"Where Are You From?"-on Separation, Belonging and Imposter Syndrome as an International Medical Graduate.

Minoritized international medical graduates (IMGs) in American graduate medical education (GME) programs face a disproportionately higher number of intersectional micro- and macroaggressions. In order to create a healthier, more equitable learning environment, GME programs must make greater efforts to understand intersectionality, provide IMG trainees with additional support systems, incorporate effective bystander training, and celebrate and acknowledge the contributions of their minoritized IMG trainees.

Perceived competences by graduated nurses before and during COVID-19 restrictions: A repeated cross-sectional study from 2019 to 2022.

AIMS: To explore the differences, if any, in the competences perceived by newly graduated nurses who attended their education before and during the COrona VIrus Disease 19 (COVID-19) restrictions. BACKGROUND: Nursing education has undergone significant changes because of the COVID-19 restrictions. However, to date the perceived competences at the point of graduation have not been investigated over the restrictions years compared with the pre-restrictions era. DESIGN: A repeated cross-sectional study followed by a pseudo-panel analysis. The Strengthening the Reporting of Observational Studies in Epidemiology checklist was used. Data on individual, nursing programme and perceived competences with Nurse Competence Scale (NCS) were collected and analysed by also using a pseudo-panel approach. METHODS: Two universities were involved. Those eligible were nursing students who graduated: (1) in 2020 (=323) as the first post-COVID-19 group, who were studying in the 3rd year at the onset of the restrictions; (2) in 2021 (=250) as the second post-COVID-19 graduated group, who were in the 2nd year at the restrictions onset; and (3) in 2022 (=247) as the third post-COVID-19 group, attending the 1st year of nursing education at the onset of the restrictions. Data were compared with those who graduated in 2019 (=336, pre-COVID-19 group). RESULTS: The overall NCS score was higher in the pre-COVID-19 group (68 out of 100, 95 % Confidence of Interval [IC] 66.4-69.5), lower in the first post-COVID-19 graduates (62.9, 95 % CI 60-65.8), higher in the second (66.6, 95 % CI 63.6-69.4) and lower again in the third post-COVID-19 group (63.8, 95 % CI 60.9-66.5). A sinusoidal pattern also emerged for the frequency of use of the competences from the pre-COVID-19 (2.3 out of 3) and the first group (2.1) and increased between the second and the third group (from 2.1 to 2.3) (p< 0.001). These sinusoidal trends are also evident in the pseudo-panel analysis. CONCLUSIONS: A different degree of perceived competences at the point of graduation emerged, with higher competences in the pre-restrictions group, lower in the first post-COVID-19 generation, higher again in the second and third group. However, all scores were over 60 points out of 100, thus indicating sufficient competences. The frequency of use of such competences slightly changed over the years with limited practical relevance. The findings may inform reflections regarding innovations in the clinical placements pathways as well as in the strategies supporting newly graduates nurses in their transition from education to health-care settings.

Mentoring to address differential attainment of international medical graduates in GP training.

INTRODUCTION: International Medical Graduates (IMGs) form an important and valued part of the United Kingdom's (UK) medical workforce but many experience difficult transitions into the National Health Service workforce. Mentoring could support IMGs as they transition into their role as General Practice (GP) trainees but there is a lack of evidence about whether mentoring is an effective intervention for this group. AIM: To evaluate the effectiveness of the NHS Education for Scotland (NES) GP mentoring programme from the perspective of mentors and mentees. METHOD: Twelve medical educators (the mentors) provided mentoring to 19 IMG GP trainees (the mentees) who were within their first six months of entering GP training in Scotland. Each mentee received four 60-minute mentoring sessions via video conferencing. RESULTS: Mentoring provided tailored support to assist IMG GP trainees' holistic transition into UK General Practice. Mentees appreciated talking to a non-supervisor, receiving non-judgemental support and protected time with a supportive listener to overcome challenges. This had a positive impact, even for those who did not anticipate the need for such support. Mentors supported diverse needs and tailored meetings, experiencing a distinct shift from previous supervisor roles. Their diverse experience enhanced their role and they developed new skills. CONCLUSION: Mentoring could provide significant support to IMG GP trainees but comes with certain challenges. Future research should evaluate the long-term impact of the NES GP IMG mentoring programme.

