents was to acquire tools to develop the scientific method and to integrate evidence-based medicine into professional practice. To do this, it focused on: 1. theoretical courses, 2. critical analysis of literature, and 3. creation of scientific research. Results: 2015, the program started with a theoretical course through research seminars and a mandatory monthly rotation. Critical analysis of articles meetings were weekly, and journal club sessions every 2 or 3 months. Residents formulated 30 research projects and presented 22 at national and international congresses. There were 27 scientific publications with resident participation (6 were lead authors). Conclusion: Through the research program, residents have acquired tools to integrate evidence-based medicine into their professional practice and develop scientific projects.

Caracterización de estilos de aprendizaje, satisfacción y acceso a residencia médica en participantes de un programa de educación médica continuada bimodal/virtual en Medellín, Colombia, 2017

Introducción: los estilos de aprendizaje son rasgos del estudiante que pueden ayudar a la planificación curricular en educación médica. No se conoce con certeza si algún estilo de aprendizaje específico se relaciona con la satisfacción en educación médica continuada o si aumenta las probabilidades de acceder a una residencia médica. Objetivo: este trabajo buscó categorizar los estilos de aprendizaje en una cohorte de médicos, describir su satisfacción según cada estilo de aprendizaje y el acceso a una residencia médica. Materiales y métodos: estudio de corte transversal en médicos cursando un diplomado de actualización médica. Se categorizaron estilos de aprendizaje y sus combinaciones (activo, reflexivo, teórico y pragmático). Se calculó la diferencia de medias de satisfacción del curso. Posteriormente, se evaluó la asociación entre el estilo de aprendizaje y el acceso a un cupo de residencia médica. Resultados: trescientos once médicos (n=311) aceptaron participar. El 75 % tenían entre uno y dos estilos dominantes, siendo el más frecuente el reflexivo/teórico (n=108; 34,7%). No se encontró una mayor satisfacción global asociada a un estilo en particular. Conclusión: el estilo de aprendizaje dominante es el reflexivo/teórico. La satisfacción global es mayor en la modalidad bimodal. No se encontró asociación con ningún estilo de aprendizaje y el acceso a residencia médica.

Introduction: learning styles are student traits that can aid in curriculum planning in medical education. It is not known for certain if any specific learning style is related to satisfaction in continuing medical education or if it increases the chances of accessing a medical residency. Objective: the learning styles are student traits that can aid in curriculum planning in medical education. This study aimed to categorize learning styles within a cohort of physicians, describe their satisfaction according to each learning style, and assess access to a medical residency program. Methods: a cross-sectional study was conducted with physicians attending a diploma in clinical and surgical areas. Learning styles were categorized according to the CAMEA40 questionnaire. The median differences of course satisfaction was calculated. Subsequently, the association between each learning styles and access to a medical residency post was evaluated. Results: three hundred eleven (n = 311) agreed to participate. A total of 75 % had between one and two dominant learning style, the most frequent being the reflective/theoretical (n = 108; 34,7 %). No greater overall satisfaction associated with a particular learning style was found. Conclusion: one-third of the doctors had a reflective/theoretical profile. The overall satisfaction and access to a medical residency were no associated with any learning style.

Career paths and workforce diversity in hematology: A cross-sectional study of a 35-year alumni cohort from an academic residency program in Brazil

ABSTRACT Introduction: Although not mandatory, medical residency has become a sine qua non condition for practicing in most medical specialties in Brazil. Residency programs are hosted mainly by university accredited academic centers and hospitals in the national public healthcare system, under guidance and accreditation by a national commission. Despite the importance of these programs for the development of the hematology workforce, few studies have addressed their characteristics and impact on society. Methods: We performed a comprehensive cross-sectional survey of a 35-year alumni cohort from a hematology academic residency program in Brazil. Results: In total, 86/98 (87.8%) responded to the survey. The mean age at residency completion was 28.5 years, 60.5% of the alumni were women and sixty-four (74.4%) self-declared their skin color as white. Higher rates of parental education attainment and low rates of trainee financial dependence were observed and these patterns were stable over time. While the proportion of trainees from other states increased steadily, the number of hematologists practicing in other states remained stable. Approximately half of the alumni worked both in the private and public sectors, mainly in malignant hematology and in outpatient clinics. Twenty-five percent of the alumni reported prior leadership and teaching positions, mainly as directors of transfusion services. Conclusion: Our results provide data that can be potentially useful for policymakers and curricular development in the planning of strategies concerning the future workforce of hematologists.

