Comparison between Mexican and International Medical Graduates' scores obtained in the ENARM competing for surgical specialties in Mexico during 2012-2019: data visualization, trend and forecasting analyses.

INTRODUCTION: We aimed to compare the performance at the Examen Nacional de Aspirantes a Residencias Médicas (ENARM) of the five direct-entry surgical specialties, and between Mexicans and International medical graduates (IMG). METHODS: This study was cross-sectional, used historical data from the annual public report of the ENARM during 8 years (2012-2019). We compare the minimum (MinSco) and maximum (MaxSco) scores of each specialty using ANOVA. Mexican versus IMG scores were evaluated with independent student t-test, trends with Spearman's correlation coefficient and a 5-years forecasting trend. RESULTS: There was a significant difference among the MinSco for five surgical specialties; F (4, 78) = 24.586, p ≤ 0.001; the global mean of MinSco was 72.572; specialties above this mean were ophthalmology, otorhinolaryngology, and general surgery. The global mean for MaxSco was 81.559, two specialties were above: ophthalmology, and general surgery. We did not find a significant difference in the MinSco between Mexicans and IMG, but significance was found in the MaxSco between both groups. CONCLUSIONS: ENARM represents a market of high-performance test-takers across the surgical specialties. Mexicans and IMG achieved similar entrance scores, but Mexicans showed a higher MaxSco over IMG in all surgical specialties.

ANTECEDENTES: Comparamos la puntuacion del ENARM (Examen Nacional de Aspirantes a Residencias Médicas) en cinco especialidades quirúrgicas de entrada directa (cirugía general, ginecología y obstetricia, oftalmología, otorrinolaringología y traumatología y ortopedia) y las puntuaciones de mexicanos en comparación con graduados médicos internacionales. MÉTODO: Estudio transversal del informe público anual del ENARM durante 8 años (2012-2019). Comparamos las puntuaciones mínimas (MinSco) y máximas (MaxSco) de cada especialidad con ANOVA. El rendimiento de los mexicanos en comparación con internacionales se analizó con la prueba t de Student independiente, las tendencias se análizaron con correlación de Spearman y calculamos el pronóstico a 5 años. RESULTADOS: Hay diferencia significativa entre los puntajes mínimos de las cinco especialidades; F (4, 78) = 24.586, p ≤ 0.001. La media global de MinSco fue 72.572. Las especialidades por encima de la media fueron oftalmología, otorrinolaringología y cirugía general. La media global para el MaxSco fue de 81.559, y dos especialidades estan por encima de esta marca: oftalmología y cirugía general. No hay diferencia significativa en el MinSco entre mexicanos e internacionales, pero si en el MaxSco entre ambos grupos. CONCLUSIONES: El ENARM cuenta con aspirantes de alto rendimiento en las especialidades quirúrgicas. Los mexicanos y los graduados médicos internacionales tienen MinSco similares, pero los mexicanos mostraron un MaxSco más alto que los internacionales.

Imaging methods used in the assessment of environmental disease networks: a brief review for clinicians.

BACKGROUND: Across the globe, diseases secondary to environmental exposures have been described, and it was also found that existing diseases have been modified by exposure to environmental chemicals or an environmental factor that has been found in their pathogenesis. The Institute of Medicine has shared a permanent concern related to the nations environmental health capacity since 1988. MAIN BODY: Contemporary imaging methods in the last 15 years started reporting alterations in different human systems such as the central nervous system, cardiovascular system and pulmonary system among others; evidence suggests the existence of a human environmental disease network. The primary anatomic regions, affected by environmental diseases, recently assessed with imaging methods include Brain (lead exposure, cerebral stroke, pesticide neurotoxicity), uses MRI, DTI, carotid ultrasonography and MRS; Lungs (smoke inhalation, organophosphates poisoning) are mainly assessed with radiography; Gastrointestinal system (chronic inflammatory bowel disease), recent studies have reported the use of aortic ultrasound; Heart (myocardial infarction), its link to environmental diseased has been proved with carotid ultrasound; and Arteries (artery hypertension), the impairment of aortic mechanical properties has been revealed with the use of aortic and brachial ultrasound. CONCLUSIONS: Environmental epidemiology has revealed that several organs and systems in the human body are targets of air pollutants. Current imaging methods that can assess the deleterious effects of pollutants includes a whole spectrum: radiography, US, CT and MRI. Future studies will help to reveal additional links among environmental disease networks.