Student-selected components in surgery: providing practical experience and increasing student confidence.

INTRODUCTION: Reviews of the medical school curriculum in the UK and Ireland have recommended the introduction of student-selected components (SSCs). The Department of Surgery in The Royal College of Surgeons in Ireland (RCSI) has introduced a 6-week surgical SSC, which aims to develop practical clinical skills, provide mentorship and prepare students for internship. METHODS: Emphasis was placed on exposure to surgical specialities, teaching practical skills and student integration into surgical teams. Students completed an online survey pre- and post-SSC, assessing attitudes towards the course and confidence in performing ward-based and surgical skills. RESULTS: The mean Likert scale scores increased for all the skills assessed. Students felt that the SSC prepared them for their first day of work and strengthened their desire to pursue surgical careers. CONCLUSION: A surgical SSC has been successful in increasing student confidence in performing practical skills required for commencing work as a doctor. Provision of dedicated SSCs is likely to influence the career choice of students.

Preparing students to be doctors: introduction of a sub-internship program.

Preparing graduates for the transformation from medical student to doctor provides medical schools with a real challenge. Medical educators advocate a process of graduated delegation of responsibility in the clinical years of medical school. This is best exemplified in the North American system of sub-internship programmes; an educational approach which European medical schools have been slow to adopt. This study reports on the introduction of an intensive two-week surgical sub-internship for final medical year students. "Sub-interns" were asked to complete pre and post sub-internship online questionnaires assessing their readiness to perform clinical and practical skills, attitudes towards the program, and how well it prepared students for internship. Forty-nine students completed a questionnaire pre sub-internship and 47 completed the post-questionnaire. Student confidence towards practical and clinical skills and their first day at work increased over the two weeks. Mean Iikert scores for all 6 practical and clinical skills improved post sub-internship. The introduction of a surgical sub-internship is timely and welcomed by medical students. Its development helps bridge the gap in responsibilities between medical student and doctor.

Sultamicillin (sulbactam/ampicillin) versus amoxycillin in the treatment of acute otitis media in children.

A comparative study of sultamicillin (an orally active dimer of sulbactam and ampicillin) and amoxycillin for the treatment of acute otitis media was carried out in 86 children with acute otitis media. After 10 days' treatment, of those with traditional middle ear pathogens, 35/36 (97%) 50 mg/kg.day or 500 mg/day sultamicillin-treated children were cured with eight relapses after a further 18 days without treatment compared with 12/13 (92%) 40 mg/kg.day or 250 mg/day amoxycillin-treated children and three subsequent relapses. All six beta-lactamase-producing pathogens were in the sultamicillin treatment group: four were Haemophilus influenzae/H. parainfluenzae that were resistant to amoxycillin, and all were cured although two then relapsed. No significant clinical or laboratory side-effects were noted in either amoxycillin- or sultamicillin-treated patients. It is concluded that sultamicillin was comparable to amoxycillin in the treatment of acute otitis media.