Ahmed Abu-Zaid

Integration of scientific research training into undergraduate medical education: a reminder call

There is an increasingly growing trend towards integrating scientific research training into undergraduate medical education. The importance and compulsoriness of this trend has been greatly highlighted at the Boyer Commission on Educating Undergraduates in the Research University. Despite the importance and benefits of undergraduate research, attempts of medical schools to encourage undergraduates to take part in formal research training during undergraduate medical education remain unsatisfactory. This article serves as a ‘reminder call’ highlighting the requisite to integrate scientific research training into undergraduate medical curricula.

Perceived barriers to physician-scientist careers among female undergraduate medical students at the College of Medicine - Alfaisal University: A Saudi Arabian perspective

Abstract Introduction: At present, only a negligible number of matriculating and graduating female medical students express interest in physician–scientist careers. The aim of this study is to explore the perceived barriers towards pursuing physician–scientist careers by female undergraduate medical students at College of Medicine – Alfaisal University, Saudi Arabia. Methods: An online, anonymous, self-rating survey was administered. The survey assessed students’ perceived barriers towards potential physician–scientist careers by responding to typical 5-point Likert scale statements. Results: One hundred sixteen students (116/171) participated in the survey with a 67.8% response rate. The top three barriers to such physician–scientist careers were greater preference towards patient care than research (75%), lack of conviction as regards merging a fruitful research profession with satisfying motherhood life (52.6%) and paucity of recognizing successful and well-known female physician–scientist role models in the country (48.3%). Discussion: Our results showed that the perceived barriers to physician–scientist careers by College of Medicine – Alfaisal University’s female undergraduate medical students were largely identical to the Western literature with few differences and more influence of cultural reasons. It is crucial for medical educators in Saudi Arabia to work on mechanisms that stimulate female students’ interest in research and resolve all barriers that stand in the face of students towards considering physician–scientist careers.

Undergraduate research: An innovative student-centered committee from the Kingdom of Saudi Arabia

Abstract Introduction: Concern has been expressed in recent times whether medical schools have adapted sufficiently to cater for the increasing demand of physician–scientists. Studies have shown that research involvement at the undergraduate level is vital to accommodate this growing need. Enhanced communication skills, improved problem-solving abilities and better future employment opportunities are among the other many benefits of undergraduate research (UR). Herein, we report projects run by a unique student driven undergraduate research committee (URC) at Alfaisal University, Riyadh, Saudi Arabia aimed at providing the future generation of physicians training opportunities for pursuing a research intensive career. Methods: The article describes the unique structure of the URC and provides an in-depth description of the various programs and activities used in promoting students’ research activities. We analyzed students’ perception of URC activities via a questionnaire and analyzed research-output of the first graduating batches through their publication record. Results: Overall, more than 60% of the graduating students were involved in the various research programs offered by the URC and around 50% published in peer-reviewed journals with an average impact factor of 2.4. Conclusions: Research involvement by medical students is an essential need of the twenty-first century and models like URC could provide crucial platform for research training to the new generation of physician–scientists.

Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for management of recurrent/relapsed ovarian granulosa cell tumor: A single-center experience

The aim of this study was to retrospectively report our experience (efficacy/morbidity) with cytoreductive surgery+hyperthermic intraperitoneal chemotherapy (CRS+HIPEC) for the management of recurrent/relapsed ovarian granulosa cell tumors (OGCT).

Esophageal Duplication Cyst

An otherwise healthy 23-year-old man presented with a 3-week history of difficulty swallowing solid food and associated vomiting. He reported no history of respiratory symptoms or weight loss. A barium-swallow examination showed substantial luminal narrowing of the distal esophagus (Panel A, arrows), and a focal mass effect could be seen anteriorly on a second projection (Panel B, arrows). Computed tomography (CT) of the chest performed after the administration of contrast material showed a well-defined, bilobed, cystic mediastinal mass measuring 7.3 cm by 3.2 cm by 7.0 cm. The mass was contiguous with the distal esophagus (Panel C, white arrows), which was immediately posterior to the mass and was compressed by it (Panel C, with the red arrow pointing to the expected location of the esophagus). Neither internal enhancement nor invasion of surrounding structures was seen on CT. The findings were most consistent with an esophageal duplication cyst. The patient underwent surgical resection of the cyst, and there were no indications of recurrence on a CT image obtained at a 2-month follow-up visit. Esophageal duplication cysts are uncommon, benign mediastinal masses. Most cases are diagnosed in infancy or childhood and involve the distal third of the esophagus. Complete surgical excision is typically curative, since recurrence is rare.

