BACKGROUND: Antibiotic resistance presents a significant global health threat to modern medicine. The awareness and attitude of future doctors undergoing training may play a crucial role in addressing this important issue, influencing the control of resistance and promoting responsible antibiotic stewardship. This study aimed to estimate knowledge, attitudes, and practices regarding antibiotic usage and antimicrobial resistance among tertiary care teaching hospital medical interns.
METHODS: The questionnaire-based cross-sectional study was conducted on 123 MBBS interns from multiple medical institutions. Intern\'s knowledge, attitudes, and self-reported practices regarding antibiotic use were recorded.
RESULTS: Based on survey responses from 123 participants, 116 (94.31%) were aware of the adverse effects of indiscriminate antibiotic use, recognizing the risks of ineffective treatment, increased adverse effects, prolonged illness, bacterial resistance, and higher medical costs. Most (106, 86.18%) acknowledged the challenges of treating antibiotic-resistant infections, and 69 (56.10%) correctly identified that bacteria are not a cause of the common cold and flu. Most (115, 93.5%) recognized antibiotic resistance as a significant global health problem. In attitude, 90 (73%) believed antibiotics should be avoided for colds, but 80 (65%) thought they hastened fever recovery. Only 48 (39%) recognized that antibiotics contribute to resistance, while 102 (83%) agreed skipping doses fosters resistance. Most support hospital policies (118, 96%) and curriculum courses (112, 91%) for rational antibiotic use. Regarding practice, 12 (9.76%) interns admitted to overusing antibiotics, 68 (55.28%) consulted a doctor before starting antibiotics, and 87 (70.73%) checked expiry dates. Additionally, 62 (50.41%) preferred antibiotics for cough and sore throat symptoms.
CONCLUSIONS: The study highlights that while interns have a good knowledge and awareness of the harms of antibiotic misuse, they are not translating this knowledge into practice. This indicates a disconnect between understanding and application. Therefore, there is a need to add a rational antibiotic prescription and stewardship module to the medical curriculum to ensure that knowledge is effectively translated into changing beliefs and practices.

BACKGROUND: The pediatric field in South Korea is experiencing a significant workforce crisis due to a sharp decline in pediatricians, exacerbated by a decrease in pediatric residents and a series of distressing incidents in pediatric healthcare institutions. No prior studies have explored the waning interest in pediatrics among South Korea\'s medical students and interns, which our research seeks to address during a pediatric workforce decline. This study aimed to investigate the declining interest in pediatrics among medical students and interns in South Korea amidst decreasing birth rates. We conducted a comprehensive survey to identify the factors deterring young medical professionals from pursuing a career in pediatrics.
METHODS: In this cross-sectional study, in December 2023 we surveyed medical students and interns at Jeonbuk National University and Hospital using a 40-item electronically distributed questionnaire tailored to assess the factors influencing specialty choice, focusing on pediatrics. The participants were divided into the pre-clinical and clinical groups, allowing for analysis across educational stages. The survey covered demographics, perceptions of pediatrics, attitudes toward medical errors, and awareness of critical issues; it included a range of question types to ensure detailed and nuanced data collection.
RESULTS: Our findings revealed a clear decrease in interest in pediatrics as medical students progressed through their education, with 86.69% displaying negative views. Although a sense of mission and emotional satisfaction from patient interactions were highlighted as positive influences, they were significantly countered by worries related to declining pediatric populations, legal challenges, and interactions with patient guardians. Additionally, 95.84% of the participants recognized the critical role of vital pediatric departments; however, litigation risks and psychological burdens substantially affected their willingness to specialize in these areas. The analysis also showed an increasing awareness of pediatric incidents as students advanced through their education; however, this did not directly correlate with their choice of specialty (P = 0.090).
CONCLUSIONS: The results emphasize the necessity for targeted interventions to alleviate concerns and improve the attractiveness of pediatrics. These efforts are essential to counteract the declining interest and ensure a sustainable pediatric workforce for the future.

