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Background: Given today's competitive climate, graduates in stomatology face the dilemma of deciding whether to pursue higher education, obtain a master's degree, or focus on clinical careers. However, their career planning tendencies and decision-making factors have not been clarified. This study aimed to analyze these aspects among stomatology undergraduate students at the Southwest Medical University (SWMU) in China. Methods: This cross-sectional study between July and August 2022 included undergraduate students majoring in stomatology at SWMU. A cross-sectional online questionnaire was used to gather data on the respondents' plans after graduation. The questionnaire included inquiries into their intentions regarding postgraduate education and standardized training. Additionally, the survey explored whether the respondents preferred academic or professional master's degrees, which stomatology subspecialty they preferred, and the factors that influenced their choices. Results: One hundred dental undergraduate students participated in this survey. Results indicated that 91.0% of respondents chose to pursue a master's degree after graduation. Moreover, 80.2% of the respondents chose the professional master rather than the academic master as their first choice. Orthodontics, oral and maxillofacial surgery, and oral implantology were the top three subspecialties that students preferred. Personal interest, expected revenue, and family suggestions were the main factors influencing subspecialty selection. Conclusions: The study reveals that stomatology undergraduate students face challenges and a dilemma at graduation. Due to the fierce competition in the job market, graduates aspire to pursue postgraduate studies instead of entering the workforce immediately after graduation. Students need to understand the employment landscape in oral medicine and familiarize themselves with the work patterns of various subspecialties while remaining flexible in charting their career paths. [ABSTRACT FROM AUTHOR]

Abstract Background Given today’s competitive climate, graduates in stomatology face the dilemma of deciding whether to pursue higher education, obtain a master’s degree, or focus on clinical careers. However, their career planning tendencies and decision-making factors have not been clarified. This study aimed to analyze these aspects among stomatology undergraduate students at the Southwest Medical University (SWMU) in China. Methods This cross-sectional study between July and August 2022 included undergraduate students majoring in stomatology at SWMU. A cross-sectional online questionnaire was used to gather data on the respondents’ plans after graduation. The questionnaire included inquiries into their intentions regarding postgraduate education and standardized training. Additionally, the survey explored whether the respondents preferred academic or professional master’s degrees, which stomatology subspecialty they preferred, and the factors that influenced their choices. Results One hundred dental undergraduate students participated in this survey. Results indicated that 91.0% of respondents chose to pursue a master’s degree after graduation. Moreover, 80.2% of the respondents chose the professional master rather than the academic master as their first choice. Orthodontics, oral and maxillofacial surgery, and oral implantology were the top three subspecialties that students preferred. Personal interest, expected revenue, and family suggestions were the main factors influencing subspecialty selection. Conclusions The study reveals that stomatology undergraduate students face challenges and a dilemma at graduation. Due to the fierce competition in the job market, graduates aspire to pursue postgraduate studies instead of entering the workforce immediately after graduation. Students need to understand the employment landscape in oral medicine and familiarize themselves with the work patterns of various subspecialties while remaining flexible in charting their career paths.

Nurses have a minimal introduction to the oncology specialty, and their exposure to radiation therapy is further limited to a superficial understanding of the patient experience. Radiation is a primary mode of oncologic treatment; thus, a comprehensive cancer center developed a 13-week training program to enhance education and clinical skills for nurses transitioning to the radiation subspecialty. Nursing retention rates were analyzed at 3, 6, 12, 18, and 24 months. Two-year postanalysis results show a 92.3% retention rate. With the cost of onboarding a single registered nurse (RN) ranging from $52,100 to $52,350, nursing leadership must develop innovative, evidence-based methods to support RN transition to practice. [ABSTRACT FROM AUTHOR]

Background: Although the technology has been available and several pilot studies have shown success, use of telemedicine has previously been limited in the United States, especially among surgeons. This study aimed to investigate the benefits and obstacles for successful implementation of telemedicine visits in paediatric surgical subspecialties amid the COVID-19 pandemic. Methods: We analysed survey data from telemedicine visits with paediatric surgical subspecialists from May 1 through June 30, 2020 at our paediatric surgery subspecialty clinics. Univariate logistic regression was used to determine associations in survey responses and various demographic factors. Results: There were 164 respondents to the survey. The most frequently cited barrier to care was ability to get time off work (46.3%). Overall satisfaction with the telemedicine visit was 93.8%, and 55.6% responded that they would choose video telemedicine rather than an in-person or telephone visit. Those living at least 25 miles from the hospital had increased odds of indicating interest in using telemedicine for future visits (OR = 2.56, 95% CI = 1.12–5.86, p = 0.026). The average respondent saved between 30 minutes and 1 hour, and 45 minutes using telemedicine. Conclusions: The implementation of telemedicine at our institution in the paediatric surgical subspecialties has proven to be effective and well-received. Given the benefits of time and money saved for families, paired with high satisfaction rates and continued interest, paediatric surgical subspecialists should work to incorporate virtual visits into regular patient care, even well after the COVID-19 pandemic. Level of Evidence: Level IV [ABSTRACT FROM AUTHOR]

As opportunities for radiologists to subspecialize have increased, many avenues to organize Radiology department subspecialties exist. This study seeks to determine how academic U.S. Radiology departments structure themselves with respect to subspecialty divisions/sections, as there are no current standards for how Radiology departments are subdivided. Additionally, the extent of Radiology fellowships offered are assessed. The websites of academic U.S. Radiology departments, a highly influential source of information, were analyzed to perform this study. Radiology department websites of all allopathic U.S. medical schools (n = 148) were assessed for the following: presence/absence of Radiology department subdivisions, division/section labels, number of divisions/sections, division/section titles, presence/absence of Radiology fellowships, number of fellowships, and fellowships titles. 114/148 (77 %) medical schools had Radiology department websites. According to their respective websites, 66/114 (58 %) academic Radiology departments had subspecialty divisions/sections, whereas 48/114 (42 %) had no divisions/sections listed. Of the departments that had divisions/sections, the median number of divisions/sections per department was nine, and ranged from two to 14. Fellowships were offered at 82/114 (72 %) academic Radiology departments that had websites, and the median number was six, ranging from one to 13. There is marked heterogeneity of departmental organization across Radiology departments nationwide, likely due to the lack of current standards for how Radiology departments are subdivided into divisions/sections. Of the 77 % of medical schools that have Radiology department websites, only 58 % of departments listed divisions/sections, and 72 % posted fellowship offerings. [ABSTRACT FROM AUTHOR]

