Medical research at Norwegian universities

This study shows that Norwegian medical research suffers from lack of both public funds and recruitment, as well as being affected by the following major factors. Norway uses less of its GNP on R&D than other Western countries and less than the OECD average. Medical research in particular receives less financial support than in any of the other Nordic countries. Norwegian medical researchers publish less material and are cited less often than their colleagues in comparable countries. More than half of the medically trained scientific staff in Norway's four medical faculties will retire during the next decade and today there are many vacant positions in academic medicine because there are not enough competent applicants to fill them. The percentage of M.D.s among professors and lecturers has fallen, and a continued decline in preclinical and laboratory medicine and in public health is predicted. This percentage has also decreased among Ph.D. students, while the age at which medical doctors dissertate has increased and is higher than for other Ph.D.s. The number of medical students doing research has fallen in recent years, and the number of doctoral theses has not increased as much in medicine as in other fields. There are significant differences between the salaries paid in medical science and those paid in clinical medicine. Lack of resources and low salaries keep doctors from pursuing a career in academic medicine. In conclusion, if Norway is to be visible in the field of international medical science, this negative trend must be reversed and medical research and academic medicine revitalised.     

Testing a medically-staffed ambulance in Aarhus. A pilot study

As an attempt to assess the value of a medically-staffed mobile emergency care unit in Aarhus City, we carried out a seven-day experiment (17 hours per day) with an anaesthesiologist and a nurse on duty in a fully equipped vehicle. Aarhus City is an area of approximately 300 km2, with a population of 330,000. The unit responded to emergency calls in 106 patients (38% of all emergency calls during this week). In 31% of all cases the response-time was less than five minutes. Medical disease was diagnosed in 73 patients. Twenty-three patients were suffering from trauma and in three cases the reason for the emergency call was attempted suicide. Fifty-seven percent were treated immediately by the emergency unit, and in 4% of these the treatment was lifesaving. Twenty percent of the patients had their treatment completed outside the hospital. Eighty percent were brought to hospital, 47% with medical assistance. We conclude that there seems to be a basis for a medically-staffed mobile emergency care unit in Aarhus City.     

Educational programs in US medical schools, 1997-1998

To describe the current status of medical education programs in the United States, we used data from the 1997-1998 Liaison Committee on Medical Education Annual Medical School Questionnaire, which had a 100% response rate, and from other sources. There were 96733 full-time medical school faculty members, a 1.2% increase from 1996-1997. The 43020 applicants for the class entering in 1997 represents an 8.4% decrease from 1996. The number of 1997 applicants who were members of underrepresented minority groups decreased 11.1 % from 1996, and the number of entering underrepresented minority group students decreased 8.4%. More than half of medical schools reported that the number of inpatients available for medical student education had decreased in at least some of their clinical sites or in some disciplines during the past 2 years. Thirty-nine medical schools (31.2%) reported having more difficulty recruiting or retaining volunteer clinical faculty to participate in medical student teaching in 1997 than in 1995.     

Selecting a doctoral program in professional psychology: Some comparisons among PhD counseling, PhD clinical, and PsyD clinical psychology programs.

Directors of American Psychological Association-accredited doctoral programs in counseling psychology (95% response) and clinical psychology (99% response) provided data regarding number of applications, credentials of incoming students, rates of acceptance, and the theoretical orientations and research areas of the faculty. The acceptance rates of PhD clinical and PhD counseling psychology programs were comparable (6% vs. 8%), despite the higher number of applications (270 vs. 130) to clinical programs. Compared with clinical students, counseling students were more likely to represent ethnic minorities and have master's degrees, but were otherwise similar in academic credentials. Clinical faculty were more likely to be involved in research with pathological populations and associated with medical settings, whereas counseling faculty were more involved in research concerning career processes, human diversity, and professional issues. These results should alert applicants and their advisors to robust differences across these specializations and should enhance matching between programs and students. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Educational programs in US medical schools, 1996-1997

