Lege Artis Medicinae

[The changing face of carrier choice: Chances and opportunities in Hungary]

GYŐRFFY Zsuzsa, SUSÁNSZKY Éva, SUSÁNSZKY Anna, SZÁNTÓ Zsuzsa

JUNE 01, 2015

Lege Artis Medicinae - 2015;25(04-05)

[BACKGROUND - In the 21st century, medicine has changed. As a part of this transformation we observe the phenomenon of deprofessionalisation, change of the recruitment and alteration of the carrier motivation. METHODS - The quantitative study included 733 medical students of four Medical Universities in Hungary. Data for the qualitative study was collected from interviews of 45 medical students. RESULTS - Both research methods confirmed the changing of the medical profession. Besides, the number of medical school applicants are decreasing, and the number of women students are increasing. The impact of the doctor parents showed a decrease. Students reported late carrier choice and that they don’t become exclusively clinicians. The most important factor of carrier choice is altruism, but scientific interest and controllable lifestyle also appears as a motivation factor. CONCLUSIONS - Results suggest challenge of the „feminization of medical profession”. The medical curriculum and the conditions of work environment need to respond to these „metamorphoses”.]

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Lege Artis Medicinae

[Day-to-day blood pressure variability measured with home monitoring for the verification of succesful antihypertensive therapy]

KÉKES Ede, PAKSY András, KISS István

[The value of „day-to-day” blood pressure variability based on home blood pressure measurements for demonstrating of successful antihypertensive treatment. Authors analyzed the effect of antihypertensive therapy on the blood pressure variability by day-to-day method based on home pressure measurements in a large number of hypertensive patients. During the four months observation period the mean blood pressure values were significantly decreased and the parameters of blood pressure variability were decreased as well, they reached the level of normal variability. The nowadays expected „double target values” has given us hope that we can successfully prevent the organ damages due to high blood pressure. The effects of some „drug family” and the drug-combinations to the blood pressure variability were analyzed. The RAS inhibitors (ACEI and ARB) reduced significantly the blood pressure variability, the ARB drugs more effectively. The ACEI agents combined with calcium antagonists or third-generation beta-blockers increased the normalization of blood pressure variability. Such effects were not observed with the ARB agents. Authors suggested the use of their method in every day practice. The guidelines also recommend this method.]

Lege Artis Medicinae

[The Sixth Sense of China – Paintings of Qi Baishi ]

NAGY Zsuzsanna

Lege Artis Medicinae

[Analysis of long term care of elderly people in residential social institutions ]

HORVÁTH Zoltán, ENDREI Dóra, MOLICS Bálint, ÁGOSTON István, BONCZ Imre

[OBJECTIVES - The aim of our study is to analyse the institutional long term social care of elderly in Hungary. DATA AND METHODS - Data were derived from the following sources: Social Sector Information System, Regional Development and Planning Information System, and the Hungarian Central Statistical Office. The analysis covered the period 2001-2012. We analysed the number of operating beds in residential social institutions (pieces) and number of residents (clients) in residential social institutions. RESULTS - Between 2001-2012 the number of available operating beds in residential social institutions increased by 28.56%, from 42658 to 54840. The number of residents (clients) in residential social institutions increased between 2001-2005 by 3% annually, while since 2007 the rate of growth decreased due to the capacity regulation. The bed occupancy rate was 97.51% in 2001, and then between 2002 and 2007 it stabilized between 96.26%-96.87%. In 2008 it decreased to 93.44%, then after a continuous increase it exceeded the 95%. CONCLUSIONS - During the survey period, the bed capacities and the number of clients in residential social institutions showed an increasing tendency under high occupancy rate.]

Lege Artis Medicinae

[Ethical Considerations of Organ and Tissue Transplant Part 1 ]

SZEBIK Imre

Lege Artis Medicinae

[Use of surgical checklists to improve the patient safety]

BENEDEK Zsófia, MOLNÁR-GALLATZ Zsolt

[In the millennium working groups were formed in several countries to create and implement control- or checklists to reduce the mortality rate and complications during surgical care. The research revealed that the use of checklists improved patient safety, reduced mortality and complication rate, and several additional positive effects were identified. The checklists improved teamwork and the communication in the surgery team. The starting financial and time costs of using checklist are low, and the maintaining costs are minimal. On the other hand, checklists result significant financial savings. These savings primarily are the costs of malpractice lawsuits and the costs of treatment complications. To ensure patient safety multiple checklists were developed. By the literature data three checklists are the most detailed and widely used: the World Health Organiza­tion’s checklist, the Universal Protocol and the Surgical Patient Safety System. Common characteristics are that they significantly reduce the complications and the mortality rate, improve patient safety, teamwork and communication. The main differences are in the using and timing. In this publication we present the most typical and used checklists, their advantages and possible disadvantages, and finally we give an overview of the examples of the Hungarian experience.]

