International Journal of Medical Students (IJMS)
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‘To Love the Patient’: A Qualitative Study of the Role of Mentorship as Part of Medical Education in Rwanda
Full text linkBackground: Medical education in Africa is changing rapidly as 21st century innovations such as e-learning, expansion of simulation laboratories, and other technologies are implemented at universities across the continent. Alongside these efforts, instilling in medical students an understanding of the larger social, economic, cultural, and political dynamics that influence health is essential. In this study, we sought to understand medical students’ experience with the novel curriculum at the University of Global Health Equity (UGHE) in Rwanda, with a focus on the role of mentorship.
Methods: We conducted a qualitative, in-depth interview study with 18 medical students who had experienced the liberal arts curriculum of UGHE. Interviews were conducted by three members of the research team until theoretical saturation was reached (n=18). The constant comparative method of qualitative data analysis was employed to characterize recurrent themes.
Results: Three recurrent themes emerged pertaining to Dr. Paul Farmer’s impact as a role model for medical students: 1) he encouraged systems thinking in his students, 2) he taught students “to love the patient,” and 3) he used practical examples to inspire action. Medical students described the medical education they received as a “mind opener.” Participants recounted how Dr. Farmer’s mentorship fostered their own confidence in becoming compassionate physicians who would inspire systemic change.
Conclusion: Our findings highlight the role that mentors can play in the development of future physicians and suggest that integrating effective mentorship into the medical school experience can affect medical students’ approach to patients and motivation to pursue systems change
Letter to the Editor Regarding “Burnout in Ophthalmology Residents in a Tertiary Referral Hospital in Mexico City"
Full text linkObesity Education and Prevention in Rural Pediatric and Adult Populations in the U.S.
No full textBackground: With the ever-increasing incidence of obesity in pediatric and adult populations nationwide, the need to find impactful and long-term solutions to the epidemic is paramount. Urban and rural populations both show climbing rates of obesity, with significantly more children and adults being affected in rural areas. Many of the most prominent factors leading to obesity are related to socioeconomic status, behavior, lack of access to quality food resources, and lack of knowledge of healthy food groups. Obesity increases the risk of disease in nearly every organ system in the body.
Methods: The authors conducted a narrative review by searching for relevant articles written in English in electronic databases such as PubMed/MEDLINE, Web of Science, Semantic Scholar, and Google Scholar. A total of 88 articles were studied, and finally, 47 articles were included.
Results: Environmental factors such as low access to fresh produce and living in a rural areas increase the risk of adults and children developing obesity. Early intervention in pediatric obesity cases have shown promising effectiveness on obesity prevention and it is suggested that stepwise, realistic goal-setting can lead to greater success in weight loss and management.
Conclusion: With the rates of obesity amongst children and adults continuing to climb in rural areas, addressing the causes is paramount. Biological, behavioral and social factors all contribute to obesity rates in rural areas, often due to the challenges of accessing healthy food and fewer spaces for physical activity
A Cross-Sectional Evaluation of Medical Students, Interns and Postgraduates Regard for Patients with Substance Abuse using the Medical Condition Regard Scale (MCRS) in Andhra Pradesh
Full text linkBACKGROUND: Positive attitudes and empathy from healthcare providers are essential in the effective treatment of patients with substance abuse, impacting both treatment outcomes and patient well-being. In India, attitudes towards substance abuse often reflect a lack of awareness and limited understanding of effective rehabilitation procedures. The Medical Condition Regard Scale (MCRS) is a valuable tool and has been shown to effectively capture the complexity of provider attitudes. However, its use in the Indian context for substance abuse has been limited.
AIMS: The study aims to evaluate and compare the regard for patients with substance abuse among medical students, interns, and postgraduates using the MCRS, and to determine any potential significant differences in attitudes based on gender, age, and occupation.