UNASSIGNED: The study and practice of medicine are known to contribute to burnout in medical students and junior doctors. There is limited data on the degree of mental health burden for Australian medical students and doctors-in-training (DiT). This scoping review aims to explore the impact of medical training on the mental health of Australian medical students and DiT. Exploring the mental health landscape across different stages of training will help to establish putative factors underlying psychiatric comorbidities in this demographic.
UNASSIGNED: The Joanna Brigs Institute (JBI) framework for scoping review was utilized, involving the Population/Concept/Context (PCC) criteria to identify the target population and develop the search strategy. Peer-reviewed articles, published in English from 2012 to 2022 focusing on Australian medical students\' and doctors-in-training mental health were considered.
UNASSIGNED: Of the 177 articles identified, 24 studies were included in the review. The majority of the studies focused on DiT (n = 19) of which interns and residents were most well represented (n = 12) followed by surgical training (n = 5), with general practice (GP) (n = 2) and physician specialties (nil) being poorly represented. Most studies were quantitative (n = 18), with qualitative studies(n = 6) under represented. Common mental health themes identified were overall psychological distress, burnout, and depression/suicidal ideation with workplace harassment and discrimination being less well represented.
UNASSIGNED: Australian DiT are not equally represented in the literature with how different specialty training pathways impact their mental health. Most studies were cross-sectional, preventing a detailed longitudinal assessment of burnout and work-associated psychological distress.

Introduction Effective communication in healthcare plays a pivotal role, significantly impacting patient experiences and outcomes. While much of the current literature focuses on communication dynamics among physicians and nurses, a gap exists in understanding these dynamics within allied health professions such as respiratory therapy. This study explores the knowledge, attitudes, and awareness of patient communication among respiratory therapy students and interns. Methods This descriptive cross-sectional study investigated the knowledge, attitudes, and awareness of effective communication methods with patients among respiratory therapy students and interns in Jeddah, Saudi Arabia. Using a validated self-administered questionnaire, the study surveyed 350 individuals from three universities and associated hospitals. Results The analysis involved 350 participants, with females comprising 55.1%. The study found that the highest level of agreement (mean 4.6±0.62) was regarding essential knowledge related to introducing respiratory therapists to patients during communication. Female students demonstrated significant proficiency in concluding patient interviews (P=0.033), while male students excelled in comprehending communication methods with unconscious patients (P=0.010). Interns exhibited the most comprehensive understanding of patient communication skills, particularly in employing open-ended questions (P=0.009) and allowing adequate time for patients to express their concerns (P=0.020). Gender and academic progression were identified as factors influencing patient communication skills in respiratory therapy students and interns. Conclusion This study highlights the need for tailored communication training for respiratory therapy students and interns. It emphasizes the importance of enhancing proficiency in this vital field by addressing knowledge gaps and identifying areas for improvement.

BACKGROUND:  In 2021, South Africa introduced a new 6-month internship in family medicine and primary care. This study aimed to assess the new rotation at district health facilities in the Western Cape.
METHODS:  A descriptive survey of interns and supervisors, as phase-two of an exploratory sequential mixed methods study. Questionnaires were developed from a descriptive exploratory qualitative study. Data were analysed with the Statistical Package for Social Sciences.
RESULTS:  Questionnaires were completed by 72 interns (response rate 21%) and 36 supervisors (response rate 90%), across 10 training programmes. Interns felt more independent (97.2%), confident (90.3%) and resilient (91.6%). They learnt to manage undifferentiated and chronic conditions (91.6%), to refer patients (94.3%) and conduct procedures (77.8%). Most interns were not exposed to community-based services (68.0%) and continuity of care (54.1%). Supervision was mostly adequate during the day (79.1%) and afterhours (80.6%). Many interns reported no structured teaching programme (41.7% - 55.6%). Most supervision was from medical officers and registrars. Supervisors saw interns as valuable members of the clinical team (100.0%), who required extra support and administration (42.5%). The majority of interns (75.0%) and supervisors (72.7%) thought the rotation was the right length and the best preparation for community service (67.6%).
CONCLUSIONS:  The rotation met most expectations of the Health Professions Council of South Africa. Programmes need to improve exposure to community-orientated primary care, public health medicine, palliative and ongoing care. Supervision and orientation of interns needs improvement.Contribution: This is the first evaluation of the new family medicine internship programme in South Africa.

