So far I have attempted to provide a broad framework within which to consider the importance of managerial and organisational integration. Inevitably in so doing I have found it necessary to raise wider educational and training issues which influence not only conceptual skills but also attitude. Indeed I have, on occasion, moved my argument or perspective to even wider considerations; issues pertaining to national culture. Culture, education policy or structure, industrial organisation, all interact in subtle and perhaps devious forms. Thus a cultural framework which is “overly status or class conscious” reflects this in its educational system. Most likely it is more predisposed to segment its secondary and tertiary education systems according to similar principles. It may well encourage separation of the university and technical college or polytechnic system to a degree that is industrially and commercially counterproductive — and integratively devisive. Such an educational system will no doubt require “preselection and filtering” which relies upon early, too early, subject specialisation; it may, subsequently, influence adversely the need for individuals and subgroups to communicate more intimately and to organise themselves more closely. In fact it may ensure the continuance of barriers, hierarchies, and polarised attitudes of class, structure and function all the way across and through commerce and industry.

A National Survey

《新世纪的医师职业精神--医师宣言》是由美国内科学基金、ACP基金和欧洲内科医学联盟共同发起和倡议,首次发表于2002年《美国内科医学年刊》和《柳叶刀》杂志.到目前为止,已有包括美国、英国、法国、德国、加拿大等国在内的36个国家和地区的120个国际医学组织认可和签署了该宣言.中国医师协会于2005年正式签署该宣言,加入推行《医师宣言》的活动。

Medical professionalism in the new millennium: a physicians' charter

Financial conflicts of interest in physicians’ relationships with the pharmaceutical industry-self regulation in the shadow of federal prosecution

Throughout the world all health professionals face stress because of time-pressures, workload, multiple roles and emotional issues. Stress does not only exist among the health professionals but also in medical students. Bangladesh has currently 77 medical colleges 54 of which are private. This study was designed to collect baseline data of stress-level among Bangladeshi students, which we believe will form the basis for further in depth studies. A cross-sectional study was conducted on medical students from 2 public and 6 private medical-schools in Bangladesh. All medical schools have common curriculum formulated by the Government of Bangladesh. The study population was 1,363 medical students of Year-III and IV of academic session 2013/2014. Universal sampling technique was used. The period of study was February to June 2014. Data was collected using a validated instrument, compiled and analysed using SPSS version-20. A total of 990 (73%) out 1,363 medical students participated in the study, of which 36% were male and 64% were female. The overall prevalence of stress of the study population was 54%. 53% of male and 55% of female were reported suffering from stress. 54% of Year-III students and 55% of Year-IV were noted suffering from stress. There was statistically significant (p = 0.005) differences in the level of stress between public (2.84 ± 0.59) and private (2.73 ± 0.57) medical schools student. More than half of Bangladeshi medical students are suffering from measureable academic stress. It would be pertinent if the relevant authorities could address the issue so as to provide a conducive medical learning environment.

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Prevalence of stress among medical students: a comparative study between public and private medical schools in Bangladesh

Antimicrobial resistance (AMR) is a high priority across countries as it increases morbidity, mortality and costs. Concerns with AMR have resulted in multiple initiatives internationally, nationally and regionally to enhance appropriate antibiotic utilization across sectors to reduce AMR, with the overuse of antibiotics exacerbated by the COVID-19 pandemic. Effectively tackling AMR is crucial for all countries. Principally a narrative review of ongoing activities across sectors was undertaken to improve antimicrobial use and address issues with vaccines including COVID-19. Point prevalence surveys have been successful in hospitals to identify areas for quality improvement programs, principally centering on antimicrobial stewardship programs. These include reducing prolonged antibiotic use to prevent surgical site infections. Multiple activities centering on education have been successful in reducing inappropriate prescribing and dispensing of antimicrobials in ambulatory care for essentially viral infections such as acute respiratory infections. It is imperative to develop new quality indicators for ambulatory care given current concerns, and instigate programs with clear public health messaging to reduce misinformation, essential for pandemics. Regular access to effective treatments is needed to reduce resistance to treatments for HIV, malaria and tuberculosis. Key stakeholder groups can instigate multiple initiatives to reduce AMR. These need to be followed up.

