Introdução: A episiotomia é intervenção instituída rotineiramente no Brasil, a partir da hospitalização do parto, em meados do século XX. Tida como facilitadora do parto no período expulsivo, vem sendo questionada pelas evidências científicas. Comprovou-se que a intervenção não impede lacerações importantes, incontinência urinária, dispareunia ou disfunções sexuais, e é associada a mais dor pós-parto e a complicações da episiorrafia. No Brasil, há médicos que fazem o procedimento rotineiramente, enquanto outros a praticam de modo seletivo ou, mais raramente, nunca o fazem. Este estudo buscou compreender o processo por meio do qual tais profissionais aprenderam e iniciaram sua prática, se esta foi revista, e as razões do posicionamento técnico e ético quanto ao procedimento, na atualidade. Objetivos: descrever e analisar o processo vivenciado pelos médicos obstetras, e que os levou ao posicionamento com relação à prática da episiotomia, tendo em vista sua formação, sua prática, o posicionamento de seus pares e o ambiente institucional. Método: Trata-se de estudo qualitativo, com análise temática a partir do referencial de gênero. A população de estudo foi composta por 12 médicos(as) obstetras que atendiam partos pela via vaginal, obedecendo ao método snowball. Os dados foram obtidos por meio de entrevistas norteadas por questões semiestruturadas. Resultados: A educação médica, no recorte da episiotomia, dá-se em escalonamento hierárquico, sem que o aluno aprenda por meio de professor, mas entre alunos, do mais graduado para o menos graduado. Transmite-se a insegurança técnica e o impedimento de questionar as indicações, a segurança do procedimento ou lesões decorrentes. Não se discute a autonomia da paciente, os direitos reprodutivos, o direito à integridade corporal ou a real informação para o consentimento. Vários entrevistados relatam dificuldades para deixar de praticar a episiotomia, o que resulta de pressão exercida pelos pares, pela corporação e pela instituição em que atende. Conclusões: É imprescindível a reforma na educação médica, para que professores, atualizados com as evidências científicas, transmitam as técnicas de modo adequado às taxas preconizadas internacionalmente. Sugerese alterar a didática e conteúdo de disciplina que discuta bioética, tornando-a mais conectada com a prática e a ética médica, além de contextualizar a lei vigente. Conclui-se, enfim, pela necessidade de exigir a justificativa em prontuário para a intervenção, a anotação de toda episiotomia realizada e de toda lesão espontânea, além da aplicação de ferramentas de segurança da paciente, adotando uma assistência que promova a integridade genital no parto. / Introduction: Episiotomy is an intervention routinely established in Brazil, from birth hospitalization, in mid-twentieth. Considered as a facilitative intervention in the expulsive stage of birth, it has been questioned by scientific evidences. It was concluded that the intervention does not prevent main lacerations, urinary incontinence, either dyspareunia or sexual dysfunction, and is related to after-birth pain and complications developed from episiorrhaphy. In Brazil, there are physicians that perform it routinely, while some perform it selectively or never use it. This ressearch aimed to understand the way those professionals learned and started their practice, if it has been reviewed, and the reasons for their technical and ethic positioning about the intervention, nowadays. Objective: Describe and analyze the process experienced by obstetricians, and what took them to their positioning regarding to episiotomy practice, in terms of their professional education, their practice, their peers positioning and institutional environment. Method: This is a qualitative study, with thematic analysis, based on gender references. The study population was composed by 12 obstetricians, who attended vaginal births, following snowball method. Data were obtained by interviews guided by semi-structured questions. Results: The medical education, on episiotomy, occurs in a hierarchical scheduling, and the student doesnt learn through a teacher, but through a more graduate student, resulting on technical uncertainty and the impossibility to question indications, the procedure safety or resulting injuries. Patient autonomy, reproductive rights, body integrity or information to the consent are not questioned. Many physician finds it difficult to stop practicing episiotomy, because of intense pressure from peers, corporative and institution. Conclusions: Some changes are essential in medical education, so that teachers, updated on scientific evidences, transmit the techniques adequately to the internationally recommended rates. It is suggested to change teaching and disciplines that discuss bioethics, making it more connected with the practice and medical ethics, and contextualize it to the current law. It follows, finally, the need to require physicians to justify interventions in medical charts, the annotation of all performed episiotomy and all spontaneous lacerations, as well as applying patient safety tools, adopting an assistance that promotes genital integrity at birth.

