Analysis of perception of training in graduates of the Faculty of Medicine at Universidad de Castilla-Mancha.

INTRODUCTION: Problem-based learning has been a key component of the teaching method employed at the Faculty of Medicine at the University of Castilla La Mancha (UCLM) in Albacete, Spain since its creation. The aim of this study was to evaluate perceptions of training among residents who graduated from the first three years of the UCLM Degree in Medicine. METHODS: Using the Jefferson Medical College postgraduate rating form, residents rated their performance in four areas of clinical competency (medical knowledge, data gathering skills, clinical judgment, and professional attitudes) at the beginning of residency training in comparison with colleagues from other faculties. The construct validity of responses was evaluated using Cronbach's alpha and exploratory factor analysis. RESULTS: Over half the respondents (57.8%) considered that they had received better training than peers from other medical schools, and 98.5% felt that their general performance in the four competencies analyzed was similar or superior to that of their colleagues. Factor analysis revealed two major factors: "the physician as scientist" and "the physician as manager and communicator". CONCLUSIONS: Our study shows that graduates from the UCLM Faculty of Medicine perceive their training, which is largely based on problem-based learning, as satisfactory.

Evaluación por los tutores de la formación adquirida por los licenciados en medicina en la Universidad de Castilla-La Mancha / Evaluation by tutors from the training of postgraduates in medicine from the University of Castilla-La Mancha

Introducción: La comunidad universitaria debe cuestionarse si su producto final, el egresado, posee las competencias necesarias para enfrentarse al mercado laboral cuando abandona las aulas. Nuestro objetivo es analizar las valoraciones de las competencias profesionales de los posgraduados por la Universidad de Castilla-La Mancha (UCLM) realizadas por sus tutores de formación especializada. Sujetos y métodos: Hemos realizado un estudio observacional transversal de 67 tutores (sobre un total de 89, contestaron 73 y se excluyeron 6), que valoran a sus egresados procedentes de la Facultad de Medicina de la UCLM mediante 'formularios de evaluación', en los cuales se analizan cuatro áreas básicas de la competencia clínica del residente (conocimientos médicos, habilidades de recopilación de datos, juicio clínico profesional y actitudes profesionales). Los resultados se presentan en porcentajes. Para la asociación estadística se han realizado determinaciones no paramétricas. Resultados: El 53% de los tutores (35/63, 4 respuestas no válidas) consideran que la formación de nuestros egresados es superior a la de otros residentes procedentes de otras universidades. Más del 30% habla de un desempeño excepcional respecto a conocimientos, recogida de datos, diagnóstico y actitudes profesionales. Al analizar al residente como gestor de recursos sanitarios, un 6,3% de ellos administran peor los recursos que sus compañeros de residencia, formados en otras facultades. Conclusiones: Parece que la formación recibida por nuestros alumnos es adecuada según sus tutores, lo que les capacita para un correcto ejercicio profesional posterior. No obstante, se evidencian deficiencias respecto a la gestión de recursos sociosanitarios, problemática psicosocial y medicina preventiva (AU)

Introduction: The university community must question whether the end product, the graduate, has the skills necessary to face the labor market when they leave the classroom. Our objective is to examine the assessments of the professional skills of postgraduate students from the University of Castilla-La Mancha (UCLM) made by their specialized training supervisor. Subjects and methods: We conducted a cross-sectional study of 67 supervisor (a total of 89, 73 and excludes answer 6) of postgraduates of the Faculty of Medicine (UCLM), who helped answering the 'evaluation form', with 32 items about four basic areas of clinical competence (medical knowledge, data-gathering skills, clinical judgment and professional attitudes) The results are shown in percentages. Non-parametric measurements have been made for the statistical association. Results: 53% of the supervisor (35/63, 4 invalid responses) believe that the education of our graduates is higher than the others graduates coming from other universities. Over 30% talk about an exceptional performance in terms of knowledge, data collection, diagnosis and professional attitudes. Considering the resident as a manager of health resources, about 6.3% are below than the others graduates coming from other universities. Conclusions: According to their tutors, the training received by our students seems to be appropriated, which enables them to practice a correct professional task. However, deficiencies are evident on the management of healthcare resources, psychosocial problems and preventive medicine (AU)

Medical therapy (methotrexate and mifepristone) alone or in combination with another type of therapy for the management of cervical or interstitial ectopic pregnancy.

OBJECTIVE: To describe cases of cervical or interstitial ectopic pregnancy managed conservatively with combined medical treatment (methotrexate and mifepristone) alone or in association with other minimally invasive strategies. STUDY DESIGN: We describe four cervical and two interstitial ectopic pregnancies at our hospital between 2006 and 2010. All received combined treatment with methotrexate and mifepristone. A search of MEDLINE is also described. RESULTS: The literature search identified only four previous cases of cervical ectopic pregnancies and no cases of interstitial ectopic pregnancy managed with combined therapy. In our study, all patients were successfully treated and had no adverse reactions with intramuscular methotrexate 50 mg/m² and oral mifepristone 600 mg, either alone or in association with minimally invasive treatment (uterine artery embolization and evacuation dilation and curettage). All patients remained asymptomatic with ß-HCG levels that decreased and became negative within 14-49 days: the median hospital stay was 5.5 days. We also describe the first patient with a cervical ectopic pregnancy treated with methotrexate and mifepristone, followed by vaginal misoprostol 800 mcg for cervical evacuation. CONCLUSION: Methotrexate-mifepristone, either alone or in combination with other minimally invasive strategies, could be considered an option for the treatment of both cervical and interstitial ectopic pregnancy. An individualized approach should be used in each patient, however, given the wide variety of possible clinical situations and the potential seriousness of ectopic pregnancy.