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Torres Perez-Iglesias C, Mathew F, Cacao Coimbra B, SenthilKumar G, Goyal R, Gangadharan SP. Essential Competencies for the Success of International Medical Graduates in Surgical Training: A Comparative Study of Trainee and Faculty Perspectives. JOURNAL OF SURGICAL EDUCATION 2025; 82:103419. [PMID: 39938191 DOI: 10.1016/j.jsurg.2024.103419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2024] [Revised: 11/09/2024] [Accepted: 12/29/2024] [Indexed: 02/14/2025]
Abstract
BACKGROUND International Medical Graduates (IMGs) occupy a third of all non-designated preliminary general surgery training positions in the United States, but fewer than half complete surgical training. Previous research has shown discrepancies between evaluators and trainees on various aspects of medical training, impacting educational outcomes. Understanding any potential divergence in perceptions between faculty and trainees on essential competencies could help trainees improve their clinical performance and their chances of obtaining categorical training positions. OBJECTIVE To assess differences in perceptions between IMGs and evaluators on essential competencies during general surgery training. DESIGN Cross-sectional, survey-based using a nonvalidated electronic survey instrument, with 13 questions aimed to assess the competencies considered essential for IMGs in preliminary PGY-1 or PGY-2 training positions to succeed in general surgery residency. Responses were collected using a snowball sampling method. SETTING The survey was distributed via X (formerly known as Twitter), WhatsApp, the American College of Surgeon Online Communities, and email between June and August 2023. Responses were captured in RedCap. PARTICIPANTS The first group ("the evaluatees") comprises IMGs and medical students applying for general surgery residency positions in the U.S. and IMGs in PGY-1 and PGY-2 preliminary general surgery training positions in the U.S. The second group ("the evaluators") included faculty in general surgery programs in the U.S. and senior general surgery residents in the U.S. RESULTS There were 196 respondents, including 70 "evaluators" and 126 "evaluatees". Most evaluators identified as male (78.5%), whereas 65.1% of evaluatees identified as female. Ethnic diversity varied widely between groups. Evaluators identified mainly as white (67.1%), while evaluatees were mostly Asian/South Asian (46%) or Hispanic/Latino (30.1%). Most evaluators worked at university-affiliated hospitals (61.4%). Both groups ranked "Knowledge Application/Critical Thinking Skills" as the most essential competency for preliminary IMG residents to do well in training. "Research Skills" followed by "Technical Skills" were rated as the least essential. The highest concordance (>80%) between groups for mandatory competencies was found for "Interpersonal and Communication Skills", "Professionalism," and "Learning, Teaching, and Teamwork". Significant differences were found between the groups' perceptions of clinical, research, and technical skills (p < 0.01). CONCLUSIONS The value of nontechnical skills in surgical training transcends cultural and educational backgrounds. IMGs place greater importance on clinical and technical skills. Future educational initiatives must bridge the gap between perceptions and expectations to enhance training outcomes for IMGs.
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Affiliation(s)
| | - Fleming Mathew
- Division of Thoracic Surgery and Interventional Pulmonology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Brendha Cacao Coimbra
- Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Gopika SenthilKumar
- Medical Scientist Training Program, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Raunak Goyal
- Department of Plastic Surgery, Brigham and Women's Hospital, Boston, Massachusetts
| | - Sidharta P Gangadharan
- Division of Thoracic Surgery and Interventional Pulmonology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
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Omar Y, Al Refaei A, Al-Qawasmeh AR, Ghazzal H, Kalbouneh H. Migration intent among Jordanian medical students: a nationwide cross-sectional investigation. Postgrad Med J 2023; 99:855-861. [PMID: 37137543 DOI: 10.1136/postgradmedj-2022-141817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 04/25/2022] [Indexed: 11/04/2022]
Abstract
PURPOSE OF THE STUDY To investigate postgraduation emigration intents of medical students throughout different years and different universities in Jordan. STUDY DESIGN This cross-sectional study was conducted via an online self-administered questionnaire from medical students in six schools of medicine in Jordan. Our questionnaire included two sections with questions regarding sociodemographic, intentions and reasons behind residency and fellowship abroad, and views on Jordanian residency programmes. RESULTS Of a sample of 1006, 55.7% were females, and 90.7% were holding Jordanian citizenship. 85% and 63% of respondents intended to pursue residency and fellowship abroad, respectively. Intention to continue residency abroad was associated with males, expatriates and those living in urban areas. The main three destinations were the USA (37.4%), UK (22.3%) and Germany (16.6%). 30% of respondents intended to leave the country permanently, because of low salaries, poor education and lower ranking of Jordan residency programmes. When asked about ranking Jordanian residency programmes, it was found that on average, students ranked military hospitals first and government hospitals last with university hospitals being in second place and private hospitals in third. CONCLUSION Unfortunately, a striking number of Jordanian medical students intended to leave the country postgraduation, which points towards the necessity for Ministry of health to take immediate actions to reduce the loss of our best students.
