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This document summarizes the experience of teaching clinical urology to medical learners training as generalists in rural Northern Ontario over the past 25 years. Key aspects include exposing learners to clinics, operating rooms, and clinical research to enrich their skills in a supportive one-on-one environment. Learners also assist with community engagement activities. While challenges include limited resources, the experience benefits learners and helps retain physicians in rural communities through increased skills and comfort managing urological conditions.
The challenges faced by nursing administrators are many and varies. An overview of such challenges will be helpful in working towards the managerial solutions.
This document outlines an agenda for a training on the role of registered nurses in primary care settings. It discusses the chronic care model, which emphasizes coordinated care systems to better manage chronic conditions. It also reviews the American Academy of Ambulatory Care Nursing standards of practice, which define ambulatory nursing practice through six standards on the nursing process and ten on professional performance. The document emphasizes the importance of nurses in areas like care coordination, patient education, and provider support in primary care settings to improve outcomes for patients with chronic conditions.
Nurse scientists serve as knowledge brokers by linking researchers and decision makers. They facilitate interaction between these groups to support evidence-based decision making in healthcare. Nurse scientists require extensive knowledge in their specialty areas and perform research by developing solutions, running experiments, and applying for grants. Their work involves producing and disseminating knowledge for government agencies, universities, and private organizations. Nurse scientists influence nursing practice by assisting with workforce planning, setting standards and processes, and designing systems to measure and improve quality of care.
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- Daily teaching, case discussions, bedside learning and faculty coverage to mentor students.
- Evaluations, research, workshops and conferences to assess progress and support continued learning.
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This document discusses trends and challenges in nursing education. It notes changing demographics like increasing populations and chronic illnesses. Nursing education must adapt, with more flexible delivery, competency-based curriculums, and use of technology. There are also challenges like lack of qualified faculty, infrastructure issues, and competition for clinical placements. Suggested actions include student-centered learning, technology integration, innovative teaching, and preparing students for future complex care needs through interprofessional education and focus on evidence-based practice.
This document summarizes the experience of teaching clinical urology to medical learners training as generalists in rural Northern Ontario over the past 25 years. Key aspects include exposing learners to clinics, operating rooms, and clinical research to enrich their skills in a supportive one-on-one environment. Learners also assist with community engagement activities. While challenges include limited resources, the experience benefits learners and helps retain physicians in rural communities through increased skills and comfort managing urological conditions.
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This document outlines an agenda for a training on the role of registered nurses in primary care settings. It discusses the chronic care model, which emphasizes coordinated care systems to better manage chronic conditions. It also reviews the American Academy of Ambulatory Care Nursing standards of practice, which define ambulatory nursing practice through six standards on the nursing process and ten on professional performance. The document emphasizes the importance of nurses in areas like care coordination, patient education, and provider support in primary care settings to improve outcomes for patients with chronic conditions.
Nurse scientists serve as knowledge brokers by linking researchers and decision makers. They facilitate interaction between these groups to support evidence-based decision making in healthcare. Nurse scientists require extensive knowledge in their specialty areas and perform research by developing solutions, running experiments, and applying for grants. Their work involves producing and disseminating knowledge for government agencies, universities, and private organizations. Nurse scientists influence nursing practice by assisting with workforce planning, setting standards and processes, and designing systems to measure and improve quality of care.
RESEARCH IN PALLIATIVE CARE PRESENTATION.pptxSamboGlo
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An expert discusses strategies for implementing a good academic emergency medicine training program. Key aspects include:
- Strong selection process and induction training to prepare students.
- Focused clinical rotations, electives, life support courses, procedures, and skills training to build proficiency.
- Daily teaching, case discussions, bedside learning and faculty coverage to mentor students.
- Evaluations, research, workshops and conferences to assess progress and support continued learning.
- Exit exams to ensure students have achieved expected competencies before completing the program.
The document describes a pre-med summer institute program that aims to promote and prepare Aboriginal students to apply to medical school in Canada. The 4-week program involves the students shadowing medical professionals, learning first aid skills, and getting mentored. It also helps the students explore a career in medicine and supports their medical school applications. Most students who completed the program decided to pursue a career in healthcare and some have now been accepted to medical school.
