Mistreatment among Undergraduate Medical Trainees: A Case Study of a Nigerian Medical School

Background: Several international studies have shown that abuse or mistreatment is a regular phenomenon faced by medical students. However; there is limited information on medical student abuse/mistreatment in Nigeria. The study was therefore conducted to assess the prevalence and patterns of mistreatment experienced by Medical Students in the University of Calabar. Materials and Methods: A descriptive cross-sectional study was conducted among 451 undergraduate medical trainees in the University of Calabar. Systematic sampling was used in recruiting participants into the study. A self-administered questionnaire was then employed to obtain information on patterns of mistreatment experienced by medical undergraduates. Data were analyzed using Statistical Package for Social Scientists version 19 and level of significance set at 0.05. Results: More than a third (35.5) of all respondents interviewed had experienced one or more forms of mistreatment during their training; with 38.5 of them experiencing it weekly. The most common form of mistreatment experienced was verbal abuse (52.5); and the main perpetrators of these incidents were medical consultants; (18.6) other cadre of doctors (17.3) and lecturers (14.4). Being in the clinical level of study and aged above 25 years were significantly associated with experiencing mistreatment in this study (P 0.05). However; only 8.8 reported these incidents. Conclusion: With more than a third of undergraduate medical trainees experiencing mistreatment; development of appropriate strategies for the prevention and reduction of these incidents are strongly recommended

Mistreatment among undergraduate medical trainees: A case study of a Nigerian medical school.

BACKGROUND: Several international studies have shown that abuse or mistreatment is a regular phenomenon faced by medical students. However, there is limited information on medical student abuse/mistreatment in Nigeria. The study was therefore conducted to assess the prevalence and patterns of mistreatment experienced by Medical Students in the University of Calabar. MATERIALS AND METHODS: A descriptive cross-sectional study was conducted among 451 undergraduate medical trainees in the University of Calabar. Systematic sampling was used in recruiting participants into the study. A self-administered questionnaire was then employed to obtain information on patterns of mistreatment experienced by medical undergraduates. Data were analyzed using Statistical Package for Social Scientists version 19 and level of significance set at <0.05. RESULTS: More than a third (35.5%) of all respondents interviewed had experienced one or more forms of mistreatment during their training, with 38.5% of them experiencing it weekly. The most common form of mistreatment experienced was verbal abuse (52.5%), and the main perpetrators of these incidents were medical consultants, (18.6%) other cadre of doctors (17.3%) and lecturers (14.4%). Being in the clinical level of study and aged above 25 years were significantly associated with experiencing mistreatment in this study (P < 0.05). However, only 8.8% reported these incidents. CONCLUSION: With more than a third of undergraduate medical trainees experiencing mistreatment, development of appropriate strategies for the prevention and reduction of these incidents are strongly recommended.

Use of the General Health Questionnaire as a screening tool for geriatric patients in Calabar, Nigeria.

BACKGROUND: Old age is inevitably associated with general biological and physical decline.Mental health issues are among the most prevalent health problems of the elderly and constitute an important source of distress for patients and caregivers. Primary care providers frequently fail to diagnose these problems, and, even when they do, management may not be optimal. This study aimed to determine the proportion of geriatric mental health morbidity detected by Family Physicians and compare this with General Health Questionnaire detection in the recognition ofmorbidity in this cohort. METHOD: This was a cross-sectional descriptive survey involving 107 elderly respondents, conveniently recruited for the study from the Family Medicine Geriatric Clinic of the University of Calabar Teaching Hospital, Calabar. Respondents were grouped into 'cases' and 'non-cases' using a cut-offscore of'3' with the General Health Questionnaire as the main comparative detection instrument. Family Physicians' abilities to identify mental health morbidity were then compared with the General Health Questionnaire ratings. Socio-demographic correlates and identification rates were determined by statistical tests of associations. RESULTS: The General Health Questionnaire identified 48.6% 'cases' while the Family Physicians identified 9.4% among the attendees. Statistically significant differences in socio-demographic characteristics of respondents were found for marital status (chi2 = 21.84; p< 0.009), level of education (chi2 = 42.58; p<0.005) and sex chi2 = (6.98; p<0.008). CONCLUSION: This study concludes that using the General Health Questionnaire and paying attention to geriatrics' socio-demographic parameters can improve the detection of mental health morbidities in the elderlyby Family Physicians.

A training need for rural primary care in Nigeria.

The major causes of maternal death in Nigeria are avoidable and preventable. Many of these deaths occur in the rural health facilities and hospitals which are severely lacking in skilled birth attendants. Of the many strategies that have been developed to reduce avoidable maternal death significantly, increasing the availability of skilled human resources is crucial. The shortage of obstetric specialists, especially in the rural and peripheral health facilities in rural Nigeria where more than 60% of the population resides, has been a major contributing factor to the low number of skilled birth attendants. The increased availability of skilled human resources ensures that all aspects of obstetrics, such as antenatal care, postnatal care and other life-saving interventions, including emergency surgery, is available for women during labour and in the immediate postpartum period. In this paper, we propose a short obstetric-training programme for generalist medical officers to increase the number of skilled birth attendants in both rural and peripheral health facilities in Nigeria. These general practice/family practitioners (GP/FPs) and hospital medical officers (MO), will have designated career structures within the primary and secondary healthcare systems, while the consultant obstetrician and sub-specialists, trained with long postgraduate programmes will function at the urban 'specialists' and in teaching hospitals.