BACKGROUND: The core of infection control in dental settings involves minimizing potential cross-infection risks between patients and from patients to other workers in health care. Infection control is important for promoting enhanced adherence to protocols through sterilization, disinfection, and infection control knowledge, attitudes, and practices (KAP) among undergraduate dental students.
METHODS: A cross-sectional survey among 222 undergraduates of Dental Students and Interns of the Dental Institute, Rajendra Institute of Medical Sciences, Ranchi, India, was conducted. KAP of participants related to sterilization and disinfection were assessed before and after educational lectures using a pre-fabricated questionnaire.
RESULTS: All 182 respondents considered the importance of sterilization and disinfection during the dental procedure. While 98.8% had adequate knowledge about isolation and immunization, only 3.8% were vaccinated against hepatitis B virus (HBV). They were perfect in hand hygiene compliance (100%) and awareness regarding autoclave sterilization stood at 78.8%. Mean KAP scores were 7.03 ± 1.39, 10.15 ± 1.40, and 9.
CONCLUSIONS: The undergraduate dental students showed a high level of awareness but wide gaps between practice and attitude of sterilization protocols. Therefore, there is a need for interventions that could bridge the theory-practice gap to improve adherence to infection control measures.

BACKGROUND: Skin cancers are the most common group of cancers diagnosed worldwide. Aging and sun exposure increase their risk. The decline in the number of dermatologists is pushing the issue of dermatological screening back onto family doctors. Dermoscopy is an easy-to-use tool that increases the sensitivity of melanoma diagnosis by 60% to 90%, but its use is limited due to lack of training. The characteristics of \"ideal\" dermoscopy training have yet to be established. We created a Moodle (Moodle HQ)-based e-learning course to train family medicine residents in dermoscopy.
OBJECTIVE: This study aimed to evaluate the evolution of dermoscopy knowledge among family doctors immediately and 1 and 3 months after e-learning training.
METHODS: We conducted a prospective interventional study between April and November 2020 to evaluate an educational program intended for family medicine residents at the University of Montpellier-Nîmes, France. They were asked to complete an e-learning course consisting of 2 modules, with an assessment quiz repeated at 1 (M1) and 3 months (M3). The course was based on a 2-step algorithm, a method of dermoscopic analysis of pigmented skin lesions that is internationally accepted. The objectives of modules 1 and 2 were to differentiate melanocytic lesions from nonmelanocytic lesions and to precisely identify skin lesions by looking for dermoscopic morphological criteria specific to each lesion. Each module consisted of 15 questions with immediate feedback after each question.
RESULTS: In total, 134 residents were included, and 66.4% (n=89) and 47% (n=63) of trainees fully participated in the evaluation of module 1 and module 2, respectively. This study showed a significant score improvement 3 months after the training course in 92.1% (n=82) of participants for module 1 and 87.3% (n=55) of participants for module 2 (P<.001). The majority of the participants expressed satisfaction (n=48, 90.6%) with the training course, and 96.3% (n=51) planned to use a dermatoscope in their future practice. Regarding final scores, the only variable that was statistically significant was the resident\'s initial scores (P=.003) for module 1. No measured variable was found to be associated with retention (midtraining or final evaluation) for module 2. Residents who had completed at least 1 dermatology rotation during medical school had significantly higher initial scores in module 1 at M0 (P=.03). Residents who reported having completed at least 1 dermatology rotation during their family medicine training had a statistically significant higher score at M1 for module 1 and M3 for module 2 (P=.01 and P=.001).
CONCLUSIONS: The integration of an e-learning training course in dermoscopy into the curriculum of FM residents results in a significant improvement in their diagnosis skills and meets their expectations. Developing a program combining an e-learning course and face-to-face training for residents is likely to result in more frequent and effective dermoscopy use by family doctors.

BACKGROUND: The current bleep communication system between nurses and interns on-call in most Irish hospitals has been linked with interruption in patient care, disruption to workflow, inefficiency, increased burden and stress to the on-call health staff. A new electronic system was introduced in a University Hospital to replace and eliminate bleep usage during on-call hours.
METHODS: An Intern on-call task electronic template was generated using Microsoft Excel Spreadsheet. This electronic system enabled users to review and respond to requests placed by nursing healthcare staff. This project initially underwent a trial process in three wards for a period of two weeks in June 2023. Interns and nurses were asked to fill a survey before and after introduction of the system. The project was implemented across all wards in August 2023 and a secondary survey was obtained. In addition, the spreadsheets were analysed retrospectively.
RESULTS: During the trial, twenty-six interns and twenty nurses were surveyed before and after implementation of the electronic system. Interns satisfaction rate was 73% and stress was reported to be reduced by 65%. Notably, 57% of interns reported a reduction in workload and the number of bleeps was reported to be as <10 by 42%. Nurses reported a decrease in the number of bleeps they needed to send overall by 65% and by 55% for repeated jobs. Workload was reported to be increased by 15% by nurses. However, exactly half of the nurses were unhappy with the new system and stress levels were unchanged.
CONCLUSIONS: This project has shown promising results, efficient and clear communication was noted with an overall positive feedback and satisfaction rate by doctors. However, as evident, from a nursing perspective further work is needed to further progress into a system that can benefit both parties involved.