METHODS: A cross-sectional survey was conducted between June and August 2024 using an online self-administered questionnaire distributed via Google Forms through social media. The survey included medical students (MBBS 3rd and 4th year), interns, and postgraduates in Andhra Pradesh. The questionnaire collected informed consent and demographic information (gender, age, state, year of study, marital status, and religion), and responses to the MCRS, which includes eleven items rated on a six-point Likert scale (1 = strongly disagree, 6 = strongly agree), with five items reverse-scored. The total regard score was derived from the sum of individual item scores, ranging from 11 to 66. Statistical analyses were performed using Microsoft Excel and RStudio v4.3.3. Chi-square tests were used to compare the number of participants with positive (total score 44 and above) and negative (total score 43 and below) regard against demographic variables.
RESULTS: A total of 206 responses were collected, of which 187 met the inclusion criteria. The majority of participants were male (n=98, 52.4%), aged 21-25 years (n=133, 71.1%), interns (n=85, 45.5%), unmarried (n=179, 95.7%), and Hindu (n=160, 85.6%). The median total regard score was 44, with a mean score of 44.7 (SD=6.7), reflecting a generally positive regard for patients with substance abuse. The highest positive regard was noted for the statement, "I wouldn’t mind getting up on call nights to care for patients with substance-use disorder" (mean=4.4, SD=1.1), indicating a position of uncertainty leaning towards agreement. The highest negative regard was for the reverse-scored statement, "Treating patients with substance-use disorder is a waste of money" (mean=4.8, SD=1.2), indicating disagreement with this viewpoint. Chi-square analysis showed that females had a significantly higher positive regard compared to males (p=0.04085). No significant differences were found with respect to age groups (p=0.3442) or occupation (p=0.6534).
CONCLUSION: This study highlights a generally positive regard toward patients with substance abuse. However, limitations include respondent bias, and restriction to a single state, potentially limiting generalizability. The skewed distribution of respondents, with a predominance of unmarried and Hindu participants, prevented analysis of associations with religion and marital status. Future research should therefore include diverse regions and demographic groups. Targeted educational interventions for healthcare professionals, and incorporating substance abuse care into medical curricula and providing opportunities for hands-on experience can help to reduce stigma and improve patient outcomes
Unseen Burden: Lifestyle Factors Impact on Mental Health Among Khartoum University Medical Students
Full text linkBACKGROUND: Mental illnesses are prevalent among youths globally, with the World Health Organization reporting 800,000 suicide deaths annually, making it the second leading cause of death worldwide. This study aimed to evaluate the mental health of medical students at Khartoum University and explore the relationship between lifestyle factors and their mental status.
METHODS: This descriptive, cross-sectional, institution-based study was conducted at the University of Khartoum, Faculty of Medicine. A sample of 322 medical students was selected using multistage stratified random sampling. Data were collected via a self-administered online form incorporating the General Health Questionnaire (GHQ-12) and the Depression, Anxiety and Stress Scale (DASS-21). Statistical analyses included chi-square testing and correlation analysis to examine the relationships between lifestyle factors and mental health. Results: The study found that 43.8% of the respondents experienced depression, 55.9% anxiety, and 48.5% stress. Severe stress was significantly associated with female gender (p = 0.02) and smoking (p = 0.004). Sleep disturbances were significantly linked to severe depression, stress, and anxiety (p < 0.01). Additionally, inadequate sleep was significantly associated with severe depression (p = 0.007) and stress (p = 0.031). Consuming a daily diet rich in fruits, vegetables, whole grain bread, and drinking water was associated with lower stress levels (p = 0.015 and p = 0.018, respectively). Overall, 22.6% of the students were found to be in psychological distress. A significant positive correlation was observed between GHQ-12 and DASS-21 scores for depression (r = 0.589; p < 0.001), anxiety (r = 0.538; p < 0.001), and stress (r = 0.718; p < 0.001).