BackgroundInternal Medicine (IM) subspecialty professional societies can provide valuable community, recognition, resources, and leadership opportunities that promote career success. Historically, this support focused on clinical and research dimensions of academic careers, but educational dimensions have gained more attention recently. This study explores how IM subspecialty professional societies support their clinician-educator members.MethodsUsing a qualitative study with two phases, the authors collected information from each IM subspecialty society's website about support for medical education. Using information from the first phase, we developed an interview guide for subspecialty society leaders. We used inductive thematic analysis to analyze interview transcripts.ResultsWebsite analysis identified various mechanisms used by several IM subspecialty societies to promote medical education. These included websites focused on medical education, dedicated medical education poster/abstract sessions at annual meetings, and strategies to promote networking among clinician-educators. Interviews with eight subspecialty society leaders about the professional societies' roles with respect to medical education yielded four main themes: [1] varying conceptions of "medical education" in relation to the society [2] strategies to advance medical education at the society level [3] barriers to recognizing medical education [4] benefits of clinician-educators to the societies. Integrating these themes, we describe recommended strategies for professional societies to better serve clinician-educators.ConclusionsWe explore how IM subspecialty societies attend to a growing constituency of clinician-educators, with increasing recognition and support of the career path but persistent barriers to its formalization. These conversations shed light on opportunities for professional subspecialty societies to better serve the needs of their clinician-educator members while also enabling these members to make positive contributions in return.

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

Abstract Background Physicians in public health administration agencies (public health physicians: PHP) play important roles in public health; however, there are not enough such physicians in Japan. This study aimed to elucidate the factors related to the resignation and migration of PHPs using nationwide survey data. Methods Data from the Survey of Physicians, Dentists, and Pharmacists (2010, 2012, 2014, and 2016) were analyzed. The outcome was the resignation of PHPs or migration to public health administration agencies. The explanatory variables in the resignation analysis were age, sex, workplace, and board certification status. The type of work was added as an explanatory variable in the migration analysis, and clinical specialty was added to the clinical doctor-restricted analysis. The odds ratios (ORs) of the explanatory variables were calculated using generalized estimation equations. Results In the resignation analysis among PHPs, women had a significantly lower OR, whereas younger PHPs and those with board certifications had significantly higher ORs. In the migration to public health administration agencies analysis among medical doctors, women and those aged between 35 and 39 years had significantly higher ORs, but those with board certifications had significantly lower ORs. Hospital/clinic founders or directors had significantly lower ORs, but the clinic staff and ‘others/not working’ had significantly higher ORs. In the migration to public health administration agencies analysis among clinical physicians, those aged between 35 and 39 years had significantly higher ORs. Still, those with two or more board certifications had significantly lower ORs. Hospital/clinic founders or directors had significantly lower ORs, but the clinic staff had significantly higher ORs. Clinical doctors specializing in surgery and other specialties had significantly lower ORs, but those specializing in pediatrics and psychiatry/psychosomatic medicine had significantly higher ORs. Conclusions Having board certifications were significantly related to the resignation of PHPs and migration to public health administration agencies. Women migrated to public health administration agencies more than men and younger PHPs were more likely to resign. However, medical doctors aged between 35 and 39 years were more likely to migrate to public health administration agencies. Similarly, clinic staff, non-clinical physicians, and those whose specialties were pediatrics and psychiatry/psychosomatic medicine were more likely to migrate to public health administration agencies.

BACKGROUND: Factors influencing the choice of subspecialty fellowship program vary between medical specialties. In dermatology, there is a disparity in the distribution of dermatologists across fellowship programs. This study aimed to determine the factors considered by Saudi-trained dermatology residents when choosing a fellowship program to aid in promoting program characteristics and refining mentorship. MATERIALS AND METHODS: A descriptive cross-sectional study was conducted in six different regions in Saudi Arabia using a validated self-administered electronic questionnaire to investigate the factors that influence dermatology residents’ choice of future subspecialty. RESULTS: The questionnaire was completed by 70 dermatology residents. Females represented 63% of the study sample. Of the study participants, only 40% decided on what subspecialty they wanted to pursue. Half of the included residents were from Riyadh, and 21% were from Jeddah. Quality of life was the most common factor influencing subspeciality choice, followed by earning potential and private practice opportunities. However, the least influential factors included the research potential of the subspeciality, family, and advice from doctors in other fields. DISCUSSION: Medical residents face a significant decision when choosing their subspecialty, as it can impact their career path. The factors influencing this decision vary between different medical specialties. For example, internal medicine residents tend to choose subspecialties that provide intellectual stimulation and complement their personalities, while orthopedic surgery residents prioritize their experience and interest in the subspecialty. Our study found that quality of life, income potential, and private practice opportunities are important factors that influence subspeciality choice in dermatology residents.

Background: The most common treatment modality for supracondylar humerus fractures (SCHFs) in children is closed reduction and percutaneous pinning (CRPP). Nonetheless, debate persists regarding the optimal technique used. Therefore, the purpose of our study was to investigate the impact of surgeon experience, surgeon subspecialty and pin configuration on short-term radiological outcomes following CRPP of displaced SCHFs. Methods: Patients less than 14 years of age who underwent CRPP for displaced SCHFs in the prone position between January 2018 and December 2022 were analyzed. Patients were separated into subgroups based on fracture type (low vs. high sagittal), pin configuration (lateral, cross, other), number and configuration of K-wires and first operator surgical experience. The following outcome measurements were collected: postoperative Baumann angle (BA), Shaft-Condylar angle (SCA), surgical duration (SD), duration of radiation exposure (DRE) and number of clinical and radiological follow-ups (FU). Results: A total of 44 patients with a mean age of 6 ± 2.5 years were included in the final analysis. The mean post-operative BA and SCA were 74.8° ± 4.9° and 37.7° ± 10.2°, respectively. No significant differences were found in the post-operative Baumann's angle or SCA among the subgroups. Regarding secondary outcomes, no differences were found among each subgroup regarding SD, DRE and FUs. Conclusion: Short-term radiological outcomes following the treatment of SCHFs treated in the prone position are not affected by fracture patterns and pinning configuration, regardless of the surgeon's years of experience or subspecialty. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Presenting geographic matching trends over 5 match cycles (2016-2020) to serve as a context for changes in residency match outcomes due to the coronavirus disease 2019 (COVID-19) pandemic. STUDY DESIGN: Retrospective review. SETTING: Single academic institution-affiliated otolaryngology-head and neck surgery residency program. METHODS: Residency match outcomes for all applicants to our institution (2015-2019) were collected from the National Residency Matching Program, including medical school and matched program. Matches were categorized as home program, home region, or out of region and sorted by US geographic region. Statistical analysis included frequencies, totals, χ2 testing, and binary logistic regression. RESULTS: From 2016 to 2020, the US MD senior match rate was 84.9%: 18.9% to home programs, 35.7% to home region, and 45.3% to out of region. Rates were similar across regions and decreased over time. Westerners matched to home programs more than Southerners or Midwesterners (27.5% vs 16.0% and 16.0%, P < .01). Southerners and Westerners were more likely to match within their regions (South: 63.1%, P = .011, odds ratio [OR] = 1.296, 95% CI, 1.060-1.584; West: 42.0%, P = .018, OR = 1.462, 95% CI, 1.066-2.004). Matching from out of region was more likely in the West and less likely in the South (West: 58.0%, P = .017, OR = 1.379, 95% CI, 1.059-1.796; South: 36.9%, P < .001, OR = 0.584, 95% CI, 0.47-0.727). CONCLUSION: From 2016 to 2020 in otolaryngology-head and neck surgery, about 1 in 5 matches were to home institutions, a trend that appeared to be more common in the West. Over 4 out of 5 trainees match to nonhome programs, and nearly half relocate to a new region for training. Changes to travel, rotations, and interviews due to COVID-19 may influence these trends.