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Affiliation(s)
- Yousef Omar
- School of Medicine, The University of Jordan, Amman, Jordan
| | | | | | - Hamza Ghazzal
- School of Medicine, The University of Jordan, Amman, Jordan
| | - Heba Kalbouneh
- Department of Anatomy and Histology, School of Medicine, The University of Jordan, Amman, Jordan
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Bodas M, Strasser J, Luo Q, Schenk E, Chen C. Association of Primary Care Physicians' Individual- and Community-Level Characteristics With Contraceptive Service Provision to Medicaid Beneficiaries. JAMA HEALTH FORUM 2023; 4:e230106. [PMID: 36930168 PMCID: PMC10024198 DOI: 10.1001/jamahealthforum.2023.0106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
Importance Little is known about primary care physicians who provide contraceptive services to Medicaid beneficiaries. Evaluating this workforce may help explain barriers to accessing these services since contraceptive care access is critical for Medicaid beneficiaries' health. Objective To describe the primary care physician workforce that provides contraceptive services to Medicaid beneficiaries and explore the factors associated with their Medicaid contraceptive service provision. Design, Setting, and Participants This cross-sectional study, conducted from August 1 to October 10, 2022, used data from the Transformed Medicaid Statistical Information System from 2016 for primary care physicians from 4 specialties (family medicine, internal medicine, obstetrics and gynecology [OBGYN], and pediatrics). Main Outcomes and Measures The main outcomes were providing intrauterine devices (IUDs) or contraceptive implants to at least 1 Medicaid beneficiary, prescribing hormonal birth control methods (including a pill, patch, or ring) to at least 1 Medicaid beneficiary, the total number of Medicaid beneficiaries provided IUDs or implants, and the total number Medicaid beneficiaries prescribed hormonal birth control methods in 2016. Physician- and community-level factors associated with contraceptive care provision were assessed using multivariate regression methods. Results In the sample of 251 017 physicians (54% male; mean [SD] age, 49.17 [12.58] years), 28% were international medical graduates (IMGs) and 70% practiced in a state that had expanded Medicaid in 2016. Of the total physicians, 48% prescribed hormonal birth control methods while 10% provided IUDs or implants. For OBGYN physicians, compared with physicians younger than 35 years, being aged 35 to 44 years (odds ratio [OR], 3.51; 95% CI, 2.93-4.21), 45 to 54 years (OR, 3.01; 95% CI, 2.43-3.72), or 55 to 64 years (OR, 2.27; 95% CI, 1.82-2.83) was associated with higher odds of providing IUDs and implants. However, among family medicine physicians, age groups associated with lower odds of providing IUDs or implants were 45 to 54 years (OR, 0.66; 95% CI, 0.55-0.80), 55 to 64 years (OR, 0.51; 95% CI, 0.39-0.65), and 65 years or older (OR, 0.29; 95% CI, 0.19-0.44). Except for those specializing in OBGYN, being an IMG was associated with lower odds of providing hormonal contraceptive service (family medicine IMGs: OR, 0.80 [95% CI, 0.73-0.88]; internal medicine IMGs: OR, 0.85 [95% CI, 0.77-0.93]; and pediatric IMGs: OR, 0.85 [95% CI, 0.78-0.93]). Practicing in a state that expanded Medicaid by 2016 was associated with higher odds of prescribing hormonal contraception for family medicine (OR 1.50; 95% CI, 1.06-2.12) and internal medicine (OR, 1.71; 95% CI, 1.18-2.48) physicians but not for physicians from other specialties. Conclusions and Relevance In this cross-sectional study of primary care physicians, physician- and community-level factors, such as specialty, age, and the Medicaid expansion status of their state, were significantly associated with how they provided contraceptive services to Medicaid beneficiaries. However, the existence of associations varied across clinical specialties. Ensuring access to contraception among Medicaid beneficiaries may therefore require policy and program approaches tailored for different physician types.