Poorly Differentiated Ovarian Sertoli-Leydig Cell Tumor in a 16-Year-Old Single Woman: A Case Report and Literature Review

Sertoli-Leydig cell tumor (SLCT) of ovary is an exceedingly unusual neoplasm that belongs to a group of sex cord-stromal tumors of ovary and accounts for less than 0.5% of all primary ovarian neoplasms. Very few case reports have been documented in the literature so far. Herein, we report a case of primary poorly differentiated ovarian Sertoli-Leydig cell tumor (SLCT) involving the left ovary in a 16-year-old single woman who presented with a 3-month history of a pelviabdominal mass, acne, hirsutism, and menstrual irregularities. In addition, a literature review on ovarian SLCTs is provided.

Perceived influential factors toward participation in undergraduate research activities among medical students at Alfaisal University—College of Medicine: A Saudi Arabian perspective

Abstract Background: The importance of undergraduate research (UR) to students is well acknowledged in literature; however, little is known about its perceived barriers. The aim of study is to explore the perceived barriers toward participation in UR activities among students at Alfaisal University—College of Medicine, Saudi Arabia. Methods: An online, anonymous, cross-sectional, self-rating survey was administered. A two-tailed Mann–Whitney U-test was used to compare the average five-point Likert scale responses between male and female students. Results: Two-hundred and twenty-one students (n = 221/350) participated in the survey with a 63.1% response rate. The percentage of participation in UR significantly differed by gender (males vs. females: 68.6% vs. 45.4%; p < 0.0005, Chi-square test). The top three barriers toward participation in UR were “lack of time” (77.4%), “lack of formal UR courses in curriculum” (76%) and “lack of UR mentors” (70.1%). Statistically significant differences of means were identified between male and female students regarding the following statements: “lack of supervising research mentors” (p < 0.01), “lack of interest in research” (p < 0.04), “lack of finding same-gender research mentor” (p < 0.00) and “lack of UR opportunities” (p < 0.00). Conclusion: Our results were fairly comparable to the Western studies. Medical educators should carefully look into all UR barriers and consider implementing applicable solutions.