Background: The annual conference of the Irish College of Ophthalmologists (ICO) is a key calendar event for ophthalmology research in Ireland. Aims: We investigated whether there were identifiable trends across various domains for the last twelve ICO meetings. Our objectives were to assess subspeciality and training centre representation, as well as the characteristics of the first author to include gender and stage of training. Methods: A retrospective analysis of paper and poster presentations from the ICO annual conference yearbooks was conducted. The representation of subspecialties, affiliated institutions, and gender distribution were noted for both categories. For paper presentations, the author's career stage, full-text publication rates, and impact factors were also determined. Results: A total of 306 paper presentations and 306 poster presentations were analysed. The subspecialty of retina had the highest representation within both sections. The overall mean publication rate was 38% (range, 6–39%), with a mean journal impact factor of 2.02. No statistically significant differences in gender noted with regard to poster, paper, or publications (p < 0.9, p < 0.1, p < 0.7, respectively). Conclusions: This is the first review of all research contributions to the ICO conference. We found that there is a need to promote research in some underrepresented subspecialities and training centres. No significant gender bias was found. There is scope to improve the publication conversion rate; this would allow for greater dissemination of the research presented at the ICO meeting. [ABSTRACT FROM AUTHOR]

Objective:This review provides a summary of historical details and current practice activities related to Forensic Neuropsychology (FN). Under the auspices of the American Board of Clinical Neuropsychology (ABCN), the Forensic Neuropsychology Special Interest Group (FNSIG) views the FN as a subspecialty, which has developed over time as the straightforward result of more than 20 years of numerous publications, extensive continuing education, focused research and growth of forensic practice within neuropsychology. In this article, the FNSIG core work group documents and integrates information that is the basis of efforts to consolidate practice knowledge and facilitate attainment of forensic practice competencies by clinical neuropsychologists. Method:Overview of continuing education topics at professional conferences, search results that identify relevant books and peer-reviewed publications, as well as pertinent findings across years of large-scale national survey results. Results:Relevant evidence has shown for decades that FN is prominent within Clinical Neuropsychology as practiced in the United States and Canada. A majority of U.S. neuropsychologists have received FN training and provide forensic evaluation services. FN practice time per week is considerable for many practitioners, and across survey epochs has been shown to be increasing. Conclusion:The present review leads to the conclusion that in the interest of promoting the acquisition of competence, FN practice should remain a focal point of training and continuing education. Alternate routes to attain competence are discussed, as are ongoing professional activities that undoubtedly will ensure continued growth of, and interest in, the subspecialty of FN. [ABSTRACT FROM AUTHOR]

To understand the factors that affect decision-making when choosing a specific subspecialty while exploring gender and geographic variables. A cross-sectional, 13-item, nonrandomized online survey was created and shared over various social media platforms of the Neurosurgery Cocktail. Data were collected between January and April 2022. The survey focused on the amount of exposure to subspecialties during training, along with factors affecting the decision in choosing a specific subspecialty. A total of 207 respondents, predominantly from Asian and European countries, with an 83.6% dominance of male respondents, completed the survey. The most common subspecialties with maximum exposure were neurosurgical oncology, spine, and neurocritical care and trauma, whereas peripheral nerve surgery and stereotactic and functional neurosurgery were the least exposed. In total, 70% of the respondents had no training or degree in a subspecialty, which was the greatest in Asian and African countries (P = 0.0205). Respondents found the prestige and lifestyle of a skull base neurosurgeon very attractive (P = 0.027, 0.034 respectively), whereas the lifestyle and salary of spine neurosurgeons made it a popular subspecialty (P < 0.001, 0.008, respectively). Personal interest in neurosurgical oncology established its popularity among the respondents (P = 0.028). Stereotactic and functional neurosurgery and peripheral nerve surgery are the emerging subspecialties and hence their exposure and access are highly limited to the developed world whereas spine and neurosurgical oncology branches had a homogenous geographic presence. Pediatric neurosurgery had the most female representation, thereby necessitating the need to uplift women in other subspecialties. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To assess the extent and drivers of telehealth use variation across clinicians within the same pediatric subspecialties. METHODS: In this mixed methods study, 8 pediatric medical groups in California shared data for eleven subspecialties. We calculated the proportion of total visits delivered via telehealth by medical group for each subspecialty and identified the 8 most common International Classification of Diseases 10 diagnoses for telehealth and in-person visits in endocrinology and neurology. We conducted semi-structured interviews with 32 pediatric endocrinologists and neurologists and applied a positive deviance approach comparing high versus low utilizers to identify factors that influenced their level of telehealth use. RESULTS: In 2019, medical groups that submitted quantitative data conducted 1.8 million visits with 549,306 unique pediatric patients. For 3 subspecialties, there was relatively little variation in telehealth use across medical groups: urology (mean: 16.5%, range: 9%-23%), orthopedics (mean: 7.2%, range: 2% -14%), and cardiology (mean: 11.2%, range: 2%-24%). The remaining subspecialties, including neurology (mean: 58.6%, range: 8%-93%) and endocrinology (mean: 49.5%, range: 24%-92%), exhibited higher levels of variation. For both neurology and endocrinology, the top diagnoses treated in-person were similar to those treated via telehealth. There was limited consensus on which clinical conditions were appropriate for telehealth. High telehealth utilizers were more comfortable conducting telehealth visits for new patients and often worked in practices with innovations to support telehealth. CONCLUSIONS: Clinicians perceive that telehealth may be appropriate for a range of clinical conditions when the right supports are available. [ABSTRACT FROM AUTHOR]

