Prevalencia de infección por COVID-19 por serología positiva (IgG/IgM) en personal médico de la cátedra y servicio de otorrinolaringología del Hospital de Clínicas / Prevalence of COVID-19 infection by positive serology (IgG/IgM) in medical personnel of the chair and service of otorhinolaryngology of the Hospital de Clínicas

Resumen Introducción: El personal de otorrinolaringología presenta una elevada exposición al virus SARS-CoV-2, debido a los procedimientos que lleva a cabo. Es fundamental tomar las medidas de protección adecuadas. Determinar la seroprevalencia nos dará un mejor panorama sobre la exposición, contagios y efectividad de medidas de protección adoptadas. Objetivo: Determinar la prevalencia de resultados serológicos positivos en personal médico que presta servicio en la Cátedra de Otorrinolaringología de marzo del 2020 a marzo de 2021. Material y Método: Estudio observacional, descriptivo, corte transversal, retrospectivo con asociación cruzada. Muestreo no probabilístico de casos consecutivos. La población total fue de 38 médicos del Servicio de Otorrinolaringología del Hospital de Clínicas. Resultados: La media de edades fue 37,4 años, 63,5% refirió haber atendido a paciente conocido portador de COVID-19. Un 42% refirió no haber cumplido con todas las medidas de protección personal, mientras que un 23,7% de los sujetos de estudio dio positivo para IgG, interpretándose como infección previa por COVID-19. Conclusión: Más de las dos terceras partes de los médicos refirió dar consulta a paciente COVID-19 positivo. Casi la cuarta parte de los médicos resultó ser positivo para COVID-19 según la prueba de serología anti-N. No se halló asociación entre consulta ni cirugía a pacientes portadores de COVID-19 y el contagio al personal médico.

Abstract Introduction: Otolaryngology personnel have a high exposure to SARS-CoV-2 virus due to the procedures they perform. It is essential to take appropriate protective measures. Determining seroprevalence will give us a better picture of exposure, contagion and effectiveness of protective measures adopted. Aim: To determine the prevalence of positive serological results in medical staff serving in the otolaryngology department from March 2020 to March 2021. Material and Method: Observational, descriptive, cross-sectional, retrospective, retrospective study with cross-association. Non-probability sampling of consecutive cases. The total population was 38 physicians of the Otolaryngology Service of the Hospital de Clinicas. Results: The mean age was 37.4. 63.5% reported having seen a patient known to be a COVID-19 carrier, while 42% reported not having complied with all personal protection measures. A 23.68% of the study subjects tested positive for IgG, interpreting previous COVID-19 infection. Conclusion: More than two-thirds of the physicians referred to giving consultation to COVID-19 positive patients. Almost a quarter of the physicians were positive for COVID-19 according to the Anti-N serology test. No association was found between consultation or surgery of patients with COVID-19 and infection of medical personnel.

What do otolaryngologists want to learn? An educational targeted needs assessment study / O que os otorrinolaringologistas querem aprender? Um estudo de avaliação das necessidades educacionais específicas

Abstract Introduction: Targeted needs assessment which includes identifying the needs of learners is a key step of program development. However, this step is commonly underestimated in postgraduate medical education programs, including otolaryngology residency training. Determining the needs of otolaryngologists may help educators to design more purposeful continuing medical education training programs. Furthermore, needs of specialists may provide a clearer insight about effectiveness of the residency programs in that specialty. Objective: To determine training needs of otolaryngology specialists and to identify deficiencies in otolaryngology residency training programs. Methods: Seventy-eight otolaryngology specialists, who completed all data gathering forms properly, were included in this descriptive, cross-sectional study. Demographic data of the participants were collected. Training needs of the participants were determined in seven basic areas of otolaryngology via two-round Delphi method. The basic areas were otology-neurotology, rhinology, laryngology, head and neck surgery, pediatric otolaryngology, sleep disorders and facial plastic surgery. Additionally, we asked an open-ended question to investigate the reasons why the participants perceived themselves incompetent and undereducated, or why they needed further training in some of the basic otolaryngology areas. Results: Facial plastic surgery, otology-neurotology and head and neck surgery were the most cited training areas in the needs assessment. Training needs differed according to experience and place of work. Financial expectations, deficiencies in residency training, regression in knowledge and skills, and special interest were effective determinants on decisions of the participants while determining their training needs. Conclusion: Otolaryngologists need further training in some areas of their field due to different reasons. Determining these areas and reasons will help in designing more effective continuous medical education activities and residency training programs in otolaryngology.