Identification of a Theory-Practice Gap in the Education of Biomedical Scientists.

Introduction: The Biomedical Scientist (BMS) role is established in healthcare, working in laboratory environments to provide diagnostic testing and to monitor treatment effects on a patients' health. The profession is subject to several professional standards which highlight the importance of working in the best interests of the patient and service user. However, Biomedical Scientists have little or no patient contact. This study aimed to determine how Biomedical Scientists evidence that they meet the professional standards and support the achievement of patient outcomes. Materials and Methods: This study utilised a Delphi method to explore the opinions of professional stakeholders to determine whether there was consensus for how this professional group contributes to patient outcomes and offers evidence that they are working in the best interests of the patient. The qualitative 1st round of the study consisted of focus groups and interviews with staff and students on the BSc Biomedical Science awards, Professional, Statutory and Regulatory body (PSRB) representatives and Biomedical Scientists from the National Health Service (NHS). The first-round responses were analysed using thematic analysis which then generated attitude statements which participants scored using a 5-point Likert scale in the 2nd round. Consensus or divergence of opinion was determined based upon a 70% consensus level within each participant group and overall. Results: Following analysis of the 2nd round data, there was divergence of opinion across all stakeholders, with consensus rates being highest in the Biomedical Scientist group (72.7% of statements reached 70% consensus), followed by the student group (54.5% of statements reached 70% consensus) and lowest in the academic group (40.9% of statements reached 70% consensus). Discussion: This demonstrates a theory-practice gap in both the academic and student groups, suggesting that graduates are insufficiently prepared for their post-graduate role. This gap was particularly evident when discussing topics such as how Biomedical Scientists contribute to patient care, professional registration and working as part of the multi-disciplinary team (MDT). The identification of a theory-practice gap in the education of Biomedical Scientists is a novel finding, indicating that students may graduate with insufficient understanding of the Biomedical Scientist role.

Representation of International Medical Graduates Among Diagnostic Radiology Chairs, Neuroradiology Chiefs, and Program Directors.

RATIONALE AND OBJECTIVES: The number of international medical graduates (IMGs) entering radiology residencies and neuroradiology fellowships averaged 9.7% and 20.9% from 2021 to 2023, respectively. We aimed to determine whether IMG graduates are populating leadership roles at a proportionate rate in diagnostic radiology (DR) and neuroradiology. MATERIALS AND METHODS: We surveyed 191 DR program directors, 94 neuroradiology program directors (PDs), 192 chairs of radiology, and 91 directors of neuroradiology inquiring about their original citizenship and medical school (American Medical Graduates [AMG] vs IMG). We reviewed institutional websites to obtain missing data and recorded H indices for each person using Scopus. RESULTS: We confirmed the original citizenship and medical school location in 61-75% and 93-98% of each leadership group. We found that 16.2% of DR program directors, 43.7% of neuroradiology PDs, 28.5% of Chairs, and 40.6% of neuroradiology directors were not originally US citizens. The IMG rate was 18/188 (9.6%), 20/90 (22.2%), 26/186 (14.0%), and 19/85 (22.4%) for the same groups respectively. The most common country of origin and medical school cited was India for all leadership groups. IMGs had a median H index of 14 while AMG 10, significantly different (p = 0.021) CONCLUSION: Compared to the rate of diagnostic and neuroradiology trainees entering from 2021 to 2023, IMGs are proportionately represented at the leadership positions studied. The H index of the IMGs was higher than AMG. We conclude that IMGs have made substantial and proportionate inroads in radiology and neuroradiology leadership.

Private practice dietetics: A scoping review of the literature.

