Background: From a patient's point of view, an 'ideal' doctor could be defined as one having personal qualities for interpersonal relationships, technical skills and good intentions. However, doctors' opinions about what it means to be a 'good' patient have not been systematically investigated. Aim: To explore how patients define the characteristics of a 'good' and a 'bad' doctor, and how doctors define a 'good' and a 'bad' patient. Material and Methods: We surveyed a cohort of 107 consecutive patients attending a community teaching hospital in February 2019, who were asked to define the desirable characteristics of a good/ bad doctor. Additionally, a cohort of 115 physicians working at the same hospital was asked to define the desirable characteristics of a good/bad patient. Responses were subjected to content analysis. Simultaneously, an algorithm in Python was used to automatically categorize responses throughout text-mining. Results: The predominant patients' perspective alluded to desirable personal qualities more importantly than proficiency in knowledge and technical skills. Doctors would be satisfied if patients manifested positive personality characteristics, were prone to avoid decisional and personal conflicts, had a high adherence to treatment, and trusted the doctor. The text-mining algorithm was accurate to classify individuals' opinions. Conclusions: Ideally, fusing the skills of the scientist to the reflective capabilities of the medical humanist will fulfill the archetype of what patients consider to be a 'good' doctor. Doctors' preferences reveal a "paternalistic" style, and his/her opinions should be managed carefully to avoid stigmatizing certain patients' behaviors.

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For many years, the majority of the observational and epidemiological studies assessing coronary artery disease patients, national and international clinical guidelines, registries and randomized trials have focused almost exclusively on men whereas women were usually excluded in most series. This underrepresentation of women in the medical literature in this field has resulted in few data being available regarding the clinical course of the condition, its management and clinical outcomes in this specific population, despite the relatively high prevalence of ischemic heart disease in women. The situation has changed -at least partially- in the past few years with publications focusing on this issue and reporting the existence of inequalities between genders regarding the diagnosis and treatment of coronary heart disease. This article will briefly review gender differences in the clinical presentation, diagnostic strategies and prognosis of coronary heart disease.

Objective: The aim was to explore how in-training junior physicians perceive their surgical performance compared with the one externally rated by their senior surgeon trainers, using a general learning curve model. Methods: Between April and June 2018, a prospective study was conducted at a community hospital associated with a school of medicine. To assess how in-training physicians estimated their surgical performance, 48 surgical residents and fellows were invited to choose one among six options using a scale ranging from "novice" to "automatic expert." In addition, five senior surgeons who supervised the residents/fellows were asked to give their own opinions on each surveyed physician's expertise level, according to the same categories. Concordance analysis was done to compare residents' and fellows' self-perceived skills and their actual performance as estimated by senior surgeons. Results: Self-assessments tended to overestimate residents' and fellows' position on the learning curve; particularly for "proficient" over "competent," and for "automatic expert" over "expert" categories (p = 0.025). The average degree of agreement among senior physicians was 50.0%. Comparison between residents' and fellows' perceived skills and their performances as estimated by senior surgeons showed a weak concordance (kappa = 0.494, 95% confidence interval 0.359-0.631, p < 0.0001). Conclusions: Nearly 51% of the residents/fellows included in some surgical specialty training program overestimated his/her actual performance as evaluated by classical learning curve categories. Underestimation of self-assessed performance was also observed in 17% of respondents. A better feedback from expert observers to in-training surgeons could result in a more accurate self-perception of their real surgical skills and competencies.

Stable angina is a common presentation of coronary artery disease (CAD), a condition that has an important effect on patients' quality of life and survival. Although women are affected by CAD to a significant extent, the vast majority of observational and epidemiological studies, randomized trials, and clinical guidelines, have for many years focused mainly on males. In the past few years, however, as a result of studies assessing healthcare provision in men vs. women, the focus has gradually shifted to include also women. Observations have been reported in recent years that have identified the existence of inequalities [1,2] regarding management of CAD, which have resulted in women [3] having less access to effective interventions compared with men. This article assesses the evidence available in relation to gender related differences in health care provision in the context of CAD. C O M P A R A T I V E S T U D I E S I N M E N V S . W O M E NThere have been only few large-scale epidemiological investigations and intervention trials in women with stable angina pectoris. Information regarding prognosis in stable angina is similarly scarce and data in this regard are primarily based on studies in male populations. Studies in the primary care setting, as well as Framingham [4] have suggested both that CAD is a condition that afflicts primarily men and that women with angina pectoris have a better prognosis than men with angina. Other studies [5,6] however have shown a higher risk of complications and recurrent events in women undergoing coronary by-pass surgery and percutaneous coronary intervention (PCI) compared with men. Despite the higher incidence of stable angina in women compared with men, there is little information regarding the effects of treatment in women. The majority of studies of secondary prevention and those assessing the effects of pharmacotherapy have been conducted in men.In recent years, several centers have reported gender differences in the diagnosis and treatment of CAD. Interestingly, studies [1][2][3]7] have shown controversial results and could not therefore give a conclusive answer to the question as to whether men and women differ regarding form of presentation, prognosis and response to treatment.