This document discusses trends and challenges in nursing education. It notes changing demographics like increasing populations and chronic illnesses. Nursing education must adapt, with more flexible delivery, competency-based curriculums, and use of technology. There are also challenges like lack of qualified faculty, infrastructure issues, and competition for clinical placements. Suggested actions include student-centered learning, technology integration, innovative teaching, and preparing students for future complex care needs through interprofessional education and focus on evidence-based practice.
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Texila American University MD Program Guyana.pptxkkanish1109
This document provides information about a Doctor of Medicine program, including its rigorous curriculum, hands-on clinical training opportunities, and requirements for admission. The MD program offers comprehensive medical education covering various subjects and specialized electives. Students gain clinical experience through rotations at affiliated hospitals. Upon completing the program, graduates will be prepared for careers in healthcare.
Shaping the Future of Nursing Education & Practice.pptxS A Tabish
This document discusses the future of nursing education and practice. It covers several topics:
1. Nursing is an evolving profession that combines scientific and caring aspects. New technologies are changing what nurses do and where they work.
2. Nursing education must also evolve to incorporate new teaching approaches like simulation, concept-based learning, and clinical intensives. Competency-based learning and evidence-based practice will be important.
3. The roles and settings for nurses are expanding. Nurses will take on more autonomous roles in areas like nurse practitioners, mobile and home health care, forensic nursing, research, and hospice care. Nursing education must prepare students for these changing roles.
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Kathmandu Medical College (KMC) was established in 1997 with the goal of providing high-quality and accessible medical education and healthcare. It has over 10 faculty members in its Department of Obstetrics and Gynecology, which sees over 75 patients daily and performs 95 surgeries per month. KMC emphasizes using modern teaching methods like problem-based learning and aims to continually improve its education and care. It faces challenges in enhancing practical training and developing new competency-based assessment models.
This document provides an overview of the history and development of nursing as a profession. It discusses how nursing has evolved from focusing primarily on providing comfort and care to also emphasizing health promotion and prevention. Key figures who helped establish nursing standards and education are highlighted, such as Florence Nightingale, who opened the first nursing school. The roles, responsibilities, and scope of nursing practice are also outlined, as well as the importance of critical thinking and use of the nursing process in clinical decision making. Professional nursing organizations and trends that continue to shape the profession are also reviewed.
Medical Careers
Medical assistants help nurses and doctors provide patient care by greeting patients, taking vitals, scheduling appointments, and ensuring medical supplies are stocked. The average salary is $17,000-$18,000. Pediatricians care for children's health by examining, diagnosing, and treating illnesses and injuries. Becoming a pediatrician requires 8 years of education beyond high school including 4 years of medical school and 3-8 years of residency, with an average salary of $124,360 per year. Veterinarians care for animal health by examining for illness or injury and sometimes performing surgeries. Becoming a veterinarian requires a Doctor of Veterinary Medicine degree which takes 4 years of study.
Medical Careers
Medical assistants help nurses and doctors provide patient care by greeting patients, taking vitals, scheduling appointments, and ensuring medical supplies are stocked. The average salary is $17,000-$18,000. Pediatricians care for children's health by examining, diagnosing, and treating illnesses and injuries. Becoming a pediatrician requires 8 years of education beyond high school including 4 years of medical school and 3-8 years of residency, with an average salary of $124,360 per year. Veterinarians care for animal health by examining for illness or injury and sometimes performing surgeries. Becoming a veterinarian requires a Doctor of Veterinary Medicine degree which takes 4 years of study.
The document outlines several challenges in mental health care including misconceptions about mental health nursing, a lack of clinical guidelines, challenges in providing care within psychiatric wards, and challenges related to the role of mental health nurses. Some key priorities of the Helsinki Declaration are also summarized such as fostering awareness of mental well-being and collectively tackling stigma. The document discusses scope and role challenges as mental health practice shifts from illness to wellness and deinstitutionalization occurs.