Abstract Background Internal Medicine (IM) subspecialty professional societies can provide valuable community, recognition, resources, and leadership opportunities that promote career success. Historically, this support focused on clinical and research dimensions of academic careers, but educational dimensions have gained more attention recently. This study explores how IM subspecialty professional societies support their clinician-educator members. Methods Using a qualitative study with two phases, the authors collected information from each IM subspecialty society’s website about support for medical education. Using information from the first phase, we developed an interview guide for subspecialty society leaders. We used inductive thematic analysis to analyze interview transcripts. Results Website analysis identified various mechanisms used by several IM subspecialty societies to promote medical education. These included websites focused on medical education, dedicated medical education poster/abstract sessions at annual meetings, and strategies to promote networking among clinician-educators. Interviews with eight subspecialty society leaders about the professional societies’ roles with respect to medical education yielded four main themes: [1] varying conceptions of “medical education” in relation to the society [2] strategies to advance medical education at the society level [3] barriers to recognizing medical education [4] benefits of clinician-educators to the societies. Integrating these themes, we describe recommended strategies for professional societies to better serve clinician-educators. Conclusions We explore how IM subspecialty societies attend to a growing constituency of clinician-educators, with increasing recognition and support of the career path but persistent barriers to its formalization. These conversations shed light on opportunities for professional subspecialty societies to better serve the needs of their clinician-educator members while also enabling these members to make positive contributions in return.

Background Fellowship training is becoming more popular in plastic surgery, with over half of residents pursuing advanced training. Here, we investigate how clinical and research fellowship training impacts career trajectory and scholastic achievement in academic plastic surgery. Methods Plastic surgery faculty members, from programs recognized by the American Council of Academic Plastic Surgeons, were identified using institutional Web sites. Data extracted included faculty demographics, training history, academic positions, and research productivity. Continuous and categorical variables were compared using t-tests and chi-square, respectively. Results In total, 949 faculty members were included, with 657 (69%) having completed fellowship training. Integrated program residents were more likely to complete a fellowship when compared with independent residents (p 0.05). In a subanalysis comparing hand, craniofacial, microsurgery, and research fellowships, those who completed a research fellowship had higher h-indices and were more likely to reach full professor status (p

Background: The most common treatment modality for supracondylar humerus fractures (SCHFs) in children is closed reduction and percutaneous pinning (CRPP). Nonetheless, debate persists regarding the optimal technique used. Therefore, the purpose of our study was to investigate the impact of surgeon experience, surgeon subspecialty and pin configuration on short-term radiological outcomes following CRPP of displaced SCHFs. Methods: Patients less than 14 years of age who underwent CRPP for displaced SCHFs in the prone position between January 2018 and December 2022 were analyzed. Patients were separated into subgroups based on fracture type (low vs. high sagittal), pin configuration (lateral, cross, other), number and configuration of K-wires and first operator surgical experience. The following outcome measurements were collected: postoperative Baumann angle (BA), Shaft-Condylar angle (SCA), surgical duration (SD), duration of radiation exposure (DRE) and number of clinical and radiological follow-ups (FU). Results: A total of 44 patients with a mean age of 6 ± 2.5 years were included in the final analysis. The mean post-operative BA and SCA were 74.8° ± 4.9° and 37.7° ± 10.2°, respectively. No significant differences were found in the post-operative Baumann’s angle or SCA among the subgroups. Regarding secondary outcomes, no differences were found among each subgroup regarding SD, DRE and FUs. Conclusion: Short-term radiological outcomes following the treatment of SCHFs treated in the prone position are not affected by fracture patterns and pinning configuration, regardless of the surgeon’s years of experience or subspecialty.

The solid foundation laid by Prof Theophilus Oladapo Ogunlesi and other founding fathers of the National Postgraduate Medical College of Nigeria (NPMCN) has consistently achieved its mandate of producing specialist medical practitioners in Nigeria. The ever-changing world requires that we have in Nigeria a critical mass of subspecialists to tackle the various old and emerging ailments that afflict the citizenry. Subspecialist training is popular among Nigerian specialists. While those who are not yet subspecialists crave for the training. Nigerian-born sub-specialists in the diaspora are willing to assist in the training. It is now left to policy makers and captains of the training institutions to seize the chance and move us forward with a view to improving the current embarrassingly low number of subspecialists in Nigeria. The NPMCN is hereby beckoned to take the lead. In doing so, it should combine excellence with relevance.

The Covid-19 pandemic brought substantial changes in clinical practice in Obstetrics and Gynaecology (O and G). Redeployment of staff and restrictions in elective services raised training concerns. We sought to assess the impact on subspecialty training, to identify issues to help mitigate the impact. We conducted cross-sectional anonymous electronic surveys of UK subspecialty trainees at three time points: June 2020, February 2021, September 2021. Surveys were analysed by descriptive statistics and thematic analysis of free-text responses. Response rates ranged from 30% to 40%, with higher response rates from urogynaecology trainees. Up to 72% reported an impact on training, most notable in gynaecological subspecialties, and particularly urogynaecology, which persisted over time. More than a third anticipated needing extra time to complete training. This raises serious future workforce and patient care concerns. Clinical recovery should consider training needs as essential when re-establishing services. Subspecialty trainees may need additional time to achieve competencies required of future consultants. What is already known on the subject? Covid-19 led to dramatic changes in clinical practice in Obstetrics and Gynaecology. Previous studies on training in O and G during the pandemic in the UK and internationally highlighted issues from redeployment, trainee absence, and changes in service provision, that had potential to severely impact training. What do the results of this study add? Subspecialty training in Obstetrics and Gynaecology has been affected by the pandemic. Urogynaecology was worst affected and continues to be affected over the course of the pandemic. What are the implications of these findings for clinical practice and/or further research? Covid-19 recovery plans need to incorporate training requirements. Extended training due to the pandemic may affect consultant workforce numbers and thus service provision in tertiary care. [ABSTRACT FROM AUTHOR]

The solid foundation laid by Prof Theophilus Oladapo Ogunlesi and other founding fathers of the National Postgraduate Medical College of Nigeria (NPMCN) has consistently achieved its mandate of producing specialist medical practitioners in Nigeria. The ever-changing world requires that we have in Nigeria a critical mass of subspecialists to tackle the various old and emerging ailments that afflict the citizenry. Subspecialist training is popular among Nigerian specialists. While those who are not yet subspecialists crave for the training. Nigerian-born sub-specialists in the diaspora are willing to assist in the training. It is now left to policy makers and captains of the training institutions to seize the chance and move us forward with a view to improving the current embarrassingly low number of subspecialists in Nigeria. The NPMCN is hereby beckoned to take the lead. In doing so, it should combine excellence with relevance. [ABSTRACT FROM AUTHOR]