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Affiliation(s)
- Mandar Bodas
- Fitzhugh Mullan Institute for Health Workforce Equity, Department of Health Policy and Management, Milken Institute School of Public Health, The George Washington University, Washington, DC
| | - Julia Strasser
- Fitzhugh Mullan Institute for Health Workforce Equity, Department of Health Policy and Management, Milken Institute School of Public Health, The George Washington University, Washington, DC
| | - Qian Luo
- Fitzhugh Mullan Institute for Health Workforce Equity, Department of Health Policy and Management, Milken Institute School of Public Health, The George Washington University, Washington, DC
| | - Ellen Schenk
- Fitzhugh Mullan Institute for Health Workforce Equity, Department of Health Policy and Management, Milken Institute School of Public Health, The George Washington University, Washington, DC
| | - Candice Chen
- Fitzhugh Mullan Institute for Health Workforce Equity, Department of Health Policy and Management, Milken Institute School of Public Health, The George Washington University, Washington, DC
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Varadaraj V, Ranjit A, Nwadiuko J, Canner J, Diener-West M, Schneider EB, Thyagarajan SP, Shrestha R, Nagarajan N. Towards diaspora-driven research capacity strengthening in low- and middle-income countries: results from India and Nepal. Int Health 2019; 11:221-228. [PMID: 30307506 DOI: 10.1093/inthealth/ihy076] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 08/12/2018] [Accepted: 09/07/2018] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Biomedical research from high-income countries often informs practice and policy in low- and middle-income countries (LMICs) with vastly different socioeconomic and health systems. Engagement of LMIC-based researchers is integral to setting research priorities in the local context. METHODS A program, comprising a research seminar and workshop, and utilizing diaspora health professionals to understand research needs and build research capacity in LMICs, was created and pilot-tested at two institutions in India (65 participants) and Nepal (30 participants). Pre- and post-program surveys were instituted to assess participants' attitudes towards research. RESULTS In the pre-program survey, most participants (India: 76%, Nepal: 100%) perceived research as 'very/extremely important' in their careers. However, a majority felt that finding time (India: 75%, Nepal: 81%) and funding (India: 82%, Nepal: 100%) for research was 'difficult/very difficult'. After the program, 86-91% and 86-100% of participants from India and Nepal, respectively, felt that the various courses were very useful/useful for their research careers. CONCLUSIONS Research is seen as an integral part of educational training and career advancement in LMICs. However, inadequate training, funding and mentorship remain a challenge. Engagement of diaspora health workers may serve as an important avenue for collaborative biomedical research capacity strengthening in LMICs.
