Disparities across the CREOG Districts —Variations of Wellness and Inclusivity Efforts in Obstetrics & Gynecology Residency Websites between Two Consecutive Years

Background: Few studies have focused on the geographic and chronologic assessment of inclusivity and wellness in Obstetrics and Gynecology residency websites across the US. Objective: To identify variations in wellness and inclusivity website depictions across CREOG districts over the past two years. Methods: This is a cross-sectional analysis of the websites of ACGME-accredited OB/GYN residency programs across the United States between April 2022 and April 2023. The assessment was based on a compilation of 22 attributes devised and piloted by 49 medical students. A racially, geographically, and gender-diverse cohort of 11 students performed data collection. Results: A total of 560 websites were analyzed over two years. Wellness efforts remained unchanged in both years (website content, dedicated support personnel, and group activities). In 2023, a reduction in referencing of wellness (22%) and inclusivity (30%) occurred in leadership messaging. However, a 7% increase in the use of inclusive pronouns was noted. A reduction in gender diversity was identified (9% in faculty, 5% in residents), with programs favoring female-only teams. Similarly, a 7% reduction in the number of underrepresented in medicine faculty and residents was noted. A 15% reduction was noted in curricula referencing inclusivity in their mission statement and inclusivity focused research. Conclusions: This study suggests the variations across websites relative to inclusivity and wellness over the past two years. Updated websites may provide an accurate reflection of the offerings of programs and their investment in wellness and inclusivity across the nation.

Application Effect of Remote Ultrasound Teaching in Standardized Residency Training

Objective:To explore the application effect of remote ultrasound teaching in the standardized training of residents.Methods:42 students who participated in the standardized residency training in the Department of Ultrasonography of our hospital from August 2022 to August 2023 were selected and divided into the control group(n=21)and the observation group(n=21)by using the random number table method.The control group was taught routinely,and the observation group was taught with remote ultrasound on the basis of the control group.The general data,teaching effect,ultrasound diagnostic compliance rate,and teaching satisfaction of the participants in the two groups were observed.Results:The baseline data of the two groups were not statistically significant(P>0.05);the theoretical and practical assessment scores of the observation group were significantly better than those of the control group(t=2.491,t=2.434,P=0.05);the ultrasound diagnostic compliance rate of the participants in the observation group was significantly higher than that of the control group(78.33%)(χ2=33.574,P=0.000<0.001);the overall satisfaction rate of students in the observation group(20/95.24%)was significantly higher than that of the control group(14/66.67%)(χ2=3.860,P=0.049<0.05).Conclusion:In standardized residency training,remote ultrasound teaching can effectively improve the comprehensive ability of students,enhance diagnostic accuracy,and improve students’teaching satisfaction.

Perceptions of emergency medicine residents on the quality of residency training in the United States and Saudi Arabia

BACKGROUND: We compare educational environments(i.e. physical, emotional and intellectual experiences) of emergency medicine(EM) residents training in the United States of America(USA) and Saudi Arabia(SA).METHODS: A cross-sectional survey study was conducted using an adapted version of the validated Postgraduate Hospital Educational Environment Measure(PHEEM) survey instrument from April 2015 through June 2016 to compare educational environments in all emergency medicine residency programs in SA and three selected programs in the USA with a history of training Saudi physicians. Overall scores were compared across programs, and for subscales(autonomy, teaching, and social Support), using chi-squared, t-tests, and analysis of variance.RESULTS: A total of 219 surveys were returned for 260 residents across six programs(3 SA, 3 USA), with a response rate of 84%. Program-specific response rates varied from 79%–100%. All six residencies were qualitatively rated as "more positive than negative but room for improvement". Quantitative PHEEM scores for the USA programs were significantly higher: 118.7 compared to 109.9 for SA, P=0.001. In subscales, perceptions of social support were not different between the two countries(P=0.243); however, role autonomy(P<0.001) and teaching(P=0.005) were better in USA programs. There were no significant differences by post-graduate training year.CONCLUSION: EM residents in all three emergency medicine residency programs in SA and the three USA programs studied perceive their training as high quality in general, but with room for improvements. USA residency programs scored higher in overall quality. This was driven by more favorable perceptions of role autonomy and teaching. Understanding how residents perceive their programs may help drive targeted quality improvement efforts.

