RESUMO
BACKGROUND: The cardiothoracic surgical (CTS) specialty has witnessed a decline in the applicant pool. Early exposure, positive experiences, inspiring role models, and career insight are key in the decision-making process for specialty choice. Our objective was to assess the effect of high tutor:student ratio interactive CTS workshops in influencing the career choice of UK undergraduate medical students. METHODS: Medical students attended a workshop comprising (1) guided dissection of fresh animal hearts, (2) surgical skills practice on models and fresh hearts, (3) operative videos (adult, congenital, transplant, and aortic) with interactive commentary, and (4) careers seminar. The tutor:student ratio was very high (between 3-1 and 5-1). A questionnaire was completed at the end of each workshop to assess its effect, including a 10-point Likert scale on the perceived attraction to CTS before and after the workshop. RESULTS: A total of 96 delegates attended 5 workshops in 3 UK medical schools. Response rate was 83% from 80 undergraduate students. In all, 58% were male (46/80). There was an equal proportion of sexes in the early years of medical school, but was significantly skewed toward male in the later years. There was a statistically significant increase of 2.1 (standard deviation [SD] = 1.5) in the Likert scores before (µ = 5.0, SD = 2.1) and after (µ = 7.1, SD = 1.9) (p = 0.001). This represents a 42% increase in the perceived attraction to the CTS specialty because of the workshops. CONCLUSIONS: Our workshops have a significant effect in stimulating undergraduate medical students toward a career in cardiothoracic surgery. We encourage national take-up of these easily organized daylong workshops to foster interest in the next generation of cardiothoracic surgeons.
Assuntos
Escolha da Profissão , Educação de Graduação em Medicina/métodos , Educação/organização & administração , Inquéritos e Questionários , Procedimentos Cirúrgicos Torácicos/educação , Tomada de Decisões , Feminino , Humanos , Masculino , Inovação Organizacional , Avaliação de Programas e Projetos de Saúde , Faculdades de Medicina/organização & administração , Estudantes de Medicina/psicologia , Estudantes de Medicina/estatística & dados numéricos , Reino Unido , Adulto JovemRESUMO
A patient with anomalous coronary circulation presented with non-ST segment elevation myocardial infarction and ischemic mitral regurgitation and underwent mitral valve repair and coronary revascularization. An unexpected tear occurred in the roof of the left atrium, and its subsequent repair caused iatrogenic damage of the anomalous circumflex artery on its abnormal course requiring an extra graft. Early suspicion of the iatrogenic damage to the anomalous artery was the key for good and complete recovery in this case.
Assuntos
Anomalias dos Vasos Coronários/complicações , Implante de Prótese de Valva Cardíaca/efeitos adversos , Doença Iatrogênica , Insuficiência da Valva Mitral/cirurgia , Infarto do Miocárdio/cirurgia , Idoso , Anomalias dos Vasos Coronários/diagnóstico por imagem , Humanos , Masculino , Insuficiência da Valva Mitral/diagnóstico por imagem , Insuficiência da Valva Mitral/etiologia , Infarto do Miocárdio/complicaçõesRESUMO
Intensive care unit-acquired weakness is an evolving problem in the burn population. As patients are surviving injuries that previously would have been fatal, the focus of treatment is shifting from survival to long-term outcome. The rehabilitation of burn patients can be challenging; however, a certain subgroup of patients have worse outcomes than others. These patients may suffer from intensive care unit-acquired weakness, and their treatment, physiotherapy and expectations need to be adjusted accordingly. This study investigates the condition of intensive care unit-acquired weakness in our burn centre. We conducted a retrospective analysis of all the admissions to our burn centre between 2008 and 2012 and identified 22 patients who suffered from intensive care unit-acquired weakness. These patients were significantly younger with significantly larger burns than those without intensive care unit-acquired weakness. The known risk factors for intensive care unit-acquired weakness are commonplace in the burn population. The recovery of these patients is significantly affected by their weakness.