Clinical teaching is an individualized
or group teaching to the nursing
student in the clinical area by the
nurse educators, staff and
clinical nurse manager
This document discusses the role of doctors in home care. It begins by defining home care and noting the decline in house calls by doctors. It then reviews the history and current state of home care in Malaysia. Home care is needed due to an aging population and increasing chronic illnesses. Reasons for doctors to conduct house calls include patients being homebound or to improve care transitions. During a house call, doctors conduct comprehensive assessments and work as part of an interdisciplinary team. The doctor's role includes identifying patient needs, documenting care, developing and reassessing treatment plans, and ensuring continuity of care. Challenges for home care teams include communication, logistics, and cost-effectiveness.
This document provides an overview of the nursing profession. It defines nursing as caring for individuals' health needs through a caring relationship. Nursing requires a bachelor's degree and license. It is considered both an art and a science focused on health promotion. As a profession, nursing is based on scientific knowledge, has educational standards, and follows a code of ethics. Nurses work in various medical settings and have an expanding scope of practice focused on patient care.
The nursing foundations course is designed to help students develop understanding of nursing philosophy, theories, and skills through 265 hours of theory and 650 hours of practical experience, including 200 lab hours and 450 clinical hours in various clinical settings. The course objectives are for students to develop knowledge in health, illness, nursing practice, ethics, communication, health assessment, basic nursing skills, and more. Specific skills taught include vital signs, health assessment, meeting patient needs, infection control, and medication administration through various routes.
The document provides an orientation for UCSD School of Medicine, founded in 1968. It summarizes the integrated scientific curriculum, which aims to foster an integrated appreciation of medicine and science through active learning and longitudinal education. It describes the contents and methods of instruction for organ system blocks, as well as elective opportunities. The orientation outlines clinical facilities, independent study projects, dual degree programs, specialty choices, academic communities, student affairs support, financial aid, housing options, and the multiple mini interview process.
The document provides information about postgraduate courses in palliative care offered at the University of Technology Sydney (UTS), including an overview of course structures, subjects, costs, and how to apply. Courses are designed for registered health professionals and offer flexible online study options while building clinical skills in palliative care. Students will gain expertise to improve palliative care outcomes through evidence-based practice and research translation.
Evidence based practice by Tanoj Patidar MSc Nursing (MSN)Tanoj Patidar
This document discusses evidence-based practice (EBP) in nursing. It provides background on EBP, noting that EBP integrates the best research evidence with clinical expertise and patient preferences. The document reviews the history of EBP and its importance for improving patient outcomes. It defines EBP in nursing as locating, appraising, and applying the best medical and nursing research evidence to improve clinical practice. The document also outlines models of EBP, barriers to implementing EBP, and strategies for overcoming those barriers.
Challenges and effective management of pediatric services in nepalNisthaShrestha
Managing pediatric services in Nepal faces many challenges. The country has a young population but inadequate child and women's hospitals. Effective hospital management requires considering cultural, developmental and health needs specific to children. These include appropriate staff training, family-centered care, and addressing disparities some children face. Future improvement needs include equitable resource allocation, supporting primary care, quality standards, and prioritizing children's well-being. The goal is for Nepal's children to realize their full potential.
clinical teaching methods
purposes
principles
models of clinical teaching methods
adult learning
types of learning
types of clinical teaching methods and their advantages and disadvantages
methods of teaching
Mentoring is very important in all organizations and institutions.
It is also very important in Medical education, training and practice.
There are different types of mentoring. this includes supervisory, mentoring circle and peer mentoring.
There are many qualities of good mentors. This includes the knowledge base, availability, honesty and the ability to inspire.
Mentors are generally Role models. Good mentors include Challengers, cheerleaders, educators, coaches, connectors and others. There are many benefits of good mentoring.
Bad mentors may be unavailable and bad role models. Some of them are nay-sayers, bloviators, puppeteers, hoarders and others.
this lecture was given in the early days of the COVID-19 PANDEMIC. There were many issues with disclosure and confidentiality.
This lecture handles the issues on issues of Medical ethics as it concerns disclosure.