Ophthalmology residency training in Jordan:an evaluation of quality and comparison with international standards

AIMTo evaluate Jordanian ophthalmology residency programs in achieving competencies outlined by the International Council of Ophthalmology (ICO) and residents' satisfaction with available training programs in Jordan, and to highlight weakness points that may be improved and strengthened.

Robotic cardiac surgery training during residency: Preparing residents for the inevitable future

Unlike other surgical residency training programs including thoracic surgery, robotic cardiac surgery skilltraining is minimal or absent in residency curricula. A review was conducted to identify residents'exposure to robotic cardiac surgery training based on databases including PubMed, MEDLINE and GoogleScholar. Published papers and cardiothoracic surgical societies with robotic cardiac surgery trainingcourses were reviewed. Robotic cardiac surgery training for residents is almost non-existent. Strategies toestablish proper robotic cardiac surgical training for residents include implementing simulation training,implementing hour requirements and establishing wet/dry lab model training in a progressive fashion.As robot-assisted cardiac surgery becomes increasingly commonplace, it will be imperative to providetraining for residents with dedicated opportunities to develop their skills in robotic cardiac surgery.

The importance and patterns for humanities education of Chinese ophthalmology residency

At this point in time,the importance of medical humanities education has not been fully understood during the standardized training of residents in China.The study of medical humanities is an important facet of ophthalmology residency that needs to be strengthened.During the standardized training of ophthalmology residents,not only the medical sciences should be strengthened,but also the nature and practice of medical humanities knowledge should be enhanced in multiple aspects.Offering medically-relevant literature,history,philosophy and other courses,simulating real medical activities,being enthusiastic in popular medical science and increasing the contents of the examination in medical humanities would all be areas that would further advance the ophthalmology residency.Along with medical science education,residents will be led and trained on medical humanities as to build good medical humanistic spirit of patient care so that they may better serve patients.

Pharmacy residency system in Gunma University Hospital

Recently,undergraduate and postgraduate pharmaceutical education systems have been changing greatly in Japan.In 2006,undergraduate pharmacist program was changed from 4 years course to 6 years course to train higher-quality pharmacists who can deal with the changes in the progression of medical technology and meet social demands for medication safety[1].As a postgraduate training system,pharmacy residency system was started in several hospital in 2002,and around 35 hospitals have pharmacy residency system at 2015[2].

Social media growth of orthopaedic surgery residency programs in response to the COVID-19 pandemic

BACKGROUND In the Spring of 2020,residency programs across the country experienced rapid and drastic changes to their application process as a result of the coronavirus disease 2019(COVID-19)pandemic.In response,residency programs shifted to virtual events and began harnessing social media to communicate with applicants.AIM To analyze the changes in social media usage by orthopaedic surgery programs in response to the COVID-19 pandemic.METHODS Based on the 2019 residency and fellowship electronic database,accredited US orthopaedic surgery programs were reviewed for social media presence on Instagram and Twitter.Approximately 47000 tweets from 2011-2021 were extracted through the Twitter application programming interface.We extracted:Total number of followers,accounts following,tweets,likes,date of account creation,hashtags,and mentions.Natural language processing was utilized for tweet sentiment analysis and classified as positive,neutral,or negative.Instagram data was collected and deemed current as of August 11,2021.The account foundation date analysis was based on the date recognized as the start of the COVID-19 outbreak in the United States,before or after March 1,2020.RESULTS A total of 85(42.3%)orthopaedic surgery residency program Twitter handles were identified.Thirty-five(41.2%)programs joined Twitter in the nine months after the 2020 covid outbreak.In 2020,there was a 126.6%increase in volume of tweets by orthopaedic surgery residency accounts as compared to 2019.The median number of followers was 474.5(interquartile range 205.0-796.5).The account with the highest number of tweets was Hospital for Special Surgery(@HSpecialSurgery)with 13776 tweets followed by University of Virginia(@UVA_Ortho)with 5063 and Yale(@OrthoAtYale)with 899.Sentiment analysis before 2020 revealed 30.4%positive,60.8%neutral,and 8.8%negative sentiments across tweets.Interestingly,the positive sentiment percentage increased in 2020 from 30.4%to 34.5%.Of the 201 ACGME-accredited orthopaedic residency programs on Fellowship and Residency Electronic Interactive Database,115(57.2%)participate on Instagram,with 101(87.8%)identified as“resident”-managed vs 14(12.2%)identified as“department”-managed.Over three quarters(77.4%)of Instagram accounts were created after March 1,2020.The average number of followers per account was 1089.5 with an average of 58.9 total posts.CONCLUSION Our study demonstrates a substantial growth of Instagram and Twitter presence by orthopaedic surgery residency programs during the COVID-19 pandemic.These data suggest that orthopaedic residency programs have utilized social media as a new way to communicate with applicants and showcase their programs in light of the challenges presented by the pandemic.