CONCLUSIONS: The study concluded that depression, anxiety, and stress levels are notably high among medical students at Khartoum University. Factors such as female gender, smoking, and poor sleep quality are associated with increased stress levels, while healthy dietary habits correlate with reduced stress. These findings highlight the need for establishing counseling services in medical schools, integrating mental health into the medical curriculum, and empowering medical students through support from academic staff
Impact of the Sudan Conflict on Asthma Management: A Cross-Sectional Study of Patient Outcomes and Healthcare Challenges
Full text linkBACKGROUND: Asthma is a chronic respiratory condition that requires effective and continuous management to prevent severe health complications and to ensure a high quality of life. In regions affected by ongoing conflict, such as Sudan, the disruption of healthcare systems can significantly impact asthma management. This study aims to evaluate the impact of the Sudan conflict on asthma management and to identify specific challenges faced by asthma patients and healthcare providers, including disruptions in medication access, healthcare services, and overall patient health outcomes.
METHODS: We conducted a cross-sectional study involving 400 asthma patients in conflict-affected regions of Sudan. The study collected data on demographic variables including age, gender, residence (urban vs. rural), and socioeconomic status. Clinical variables were measured, including asthma severity (mild, moderate, severe), medication adherence, frequency of exacerbations, lung function (FEV1 levels), and asthma control as assessed by the Asthma Control Test (ACT). Healthcare access variables included medication availability, frequency of healthcare visits, healthcare provider availability, and healthcare infrastructure. The impact of conflict variables comprised disruptions in medication supply, damage to healthcare facilities, barriers to accessing healthcare (e.g., roadblocks, insecurity), and the psychological impact on patients, such as increased stress and anxiety levels. The data was obtained through patient surveys and medical records.
RESULTS: The conflict has severely impacted asthma management in the Sudanese population. Among the 400 patients, 65% reported significant interruptions in their medication supply, leading to a 50% increase in asthma exacerbations and emergency room visits. Medication adherence decreased by 40% due to the inconsistent availability of essential drugs. Lung function assessments revealed a 30% decline in FEV1 levels compared to pre-conflict measurements. Patient-reported asthma control, measured using the ACT, deteriorated in 55% of patients, with average scores dropping from 22 to 16, indicating poorer control. Healthcare providers reported severe shortages of essential supplies and equipment, with 70% experiencing difficulties in maintaining consistent care. Additionally, 45% of patients reported heightened psychological distress, including elevated stress and anxiety levels, which exacerbated asthma symptoms. Barriers to accessing healthcare, such as roadblocks and insecurity, led to a 35% reduction in healthcare visits.
CONCLUSION: The ongoing conflict in Sudan has critically impaired asthma management, resulting in increased health complications and deteriorated patient outcomes. A comprehensive approach is needed, including improving medication distribution, strengthening healthcare services, and offering psychological support. This study provides valuable insights into the intersection of chronic disease management and conflict, offering lessons for enhancing care in similar crises
Uncommon Presentation: Simultaneous Herpes Zoster Infection in Immunocompetent Patients
Full text linkBACKGROUND: Herpes Zoster occurs due to reactivation of the varicella zoster virus (VZV). It mainly affects patients with suppressed cell-mediated immunity, however, there have been cases reported in immunocompetent patients.
THE CASES: Case 1: A 26-year-old male presented with severe headache in the frontal region on his right side, nausea and dizziness. Analgesic treatment with oral Diclofenac every 12 hours at unspecified dose was indicated. Three days later she returned with vesicles with erythematous base in the course of the ophthalmic trigeminal branch (Figure 1). The patient referred varicella at 6 years of age. Treatment was started with 1 tablet of Acyclovir 400 mg per oral (PO) every 6 hours for 8 days, Diclofenac Complex B intramuscularly (IM) at a dose of 1 ampoule every 24 hours for six days and sublingual ketorolac every 24 hours for eight days. Case 2: A 19-year-old woman with erythematous lesions with vesicular lesions in the abdominal region. She reported a history of chickenpox at 3 years of age. Treatment with 1 tablet of Acyclovir 400 mg PO every 6 hours for 8 days, B complex with Diclofenac IM every 24 hours for six days and ketorolac sublingual every 24 hours. Case 3: A 56-year-old male with erythematous lesions and papules on the neck with mild pain and a history of chickenpox in childhood, without the presence of any immunosuppressive symptoms. She started treatment with oral acyclovir 400 mg every 8 hours PO for 7 days and diclofenac every 12 hours PO. All three patients presented at the follow-up visit with disappearance of all skin lesions, and without any complication.