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2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
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9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
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12. Comprehend the vectorial analysis of the normal ECG
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Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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Challenges of Residency training in Nigeria.pptx
1. Challenges of
Residency training in
Nigeria
Presented by Dr Bertha C Ekeh at the 2013 AGM/Scientific
conference of the Association of Resident Doctors UUTH,
Uyo on 16TH OF December 2013
2. Outline
• Introduction
• Definition of Residency
• History
• History in Nigeria
• Components of Residency training
• Competencies
• Challenges
• Overcoming the challenges
5. History
• Residency is an opportunity for advanced training in a medical
or surgical specialty
• Evolved in the late 20th century from brief and informal
programs for extra training in a special area of interest
• The first formal residency programs were established by Sir
William Osler and William Stewart Halsted at the Johns
Hopkins Hospital
6. Characteristics
• Residencies are traditionally hospital-based
• In the middle of the twentieth century, residents would often
live (or "reside") in hospital-supplied housing
• "Call" (night duty in the hospital) was sometimes as frequent
as every minute or third night for up to three years
• Pay was minimal beyond room, board, and laundry services
• It was assumed that most young men and women training as
physicians had few obligations outside of medical training at
that stage of their careers
7. contd
• Residencies elsewhere then became formalized and
institutionalized for the principal specialties in the early 20th
century
• But even mid-century, residency was not seen as necessary for
general practice and only a minority of primary care physicians
participated
• Became more popular by the end of the 20th century in
North America
8. Residency training in Nigeria
• Formally established in 1974
• Objective of providing specialist training at a high level and
appropriate to the needs of Nigerian population
• The other objective was to halt the brain drain taking place as
a result of relocation of the much-needed medical specialists
to the developed world
• The training of specialists in our country in the long run was
cheaper, with the downturn of the Nigerian economy
9. Myths
• Residency is not a career
• Residency is not just a job
• Residency is not fun
10. Who is a resident
• The resident is a learner while being responsible for patients
as a “provider of care”
• It is transition period
• Divided into junior and senior residency
13. Training institutions
• The training institutions sponsor majority of the residents
• These training institutions are accredited by the National and
West African Postgraduate Medical Colleges
• The sites are usually tertiary institutions
• Few secondary institutions and private hospitals have training
in some specialties
16. 6 competencies
• Medical knowledge
• Patient care
• Practice-based learning and improvement
• Interpersonal and communication skills
• Professionalism
• Systems-based practice
17. Medical knowledge
• Personal study (textbooks and journals)
• Discussion groups
• Clinical rotations
• Ground rounds/journals/reviews etc.
• Bed side teachings
• Didactic lectures
• Update/Revision courses
• Conferences
• Workshops
• E-learning
18. Patient care
• Clinical rotations
• Clinical care
• Morning reviews
• Mortality reviews
• Achieve Compassionate, comprehensive and high quality care
19. Practice based learning
• Use of evidence-based medicine in clinical decision making
and patient care
• Application of critical/analytical thinking skills and critical
appraisal medical literature
• Application of quality improvement tools with focus on
improving care and ensuring patients’ safety
• Acquisition of skills( surgical, instrumentation)
20. Professionalism
• According to the American Board of Internal Medicine,
professionalism “comprises those attitudes and behaviours
that sustain the interests of the patient above one’s own self-
interest.
• Professionalism entails altruism, accountability, commitment
to excellence, duty, commitment to service, honour and
respect for others.”
• Humanism and professionalism are both however inextricably
woven into the art and practice of medicine
• Medical ethics
21. System based Practice
• The understanding that beyond the pharmacological
treatment of multiple factors can influence the outcome
of patient care
• Assess the social needs of the patients and their family
• Funds
• Care coordination with other healthcare professionals
• Availability of drugs
• Cultural beliefs
• System challenges( electricity, ambulance, oxygen, suction
machines, incubators etc.
