Due to sanitary restrictions secondary to the COVID-19 pandemic, various interactions between the pharmaceutical industry and physicians have changed. One of them has been the method for promoting medicinal products through academic meetings around diseases of financial interest. A recent modality has been unilateral promotion by the pharmaceutical industry through academic events with the invitation of so-called \"experts\" for the promotion of a specific drug. These meetings are often biased not towards optimal care of a disease, but rather towards commercial promotion of a specific drug, which may or may not be the best option, without considering associated therapeutic alternatives. The Committee of Ethics and Transparency in the Physician-Industry Relationship, of the National Academy of Medicine, analyzes this new circumstance and proposes some considerations to the medical community.
Debido a las restricciones sanitarias secundarias a la pandemia de COVID-19, diversas interacciones entre la industria farmacéutica y los médicos cambiaron. Una de ellas ha sido el método promocional de medicamentos a través de reuniones académicas en torno a padecimientos de interés financiero. Una modalidad reciente ha sido la promoción unilateral de un fármaco determinado por parte de la industria farmacéutica por medio de eventos académicos con la invitación de aparentes “expertos”. Estas reuniones frecuentemente están sesgadas no hacia la atención óptima de un padecimiento, sino a la promoción comercial de un medicamento específico que pudiera o no ser la mejor opción o sin la consideración de alternativas terapéuticas asociadas. El Comité de Ética y Transparencia en la Relación Médico-Industria, de la Academia Nacional de Medicina de México, analiza esta nueva circunstancia y propone algunas consideraciones a la comunidad médica.

This study aims to evaluate the effectiveness of an online course to enable orthopaedic surgeons to acquire the core competencies necessary to prevent and treat fracture-related infections (FRI). This study included orthopaedic surgeons and residents from Latin American countries who attended an online course focused on FRI. The online course included: didactic lectures, small-group clinical case discussions, and panel case discussions. The course was delivered using Zoom® platform and designed to address four core competencies: prevention, definition and diagnosis, antimicrobial therapy, and surgical treatment. An online questionnaire was created distributing 16 questions through six clinical scenarios. Participants were invited to answer the questionnaire before and after the course. Sixty of the 78 course participants answered the pre-course, and 42 the post-course assessment. Relative to before the course, the mean post-course assessment score rose significantly for prevention of FRI (4.1 before and 4.5 after; p = 0.014), definition and diagnosis (2.4 before and 3.4 after; p = 0.001), and surgical treatment (2.2 before and 2.8 after; p = 0.011). The final score encompassing all four core competencies also rose significantly (2.7 before and 3.3 after; p = 0.001). The online course on FRI was feasible and effective, significantly increasing course users\' knowledge of overall competency in managing FRI.

