Background: Specialty career choice is a critical decision for medical students, and research has examined factors influencing particular specialties or assessed it from a demographic perspective. The purpose of this study was to explore and describe influential factors in students' decision-making, irrespective of their particular specialty in a Canadian medical school.Methods: Study participants were recruited from fourth-year medical classes at the Memorial University of Newfoundland in 2003, 2006, 2007 and 2008. Sixteen focus groups (n = 70) were led by a nonfaculty facilitator to uncover factors affecting medical student career choice. The analysis was guided by principles of grounded theory methodology. The focus group transcripts were sequentially coded based on recurring topics and themes that arose in the students' discussions. A set of key themes emerged and representative quotations for each theme were tracked.Results: Twenty themes were identified from the focus group discussions: 7 major, 3 intermediate and 10 minor themes. The major themes were undergraduate experience, exposure, public perception and recruitment, teacher influence, family/outside influences, residency issues and personal philosophy. Intermediate themes included lifestyle, bad-mouthing/negative perceptions and context. Minor themes included critical incidents/experiences, information gaps, uncertainty, nature of the work, extracurricular programs, timing of decision-making, financial issues, prestige, fit with colleagues and gender issues.Interpretation: Exposure to specialties and the timing of this exposure appears to be crucial to career choice, as does the context (who, what, when, where) of any particular rotation. Given the influence of personal philosophy, future research examining students' level of self-assessment and self-reflection in their decision-making processes and level of certainty about their selected specialty would be useful. Abstract Research CMAJ OPEN E148CMAJ OPEN, 4(2) Methods SettingThis is a qualitative study using focus groups to determine what factors influence medical students' career choice. Medical students at the Memorial University of Newfoundland in the graduating classes of 2003, 2006, 2007 and 2008 were invited to participate in focus groups. Memorial University's medical school program is 4 years long, where the first 2 years are mostly classroom-based and the final 2 years are clinically based. The preclerkship curriculum included exposure to rural practice for 10 days each year. The mandatory clinical rotations are completed in the third year of study, whereas there are elective opportunities from September to November in fourth year. The students have surgical selective opportunities after the Canadian Resident Matching Service (CaRMS) ranking deadline in fourth year. Study participants were recruited from fourth-year classes in 2003, 2006, 2007 and 2008. Classes were approached as a whole to describe the focus group and identify it as part of the longitudinal survey in which they had part...

Lifestyle issues including physical activity, diet, smoking, alcohol consumption, and self-reported stress have all been shown to predispose people to higher risk of cardiovascular disease. This study provides further psychometrics on the Simple Lifestyle Indicator Questionnaire (SLIQ), a short, easy-to-use instrument which measures all these lifestyle characteristics as a single construct. One hundred and ninety-three individuals from St. John's, Newfoundland, and Labrador, Canada completed the SLIQ and reference standards for diet, exercise, stress, and alcohol consumption. The reference standards were a detailed Diet History Questionnaire (DHQ), the Social Readjustment Rating Scale (SRRS), the SF36 Health Status Questionnaire, and a survey of eight questions from a cardiovascular risk questionnaire. Physical activity score was compared with number of steps on a pedometer. Correlations between scores on the SLIQ and the reference standards were the SLIQ versus DHQ (r = 0.679, P = 0.001), SLIQ versus pedometer (r = 0.455, P = 0.002), SLIQ versus alcohol consumption (r = 0.665, P = 0.001), SLIQ versus SRRS (r = −0.264, P = 0.001), SLIQ versus eight-question risk score (r = 0.475, P = 0.001), and SLIQ versus Question 1 on SF36 (r = 0.303, P = 0.001). The SLIQ is sufficiently valid when compared to reference standards to be useful as a brief assessment of an individual's cardiovascular lifestyle in research and clinical settings.

Designed to support and aid teachers and those charged with faculty development, the Fundamental Teaching Activities Framework holds promise for all teachers in health sciences education.

