Reneé Pereyra-Elías

[Latin American medical students' appraisal on university scientific research training].

Learning research skills should be a goal during undergraduate training of physicians. Aim: To identify Latin American medical students’ appraisal on research skills university training. Material and Methods:A self-administered survey about experience in research, self-assessment of research skills, quality of training in the area received at the university and that importance of publishing as undergraduate students, was answered by 208 medical students aged 23 ± 3 years (54% male), attending a medical students congress. Results: Seventy percent of respondents pertained to medical students’ scientific societies and 34% had published in a scientific journal. Fifty two percent considered as good or very good the training level received at their universities on information retrieval and 45% considered good the training in research methodology. Thirty two percent considered as poor or none the training received in scientific writing and 37% in the publishing process. Eighty nine percent considered student publishing as important and 61% perceived limitations in this matter. Conclusions: The university training level received by Latin American medical students on research and publication process was evaluated as deficient by these students.

Prevalencia y factores asociados con síntomas depresivos en estudiantes de ciencias de la salud de una Universidad privada de Lima, Perú 2010

Introduccion. Los sintomas depresivos en estudiantes de ciencias de la salud son comunes y podrian ser potencialmente perjudiciales. Objetivos. Determinar la prevalencia de sintomas depresivos y sus factores asociados en los estudiantes de la Facultad de Ciencias de la Salud de la Universidad Peruana de Ciencias Aplicadas, Lima (Peru), junio 2010. Materiales y metodos. Estudio analitico transversal; se realizo una encuesta previo consentimiento informado a 590/869 estudiantes. Para medir la variable de respuesta (sintomas depresivos) se uso la escala de Zung abreviada. Se empleo la regresion logistica multiple para evaluar los factores asociados, considerando un nivel de significancia de p 0,05). En el analisis multivariado, se encontro asociacion con la inconformidad de su rendimiento academico (OR=2,13; IC95%:1,47-3,08), inconformidad con la situacion economica actual (OR=1,93; IC95%:1,24-2,99) y vivir con un familiar externo a la familia nuclear (OR=1,62; IC95%:1,07-2,45). Conclusion. Existe una alta prevalencia de sintomas depresivos en la poblacion estudiada, especialmente en los alumnos de la carrera de medicina, siendo la inconformidad con el rendimiento academico, con su economia y vivir con un familiar externo a la familia nuclear, factores asociados que podrian tomarse en cuenta para trabajar programas preventivos.

Publicación de los trabajos presentados a los congresos científicos de estudiantes de medicina, Perú 2002-2009: características y factores asociados.

Objetivos. Determinar la proporcion de publicacion de los resumenes presentados a los congresos cientificos nacionales de estudiantes de medicina de Peru entre los anos 2002 y 2009 y sus factores asociados. Materiales y metodos. Se realizo una cohorte retrospectiva, se evaluo las caracteristicas de todos los resumenes presentados y se determino si habian sido publicados en revistas cientificas utilizando una estrategia de busqueda validada con Google Academico. Se calculo los riesgos relativos (RR), crudos y ajustados mediante la regresion de Poisson con varianza robusta para evaluar asociacion con los factores analizados. Resultados. Se analizo 532 resumenes; 52 (9,8%) fueron publicados en revistas cientificas luego de su participacion en el congreso; en todos los casos fue en revistas peruanas y en espanol. La principal revista donde se publicaron fue (CIMEL) (13/52). La mediana del tiempo de publicacion fue de 13 meses (rango: 0-75). El que un alumno de la Universidad Nacional Mayor de San Marcos (RR: 5,18; IC95%:2,3-11,6) sea autor del resumen y que el resumen sea de autoria colaborativa entre alumnos de dos universidades (RR: 3,64; IC95%:1,1-11,7) son factores asociados en el analisis multivariado. Conclusiones. La proporcion de publicacion de resumenes presentados a los congresos cientificos nacionales de estudiantes de medicina de Peru es baja. Se deben implementar nuevas medidas y reforzar las existentes para incentivar una mayor publicacion de los trabajos presentados.

Recruiting researchers through Facebook.