AIM: Private practice is one of the most rapidly growing, but under-researched employment sectors for graduate dietitians in Australia, limiting evidence-based workforce development. This scoping review examines existing international literature to gain an understanding of the current private practice workforce size, distribution, demography and workforce development considerations, including competencies, supply and demand, remuneration and professional development activities. METHODS: The databases MEDLINE, EMBASE, CINAHL, EMCARE, PsycInfo (Ovid) and grey literature were systematically searched in August 2023 using key search terms to identify studies for inclusion. Articles were included if they related to private practice dietetics and described an aspect of workforce. Original research, government and organisational reports, statements of practice and websites providing governmental or organisational statistics were included. A directed content analysis and qualitative constant comparison technique were used to deductively map intelligence sources against a workforce development framework. A gap analysis was also conducted to provide a focus for future workforce development research. RESULTS: A total of 72 peer-reviewed and grey literature sources were included, with 65% of the studies being Australian-based publications. Private practice dietetics research interest has increased in the last decade. Despite a breadth of published sources, this review found little published data on workforce size, distribution, demography, supply, demand, continued professional development and remuneration, indicating a significant gap in the evidence base. Existing literature focuses on workforce challenges and barriers, the work of private practice dietitians, with limited exploration of competency requirements for graduate private practitioners. CONCLUSIONS: The literature on the private practice dietetics workforce is lacking worldwide, which constrains evidenced-based workforce development initiatives. Workforce development research across all workforce aspects is warranted to address current evidence gaps.

'I feel many of my reflections are forced': a mixed methods qualitative study of international medical graduates' perspectives on reflection in UK general practice training.

BACKGROUND: UK general practice training requires trainees to evidence clinical competencies through reflective writing entries in online portfolios. Trainees who complete their medical degree in the UK experience reflection as an undergraduate, whereas 80% of international medical graduates (IMGs) have no previous experience of reflection. AIM: To explore international graduates' perspectives on the positive and negative aspects of reflection in the context of postgraduate GP training. DESIGN & SETTING: Qualitative 'free text' survey data obtained in 2021 was analysed with themes further explored by semi-structured interviews conducted 2022-2023. METHOD: Participants were IMGs with experience of the UK GP training scheme. Verbatim open question survey data underwent content analysis. Broad themes identified were used to develop the interview topic guide. A geographically dispersed, purposive sample of participants were recruited for semi structured interviews. Interview and survey data were then analysed thematically. RESULTS: 433 participants data sets are included: 422 of 485 responses to a UK wide survey including open questions and 11 interview transcripts. IMGs considered reflection to provide an effective approach for learning, an opportunity for self-assessment and professional development and a means of developing self-awareness. Concerns were expressed about how time-consuming recording reflection is, how its mandated aspect makes it forced, and fears regarding the medico-legal consequences of reflective writing. CONCLUSION: Despite a lack of previous experience in reflection, most international graduates showed an understanding of the benefits of reflection in GP training. However, the challenges of reflection must be addressed, to avoid devaluing reflection for clinical learning.

Effectiveness of spaced repetition learning using a mobile flashcard application among dental students: A randomized controlled trial.

BACKGROUND: Dental education in India predominantly relies on traditional lecture-based learning (LBL), which may hinder student engagement and learning outcomes. To address these limitations, innovative learning methodologies, such as spaced repetition learning (SRL), are imperative. SRL prioritizes active recall and can enhance long-term knowledge retention. This study aims to assess the effectiveness of SRL delivered through a mobile flashcard application, in enhancing knowledge retention among dental undergraduates. METHODS: This single-blind randomized controlled trial (CTRI/2023/10/059347), conducted in Belagavi, India, involved 90 dental students who were equally distributed into control (LBL) and test (lecture followed by SRL demonstration) groups after randomization. Rigorous expert review ensured the quality of PowerPoint presentation and mobile flashcard contents. Knowledge assessments were conducted at baseline, first, and third months using a validated and reliable questionnaire. A perception survey on learning techniques was administered after the first month. Analysis methods included descriptive analysis, Pearson's chi-square test, independent t-test, and repeated measures ANOVA with Bonferroni's post hoc test. RESULTS: The pre- and post-intervention knowledge showed no significant differences, but the SRL group exhibited significantly higher retention at both first month (p ≤ 0.001) and third months (p ≤ 0.001) than the LBL group. Repeated measures ANOVA revealed significant pairwise differences in mean knowledge scores in SRL group. Students had significantly favorable perception toward SRL than LBL group. CONCLUSION: SRL delivered through mobile flashcards significantly enhances knowledge retention compared to LBL among dental students. Positive student perceptions support SRL's integration into dental curricula, with implications for improving knowledge retention among them.

Unveiling Disparities: Exploring Differential Attainment in Postgraduate Training Within Clinical Oncology.

