4-1. Inclusive Education and Medical School Syndrome / 医学教育

What are the barriers that hinder inclusive education in medical schools? There is an assumption that medical students must inevitably become medical doctors and that they must be completely healthy, without any disabilities. It is true that this assumption has long sustained the medical community in Japan. However, on the flip side, these assumptions have also rendered the medical community insular, and medical students are still subjected to several syndromes that undermine their humanity. In this paper, I will examine these syndromes and discuss the psychological issues and methods to promote inclusive education. Additionally, I will explore the social effects that could result from the implementation of inclusive education within the medical community.

Conocimientos y prácticas de los médicos cubanos respecto a Enterobacterales resistentes a carbapenémicos / Knowledge and practice on carbapenem-resistant Enterobacterales in medical doctors from a tertiary hospital in Cuba

Introducción: En el contexto de la pandemia de COVID-19, la infección por Enterobacterales resistentes a carbapenémicos productores de carbapenemasas (ERC-PC) se convierte en un problema de salud pública desafiante a nivel mundial. Los médicos desempeñan un papel fundamental en el manejo clínico de las infecciones por patógenos resistentes a carbapenémicos a nivel hospitalario y por ende en el control de estas. Sin embargo, no existen estudios sobre el conocimiento y prácticas de estos sobre ERC-PC en Cuba. Objetivo: Abordar conocimientos y prácticas sobre las infecciones por ERC-PC, su manejo terapéutico, prevención y control en médicos cubanos en un hospital terciario. Métodos: Se realizó un estudio observacional (descriptivo, de corte transversal) y se aplicó un cuestionario específico elaborado a 70 médicos asistenciales. Resultados: Hubo variabilidad en las opiniones sobre las ERC-PC y un conocimiento medio sobre estas en la mayoría de los encuestados. El 58,6 % de los médicos tenía experiencia en el manejo clínico de la infección por ERC-PC. Las brechas de conocimiento encontradas estuvieron asociadas a la escasa experiencia práctica en el manejo de casos. Hubo diferencia estadísticamente significativa en el nivel de conocimientos sobre los ERC-PC en los médicos con experiencia en el manejo de los ERC-PC en comparación con los médicos sin experiencia (p = 0,039). Conclusiones: Es necesario establecer un plan de formación continua en la temática para mejorar el desempeño de los profesionales de la salud en el control de las infecciones por ERC-PC y en el uso optimizado de los antibióticos.

Introduction: In the context of COVID-19 pandemic, carbapenemase-producing carbapenem-resistant Enterobacterales (CP-CRE) infection becomes a global public health threat. Medical doctors play a fundamental role in the clinical management and control of infections caused by carbapenem-resistant pathogens. However, in Cuba there are not previous studies on the knowledge and practice of medical doctors about CR-CRE. Objective: To study the knowledge and practice of Cuban medical doctors in a tertiary hospital about CR-CRE infections, their clinical management, prevention and control. Methods: It was conducted an observational study (descriptive, cross-sectional) and an specific questionnaire to 70 medical doctors was applied. Results: There was variability on the opinions about CP-CRE and average knowledge in the majority of the respondents. 58.6% of the medical doctors had some experience in the clinical management of CP-CRE infections. Knowledge gaps were associated with the limited practical experience in the management of cases. There was statistically significant difference in the level of knowledge about CP-CRE of medical doctors with experience in the management of CP-CRE compared to inexperienced medical doctors (p = 0.039). Conclusions: It is necessary to establish a continuous training plan on this topic to improve the performance of health professionals in the control of CP-CRE infections and in the appropriate use of antibiotics.

Exploring the selection mechanism of "3+3 Successive Master-Doctor Program" for academic medical doctor: evidence from Guangzhou Medical University / 中华医学教育探索杂志

This article reviews that Guangzhou Medical University has explored the selection mechanism of "3+3 Successive Master-Doctor Program" for academic postgraduates of medical doctor and improved the quality of doctoral student selection by the following ways: stimulating the enthusiasm of the supervisor team through "competition", improving the quality of doctoral students through "selection", and optimizing the allocation of graduate education resources through "management mechanism reform". Our selection mechanism focuses on improving the quality of graduate education, fully listens to teachers and students, gives full play to the role of scholarships and financial aids, and pays equal attentions to the selection of outstanding applicants and the management of the training process of successive Master-Doctor program, which provides the beneficial reference for medical schools to explore the innovation of talent training models.