CONCLUSION: All patients had an atypical presentation, secondary to the lack of a history of immunosuppression. Although advanced age is one of the most important risk factors, the three patients did not meet this factor. There are few cases of immunocompetent patients reported in the literature, which were treated mainly with Acyclovir, as used in our patients, obtaining a positive response. This type of presentation is important for medical literature, mainly because it is not considered as differential diagnosis, therefore it is important to consider it due to the recent cases reported in the last years
Assessment of HIV prevalence in Adults Within the Aliade Community, Benue State.
Full text linkBACKGROUND: Benue State is recognized as one of Nigeria\u27s high-risk zones for HIV, with an estimated prevalence of 4.8% among adults aged 15-64 years. The prevalence is notably higher among females at 6.3% and lower among males at 3.5%, making it the second highest HIV prevalence state in Nigeria. Despite relatively high awareness levels, the infection rate continues to rise in rural areas. This study focused on Aliade, a community in the TIV land, conducting random HIV testing on 500 adult outpatients aged 15-64 years over a period of five months, with Aliade General Hospital serving as the testing site. The study aimed to determine the HIV infection rate among adults in the Aliade community of Benue State, Nigeria, by assessing the prevalence of HIV.
METHODS: A hospital-based randomized study was conducted at Aliade General Hospital, Benue State. HIV testing was performed using the rapid diagnostic testing algorithm according to Nigeria\u27s National HIV testing guidelines, with seropositive samples confirmed by supplemental assays. Data was collected over five months and analyzed using IBM SPSS version 26.
RESULTS: The study included 500 respondents with a mean age of 39.4 years. Of the participants, 215 were male and 285 were female. Over half were married, and approximately 70% had only secondary education. While 90% of respondents were aware of HIV, only 60% had previously undergone testing. The prevalence of HIV was 5.6% overall, with 6.7% among females and 3.3% among males.
CONCLUSION: Despite awareness of HIV, the prevalence remains high and is increasing. This study underscores the need for enhanced awareness and intervention strategies to address the growing HIV epidemic in Benue State
Awareness and Perspectives on the Role of Artificial Intelligence in Primary Care: A Cross-Sectional Survey of Rural and Urban Primary Care Physicians in Alberta, Canada
Full text linkBackground: Artificial intelligence (AI) is increasingly integrated into healthcare, yet physicians’ awareness and perspectives remain underexplored. While often associated with imaging, AI applications also include online scheduling, digitized records, virtual consultations, and drug dosage algorithms. This study surveyed Canadian primary care physicians (PCPs) to assess their awareness and attitudes toward AI in healthcare.
Methods: A cross-sectional survey was distributed via email and newsletters to family physicians across Alberta, including both urban and rural settings. Responses were collected through Qualtrics.
Results: Of 79 responses, 46 met inclusion criteria. Most respondents practiced in urban areas (63%) and had no prior AI training (65%). Rural physicians reported greater comfort and interest in AI, including its use for monitoring treatment adherence (p=0.043) and analyzing EMR data for health management (p=0.027). Knowledge of AI varied widely: only 30% recognized that deep learning involves artificial neural networks, while 44% reported no knowledge of the concept. Commonly used AI tools included ECG interpreters (65%) and language translators (37%). Physicians showed interest in expanded medical uses of AI.
Conclusion: There is a lack of knowledge and use of AI tools in medicine, with both urban and rural physicians’ responses suggesting a need for more education and training in AI. The “Lack of human connection” was the main fear that was expressed regarding the use of AI in healthcare suggesting concerns about potential impacts on patient-provider relationships. This survey\u27s findings may inform future research into the development and implementation of AI in primary care