An investigation on social accountability of general medicine curriculum.

INTRODUCTION: Experts consider social accountability as a new paradigm in medical education and a cultural change that is necessary to be studied and understood more deeply. One of the problems of medical education is the inadequacy of medicine graduates to meet the social accountability. Therefore, the aim of this study was to examine the general medicine curriculum for social accountability. METHODS: This cross-sectional study was conducted on three groups of experts, faculty members, and general physicians working in health centers in Mashhad in 2014. According to the needs assessment and definition of need as a requirement or preference, the research was conducted in three stages using the Delphi method, in which the opinions of experts, lecturers, and practitioners were collected and classified based on the CARE model in four areas, i.e., clinical activities, advocacy, research, and educational categories, and, ultimately, the percentage of agreement was determined. RESULTS: As indicated by the results of the need analysis, in order to reach social accountability of medical students of Mashhad University of Medical Sciences, the curriculum should cover four major areas, i.e., clinical activities, advocacy, research, and training. We found 38 items for social accountability that are required in the general medical curriculum, including clinical activities (12 items), advocacy (10 items), and scope of research (8 items). The educational area was comprised of 8 items. In this study, from 30 participants, only 19 people participated in the three-step Delphi, and there was a 70% response rate in the first stage and second stage, but 90.47% in the third stage. CONCLUSION: There is a growing interest around the world for social accountability in medical schools and other health-related schools. It is expected that the results will be of interest to planners and policy-makers in this field so that we will observe a promotion in the culture of social accountability in Mashhad University of Medical Sciences.

Intraoral mass presenting as maxillary sinus carcinoma: a case report.

Sinonasal undifferentiated carcinoma is an extremely rare malignancy of the paranasal sinuses and nasal cavity. It is of unknown etiology, and occurs more commonly in the elderly men, with a routinely shown aggressive behavior and poor prognosis for survival. Radiographically, it looks like severe osteomyelitis. Histopathologic study is essential to confirm diagnosis, and the undifferentiated histologic appearance often necessitates immunohistochemical studies for differentiation from other high-grade neoplasms. We present an 83-year-old man complaining of pain and unilateral swelling on the left side of the face due to a rare malignant tumor of maxillary sinus origin, a sinonasal undifferentiated carcinoma. He underwent hemimaxillectomy and radiotherapy, but refused chemotherapy. Maxillary sinus malignancy may be presented with unspecific symptoms mimicking sinusitis or dental pain. Coming across such symptoms, the physician or dentist must consider malignancies as well, and carry out medical and dental workups.