AIMS: Differential attainment (DA) in post graduate medical training is a recognised challenge and refers to unexplained variation across groups when split by several protected characteristics. The Royal College of Radiology is committed to fostering diversity, inclusivity, and equality with the goal of narrowing existing gaps and improving training outcomes. MATERIALS AND METHODS: This was a mixed methods study aiming to understand the causes of DA with view to helping the RCR develop strategies to address this. A cross-sectional survey was completed by 140 clinical oncology trainees in September 2022. Trainees and trainers (17 and 6 respectively) from across England, Scotland, Wales and Northern Ireland, took part in focus group and interviews from August to December 2022. Quantitative and qualitative data merged and interpreted. RESULT: Results showed international medical graduates and trainees from ethnic minority backgrounds were more likely to encounter challenges. The qualitative findings were used to identify three themes through which these problems could be framed. The trainee as a "space invader," the hidden curriculum of clinical oncology training and the process of navigating and tacking the training journey. CONCLUSION: Differential attainment is the product of a complex interplay between the trainee, trainer, and the training environment. Therefore, interventions must be tailored to different people and contexts. At a national level, the RCR can adopt general policies to promote this such as mentorship programmes, protected time for supervision and cultural competency training. Efficacy of proposed interventions for trial and their impact on DA should be evaluated to drive evidence-based changes.

A 10-year analysis of application and match rates for pain medicine training in the United States.

OBJECTIVE: We analyzed application and match rates for pain medicine training in the United States and hypothesized that there would be (1) greater growth in the number of training positions than applicants, (2) higher match rates among US allopathic graduates relative to non-US allopathic graduates, and (3) greater number of unfilled training positions over time. DESIGN: Retrospective, cross-sectional study of all applicants for pain medicine training in the United States. METHOD: National Resident Matching Program data were obtained over a ten-year period (2014-2023). Match rates and applicant-to-position ratios were calculated and compared over time with linear regression. Comparisons were made with chi-square tests. RESULTS: Growth in the number of annual training positions (261-377, 44% increase) exceeded growth in the number of interested applicants (398-415, 4% increase) (P < .001). Annual applicant-to-training position ratios decreased (1.5-1.1, P < .001). The representation of US allopathic graduates among incoming pain medicine fellows decreased over the study period (73%-58%, P < .001) while US osteopathic graduates increased (9%-28%, P < .001).Match rates increased for both US allopathic graduates (71%-91%, P < .001) and non-US allopathic graduates (51%-81%, P < .001). From 2018 to 2023, US allopathic graduates (79%) had higher match rates than US osteopathic graduates (60%, P < .001) and international medical graduates (57%, P < .001). More available annual training positions went unfilled over the study period (2%-5%, P = .006). CONCLUSIONS: Stagnant annual applicant volume and increasing number of available training positions have led to increasing match rates for pain medicine fellowship training. Fewer US allopathic graduates are pursuing pain medicine training. The increasing percentage of unfilled training positions warrants ongoing surveillance.

Insights Into the Employability of Midwifery Graduates. A Case Study of the International Hellenic University.

Background: This study examines the employability and career trajectories of International Hellenic University's (IHU) midwifery students who graduated between 2016 to 2021, with a focus on undergraduate curriculum changes. Objective: To comprehensively examine the post-graduation journey of recent IHU Midwifery graduates. This includes shedding light on their employment trajectories, satisfaction levels, and the practical application of academic knowledge. Through this exploration, the study seeks to inform educational strategies to ensure alignment with the evolving needs of midwifery professionals in Greece. Methods: Online questionnaires that explored post-graduation experiences, perspectives on the study program, and future plans. The questionnaires consisted of a mix of open and closed-ended questions and were completed by 273 recipients. The study was conducted from May to September 2023, with participant anonymity maintained. Statistical analysis was performed using SPSS. Results: This study revealed differences between graduates of the 'old' and 'new' midwifery undergraduate curriculum. There were notable variations in the perceived impact of the six-month internship on employment. The study also highlighted the impact of the COVID-19 pandemic on educational experiences, emphasizing the nuanced challenges faced during clinical practice, practical training, and simulation training. Finally, the self-employed professionals and those employed in the public sector expressed higher satisfaction with the alignment of their employment with their undergraduate studies, than their counterparts in the private sector (p=0.038). Conclusions: Our study offers valuable insights into job placement, knowledge sufficiency, and the impact of the pandemic on midwifery undergraduate education. These findings can guide tailored strategies for improved education and holistic professional development, ultimately enhancing maternal and neonatal care.