A Study of the Current Scenario of the Obstetrics and Gynecology Residency during the COVID-19 Pandemic / Um estudo do cenário atual da residência em obstetrícia e ginecologia durante a pandemia de COVID-19

Abstract Objective To analyze the impact of the COVID-19 pandemic on the residency of gynecology and obstetrics in São Paulo. Methods Cross-sectional study developed by representatives of residents of the Association of Gynecology and Obstetrics of the State of São Paulo (SOGESP, in the Portuguese acronym). Data were collected from questionnaires applied to gynecology and obstetrics residents registered on the SOGESP website in February 2022. The interviewees answered about the repercussions of the pandemic on medical residency and whether they had technical and psychological support during the period. Results A total of 247 questionnaires were collected from residents of gynecology and obstetrics. The residents had an age of 28.3 ± 3 years old, and most of them were female (88.4%). The displacement to COVID care was reported by 62.34% of the students, but only 35.6% reported completely adequate personal protective equipment and only 7.7% reported complete theoretical and technical instruction to support these patients. Almost all of the interviewees stated that the gynecology sector was the most affected. The majority of the interviewees considered that the second-year residents had the greatest loss, and more than half of the residents in the 1st and 2nd year said they wished to give up their residency during the pandemic. More than 80% of the residents reported online theoretical classes and/or presentation of articles, reinforcing the fact that virtual activities gained a greater space within the medical residency. Conclusion The pandemic impacted the residency in greater proportion in outpatient clinics and gynecological surgeries, also interfering with the physician's desire to continue with the program.

Resumo Objetivo Analisar o impacto pandemia de COVID-19 sobre a residência de ginecologia e obstetrícia do Estado de São Paulo. Métodos Estudo transversal desenvolvido por representantes dos residentes da Associação de Ginecologia e Obstetrícia do Estado de São Paulo (SOGESP). Foram coletados dados de questionários aplicados aos residentes de ginecologia e obstetrícia cadastrados no site da SOGESP em fevereiro de 2022. Os entrevistados responderam sobre repercussões da pandemia sobre a residência médica e se tiveram suporte técnico e psicológico durante o período. Resultados Foram levantados 247 questionários de residentes de ginecologia e obstetrícia. Os residentes apresentaram idade de 28,3 ± 3 anos, sendo a maioria do sexo feminino (88,4%). O deslocamento para "covidários" foi referido por 62,34% dos avaliados, porém somente 35,6% referiram equipamento de proteção individual completamente adequado e apenas 7,7% referiram instrução completa teórica e técnica para o suporte destes pacientes. Quase a totalidade dos entrevistados afirmou que o setor de ginecologia foi o mais afetado. A maioria dos entrevistados considerou que o os residentes do segundo ano foram os que tiveram maior prejuízo, sendo que mais da metade dos residentes do 1° e 2° ano afirmou ter desejado desistir da residência durante a pandemia. Mais de 80% dos residentes referiram aulas teóricas e/ou apresentação de artigos online, reforçando o fato de que as atividades virtuais ganharam um espaço maior dentro da residência médica. Conclusão A pandemia impactou nas residências em maior proporção nos ambulatórios e cirurgias ginecológicas, interferindo também sobre o desejo do médico de seguir com o programa.

Impact of a formal manual small-incision cataract surgery curriculum in an American ophthalmology residency program

Purpose: Global ophthalmology educational activities often include the ability of ophthalmology residents to partake in low?resource clinical care at home and abroad. Low?resource surgical techniques have become a pillar of education during formalized global ophthalmology fellowships. A formal manual small?incision cataract surgery (MSICS) curriculum was started in the University of Colorado’s residency training program to meet the growing demand for this surgical skill and to allow for more sustainable outreach work from our graduates. The survey was conducted to collect evaluations on the value of formal MSICS training within a United States–based residency program. Methods: This was a survey study in a US ophthalmology residency program. A formal MSICS curriculum was created that included didactic lectures on epidemiology of global blindness, MSICS technique, and how MISCS compared to phacoemulsification in terms of cost and sustainability in low?resource settings, followed by a formal wet lab experience. Residents were then exposed to MSICS procedures in the operating room (OR) under supervision of an experienced MSICS surgeon. An anonymous online survey was conducted on three consecutive cohorts of recently graduated senior ophthalmology residents from 2019 to 2021 with the aim of eliciting opinions about and outcomes from the new curriculum. Results: Fifteen graduating senior residents comprised the three cohorts with a 100% survey response rate. All residents agreed or strongly agreed that “MSICS is a valuable skill to have”. Eighty percent of respondents agreed or strongly agreed that “exposure to MSICS has increased my likelihood of doing any type of outreach work in the future” and 86.67% agreed or strongly agreed that “exposure to MSICS increased my understanding about sustainable outreach work”. The average number of cases assisted or performed per resident was 8.2 (SD 2.7, range 4–12). Conclusion: A formal MSICS curriculum for US?based ophthalmology residents was well?received by the trainees. The majority felt it increased their likelihood of pursuing and improved their understanding of sustainable outreach work. The curriculum, which included lectures, wet lab training, and formal teaching in the OR, could add value to a residency program’s curriculum. Furthermore, a formal domestic program can avoid ethical pitfalls that can be seen with resident teaching during international mission work.