ObjectiveThis study surveyed all Iraqi medical schools and a cross-section of Iraqi medical students regarding their institutional and student experiences of medical education amidst ongoing conflict. The objective was to better understand the current resources and challenges facing medical schools, and the impacts of conflict on the training landscape and student experience, to provide evidence for further research and policy development.SettingDeans of all Iraqi medical schools registered in the World Directory of Medical Schools were invited to participate in a survey electronically. Medical students from three Iraqi medical schools were invited to participate in a survey electronically.OutcomesPrimary: Student enrolment and graduation statistics; human resources of medical schools; dean perspectives on impact of conflict. Secondary: Medical student perspectives on quality of teaching, welfare and future career intentions.FindingsOf 24 medical schools listed in the World Directory of Medical Schools, 15 replied to an initial email sent to confirm their contact details, and 8 medical schools responded to our survey, giving a response rate from contactable medical schools of 53% and overall of 33%. Five (63%) medical schools reported medical student educational attainment being impaired or significantly impaired; 4 (50%) felt the quality of training medical schools could offer had been impaired or significantly impaired due to conflict. A total of 197 medical students responded, 62% of whom felt their safety had been threatened due to violent insecurity. The majority (56%) of medical students intended to leave Iraq after graduating.ConclusionsMedical schools are facing challenges in staff recruitment and adequate resource provision; the majority believe quality of training has suffered as a result. Medical students are experiencing added psychological stress and lower quality of teaching; the majority intend to leave Iraq after graduation.

Situational awareness (SA) is critical to mobilizing a rapid, efficient, and effective response to disasters. Limited by time and resources, response agencies must make decisions about rapidly evolving situations, which requires the collection, analysis, and sharing of actionable information across a complex landscape. Emerging technologies, if appropriately applied, can enhance SA and enable responders to make quicker, more accurate decisions. The aim of this systematic review is to identify technologies that can improve SA and assist decision-making across the United States Government and the domestic and international agencies they support during disaster response operations. A total of 1459 articles and 36 after-action reports were identified during literature searches. Following the removal of duplicates and application of inclusion/exclusion criteria, 302 articles and after-action reports were included in the review. Our findings suggest SA is constrained primarily due to unreliable and significantly delayed communications, time-intensive data analysis and visualization, and a lack of interoperable sensor networks and other capabilities providing data to shared platforms. Many of these challenges could be addressed by existing technologies. Bridging the divide between research and development efforts and the operational needs of response agencies should be prioritized.

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MD3 students participated; 62% male; 62% < 25 years; and 72% direct from secondary school students. Overall, 81% MD3 students were satisfied with rural rotations,(sCns¼ 83%). Likelihood of accepting to be deployed in rural practice after graduation was predicted by being satisfied with the rural rotation program (AOR, 4.32; 95% CI, 1.44-12.96; p, 0.009) and being male (AOR, 2.73; 95% CI, 1.09-6.84; p, 0.032). Also, being an in-service student increased the likelihood of accepting rural practice after graduation by 300% compared to enrolment direct from school, although the difference was not significant (AOR, 4.99; 95% CI, 0.88-28.41; p, 0.070). 29% of variation was explained these variables (Nagelkerke R2, 0.289). However, students who joined school after health-related practice were almost 3X more likely to be satisfied than students direct from school, with no significant difference (COR, 2.6; 95% CI, 0.7-9.4; p, 0.310). Likewise, in-service students were more 2X more likely to be satisfied than direct from school students with insignificant difference (COR, 2.4; 95% CI, 0.9-6.4; p, 0.073). No significant difference was exhibited for students born in rural or urban areas. Going Forward: The rural rotation program increased the likelihood of rural practice after graduation. More effort should be undertaken to further improve the program to increase student satisfaction with rural rotations, and hence likelihood for rural practice after graduation.