Perfil académico y profesional de los egresados de la especialidad de Cardiología de 2000 a 2015 en el Instituto Nacional de Cardiología Ignacio Chávez / Academic and professional profile of cardiology fellowship graduates of National Institute of Cardiology Ignacio Chávez from 2000 to 2015

Resumen Antecedentes: El Instituto Nacional de Cardiología Ignacio Chávez (INC) se ha posicionado como un referente internacional en la educación médica cardiológica, destacándose por su alto nivel académico y calidad humana. Objetivo: El objetivo de este estudio fue identificar el perfil laboral y académico actual de los egresados del Instituto Nacional de Cardiología Ignacio Chávez (INC). Métodos: Se llevó a cabo un estudio transversal y retrospectivo que incluyó a 473 egresados del INC graduados entre 2000 y 2015. Se utilizó una encuesta electrónica para recopilar los datos. Resultados: Un total de 221 egresados aceptaron participar en el estudio, lo que representa el 46.7% del total de egresados. El 85.2% de los participantes son hombres. La mayoría de los egresados son de nacionalidad mexicana (82.4%), mientras que el resto se distribuye en varios países de Latinoamérica. El 89% de los egresados completó otro posgrado después de cardiología. De este grupo, el 95.4% realizó al menos una alta especialidad, mientras que el 4.6% obtuvo una maestría o doctorado. La especialidad más comúnmente elegida fue Cardiología Intervencionista. Los egresados del INC trabajan en promedio 10.8 horas al día, de las cuales 6.4 horas se dedican a la cardiología clínica y 4.3 horas al otro posgrado. Aquellos que trabajan en el sector público y privado dedican 6.1 horas y 5.2 horas al día, respectivamente. Además, el 75% de los egresados desempeña actividades de enseñanza. El 84% de los egresados trabajan en México. Conclusión: En su mayoría, los egresados del INC son médicos especialistas que continúan su formación académica a través de la realización de otros posgrados. Trabajan más horas al día en comparación con el resto de la población mexicana, y dedican la mayor parte de su tiempo al ejercicio de la cardiología clínica. También buscan transmitir sus conocimientos a través de actividades académicas y de enseñanza.

Abstract Background: The Ignacio Chávez National Institute of Cardiology (NIC) has positioned itself as an international benchmark in cardiovascular medical education, standing out for its high academic standards and human quality. Objective: This study aims to identify the employment and academic profile of cardiology fellowship graduates from the National Institute of Cardiology of Mexico (NIC). Methods: A cross-sectional and retrospective study was conducted, involving 473 graduates from the period 2000-2015. Data was collected through an electronic survey. Results: A total of 221 graduates agreed to participate, accounting for 46.7% of the total number of graduates. Among the participants, 85.2% were male. The majority of graduates (82.4%) held Mexican nationality, while the remaining individuals represented various Latin-American nationalities. Following the completion of the cardiology fellowship, 89% of graduates pursued further postgraduate degrees. Within this group, 95.4% completed at least one additional fellowship, while 4.6% pursued a master's or PhD program. The most popular fellowship program chosen was Interventional Cardiology. On average, NIC graduates dedicate 10.8 hours per day to their work, with 6.4 hours dedicated to cardiology and 4.3 hours to their other postgraduate degree. Those employed in both public and private health systems allocate 6.1 hours and 5.2 hours per day, respectively. Additionally, 75% of graduates are involved in teaching activities. Currently, 84% of graduates are employed in Mexico. Conclusion: The majority of NIC graduates are physicians who further their academic training by pursuing additional postgraduate programs. They work longer hours per day compared to the general Mexican population, with a significant focus on clinical cardiology. Graduates actively seek opportunities to share their expertise through various academic activities.

Medical school origins of award-winning physicians; analysis of a complete national dataset.

