Study Habit of Post-graduate Trainees and Residents in Medicine and Major Barriers in Achieving an Effective Training: A Multi-Institutional Survey Dr. Muhammad Abdur Rahim MBBS, FCPS (Medicine) Registrar, Internal Medicine Ibrahim Medical College and BIRDEM

Background FCPS (Medicine)- 8.68% (Jan, 2012), 16.81% (July, 2011)* MD 30-50%, Diploma 40- 60%** MRCP- 44.2% ( UK Graduates- 60.2%)*** - Repeated attempts - Wastage of productive years - Depression - Performance deteriorates *BCPS year book, 2012, p77 **Examination Controllers’ Office ***www.mrcpuk.org › MRCP(UK) Home > Results

Rationale Early years of training- training certificate Later years- burdened with studies - If the training is well organized, structured - Students utilize this period judiciously - Good guidance and supervision - Good outcome

Aims and objectives How much time trainees utilized for study What were the purposes of study What were the main study materials Where did they study What were the main barriers against a good training (students’ view)

Methods Design: Cross-sectional study Study period: 3 months (Jan- March, 2012) Study place: 4 post-graduate medical institutes in Dhaka Study population: 67 post-graduate students

Inclusion criteria Post-graduate medical students (Trainees, Residents, Medical Officers, Assistant Registrars, Students) Students preparing for medicine and/ or sub-speciality Who were willing to be included

Exclusion criteria Already attempted in final examination and not doing training now Already obtained a degree and not doing training now Not passed FCPS part-I, not entered in MD/ Diploma course, not passed MRCP part-I

Results Total number of students: 67 (67 students responded out of 100) Male 31, female 37 (M:F ratio 1: 1.2) Mean age- 31.3 years (range 27-39 years) Married- 59 (88%) Having children- 45 (76%)

Respondents are from

Preparing for

Speciality Speciality Frequency Percent Medicine 57 85 Cardiology 13 19.4 Endocrinology 6 8.9 Nephrology Gastroenterology 5 7.4 Dermatology 3 4.5 Neurology 2

Training years

Responsibilities during training period Activity Freq/ comment Patient care 67 (100%) Lectures 2-4 hour/week Ward rounds Clinical classes 6-12 hour/week Journal clubs Teaching 5 (7.4%) Grand rounds 62 (92.5%) Research 8 (11.9%) OPD placement 16 (23.9%) Presentations 21 (31.3%) Skilled activity Occasional Seminars

Optional methods of skill development Communication skill- 13 (19.4%) Thesis/ dissertation- 23 (34.3%) Orientation program- 19 (28.4%) MOCK- 23 (34.3%) - MOCK exams and targeted trainings are highly beneficial

Mean study hours per week

Study place

Study materials

Purpose of study

Evaluation of own activity Satisfied- 0 (0%) Not satisfied- 67 (100%)

Contribution by trainers

At the end of training

Barriers More than one- all

Suggestions More structured, targeted, exam oriented and supervised Number of trainees should be limited Examination system might be reviewed Trainers assessment should contribute at final exams Remuneration should be increased

Limitations Short period Limited number Institutions in Dhaka only, not peripheral ones Institutional/ sampling bias Evaluation is from only the students’ side, not bilateral

Conclusions Study time adequate Library based Written examinations Inadequate remunerations Familial responsibilities Lack of well structured training program

Thank you