State of dermatology training: the residents' perspective

Residency training in Ghana: the residents' perspective

Background

Prior to 1973, West African citizens completed postgraduate medical and surgical training abroad, particularly in the United Kingdom. In 2003, the Ghana College of Physicians and Surgeons were established respectively and began to offer specialized training locally. The aim of this study was to obtain and evaluate the views of Medical and Surgical Residents of the GCPS on their training in Ghana.

Method

A descriptive cross-sectional study was undertaken whereby a 25 item, self-administered questionnaire, was distributed to 170 residents of Korle Bu and Komfo Anokye Teaching Hospitals in Ghana. Information regarding the residents' sociodemographic characteristics, level of residency, and satisfaction with the programs in terms of clinical supervision, didactic teaching, program duration and research training was collected.

Results

117 residents completed the survey, yielding a response rate of 68.8%. 59.8% were males and 40.2% females. The age of the residents ranged from 25 to 40 years with a mean age of 32.7+1.4 years. Majority of residents (92.3%) were satisfied with the duration of the programs . Slightly more than half of the residents (50.4%) were satisfied with the clinical supervision, however only a third of the respondents (33.3%) were satisfied with the didactic teaching and an even smaller percentage (17.1%) with research training.

Conclusion

Whilst majority of residents were satisfied with the duration of the residency program, the perspective of the respondents was that trainees would benefit from additional didactic teaching and increased research exposure.

Funding

None

Simulation: An Effective Method of Teaching Cosmetic Botulinum Toxin Injection Technique

BACKGROUND

Learning to inject botulinum toxin for cosmetic purposes is difficult for beginners, given the nature of the procedure and patient population. Simulation training is an effective modality for medical professionals to acquire skills in an environment that provides low stress and ample opportunity for questions and correction of mistakes.

OBJECTIVES

Compare posttraining comfort, knowledge, and practical botulinum toxin injection scores among trainees who underwent simulation vs video training only.

METHODS

A total of 20 nurse practitioners, physician assistants, and resident physicians underwent cosmetic botulinum toxin injection training either through lecture and video, or lecture and hands-on simulation training. Comfort, knowledge, and practical test scores were recorded and compared between the groups.

RESULTS

There was no evidence of a statistically significant difference in comfort or knowledge scores between simulation and video groups. The median (range) practical score was significantly higher in the simulation group compared to the video group (59.0 [31-60] vs 44.5 [27-57]; P < 0.01).

CONCLUSIONS

Despite feeling similarly comfortable and having similar written knowledge test scores, the trainees who underwent simulation training had significantly higher hands-on practical test scores compared to trainees who underwent video training only for cosmetic botulinum toxin injections.

Increase in Procedures Performed at Dermatology Office Visits from 1995 to 2001

BACKGROUND

Over the past few decades, dermatologists have expanded the scope of their practice to include many surgical and cosmetic procedures in response to the development and demand for new procedures.

OBJECTIVE

To examine the trend from 1995 in the proportion of dermatology visits associated with procedures to determine if there has been an increase in the number of procedures performed.

METHODS

Data from the National Ambulatory Medical Care Survey were used to look at the proportion and types of dermatology visits associated with procedures performed during the years 1995 to 2001.

RESULTS

There has been a progressive increase in the number of dermatology visits with procedures, occurring in 29.8% of visits in 1995 and 40.0% of visits in 2001. The top procedures performed are that of excision and destruction, including cryotherapy, electrodesiccation and curettage, and biopsies.

CONCLUSION

The number of dermatology visits associated with procedures has increased since 1995. With the numerous new procedures and techniques that have emerged and continue to develop in our field, we expect that dermatologists will continue to be providers of medical, as well as surgical, care for the skin.

Research during pediatric residency: predictors and resident-determined influences

PURPOSE

Participation in research during residency is thought to be a strong predictor of future research activity; however, the proportion of residents who actually engage in research is small. This study examined (1) which factors are associated with research during residency; (2) which factors influence residents' abilities to conduct research; and (3) the number of residents conducting research in a research-oriented training program.

METHOD

One hundred fifteen pediatrics residents were asked at a housestaff retreat to complete a questionnaire about their attitudes toward research. Comparisons between those who were or were not conducting research during residency were made using chi-square or Fisher exact tests; stepwise logistic regression was used to identify factors associated with conducting research during residency.

RESULTS

The response rate was 95% (n = 110, or 82% of the residency program). Respondents were representative of postgraduate year, gender, and residency track. Although 92% of respondents reported having conducted research before residency, only 18% were currently involved in research (p <.001). Fifty-five percent reported interest in conducting research. Advanced degrees and future career plans influenced their decisions to do research (p <.05). Respondents were more likely to conduct clinical research than basic science or laboratory-based research (14% versus 3% of all respondents, p =.007). The most commonly identified influences to conducting research were availability of time (97%), personal interest in research (84%), availability of opportunities (76%), and mentors on hand (72%).

CONCLUSION

Interest in research during residency is high, but participation in research is low. There are several influences to the types and amounts of research conducted during pediatrics residency.

Dermatologic surgery training in residency

BACKGROUND

Dermatologic surgery is an integral part of dermatology residency training.

OBJECTIVE

To characterize the current level of surgical training in dermatology residency programs.

METHODS

A survey was mailed to the 112 dermatology residency programs in North America and Puerto Rico.

RESULTS

A total of 71 residency programs (63%) responded. All programs offer training in surgical excisions, 97% of programs train residents in at least one cosmetic procedure, 92% of programs offer Mohs micrographic surgery, and 90% of programs train their residents in laser surgery.

CONCLUSION

Surgical training in dermatology residency varies widely, with a trend toward more cosmetic procedures when compared with prior studies.