The Current Pediatric Surgery Job Market: A Perspective of Recent Fellowship Graduates

PurposeThis study describes the job market from the perspective of recent pediatric surgery graduates.MethodsAn anonymous survey was circulated to the 137 pediatric surgeons who graduated from fellowships 2019–2021.ResultsThe survey response rate was 49%. The majority of respondents were women (52%), Caucasian (72%), and had a median student debt burden of $225,000. Considering job opportunities, respondents strongly emphasized camaraderie (93%), mentorship (93%), case mix (85%), geography (67%), faculty reputation (62%), spousal employment (57%), compensation (51%), and call frequency (45%). 30% were satisfied with the employment opportunities available, and 21% felt strongly prepared to negotiate for their first job. All respondents were able to secure a job. Most jobs were university-based (70%) or hospital employed (18%) positions where surgeons covered median of two hospitals. 49% wanted protected research time, and 12% of respondents were able to secure substantial, protected research time. The median compensation for university-based jobs was $12,583 below the median AAMC benchmark for assistant professors for the corresponding year of graduation.ConclusionThese data highlight the ongoing need for assessment of the pediatric surgery workforce and for professional societies and training programs to further assist graduating fellows in preparing to negotiate their first job.Type of studySurveyLevel of EvidenceLevel V.     

Efficacy of percutaneous and transcutaneous tibial nerve stimulation in women with idiopathic overactive bladder: A prospective randomised controlled trial

BackgroundDifferent studies have reported the efficacy of percutaneous tibial nerve stimulation (PTNS) and transcutaneous tibial nerve stimulation (TTNS) in treating idiopathic overactive bladder (OAB). However, no study has compared the effectiveness of PTNS and TTNS added to bladder training (BT) in idiopathic OAB.ObjectiveTo compare the efficacy of PTNS and TTNS added to BT in women with idiopathic OAB.MethodsWe randomised 60 women with idiopathic OAB into 3 groups. Group 1 (n = 19) received BT, Group 2 (n = 19) received PTNS in addition to BT, and Group 3 (n = 20) received TTNS in addition to BT. PTNS and TTNS were performed 2 days a week, for 30 min a day, for a total of 12 sessions for 6 weeks. Patients were evaluated by incontinence severity (pad test), a 3-day voiding diary (frequency of voiding, incontinence episodes, nocturia and number of pads used), symptom severity, quality of life, treatment success (positive response rate), treatment satisfaction (Likert scale), discomfort level and preparation time for stimulation (sec).ResultsAt the end of treatment; severity of incontinence, frequency of voiding, incontinence episodes, nocturia, number of pads used, symptom severity and quality of life were significantly improved in Groups 2 and 3 versus Group 1 (P < 0.0167). Treatment success and treatment satisfaction were higher in Groups 2 and 3 than Group 1 (P < 0.001 and P < 0.0167, respectively). Level of discomfort was lower, treatment satisfaction was higher and preparation time for stimulation was shorter in Group 3 than Group 2 (P < 0.05).ConclusionBoth the PTNS plus BT and TTNS plus BT were more effective than BT alone in women with idiopathic OAB. These 2 tibial nerve stimulation methods had similar clinical efficacy but with slight differences: TTNS had shorter preparation time, less discomfort level and higher patient satisfaction than PTNS.     

The effect of different statistical approaches on image quality data obtained from radiological examinations

IntroductionSelection of optimal image acquisition protocols in medical imaging remains a grey area, the superimposed use of the Likert scale in radiological image quality evaluations creates an additional challenge for the statistical analysis of image quality data.Using a simulation study, we have trialled a novel approach to analysing radiological image quality Likert scale data.MethodsA simulation study was undertaken where simulated datasets were generated based on the distribution of Likert scale values according to varying image acquisition protocols from a real dataset. Simulated Likert scale values were pooled in four different ways; the mean, median, mode and the summation of patient Likert scale values of which the total was assigned a categorical Likert scale value. Estimates of bias, MAPE and RMSPE were then calculated for all four pooling approaches to determine which method most accurately represented an expert's opinion.ResultsWhen compared to an expert's opinion, the method of summation and categorisation of Likert scale values was most accurate 49 times out of the 114 (43.0%) tests. The mean 28 times out of 114 (24.6%), the median 23 times out of 114 (20.2%) and the mode 17 times out of 114 (14.9%).ConclusionWe conclude that our method of summation and categorisation of Likert scale values is most often the best representation of the simulated data compared to the expert's opinion.Implications for practiceThere is scope to reproduce this simulation study with multiple observers to reflect clinical reality more accurately with the dynamic nature of multiple observers. This also prompts future investigation into other anatomical areas, to see if the same methods produce similar results.     

小儿弱视采用多媒体训练与传统遮盖治疗的效果对比

目的分析小儿弱视采用多媒体训练与传统遮盖治疗的效果。方法 100例小儿弱视患儿,采用计算机随机法分为传统组和多媒体组,每组50例。传统组患儿采用传统遮盖治疗,多媒体组患儿采用多媒体训练。比较两组患儿治疗前后立体视觉情况、视力水平及治疗效果。结果多媒体组患儿治疗总有效率为94.00%(47/50),高于传统组的80.00%(40/50),差异具有统计学意义(P<0.05)。治疗后,多媒体组患儿立体视觉正常率为90.00%(45/50),高于传统组的74.00%(37/50),差异具有统计学意义(P<0.05)。治疗后,两组患儿视力水平均高于本组治疗前,且多媒体组患儿视力水平(0.93±0.12)高于传统组的(0.84±0.12),差异具有统计学意义(P<0.05)。结论小儿弱视采用多媒体训练与传统遮盖治疗的效果存在差异,多媒体训练可更好地改善患儿视力,值得推广和应用。     

全国2015-2020年精神科医师转岗培训状况

目的:调查全国精神科医师转岗培训情况,为优化精神科医师转岗培训和制定精神卫生人才培养体系建设提供参考。方法:设计精神科医师转岗培训调查问卷,调查全国31个省(自治区、直辖市)和新疆生产建设兵团2015-2020年转岗培训情况。采用描述性分析方法,对全国精神科医师转岗培训和培训区县覆盖等情况进行分析;采用χ~2检验比较东中西部地区转岗医师中已提供精神科诊疗服务情况。结果:全国共13 388人完成精神科医师转岗培训,9923人变更或加注了精神科执业资质,6538人已提供精神科诊疗服务,无精神卫生资源空白区县数减少85.1%。结论:转岗培训短期内缓解了精神卫生人才紧缺现状,提高了精神卫生服务可及性。