22. Interpersonal and communication
skills
• Day –to –day interactions with colleagues
• Interaction with other healthcare professionals
• Health education
• Communication skills with patients (e.g. breaking bad news,
providing informed consent)
24. System challenges
• Funding
• Man power shortage/ workload
• Teething problems in new centers
• Call rooms/offices
• Library facilities
25. Other system challenges
• Facilities
• Outdated
• Below average( ICU, Theater )
• Investigations
• Procedures
26. Work load
• Residents work for between 80 and 168 hours per week
(median, 92 hours), excluding call duty
• Forgone leaves
• Sleep deprivation alone, has been shown to predispose
residents towards more medical errors, injuries, increased
alcohol and drug use, and increased conflict with other
healthcare staff
27. Personal Challenges
• Family issues
• Other extra curricular activities
• Ill health
• Accidents
• Death
• Favouritism etc.
28. Curriculum
• It is estimated that the doubling time of medical knowledge in
1950 was 50 years
• In 1980, 7 years
• In 2010, 3.5 years
• In 2020 it is projected to be 0.2 years—just 73 days
• Knowledge is expanding faster than our ability to assimilate
and apply it effectively; and this is as true in education and
patient care as it is in research.
31. Women issues
• Gender bias
• Sexual harassment
• Scarcity of female mentors
• Work/family conflicts
32. Individualized
• Challenges differ
• Personality/Temperament
• Available funds
• Family issues
• Spousal understanding
• Number and ages of children
33. Problem residents
• “A trainee who demonstrates a significant enough problem
that requires intervention by someone of authority
• Problem residents are challenging to the residency program
directors, attending physicians, and often their fellow trainees
• They can threaten the integrity of a training program
• Can negatively influence the residency training experience for
other trainees
34. Categories of problem
residents
• 1)Behavioral issues
• 2)Medical conditions including psychiatric illness
• 3)Difficulty coping with stress
• 4)Substance abuse
• 5)Cognitive issues such as inadequate knowledge base or
learning disabilities (about which there is no evidence)
35. Experience of residents
• Fifty percent of residents reported their life was stressful
• There were gender differences in conditions like work
situation, residency programme, employment status, personal
and family safety, caring for children and discrimination in
favour of men
• Some residents resorted to the use of alcohol (5.2%), cigarette
(1.7%), drugs and medications (8.6%) to handle stress
• A greater majority of the residents (61.4%) would pursue
another career if they had to do it all over, while 34.5%
would consider changing to another teaching hospital for their
residency
36. Contd
• Many residents reported experiencing intimidation and
harassment
• Eighteen (31%) of the residents admitted to have had
emotional or mental health problems during the residency
program.
• About 29% will require further screening for depression,
21.6% for panic disorder, 15.8% for generalized anxiety, 9.3%
for social phobia and 8.8% for agoraphobia
37. Identified problems
• Inadequate teaching and supervision by trainers
• Absence of foreign training exposures
• No period of time dedicated strictly for research training
• Unclear structuring of training program
• Lack of adequate practical exposure with paucity of surgical
skills
• Lack of surgical equipment and paucity of facilities
38. Suggested interventions
• Incorporation of didactic lectures and enhanced teaching by
Consultants during ward rounds – 50 (89.2%).
• Compulsory overseas training program – 48 (85.7%).
• Training should be more inclined to surgical skill acquisition –
44 (78.6%)
• Commence research trainings programs – 44 (78.6%)
• Support research by Residents through grants and
sponsorships – 43 (76.7%)
• Procurement of modern diagnostic and surgical equipment–
40 (71.4%)
• Improved remuneration – 34 (60.7%)
• A closer and cordial trainer and trainee relationship – 34
(60.7%)
40. Role of teachers and mentors
• Supervision by an experienced medical practitioner has long
been considered the sine qua non of residency training and
professional development.
• This careful professional guidance enables students and
residents to step gradually into the role of professional
decision maker under the tutelage of a more seasoned,
experienced mentor.
• In this system, highly technical learning occurs, and the habits
of day-to-day medical practice can be rehearsed.
41. contd
• Learning the mechanics of patient care under supervision
• Enhances patient safety
• Helps prevent unnecessary medical errors
• And lays the foundations for the public trust in physician
competence
• The contribution by consultants to training is between 26%
and 50% as reported by some 53 (44.5%) of the respondents
• When the student is ready, the teacher
will appear ( Chinese saying)
42. Impact on health care
• When residency programs are not working well, both patients
and residents are placed at risk.