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Affiliation(s)
- Varshini Varadaraj
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD, USA
| | - Anju Ranjit
- Center for Surgery and Public Health, Brigham and Women's Hospital, 1620 Tremont St, Boston, MA, USA
| | - Joseph Nwadiuko
- Department of Medicine, Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD, USA
| | - Joseph Canner
- Department of Surgery, Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD, USA
| | - Marie Diener-West
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, USA
| | - Eric B Schneider
- Department of Surgery, University of Virginia School of Medicine, 1215 Lee St, Charlottesville, VA, USA
| | | | - Rajeev Shrestha
- Departments of Research Development and Medical Education, Kathmandu University, Dhulikhel, Nepal
| | - Neeraja Nagarajan
- Department of Surgery, Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD, USA
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Duvivier RJ, Burch VC, Boulet JR. A comparison of physician emigration from Africa to the United States of America between 2005 and 2015. HUMAN RESOURCES FOR HEALTH 2017; 15:41. [PMID: 28651539 PMCID: PMC5485566 DOI: 10.1186/s12960-017-0217-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 06/15/2017] [Indexed: 05/26/2023]
Abstract
BACKGROUND Migration of health professionals has been a cause for global concern, in particular migration from African countries with a high disease burden and already fragile health systems. An estimated one fifth of African-born physicians are working in high-income countries. Lack of good data makes it difficult to determine what constitutes "African" physicians, as most studies do not distinguish between their country of citizenship and country of training. Thus, the real extent of migration from African countries to the United States (US) remains unclear. This paper quantifies where African migrant physicians come from, where they were educated, and how these trends have changed over time. METHODS We combined data from the Educational Commission for Foreign Medical Graduates with the 2005 and 2015 American Medical Association Physician Masterfiles. Using a repeated cross-sectional study design, we reviewed the available data, including medical school attended, country of medical school, and citizenship when entering medical school. RESULTS The outflow of African-educated physicians to the US has increased over the past 10 years, from 10 684 in 2005 to 13 584 in 2015 (27.1% increase). This represents 5.9% of all international medical graduates in the US workforce in 2015. The number of African-educated physicians who graduated from medical schools in sub-Saharan countries was 2014 in 2005 and 8150 in 2015 (304.6% increase). We found four distinct categorizations of African-trained physicians migrating to the US: (1) citizens from an African country who attended medical school in their own country (86.2%, n = 11,697); (2) citizens from an African country who attended medical school in another African country (2.3%, n = 317); (3) US citizens who attended medical school in an African country (4.0%, n = 537); (4) citizens from a country outside Africa, and other than the United States, who attended medical school in an African country (7.5%, n = 1013). Overall, six schools in Africa provided half of all African-educated physicians. CONCLUSIONS The number of African-educated physicians in the US has increased over the past 10 years. We have distinguished four migration patterns, based on citizenship and country of medical school. The majority of African graduates come to the US from relatively few countries, and from a limited number of medical schools. A proportion are not citizens of the country where they attended medical school, highlighting the internationalization of medical education.
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Affiliation(s)
- Robbert J Duvivier
- Foundation for Advancement of International Medical Education and Research (FAIMER), Philadelphia, United States of America.
- Medical Education Unit, School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
| | - Vanessa C Burch
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - John R Boulet
- Foundation for Advancement of International Medical Education and Research (FAIMER), Philadelphia, United States of America
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Freeman TR, Petterson S, Finnegan S, Bazemore A. Shifting tides in the emigration patterns of Canadian physicians to the United States: a cross-sectional secondary data analysis. BMC Health Serv Res 2016; 16:678. [PMID: 27903252 PMCID: PMC5131528 DOI: 10.1186/s12913-016-1908-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 11/09/2016] [Indexed: 12/03/2022] Open
Abstract
Background The relative ease of movement of physicians across the Canada/US border has led to what is sometimes referred to as a ‘brain drain’ and previous analysis estimated that the equivalent of two graduating classes from Canadian medical schools were leaving to practice in the US each year. Both countries fill gaps in physician supply with international medical graduates (IMGs) so the movement of Canadian trained physicians to the US has international ramifications. Medical school enrolments have been increased on both sides of the border, yet there continues to be concerns about adequacy of physician human resources. This analysis was undertaken to re-examine the issue of Canadian physician migration to the US. Methods We conducted a cross-sectional analysis of the 2015 American Medical Association (AMA) Masterfile to identify and locate any graduates of Canadian schools of medicine (CMGs) working in the United States in direct patient care. We reviewed annual reports of the Canadian Resident Matching Service (CaRMS); the Canadian Post-MD Education Registry (CAPER); and the Canadian Collaborative Centre for Physician Resources (C3PR). Results Beginning in the early 1990s the number of CMGs locating in the U.S. reached an all-time high and then abruptly dropped off in 1995. CMGs are going to the US for post-graduate training in smaller numbers and, are less likely to remain than at any time since the 1970’s. Conclusions This four decade retrospective found considerable variation in the migration pattern of CMGs to the US. CMGs’ decision to emigrate to the U.S. may be influenced by both ‘push’ and ‘pull’ factors. The relative strength of these factors changed and by 2004, more CMGs were returning from abroad than were leaving and the current outflow is negligible. This study supports the need for medical human resource planning to assume a long-term view taking into account national and international trends to avoid the rapid changes that were observed. These results are of importance to medical resource planning.
