Backgrounds In 2013, the total number of obstetrician‐gynecologists decreased. The Japanese Society of Obstetrics and Gynecology established the Obstetrics and Gynecology MIRAI Committee in 2015. Within the MIRAI Committee, Japanese Trainees in Obstetrics and Gynecology (JTOG) was established; it was comprised of 20 promising young obstetrician‐gynecologists recommended from regions across Japan. The office term is 2 years. Objective The purpose of this report is to learn and inform about the results of MIRAI's activities. Methods We surveyed the trends in new obstetrician‐gynecologists and also matched each seminar participant with them. Result The number of new memberships has been increasing since the nadir in 2016. In particular, there are over 100 more new physicians specializing in the field in 2020 than there were at the nadir in 2016. It was revealed that approximately 50% of the participants in the summer school specialized in obstetrics and gynecology. Furthermore, approximately 70% of POP2 participants specialized in obstetrics and gynecology, which shows that these two recruitment seminars are extraordinarily effective events that result in an increase in the number of new obstetricians and gynecologists. Conclusion We conclude that the activities of this MIRAI Committee and JTOG have been effective. With the spread of COVID‐19 and the inability of obstetrician‐gynecologists and students/clinical trainees to perform social distancing, it is currently difficult to hold hands‐on seminars. However, we hope that new JTOG members will be able to create a new seminar format.
Aim The Ministry of Health, Labour, and Welfare of Japan proposed a regulation of overtime work as a reform in work style. However, the regulation may deteriorate the quality of medical services due to the reduction in training time. Thus, the study aimed to reveal perceptions in terms of generation gaps in views on self‐training and overtime work, among members of the Japan Society of Obstetrics and Gynecology (JSOG). Methods A web‐based, self‐administered questionnaire survey was conducted among members of the JSOG. In total, 1256 respondents were included in the analysis. Data were collected on age, sex, experience as a medical doctor, location of workplace, work style, the type of main workplace, and number of full‐time doctors in the main workplace. The study examined the attitudes of the respondents toward overtime work and self‐training. The respondents were categorized based on experience as a medical doctor. Results According to years of experience, 112 (8.9%), 226 (18.0%), 383 (30.5%), 535 (42.6%) doctors have been working for ≤5, 6–10, 11–19, and ≥ 20 years, respectively. Although 54.5% of doctors with ≤5 years of experience expected the regulation on working hours to improve the quality of medical services, those with ≥20 years of experience expressed potential deterioration. After adjusting for covariates, more years of experience were significantly related with the expectation of deterioration in the quality of medical services. Conclusions The study revealed a generation gap in the views about self‐training and overtime work among obstetricians and gynecologists in Japan.
Objectives: To investigate the association between online activities and the number of new obstetrics and gynecology senior residents. Methods: A nationwide web-based, self-administered anonymous survey was conducted to investigate recruitment and clerkship activities during the coronavirus disease 2019 pandemic. An online questionnaire was sent to 576 obstetrics and gynecology training institutions in Japan between December 21, 2020, and January 31, 2021. Overall, 334 institutions that gave valid responses were included (response rate: 58.0%). Multivariate logistic regression analysis examined the association between online activities, including recruitment and clerkship activities, and the number of new obstetrics and gynecology senior residents in 2021. The stratified analysis by implementing face-to-face activities was conducted to clarify the association. Results:The number of new senior residents increased in 187 facilities (56.0%) and decreased in 147 facilities (44.0%). The facilities that implemented face-to-face and online activities were 185 (55.4%) and 120 (35.9%), respectively. In multivariate logistic regression analysis, an increased number of new obstetrics and gynecology senior residents was significantly associated with face-to-face activities (adjusted odds ratio (AOR)=2.58, 95% confidence interval (CI): 1.11-5.97, p<.001) but not with online activities. In the stratified analysis, online activities were significantly associated with an increased number of new obstetrics and gynecology senior residents among the facilities without face-to-face activities (AOR=3.81, 95% CI: 1.40-10.32, p=.009) but not among those with face-to-face activities (AOR=0.87, 95% CI: 0.42-1.78). Conclusions: Online activities were associated with an increased number of new obstetrics and gynecology senior residents among the facilities that did not conduct face-toface activities.
Aim Obstetrics and gynecology (Ob/Gyn) training became compulsory for Japanese physician interns from April 2020 to improve medical competence in treating women's diseases. This study aims to understand the Ob/Gyn training needs of postgraduate year 1–2 physicians (interns) and thereby improve training efficiency. Methods This study was administered to interns at Ob/Gyn training facilities from December 2019 to February 2020. An original questionnaire was used to evaluate their assessment of training needs. In analyses, interns were categorized according to whether they were willing to major in Ob/Gyn. Results Of the 1154 participants, 163 (14.1%) would major in Ob/Gyn (Ob/Gyn applicants) and 967 (83.8%) would not (non‐Ob/Gyn applicants). At the time of the survey, 634 (54.9%) had rotated in Ob/Gyn, 253 (21.9%) planned to rotate, and 267 (23.1%) chose not to rotate. The two most favorable training experiences were “experience in surgical procedures” (81/141, 57.4%) and “wide treatment areas covered by Ob/Gyn” (78/141, 55.3%) among the Ob/Gyn applicants, and “specificity of women's treatment” (308/488, 63.1%) among the non‐Ob/Gyn applicants. Conclusions Ob/Gyn applicants and non‐Ob/Gyn applicants differed in their assessment of Ob/Gyn rotations. It is crucial to provide medical training based on interns' needs to improve their skills for treating female patients.
Stroke associated with pregnancy or puerperium is rare, but represents an important problem for women of childbearing age. We herein report a case of subarachnoid hemorrhage (SAH) due to suspected lateral posterior choroidal artery (LPChA) dissection during delivery. A 34-year-old woman developed deterioration of consciousness during delivery at a maternity clinic. Her Glasgow Coma Scale score was E3V3M6. She was sent to our hospital after 12 hr, where CT revealed SAH with intraventricular hematoma. Radiographic examinations showed contrast pooling on the left LPChA. Repeated angiography showed enlargement of the contrast pooling, which indicated pseudoaneurysm. It also showed a relatively clear but stenosed LPChA communicated with the lesion which could not be recognized in the angiography on day 0. This stenosed LPChA indicated arterial dissection. Therefore, endovascular parent artery occlusion was performed on day 11. Determining the exact extent of dissection was difficult because the LPChA was extremely narrow. Occlusion of the posterior cerebral artery was needed to achieve complete hemostasis, which, however, resulted in infarction of the medial temporal and occipital lobes. At the time of final follow-up 3 years later, the patient was alert and completely independent, but showed persistent incomplete homonymous hemianopsia. We reported a rare case of SAH from suspected LPChA dissection during delivery. Repeated angiography provided information about the source of hemorrhage and definite diagnosis, which opened the way to treatment. It is also important to recognize the difficulty in identifying the exact extent of dissection when treating dissections of small arteries.
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