In 1993, the UK General Medical Council published Tomorrow's Doctors leading to a nationwide restructuring of undergraduate medical courses. Traditional courses with distinct pre-clinical and clinical phases gave way to a more integrated approach to undergraduate medical education, with an emphasis on the quality and variety of teaching provided. More than a decade after Tomorrow's Doctors, postgraduate medical training is being transformed. Modernising Medical Careers is leading to the introduction of a two-year Foundation Programme, with subsequent streamlined specialist training. In the context of these changes, we consider how the creation of posts for medically-qualified anatomy demonstrators would present an opportunity to fulfil needs in both undergraduate education and postgraduate training. We outline the threats facing established posts, and how these problems may be resolved. We hope that this overview of the challenges facing undergraduate and postgraduate education in the UK, with particular reference to anatomy, may offer some useful insight to teachers and learners in other countries. We conclude that the role of the medically-qualified anatomy demonstrator has proved valuable in the context of Tomorrow's Doctors, and that this role can evolve and expand as part of the 21st century "modern medical career."

Near-peer, cross-cultural academic exchange is an effective method of medical student-centered emergency training in Haiti. Limitations such as successfully implementing sustainability measures, addressing cultural differences, and coordinating between groups persist. This scalable, reproducible, and mutually beneficial collaboration between North American and Haitian medical trainees is a valid conduit for building Haiti's emergency response infrastructure and promoting global health.

Background: In low resource settings, maximizing effective use of emergency room (ER) services is imperative. This problem is anecdotally observed in the public hospital setting in Santiago, Dominican Republic (DR). There are no studies presently published examining ER use in this pediatric population or reasons caregivers choose to utilize the pediatric ER. Financial and systemic limitations have been previously cited as important contributors to the high pediatric mortality rate in the DR. Methods: In this cross-sectional, descriptive study, a survey was administered to 117 caregivers (e.g. mother, father) of children in the ER at Hospital Especializado Juan XXIII over an eight-week period. Survey questions included perceived urgency of illness, education level, monthly income, and frequency of ER visits in the last six months. We defined frequent ER visits as greater than four visits within the last six months, low income as below 10,000 pesos/month, and low education as having no high school education. Logistic regression was used to assess significant associations between variables. Results: Caregivers in the pediatric ER were predominantly female (94%) with a mean age of 30 ± 11 years. 72% of respondents reported the child’s problem as “extremely urgent,” while 82% of the children were triaged as non-urgent. Children of caregivers with any high school education had 69% lower odds of having 4 or more ED visits in the last 6 months (OR, 0.31; 95% CI, 0.13–0.75; p = 0.009), compared to children of caregivers with no high school education, after adjusting for the income category of the caregiver. Conclusions: Perceived urgency of pediatric medical problems may contribute to increased use of the ER for non-urgent medical problems. Low education level is associated with increased pediatric ER use over a six-month period. Assessing utilization of pediatric ERs in the public health care system in Santiago could provide a framework for the design of targeted educational and systemic changes, supporting the ultimate goal of providing the best possible care for pediatric patients in low-resource settings.

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access to clean water and sanitation. High prevalence of malnutrition, anemia and growth stunting resulted in several nutritional interventions. Finally, a sustained prevalence of disease despite improved infrastructure highlighted the need for behavioural interventions and a health curriculum. Outcome & Evaluation: Between 2007-2015, the prevalence of malnutrition and growth stunting declined (height: 30.9% <3 rd percentile to 17.0% 5 th percentile, weight: 10.3% <3 rd percentile to 7.6% 5 th percentile). Similarly, scabies dropped from 35.2% to 7.2%. The prevalence of intestinal helminths slightly increased to 7.2% from 6.6%. In 2015, fifty-nine of the 517 students required further treatment and were referred to local physicians in a nearby village, sustainably engaging the population with the medical system. Going Forward: Physical exams proved to be an invaluable tool. They will continue to guide and evaluate interventions, and screen for students requiring urgent treatment until permanent local medical staff is employed. The unique bond between volunteers and students has been essential to the continued success of the project. Eager to return, all 2015 volunteers have become leaders for 2016, and will focus on the completion of water and sanitation systems and the sustainable implementation of the health curriculum.