Resumo: Introdução: A avaliação de necessidades específicas, que inclui a identificação das necessidades dos alunos, é um passo fundamental no desenvolvimento de programas educacionais. No entanto, essa etapa costuma ser subestimada em programas de pós-graduação em educação médica, inclusive na residência em otorrinolaringologia. Determinar as necessidades dos otorrinolaringologistas pode ajudar os educadores a projetar programas mais direcionados de treinamento em educação médica continuada. Além disso, a análise das necessidades dos especialistas pode oferecer uma visão clara sobre a eficácia dos programas de residência nessa especialidade. Objetivo: Determinar as necessidades de treinamento de especialistas em otorrinolaringologia e identificar deficiências nos programas de residência em otorrinolaringologia. Método: Este estudo descritivo e transversal incluiu 78 especialistas em otorrinolaringologia que preencheram todos os formulários de coleta de dados adequadamente. Os dados demográficos dos participantes foram coletados. As necessidades de treinamento dos participantes foram determinadas em sete áreas básicas da otorrinolaringologia com o método Delphi em duas rodadas. As áreas básicas foram otologia/neurotologia, rinologia, laringologia, cirurgia de cabeça e pescoço, otorrinolaringologia pediátrica, distúrbios do sono e cirurgia plástica facial. Além disso, uma pergunta aberta foi usada para investigar os motivos pelos quais os participantes consideravam ter pouco conhecimento ou ser incapazes de atuar nessa área, ou por que precisavam de mais treinamento em algumas dessas áreas básicas. Resultados: Na avaliação das necessidades, cirurgia plástica facial, otologia-neurotologia e cirurgia de cabeça e pescoço foram as áreas de treinamento mais relatadas. As necessidades de treinamento variaram de acordo com a experiência e o local de trabalho. Expectativas financeiras, deficiências no treinamento durante a residência, regressão do conhecimento e habilidades, além de interesse especial, foram determinantes efetivos nas decisões dos participantes ao identificar suas necessidades de treinamento. Conclusão: Por diferentes motivos, os otorrinolaringologistas precisam de mais treinamento em algumas áreas. A determinação dessas áreas e motivos ajudará a planejar atividades de educação médica continuada e programas de treinamento em residência em otorrinolaringologia mais eficazes.

Permanencia laboral de otorrinolaringólogos en el servicio público luego de egresar de la especialidad y factores asociados a ésta / Permanence of otolaryngologists in public service after graduating from the specialty and factors associated with this

Introducción: En Chile existe un problema en la distribución de médicos otorrinolaringólogos (ORL) entre el sistema público (SP) y privado. Además, recién a partir del presente año existe un sistema formal de vínculo entre algunos especialistas recién egresados y el SP, por lo que hay un déficit de ORL en éste. Objetivo: Describir el grupo de ORL egresados en la última década y evaluar permanencia en SP de salud. Material y método: Estudio de corte transversal. Se analizaron los titulados como ORL en el período 2003-2012. Se evaluó mediante un cuestionario online si trabajaba en el SP, carga horaria, tiempo de permanencia, razones de ingreso y retiro del SP, y ventajas y desventajas de éste. Resultados: Hubo 114 egresados. La cantidad de especialistas formados se ha mantenido en alrededor de 12 por año entre todos los centros del país. Del total, 43 contestaron el cuestionario, de los cuales actualmente trabajan en hospitales del SP el 58,1%. El tipo de contrato en el SP disminuyó con el tiempo en 26,2% de los casos. El promedio de tiempo trabajado en el SP fue 3 años 10 meses. Dentro de las principales ventajas de trabajar en el SP se mencionan la experiencia quirúrgica, complejidad de patologías y trabajo en equipo, y dentro de las desventajas se menciona la baja remuneración, y poca disponibilidad infraestructura, instrumental y pabellones. Discusión: Es importante considerar estos factores al diseñar las políticas de vínculo y retención de ORL en el sector público de salud.

