Objectives: To compare initial and one year costs of coronary artery bypass grafting (CABG) versus percutaneous coronary intervention (PCI) in the stent or surgery trial. Design: Prospective, unblinded, randomised trial. Setting: Multicentre study. Patients: 988 patients with multivessel disease. Interventions: CABG and stent assisted PCI. Main outcome measures: Initial hospitalisation and one year follow up costs. Results: At one year mortality was 2.5% in the PCI arm and 0.8% in the CABG arm (p = 0.05). There was no difference in the composite of death or Q wave myocardial infarction (6.9% for PCI v 8.1% for CABG, p = 0.49). There were more repeat revascularisations with PCI (17.2% v 4.2% for CABG). There was no significant difference in utility between arms at six months or at one year. Quality adjusted life years were similar 0.6938 for PCI v 0.6954 for PCI, D = 0.00154, 95% confidence interval (CI) 20.0242 to 0.0273). Initial length of stay was longer with CABG (12.2 v 5.4 days with PCI, p , 0.0001) and initial hospitalisation costs were higher (£7321 v £3884 for PCI, D = £3437, 95% CI £3040 to £3848). At one year the cost difference narrowed but costs remained higher for CABG (£8905 v £6296 for PCI, D = £2609, 95% CI £1769 to £3314). Conclusions: Over one year, CABG was more expensive and offered greater survival than PCI but little added benefit in terms of quality adjusted life years. The additional cost of CABG can be justified only if it offers continuing benefit at no further increase in cost relative to PCI over several years.

INTRODUCTION. Burnout among resident physicians has been an area of concern that predates the COVID-19 pandemic. With the significant turmoil during the pandemic, this study examined resident physicians’ burnout, depression, anxiety, and stress as well as the benefits of engaging in activities related to  wellness, mindfulness, or mental wellbeing. METHODS. The authors conducted a cross-sectional survey of 298 residents from 13 residency programs sponsored by the University of Kansas School of Medicine-Wichita, in October and November 2021. Authors used a 31-item questionnaire to measure levels of burnout, depression, anxiety, and stress. A mixed method approach was used to collect, analyze, and interpret the data. Descriptive statistics, One-way ANOVA/Kruskal-Wallis tests, adjusted odds ratios (aOR), and immersion-crystallization methods were used to analyze the data. RESULTS. There was a 52% response rate, with 65.8% (n=102) of the respondents reporting manifestations of burnout. Those who reported at least one manifestation of burnout experienced a higher level of emotional exhaustion (aOR=6.73; 95% CI, 2.66-16.99; P<.01), depression (aOR=1.21; 95% CI, 1.04-1.41; P=.01), anxiety (aOR=1.14; 95% CI, 1.00-1.30; P=.04), and stress (aOR=1.36; 95% CI, 1.13-1.64; P<.01). Some wellness activities respondents engaged in included regular physical activities, meditation and yoga, support from family and friends, religious activities, time away from work, and counseling sessions. CONCLUSIONS. The findings suggest the COVID-19 pandemic continues to pose a significant and worsening prevalence of burnout and other negative mental health effects on residents. Appropriate wellness and mental health support initiatives are needed to help resident physicians thrive in the health care environment.

Background and Objectives: Current literature on review of applicant social media (SoMe) content for resident recruitment is scarce. With the recent increase in the use of privacy settings, and the cost of the recruitment process, the aim of this study was to describe the practice and outcomes of review of applicant SoMe in resident recruitment and its association with program director or program characteristics. Methods: This study was part of the 2020 Council of Academic Family Medicine’s Educational Research Alliance (CERA) annual survey of family medicine residency program directors (PDs) in the United States. Results: The overall response rate for the survey was 39.8% (249/626). About 40% of PDs reported reviewing applicant SoMe content. The majority (88.9%) of programs did not inform applicants of their SoMe review practices. The most common findings of SoMe review were that the content raised no concerns (38/94; 40.4%) or was consistent with the application material (34/94; 36.2%). Forty PDs (17.0%) have ever moved an applicant up or down the rank list based on SoMe review. Review of applicant SoMe was not statistically associated with program size, program type, PD age, PD SoMe use, or program SoMe use. Conclusions: SoMe review has not become routine practice in family medicine resident recruitment. The outcome of SoMe review was mostly consistent with the applicant profile without any concerns and only very few changed the ranking order. This calls for more studies to explore the value of SoMe review for resident selection regarding its effect on future performance.

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Background: Burnout among resident physicians has been an area of concern that predates the COVID-19 pandemic. With the significant turmoil during the pandemic, this study examined resident physicians' burnout, depression, anxiety, and stress as well as the benefits of engaging in activities related to wellness, mindfulness, or mental wellbeing.

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