Introduction: Although many studies have explored the perceived ease-of-use of telemedicine, the perceived usefulness of telemedicine for pediatric subspecialty care is less clear. Methods: We invited a national sample of 840 general pediatricians and 840 pediatric subspecialists to participate in a survey fielded in May–June 2020. Respondents ranked perceptions of usefulness of telemedicine for pediatric subspecialty care on a 5-point Likert scale and prioritization of potential strategies to support telemedicine use on a 4-point scale. Results: Of 285 respondents (18% response rate), physicians perceived that increased telemedicine use by pediatric subspecialists would modestly improve child health (mean = 3.5, standard deviation [SD] = 0.7), and access to care (mean = 3.9, SD = 0.6), but would slightly worsen the clinician experience (mean = 2.8, SD = 0.8). Most respondents highly prioritized payment-related strategies to support use of telemedicine. Conclusions: Pediatric clinicians anticipated that increased telemedicine use by pediatric subspecialists would improve child health and health care access but would worsen clinician experience. [ABSTRACT FROM AUTHOR]

Introduction: Persistent racial and gender disparities are prevalent within the higher education and medical training system, notably seen in the underrepresentation of Hispanic or Latinos, Black Americans, and female surgeons compared to their respective population proportions. This study aims to quantify publications addressing ethnic or gender diversity across various surgical specialties, analyze publication trends, and explore specific topics within medical literature., Database: The Database includes PubMed, Google Scholar, and Scopus., Methods: Employing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), we conducted a systematic literature review utilizing the PubMed, Google Scholar, and Scopus databases. A broad inclusion criterion for both ethnic and gender diversity of plastic surgery, neurosurgery, otolaryngology, dermatology, orthopedic surgery, and gender surgery was utilized. The literature was selected between 2014 and 2024. In the content of our study, diversity in articles was defined as any article that focused on addressing gender or racial/ethnicity in the subspecialty., Results: Of 1529 initially screened articles, 346 were included. Orthopedic surgery had the most diversity publications (n = 86), followed by general surgery (n = 67) and plastic surgery (n = 51). Significant increases in diversity publications were observed across all specialties. Orthopedic surgery showed the highest growth (+0.17 publications/year, p < 0.001), followed by plastic surgery (+0.12, p = 0.002) and general surgery (+0.11, p = 0.003). Race/ethnicity was the primary focus (51.4%), with fewer articles on gender (19.7%) or both (28.9%). Diversity topics included demographics, pipeline/recruitment, application process, training experience, leadership, and workplace treatment., Conclusion: These insights underscore the importance of continued efforts to promote diversity within surgical specialties to enhance patient care and outcomes. Further research and initiatives are needed to ensure equitable representation in surgical fields. Addressing diversity issues in surgical specialties is essential for improving healthcare outcomes and reducing disparities., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Inspired by NFL player Dak Prescott's demonstration encouraging help-seeking in sports, my art piece continues the advocacy within sport social work to "kick the stigma" of mental health and wellness. [ABSTRACT FROM AUTHOR]

Aim: To determine (1) frequency of resident research projects being in the same orthopaedic subspecialty that they ultimately choose for fellowship and practice; (2) percentage of research projects that were published.Methods: Resident Thesis Day programs were independently assessed by two reviewers from 2010 to 2020. Reviewers classified projects based on orthopaedic subspecialty: Spine, Joints, Trauma, Hand, Foot and Ankle, Sports, Pediatrics, Oncology, and Shoulder Elbow. Presenting residents' fellowship subspecialty, current practice specialty, and geographic state of current practice were collected using internet searches. Correlation of residents who completed a thesis day project in the same subspecialty as their fellowship and current practice was calculated.Results: A total of 81 resident physicians, 11 (13.6%) female, were included. In the entire cohort, 50.6% did a thesis day project in a different field than their current or projected subspecialty. Of those who completed, or are currently completing fellowship, 33 (52.4%) did their thesis day project in the same subspecialty as their fellowship. Of the current residents who have matched into fellowship, 46.7% did a thesis day project in the same subspecialty. A total of 51 (63.0%) projects were published.Conclusion: The majority of resident research projects were published, and about 50% of orthopaedic residents went on to complete a fellowship and practice in the same subspecialty as their research project. As residents often spend a considerable amount of time and effort on their projects, these findings may help tailor resident education and research curriculums to focus more on research principles than specific orthopedic content. [ABSTRACT FROM AUTHOR]

Keywords: clinical practice; education; subspecialty; training; vascular nurse; vascular service EN clinical practice education subspecialty training vascular nurse vascular service 88 90 3 06/01/23 20230501 NES 230501 Like most developed countries with an ageing population, the incidence of patients with vascular disease in Hong Kong is predicted to increase rapidly in the next few decades. The vascular nurse clinic is mainly aimed at stable patients, providing them with a comprehensive service (eg, vascular patients suffering from asymptomatic carotid stenosis <70%, abdominal aortic aneurysm <5 cm and varicose veins; Figure 1A-C). The establishment of vascular nurse clinics may reduce waiting time in physician's clinic and enhance patients' background knowledge on their vascular disease. [Extracted from the article]

Objective: We aimed to evaluate the neurology and intensive care training of neurology specialists who have started and/or completed intensive care subspecialty training and their views on neurological intensive care organizations. Materials and Methods: All neurology specialists who have started and/or completed intensive care subspecialty training were invited to contribute a 30 question survey via e-mail or text message from mobile phone, which contained a link to the online questionnaire form. Results: There are 29 neurology specialists in Turkey who have started and/or completed intensive care subspecialty training, and all of these specialists completed the survey. Of the neurologists, 12 reported that they completed the intensive care subspecialty training, 12 continued their intensive care subspecialty training, and 5 left the training process. Of the neurologists, 86.2% stated that they wanted to work in neurological intensive care units, 79.3% stated that neurological and neurosurgical intensive care units should be combined, 75.9% stated that they could work in these common intensive care units. However, it was determined that none of the 12 neurology-based intensive care specialists could work in the neurological intensive care units. Conclusion: Studies have shown that providing neurocritical care services, neurological intensive care units and neurointensivists could improve clinical outcomes in patients with neurocritical illnesses. In our study, neurology-based intensive care specialists reported that they could not work in neurological intensive care units. Worldwide neurointensivists cared for only a fifth of patients in neurological intensive care units. Neurointensivists need to manage neurological intensive care units to improve patient outcomes both in the world and in Turkey.