• Patients are put at risk because residents may not be
receiving the guidance they need to provide optimum patient
care and to avoid making errors.
• Residents are at risk because they may not be learning what
they should be learning to become independent practitioners.
• The goal of residency training should not be only to develop
their competence to care for patients in the hospital today,
but to develop the capability to care for their patients of
tomorrow
43. Health financing
• Nigeria’s overall heath system performance was ranked 187th
among the 191 member states by the WHO in 2000
• Public expenditure is <$8 per capita as against the
recommended $34 internationally
• Private expenditures are estimated to be >70% of total health
expenditure with most of it coming out of the pocket despite
the endemic nature of poverty
44. Revised
• A minimum of 15% of the allocation to health shall be devoted
to human resources for health development
• Private participation in human resources for heath
development shall be encouraged through foundations,
philanthropies and endowments shall be encouraged
46. Few tips
• Be aware of, and accept that these challenges are inevitable
in life
• Build your internal resources
• Prepare yourself mentally for confronting these challenges
head-on.
• Another invaluable inner resource is faith. Faith that
everything will work out; faith that there is always light at the
end of the tunnel, and faith that "this too shall pass.“
• Motivate yourself
• Plan/organize yourself
47. Contd
• Build your external resources
• Build a support system of family, colleagues and friends
• We all need encouragement and support
• Let failure fuel and fear you in a positive way. Everyone fails
at times.
• Pick yourself up, and learn from why you've failed, and move
on in positive direction.
• Take inspiration and learn from others who have dealt
successfully with these challenges
• Help others
48. Overseas clinical attachment
• 1-year elective posting abroad
• Helps bridge the gap between our training and the training
abroad
• Offers residents the opportunity to observe and practice
medicine at the best of centers
• The benefits cannot be overemphasized
• Stopped because of lack of funds
• A Senior Registrar shall be granted study leave with pay for
one year only for clinical attachment overseas subject to
availability of funds.
• Extension beyond the one year period shall not normally be
granted
55. Summary
• Residency is the period of specialization
• Residency is time constrained
• Residency is tough call
• Challenges are many
56. • FLY,
• IF YOU CANT FLY, RUN
• IF YOU CAN’T RUN, WALK
• AND IF YOU CAN’T WALK THEN CRAWL
• BUT BY ALL MEANS, KEEP MOVING
FORWARDS
• Martin Luther King
Conclusion
57.
58. References
• Zikos E. Professionalism in residency training. CPA Bulletin
2002;34:32–4.
• J Grad Med Educ. 2010 March; 2(1): 37–45.
• Baldwin DW C, Daugherty SR, Ryan PM. How Residents View
Their Clinical Supervision: A Reanalysis of Classic National
Survey Data; J Grad Med Educ. 2010 June; 2(2): 153.
Yusufu L M D, Ahmed A, Odigie VI, Delia IZ , Mohammed AA
Residency training program: Perceptions of residents. Ann Afr
Med 2010;9:91-4
• Anyaehie UE, Anyaehie USB, Nwadinigwe CU, Emegoakor CD
and Ogbu VO. Surgical Resident Doctor's Perspective of Their
Training in the Southeast Region of Nigeria. Ann Med Health
Sci Res. 2012 Jan-Jun; 2(1): 19–23.
59. References contd
• Ogunsemi OO, Alebiosu OC, Shorunmu OT. A survey of
perceived stress, intimidation, harassment and well-being of
resident doctors in a Nigerian Teaching Hospital. Niger J Clin
Pract. 2010 Jun;13(2):183-6.
• Wong TY, Chong PN, Chng SK, Tay EG. Postgraduate family
medicine training in Singapore--a new way forward. Ann Acad
Med Singapore. 2012 May ;41(5):221-6.
• Omisanjo O A: The ideal Resident doctor: A Resident’s
perspective. Ann Ib Postgrad Med 2005: 3;67-71