<p>Background: The global human resources for health crisis has affected Uganda deeply as is evidenced by grossly inadequate medical doctor to population ratios. Strategies to increase training and retention initiatives have been identified as the most promising ways to address the problem. In Uganda, the dual track tuition policy of higher education (called the Private Students Scheme or PSS) at the University of Makerere was initiated in the academic year 1993/94, to boost student intake and to supplement university revenue. However, the impact of this scheme on the enrolment and graduation of medical students at this University is unknown. Aim: This study aimed to assess the effect of the PSS on enrolment, time to completion, attrition and number of graduated medical students at Makerere University Medical School after (post-)&nbsp / the Private Students Scheme (PSS). Study design: A quantitative cross-sectional descriptive&nbsp / study based on a retrospective review of enrolment and graduation records of medical students was conducted comparing records of students enrolled five years before and after the&nbsp / privatisation scheme. Numbers enrolled, attrition rates, time to completion and graduation numbers were analysed. Results: There were 895 students enrolled in the study period, 612 (72.2%) males and 236 (27.6%) females. Pre- and post-PSS periods had 401 and 494 enrolments respectively (a net increase of 93 students). During the post-PSS period, 447 (90.5%) government&nbsp / sponsored students were enrolled - 351 (71.1%) males and 143 (28.9% females) / in the same period, 47 (9.5%) private students were enrolled, 30 (63.8%) male and 17 (36.2%) female.&nbsp / Graduation rates for the entire study period were 96% (859), which represented 44% (378) in the pre-PSS and 56% (481) in the post-PSS periods. Private students contributed 8.9% (43) of the graduates 9in the post-PSS period. The majority of students (90.4%) graduated in five years. Thirty four students (3.8%) dropped out in the entire period, constituting significantly more in the pre-PSS - 22 (5.5%) than in the&nbsp / post PSS-period - 12 (2.4%). Males were more likely to drop out: 31 males did so (4.4%) compared with 3 (1.2%) females. In the post-PSS period, males made up 83.3% (10/12) of the attrition&nbsp / rate. Nine of them were government sponsored while three were private students. Conclusions: The PSS resulted in a 10% increase in enrolments when compared to the pre-PSS period.&nbsp / Furthermore the number of private medical student enrolments contributed 8.9% of the total graduations indicating that PSS succeeded in increasing the number of medical doctors graduated at MUSM. More males than females enrolled across all the years which might indicate&nbsp / a tendency for females to pursue non-medical professions which should be discouraged. Attrition of students&nbsp / was low which is encouraging but the finding that males were more likely to drop out than females deserves attention.</p>

<p>Background: The global human resources for health crisis has affected Uganda deeply as is evidenced by grossly inadequate medical doctor to population ratios. Strategies to increase training and retention initiatives have been identified as the most promising ways to address the problem. In Uganda, the dual track tuition policy of higher education (called the Private Students Scheme or PSS) at the University of Makerere was initiated in the academic year 1993/94, to boost student intake and to supplement university revenue. However, the impact of this scheme on the enrolment and graduation of medical students at this University is unknown. Aim: This study aimed to assess the effect of the PSS on enrolment, time to completion, attrition and number of graduated medical students at Makerere University Medical School after (post-)&nbsp / the Private Students Scheme (PSS). Study design: A quantitative cross-sectional descriptive&nbsp / study based on a retrospective review of enrolment and graduation records of medical students was conducted comparing records of students enrolled five years before and after the&nbsp / privatisation scheme. Numbers enrolled, attrition rates, time to completion and graduation numbers were analysed. Results: There were 895 students enrolled in the study period, 612 (72.2%) males and 236 (27.6%) females. Pre- and post-PSS periods had 401 and 494 enrolments respectively (a net increase of 93 students). During the post-PSS period, 447 (90.5%) government&nbsp / sponsored students were enrolled - 351 (71.1%) males and 143 (28.9% females) / in the same period, 47 (9.5%) private students were enrolled, 30 (63.8%) male and 17 (36.2%) female.&nbsp / Graduation rates for the entire study period were 96% (859), which represented 44% (378) in the pre-PSS and 56% (481) in the post-PSS periods. Private students contributed 8.9% (43) of the graduates 9in the post-PSS period. The majority of students (90.4%) graduated in five years. Thirty four students (3.8%) dropped out in the entire period, constituting significantly more in the pre-PSS - 22 (5.5%) than in the&nbsp / post PSS-period - 12 (2.4%). Males were more likely to drop out: 31 males did so (4.4%) compared with 3 (1.2%) females. In the post-PSS period, males made up 83.3% (10/12) of the attrition&nbsp / rate. Nine of them were government sponsored while three were private students. Conclusions: The PSS resulted in a 10% increase in enrolments when compared to the pre-PSS period.&nbsp / Furthermore the number of private medical student enrolments contributed 8.9% of the total graduations indicating that PSS succeeded in increasing the number of medical doctors graduated at MUSM. More males than females enrolled across all the years which might indicate&nbsp / a tendency for females to pursue non-medical professions which should be discouraged. Attrition of students&nbsp / was low which is encouraging but the finding that males were more likely to drop out than females deserves attention.</p>