Importance A same-day ophthalmic urgent care clinic can provide efficient eye care, a rich educational environment, and can improve patient experience. Objective The aim of this study was to systematically evaluate volume, financial impact, care metrics, and the breadth of pathology of urgent new patient encounters based on their site of initial presentation. Design, Setting, and Participants A retrospective analysis was performed on consecutive urgent new patient evaluations in our same-day triage clinic at the Henkind Eye Institute at Montefiore Medical Center between February 2019 and January 2020. The cohort of patients who presented directly to this urgent care clinic were referred to as the “TRIAGE” group. Patients who initially presented to an emergency department (ED), and were subsequently referred to our triage clinic, are referred to as the “ED + TRIAGE” group. Main Outcomes and Measures Visits were evaluated on a variety of metrics, including diagnosis, duration, charge, cost, and revenue. Furthermore, return to the ED or inpatient admission was documented. Results Of 3,482 visits analyzed, 2,538 (72.9%) were in the “TRIAGE” group. Common presenting diagnoses were ocular surface disease (n = 486, 19.1%), trauma (n = 342, 13.5%; most commonly surface abrasion n = 195, 7.7%), and infectious conjunctivitis (n = 304, 12.0%). Patients in the “TRIAGE” group, on average, were seen 184.6% faster (158.2 vs. 450.2 minutes) than patients in the “ED + TRIAGE” group (p

Superspeciality training and subspecialty developments have become vital in the present era. It helps to gain excellence in patient care, academics, research, and widespread recognition among peers and the community. Selecting a subspecialty is challenging but can be accomplished with perseverance and following some principles. One should be an accomplished surgeon in the concerned superspeciality before deciding to choose a subspecialty. It should be unique, interesting, affordable, and possible in the given setup, having good appeal among masses, and the results should be better or comparable to conventional treatment. Publishing and presentations at appropriate forums are critical. This article details the Jabalpur model for developing a superspeciality and a subspecialty branch with neurosurgery and neuroendoscopy as a prototype. [ABSTRACT FROM AUTHOR]

Background Fellowship training is becoming more popular in plastic surgery, with over half of residents pursuing advanced training. Here, we investigate how clinical and research fellowship training impacts career trajectory and scholastic achievement in academic plastic surgery. Methods Plastic surgery faculty members, from programs recognized by the American Council of Academic Plastic Surgeons, were identified using institutional Web sites. Data extracted included faculty demographics, training history, academic positions, and research productivity. Continuous and categorical variables were compared using t-tests and chi-square, respectively. Results In total, 949 faculty members were included, with 657 (69%) having completed fellowship training. Integrated program residents were more likely to complete a fellowship when compared with independent residents (p < 0.0001). Fellowship trained faculty were more likely to have graduated from a higher ranked residency program, in terms of both overall and research reputation (p = 0.005 and p = 0.016, respectively). When controlling for years in practice, there was no difference found in number of publications, Hirsch index (h-index), or National Institutes of Health funding between faculty between the two cohorts (p > 0.05). In a subanalysis comparing hand, craniofacial, microsurgery, and research fellowships, those who completed a research fellowship had higher h-indices and were more likely to reach full professor status (p < 0.001 and p = 0.001, respectively). Fellowship training had no effect on being promoted to Chief/Chair of departments (p = 0.16). Conclusion Fellowship training is common among academic plastic surgeons. In this study, both clinical and research fellowships were associated with various aspects of academic success. However, fellowship training alone did not affect attainment of leadership positions. [ABSTRACT FROM AUTHOR]

This study evaluates the gender distribution of Centralized Otolaryngology Research Efforts (CORE) grants by research subspeciality over the past decade. Demographic information on CORE grant recipients from 2010 to 2019 was extracted through an Internet search, and research projects were categorized by subspeciality. Of 343 grants awarded during this period, 127 (37%) were awarded to women. Analysis demonstrated lower absolute rates of CORE funding for women in all fields except pediatrics, but women receive a proportional number of grants for most subspecialities based on their representation within the field. [ABSTRACT FROM AUTHOR]

Study Design: Cross-sectional survey.Objective: To determine the influence of surgeons' level of experience and subspeciality training on the reliability, reproducibility, and accuracy of sacral fracture classification using the Arbeitsgemeinschaft für Osteosynthesefragen Spine Sacral Classification System.Summary Of Background Data: A surgeons' level of experience or subspecialty may have a significant effect on the reliability and accuracy of sacral classification given various levels of comfort with imaging assessment required for accurate diagnosis and classification.Methods: High-resolution computerized tomography (CT) images from 26 cases were assessed on two separate occasions by 172 investigators representing a diverse array of surgical subspecialities (general orthopedics, neurosurgery, orthopedic spine, orthopedic trauma) and experience (<5, 5-10, 11-20, >20 yrs). Reliability and reproducibility were calculated with Cohen kappa coefficient (k) and gold standard classification agreement was determined for each fracture morphology and subtype and stratified by experience and subspeciality.Results: Respondents achieved an overall k = 0.87 for morphology and k = 0.77 for subtype classification, representing excellent and substantial intraobserver reproducibility, respectively. Respondents from all four practice experience groups demonstrated excellent interobserver reliability when classifying overall morphology (k = 0.842/0.850, Assessment 1/Assessment 2) and substantial interobserver reliability in overall subtype (k = 0.719/0.751) in both assessments. General orthopedists, neurosurgeons, and orthopedic spine surgeons exhibited excellent interobserver reliability in overall morphology classification and substantial interobserver reliability in overall subtype classification. Surgeons in each experience category and subspecialty correctly classified fracture morphology in over 90% of cases and fracture subtype in over 80% of cases according to the gold standard. Correct overall classification of fracture morphology (Assessment 1: P = 0.024, Assessment 2: P = 0.006) and subtype (P2 < 0.001) differed significantly by years of experience but not by subspecialty.Conclusion: Overall, the Arbeitsgemeinschaft für Osteosynthesefragen spine sacral classification system appears to be universally applicable among surgeons of various subspecialties and levels of experience with acceptable reliability, reproducibility, and accuracy.Level of Evidence: 4. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to examine the current status and the future of pediatric otolaryngology in Turkey by evaluating the opinions of young otolaryngologists on pediatric otolaryngology.Methods: The study included 224 otolaryngology physicians who were senior residents registered with the Turkish Otolaryngology and Head-Neck Surgery Association (TORL-HNS). The physicians were in their last two years of otolaryngology training (154 physicians) or had completed their residency training and were in their first year of otolaryngology practice (70 physicians). They were approached via e-mail and Short Message Service (SMS) in October through December 2019 with a descriptive letter and asked to voluntarily complete an online questionnaire consisting of total 25 questions in five sections.Results: The online questionnaire was sent to 224 physicians, and 109 (49%) participated in the survey. All 109 participants answered all the questions. Overall, 71 participants (65.1%) were in training for residency and 38 (34.9%) were in their first year of expertise. According to their professional interests, the participants listed rhinology (45 participants, 41.3%), head and neck surgery (27 participants, 24.8%), facial plastic surgery (19 participants, 17%), otology-neurotology (16 participants, 14.7%), and laryngology-phoniatry (2 participants, 1.8%) as their first preference for subspecialty. Pediatric otolaryngology was never a first choice among the participants, although four (3.7%) listed pediatric otolaryngology as their second preference.Conclusion: The aim of this study was to shed light on the current and future status of pediatric otolaryngology in Turkey. We believe the establishment of exclusive pediatric otolaryngology clinics under the umbrella of general ear, nose and throat (ENT) clinics and the foundation of officially approved fellowship programs would bring this subspecialty field to its deserved and desired level in our country.