Management of Helicobacter pylori among medical doctors working in Khartoum, Sudan 2019: a cross-sectional study

Background: Various international guidelines have been developed regarding Helicobacter pylori (H. pylori) management, as it is infecting more than half of the world's population. Sudan's health system lacks guidelines regarding H. pylori management, leading to a discrepancy in practice. Investigating the current approach could be a step forward in the formulation of a national consensus in the management of H. pylori. Methods: A cross-sectional study was conducted among medical doctors currently working in Khartoum, Sudan. Participants were enrolled from platforms of medical associations through an online questionnaire. The questionnaire was scored out of 25 points, and scoring 13 or above considered a good approach. Data analysis was carried out using Statistical Package for Social Sciences (SPSS). Results: A total of 358 medical doctors participated in the study. The mean (±SD) score was 12.9(±4.5). Those who were using textbooks, campaigns, symposiums or general medical information to their primary Source of knowledge significantly scored higher. The most selected indication for both diagnosis (76.8%) and treatment (67.6%) was an active peptic ulcer. Stool antigen test (SAT) was the most preferred test (70.7%). The majority of respondents selected triple therapy (82.1%) as a first-line regimen. Only 37.7% confirmed the eradication after four weeks of stopping the treatment. They ensure eradication mainly through SAT (29%). Conclusion: A suboptimal approach was noted among medical doctors of Khartoum, Sudan, regarding H. pylori management. Efforts should be invested in forming national guidelines and the implementation of continuous medical education programs.

Knowledge of the national health act among physicians in two tertiary hospitals in Southern Nigeria

Objective: Knowledge of provisions of the National Health Act among physicians and stakeholders is pivotal to its successful implementation. This study aimed to assess the knowledge of the National Health Act (NHA) among Physicians in two tertiary hospitals in Nigeria. Methods: This was a cross-sectional study conducted in two tertiary hospitals in Southern Nigeria. The consecutively recruited eligible respondents were assessed for knowledge of NHA using a 24-item self administered close-ended structured questionnaire. The total obtainable score was 26. Those with <13 points had poor knowledge, 13-21 points had good knowledge and >21 points had excellent knowledge. Data were analyzed using SPSS version 21 software. P-value of < 0.05 was taken as significant. Results: One hundred and ninety-five doctors with a male: female ratio of 1.9:1 participated in the study. The majority (91.8%) were ≤40 years and 129(66.2%) of the participants were ≤ 10 years post qualification. The frequency of correctly answered questions ranged between 7.7% - 89.2%. According to overall knowledge scores; 64.6% had poor knowledge; 35.4% had good knowledge and none had excellent scores. There was no statistically significant association between knowledge of NHA and gender, age, and number of years post qualification (p > 0.05). Conclusion: This study showed that only about a third of the participants had good knowledge of key provisions of the NHA. We strongly recommend that relevant sections of the Act should be incorporated into the medical curriculum both at the undergraduate and postgraduate levels.

Summary of the 2019 Academic Annual Meeting of the Society of Burn Surgery of Chinese Medical Doctor Association / 中华烧伤杂志

The 2019 Academic Annual Meeting of the Society of Burn Surgery of Chinese Medical Doctor Association, sponsored by the Chinese Medical Doctor Association, was successfully held in Jinan, Shandong Province from May 22th to 24th. More than 300 representatives of burn department attended the meeting. With the theme of " Standardization and Innovation" , the conference focused on academician lectures and invited reports, thematic reports, thematic discussions, and discussion of difficult and complex cases in view of the current situation and challenges of burn specialty in China, and closely combined with the actual clinical needs. In order to reserve the reserve force, the Youth Committee of the Society of Burn Surgery of Chinese Medical Doctor Association was established.

