Search Results (10)

This study aimed to compare the performance of various Large Language Models (LLMs) in answering multiple-choice questions from the last six editions (2017 to 2024) of Revalida exam. The evaluation focused on models capable of processing content in Brazilian Portuguese (PT-BR), including open-source models, namely LLaMA 3.1 (8B parameters), Qwen 2.5 (7B parameters), and their reasoning-oriented distilled variants based on the DeepSeek-R1 architecture, as well as open-access commercial models such as GPT-3.5, GPT-4o, and Gemini. After evaluating the models’ accuracy against the official answer keys, GPT-4o emerged as the top-performing model, achieving an average accuracy of 63.85%. Next, GPT-4o was prompted to justify its answers to the 2024 exam, and its explanations were independently reviewed by three licensed physicians. The evaluators reported full agreement with the clinical reasoning presented, indicating the model’s ability to produce coherent and medically relevant justifications. Lastly, justifications generated by GPT-4o for correctly answered questions from previous exams (2017–2023) were compiled into a knowledge base, which was then used to enhance GPT-4o through retrieval-augmented generation and to fine-tune LLaMA 3.1, leading to measurable performance improvements on the 2024 exam. Despite promising performance, these models still demonstrate variability in responses, hallucinations, and limited reliability in high-stakes contexts. As such, their outputs should always be reviewed by qualified professionals, and human expertise remains essential in clinical decision-making and medical education scenarios, considering the PT-BR language. However, the observed gains from integrating prior exam content indicate that domain-specific adaptation strategies may help mitigate some of these limitations and enhance model alignment. Full article

This essay is based on a case study of international medical graduates (IMGs) in Canada who migrated from sub-Saharan Africa. The chapter examines how narratives of race are situated and deployed in the field of medicine and can produce some aversive social–psychological landscapes in the credentialing and the professional-entry process as it relates to persons of African descent. It will show that, often without predetermination or intent, professionals of African descent in Canada are highly susceptible to implicit racial associations and implicit racial stereotyping in relation to evaluations of character, credentials, and culture. The article exposes some of the critical intersections of common experience, such as: (a) cultural deficit bias—Whiteness as an institutionalized cultural capital attribute; (b) confirmation bias—reaching a negative conclusion and working backwards to find evidence to support it; (c) repurposed sub-Saharan Blackness stereotypes—binary forms of techno-scamming and fraud; and (d) biased deception judgement—where the accuracy of deception judgements deteriorates when made across cultures. These social psychological phenomena result in significantly disproportionate returns on their foreign education and labour market experience for Black medical professionals that require decisive efforts in changing the narratives. Full article

Background: To identify factors necessary for the proper inclusion of foreigners in Japanese healthcare, we conducted a survey to determine whether foreign residents, even those with high socioeconomic status, referred to as “Highly Skilled Foreign Professionals”, experience difficulties when visiting medical institutions in Japan, using satisfaction level as an indicator. Method: A five-point Likert-scale, anonymous, online questionnaire was administered to faculty and doctoral students enrolled at the Okinawa Institute of Science and Technology Graduate University (OIST). The respondents’ demographics and their opinions on what they found difficult or important during medical examinations, their impression of Japanese medical personnel, their requirements for language support and interpretation, and their opinions about local healthcare delivery systems were collected. The questionnaires were distributed and collected using Microsoft Forms. Results: Responses were obtained from 90 respondents (response rate: 20.7%). The percentage of respondents who were dissatisfied (bottom two of five Likert scales) with medical care in Japan was 23.4%. In univariate logistic regression analysis, 11 of 35 questions were significantly correlated with dissatisfaction with medical care (p < 0.1). Duration of stay, presence of family members living with the patient, satisfaction with life, and perceived usefulness of language support were negatively correlated with dissatisfaction with medical care, while communication problems with medical personnel, need for medical personnel to respect patients’ culture, religion, and privacy, and difficulty in getting to medical facilities were positively correlated with dissatisfaction with medical care. No significant correlations were found with age, gender, or Japanese language level. Multiple logistic regression analysis showed that the presence of family members living with the subject (AOR = 0.092, p = 0.010), the desire for multilingual documentation (AOR = 0.177, p = 0.046), the physician’s concern for the patient’s culture and religion (AOR = 8.347, p = 0.029), and difficulty in communication with healthcare providers (AOR = 6.54, p = 0.036) were significantly correlated with overall dissatisfaction with medical care. Discussion: On average, the targeted Highly Skilled Foreign Professionals did not have strong levels of dissatisfaction with Japanese healthcare, but when they did have dissatisfaction, it was related to language barriers, lack of cultural and religious considerations, and difficulty in communication with healthcare providers. We believe that the results indicate the focus points of support necessary for the inclusion of foreigners. We also believe that the finding that family cohabitation is associated with satisfaction with medical care is a useful insight into effective reciprocal support on the part of patients. Full article

