Introduction:The transition from undergraduate student to independent practitioner for medical graduates is a challenging one. This paper describes a multi-faceted training model-the "Good Intern Programme (GIP)"-that aims to provide such training for newly qualified doctors (pre-interns, PI) in Sri Lanka. Methods: The development and implementation of the GIP included the following: focus group discussions to understand the requirements; a needs assessment including identification of the main stressors; a 10-day practical Tamil language-training programme; a 4-day acute care skills training (ACST) program; and a 4-day Good Medical Practice (GMP) workshop based on the system building blocks of the WHO. Results: 980 PIs participated in the needs assessment; 383 (39.1%) stated that the first half of their internship was more stressful than the second (p<0.003). Amongst the 866 PI who registered for the GIP, 783 (90.4%) considered knowledge of medical administrative matters to be of importance to doctors. Hospital based clinical training, conducted in 28 hospitals island-wide, was attended by 278 PI; a statistically significant increase for all surveyed skills was demonstrated. The feedback for the GMP workshop, attended by 796 PI, was broadly positive with the session on "essential skills for interns" receiving the highest positive rating for relevance. Conclusion:The GIP provides a comprehensive opportunity to facilitate the transition of medical graduates in Sri Lanka using a multimodal, integrated and sustainable platform. This national program may have applicability beyond Sri Lanka.

Objective: To describe the existing knowledge among pre-intern medical graduates regarding the tobacco and alcohol prevention.Method: A descriptive cross-sectional study was done among pre-intern medical graduates who were awaiting the medical-internship from August to November 2016. A web-based self-administered questionnaire was used. The questionnaire was developed with expert-guidance and was judgmentally-validated. The responses to selected questions were presented with the frequency and the percentage.Results: A total of 721 pre-interns were included in the study. Of them 94.6% (n=682) were concerned on substance consumption of the patients and 96.4%(n=695) stated that it was necessary to include substance-use-history in clinical history taking. More than 95% (n=681) stated they have a role in ceasing substance-use among patients while 3.3% (n=24) thought that it was not their role. Of the participants, 82.8% (n=597) answered as being capable of identifying stages of substance-use while 15.7% (n=113) thought that they were not. Nearly 70% (n=506) answered that advising a patient once, to stop substance-use has no significant impact and 28.3% (n=204) thought that it has. More than 80% thought that there is a safe-limit of alcohol consumption (n=595) while only 16% (n=115) stated that a safe limit does not exist. More than half (52%, n=379) thought anxiety as the commonest psychiatric disorder which leads to consume alcohol. Nearly 41% (n=295) stated that nicotine-replacement therapy is available in government sector as an effective safe treatment option. Appearance of withdrawal symptoms (96.7%, n=697), continuous alcohol consumption by a cirrhotic patient (84.9%, n=612), neglecting alternative pleasures and recreational activities (93.8%, n=676), inability to control no of cigarettes smokes per day (89.9%, n=710) and consuming same amount of alcohol in every weekend (12.6%, n=91) were recognized as features of substance dependence by pre-interns. Conclusion:There are inadequacies of the knowledge on selected aspects of tobacco and alcohol prevention among pre-intern medical graduates. A comprehensive, well-planned orientation using effective teaching methods on these aspects prior to the commencement of medical internship would be beneficial for the patient management.