We describe the impact of an interprofessional education programme in mental health for professionals in six rural Canadian communities. The 10-session programme, offered primarily via videoconference, focussed on eight domains of mental health practice. One hundred and twentyfive professionals, representing 15 professions, attended at least some sessions, although attendance was variable. Data were collected between September 2006 and December 2007. The programme was evaluated using a mixed methods approach. Participants reported high levels of satisfaction for all topics and all aspects of the presentations: they were most satisfied with the opportunity to interact with other professionals and least satisfied with the videoconference technology. Professionals' confidence (n = 49) with mental health interventions, issues and populations was measured pre-and post-programme. There was a significant increase in confidence for seven of the eight mental health interventions and four of the six mental health issues that had been taught in the programme. Participants reported developing a more reflective mental health practice, becoming more aware of mental health issues, integrating new knowledge and skills into their work and they expressed a desire for further mental health training. They noted that interprofessional referrals, inter-agency linkages and collaborations had increased. Conditions that appeared to underpin the programme's success included: scheduling the programme over an extended time period, a positive relationship between the facilitator and participants, experiential learning format and community co-ordinators as liaisons. Participants' dissatisfaction with the videoconference technology was mitigated by the strong connection between the facilitator and participants. One challenge was designing a curriculum that met the needs of professionals with varied expertise and work demands. The programme seemed to benefit most of those professionals who had a mental health background. This programme has the potential to be of use in rural communities where professionals often do not have access to professional development in mental health.

This paper reports on the results of a demonstration project that examined the role of telehealth/telemedicine (hereafter referred to as telehealth) in providing interdisciplinary mental health training and support to health professionals in a rural region of Atlantic Canada. Special emphasis was placed on addressing the question of how training might affect interdisciplinary collaboration among the rural health professionals. Five urban mental health professionals from three disciplines provided training and support via video-satellite and internet, print and video resources to 34 rural health and community professionals. In order to assess the rural community's needs and the impact of the interventions, questionnaires were administered and on-site interviews were conducted before and after the project. Throughout the project, field notes were recorded and satisfaction ratings were obtained. Satisfaction with the video-satellite presentations was high and stable, with the exception of one session when signal quality was very poor. Rural participants were most satisfied with opportunities for interaction and least satisfied with the variable quality of the video transmission signal. High staff turnover among rural professionals resulted in insufficient power to permit statistical analysis. Positive reports of the project impact included expanded knowledge and heightened sensitivity to mental health issues, increased cross-disciplinary connections, and greater cohesion among professionals. The results suggest that, with some refinements, telehealth technology can be used to facilitate mental health training and promote interdisciplinary collaboration among professionals in a rural setting.

The OSTE is a novel tool to enhance faculty development. We describe 12 key elements that are important for its successful development and delivery.

The pursuits of personal and professional goals, as well as contextual factors, were the major themes that influenced decision-making for women and men. Composition of these major themes varied between genders. Influence of a partner, consideration of familial commitments (both present and future), feeling a sense of connectedness with the field in question, and social accountability were described by women as important. Both genders hoped to pursue careers that would afford "flexibility" in order to balance work with their personal lives, though the construct of work-life balance differed between genders. Women did not explicitly identify gender bias or sexism as influencing factors, but their narratives suggest that these elements were at play. Insights: Our findings suggest that unlike men, women's decision-making is informed by tension between personal and professional goals, likely related to the context of gendered personal and societal expectations.

Family Medicine (FM) is a new specialty in Ethiopia. The first seven family physicians graduated in February 2016 from the inaugural residency programme at Addis Ababa University. Cooperation amongst Ethiopian and expatriate decision-makers and physicians was needed to begin the programme. Intentional replacement of expatriates with Ethiopian family physicians has begun. Barriers include lack of understanding of FM and the human and financial resources needed for scaling up the programme. Regular programme review with resident physician involvement has allowed the FM training programme to adapt and fit the Ethiopian context. Further successes will result from ongoing support and advocacy from the Federal Ministry of Health and other Ethiopian, African, and international primary care organisations.