BACKGROUND: Educators and medical students share the same objective of achieving success in medical practice. Both groups consider doctors' successes to include optimum patient care outcomes and positive career progressions. Accordingly, identifying common educational features of such high-achieving doctors facilitates the generation of excellence amongst future medical trainees. In this study we use data from the British clinical merit award schemes as outcome measures in order to identify medical school origins of doctors who have achieved national or international prominence. METHODS: Britain has Clinical Excellence Awards/Distinction Awards schemes that financially reward all National Health Service doctors in England, Scotland and Wales who are classified as high achievers. We used these outcome measures in a quantitative observational analysis of the 2019-20 dataset of all 901 national award-winning doctors. Where appropriate, Pearson's Chi-Square test was applied. RESULTS: The top five medical schools (London university medical schools, Glasgow, Edinburgh, Oxford and Cambridge) were responsible for 51.2% of the physician merit award-winners in the 2019-20 round, despite the dataset representing 85 medical schools. 91.4% of the physician merit award-winners were from European medical schools. The lowest national award-winners (tier 3) originated from 61 medical schools representing six continents. International medical graduates comprised 11.4% of all award-winners. CONCLUSIONS: The majority of physicians who were national merit award-winners originated from only five, apparently overrepresented, UK university medical schools. In contrast, there was a greater diversity in medical school origin among the lower grade national merit awards; the largest number of international medical graduates were in these tier 3 awards (13.3%). As well as ranking educationally successful university medical schools, this study assists UK and international students, by providing a roadmap for rational decision making when selecting physician and non-physician medical education pathways that are more likely to fulfil their career ambitions.

Medical school origins of award-winning psychiatrists; analysis of a complete national dataset.

BACKGROUND: Britain attracts doctors from all over the world to work in the National Health Service. Elucidating the educational backgrounds of award-winning doctors working in the country is potentially an important medical education issue and a merit award audit. Using the British clinical merit award schemes as outcome measures, we identify medical school origins of award-winning doctors who have been identified as having achieved national or international prominence. METHODS: The Clinical Excellence Awards/Distinction Awards schemes select doctors in Britain who are classified as high achievers, with categories for national prominence and above. We used this outcome measure in a quantitative observational analysis of the 2019-20 dataset of all 901 award-winning doctors. Pearson's Chi-Square test was used where appropriate. RESULTS: Five university medical schools (London university medical schools, Glasgow, Edinburgh, Aberdeen and Cambridge) accounted for 59.1% of the psychiatrist award-winning doctors in the 2019 round, despite the dataset representing 85 medical schools. 84.1% of the psychiatrist award-winners were from European medical schools, compared to 92.1% of the non-psychiatrist award-winners. International medical graduates accounted for 22.7% of the award-winning psychiatrists. Psychiatrists with the lower grade national awards came from a more diverse educational background of 17 medical schools. IMGs represented diverse medical schools from five continents and were most represented in the lowest grade of national merit awards at 24.2%. CONCLUSIONS: The majority of the award-winning psychiatrists originated from only five medical schools. A greater diversity of medical school origin existed for the lowest grade national psychiatrist award-winners. International medical graduates contributed substantially to these award-winners; psychiatrist award-winners were more likely to be international medical graduates (22.7%) than non-psychiatrist award-winners (10.8%). This study not only indicates educational centres associated with the production of award-winners but also provides students with a roadmap for rational decision making when selecting medical schools.

Turnover intention of foreign trained physicians in German rehabilitation facilities-a quantitative study.