We use data from the 1996-1997 Liaison Committee on Medical Education Annual Medical School Questionnaire, which had a 100% response rate, to describe medical education programs in the United States. In the 1996-1997 academic year, there were 95 568 full-time medical school faculty members, a 4.5% increase from 1995-1996. In clinical departments, the largest increases were in emergency medicine (a 29% increase from 1995-1996) and family medicine (a 13% increase). Of all full-time faculty members in clinical departments, 76.9% have an MD or DO as the highest degree, 4.5% have both an MD and PhD, 13.9% have a PhD, and 4.7% have an academic or professional bachelor's or master's degree as their final degree. The total number of applicants for the class entering in 1996 was 46968 (0.8% increase from 1995), while the number of first-time applicants decreased 1% from 1995. First-year medical students who were members of underrepresented minority groups numbered 2236, a 4% decrease from 1995. In 1996-1997, the total number of medical students was 66712 (0.3% less than in 1995-1996). For students graduating during the 1995-1996 academic year, 13% took longer than 4 years to complete the program. There were 47 medical schools that reported that 1 or more hospitals used for required clinical clerkships had changed ownership, merged, or closed during 1996. Medical schools used an average of 6 (range, 1-36) hospitals for core clinical clerkship. Ninety-five schools required a passing grade on Step 1 of the US Medical Licensing Examination (USMLE) for promotion or graduation; 54 schools required a passing grade on Step 2 of the USMLE.     

Continuing medical education in marital and family therapy: a survey of South Australian psychiatrists

OBJECTIVE: South Australian psychiatrists were surveyed to determine their impressions of the usefulness of marital and family therapy (MFT) in the management of serious psychiatric conditions and to ascertain their previous experience with Continuing Medical Education (CME) about family therapy. It was expected that psychiatrists' preferences regarding CME would be related to their clinical experience of the usefulness of MFT. METHOD: One hundred and twenty psychiatrists returned a questionnaire about their training, clinical and research interests, with ratings of the usefulness of MFT and CME preferences. This represented 65% of those eligible for the CME programme. RESULTS: Thirteen percent of the respondents found MFT to be extremely useful and a further 47% found it moderately useful in their current practice. There was evidence of a possible training effect: respondents who had previous CME rated MFT as more useful, especially for mood disorders. Furthermore, the treatment of mood disorders seemed to have a particular relevance in family psychiatry, making a statistically unique contribution to ratings of MFT usefulness in the respondents' total practice. Sixty-nine percent of the respondents requested further CME in family therapy. This represented 45% of all South Australian psychiatrists. Respondents who rated MFT as more useful in practice were significantly more likely to be interested in CME. CONCLUSIONS: There seems to be sufficient interest and clinical experience among psychiatrists for MFT to be included in CME courses. It is recommended that further training focus on major mental disorders, especially mood disorders and schizophrenia.     

La psychologie a l'universite d'Ottawa.

A sketch is made of the historical developments of the Faculty of Psychology and Education of the University of Ottawa. In the last 18 years the teaching of Psychology has taken major proportions at the University. What was a department of the Faculty of Arts until 1949 has now become an autonomous Faculty. Since July of 1967, Education has separated itself from the Faculty of Psychology although through cross-appointments of staff and through courses that are common to both Psychology and Education students, the two Faculties remain close to one another. To complete an M.A. in Psychology, a student must put in three years of residence during which he attends classes, undergoes internship training and finally prepares a thesis. At the Ph.D. level, the residence requirements are of two years (post M.A.). Specialization is offered in the following areas: Counselling, Educational Psychology, General Psychology, Clinical Psychology, School Psychology and Child Psychology. More recently (in 1964) the Faculty instituted a research centre in psychophysiology. This centre has developed a section of animal psychology and very recently a cybernetics laboratory which has concentrated its efforts on the electronic measurement of intelligence. Projects are under way for expansion in the form of new buildings and new research centres. The first of these, a Centre for Child Study is being built this year at the cost of $2.5 million. Plans are also drawn for more buildings to house classrooms and laboratories, and these are expected to be completed by 1970. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Gender audit of health research--10 years of the South African Medical Journal

OBJECTIVE: To examine the extent to which gender bias, which has been identified as a feature of medical research internationally, is present in medical research published in South Africa. DESIGN: A retrospective review was undertaken of 789 articles, 106 letters and 266 editorials in 10 years of the South African Medical Journal (1986-1995). MAIN OUTCOME MEASURES: These were gender of study subjects, proportion of women in the sample, and evidence of analysis of results according to gender of study subject. RESULTS: Forty-eight per cent of articles (377) and 98% of letters (104) did not mention the gender of the sample. Samples that included both genders had significantly fewer women than men, with 80% (297) of such articles and 93% (14) of such letters not presenting a comparative analysis of results. CONCLUSIONS: These findings, similar to those of the international literature, indicate a predominant 'gender blindness' in published works. This precludes investigation of differences in the ways men and women experience disease and differential access to care.     

