Background: Modern medical education teaching and learning approaches now lay emphasis on students acquiring knowledge, skills and attitudes relevant to medical practice. Aims: To explore students' perceived impacts of using hands-on approaches involving peer/life model physical examination and palpation in teaching and learning living human anatomy on their practice of physical examination of real patients. Methods: This study used exploratory focus groups and a questionnaire survey of years 3-5 medical students. Results: The focus group discussions revealed new insights into the positive impacts of the hands-on approaches on students' clinical skills and professional attitudes when dealing with patients. Students' exposure to the hands-on approaches helped them to feel comfortable with therapeutically touching unclothed patients' bodies and physically examining them in the clinical environment. At least 60% of the questionnaire survey respondents agreed with the focus group participants on this view. Over 75% also agreed that the hands-on experiences helped them develop good professional attitudes in their encounter with patients. Conclusions: This study highlights the perceived educational value of the hands-on approaches as a pedagogic tool with a positive impact on students' clinical skills and professional attitudes that helps in easing their transition into clinical practice.

Gender dysphoria (GD) is a facet of modern human biology which is believed to be derived from the sexual differentiation of the brain. GD “involves a conflict between a person’s physical or assigned gender and the gender with which he/she/they identify”, as defined in the DSM-5. Individuals report feeling uncomfortable and faced with prejudice from those around them, affecting their mental health. Elucidating the relationship between genetic influences on gonadal and brain development could give an insight into understanding this clinical condition. To explore this issue, a review of the literature database was carried out. Evidence suggests that abnormal biological processes, including mutations in certain genes, can lead to abnormal gonadal development, causing some fetuses to present with indifferent gonads and to be reassigned at birth to the default female sex. This disparity in genetic influences relates to an increased likelihood of a diagnosis of GD. An investigation into complete androgen insensitivity syndrome, involving androgen receptor (AR) gene mutation, suggests that such individuals also experience GD. It is known that the brains of males and females are different. Evidence further suggests that brain anatomy and neuronal signaling pathways are more closely aligned with a person’s perceived gender identity. Individuals who present with discordant gonadal and brain developments experience psychological challenges that may contribute to a state of unease or generalized dissatisfaction with their biological sex. These point to a possible biological and genetic underpinning of GD as stemming from a discordance between gonadal and brain development. However, not enough evidence has associated these differences with GD. Further research is required to elucidate the true mechanisms and possible inheritance pattern of GD for a better education and greater understanding by clinicians and the general public on perceptions regarding GD.

Introduction: This study aimed to compare the paediatric endocrinology curriculum across Southern Nigeria medical schools, using reports from learners. It also checked the learners’ perceptions about different learning patterns and competency in some expected core skills. Methods: This mixed (quantitative and qualitative) study was conducted with 7 medical schools in Southern Nigeria. A multi-staged randomized selection of schools and respondents, was adopted for a focus group discussion (FGD), and the information derived was used to develop a semi-structured questionnaire, which 314 doctors submitted. The FGD discussed rotation patterns, completion rates of topics and perceptions for some skills. These themes were included in the forms for general survey, and Likert scale was used to assess competency in skills. Data generated was analysed using statistical package for social sciences, SPSS 24, and p values < 0.05 were considered significant Results: Lectures and topics had various completion rates, 42.6% - 98%, highest being “diabetes mellitus”. Endocrinology rotation was completed by 58.6% of respondents, and 58 – 78 % perceived competency in growth measurement and charting. Significantly more learners, 46.6% who had staggered posting got correct matching of Tanner staging, versus learners who had block posting, 33.3%, p = 0.018. Conclusion: Respondents reported high variability in the implementation of the recommended guidelines for paediatric endocrinology curriculum between schools in Southern Nigeria. Variabilities were in the courses’ completion, learners’ skills exposure and how much hands-on were allowed in various skills acquisitions. This variability will hamper the core objectives of human capital development should the trend continue.

The Medical and Dental Council of Nigeria (MDCN), the regulatory body for medical practice in Nigeria, provides the benchmark for minimum academic standards (BMAS). While it is expected that there will be differences across schools, the extent of this is unknown and the effect/impact it will have on future medical practice in Nigeria is unknown. This study aimed to evaluate the differences in undergraduate paediatric endocrinology contents across medical schools in southern Nigeria and to understand the factors that influence these differences. Seven paediatric endocrinology lecturers were interviewed, and they filled a questionnaire generated from the themes of the discussion. The themes included the contents of diabetes mellitus lectures, the level of participation lecturers allowed students in emergency room management of DKA, and the assessment methods. Lecture notes on diabetes mellitus (DM) were scored using ISPAD guidelines and the differences were analysed using Student’s T test. The extent to which competence was assessed for students was also provided by the lecturers. Two lecturers had reduced contents in their DM lectures, compared to others, $p = 0.003$. Most lecturers did not consult the MDCN BMAS while preparing their lecture notes. This study highlights the differences in curriculum contents in Southern Nigeria medical schools for endocrinology training in paediatrics, and significant differences methods of training. These differences will hamper the core objectives of human capital development should the trend continue. It is recommended that uniform curriculum template that is acceptable to many to streamline training and medical practice.

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