Research skills: the neglected competency in tomorrow's 21st-century doctors

Lemon and colleagues [1] published an interesting article shedding light on an issue which I call: ‘research skills: the neglected competency in tomorrow’s 21st century doctors’. The authors asserted the unrecognized compulsoriness of research skills for medical undergraduates [1]. This perspective has been also emphasized by the Boyer Commission on Educating Undergraduates in the Research University [2]. Few medical students express interest in undergraduate research engagement and research-focused careers. The reasons for this include: insufficient exposure to scientific research early in education, no interest in incorporating a research component into education, unwillingness to prolong medical training, personal preference for direct clinical practice-based careers, and failure to realize what it really means to pursue research-focused physician-scientist or academic/clinical medicine careers before a career decision is determined. Generating research-oriented medical workforces is necessary. Intentions of medical students in undertaking research activities may be wheeled by aspirations to develop research-based competencies, curiosities to explore particular scientific disciplines, or pure strategic tactics to smooth acceptance to residency, fellowship and other higher degree medical programmes of choice. However, regardless of the intentions, it is crucial to guide students to develop positive attitudes towards scientific research as the substratum for modern medicine. Also, it must be conveyed that possessing a solid knowledge base and skills in scientific research is becoming an essential competency for tomorrow’s 21st century doctors. Moreover, it must be pointed out that practising biomedical/clinical scientific research is indispensible to up-to-date evidence-based medicine, incompletely distanced from clinical practice and directly contributes to patient care. Furthermore, it is essential to illuminate the significance of physician-scientists and their important contributions to translational research—the primary driving force towards improving patient well-being by promoting the ‘bench-to-bedside’ transition [3]. Teaching scientific research (theoretically and practically), and engagement in research endeavours—early in medical education—enhances research intellectual and practical skills, nurtures high-order cognitive skills (e.g., critical appraising, problem troubleshooting, idea processing and wise judging), augments interest in inquiry-based learning, generates scientific publications, encourages involvement in future research activities and ultimately supports entry to varying research-focused careers. Moreover, students’ development of positive attitudes towards research and future research professions are considerably influenced by the presence of enthusiastic research-oriented teachers who possess a vast research expertise and skillful teaching capabilities. Those teachers—as passionate instructors, ideal role models, valuable mentors and ambassadors of scientific research—are anticipated to spike intensified interest of students in research, illuminate its indispensable relevance in contemporary medicine, encourage research-focused careers and resolve all research-related obstacles standing in the face of students. Unfortunately, such researchers/teachers are not present in many medical schools and universities—an issue to be highly reconsidered by medical education councils. It is possibly the right time to explore undergraduates’ perceptions of the so-called: ‘research skills for undergraduates: a must’ [1] as to acquire a thorough understanding of the philosophical viewpoint: ‘teaching scientific research is indispensable in the 21st century undergraduate medical curricula’. The evolving trend towards utilizing students’ perceptions is largely driven by the universal move towards student-centred education. Students’ perceptions represent valuable inputs to effectively address curricular concerns and accordingly optimize medical education. Lastly, I would like to praise the authors and congratulate the editors for bringing into our attention this endlessly important topic for further continued discussion.

Mature (Benign) Cystic Retroperitoneal Teratoma Involving the Left Adrenal Gland in a 22-Year-Old Male: A Case Report and Literature Review

Primary retroperitoneal teratomas involving adrenal glands are exceedingly uncommon accounting for only 4% of all primary teratomas. They are more common in childhood and rarely occur in adults. Only a very few case reports have been documented in literature so far. Herein, we report a mature (benign) cystic retroperitoneal teratoma in the region of left adrenal gland in a 22-year-old otherwise healthy male patient who presented with a 1-month history of left flank pain. In addition, a literature review on teratomas is included.

Hepatic inflammatory pseudotumor presenting in an 8-year-old boy: A case report and review of literature

Hepatic inflammatory pseudotumors are uncommon benign lesions. Accurately diagnosing hepatic inflammatory pseudotumor can be very challenging because the clinical presentation and radiological appearances are nonspecific and cannot be certainly distinguished from malignant neoplastic processes. Herein, we present a case of hepatic IPT in an 8-year-old boy who presented to clinic with a 3-mo history of a tender hepatic mass, fever of unknown origin, and 9-kg weight loss. The physical examination was notable for tender hepatomegaly. Laboratory investigations were notable for a normal hepatic profile and elevated erythrocyte sedimentation rate and C-reactive protein. A T2-attenuated magnetic resonance imaging scan of the abdomen showed a 4.7 cm × 4.7 cm × 6.6 cm, contrast-enhancing, hyper-intense, well-defined lesion involving the right hepatic lobe. In view of the unremitting symptoms, tender hepatomegaly, thrombosed right hepatic vein, nonspecific radiological findings, and high suspicion of a deep-seated underlying infection or malignancy, a right hepatic lobectomy was recommended. Microscopically, the hepatic lesion exhibited a mixture of inflammatory cells (histiocytes, plasma cells, mature lymphocytes, and occasional multinucleated giant cells) in a background of dense fibrous tissue. Immunohistochemically, the cells stained negative for SMA, ALK-1, CD-21 and CD-23, diffusely positive for CD-68, and focally positive for IgG4. The final histopathological diagnosis was consistent with hepatic IPT. At the postoperative 4-mo follow-up, the patient was asymptomatic without radiological evidence of recurrence.