Summary of the 2018 Academic Annual Meeting of the Society of Burn Surgery of Chinese Medical Doctor Association / 中华烧伤杂志

The 2018 Academic Annual Meeting of the Society of Burn Surgery of Chinese Medical Doctor Association, sponsored by the Chinese Medical Doctor Association, was successfully held in Guangzhou, Guangdong province from November 16th to 18th, 2018. More than 300 representatives of burn surgery attended the meeting. The content of the meeting included academician lectures, special reports, seminar, difficult and complex case discussions, which were closely related to clinical needs. In response to the development status and challenges of burn specialty and the status and problems of the training of burn specialist in China, special experts were invited to make special reports and discussions. During the meeting, a general election meeting of the Society of Burn Surgery of Chinese Medical Doctor Association was held, the fourth committee was elected, and professor Peng Yizhi was elected as the president.

Qualitative research on the effect of the implementation of electronic medical records based on electronic medical records / 中国实用护理杂志

Objective To explore the reasons for disharmony between medical staff and medical staff because of electronic clinical ordering,to specificate electronic medical order in ward in order to create a harmonious relationship between doctors and nurses. Methods The methods of qualitative research conducted in-depth interviews of 12 medical staff, field recordings and transcripts, and the method of content analysis were used. Results Two themes were sublimated:medical staff reasons:lack of communication between the medical staff;new doctors didn't have a good command of medical norms of specialist electronic orders; on the responsibility of checking the doctor's advice problems may lead to potential adverse events occurrence. System equipment reason: the electronic doctor's advice system set up the problem; the office computer quantity is insufficient. Conclusions Nonstandard electronic medical management leads to the disharmony of health care. It is suggested to standardize the management of electronic medical advice by implementation of the responsibility to avoid medical coupling errors. The health care workers need to strengthen communication, mutual understanding and forgiveness, in order to create a harmonious medical environment.

The construction, of evaluation system for academic medical doctoral dissertation / 中华医学教育探索杂志

Objective To explore and establish a kind of dissertation evaluation system which can fully reflects the characteristics of academic medical doctoral training.Methods 41 medical doctoral dissertation evaluation systems and related literatures were collected,to get the current situation of this dissertation evaluation system in our country and find the key points of various evaluation systems.A questionnaire survey was conducted among 350 doctoral supervisors coming from 6 universities so as to define the framework and connotation of evaluation indicators.Using the Delphi expert consultation method,the connotation of evaluation indicators and composition as well as the weight of various indicators was improved.Results The doctoral supervisors who participated in the research considered that building the dissertation evaluation system should follow the principle of science,innovation and fairness,and the evaluation frame-work should have secondary index and evaluation elements.The evaluation contents concluded choosing topic,literature review,basic theory and professional knowledge,paper writing,innovation,research ability and academic morals and so on.And on the basis of this,the paper explored and developed a more scientific and comparative dissertation quality evaluation system with medical specialty.Conclusion The cultivation units should take the educational goal of evaluation target and the requirements of awarding degree into consideration,seeking opinions fully to the first-line supervisors and combing quantitative and qualitative evaluation effectively with scientific and operable principles when specifying evaluation system.

Culture characteristics and enlightenment of biomedical doctoral students in Einstein Medical College / 中华医学教育探索杂志

The training mode of the medical doctoral students in Albert Einstein College of Medicine is relatively perfect. Its advances are mainly embodied in the following three aspects:detailed and comprehensive training in scientific research capabilities, great emphasis on the process control and the strict assurance system in quality control. The above training mode helps Albert Einstein Col-lege of medicine to set up the good medical doctoral cultivation characteristics with the tolerance, competition, flexibility and freedom. To learn from those good traits, great efforts should be made in our medical doctoral cultivation mode to strengthen the role of tutor team, ensure the students' inter-ests, deepen the academic exchanges and meet the various needs of society.