Aim: The aim of the study was to identify factors that influence urology physicians for choosing subspecialty and to know the most competitive urology subspecialty among residents. Methodology: An online questionnaire was sent to all Saudi Urology residents, registrars, and fellows all over Saudi Arabia, during February 2019–June 2019. The survey included demographic data, level and location of training, a subspecialty of interest, as well as 15 influencing factors that could affect physicians' choice in the form of Likert scale, ranging from strongly disagree = 0 to strongly agree = 4. Results: Of the 193 urology Saudi physicians, 85 replied (44.1%). Their mean age was 29 + 3.2 years. The majority of them were male (98.8%). There were 66 (77.6%) residents, 12 (14.1%) were fellows, and 7 (8.2%) were registrars. Four factors were found to be significantly different across positions, i.e., personal interest in the subspecialty, patient's prognosis, potential to join a private hospital, and family/friend advice. Among residents, the highest score means of the impact factors were the patient's prognosis, potential to join a private hospital and family/friend advice. The most prominent factors that influence urology physicians to select their subspecialty were personal interest in the specialty (88.2%), followed by the patient prognosis and lifestyle (84.7%, 78.8%). About 28.2% of the participants have a desire of endourology, followed by infertility and pediatric urology (23.5% and 20%, respectively). Conclusion: The most influencing factors among urology physicians for choosing their subspecialty are the patient's prognosis and personal interest. Female medical graduates should be encouraged to join a urology residency.

Background: Internal medicine (IM) doctors in Japan play the role of primary care physicians; however, the shortage of rural physicians continues. This study aims to elucidate the association of age, sex, board certification, type of work, and main clinical work with the retention or migration of IM doctors to rural areas. Methods: This retrospective cohort study included 82,363 IM doctors in 2010, extracted from the national census data of medical doctors. The explanatory variables were age, sex, type of work, primary clinical work, and changes in board certification status. The outcome was retention or migration to rural areas. The first tertile of population density (PD) of municipalities defined as rural area. After stratifying the baseline ruralities as rural or non-rural areas, the odds ratios (ORs) of the explanatory variables were calculated using generalized estimation equations. The analyses were also performed after age stratification (

Background: Factors influencing the choice of subspecialty fellowship program vary between medical specialties. In dermatology, there is a disparity in the distribution of dermatologists across fellowship programs. This study aimed to determine the factors considered by Saudi-trained dermatology residents when choosing a fellowship program to aid in promoting program characteristics and refining mentorship., Materials and Methods: A descriptive cross-sectional study was conducted in six different regions in Saudi Arabia using a validated self-administered electronic questionnaire to investigate the factors that influence dermatology residents' choice of future subspecialty., Results: The questionnaire was completed by 70 dermatology residents. Females represented 63% of the study sample. Of the study participants, only 40% decided on what subspecialty they wanted to pursue. Half of the included residents were from Riyadh, and 21% were from Jeddah. Quality of life was the most common factor influencing subspeciality choice, followed by earning potential and private practice opportunities. However, the least influential factors included the research potential of the subspeciality, family, and advice from doctors in other fields., Discussion: Medical residents face a significant decision when choosing their subspecialty, as it can impact their career path. The factors influencing this decision vary between different medical specialties. For example, internal medicine residents tend to choose subspecialties that provide intellectual stimulation and complement their personalities, while orthopedic surgery residents prioritize their experience and interest in the subspecialty. Our study found that quality of life, income potential, and private practice opportunities are important factors that influence subspeciality choice in dermatology residents., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Education and Health Promotion.)

Background and objectives Dual-trained medicine-pediatrics physicians (med-peds) play an important role in the healthcare ecosystem. Little is known about the subspecialty choices of med-peds residency graduates. This study aims to characterize the subspecialty choices of med-peds residency graduates. Methods The Medicine-Pediatrics Program Directors Association (MPPDA) administers an annual survey to the program directors of all med-peds residency programs accredited by the Accreditation Council for Graduate Medical Education (ACGME). This project represents aggregate survey data from 2020-2023. Results The number of program directors responding to the survey ranged from 80.8% (63/78) to 85.7% (66/77; mean response rate: 82.8%). About 465 of 1,245 (37%) graduates over the four years chose fellowship training, across 51 unique subspecialties. The top five selected pathways were: adult pulmonary and critical care 54 (11.6%), allergy and immunology 37 (7.9%), adult infectious diseases 30 (6.5%), adult cardiology 30 (6.5%), and pediatric cardiology 30 (6.5%). Conclusions Med-Peds residents pursue a diversity of subspecialty training and represent an important contribution to the subspecialty workforce. Improving combined subspecialty opportunities may increase participation by med-peds graduates and, in particular, may support the increasing need for pediatric subspecialists., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Pearl IRB issued approval 22-AAIM-119. This study was reviewed and deemed exempt by Pearl IRB. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Agrawal et al.)

The last one century has seen tremendous advancement in the field of medicine. In fact, the pace of this development has been so rapid, that each basic specialty had to be diversified into many new subspecialties to encompass the rapidly evolving technology, expertise and even newly identified diseases in the mankind. Pain medicine is unique, that this specialty has yet to be recognized as an independent specialty in many parts of the world, yet the development in this field has been exponential. Pain and pain medicine are an ocean, and it is impossible for a single human being to master every aspect of it. With this concept in mind, the Editor-in-Chief (THK) of this journal invited renowned pain specialists of the world to write on the concept of subspecialties (or super-specialties) in Pain Medicine to show the path to budding pain specialists. [ABSTRACT FROM AUTHOR]

Whether one wants to or not, interactions between the heart and the kidneys exist and manifest nevertheless. Both from theoretical and clinical perspectives, it seems the need for a subspecialty of cardionephrology seems justified. Our editorial is a cardiologist perspective on the article by Diez and Ortiz published in Clinical Kidney Journal related to the 'need for a cardionephrology subspecialty'. We analysed the historical similarities of the emergence of already ingrained clinical fields with the current needs in the cardionephrology sector. We motivated our approach based on novel cardiovascular diagnostic and therapeutic developments and significant pathophysiological differences from a cardiological perspective, accounting for the foundation of a novel sustainable medical field. One of the sensitive issues we also addressed was the operationality and applicability of the principles. We answered with some examples from high-risk debatable contexts the question of where a cardionephrologist should be integrated. Clarifying the operationality aspects would be a positive shift towards improving guidelines adherence in managing complex patients. In conclusion, we underline that the necessity of a cardionephrologist must be addressed from an operational and scientific perspective, with the ultimate goal of reducing mortality and complications in cardiorenal patients. [ABSTRACT FROM AUTHOR]