Introduction: In Chile there is a problem in the distribution of ENT surgeons between the public (PHS) and private health system. Furthermore, only since this year there is a formal link between some recent ENT surgeons graduates, so there is a deficit of ENT in PHS. Aim: To describe the group of ENT graduates in the last decade and evaluate their permanence working in the PHS. Material and method: Cross sectional study. There were analyzed the ORL graduates in the period2003-2012. We evaluated by an email questionnaire if working at PHS, workload, time worked, reasons why linking with PHS, and advantages and disadvantages of this. Results: There were 114 graduates. The number of trained specialists has remained at about 12 per year from all teaching centers of the country. Of the total, 43 completed the questionnaire, of whom currently work in PHS hospitals 58.1%. The type of contract in the PHS decreased with time in 26.2% of cases. The average time worked in the PHS was 3 years 10 months. Among the main advantages of working in the PHS, they mentioned gain surgical experience, complexity of pathologies and teamwork, and within the disadvantages mentioned low payment, and poor availability of infrastructure, instrumental and operating rooms. Discussion: It is important to consider these factors when designing policies of linking and retention of ENT surgeons in public health system hospitals.

Cantidad y distribución de otorrinolaringólogos en los sectores público y privado de salud en Chile / Quantity and distribution of otolaryngologists in public and private health sectors in Chile

Introducción: Constantemente se menciona que existe un déficit de otorrinolaringólogos en Chile. Se desconoce la distribución entre el sector público y privado de salud. Objetivo: Determinar la cantidad y distribución de los otorrinolaringólogos que trabajan en el sector público y privado de salud en Chile. Material y método: Estudio de corte transversal para el que se usaron registros del Ministerio de Salud, Sociedad Chilena de Otorrinolaringología, Superintendencia de Salud y del Departamento de Estadísticas e Información en Salud. Resultados: Se aprecia que hay 152 especialistas que trabajan en el sector público, en contraste con los 405 totales del país, correspondiendo a 37,5% de los profesionales que trabajan en el sectorpúblico. Al evaluar el total de otorrinolaringólogos registrados a nivel nacionaly la población total se obtiene una relación de 1 otorrinolaringólogo/42.589 habitantes, mientras que la relación de otorrinolaringólogos que trabajan en sector público con población beneficiaria de FONASA es de 1 otorrinolaringólogo/85.162 habitantes. Discusión: El principal problema en Chile no es la cantidad de otorrinolaringólogos, sino su distribución, la que es muy asimétrica. Esto es considerando sólo el número de otorrinolaringólogos, no su carga horaria, ya que al evaluar esta relación probablemente la asimetría aumentaría aún más. Es necesario fomentar la permanencia de los especialistas en el sector público.

Introduction: Constantly there are mentions that there is a shortage of otolaryngologists in Chile. It is unknown the reality of the distribution between public and private health sector. Aim: The objective of this study was to determine the amount and distribution of otolaryngologists working in the public and private health sector in Chile. Material and method: A cross sectional study that used the records of the Ministry of Health, Chilean Society of Otolaryngology, Superintendent of Health, and Department of Health Statistics and Information. Results: There are 152 specialists working in the public sector, in contrast to the 405 total in the country, corresponding to 37,5(0)% of total professionals working in the public sector. In assessing the relationship between total otolaryngologists in the country with the total population, and otolaryngologists working in the public sector and the beneficiary population of FONASA, there is a relationship of 1 ORL/42.589 and 1 ORL/85.162 inhabitants, respectively. Discussion: The main problem in Chile is not the amount of otolaryngologists, but its distribution, which is very asymmetric between the private and public sector. It is necessary to promote the retention of specialists in the public sector.