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"Uniformed medical students and residents" refers to medical school enrollees and physicians in training who are obligated to serve in the military after graduation or training completion. This is in exchange for 2 forms of financial support that are provided by the military for individuals interested in pursuing a career in medicine. These programs are offered namely through the Uniformed Services University of Health Sciences (USUHS) and the Health Professions Scholarship Program (HPSP). Uniformed medical school graduates can choose to serve with the military upon graduation or to pursue residency training. Residency can be completed at in-service programs at military treatment facilities, at out-service programs, at civilian residency training programs, or via deferment programs for residency training at civilian programs. Once their residency training is completed, military physicians should then complete their service obligation. As such, both USUHS and HPSP students should attend a basic officer training to ensure their preparedness for military service. In this article, we elaborate more on the mission, requirements, application, and benefits of both USUHS and HPSP. Moreover, we expand on the officer preparedness training, postgraduate education in the military, unique opportunities of military medicine, and life after completion of military obligation.

"Uniformed medical students and residents" refers to medical school enrollees and physicians in training who are obligated to serve in the military after graduation or training completion. This is in exchange for 2 forms of financial support that are provided by the military for individuals interested in pursuing a career in medicine. These programs are offered namely through the Uniformed Services University of Health Sciences (USUHS) and the Health Professions Scholarship Program (HPSP). Uniformed medical school graduates can choose to serve with the military upon graduation or to pursue residency training. Residency can be completed at in-service programs at military treatment facilities, at out-service programs, at civilian residency training programs, or via deferment programs for residency training at civilian programs. Once their residency training is completed, military physicians should then complete their service obligation. As such, both USUHS and HPSP students should attend a basic officer training to ensure their preparedness for military service. In this article, we elaborate more on the mission, requirements, application, and benefits of both USUHS and HPSP. Moreover, we expand on the officer preparedness training, postgraduate education in the military, unique opportunities of military medicine, and life after completion of military obligation.

Objectives: Clinical rotations play a major role in the learning process for medical students. During training, students are usually supervised by a team of residents and their consultants. This study was conducted in order to determine the perceptions of undergraduate medical students towards Emergency Medicine [EM] residents as teachers.Methods: An online survey that could be downloaded via Google documents was conducted among undergraduate medical students and interns from six government teaching hospitals in Riyadh, Saudi Arabia. Results: The survey was completed by 384 undergraduate medical students [interns: 88.8%; 5th year students: 11.2%]. About 63% of respondents indicated that EM residents taught them the general principles of medicine; 40.0% of respondents agreed that EM residents have a high level of theoretical knowledge, and 59.0% felt relaxed and confident when an EM resident was present to teach and guide them. Approximately 18% of students attributed 75 % of their clinical knowledge to the EM residents who taught them. However, 62.0% of the respondents believed that there is a need for EM residents to acquire more teaching skills.Conclusion: Undergraduate medical students and interns perceived teaching by EM residents positively. Moreover, EM residents who undertook a teaching role had a great impact on the acquisition of knowledge by undergraduate students. However, many students thought that there was still a need for EM residents to acquire more teaching skills and gain further competence in teaching. Keywords: emergency residents ; Education; teaching; medical student ; perception

Introduction: Unprofessionalism is a major reason for resident dismissal from training. Because of the high stakes involved, residents and educators alike would benefit from information predicting whether they might experience challenges related to this competency. Our objective was to correlate the outcome of professionalism-related remedial actions during residency with the predictor variable of resident response to a standardized interview question: "Why is Medicine important to you?" Methods: We conducted a professional development quality improvement (QI) initiative to improve resident education and mentorship by achieving a better understanding of each resident's reasons for valuing a career in medicine. This initiative entailed an interview administered to each resident beginning emergency medicine training at San Antonio Military Medical Center during 2006-2013. The interviews uniformly began with the standardized question "Why is Medicine important to you?" The residency program director documented a free-text summary of each response to this question, the accuracy of which was confirmed by the resident. We analyzed the text of each resident's response after a review of the QI data suggested an association between responses and professionalism actions (retrospective cohort design). Two associate investigators blinded to all interview data, remedial actions, and resident identities categorized each text response as either self-focused (e.g., "I enjoy the challenge") or other-focused (e.g., "I enjoy helping patients"). Additional de-identified data collected included demographics, and expressed personal importance of politics and religion. The primary outcome was a Clinical Competency Committee professionalism remedial action. Results: Of 114 physicians starting residency during 2006-2013, 106 (93.0%) completed the interview. There was good inter-rater reliability in associate investigator categorization of resident responses as either self-focused or other-focused (kappa coefficient 0.85). Thirteen of 50 residents (26.0%) expressed self-focus versus three of 54 (5.4%) residents expressed other-focus experienced professionalism remedial actions (p<0.01). This association held in a logistic regression model controlling for measured confounders (p=0.02). Conclusion: Self-focused responses to the question "Why is Medicine important to you?" correlated with professionalism remedial actions during residency.