Feasibility of Gastrointestinal Endoscopy Training in Surgery Residency at a Public Referal Hospital in Malawi

Objective: We set out to explore the impact of gastrointestinal (GI) endoscopy training on the surgery residency program at Kamuzu Central Hospital (KCH), Lilongwe, Malawi. Methods: We reviewed the hospital and published data regarding GI endoscopy and the surgical training at KCH from 2009 to 2015. The endoscopy database was reviewed determining endoscopic procedures done during the same period. Results: Since the onset of surgical residency program at KCH in 2009, 7 residents (5 now COSECSA Fellows) have been trained as independent GI endoscopists with support from the British Society of Gastroenterology andLiverpool Malawi Wellcome trust. Between them, with supervision, 1304 upper and 28 lower GI scopes have been done;22% therapeutic. Endoscopy capacity has improved from an average of 12 patients per week to about 30 patients per week with a well-developed oesophageal variceal banding and tumour stenting capacity. Weekly endoscopy training lists by the fellows have also been established. During the same time period, 3 papers have been published from the endoscopy data with the residents as principle investigators or co-authors. Conclusion: With dedicated support endoscopy training during surgical residency is feasible in resource poor settings and improves diagnostic capacity for better patient care ultimately benefiting trainees in gaining endoscopy diagnostic and therapeutic skills, appreciating disease spectrum and management, and exposure to research skills.

Tang Maohong:Noa Noa,Southeast Asia Residency Exhibition

Artists:TANG Maohong Date:05.03,2019-07.14,2019 Duration:4 May-30 June,2019 Address:ShanghART Singapore,9 Lock Road,#02-22,Gillman Barracks,Singapore 108937Asolo exhibition by our artistin-residence,Tang Maohong,was shown from 4 May to 14 July 2019.Taking inspiration from Paul Gauguin’s famed but controversial residency in the Tahiti,the exhibition title borrows from Gauguin’s travelogue Noa Noa:The Tahitian Journal.Such a reference reflects the artist’s initial impression of Southeast Asia as a place of lush greenery and azure skies.