Strategies to improve antimicrobial utilization with a special focus on developing countries

Background: Countries have introduced a variety of measures to prevent and treat COVID-19 with medicines and personal protective equipment (PPE), with some countries adopting preventative strategies earlier than others. However, there has been considerable controversy surrounding some treatments. This includes hydroxychloroquine where the initial hype and misinformation lead to shortages, price rises and suicides. Price rises and shortages have also been seen for PPE. Such activities can have catastrophic effects on patients where there are high co-payment levels and issues of affordability. Consequently, there is a need to investigate this further. Objective: Assess changes in the availability, utilization and prices of relevant medicines and PPE during the pandemic among a range of Asian countries. Our approach: Narrative literature review combined with interviews among community pharmacists to assess changes in consumption, prices and shortages of medicines and PPE from the beginning of March 2020 until end of May 2020. In addition, suggestions on ways to reduce misinformation. Results: 308 pharmacists took part from five Asian countries. There was an appreciable increase in the utilization of antimicrobials in Pakistan (in over 88% of pharmacies), with lower increases or no change in Bangladesh, India, Malaysia and Vietnam. Encouragingly, there was increased use of vitamins/immune boosters and PPE across the countries, as well as limited price rises for antimicrobials in India, Malaysia and Vietnam, although greater price rises seen for analgesics and vitamin C/immune boosters. Appreciable price increases were also seen for PPE across some countries. Conclusion: Encouraging to see increases in utilization of vitamins/immune boosters and PPE. However, increases in the utilization and prices of antimicrobials is a concern that needs addressing alongside misinformation and any unintended consequences from the pandemic. Community pharmacists can play a key role in providing evidence-based advice, helping to moderate prices, as well as helping address some of the unintended consequences of the pandemic.

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Rapid Assessment of Price Instability and Paucity of Medicines and Protection for COVID-19 Across Asia: Findings and Public Health Implications for the Future.

Objectives: Medical professionalism forms the bridge between doctors and society. Conserving and maintaining professionalism is obligatory for physician curriculum. The objective of this study was to scrutinize and compare the professionalism of future medical professionals among different medical institutes. Methodology: It was a cross-sectional study conducted on 332 year-III and year-IV MBBS students of session 2012-2013 from three private medical colleges in Bangladesh. Data was collected using a mixed validated instrument containing items under fundamental elements of professionalism, measured by 5-points Likert scale giving a maximum score of 220. Results: Among 332 respondents, 44% were male, 56% female; Year-III respondents constituted 51% and Year-IV constituted 49%. Mean professionalism scores for male and female were 176.21 and 175.33, while for Year-III and Year-IV were 174.96 and 176.50 respectively. No significant differences observed between gender and year of study. However, significant differences were noticed between year-IV male students among three medical colleges. Majority (83%) students were imprecise of professionalism. Conclusions: Lack of focus is a worry for professionalism. Educators should focus on fundamental elements of professionalism. KEYWORDS : Professionalism, Medical-student, Core-values, Comparisons, Bangladesh.

Comparative study of professionalism of future medical professionals among three private medical colleges of bangladesh

Professionalism with high moral character should be developed from the schooling time of the students. The objective of this study was to explore the professionalism of medical students.  It was a cross-sectional study conducted on 108 year-I and year-II medical students of session 2012-2013 selected conveniently at UniSZA, Malaysia. Data was collected using a mixed type of validated instrument and analyzed using SPSS. Year-I and year-II were 86% and 98% respectively. Only 27% respondents were male and 73% were female. Mean professionalism scores for year-I and year-II were 175.20 and 172.91, while for male and female were 172.31 and 174.58 respectively. No significant differences observed between gender (p=0.536) and study-year (p=0.484). However, 34% year-I and 19% year-II students defined professionalism diversely while 18% and 9% were un-responded. Professionalism is a braod-concept; a burning issue worldwide. Teachers should emphasis on core elements of professionalism which are unique for all professions.

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Md. Zakirul Islam

Papers

Rapid Assessment of Price Instability and Paucity of Medicines and Protection for COVID-19 Across Asia: Findings and Public Health Implications for the Future.

Comparative study of professionalism of future medical professionals among three private medical colleges of bangladesh

Professionalism of future medical professionals in Universiti Sultan Zainal Abidin, Malaysia