Vein of Galen malformation with diencephalic syndrome: a clinical pathologic report

An international collaborative project for the evaluation of clinical competence at the end of the Medical School curriculum using the ECFMG-CSA (Educational Commission for Foreign Medical Graduates--Clinical Skills Assessment) prototype was started in Italy in April 1996. Faculty representatives from Italian Medical Schools and experts from the ECFMG in Philadelphia participated in the Project. The CSA consists of integrated clinical encounters with 10 standardized patients during which the examinee is asked to obtain a focused history, perform a relevant physical examination and communicate initial diagnoses and management plan to the Standardized Patient (SP). The SP then completes checklists that are scored by Faculty members. The project was concluded in Spring 1998 and a total of 173 new graduates were examined. The data elaborated by the primary site in Chieti University will be available in the Fall 1998 by the ECFMG in Philadelphia. This preliminary communication reports the opinions of the examinees on the ECFMG-CSA, contained in the questionnaires administered after the test. Most of the examinees considered this new methodology as a valid tool for the assessment of clinical competence, especially history-taking and interpersonal skills and stated that the SP simulations were realistic. The 72% of examinees indicated that the Medical School curriculum does not adequately prepare for the CSA examination. Lastly, 68% was in favour of including the SP in the Medical Licensing Examination.     

Self application of preventive measures and opinion about applying them to the population at the health centers of Cantabria

OBJECTIVE: To establish the degree of fulfillment of preventive measures and health promotion recommended by the Spanish Society of Family and Community Medicine for medical staff; to determine the opinion for medical staff about the application to these preventive measures in the general population and to analyse the relationship between the self application and the recommendation to the population. DESIGN: Cross-sectional observational through questionnaire. SETTING: Health Centers in Cantabria. PARTICIPANTS: Medical staff of Health Centers. MEASUREMENTS AND MAIN RESULTS: A response of 67.9% (146 out of 215) was obtained. The results of the self application had been: smokers, 35.6%; know their TA, 89.5%; know their weight, 99.3%; know their cholesterol, 81.5%; tetanus vaccinated, 41.4%; influence vaccinated, 33.6%; hepatitis B vaccinated, 38.6%; consume alcohol in excess, 5.6%; make breasts annual exploration, 44.4%; mammography, 33.0%; cervical cytology, 73.1% protected against german measles, 87.2%. The opinion of the medical staff about the application of the preventive measures in the general population of was positive in more of 90% the respondent. We found a significant relation (p < 0.01) between self application and recommendations to the population; and the population recommendation also showed an inverse relationship with the number of years of experience in First Aid (p < 0.01). However, the statistical was low for these variables (0.2). CONCLUSION: The self application of the preventive measures in the Health Centers of Cantabria is in general better than in other Spanish regions and although, we found relations between self application and recommendation to the population the statistics potency was low for this variable.     

Medical investigators' views about ethics and fraud in medical research

The objective of this study was to ascertain the views and attitudes of medical investigators on medical ethics, and ethics and fraud in medical research. We sent postal questionnaires to all principal investigators whose study protocols had been assessed by their regional medical ethics committee for biomedical research (mid-Norway) in the years 1986-92 (n = 159). The response rate was 70% (n = 119). Some 80% agreed that ethical considerations had influenced their research and 12% that they would have had ethical scruples today about some of their previous projects. One in ten agreed that they might have achieved better results if they could have paid less attention to ethics. About 70% of the respondents found that the committee's comments were useful and relevant, but most agreed only in part. Around 85% agreed fully or in part that scientific quality is an important ethical element of any project and that researchers put more effort into their study protocol when they knew it would be evaluated by an ethics committee. One in six (18%) respondents agreed fully or in part that they had been exposed to scientific misconduct. Also, 27% knew about one or more cases of fraud or misconduct while 42% stated that this knowledge was not public. We concluded that ethics in medicine and medical research have an important and increasing role among investigators with little or no theoretical background and training in ethics. Scientific fraud and misconduct in medicine is a growing concern among researchers, who welcome a professional body that can manage allegations and cases of fraud.     

Employment-seeking experiences of resident physicians completing training during 1996