Title Page -- Contents -- Preface -- Introduction: An Overview of The Vue -- 1. Don't Go Away Mad -- 2. It's Hard to Get Good Help Nowadays -- 3. Of Bums and Camel Drivers -- 4. The Chicken-Soup-for-Lunch Bunch -- 5. Gays, Too, Came to The Vue -- 6. Marriages Are Made in Heaven -- 7. Things Ain't Always What They Seem -- 8. The Healing of John the Baptist -- 9. I'd Rather Be Lucky Than Good -- 10. The Dumping Syndrome -- 11. A Receptacle for All Purposes -- 12. You Rape 'Em, We Scrape 'Em -- 13. Come Quick, Doc, He's Dead -- 14. All the Monkeys Weren't in the Zoo -- 15. Visitations at The Vue

The training of physicians in the past century was based primarily on responsibility and the chain-of-command. Those with the bulk of that responsibility in the fields of pediatrics and internal medicine were residents. Residents trained the medical students and supervised them carefully in caring for patients. Most attending physicians supervised their teams at arm's length, primarily serving as teachers of the finer points of diagnosis and treatment during set periods of the day or week with a perfunctory signature on write-ups or progress notes. Residents endeavored to protect the attending physician from being heavily involved unless they were unsure about a clinical problem. Before contacting the attending physician, a more senior resident would be called. Responsibility was the ultimate teacher. The introduction of diagnosis-related groups by the federal government dramatically changed the health care delivery system, placing greater emphasis on attending physician visibility in the medical record, ultimately resulting in more attending physician involvement in day-to-day care of patients in academic institutions. Without specified content in attending notes, hospital revenues would decline. Although always in charge technically, attending physicians increasingly have assumed the role once dominated by the resident. Using biographical experiences of more than 40 years, the author acknowledges and praises the educational role of responsibility in his own training and laments its declining role in today's students and house staff.

Background: Multiple studies have assessed the appropriateness of the use of medicines for nursing home residents ; however, few have included duration of use in their assessment. The aim of this study was to assess the level and duration of use of medications recommended for short-term use in residents of aged care facilities in Australia. Methods: Australian Government Department of Veterans&rsquo ; Affairs (DVA) administrative claims data were used for this study. Veterans eligible for all health services subsidised by DVA were followed for one year from 1 July 2015 to 30 June 2016. The number of days covered for each medicine was calculated by multiplying the number of prescriptions dispensed during the year by the pack duration for the medicine. The pack duration was calculated by dividing the quantity supplied at each dispensing by the usual number of doses per day in older people according to Australian prescribing guidelines. The proportion of patients using each medicine and the number of days covered during the study period were determined. Results: 14, 237 residents met the inclusion criteria. One in five participants were dispensed antipsychotics, and the median duration of use was 180 days in the one-year period. More than one-third were dispensed a benzodiazepine, and the median duration of use was 240 days in the year. Half were dispensed an opioid analgesic with a median duration of use of 225 days in the year. Fifty-two percent were dispensed proton pump inhibitors with a median duration of use of 360 days in the year. A quarter received an antibiotic recommended for the management of urinary tract infection, with a median duration of use of 14 days in the year. Conclusion: Long-term use of antipsychotics, benzodiazepines, opioid analgesics and proton pump inhibitors is common in aged care residents. Ensuring appropriate duration of use for these medicines is necessary to reduce risk of harm.

The emergency department is a place of challenging ethical dilemmas and little time and resources to solve them. Ethical Dilemmas in Emergency Medicine provides invaluable information, perspectives, and solutions to common ethical dilemmas in emergency medicine. It addresses important topics seen in the emergency department, including medicolegal issues, triage, privacy and confidentiality, social media, difficult patients, minors, research, patient safety, disasters, suicide, and end of life issues. The accompanying educational modules provide a unique educational opportunity for resident and staff education on ethical issues in emergency medicine. Featuring twenty-three case-based discussions of ethical dilemmas in emergency medicine along with numerous multimedia resources, including media presentations, case based discussions, and multiple choice questions, this book is an invaluable resource for residents in training as well as practicing physicians

Background: Multiple studies have assessed the appropriateness of the use of medicines for nursing home residents; however, few have included duration of use in their assessment. The aim of this study was to assess the level and duration of use of medications recommended for short-term use in residents of aged care facilities in Australia. Methods: Australian Government Department of Veterans' Affairs (DVA) administrative claims data were used for this study. Veterans eligible for all health services subsidised by DVA were followed for one year from 1 July 2015 to 30 June 2016. The number of days covered for each medicine was calculated by multiplying the number of prescriptions dispensed during the year by the pack duration for the medicine. The pack duration was calculated by dividing the quantity supplied at each dispensing by the usual number of doses per day in older people according to Australian prescribing guidelines. The proportion of patients using each medicine and the number of days covered during the study period were determined. Results: 14, 237 residents met the inclusion criteria. One in five participants were dispensed antipsychotics, and the median duration of use was 180 days in the one-year period. More than one-third were dispensed a benzodiazepine, and the median duration of use was 240 days in the year. Half were dispensed an opioid analgesic with a median duration of use of 225 days in the year. Fifty-two percent were dispensed proton pump inhibitors with a median duration of use of 360 days in the year. A quarter received an antibiotic recommended for the management of urinary tract infection, with a median duration of use of 14 days in the year. Conclusion: Long-term use of antipsychotics, benzodiazepines, opioid analgesics and proton pump inhibitors is common in aged care residents. Ensuring appropriate duration of use for these medicines is necessary to reduce risk of harm.