To the Editor: We have read with considerable interest Dr. Richiardi’s communication regarding the use of Facebook to recruit participants in the NINFEA study. As previous initiatives report, Facebook provides a positive virtual environment in which study participants can be enrolled and followed. As a widely used online social network, Facebook may be useful for other research purposes. We would like to share our experience in recruiting researchers through this website. In June 2011, our Collaborative Working Group for the Research of Human Resources for Health, RedLIRHUS (Grupo Colaborativo Latinoamericano para la Investigación de Recursos Humanos en Salud), designed a multicenter study to explore the profile and professional expectations of Latin American medical students, with questions on topics such as emigration intention and primary-care labor perspectives. This study was conceived as a continent-wide evaluation, using a pilot tested self-administered survey. To gather these data, we decided to start the fieldwork by enrolling researchers from various countries in Latin America via Facebook. Given that medical students were the potential study subjects, we decided to involve them also as the local principal investigators. In October 2011, the project was approved by the Ethical Committee of the Instituto Nacional de Salud del Perú. We started with a limited number of universities, but this situation was insufficient to achieve our objective. We, therefore, implemented a new recruiting strategy by posting an invitation on the “wall” of the local organizations’ Facebook pages (by country or university) of the Medical Students’ Scientific Societies (Sociedades Científicas de Estudiantes de Medicina) and similar groups, such as the International Federation of Medical Students’ Associations. Overall, 80 researchers agreed to take part in this project; they represented 80 universities from 15 Latin American countries. Approximately half of these researchers were recruited by Facebook. Also, in October 2011, we created a Facebook “Closed Group,” called Red-LIRHUS, to connect all participant researchers (including those who were contacted using Facebook and those who were not). This group provided responses to common questions and included 95% of the participant researchers in their local universities. As our experience suggests, Facebook can be helpful in recruiting and communicating with a research team, even in a multinational context.

Profile and professional expectations of medical students from 11 Latin American countries: the Red-LIRHUS project

BackgroundLatin America is undergoing a human resource crisis in health care in terms of labor shortage, misdistribution and poor orientation to primary care. Workforce data are needed to inform the planning of long-term strategies to address this problem. This study aimed to evaluate the academic and motivational profile, as well as the professional expectations, of Latin American medical students.ResultsWe conducted an observational, cross-sectional, multi-country study evaluating medical students from 11 Spanish-speaking countries in 2011–2012. Motivations to study medicine, migration intentions, intent to enter postgraduate programs, and perceptions regarding primary care were evaluated via a self-administered questionnaire. Outcomes were measured with pilot-tested questions and previously validated scales. A total of 11,072 valid surveys from 63 medical schools were gathered and analyzed.ConclusionsThis study describes the profile and expectations of the future workforce being trained in Latin America. The obtained information will be useful for governments and universities in planning strategies to improve their current state of affairs regarding human resources for health care professions.

Gender Associated with the Intention to Choose a Medical Specialty in Medical Students: A Cross-Sectional Study in 11 Countries in Latin America.

Introduction The selection of a medical specialty has been associated with multiple factors, such as personal preferences, academic exposure, motivational factors and sociodemographic factors, such as gender. The number of women in the medical field has increased in recent years. In Latin America, we have not found any studies that explore this relationship. Objective To determine whether there is an association between gender and the intention to choose a medical specialty in medical students from 11 countries in Latin America. Methods Secondary analysis of the Collaborative Working Group for the Research of Human Resources for Health (Red-LIRHUS) data; a multi-country project of students in their first year and fifth year of study, from 63 medical schools in 11 Latin American countries. All students who referred intention to choose a certain medical specialty were considered as participants. Results Of the 11073 surveyed students, 9235 indicated the name of a specific specialty. The specialties chosen most often in the fifth year were General Surgery (13.0%), Pediatrics (11.0%), Internal Medicine (10.3%) and Obstetrics/Gynecology (9.0%). For women, the top choices were Pediatrics (15.8%), Obstetrics/Gynecology (11.0%), Cardiology (8.7%), General Surgery (8.6%), and Oncology (6.4%). In the adjusted analysis, the female gender was associated with the choice of Obstetrics/Gynecology (RP: 2.75; IC95%: 2.24–3.39); Pediatric Surgery (RP: 2.19; IC95%: 1.19–4.00), Dermatology (RP: 1.91; IC95%:1.24–2.93), Pediatrics (RP: 1.83; IC95%: 1.56–2.17), and Oncology (RP: 1.37; IC95%: 1.10–1.71). Conclusions There is an association between the female gender and the intention to choose Obstetrics/Gynecology, Pediatrics, Pediatric Surgery, Dermatology, and Oncology. We recommend conducting studies that consider other factors that can influence the choice of a medical specialty.