The United States of America has traditionally attracted people from various countries, including physicians and dentists, who wish to further their education and career in the U.S. international medical graduates’ (IMGs) role has been shown to be vital in medical academics and healthcare delivery systems. IMGs’ demographics, contribution to the U.S. healthcare system, education and research, and challenges in the U.S. medical system have been extensively investigated. However, similar data are limited to foreign-trained dentists (FTDs). This study reviews the current literature related to IMGs and FTDs and proposes some recommendations for future studies. Full article

In order to understand the difficulties faced by highly skilled foreign professionals when dealing with the Japanese healthcare system and to identify the support they require therein, university health center staff members of the Okinawa Institute of Science and Technology Graduate University conducted semi-structured interviews with faculty, staff, and students from the Institute. Data from the interviews were analyzed by subject matter analysis using a narrative-oriented approach. In total, 13 participants were interviewed, and five themes and 15 subthemes were generated from the 40 codes extracted. Although participants considered themselves to be accepting of other cultures and made little mention of the need for cultural and religious considerations that previous studies have identified as important, they reported that their experiences receiving healthcare in Japan were fraught with many difficulties. They felt that the capacity to communicate in Japanese was a prerequisite for receiving appropriate healthcare and that hospitals should assume the responsibility of providing language support. While they reported satisfaction with the easy and inexpensive access to advanced medical equipment and specialists in Japan, they also noted challenges in selecting medical institutions and departments, the flow and procedures in the hospital, and building open and direct relationships with doctors. In addition, based on the present study, people with chronic illnesses felt isolated from the community, worried about a lack of privacy, and wanted a primary care physician they could trust. In order to provide appropriate healthcare to foreigners, we require an accurate understanding of their needs, how to address these comprehensively and in a multifaceted manner, and how the communication responsibilities should be shared among the involved parties (i.e., foreign care recipients and Japanese medical professionals). Full article

Skilled migration has been an important part of the socioeconomic development and progression of many industrialised Western countries. However, successful migration includes facilitating sociocultural and professional environments, policies, and practices in a way that utilizes the skills of migrants appropriately. Internationally educated physicians (IEPs) are an important part of the health and wellness care program of these countries. Nevertheless, because of regulations and limited available positions, many of these migrated physicians find they cannot enter into the healthcare workforce as practicing physicians. Utilizing their health-related knowledge and skills through nonphysician careers in health and wellness is a beneficial way to integrate these highly skilled professionals into a country’s socioeconomic flow. Despite the availability of alternative careers for IEPs, we identified that these paths are often not explored and facilitated, resulting in un/underemployment and wastage of these highly skilled human resources. A lack of willingness among IEPs, under/overestimation of their transferable skills by themselves and by potential employers, and a lack of strategic support and career guidance are prominent obstacles. A collaborative approach from multiple sectors, including academics, integration service providers, and policy makers, is needed to create awareness of these alternative opportunities and facilitation of the socioeconomic integration of IEPs. Full article

The ERASMUS program is one of the most popular student exchange projects, particularly among the students of Central and Eastern European countries. However, limited research is available with regard to its influence on the professional and personal development of its participants. The study aimed at investigating the experiences and impact of the ERASMUS program on different domains of the personal and professional life of medical students. A questionnaire containing closed and open-ended questions was distributed among 269 former participants of the ERASMUS program from the Poznan University of Medical Sciences to collect qualitative and quantitative data regarding the topic. The response rate was 41%. Mastering professional foreign language skills was the most frequently reported benefit of ERASMUS (94%), followed by a change of approach towards learning by exposure to innovative teaching techniques, character, professionalism and cultural competency development, impact on the migration decisions of the students, as well as the opportunity to compare healthcare and educational systems across countries. Additionally, 57% of respondents stated that ERASMUS impacted their career plans, and few indicated that it had affected their specialty choice. Approximately 28% of respondents have worked abroad in healthcare or research since graduating. Participation in the ERASMUS program proved to be a unique opportunity for professional and personal development. Full article