Background Internship is the time period when young doctors learn to balance between professional and personal lives. If they have good awareness and practice of any kind of physical activity during this period, it will help them to continue it forward. This enables them to educate and inspire people and patients around them. The main objectives of this study were to assess patterns of physical activity among medical interns and to understand the factors preventing physical activity among them. Methodology This cross-sectional survey was carried out among interns of a tertiary care hospital in western Maharashtra from July 2022 to September 2022. Ethical clearance was obtained before starting data collection. The survey was administered to those who fulfilled the inclusion criteria. The questionnaire was adopted from the Global Physical Activity Questionnaire. The data collected were entered into Microsoft Excel (Microsoft Corporation, Redmond, WA) and analysis was done using MedCalc v.18.2.1 (MedCalc Software Ltd, Ostend, Belgium). Results A total of 220 interns were enrolled in the survey, of which 13 were removed due to incomplete data and 28 interns did not participate in the study. Finally, 179 interns were included for analysis in the study. The response rate was 87.27%. The mean age of participants was 23.12 years. The study population consisted of 72 (40.22%) males and 107 (59.78%) females. Among participants, 33 interns (18.44%) were involved in vigorous activity during work, and 108 interns (60.34%) were involved in moderate physical activity during work. The median time of a sedentary lifestyle was 300 minutes per day and was more common among males. Cumulatively busy working schedules and exam preparation were the important reasons for reduced physical activity. Conclusion There is a gap in the practice of physical activity among interns. A sedentary lifestyle was more prevalent among male interns than in female interns. The main constraints were demanding working hours and the pressure of competitive exams. Medical students will become doctors in the future who can advise their patients on healthy lifestyle habits. We recommend that it is necessary to promote physical activity in medical schools and to reinforce the importance of physical exercise in the medical curriculum.

OBJECTIVE: To provide a more granular understanding of the expectations of general surgery interns regarding workplace demand, control, and support prior to starting training.
UNASSIGNED: General surgery (GS) interns are at highest risk for burnout and attrition. Maslach frames burnout as resulting from a mismatch between workplace expectations and reality. Occupational science demonstrates workplace demand, control, and support (DCS) as strong influencers of job strain. GS interns\' realistic expectations of demands are associated with decreased likelihood of attrition, but their expectations regarding this factor are poorly understood.
METHODS: Semi-structured interviews were conducted with 14 incoming surgical residents at UCSF: University of California, San Francisco (57% women, 71% non-White), exploring expectations regarding workplace DCS. Transcripts were uploaded to analytic software and coded in dyads using an iterative approach to consensus. Transcripts were thematically analyzed using inductive and deductive reasoning, applying job-demand-resource theory frameworks, and following a published 6-step approach.
RESULTS: Four main themes emerged: past experiences, expected rewards, anticipated challenges, and the desire to belong. Past experiences describes the expectation to successfully cope with future stressors via self-reliance. Rewards such as professional mastery, personal growth, and sense of meaning were expected outcomes seen as balancing anticipated challenges. Anticipated challenges included low control, toxic cultural elements, and discrimination. Desire to belong (i.e., earned recognition as a peer, inclusion in an elite culture) emerged as a powerful motivator, with survival connotations for women and non-Whites.
CONCLUSIONS: Our results suggest incoming interns overestimate the efficacy of self-reliance for coping; count on specific rewards; express realistic expectations regarding challenges; and see inclusion among surgeons as an aspiration that off-sets prolonged effort. Further study is warranted to understand expectation-reality mismatch and potential interventions to target dissonance.
CONCLUSIONS: In this institutional study of general surgery interns, we provide a more granular understanding of the expectations of general surgery interns regarding workplace demand, control, and support prior to starting training, and how we might target \"expectations-reality\" mismatch and the \"desire to belong\" as a means of mitigating burnout and minimizing attrition from training.