Differences on Primary Care Labor Perceptions in Medical Students from 11 Latin American Countries

Background The shortage in Latin-American Primary Care (PC) workforce may be due to negative perceptions about it. These perceptions might be probably influenced by particular features of health systems and academic environments, thus varying between countries. Methods Observational, analytic and cross-sectional multicountry study that evaluated 9,561 first and fifth-year medical students from 63 medical schools of 11 Latin American countries through a survey. Perceptions on PC work was evaluated through a previously validated scale. Tertiles of the scores were created in order to compare the different countries. Crude and adjusted prevalence ratios were calculated using simple and multiple Poisson regression with robust variance. Results Approximately 53% of subjects were female; mean age was 20.4±2.9 years; 35.5% were fifth-year students. Statistically significant differences were found between the study subjects’ country, using Peru as reference. Students from Chile, Colombia, Mexico and Paraguay perceived PC work more positively, while those from Ecuador showed a less favorable position. No differences were found among perceptions of Bolivian, Salvadoran, Honduran and Venezuelan students when compared to their Peruvian peers. Conclusions Perceptions of PC among medical students from Latin America vary according to country. Considering such differences can be of major importance for potential local specific interventions.

Facebook use by Peruvian physicians: exposing private life to patients.

al behavior such as alcohol consumption, and revealed other sensitive aspects of their personal lives on Facebook, thereby making them available for observation by patients, as previously reported [1–4] . In this scenario, Facebook could play a key role in transforming the doctor-patient relationship: becoming aware of the doctor’s past and habits in everyday life beyond the consultation room might well compromise the professional relationship between doctor and patient [4] . In summary, a major proportion of our biased sample of Peruvian physicians have Facebook accounts and have patients as their Facebook ‘friends’. In light of this situation, medical schools and/ or major health care institutions should outline and implement guidelines for the use of Facebook and other online social network utilities, identifying those practices which may potentially be prejudicial to the establishment and maintenance of a good doctor-patient relationship. Facebook, a social networking service with over 100 million unique users, is widely established in many contexts around the world. A significant number of physicians have opened Facebook accounts [1, 2] , which is resulting in major ramifications for the medical profession. To investigate Facebook use by physicians, in June 2010, we e-mailed an anonymous questionnaire to 2,045 Peruvian physicians, with a response rate of 6% (121/2,045). Of the 121 physicians, 72 (60%) had a Facebook profile, and 14% of those (10/72) referred to their patients as ‘friends’. According to multivariate analysis, being 30 years old or younger (odds ratio, OR: 4.4; 95% CI: 1.6–12.3), having access to the Internet at home (OR: 11.7; 95% CI: 1.3–106.5) and using the Internet more than 25 h weekly (OR: 3.1; 95% CI: 1.1–8.8) were the factors associated with the use of Facebook. Gender, smartphone use and previous experience of conducting research or publishing were not associated factors in bivariate analysis. Facilities for Internet access and overwhelming use in and of itself can explain the affinity many people have for this social network. As previously reported, use of Facebook is more common among young doctors [2, 3] . Although we did not evaluate the characteristics of their Facebook accounts (privacy settings, uploaded personal information and photographs), many young doctors exposed potentially embarrassing situations or unprofessionReceived: March 6, 2011 Accepted: May 5, 2011 Published online: October 21, 2011

Does physicians’ right to strike outweigh students’ right to an education? The on-going ethical dilemma in Peru.

Although often viewed as an action of last resort, going on strike remains a legal and often effective option for physicians seeking labor improvements and better working conditions. Indeed, in some countries, there have been reports of strikes by physicians (1, 2), followed by ensuing discussions of potential ethical implications (35). However, little has been said about the consequences of such a mass labor stoppage on undergraduate medical education and those students who aspire to the profession. (Published: 19 December 2012) Citation: Med Educ Online 2012, 17 : 19870 - http://dx.doi.org/10.3402/meo.v17i0.19870

Religious affiliation and the intention to choose psychiatry as a specialty among physicians in training from 11 Latin American countries

The worldwide scarcity of psychiatrists makes the identification of the factors associated with the intention to choose this specialty an important issue. This study aims to evaluate the association between religious affiliation and the intention to choose psychiatry as a specialty among medical students from 11 Latin American countries. We conducted a cross-sectional, multi-country study that included first- and fifth-year students of 63 medical schools in 11 Latin-American countries between 2011 and 2012. The main outcome and measures were the intention to pursue psychiatry as a specialty over other specialties (yes/no) and religious affiliation (without: atheist/agnostic; with: any religion). A total of 8308 participants were included; 53.6% were women, and the average age was 20.4 (SD = 2.9) years. About 36% were fifth-year students, and 11.8% were not affiliated with any religion. Only 2.6% had the intention to choose psychiatry; the highest proportion of students with the intention to choose psychiatry was among students in Chile (8.1%) and the lowest among students in Mexico (1.1%). After adjusting for demographic, family, academic as well as personal and professional projection variable, we found that those who had no religious affiliation were more likely to report the intention to become a psychiatrist [OR: 2.92 (95%CI: 2.14-4.00)]. There is a strong positive association between not having a religious affiliation and the intention to become a psychiatrist. The possible factors that influence this phenomenon must be evaluated in greater depth, ideally through longitudinal research.