Abstract The high prevalence of allergic diseases warrants for sufficient health care provisions available to patients with allergic diseases. Allergy care should be delivered by well-trained specialists. However, the current status of allergy care is not well documented. For this reason a survey among European and a few non-European countries was launched by the National Allergy Society Committee from the European Academy of Allergy and Clinical Immunology and the Union Européenne des Médecins Spécialistes section and board of Allergology. The survey shows that in the vast majority of countries allergy care services are available. However, a substantial heterogeneity is reported regarding recognition of the full specialty, the number of practicing specialists or subspecialists, and training aspects. Growth but also decline of specialty and subspecialties is reported. In addition, the survey gives insight in strengths, weaknesses, opportunities and threats in this field. It appears that the recognition of the full specialty determines strength as well as weakness. Aging of specialists combined with a decline in the number of trainees form a major threat. Opportunities are seen in creating awareness for allergy, focus on attracting young physicians. The conclusion is that harmonization of allergy services across Europe is needed. Investment in young doctors, creating new opportunities and lobbying for the full specialty is required.

Context: The urogynecological problems in women increase with age. The National Health Services (NHS) is experiencing an increase in the demand for and costs of health and social care for women in midlife. It is a relatively new subspecialty which requires a holistic approach to a patient symptoms and expert skills to overcome demands from aging female population and fulfilling patient expectations. Aims: The aim of the study was to analyze the referral pattern in relation to urogynecological symptoms referred to district general hospital in the United Kingdom and in turn to understand the gravity of the situation for improving the care of these women. Subjects and Methods: This was a retrospective study of case notes of women attending the gynecological outpatient clinic led by an urogynecology subspecialist at district general hospital in the United Kingdom having attended the clinic with symptoms suggestive of pelvic floor dysfunction. Results: We identified 777 women who attended the clinic with symptoms of pelvic floor dysfunction. The most frequently stated reason for referral was pelvic organ prolapse, followed by primary urinary incontinence. Majority of the patients (44%) had prolapse at diagnosis and 26% of the patients had multiple symptoms related to pelvic floor dysfunction after a urogynecologist's consultation, 5% of the patients had combined symptoms diagnosed at urogynaecology clinic. Majority of the referrals were from the general practitioners (43%). Conclusions: The study revealed that health practitioner referring the women needs better understanding of the urogynecological symptoms and with a better understanding and a thorough symptom treatment can be initiated for various symptoms at the same time. This allows patients' multiple symptoms improvement, avoids repeat referrals from primary care, avoids repeat visits to the clinics, avoids repeat interventions, and improves patients' satisfaction and therefore saves NHS resources.

Telemedicine has rapidly expanded in many aspects of pediatric care as a result of the COVID-19 pandemic. However, little is known about what factors may make pediatric subspeciality care more apt to long-term adoption of telemedicine. To better delineate the potential patient, provider, and subspecialty factors which may influence subspecialty adoption of telemedicine, we reviewed our institutional experience. The top 36 pediatric subspecialties at Stanford Children's Health were classified into high telemedicine adopters, low telemedicine adopters, and telemedicine reverters. Distance from the patient's home, primary language, insurance type, institutional factors such as wait times, and subspecialty-specific clinical differences correlated with differing patterns of telemedicine adoption. With greater awareness of these factors, institutions and providers can better guide patients in determining which care may be best suited for telemedicine and develop sustainable long-term telemedicine programming.

Background: Back and neck pain are common in the general population and a common occupational condition. Occupationally related back and neck pain is common amongst ophthalmologists. Aim: The aim of this study was to determine the prevalence of back and neck pain amongst South African ophthalmologists. Setting: This was a survey that was conducted amongst South African ophthalmologists (n = 324) and ophthalmologists-in-training (n = 115). Methods: The response rate was 44.8% (n = 197). There was no sampling and a hyperlink to an electronic questionnaire, hosted on the REDCap survey platform, was sent to 440 potential respondents. A descriptive analysis was carried out using STATA version 15. Ethical approval was obtained from the University of Witwatersrand. Results: Mean age was 47.1 years (standard deviation [s.d.] ± 12.1) and 62 (31.5%) women. The cohort was stratified into specialists (n = 81, 41.1%), subspecialists (n = 75, 38.1%) and ophthalmologists-in-training (n = 41, 20.8%). Most of the participants (n = 156, 79.2%) were qualified ophthalmologists. Respondents reported current back pain (n = 124, 62.9%), lower back pain (n = 66, 33.5%) and neck pain (n = 76, 38.6%). The overall median pain rating (on a scale from 1 to 10) was 4. Respondents reported mild pain (n = 71, 36%) and severe pain (n = 35, 17.7%). Operating and using a slit lamp were pain aggravating factors in 36% (n = 71) and 37.1% (n = 73), respectively. Conclusion: Back and neck pain are prevalent amongst South African ophthalmologists and comparable to other ophthalmologists worldwide.

Background: Back and neck pain are common in the general population and a common occupational condition. Occupationally related back and neck pain is common amongst ophthalmologists. Aim: The aim of this study was to determine the prevalence of back and neck pain amongst South African ophthalmologists. Setting: This was a survey that was conducted amongst South African ophthalmologists (n = 324) and ophthalmologists-in-training (n = 115). Methods: The response rate was 44.8% (n = 197). There was no sampling and a hyperlink to an electronic questionnaire, hosted on the REDCap survey platform, was sent to 440 potential respondents. A descriptive analysis was carried out using STATA version 15. Ethical approval was obtained from the University of Witwatersrand. Results: Mean age was 47.1 years (standard deviation [s.d.] ± 12.1) and 62 (31.5%) women. The cohort was stratified into specialists (n = 81, 41.1%), subspecialists (n = 75, 38.1%) and ophthalmologists-in-training (n = 41, 20.8%). Most of the participants (n = 156, 79.2%) were qualified ophthalmologists. Respondents reported current back pain (n = 124, 62.9%), lower back pain (n = 66, 33.5%) and neck pain (n = 76, 38.6%). The overall median pain rating (on a scale from 1 to 10) was 4. Respondents reported mild pain (n = 71, 36%) and severe pain (n = 35, 17.7%). Operating and using a slit lamp were pain aggravating factors in 36% (n = 71) and 37.1% (n = 73), respectively. Conclusion: Back and neck pain are prevalent amongst South African ophthalmologists and comparable to other ophthalmologists worldwide. [ABSTRACT FROM AUTHOR]