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Lege Artis Medicinae

[EFFECT OF END-OF-LIFE EDUCATION ON MEDICAL STUDENTS’ AND HEALTH CARE WORKERS’ DEATH ATTITUDE]

HEGEDÛS Katalin, ZANA Ágnes, SZABÓ Gábor

[INTRODUCTION - The aim of our research was to evaluate the effect of courses for health care workers and medical students that deal with death, dying and bereavement and that of courses on hospice care of dying patients. The goal of the courses is to make communication on death more open by exploring critical issues related to fear of death to reduce inner anxiety and to improve attitude to dying patients. PARTICIPANTS AND METHOD - Participants (n=168) completed Neimeyer and Moore's Multi-dimensional Fear of Death Scale (MFODS) and Shortened Beck Depression Questionnaire (BDI) on the first and last day of the courses. In case of health care workers a follow-up survey was also performed 2 to 3 months after the course (n=32). RESULTS - The most significant factors of fear of death are: fear for significant others, fear of the dying process and fear of premature death. Overall fear of death scores are reduced as an effect of the courses, the alteration of the components of fear of death depends on the participants’ gender, age and profession as well. Improvement was observed in both groups in attitudes that can be related to the increase of knowledge on the quality care of dying patients like fear from the process of dying and fear from conscious experience of death. CONCLUSION - Besides education containing training as well it is important to strengthen the support function of workplaces in caring for the mental health of the health care staff. Furthermore it is important during gradual education that students participate in courses that aim to achieve opened communication in the most anxiety-evoking issues.]

Lege Artis Medicinae

[Medical anthropology - medical students fieldwork experiences]

ZANA Ágnes, ZSINKÓ-SZABÓ Zoltán

[The experience gained in teaching medical anthropology at Semmelweis University of Medicine is reported in the study. Very often medical anthropology is identified by the physical anthropology of “Dr. Bone”, although this discipline is a branch within cultural anthropology which deals with applied anthropology. During practices, students following their preclinical studies - that is already not lay but still not doing healing work - had to carry out fieldwork and participate as observants at a medical facility of their choice: inpatient, primary care clinic or alternative medical center/ clinic. The purpose of the field work was the examination and the analysis of the different healing systems, and of the doctorpatient relationship. During the nine years, more hundreds of fieldworks were made. In the study, we attempted to sum up these experiences for a better understanding of pluralism of the Hungarian medical system, the usability and eventual faults of different healing systems, and ultimately the effectiveness of the medical anthropology course.]

Lege Artis Medicinae

[Future perspectives and health conditions of recently graduated physicians]

PAPP Szidónia, TÚRY Ferenc

[INTRODUCTION - The purpose of our study was to survey the opinion of students graduating in 2008 at the Semmelweis University Faculty of Medicine about university education, future perspectives and physical as well as their mental health conditions. We have considered factors that might cause or might protect against burnout syndrome. METHODS - The electronic questionnaire has been sent to all graduating students and included the Beck Depression Inventory, the Hungarian version of Spielberger’s State-Trait Anxiety Inventory (STAI), which assesses anxiety, the Hungarian adaptation of the Maslach Burnout Inventory for Human Profession modified for students and the CAGE test, which evaluates alcohol consumption. The questionnaire included general questions concerning medical school education, health condition, support from the community, future perspective and livelihood. RESULTS - 31.4% of the graduating class (94 people) answered the questionnaire. These former students felt that the theoretical education at the university was of high quality; however, 61% considered the practical education insufficient. At the beginning of their careers, merely 5% of the young physicians felt well-prepared professionally. 30% of the responders reported a high degree of burnout; 59% would like to work abroad, and 26% were considering leaving the field of healthcare. A quarter of the students had psychosomatic symptoms. CONCLUSIONS - After graduating from medical school, young physicians have to face the difficulties of finding a job, an unstable livelihood and a high risk of burnout syndrome. The high percentage of young medical school graduates leaving the profession as well as the high migration rate might contribute to the growing problems of the healthcare system.]

Lege Artis Medicinae

[Lifestyle and self-perceived health status differences of Hungarian and foreign medical students]

TEREBESSY András, HORVÁTH Ferenc, BALÁZS Péter

[INTRODUCTION - Physicians, while concerning also the whole personality, advice their patients in life-style problems too and these types of advices may contribute even decisively to the patients’ recovery. The physicians’ personal health behaviour and self-assessed health status are interrelated with counselling the patients. Undergraduate years play a significant role in the later established behavioural patterns therefore it is important to study the medical students’ health status and lifestyle. MATERIAL AND METHODS - Self-administered questionnaires were used to assess the lifestyle and self-perceived health status differences of domestic (Hungarian) and foreign (English course) medical and dental school students in the 4th year of the Semmelweis University (response rate: 96% and 55.6%). Dichotomous variables were analysed by Pearson chi-square probe and multivariable logistic regression models at significance level of p<0.05 and odds ratios were calculated with 95% confidence interval. RESULTS - The rate of healthy diet was 41.0% (n=55) among Hungarian students and 57.7% (n=67) among the foreign students. Foreign students exercise more often vigorously 41.5% (n=51) than the Hungarians 20.0% (n=29). Foreign students ranked their self-perceived health status higher in all but one categories, than Hungarians. CONCLUSIONS - The results of our study indicate that comparing health behaviour of students of different cultural-geographical background, dietary habits and the selfperceived health status are more favourable among those out of foreign countries.]