© 2015, Society of General Internal Medicine.BACKGROUND : In order to teach residents how to work in interprofessional teams, educators in graduate medical education are implementing team-based care models in resident continuity clinics. However, little is known about the impact of interprofessional teams on residents' education in the ambulatory setting. OBJECTIVE: To identify factors affecting residents' experience of team-based care within continuity clinics and the impact of these teams on residents' education. DESIGN: This was a qualitative study of focus groups with internal medicine residents. PARTICIPANTS: Seventy-seven internal medicine residents at the University of California San Francisco at three continuity clinic sites participated in the study. APPROACH: Qualitative interviews were audiotaped and transcribed. The authors used a general inductive approach with sensitizing concepts in four frames (structural, human resources, political and symbolic) to develop codes and identify themes. KEY RESULTS: Residents believed that team-based care improves continuity and quality of care. Factors in four frames affected their ability to achieve these goals. Structural factors included communication through the electronic medical record, consistent schedules and regular team meetings. Human resources factors included the presence of stable teams and clear roles. Political and symbolic factors negatively impacted team-based care, and included low staffing ratios and a culture of ultimate resident responsibility, respectively. Regardless of the presence of these factors or resident perceptions of their teams, residents did not see the practice of interprofessional team-based care as intrinsically educational. CONCLUSIONS: Residents' experiences practicing team-based care are influenced by many principles described in the interprofessional teamwork literature, including understanding team members' roles, good communication and sufficient staffing. However, these attributes are not correlated with residents' perceptions of the educational value of team-based care. Including residents in interprofessional teams in their clinic may not be sufficient to teach residents how team-based care can enhance their overall learning and future practice.

Yahya Abdulrahman Al-Najmi,1 Ahmed Hussein Subki,2 Nazih Suwalih Alzaidi,3 Nadeem Shafique Butt,4 Alaa Abdulhamid Alsammahi,5 Firas Mohamed Madani,5 Mohammed Saad Alsallum,6 Rakan Salah Al-Harbi,7 Nizar Mohammed Alhibshi5 1Saggaf Eye Center, Jeddah, Saudi Arabia; 2Department of Internal Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia; 3Ophthalmology Department, Prince Mansour Military Hospital, At Taif, Saudi Arabia; 4Department of Community Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; 5Department of Ophthalmology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia; 6Department of Neurology, King Abdulaziz Medical City, Jeddah, Saudi Arabia; 7Department of Family Medicine, King Fahd Armed Forces Hospital, Jeddah, Saudi ArabiaCorrespondence: Yahya Abdulrahman Al-NajmiSaggaf Eye Center, Abdullah Salman St., Al Faiha'a Dist., P.O. Box: 31903, Jeddah, 21418, Saudi ArabiaTel +966 564844281Email dr.alnajmi@gmail.comNizar Mohammed AlhibshiDepartment of Ophthalmology, King Abdulaziz University Hospital, P.O. Box 50805, Jeddah, 21533, Saudi ArabiaTel +966 505609950Email alhibshi@doctor.comObjective: To investigate the perception and satisfaction of ophthalmology residents with the currently provided ophthalmology curricula to medical students.Methods: A cross-sectional survey involving first to fourth year ophthalmology residents (N = 106) from all regions of Saudi Arabia was conducted between December 2018 and February 2019. An online questionnaire explored opinions about the ophthalmology course regarding three dimensions. Firstly, adequacy in covering essential parts of the specialty; secondly, improvements required; and thirdly, effectiveness. A score (0– 21) was calculated, indicating the overall suitability of the ophthalmology course. In addition, factors of good overall suitability (score ≥ 10) were analyzed.Results: Regarding adequacy, respondents opined that the ophthalmology course did not reasonably cover the basic part (35.8%), clinical part (61.3%), common disease (26.4%), and emergencies (39.6%). Concerning improvements required, more than 80% of the participants expressed that the course required to be improved for all its features, including duration (80.2%), objectives (85.8%), content (82.1%), organization (83.0%), and supervision (81.1%). As to effectiveness, half of them deemed the course unhelpful in familiarizing general practitioners with common ophthalmic diseases and emergencies. Overall, the ophthalmology course was generally deemed suitable (score ≥ 10) for only 27.4% of the participants, with no differences across gender, level, or region.Conclusion: Ophthalmology residents perceived multiple deficits in the current Saudi ophthalmology teaching course. Significant improvements in ophthalmologic curricula are required, besides coping with unprecedented technological advancement in the ophthalmological field.Keywords: ophthalmology, course, curriculum, academic, specialty, assessment, residents, opinions