Ο ιατρός καλείται να ανταποκριθεί σε ένα ρόλο με διττή σημασία: σε αυτόν του θεραπευτή και σε αυτόν του επαγγελματία. Η σύγχρονη ιατρική εκπαίδευση στοχεύει στην καλλιέργεια στάσεων για τον επαγγελματισμό. Η παρούσα εργασία πραγματεύεται το ζήτημα της διαμόρφωσης της επαγγελματικής ταυτότητας των προπτυχιακών φοιτητών του Ιατρικού Τμήματος του Πανεπιστημίου Πατρών. Πιο συγκεκριμένα, διερευνάται το πλαίσιο στο οποίο βιώνεται η ασθένεια, αναγνωρίζεται η ανάγκη παροχής υπηρεσιών υγείας προς την κοινωνία και εξετάζεται η ανάπτυξη του ιατρικού επαγγέλματος. Αρχικά, πραγματοποιείται μια εκτενής εννοιολογική αναφορά στον επαγγελματισμό, όπου βασίζεται και η επαγγελματική ταυτότητα του ιατρού. Ακολούθως, με την εμπειρική έρευνα επιδιώκεται η διερεύνηση των απόψεων και των στάσεων, που αναπτύσσουν οι προπτυχιακοί φοιτητές της εν λόγω Σχολής σχετικά με τις βασικές παραμέτρους διαμόρφωσης της επαγγελματικής τους ταυτότητας. Επιπρόσθετα, εξετάζεται η σύνδεση του Οδηγού Σπουδών του Τμήματος με τα χαρακτηριστικά του επαγγελματισμού και ειδικότερα της ιατρικής ταυτότητας. / Doctors are expected to cope with the roles of both healer and professional. Current guidelines for medical education require students to develop proper attitudes towards professionalism. In this work we explore the theoretical concept of professionalism, concerning the undergraduate students, who attend the Medical School at the University of Patras. In particular, we examine the context in which the disease, the health service and the medical profession are encountered. Empirical study is carried out in order to identify the core elements of the undergraduate students regarding medical identity. In the theoretical part, we extensively examine the notion of professionalism, in which the formation of medical identity is based on. In the empirical part of the dissertation, we seek to reveal the attitudes which are related to medical professionalism, according to students’ beliefs. Furthermore, we examine the connection among the Medical School’s curriculum, the characteristics of professionalism and the elements, which are being identified in medical identity’s definition.

This diploma thesis was compiled on the topic of first aid. First aid is always actual problem, which needs attention. It is suitable to start with the first aid education at a very young age and throughout the years add more difficult situations first aid in CBRNE substance attack, first aid in extraordinary situations (floods, car accidents with a big number of injured). The aim of the thesis was to find out the knowledge of the pupils in secondary schools about providing the first aid, and subsequent comparation of the results between secondary medical school and other, nonmedical schools. The knowledge of the first aid was found out by means of questionnaires. In this statistical research were involved 400 pupils form 5 secondary schools in the South Bohemian region, including one secondary medical school. The questionnaires were evaluated and processed. To verify the hypotheses, x2 test of a good match was used (to verify the normality) and a t-test was used as well, to verify zero and alternative hypotheses. The pupils of secondary medical school reached in questioning research better results than pupils of nonmedical schools. Therefore it was possible to accept set hypotheses. The secondary schools, which took part in the statistical research, were provided with a feedback. This diploma thesis could serve as a study material, eventually also as a motive for other qualification theses. According to my opinion, a thesis about knowledge of pedagogues about providing the first aid would be beneficial.

abstract: This study determined if differences exist among the health professions advising community between factors (academic and non-academic) used as selection criteria in medical school admissions, as well as the impact of the holistic review in admissions on new admissions initiatives with respect to personal and professional backgrounds of advisors. The study examined the differences based on the gender, race and ethnicity, age, years of advising experience, institution size and type, classification and region of the population. Statistical analyses were conducted using comparison of means tests: one-sample t-tests and one-way ANOVA to determine the significance of differences for each of the variables. Significant differences were found to exist among the health professions advising community based on gender, race and ethnicity, institution type, classification of appointment, institution size and type. The findings of the study suggested that the personal and professional background of a health professions advisor did impact the perception of importance among the academic and non-academic factors used in the selection of medical students. The medical school admissions community should appreciate the unique viewpoints of the broader health professions advising community when building relationships and finding opportunities to collaborate. / Dissertation/Thesis / Ed.D. Educational Administration and Supervision 2012