Survey Evaluating Sleep Education Catalyzed Change in Residency Training

Background: Despite the high prevalence and negative effects of sleep disorders, sleep issues often remain unexplored during medical encounters. Research has shown that primary care physicians regard their knowledge as inadequate. Objective: We investigated residents’ perceived adequacy of sleep education and level of competency in diagnosing and treating sleep disorders. Methods: A questionnaire via Survey Monkey was administered to senior residents in University of California, Davis (UCD) from family medicine, internal medicine, neurology, and psychiatry to assess perception of their knowledge and training of sleep disorders. Likert scale ratings were used, from 1 (not adequate/competent) to 5 (extremely adequate/competent). Non-parametric statistical methods were used to evaluate differences in survey responses among specialties and assess the correlation between survey responses. Results: Only 33 residents responded with a 29.5% response rate. Neurology residents routinely rotate with a sleep medicine attending and subsequently reported the highest self-competency, adequacy of training, hours of didactics received and frequency of asking patients about sleep. All other residents reported receiving insufficient sleep medicine education. The combined mean score was 1.5 across the specialties regarding adequacy of sleep education in their respective medical schools with 31.3% reporting no sleep medicine training. Conclusions: This study demonstrated that there is a perceived deficit in most residents’ training and competency regarding sleep disorders. These results prompted 2 of the 4 residency programs to change their educational structure with electives in clinical sleep medicine. We believe that this paper illuminates potential need for increasing sleep medicine education throughout various levels of training. Nationwide educational research is needed to promote ACGME to incorporate the fundamentals of sleep medicine into core curriculum. Current Knowledge/Study Rationale: There are no studies, to our knowledge, directly measuring residents’ perceived adequacy of sleep medicine education provided and their perceived level of competency in diagnosing and treating sleep disorders. The aim of this study was to evaluate both the amount of time and quality of sleep education provided to residents as insufficient knowledge in addressing sleep problems may reflect gaps in educational requirements and standards within residency training. Study Impact: This study revealed a perceived deficit in most residents’ training and competency regarding sleep disorders. This study stimulated half of the UC Davis residency programs evaluated to offer electives in clinical sleep medicine suggesting that the study highlighted need for additional educational opportunities in sleep medicine.

Factors Affecting Training Efficacy in Residency Program Adopted by New Graduate Nurses in Saudi Arabia

Objective: The purpose of the studies is to analyze and identify the level of competency, which includes knowledge and skills between SCDP nurses (Residence Program) and newly graduate nurses (Non-residence) in Saudi Arabia. Methods: A survey uses an open-ended question conducted among the participant. The data is collected by using tape recording during the interview session. Newly graduate nurses and SCDP nurses were included in this study. (5) Resident nurses vs. (5) non-resident were included in this study making 10 sample size of qualitative study. Results: Findings of the study show significant differences between nonresident and resident in their journey of orientation, competency development and their learning opportunities. Residents are more likely feel less distress and more satisfied about their experience entering the residence program. Conclusion: Nursing Residency program helps in supporting nurses to build a future leader. Hence, it helps in their critical thinking, skills and knowledge, which elevate their confidence level.

Burnout Syndrome during Pediatric Residency Training

Background: Burnout syndrome is a common professional problem causing mental fatigue, depersonalization, and diminished self-value. Burnout during pediatric residency can significantly influence the resident’s performance and the quality of their training. Objectives: To evaluate the burnout status of pediatric residents across Jeddah, KSA. Methods: A cross-sectional, descriptive study involving pediatric residents across Jeddah, Saudi Arabia was conducted from the 1st of August to 1st of December, 2012. The Maslach Burnout Inventory was utilized in addition to questions about their work environment and lifestyle. Results: Sixty pediatric residents (67% females) were included with ages ranging between 25 - 30 years (mean 26.5). They practiced in various institutions, mostly (41%) in ministry of health hospitals. Burnout scores were abnormal in 49 (82%) and in 19 (32%) the syndrome was severe. Males were more likely to reach a severe burnout category when compared to females (32% vs 19%, p = 0.01). Residents working in the university hospital (23%), were more likely to have severe burnout when compared to those working in other hospitals (p = 0.002). Junior residents (R1 and R2) were also more likely to have severe burnout when compared to senior residents (34% vs 21%, p = 0.013). Conclusions: Many pediatric residents are suffering from burnout syndrome. It is more common among males, junior residents, and those working in a university hospital setting. Specific strategies should be developed to prevent resident burnout.