BACKGROUND: Germany's medical specialist shortage is an acute challenge, especially in the rehabilitation segment. One countermeasure is to recruit foreign trained physicians (FTP), but the high turnover of FTP is a burden on the departments that train them and integrate them professionally. Preliminary research showed that currently one in three physician positions in German Pension Insurance (DRV) contract facilities is filled by FTP.This paper examines factors related to turnover intention of FTP in German rehabilitative departments. METHODOLOGY: In spring 2022, we surveyed FTP across all inpatient and outpatient rehabilitation departments under the German Pension Insurance, using a two-stage cross-sectional approach. We conducted an online survey of FTP and developed a specialized questionnaire that captured sociodemographic, occupation related and professional biographical data, turnover intention, satisfaction, difficulties with professional integration and departmental structural characteristics. To analyze retention within the rehabilitation field, we used a measure of turnover intention, taking into account the direction of potential turnover, residency requirements and considerations of returning to the rehabilitation field. The data was evaluated in a subgroup analysis comparing FTP with and without turnover intention using Fisher's exact tests. RESULTS: The sample includes n = 145 FTP, 119 stating no turnover intention and 27 with turnover intention. More than half of FTP with turnover intention wished to move to an acute care hospital. FTP with turnover intention are comparatively younger and came to Germany and were employed in the rehabilitation departments more recently, indicating an earlier career stage. Besides, career-related and regional factors show the strongest relation to turnover intention. DISCUSSION AND CONCLUSION: The results reveal a group of "established FTP" whose professional integration has been successfully completed. FTP with turnover intention are comparatively younger, career-oriented physicians for whom work in a rehabilitative facility is a career springboard to gain a foothold in acute care clinics. A limitation is that FTP with turnover intention are difficult to reach and may be underrepresented in our sample.

The Impact of a Web-Based Restorative Dentistry Course on the Learning Outcomes of Dental Graduates: Pre-Experimental Study.

BACKGROUND: Restorative dentistry plays a crucial role in dental practice, necessitating professionals to stay abreast with the latest advancements in the field. The advancement of technology has made web-based learning a widely used method of education delivery in dentistry, providing learners with extensive information and flexibility. OBJECTIVE: This study aims to evaluate how effective an online educational course in restorative dentistry is for dental graduates in Syria. METHODS: This study used a pre-experimental study design, with pretest and posttest assessments to measure changes in participants' knowledge and skills. A total of 21 dental graduates completed the online course in restorative dentistry, which was hosted on Moodle, using the learning management system of the Syrian Virtual University. Participants were provided with a suggested learning sequence and had the flexibility to navigate the course on their own and at their own pace. The course was developed based on the principles of web course design and web-based course development using the ADDIE (Analysis, Design, Development, Implementation, and Evaluation) general instructional design model. The pretest and posttest assessments consisted of 50 multiple-choice questions with a single correct answer, aligning with the course content. Furthermore, participants were asked to complete a course acceptance survey upon finishing the course. RESULTS: The results showed a significant improvement in the participants' knowledge of restorative dentistry, supported by a statistically significant P value of less than .05. The effect size of the difference between the pre and posttest indicated that the effect size, as indicated by ω2, demonstrated a significant 62.1% difference between the pre and posttest, indicating a high and statistically significant effect. Furthermore, the value derived from the Haridy obtained work ratio formula indicated that the educational program was effective, with an effectiveness amount of 3.36%. Additionally, 93% (n=19) of respondents expressed confidence in having gained the expected benefits from the educational course upon its completion. CONCLUSIONS: The findings indicated a notable enhancement in the participants' understanding of restorative dentistry. The participants' high satisfaction rate and positive feedback from the course acceptance survey further emphasize the favorable reception of the web-based learning approach. This study highlights the potential of web-based learning in dental education, opening the door for future research in this area. The findings of this study carry important implications for the design and implementation of web-based educational programs in dentistry, suggesting that such programs can serve as an effective tool for continuous professional development in the field.

Academic and professional profile of cardiology fellowship graduates of National Institute of Cardiology Ignacio Chávez from 2000 to 2015.

BACKGROUND: The Ignacio Chávez National Institute of Cardiology (NIC) has positioned itself as an international benchmark in cardiovascular medical education, standing out for its high academic standards and human quality. OBJECTIVE: This study aims to identify the employment and academic profile of cardiology fellowship graduates from the National Institute of Cardiology of Mexico (NIC). METHODS: A cross-sectional and retrospective study was conducted, involving 473 graduates from the period 2000-2015. Data was collected through an electronic survey. RESULTS: A total of 221 graduates agreed to participate, accounting for 46.7% of the total number of graduates. Among the participants, 85.2% were male. The majority of graduates (82.4%) held Mexican nationality, while the remaining individuals represented various Latin-American nationalities. Following the completion of the cardiology fellowship, 89% of graduates pursued further postgraduate degrees. Within this group, 95.4% completed at least one additional fellowship, while 4.6% pursued a master's or PhD program. The most popular fellowship program chosen was Interventional Cardiology. On average, NIC graduates dedicate 10.8 hours per day to their work, with 6.4 hours dedicated to cardiology and 4.3 hours to their other postgraduate degree. Those employed in both public and private health systems allocate 6.1 hours and 5.2 hours per day, respectively. Additionally, 75% of graduates are involved in teaching activities. Currently, 84% of graduates are employed in Mexico. CONCLUSION: The majority of NIC graduates are physicians who further their academic training by pursuing additional postgraduate programs. They work longer hours per day compared to the general Mexican population, with a significant focus on clinical cardiology. Graduates actively seek opportunities to share their expertise through various academic activities.

