Purpose To analyse the preference of end of life care place in paediatric oncology patients, and to understand the end of life care needs and regrets among the care givers. Method This was an observational qualitative study. Parents of incurable paediatric malignancy patients who died during the years 2016-2018 were interviewed using a pre-formed open-ended questionnaire. Fears during the last phase of child's life, most disturbing symptoms, choice of end of life care plan, regret of care givers and reasons for such choices were noted and analysed. Result Twenty six families were interviewed. A median of 3 months of discordance was noted between declaration of incurability and acceptance of the same by the family. During terminal months, pain (84.62%) was described as the most bothersome symptom followed by respiratory distress (73.08%). Eighteen families (69%) opted for home-based terminal care, 8 (31%) for hospital-based terminal care. Regret of choice was noted in 62.5% families of the hospital-based care group (separation from home environment being the main reason) and 38.89% of the home-based care group (lack of access to health care personnel and pain medication being the main reasons). Conclusion Home-based care is the preferred option for end of life care by the care givers. Lack of community-based terminal care support system and availability of analgesics are the main areas to work on in India.
National policies on the number and distribution of post graduate seats in medical colleges are based on estimated projections of the quantum need of medical work force in the country in future. In order to attract talent, it is imperative to know what factors, modifiable or non modifiable, affect the choice of specialization.Methods: This is a cross-sectional, observational study. Subjects were undergraduate medical students, at four different phases of their course. They were asked to fill an anonymous feedback form regarding their family and educational background and prospective fields of specialization and placement. Medium of education, interaction with faculty, practices of evaluation and feedback to and from students and use of media in teaching etc were also studied in order to gain an insight into the temporal progression of the thought process of undergraduates.Results: Majority (88.5%) students wanted to study clinical subjects in post graduation. General Medicine and General Surgery were the most coveted specialties. Passion for the subject, monetary gains and how well the subject was taught were the three main bases for the choice of specialty. Majority of students wanted to serve in government sector after study. Work life balance remained the top priority for more than 78% students in their future lives.
Conclusion:Clinical branches remain preferred over non clinical specialties and research remains a low priority among students. Introducing innovative methods in teaching pre and paraclinical subjects and making medical teaching a more attractive career prospect can help improve this picture.
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