A Missing Step: The Value of Psychological Mindedness Training during Psychiatry Residency

Psychiatry residents, who lack psychological mindedness, struggle to understand the multiple determinants of behavior, or the numerous meanings of a single symptom. This is unfortunate because most psychiatry resident interns feel that they are finally among the group where they belong… like-minded physicians who share a fascination with human nature and a desire to grasp all the nuances and complexities of human behavior. This paper provides a framework for psychiatry departments to train residents along a continuum of psychological mindedness. The authors explain the concept of psychological mindedness, explore the pros and cons of acquiring psychological mindedness, and a scientific basis for its use in general psychiatry. A new model is included to capture any resident’s ability to become psychologically minded, with direction for Program Director’s to possibly develop growth in a resident’s psychological mindedness over four years of training.

Site Fidelity and Residency of Tursiops truncatus off the Aragua Coast,Venezuela-First Records of Long Residency

This study represents the first comprehensive analysis of the residency patterns of a coastal population of bottlenose dolphin off the coast of Aragua,Venezuela,over a multi-year period.Using photo-identification,the most recent study(2019-2020)identified 56 individuals with the time between encounters from one to 344 days between the first and last sighting.Site Fidelity(SF)and Residence(RES)indices were calculated and Agglomerative Hierarchical Clustering(AHC)modeling was performed,with three patterns of residence obtained:resident(25%),semi-resident(17.86%)and transient(57.14%).These results were contrasted with remodeled data from a previous study(2006-2007),showing similar patterns:resident(24.44%),semi-resident(28.89%)and transient(46.67%).Importantly,two individuals were found to have been resident over the extended period.A breeding female sighted for the first time in 2004 and again in 2020(16 years)and the other from 2005 to 2020(15 years).This region is an important area for marine mammals,known to support a resident reproductive population over many years,as well seabirds,sea turtles,whale sharks and fishermen.We recommend that consideration be given to designating the waters as a Marine Protected Area to safeguard the existing population and provide benefit to the surrounding marine environment.

Otolaryngology residency program factors associated with female resident representation

Objective:Female representation in the field of otolaryngology is lacking.Residency is the first point at which medical school graduates specialize in a chosen field and thus represents an opportunity to recruit and train more female otolaryngologists.This study sought to identify program factors associated with greater female representation among resident physicians.Methods:Departmental websites of all 124 otolaryngology residency programs in the United States and Puerto Rico were examined for a list of residents.For programs with a resident roster available,the genders of residents,faculty,program directors,and chairpersons were recorded.Location and city population for each program was also recorded,as was female resident representation.Programs were compared using Pearson Chi‐squared univariate tests.Results:1,632 residents and 2,605 faculty were included in the analysis of 109 programs.The median female resident representation was 40%.Programs with larger faculty sizes,more female faculty,and urban location were associated with an above‐median female resident representation.Programs with a larger residency cohort approached significance regarding above‐median female resident representation.Higher female faculty representation,program director gender,chairperson gender,and US region were not associated with variation in female resident representation.Conclusions:Greater female otolaryngology residency representation was associated with programs having an urban location and greater numbers of female and total faculty.It was also likely that a larger resident cohort size may affect female resident representation.The proportions of female faculty,program director,and chairperson gender,as well as the US region,were not associated with variation in female resident gender representation.

Ophthalmic exam and ophthalmology residents’ subspecialty preference

AIM:To evaluate residents’perceptions and attitudes toward the various aspects of a comprehensive ophthalmic examination,and to determine if these factors correlate with their choices for fellowship and future career plans.METHODS:This is a cross-sectional study.A questionnaire on the perception of the ophthalmic exam was sent via SurveyMonkey to ophthalmology residents throughout Israel.Eighty of them(one-half of all ophthalmology residents in 2019)completed it.The first part related to how they perceived each component of the ophthalmic evaluation.The second part related to their future fellowship plans.The Chi-squared test was used to compare categorical variables and Student’s t-test and One-way ANOVA were used to compare continuous variables.Multivariate logistic regression analysis was applied as needed to detect interactions between variables and to exclude confounder effects.RESULTS:Slit-lamp examination of the anterior and posterior segments ranked as the most likeable aspects,whereas gonioscopy,ocular motility examination and visual acuity assessment were least likeable.Anterior segment and retina subspecialties were the ones most sought after.Forty-nine respondents(61.3%)noted a direct correlation between their preferred parts of comprehensive ophthalmic evaluations and their choice of subspecialty.Perceptions of selected components of those evaluations were significantly associated with responders’intentions to pursue anterior segment,retina,or oculoplastic fellowships(P<0.05).CONCLUSION:Perspectives of residents toward the ophthalmic examination,and most specifically its individual components,play an important role in their choice of subspecialty training.