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Affiliation(s)
- Thomas R Freeman
- Department of Family Medicine, Centre for Studies in Family Medicine, Western University, London, ON, Canada.
| | - Stephen Petterson
- The Robert Graham Center for Policy Research in Family Medicine and Primary Care, Washington, D.C, USA
| | - Sean Finnegan
- The Robert Graham Center for Policy Research in Family Medicine and Primary Care, Washington, D.C, USA
| | - Andrew Bazemore
- The Robert Graham Center for Policy Research in Family Medicine and Primary Care, Washington, D.C, USA
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Nwadiuko J, James K, Switzer GE, Stern J. Giving Back: A mixed methods study of the contributions of US-Based Nigerian physicians to home country health systems. Global Health 2016; 12:33. [PMID: 27301262 PMCID: PMC4908684 DOI: 10.1186/s12992-016-0165-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 05/09/2016] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND There is increased interest in the capacity of US immigrants to contribute to their homelands via entrepreneurship and philanthropy. However, there has been little research examining how immigrant physicians may support health systems and what factors facilitate or raise barriers to increased support. METHODS This study used an observational design with paper questionnaire and interview components. Our sample was drawn from attendees of a 2011 conference for US Based Nigerian physicians; respondents who were not US residents, physicians, and of Nigerian birth or parentage were excluded from further analysis. Respondents were randomly selected to complete a follow-up interview with separate scripts for those having made past financial contributions or medical service trips to support Nigerian healthcare (Group A) and those who had done neither (Group B). Survey results were analyzed using Fischer exact tests and interviews were coded in pairs using thematic content analysis. RESULTS Seventy-five of 156 (48 %) individuals who attended the conference met inclusion criteria and completed the survey, and 13 follow-up interviews were completed. In surveys, 65 % percent of respondents indicated a donation to an agency providing healthcare in Nigeria the previous year, 57 % indicated having gone on medical service trips in the prior 10 years and 45 % indicated it was "very likely" or "likely" that they would return to Nigeria to practice medicine. In interviews, respondents tended to favor gifts in kind and financial gifts as modes of contribution, with medical education facilities as the most popular target. Personal connections, often forged in medical school, tended to facilitate contributions. Individuals desiring to return permanently focused on their potential impact and worried about health system under-preparedness; those not desiring permanent return centered on how safety, financial security and health systems issues presented barriers. CONCLUSIONS This study demonstrates several mechanisms by which health systems may benefit from expatriate engagement. Greater identification of reliable local partners for diaspora, deeper collaboration with those partners and a focus on sustainable interventions might improve the quantity and impact of contributions. Ethnic medical associations have a unique role in organizing and facilitating diaspora response. Public-private partnerships may help diaspora negotiate the challenges of repatriation.