ANTECEDENTES: El Instituto Nacional de Cardiología Ignacio Chávez (INC) se ha posicionado como un referente internacional en la educación médica cardiológica, destacándose por su alto nivel académico y calidad humana. OBJETIVO: El objetivo de este estudio fue identificar el perfil laboral y académico actual de los egresados del Instituto Nacional de Cardiología Ignacio Chávez (INC). MÉTODOS: Se llevó a cabo un estudio transversal y retrospectivo que incluyó a 473 egresados del INC graduados entre 2000 y 2015. Se utilizó una encuesta electrónica para recopilar los datos. RESULTADOS: Un total de 221 egresados aceptaron participar en el estudio, lo que representa el 46.7% del total de egresados. El 85.2% de los participantes son hombres. La mayoría de los egresados son de nacionalidad mexicana (82.4%), mientras que el resto se distribuye en varios países de Latinoamérica. El 89% de los egresados completó otro posgrado después de cardiología. De este grupo, el 95.4% realizó al menos una alta especialidad, mientras que el 4.6% obtuvo una maestría o doctorado. La especialidad más comúnmente elegida fue Cardiología Intervencionista. Los egresados del INC trabajan en promedio 10.8 horas al día, de las cuales 6.4 horas se dedican a la cardiología clínica y 4.3 horas al otro posgrado. Aquellos que trabajan en el sector público y privado dedican 6.1 horas y 5.2 horas al día, respectivamente. Además, el 75% de los egresados desempeña actividades de enseñanza. El 84% de los egresados trabajan en México. CONCLUSIÓN: En su mayoría, los egresados del INC son médicos especialistas que continúan su formación académica a través de la realización de otros posgrados. Trabajan más horas al día en comparación con el resto de la población mexicana, y dedican la mayor parte de su tiempo al ejercicio de la cardiología clínica. También buscan transmitir sus conocimientos a través de actividades académicas y de enseñanza.

Sound the Alarm: The Sonographer Shortage Is Echoing Across Healthcare.

OBJECTIVES: The growth in ultrasound usage necessitates concurrent growth in the number of sonographers. Despite the increasing importance of ultrasound, there is a shortage of sonographers in the United States that has never been specifically quantified. This study examines recent trends in the number of ultrasound exams, sonography graduates, open sonographer positions, and wages. METHODS: This retrospective study uses public databases and surveys including the Medical Expenditure Panel Survey (MEPS), Bureau of Labor Statistics (BLS), Integrated Postsecondary Education Data System (IPEDS), and Zippia, a human resources platform to determine metrics. These metrics include the number of ultrasound exams conducted in the United States (excluding inpatient setting), number of sonographers and sonographer wages, sonography graduates, and open sonographer positions. RESULTS: Ultrasound exams in the United States from 2011 to 2021 increased from 38.6 million to 59.8 million (+55.1%,) while the number of sonographers (2011-2021) increased from 54,760 to 78,640 (+43.6%). There was a significant difference between supply and demand of sonographers with the number of sonography graduates (2011-2021) increasing from 4,386 to 5,393 (+23.0%) while the number of open sonographer positions (2012-2021) increased from 18,462 to 25,162 (+36.3%). CONCLUSIONS: From 2011 to 2021, the increase in the number of ultrasound exams has significantly outpaced the increase in the number of sonographers. Furthermore, the increase in demand for sonographers has grown significantly faster than the supply, leading to a shortage and consequent strain on the healthcare system. To address the shortage, the number of sonography school openings should be increased, and the attendant challenges addressed.