Report on the American Academy of Medical Acupuncture: 26 th Annual Symposium for Medical Acupuncture / 全日本鍼灸学会雑誌

2014 The American Academy of Medical Acupuncture (26 th Annual Symposium for Medical Acupuncture) was held in Denver, Colorado, USA on April 11-13. The symposium had 11 lectures, 13workshops, 4oral presentations and 6 poster sessions. All presentations were the contents that concerning acupuncture. There were 215 participants in the symposium. The above-mentioned presentations were not only research, but also included clinical practice, basic theory and therapeutic principle of acupuncture. Education of acupuncture for physicians sufficiently was considered in the symposium. Further, 16 companies took part in the exhibition of the symposium.

Becoming Medical Doctors in Colonial Korea: Focusing on the Faculty of Medical Colleges in Early North Korea / 의사학

This paper traces how Koreans of north area became medical doctors in colonial Korea. Most of the past research have focused only on the well-known medical doctors, or even when they discussed a great number of doctors, many research tended to only pay attention to the explicit final results of those doctors. This research, on the other hand, includes ordinary medical doctors as well as the renowed ones, and adjusts the focus to the lifetime period of their growth and activities. As a result, the misunderstanding and obscurity about the Korean medical doctors of north area during this period have been cleared. The new characteristics of the Korean medical doctors of this period have been found, along with their embodiment of historical significance. At the time, Koreans had to get through a number of qualifications in order to become doctors. First is the unique background of origin in which the family held interest in the modern education and was capable of supporting it financially. Second is the long-term status of education that the education from elementary to high school was completed without interruption. Third is the academic qualification that among various institutions of higher education, medical science was chosen as a major. Fourth is the condition of career in which as the career as a doctor had consistently continued. Thus, in oder to become a modern medical doctor, Koreans had to properly complete these multiple steps of process. The group of Korean medical doctors in north area, which was formed after getting through these series of process, possessed a number of characteristics. Firstly, as the upper-middle classes constituted the majority of medical doctors in Korea, the societal status of doctors rose and the foundation for the career as a doctor to be persisted as the family occupation settled. Secondly, the research career and academic degree became the principal method to escape from the discrimination and hierarchy existed between doctors. A PhD degree, especially, was the significant mark for clearly displaying the abilities and outcomes of the doctors. Lastly, the research career, education experience, clinical training and such that the Korean doctors of the period had built up were weak at the time, however, they were important sources for the future medical science development. Indeed, after Liberation, the rapid settlement and growth of Korea's medical science field were largely beholden to thus. Therefore, the growth of the Koreans as doctors did not cease in colonial Korea, but instead continued onto the history of future generations. In spite of the fact that the Korean doctors's growth and activities were greatly limited under the forceful policy of colonial domination of the era, the efforts the Korean doctors had put were not in vain. Likewise, if we do not fix our attention at the dominating policy and system, but rather put together the actors' correspondence and struggles of the period, then the Korean doctors will be a part of the living history. Hereby, the clue to the paradox between the suppression of medical science in colonial Korea and its leap after Liberation can be untied.

Federico Milá de La Roca: un personaje inolvidable / Federico Milá de la Roca: an unforgettable character

En este artículo se presenta una semblanza de la vida y obra del Dr. Federico Milá de la Roca, médico venezolano, quien fue uno de los fundadores del Instituto Nacional de Higiene, resaltando diferentes rasgos de su personalidad y sus destacadas actuaciones en el campo profesional y personal.

This paper presents a brief biography of Federico Milá de la Roca, Venezuelan medical doctor, who was one of the founders of the Instituto Nacional de Higiene, highlighting various features of his personality and outstanding performances related with his personal and profesional life.

Rufus de éfeso (I d.C. ), médico y anatomista greco-romano / Rufus of ephesus (I a.C. ), medical doctor and greco-roman anatomist

Rufus de Éfeso (I d.C.), prominente médico-cirujano y anatomista greco-romano. Experto en anatomia, fisiología, observación clínica, cirugía y en el tratamiento de enfermedades, realizo hallazgos anatómicos y fisiológicos extraordinarios, entre otros permanecen conservados fragmentos de sus obras como: en la nomenclatura de las partes del cuerpo humano, en enfermedades del riñón y la vejiga, así como y en el interrogatorio del paciente.