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Affiliation(s)
- Joseph Nwadiuko
- Johns Hopkins School of Medicine, 4640 Eastern Avenue, Baltimore, MD, 21202, USA.
| | - Keyonie James
- Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, 15213, USA
| | - Galen E Switzer
- Department of Medicine, Psychiatry, and Clinical and Translational Science, University of Pittsburgh, 3501 Forbes Ave, Pittsburgh, PA, 15213, USA
| | - Jamie Stern
- Department of Medicine, University of Pittsburgh, 3459 Fifth Avenue, Pittsburgh, PA, 15213, USA
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Nádas M, Bedenbaugh R, Morse M, McMahon GT, Curry CL. A Needs and Resource Assessment of Continuing Medical Education in
Haiti. Ann Glob Health 2015; 81:248-54. [DOI: 10.1016/j.aogh.2015.03.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Opoku ST, Apenteng BA. Seeking greener pastures? The relationship between career satisfaction and the intention to emigrate: a survey of Ghanaian physicians. Int Health 2014; 6:208-12. [PMID: 24958784 DOI: 10.1093/inthealth/ihu030] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND A significant number of physicians from developing nations emigrate to developed nations in search of better career opportunities. In addition to crippling the health systems of developing nations, the emigration of physicians from sub-Saharan African (SSA) countries results in a loss of return on investment to these nations. The purpose of this study was to identify the relationship between career satisfaction and the intention of active Ghanaian physicians to leave the country within the next 5 years. METHODS This study was a cross-sectional correlational study using data from a survey of practicing physicians in Ghana. The primary independent variables examined were dimensions of career satisfaction, assessed using an abridged form of the Physician Work Life Survey. RESULTS Data from the multivariate ordered logistic regression model indicated that physicians who were house officers or medical officers and those who reported dissatisfaction with their compensation were more likely to report that they were thinking about leaving Ghana within the next 5 years. CONCLUSIONS Health policies aimed at increasing monetary compensation and providing junior physicians with the resources needed to excel in their careers may improve the retention of physicians in Ghana.
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Affiliation(s)
- Samuel T Opoku
- Department of Health Services Research & Administration, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska 68198-4350, USA
| | - Bettye A Apenteng
- Department of Health Policy and Management, Jiann-Ping Hsu College of Public Health, Georgia Southern University, P.O. Box 8015, Statesboro, GA 30460-8149, USA
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Asombang AW, Turner-Moss E, Seetharam A, Kelly P. Gastroenterology training in a resource-limited setting: Zambia, Southern Africa. World J Gastroenterol 2013; 19:3996-4000. [PMID: 23840144 PMCID: PMC3703186 DOI: 10.3748/wjg.v19.i25.3996] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Revised: 03/31/2013] [Accepted: 05/22/2013] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate need for and efficacy of a structured gastroenterology didactic session in expanding awareness and understanding of digestive disorders.
METHODS: A four-day symposium was developed with didactic sessions (days 1, 2) and practical endoscopy (days 3, 4). Didactic sessions included case presentations highlighting pathophysiology and management. One nurse and four practicing gastroenterologists from the United Kingdom led lectures and supervised workshops with audience participation. Practical endoscopy focused on diagnostic and therapeutic procedures and their application to diagnosis and treatment of ailments of the gastrointestinal tract. Pre- and post-workshop questionnaires were distributed to participants during didactic sessions. A pre-workshop questionnaire gauged expectations and identified objectives to be met at the symposium. Post-workshop questionnaires were administered to assess efficacy of each session. Participants graded sessions from 1 (poor) to 5 (excellent) on quality of case presentations, knowledge, clarity and mode of presentation. We assessed if time allotted to each topic was sufficient, value of sessions, impact on practice and interest in future symposiums.
RESULTS: There were 46 attendees on day 1: 41% undergraduates, 41% residents, 11% consultants and 4% unspecified. Day 2 (a Saturday) had 24 participants: 17% undergraduates, 71% residents, 9% consultants, 4% unspecified. Primary pre-workshop symposium expectation was to gain knowledge in: general gastroenterology (55.5%), practical endoscopy (13.8%), pediatric gastroenterology (5%), epidemiology of gastrointestinal disorders specific to Zambia (6%), and interaction with international speakers (6%). The post-symposium questionnaire was answered by 19 participants, of whom 95% felt specific aims were met; all would attend future conferences and recommend to others.
CONCLUSION: The beneficial effect of a structured symposium in developing countries warrants further attention as a mechanism to improve disease awareness in areas where resources are limited.
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