CONTEXT: Studies analyzing the physician workforce have concluded that the United States is verging on a physician oversupply, yet we lack persuasive evidence that this is resulting in physician underemployment and/or unemployment. OBJECTIVE: To determine the degree to which graduating residents have difficulty finding or are unable to find employment in their primary career choices. DESIGN: Two 1-page surveys sent separately to residents and to program directors to collect information on the employment status of residents who were completing a graduate medical education program at the end of the 1995-1996 academic year. SETTING: A total of 25 067 resident physicians scheduled in the spring of 1996 to complete a residency program accredited by the Accreditation Council on Graduate Medical Education, and 4569 program directors in 31 specialties and subspecialties. MAIN OUTCOME MEASURE: Both the graduates' employment status and the degree of difficulty they experienced securing a practice position, as reported by resident physicians and program directors. RESULTS: After 6 months of data collection, 12135 (48.4%) of 25 067 resident physicians responded to the survey. Of the respondents, 11 200 had completed their training, and 7628 (68.1%) were attempting to enter the workforce, 28.4% were seeking additional training, and 3.5% were fulfilling their military obligations. Of the 7628 resident physicians who sought employment, 67.3% obtained clinical practice positions in their specialties, 15.5% took academic positions, 5.0% found clinical positions in other specialties, 5.1% had other plans, and 7.1% did not yet have positions but were actively looking. In addition, 22.4% of resident physicians who found clinical positions reported significant difficulty finding them. The subgroup reporting greater difficulty finding clinical positions included international medical graduates (more than 40%),those completing programs in the Pacific or East North Central region, and those in several specialties. The 1996 graduating residents reported significantly higher rates of difficulty finding suitable employment than program directors reported for their graduates (22.4% vs 6.0%); however, the percentage of graduates reported by both groups as entering the workforce was the same (68.1%). Program directors reported an unemployment rate of only 1.2%, for their 1996 graduates, which was less than the rate reported by the resident physicians (7.1%). CONCLUSIONS: Resident physicians' direct reports of their employment-seeking experiences differ from what program directors report. Program directors accurately determined the number of residents pursuing further training; however, they did not have complete information about the employment difficulties experienced by their graduates. Based on graduates' reports, we conclude that employment difficulties are greatest among international medical graduates and vary by specialty and geographic region.     

Professional and social responsibilities of clinical pharmacology

According to the decision of the Scientific and educational board of the Medical Faculty in Novi Sad the Institute for pharmacology toxicology and clinical pharmacology introduced the clinical pharmacology in 1975. Postgraduate studies were organized for those wishing to specialize, i.e. to get their M.Sc. degree in clinical pharmacology. Besides the youngest members of the Institute (now they are all associate professors) these studies were successfully completed by many doctors from other clinics or those employed in pharmaceutical industry. The publications which the Institute published from the field of pediatric clinical pharmacology were the very first ones not only in our country but also in world proportions. International methods for the evaluation (DDD, ATC code) of the scope and structure of drugs usage were introduced and modified according to our conditions and requirements. The studies on the usage of drugs were among the first pharmacoepidemiological studies in country and abroad. On the basis of these activities the Institute was two times the organizer of the scientific meeting sponsored by WHO. As a response to a sudden increase of the need for information on drugs due to disturbed supply and distribution of drugs from abroad (through humanitarian aid) a telephone and modem information service has been organized within the Institute. The printing of the book titled Drugs in Use was initiated (five editions since 1992) together with the issues on computer discs. The publishing of the journal Pharmaca Iugoslavica was also started under the auspices of the Association of Health Care Organizations. The service for adverse events registration was also organized. Through its activities in planning and organization of pharmacokinetic and clinical investigations, development of new analytic methods and performance of pharmacokinetic studies the Institute contributed to the development of new drugs and gave new theoretical solutions in pharmacokinetics. The Institute also initiated the establishment of the Committee for drugs of the Medical Faculty. Its professors are members of the Commission for Social Insurance, Federal Commission for Drugs and Federal Commission for Poisons. Through all mentioned activities the Institute has greatly influenced not only our but also general medical community.     

Student and faculty collaboration in a clinic for the medically underserved

BACKGROUND AND OBJECTIVES: Growing numbers of uninsured and underinsured individuals in the United States have resulted in increased needs for health care for medically underserved populations. Educational strategies are needed that provide opportunities for students to develop the attitudes, knowledge, and skills necessary for providing quality health care for underserved patients. METHODS: Medical students, residents, and faculty of the University of Wisconsin-Madison Medical School worked together to establish extracurricular opportunities for first- and second-year students to participate in medical clinics serving the poor and homeless. The process for the development and operation of a volunteer clinic is described. RESULTS: In the last 2 years, 163 medical students, 27 residents, and 21 faculty have provided care to more than 1,000 patients. Patients, students, residents, and faculty reported high satisfaction with the experience. CONCLUSIONS: Medical students, residents, and faculty working in collaboration can provide increased access to care for the medically underserved. Engaging in community-oriented primary health care early in their medical education provided positive learning opportunities for medical students, especially those interested in generalist careers.     