The unexpected COVID-19 crisis has disrupted medical education and patient care in unprecedented ways. Despite the challenges, the health-care system and patients have been both creative and resilient in finding robust \"temporary\" solutions to these challenges. It is not clear if some of these COVID-era transitional steps will be preserved in the future of medical education and telemedicine.
The goal of this commentary is to address the sometimes substantial changes in medical education, continuing medical education (CME) activities, residency and fellowship programs, specialty society meetings, and telemedicine, and to consider the value of some of these profound shifts to \"business as usual\" in the health-care sector.
This is a commentary is based on the limited available literature, online information, and the front-line experiences of the authors.
COVID-19 has clearly changed residency and fellowship programs by limiting the amount of hands-on time physicians could spend with patients. Accreditation Council for Graduate Medicine Education has endorsed certain policy changes to promote greater flexibility in programs but still rigorously upholds specific standards. Technological interventions such as telemedicine visits with patients, virtual meetings with colleagues, and online interviews have been introduced, and many trainees are \"techno-omnivores\" who are comfortable using a variety of technology platforms and techniques. Webinars and e-learning are gaining traction now, and their use, practicality, and cost-effectiveness may make them important in the post-COVID era. CME activities have migrated increasingly to virtual events and online programs, a trend that may also continue due to its practicality and cost-effectiveness. While many medical meetings of specialty societies have been postponed or cancelled altogether, technology allows for virtual meetings that may offer versatility and time-saving opportunities for busy clinicians. It may be that future medical meetings embrace a hybrid approach of blending digital with face-to-face experience. Telemedicine was already in place prior to the COVID-19 crisis but barriers are rapidly coming down to its widespread use and patients seem to embrace this, even as health-care systems navigate the complicated issues of cybersecurity and patient privacy. Regulatory guidance may be needed to develop safe, secure, and patient-friendly telehealth applications. Telemedicine has affected the prescribing of controlled substances in which online counseling, informed consent, and follow-up must be done in a virtual setting. For example, pill counts can be done in a video call and patients can still get questions answered about their pain therapy, although it is likely that after the crisis, prescribing controlled substances may revert to face-to-face visits.
The health-care system finds itself in a very fluid situation at the time this was written and changes are still occurring and being assessed.
Many of the technological changes imposed so abruptly on the health-care system by the COVID-19 pandemic may be positive and it may be beneficial that some of these transitions be preserved or modified as we move forward. Clinicians must be objective in assessing these changes and retaining those changes that clearly improve health-care education and patient care as we enter the COVID era.

Statistical methods to calculate the hours into which cases are scheduled, based on minimizing the inefficiency of use of anesthesia and/or operating room (OR) time, assure that anesthesiologists and OR nurses are available on each day to care for patients while infrequently working late. The method assumes that anesthesia staffing is planned based on the workload and not vice-versa. We used the American Society of Anesthesiologists (ASA) meeting to test the assumption across a large population. The observational study cohort was all 3,191,282 major therapeutic procedures performed during 2,517,842 cases at all 121 non-federal hospitals in the State of Iowa, 2007-16. The Fridays to Wednesdays of the annual ASA meetings were compared pairwise by year with those days of the other (mean = 43.0 [SE =0.3]) weeks without a federal holiday. Differences in counts of procedures (P = 0.45, 0.5% [0.7%]) and cases performed (P = 0.93, 0.1% [1.0%]) were not significant. In contrast, compared to non-meeting weeks, during the American College of Surgeons meeting, there were fewer general surgery procedures performed (P = 0.0009, -9.1% [1.9%]), fewer procedures performed of any type (P = 0.022, -2.1% [0.8]), and fewer cases of any type (P = 0.003, -2.5% [0.6%]). Similarly, during the American Academy of Orthopaedic Surgeons meeting, there were fewer joint arthroplasties performed (P < 0.0001, -27.1% [3.1%]), fewer procedures (P = 0.011, -6.3% [2.0%]), and fewer cases (P = 0.018, -5.9% [2.0%]). The results show that, in routine practice, anesthesia staffing and staff scheduling are being chosen to prevent the meeting from affecting patients\' and surgeons\' access to OR time.

BACKGROUND: Some university curricula struggle to present evidence-based promotion of global health principles and global health diplomacy within an undergraduate setting. The de facto global health paradigm has experienced significant stress and pressure from epidemics, war and violence, climate change and resource challenges. These stressors may lead to increased morbidity and mortality, in turn requiring medical professionals to play a larger role in global health action across borders.
METHODS: In the academic year 2014-2015, an English-speaking international medical school promoted a global health forum with pre-course readings and a pre-attendance quiz. All students from the university were invited to attend and the event was not mandatory.
RESULTS: The one-day-event culminated in expert speakers, discussions and a post-event questionnaire to gauge students\' reactions and expectations as future physicians regarding the most pressing global health topics. Emphasis was also placed on what future doctors foresee as pressing issues in forthcoming global health policy and programming. This paper is a brief commentary of the Global Health Forum in Prague 2014, and presents novel results from a post-event student questionnaire, with conclusions provided by students on innovative global health policy.