Rufus of Ephesus (I a.C.), outstanding medical doctor, surgeon and greco-roman anatomist. Expert in anatomy, physiology, clinical observation, surgery and in treatment of the diseases, He realized extraordinary anatomical and physiological findings; among others remain conserved fragments of his works like: In nomenclature of the parts of the human body, In diseases of the kidney and the bladder, and In the interrogation of the patient.

Reform and assessment on English curriculum for medical doctor-postgraduates based on the requirement analysis theory / 中华医学教育探索杂志

Objective To reform and assess the English curriculum for medical doctor-post-graduates based on the requirement analysis theory. Methods All of the medical doctor-postgradu-ates in grade 2012 of the Third Military Medical University were surveyed using questionnaires and face-to-face interviews on randomly chosen students,which collected information on the current Eng-lish skill levels,the requirements and the motivations of English learning,the satisfiable degree of English curriculum,and the outcomes of the curriculum reform. Statistical analysis methods were ap-plied in this study,especiallyχ22 test which was used to test the impact of current English levels on the requirements and motivations of English learning and the analysis results were applied to guide the curriculum reform and assessment. Results The questionnaires were handed out for twice,340 in total. Before and after the course setting,168 and 170 effective ones were got respectively. The first questionnaire showed the requirement of English learning wasn't influenced by the current English skill levels (P=0.329). That was to say 70.2%(118/168)of the surveyed students whether they were in level 4 or 6 all desired to improve English listening and speaking skills;and regard to English lear-ning motivations,publishing SCI papers,studying abroad,personal interest,or passing the course's exams accounted for 53.6%(90/168),24.4%(41/168),15.5%(26/168),6.5%(11/168)respec-tively,but relevant to their English levels (P=0.036). Regardless of their English levels,publishing SCI papers was the chief motivation of English learning. However,passing curriculum examinations as a motivation was more relevant to low-level students. The second survey also showed that 86.5%(147/170)students satisfied the setting of ‘listening and speaking’to ‘reading and writing’(2∶1) and 86 . 3%(145/168 )of students considered necessary to have a SCI dissertation writing course . However,once taking it,30.3%(44/145)out of the 86.3%(145/168)students expressed dissatisfac-tion to the course. In addition,about 48.8%(83/170)of students supported the tiered teaching model. Conclusions The requirement analysis technique is conducive to curriculum setting for medical doc-tor-postgraduates. However,the curriculum system needs to be optimized from the aspects of teaching methods,the tiered teaching model,and the teaching staff team. In particular,the cooperation be-tween English language teachers and medical major teachers should be strengthened in order to ap-proach an adequate and effective curriculum.

Inspiration of the training mode of German medical doctors on medicine graduate education in China / 中华医学科研管理杂志

Compared with the education model of German medical doctors,the education of medical doctors in our country starts late,still need exploration and improvement.Based on the history of the education mode of modern higher medical education in Germany,the educational characteristics of German medical PhD were analyzed and a comparative study on the Chinese and German education mode of medical doctors in terms of training objectives,admission requirements,mentoring system were conducted,which provides reference for the reform of the education mode of medical doctors in our country.

Report on the American Academy of Medical Acupuncture:24th Annual Symposium for Medical Acupuncture / 全日本鍼灸学会雑誌

The American Academy of Medical Acupuncture’s 24th Annual Symposium for Medical Acupuncture was held in Atlanta, Georgia, USA on April 27-29, 2012. The American Academy of Medical Acupuncture (AAMA) is an academic society made up mostly of doctors who are interested in acupuncture. This symposium had 11 lectures, 8workshops, 6oral presentations and 7 poster sessions. The contents of almost all presentations concerned acupuncture. There were 300 participants in the symposium. 20 companies took part in the exhibitions at this symposium, and the Japan Society of Acupuncture and Moxibustion (JSAM) was introduced with a large vertical banner in its exhibition booth, and leaflets from JSAM were distributed. I attended the symposium as a representative of the Department of International Affairs in JSAM.

