Optimum Working Hours for College of Physicians and Surgeons Pakistan Fellowship Residents of General Medicine and General Surgery Disciplines.

OBJECTIVE: To determine the optimum working hours per week for CPSP trainees of Fellowship Programmes in the disciplines of General Surgery and General Medicine. STUDY DESIGN: Mixed-methods, explanatory study. Place and Duration of the Study: Department of General Medicine and Department of General Surgery, Abbasi Shaheed Hospital, Karachi, from February to August 2023. METHODOLOGY: The total number of subjects included were 33 residents, 7 supervisors (4 from General Medicine and 3 from Geneneral Surgery), and 3 hospital managers (from private sector), constituting a representative sample. Postgraduate trainees (PGTs) of third-and fourth-year FCPS training programme who showed willingness to participate were included as were all supervisors and hospital managers involved in the training programme. FCPS residents, who were not willing, on leave, and on rotation to other departments were excluded, as were PGTs enrolled in university and other programmes. For quantitative analysis, survey forms were distributed to the selected participants. For qualitative analysis, one-to-one interviews were conducted in-person and through video-link. Data collection procedure included distribution by hand and via email. SPSS was used for the data analysis. RESULTS: All residents recorded that duty stress, fatigue, and burnout resulted in poor quality of family and social life. All the stakeholders were convinced that acquisition of skills, learning outcomes, and patient safety with optimum care is compromised. The duration of emergency calls varied from 30 to 36 hours. There were 19 out of 33 residents (57.5%) who recommended 24 hours of rest after each emergency call. All the supervisors recommended six to eight daily duty hours and 66 to 90 weekly working hours. Four out of seven supervisors (57.1%) suggested emergency duty of 30 hours with post-call rest of 24 hours at every 3rd  day. CONCLUSION: There is a need for a comprehensive approach that caters to the patient care as well as learning outcomes and residents' well-being when devising the duty schedules. KEY WORDS: Training hours, Fellowship programme, Fatigue, Learning outcomes.

Comparison of performance on written and OSCE assessment during end semester pediatric examination.

OBJECTIVE: To compare the scores obtained on written and OSCE examination during pediatrics end semester examination and to find out the reasons for the discrepancies among the scores obtained. METHODS: This co-relational study was carried out in pediatric department, Liaquat University of Medical and Health Sciences (LUMHS). The performance of medical students who were posted in the pediatric department for one semester (November 2016 to October 2017) was compared on the basis of scores obtained in their written and OSCE during end semester examination. To find out the reasons for discrepancies qualitative data was collected by using likert scale on Pre-designed questionnaire distributed among the students at the end of assessment. Frequencies of their responses were calculated. RESULTS: Data of 160 students who participated in study was analyzed by SPSS version 22. The mean and standard deviation of participant's score was 51.25 ± 12.19. Females performed better in written as well as in OSCE. Moderate correlation was seen between MCQ and SAQ scores (r=0.5, p <0.01). Around 60% considered OSCE as their preferred mode of assessment. Deep learning approach and group discussion was found in female students (65%). CONCLUSION: Our study concluded that students performed better in OSCE than in written assessment. However, in OSCE they had shown unsatisfactory performance for some important competencies like clinical examination methods and procedural skills. Female students performed better in both segments of assessment.