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Purpose: This study aimed to assess the educational environment of residents in Morocco and to compare residents’ perceptions depending on their specialty.Methods: We applied the French version of the Postgraduate Hospital Educational Environment Measure (PHEEM) to measure the educational environment at 6 hospitals in Rabat from January to June 2017. The internal reliability of the questionnaire was assessed using Cronbach’s α coefficient. Principal component analysis was conducted to assess the construct validity of the 3 subscales of the PHEEM questionnaire. Analysis of variance was performed to compare the mean scores of the overall PHEEM, its subscales, and each item among the 6 specialties.Results: Responses from 255 residents were included. The 40-item PHEEM questionnaire showed a high level of reliability, with a Cronbach’s α of 0.91. Principal component analysis of all 40 items suggested that 3 factors explained 48% of the variance, with better results for the teaching subscale. Moroccan residents perceived their educational environment as more positive than negative. There were significant differences in the overall and subscale scores among the 6 specialties.Conclusion: The French version of the PHEEM was confirmed to be a valid and reliable instrument in Morocco. Moroccan residents perceived their educational environment as more positive than negative, but room for improvement remained, with challenges including the poor infrastructure, the suboptimal quality of supervision, and inadequate teaching and work regulations.

BackgroundAllgrove syndrome is a rare autosomal recessive disorder characterized by the triad of achalasia, alacrimia and adrenal insufficiency. It is caused by the mutations of the AAAS gene located on chromosome 12q13. The c.1331 + 1G > A mutation is one of the most common described in North Africa including Tunisia, Algeria and Libya. We report here the clinical and genetic profile of a Moroccan family with Allgrove syndrome.Case presentationA Moroccan sister and brother born to consanguineous parents were found, at the ages of twelve and fifteen months old respectively, to have alacrimia and isolated glucocorticoid deficiency. Later, they developed achalasia whereupon Allgrove syndrome was diagnosed clinically and confirmed by DNA sequencing which revealed a c.1331 + 1G > A mutation in the AAAS gene.ConclusionThis finding reinforces previous studies in demonstrating the geographic expansion of the ancestral mutation c.1331 + 1G > A in North African patients and thus enabling targeted genetic counseling. To the best of our knowledge, this is the first report of the AAAS gene mutation in Moroccan patients.

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