Current situation and future trend of antimicrobial drugs consumtion / Монголын Анагаах Ухаан

IntroductionAvailability of antimicrobials for customers without prescription is anticipated as one of the factors to accelerate the emergence of drug-resistant pathogens. In countries under economic development, an improvement of socioeconomic status of the population improves consumption of medicines.ObjectiveThe objective of this study was to examine if there are socio-demographic gradients associated with purchasing antimicrobials without prescriptions at retail stores in Ulaanbaatar, Mongolia.Methods and MaterialsA survey was conducted in among medical doctors and the randomly selected 250 pharmacy stores in Ulaanbaatar city and provinces (aimags). Customers who left from the stores were interviewed outside of the pharmacy and the medicines they bought at the stores were examined. The use of prescriptions and advice in purchasing medicines, instructions given at pharmacy stores, were interviewed and the type of medicines and details of antimicrobials purchased were examined by pharmacists.ResultsWe found that, quite common consumption of antimicrobials drugs specially betta-lactamas antibiotics and were sold without prescription. There are several reason to purchase antibiotics without prescription were several brand name of drugs, takes a lot of time.ConclusionThe purchase of antimicrobials without prescriptions was common across socio-demographic strata in Ulaanbaatar. By considering the increase of retail pharmacies and followed sales of antimicrobials according to the economic development, measures to enforce regulations and promote education to general public and professionals are urgently required.

Medical Doctor Lee Hyeon Yang's Writings in Gokcheongsago / 의사학

Medical doctors in the Chosun Dynasty read Chinese literature of high level in order to take the medical civil service examination, but there are not many extant writings of theirs except some medical books. Middle class people's selections of poems such as Haedongyuju, Sodaepungyo, Pungyosokseon and Pungyosamseon were published, and among the list of the writers, those who were identified as medical doctors were Park Gun, Baek Heung jeon, Shin Myeong hee, Shin Hee myeong, Oh Chang ryeol, Yoo Dong yeok, etc. Even their works are not many, and this suggests that doctors' writing was not active except for medical books. Lee Hyeon yang (1783 1852), the author of Gokcheongsago, was born the only son of Lee Jaewoo (1750 1808), an acupuncturist at the Lee family from Ansan, which was an influential middleclass family. His pen name was changed from Gokcheong to Anrakwa, Yongheon and Gyeongsudang, and for each pen name, he wrote a foreword explaining the origin of the name and his resolution. The Lee family from Ansan produced 20 medical officials through eight generations from Lee Yoon yeong in the 7th generation to Lee Myeong ryun in the 15th generation. He learned medicine, his family occupation, diligently and passed the medical civil service examination in 1803 when he was 21. In addition, he studied Confucian scriptures enthusiastically and left many writing along with medical books. Based on the forewords in his anthology Gokcheongsago, there are eight writings of his as follows in chronological order: Suseongpyeongam(1798), Cheongimiyo(1799), Euihakjeongwon(1801), Gwangjebiyo(five volumes, 1810), Wonbyeonggiyo (1819), Bonchojeongeui(1826), Euiyakcheongji(1838), and Yeonghwaji (1843). He wrote not only medical books but also traditional Chinese texts in different styles. In the 180pages transcription, he as a medical doctor showed various writing styles based on Confucianism including 22 prologues and epilogues, 9 diaries, discussions and opinions, 2 biographies, 5 letters, 10 memorial addresses and condolence messages, and 8 miscellaneous writings. His writing attitude was different among the periods when preparing for the medical civil service examination, when acting as a medical doctor, and when working as a magistrate, and it shows medical doctors' life in the 18th and 19th centuries.

Development and Changes of the United States Medical Licensing Examination(USMLE) / 中华医院管理杂志

Purpose of this study is to re-compute and analyze the hospitalization rates of residents in China and explore the methodology of systematic review in health policy research.Methodology:DThanks to a history of 90 years,USMLE has evolved into a mature system of international recognition in the industry.This paper covers the history and changes of USMLE and details its goals construction and implementation,examination question selection model,procedures and principles,selection of criteria and the development trends.