Background: The COVID-19 pandemic has profoundly disrupted medical education and the residency application process. Methods: We conducted a descriptive observational study in April 2020 of medical students and foreign medical graduates considering or pursuing careers in neurosurgery in the United States to examine the impact of the pandemic. Results: A total of 379 respondents from 67 medical schools completed the survey. Across all participants, 92% (n = 347) stopped in-person didactic education, and 43% (n = 161) experienced basic science and 44% (n = 167) clinical research delays. Sixty percent (n = 227) cited a negative impact on academic productivity. Among first year students, 18% (n = 17) were less likely to pursue a career in neurosurgery. Over half of second year and third year students were likely to delay taking the United States Medical Licensing Examination Steps I and II. Among third year students, 77% (n = 91) reported indefinite postponement of sub-internships, and 43% (n = 53) were unsatisfied with communication from external programs. Many fourth-year students (50%, n = 17) were graduating early to participate in COVID-19-related patient care. Top student-requested support activities included access to student-focused educational webinars and sessions at upcoming conferences. Conclusions: Medical students pursuing careers in neurosurgery faced unique academic, career, and personal challenges secondary to the pandemic. These challenges may become opportunities for new initiatives guided by professional organizations and residency programs. Full article

Introduction: At the beginning of 2020, the worldwide infection of coronavirus (SARS-CoV-2) changed many aspects of human lives. The controlled lockdown was not only an obligatory lifestyle change to communities across the globe, but it was also an emotional struggle. The aim of the presented study was to identify and compare the main difficulties that final-year students (both Polish and foreigners) of Dentistry, Faculty of Medical Sciences in Zabrze Medical University of Silesia had to cope with during the first wave of the pandemic. Application of the biographical method in the form of essays written was done. Authors discussed the following issues: possible losses and benefits subjectively felt by individuals due to the COVID-19 pandemic, adaptation to online type of studying, students’ opinions regarding change of habits, and psychological impact of the lockdown. Students’ responses varied between groups in the aspect of what they considered as the biggest struggle of the pandemic time period. Adaptation to e-learning was easier for the group of foreign students. The Polish group considered it as a serious stress factor. Foreigners were much more worried about not being able to help their families in comparison to Polish students. Polish students’ fear was related to the fear of virus transmission to their older relatives. Both groups were aware of how serious the situation was and of the possible impact of lack of practical classes on their future internships. As benefits of that situation, both groups listed development of new hobbies and increased sport activities. The Polish group emphasized improvement of interpersonal bonds during the lockdown in their families. The main conclusion proved an awareness of the seriousness of the situation in which students of medical, especially dental faculties found themselves. Concerns were related to the form of further studies and the possibility of taking up employment after graduation. Polish students declared more intense concerns about e-learning and remote study than foreign-language students who were more familiar with this form of communication. A particularly valuable form of teaching for students may be increased numbers of online consultations, since even though they cannot replace practical classes, they may still be helpful in explaining doubts and simply “being there”. Encouraging young people to discover constructive benefits of the pandemic can also be one of a task-oriented strategies of help. Full article

Almost 500 international students graduate from Australian medical schools annually, with around 70% commencing medical work in Australia. If these Foreign Graduates of Accredited Medical Schools (FGAMS) wish to access Medicare benefits, they must initially work in Distribution Priority Areas (mainly rural). This study describes and compares the geographic and specialty distribution of FGAMS. Participants were 18,093 doctors responding to Medicine in Australia: Balancing Employment and Life national annual surveys, 2012–2017. Multiple logistic regression models explored location and specialty outcomes for three training groups (FGAMS; other Australian-trained (domestic) medical graduates (DMGs); and overseas-trained doctors (OTDs)). Only 19% of FGAMS worked rurally, whereas 29% of Australia’s population lives rurally. FGAMS had similar odds of working rurally as DMGs (OR 0.93, 0.77–1.13) and about half the odds of OTDs (OR 0.48, 0.39–0.59). FGAMS were more likely than DMGs to work as general practitioners (GPs) (OR 1.27, 1.03–1.57), but less likely than OTDs (OR 0.74, 0.59–0.92). The distribution of FGAMS, particularly geographically, is sub-optimal for improving Australia’s national medical workforce goals of adequate rural and generalist distribution. Opportunities remain for policy makers to expand current policies and develop a more comprehensive set of levers to promote rural and GP distribution from this group. Full article