Maxillofacial Surgery Education: Where Is It Heading?

Oral and maxillofacial surgery have a long history dating back to ancient civilizations such as the Egyptians. Since then, surgeons have treated craniofacial trauma and alveolodental fractures. In 1846, Hullihen performed a mandibular body osteotomy to correct prognathism, marking a significant milestone in the field. Over time, the specialty has evolved significantly. The field of craniofacial surgery has undergone several phases, including its involvement in conflicts during world wars and the treatment of craniofacial fractures and discrepancies. The process of learning and teaching specialties has evolved differently in various countries throughout the 20th century. Currently, there is no uniformity in the training and registration of specialized professionals, resulting in distinct scenarios. Considering the accessibility of scientific knowledge through technology and globalization, it is crucial to provide an objective overview of the current state of education in the field. This paper focuses on effective professional training as the primary subject of residency courses in this specialty. A proposal is presented for education, emphasizing the significance of providing quality professional training that is tailored to the specific legislation of each country.

Foreign residency rights and companies’ auditor choice

Recently, with the migration of wealthy Chinese elites becoming increasingly prevalent, the market has come to believe that firms with controlling persons with foreign residency rights have serious agency problems. We study the impact of controlling persons with foreign residency rights on corporate audit perspective. We find that firms whose controlling persons have foreign residency rights are more likely to use high-quality auditing services, and that this behavior is more obvious in regions with lower marketization and in firms with higher separation of ownership and control. We further study the effect of firms whose controlling persons have foreign residency rights that use high-quality Big 4 auditors and find that such firms have better corporate governance and accounting performance.

Geochemical and Isotopic Techniques Constraints on the Origin,Evolution,and Residence Time of Low-enthalpy Geothermal Water in Western Wugongshan,SE China

Geothermal resources are increasingly gaining attention as a competitive,clean energy source to address the energy crisis and mitigate climate change.The Wugongshan area,situated in the southeast coast geothermal belt of China,is a typical geothermal anomaly and contains abundant medium-and low-temperature geothermal resources.This study employed hydrogeochemical and isotopic techniques to explore the cyclic evolution of geothermal water in the western Wugongshan region,encompassing the recharge origin,water-rock interaction mechanisms,and residence time.The results show that the geothermal water in the western region of Wugongshan is weakly alkaline,with low enthalpy and mineralization levels.The hydrochemistry of geothermal waters is dominated by Na-HCO_(3)and Na-SO_(4),while the hydrochemistry types of cold springs are all Na-HCO_(3).The hydrochemistry types of surface waters and rain waters are NaHCO_(3)or Ca-HCO_(3).The δD and δ^(18)O values reveal that the geothermal waters are recharged by atmospheric precipitation at an altitude between 550.0 and 1218.6 m.Molar ratios of maj or solutes and isotopic compositions of^(87)Sr/^(86)Sr underscore the significant role of silicate weathering,dissolution,and cation exchange in controlling geothermal water chemistry.Additionally,geothermal waters experienced varying degrees of mixing with cold water during their ascent.Theδ^(13)C values suggest that the primary sources of carbon in the geothermal waters were biogenic and organic.Theδ^(34)S value suggests that the sulfates in geothermal water originate from sulfide minerals in the surrounding rock.Age dating using 3H and^(14)C isotopes suggests that geothermal waters have a residence time exceeding 1 kaBP and undergo a long-distance cycling process.