Sources of medical student stress.

BACKGROUND: Key elements in the clinical practice of prevention, health and wellness are best cultivated in medical professionals during undergraduate medical training. This study explores students' self-assessed stress relative to gender, academic expectations, and level of medical training to guide development of targeted wellness interventions. METHODS: In early 2012, undergraduate (M1-M4) students in four Southeastern U.S. allopathic medical schools were surveyed about health-related attitudes and behaviors. RESULTS: A total of 575 students returned completed questionnaires. Students in the preclinical years (M1-M2), especially females, reported significantly higher stress levels. Academic expectations and satisfaction were also significantly implicated. DISCUSSION: These findings highlight the general areas of potential concern regarding stressors associated with medical training. Future research should guide programmatic efforts to enhance students' overall health and wellness vis-à -vis curriculum, skills training, and support services.

Trends in the Management of Spontaneous Pneumothorax: A Single Center Experience.

Objectives: Management of patients with primary spontaneous pneumothorax is controversial. We sought to review our experience in the treatment of primary spontaneous pneumothorax (PSP) by comparing outcomes from video-assisted thoracoscopic surgery (VATS) with thoracotomy.A retrospective review of electronic and paper medical charts identified 104 consecutive operations performed at University of Kentucky Chandler Medical Center for spontaneous pneumothorax management between the dates of January 2000 and January 2013. Follow-up phone calls were made to ensure absence of re-ocurrences outside of our hospital system.Eighty-eight patients (85%) underwent VATS repair with unilateral and contralateral recurrence rates of 7% and 11% respectively. Mean operative time was 97 minutes; mean postoperative hospital stay was 6 days. Mechanical pleurodesis/pleurectomy was performed in 94% of cases. Comparatively 16 patients (16%) underwent thoracotomy repair with unilateral and contralateral recurrence rates of 0.00% and 6% respectively. Mean operative time for the thoracotomy group was 188 minutes; mean postoperative hospital stay was 5 days. Mechanical pleurodesis was performed 12 times (75%).In our study, the VATS group had a significant reduction in operating room time (P = .001), a non-significant increase in unilateral recurrence (p = .587), and no reduction in postoperative length of stay. Contralateral recurrence rate did not vary between groups.