General practitioner teaching in the community: a study of their teaching experience and interest in undergraduate teaching in the future

BACKGROUND: In line with the General Medical Council (GMC) recommendations for undergraduate teaching, many medical schools are implementing new programmes of community-based teaching. Little is known about the enthusiasm of general practitioners (GPs) for, or their ability to undertake, an additional teaching role. AIM: To assess the reservoir of teaching experience among GPs and, in particular, their undergraduate teaching experience, their views on the rewards and problems of teaching, their interest in teaching in the future, and their needs for support. METHOD: Postal questionnaire sent to all 417 GP principals with Lambeth, Southwark, and Lewisham family health service authorities (FHSAs) in January 1995. RESULTS: We achieved a 74% (310/417) response rate. A total of 86% (261/303) of GPs have some sort of teaching experience in their current practice. A large number of medical and non-medical subjects are already being taught. Overall, 75% (228/303) of GPs had experience of undergraduate teaching. Only 13% (41/303) had no teaching experience of any kind. Very few responders felt that teaching was best done in hospital. Different rewards and problems of teaching were perceived by undergraduate teaching GPs and other GPs. There was a high level of interest in undergraduate teaching in the future and a demand for a variety of support measures from medical schools. CONCLUSIONS: New community-based programmes are likely to receive support from GPs, but the vital issues of time, adequate financial reward, and teacher training must be addressed by medical schools if large-scale changes in undergraduate teaching are to be achieved.     

Sequence analysis of the terminal protein precursor coding regions from bovine adenovirus serotypes 2 and 3

The acceptability of medical abortion (mifepristone and misoprostol) among US women was investigated in a 1995 survey of 262 women seeking this method of pregnancy termination at 3 clinics in Oregon, Washington, and Vermont. The abortion patients' mean age was 27 years; mean gestational age was 49.5 days. 51.1% of respondents had experienced at least one prior abortion. Women completed a questionnaire at their initial clinic visit and again two weeks after the procedure. Participants chose medical abortion to avoid surgery (62.8%) or because they perceived it to be less invasive (56.3%), more natural (40.5%), and associated with a lesser risk of infection or damage to the uterus (35.1%) than vacuum aspiration, and could be performed earlier in pregnancy (27.2%). 49.8% indicated they preferred to wait for abortion to occur with a partner, friend, or family member, while 30.6% preferred to be alone; only 17.6% wanted to wait with other women undergoing the same procedure. Comparison of pre- and post-abortion questionnaires indicated women expected significantly more discomfort than they actually experienced and underestimated the number of days of bleeding. 72.8% of respondents were very satisfied with their medical abortion and 15.5% were somewhat satisfied. Women in the somewhat satisfied group had experienced significantly more abortion-related discomfort and anxiety than those who were very satisfied. Prior abortion experience and demographic characteristics did not influence satisfaction. 94% stated they would recommend medical abortion to a friend and 87% would select medical abortion if they had to terminate another pregnancy. Medical abortion has the potential to increase access to abortion among underserved groups of US women. Appropriate educational materials should be developed to help women choose between abortion methods.     

Student enrollment in Canadian medical schools, 1976-77

The 1976-77 statistical study of medical school enrollment by the Association of Canadian Medical Colleges shows that total enrollment in Canadian medical schools had increased 103.8% since 1960-61, although the rate of increase had decreased to almost zero by 1976-77. Women accounted for 30.3% of the total enrollment in 1976-77 (for all years of the course), which represents an increase of more than 550% in the 17-year period; for the 16 schools the proportion ranged between 23.9% and 43.8%. Enrollment of foreign students had decreased from 340 in 1966-67 to 90 (1.2%) in 1976-77; 71 of the 90 students were American. For the entire nation the mean number of medical students per 10 000 population was 3.1, but in British Columbia the figure was only 1.5. Of the Canadian and landed immigrant students 94.5% were attending medical school in their home province.     

Telematics in undergraduate teaching

The use of telematics in the practice of medicine has received much recent attention but little has been written about the use of these techniques in medical education. This is a report of a pilot study in which an interactive video-conference took place between medical students at the UAE University and their opposite numbers at Aberdeen University. In Aberdeen, the Dean of the Medical Faculty simultaneously taught Aberdeen and UAE students on a clinical case. He was able to confine his activities largely to the correction of misconceptions, the emphasis of important points and the addition of missing information, while the students themselves conducted most of the presentation. The UAE students presented their Community Health projects and had a spirited discussion on them with the Aberdeen students. Recent technological advances have so improved the quality of transmission of both visual and auditory images and at reasonable cost, using the ISDN telephone system, that the feasibility of using this medium as an aid to teaching has suddenly materialized. The experiment showed that the technology was adequate for easy, fully interactive teaching among students from different continents and with different cultural backgrounds. It is particularly suitable for the Arab world where it is the custom to teach males and females separately. The pilot study has pointed out the existence of a medium of communication and teaching which, if proved to be effective, could have far-reaching consequences in the undergraduate and postgraduate teaching of medicine.