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PubMed2002

[The neurology training in the United States and Japan].

The practice of neurology, like many other fields of medicine, currently faces a number of critical problems in the United States mostly by cumbersome restrictions designed to contain rapidly escalating medical costs. Fortunately, however, the residency training has maintained the spirit of the time-tested tradition, which has served the medical community well ever since its inception in 1910. The system has continued with little modifications after a switch of internship to Basic Residency Program (PG1) in the late 1960s. In comparison, the neurology training in Japan suffers from following deficiencies: 1) a paucity of bedside teaching in most medical schools, necessitating the initiation of unprepared residents into patient care; 2) an insufficient number of staff, especially at a governmental school, precluding an adequate coverage of neurological subspecialities such as electrophysiology and neuropathology; 3) absence of a tutorialship from senior to junior residents, and from interns to medical students, mostly for the lack of organization and logistics; and 4) no incentive to specialize without board certification by the governmental agencies or proper recognition by insurance providers. We must address these fundamental issues to promote neurology as an independent discipline for improved care of patients with neurological disorders.

Internship and Residency↗
PubMed1989

Child psychiatry program directors' ratings of residency experiences.

Child and adolescent psychiatry program directors' (PDs) were asked to complete survey forms to rate the importance of required residency experiences and express views on length of training. There was a 93% return rate of questionnaires sent to the 129 academic programs represented in the Society of Professors of Child and Adolescent Psychiatry. The majority of PDs favor the status quo and do not want to add or subtract from the present requirements. Experiences most favored were those with older children, adolescents, and parents, and those in the use of psychopharmacology. Least favored experiences were with cognitive therapy, research, psychological testing, and teaching. There was little interest in eliminating the internship year or residency time with adults.

Adolescent Psychiatry↗
PubMed2004

Surgery or general medicine--a study of the reasons underlying the choice of medical specialty.

CONTEXT: The reality of medical services in Brazil points towards expansion and diversification of medical knowledge. However, there are few Brazilian studies on choosing a medical specialty. OBJECTIVE: To investigate and characterize the process of choosing the medical specialty among Brazilian resident doctors, with a comparison of the choice between general medicine and surgery. TYPE OF STUDY: Stratified survey. SETTING: Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HC-FMUSP). METHODS: A randomized sample of resident doctors in general medicine (30) and surgery (30) was interviewed. Data on sociodemographic characteristics and the moment, stability and reasons for the choice of specialty were obtained. RESULTS: The moment of choice between the two specialties differed. Surgeons (30%) choose the specialty earlier, while general doctors decided progressively, mainly during the internship (43%). Most residents in both fields (73% general medicine, 70% surgery) said they had considered another specialty before the current choice. The main reasons for general doctors' choice were contact with patients (50%), intellectual activities (30%) and knowledge of the field (27%). For surgeons the main reasons were practical intervention (43%), manual activities (43%) and the results obtained (40%). Personality was important in the choice for 20% of general doctors and for 27% of surgeons. DISCUSSION: The reasons found for the choice between general medicine and surgery were consistent with the literature. The concepts of wanting to be a general doctor or a surgeon are similar throughout the world. Personality characteristics were an important influencing factor for all residents, without statistical difference between the specialties, as was lifestyle. Remuneration did not appear as a determinant. CONCLUSION: The results from this group of Brazilian resident doctors corroborated data on choosing a medical specialty from other countries with different social and educational characteristics. This congruence indicates that the choice involves very similar desires and needs in different settings and has little dependence on the students' educational context.

Adult↗