Magister Public Health - MPH / Background: The global human resources for health crisis has affected Uganda deeply as is evidenced by grossly inadequate medical doctor to population ratios. Strategies to increase training and retention initiatives have been identified as the most promising ways to address the problem. In Uganda, the dual track tuition policy of higher education (called the Private Students Scheme or PSS) at the University of Makerere was initiated in the academic year 1993/94, to boost student intake and to supplement university revenue. However, the impact of this scheme on the enrolment and graduation of medical students at this University is unknown. Aim: This study aimed to assess the effect of the PSS on enrolment, time to completion, attrition and number of graduated medical students at Makerere University Medical School after (post-) the Private Students Scheme (PSS). Study design: A quantitative cross-sectional descriptive study based on a retrospective review of enrolment and graduation records of medical students was conducted comparing records of students enrolled five years before and after the privatisation scheme. Numbers enrolled, attrition rates, time to completion and graduation numbers were analysed. Results: There were 895 students enrolled in the study period, 612 (72.2%) males and 236 (27.6%) females. Pre- and post-PSS periods had 401 and 494 enrolments respectively (a net increase of 93 students). During the post-PSS period, 447 (90.5%) government sponsored students were enrolled - 351 (71.1%) males and 143 (28.9% females); in the same period, 47 (9.5%) private students were enrolled, 30 (63.8%) male and 17 (36.2%) female. Graduation rates for the entire study period were 96% (859), which represented 44% (378) in the pre-PSS and 56% (481) in the post-PSS periods. Private students contributed 8.9% (43) of the graduates 9in the post-PSS period. The majority of students (90.4%) graduated in five years. Thirty four students (3.8%) dropped out in the entire period, constituting significantly more in the pre-PSS - 22 (5.5%) than in the post PSS-period - 12 (2.4%). Males were more likely to drop out: 31 males did so (4.4%) compared with 3 (1.2%) females. In the post-PSS period, males made up 83.3% (10/12) of the attrition rate. Nine of them were government sponsored while three were private students. Conclusions: The PSS resulted in a 10% increase in enrolments when compared to the pre-PSS period. Furthermore the number of private medical student enrolments contributed 8.9% of the total graduations indicating that PSS succeeded in increasing the number of medical doctors graduated at MUSM. More males than females enrolled across all the years which might indicate a tendency for females to pursue non-medical professions which should be discouraged. Attrition of students was low which is encouraging but the finding that males were more likely to drop out than females deserves attention. / South Africa

Magister Public Health - MPH / Aim: This study aimed to assess the effect of the PSS on enrolment, time to completion, attrition and number of graduated medical students at Makerere University Medical School after (post-) the Private Students Scheme (PSS).

First-generation and low-income college graduates are an invisible minority within medicine that has gone largely unstudied. I explored their unique experiences to better understand how diversity and inclusion can be improved. Through gathering stories from students, residents, and attending physicians, I identified unique challenges that they face, and formulated strategies to address them. First-generation college graduates in medicine have a unique set of strengths, challenges, and opportunities that position them to be valuable physicians in the communities that they serve. The American Medical Association states that when minority students finish medical school and residency, they go on to serve society in a way that has not been done before. Furthermore, they are more likely to serve underserved and minority populations, in turn fostering justice and equity in medicine. Some of the qualities that most first-generation college graduates possess that make them well-suited to become successful physicians are resilience, self-motivation, and efficacy. Paving the path for future physicians is a tremendous pressure that can motivate or overwhelm them as they trailblaze their way through medicine. There is an accumulated disadvantage as they are more likely to be underprepared academically, to have less guidance, and to have more financial struggles. First-generation students have several traits that characterize them as an at-risk population in higher education; they take longer to complete their bachelor’s degree and have lower degree aspirations when compared with their peers. They also face moral distress and a growing disconnect as they balance their familial obligations with academics and experience social mobility. Though these are factors that impact their success in college, they do not cease to pose issues when they successfully enter medical school and have to navigate the culture and hierarchy of medicine, as well as the disparate allocation of resources in medical school as they are not deemed as underrepresented in medicine. By understanding these factors, administrators can strengthen pipeline programs and support systems. In supporting the next generation of first-generation physicians at all stages of their training, they can promote a workforce as diverse as the patients it serves. / Urban Bioethics

There are seven schools in the United States and Canada that offer a training program for students qualified in art and the biological sciences to meet the visual communication requirements in medical education and research. A survey of each of these schools in relation to the medical illustration curriculum of North Texas State University will give a broader picture of the educational requirements, nature of work, qualifications of the candidate, and the outlines of the curricula in this field. From this survey a guidance program will be determined to prepare toe undergraduate student for admission to medical school. This investigation of each training program will provide a better understanding of the variances of the medical schools which have departments of art as applied to medicine.