Background: Medical educational programmes strive to produce competent and skilled graduates. However, studies have shown that undergraduate medical students experience varying degrees of stress which impacts on their health, academic performance and social functioning. This study explored the prevalence and causes of stress, its impact on students and their coping strategies in a racially diverse cohort of final-year medical students exposed to a problem-based learning curriculum in South Africa. Method: This descriptive cross-sectional study was undertaken by final-year medical students in 2008 at a South African medical faculty with a racially diverse student population. Semi-structured interviews were conducted. Data were thematically analysed. Results: Ninety-four students, representing 47% of the final-year medical student cohort, participated in the study. Seventy-eight per cent of the participants (n = 73) experienced stress during the programme, and the majority (n = 49) were females. Ethnic and gender differences were observed for the variables studied. Academic and personal problems were the main sources of stress. Coping strategies included individual lifestyle adaptations, family support, religious structures and study groups. Conclusion: Maladaptive stress impacts negatively at multiple levels on undergraduate medical students. Mentorship and educational support programmes should be integrated into the undergraduate medical curriculum and made available to all preclinical and clinical students. Students need to be taught and guided to identify and monitor their own well-being and to select positive strategies to overcome stress. These measures should assist students to manage their workload and time effectively.

Background: The shortage of doctors and their maldistribution between urban and rural areas contribute to inequitable health care delivery. Strategies are being sought by the government and universities to address these challenges. At the Nelson R Mandela School of Medicine of the University of KwaZulu-Natal the admissions policy ensures greater access to rural students and curricular interventions have been introduced to increase an awareness of the plight of vulnerable communities. This study attempted to ascertain the career intentions of final-year medical students and the influence of area of origin and gender on the location of their proposed future practice. Methods: The 2005 final-year cohort was surveyed by means of an anonymous questionnaire. Demographic information, area of origin and career intentions were canvassed. Students of rural origin were identified as those who matriculated from rural schools and lived more than 200 km from the nearest city. The data were analysed descriptively. Results: Female and rural students accounted for 63% and 11% of the sample respectively. Women were less likely than men to practise in rural areas. Thirty-five per cent indicated a preference for a public government service career as opposed to a private medical (26%) career. Slightly more than 13.7% (n = 26) of the cohort wished to pursue practice or postgraduate careers overseas. Nearly 62% (n = 90) of the students in the current cohort received government subsidies for their studies. Conclusions: The increased intake of students from rural origin and curricular attempts to increase social awareness of vulnerable rural communities are inadequate to alter the perceptions of medical graduates towards rural practice. While government initiatives and medical schools are starting to work together to service rural communities, alternative strategies need to be explored to entice physicians to rural practice.

In South Africa, the smoking prevalence among adults has declined from 34% (52% male and 17% female) in 1995 4 to 21.4% (35.8% male and 8.1% female) in 2003. 5 The smoking prevalence among health care workers (HCWs) varies widely around the world. A study carried out in 1991 among hospital staff at Llandough Hospital, Cardiff, showed that 20% of nurses and 5% of doctors smoked. 6 A review by Smith and Leggat carried out in 2004 showed a high smoking prevalence among physicians in Greece (49%), China (45%), Japan (43%), Kuwait (38%) and the United Arab Emirates (36%), and the lowest smoking prevalence among doctors in the United States of America (2%), Australia (3%), the United Kingdom (3%) and Nigeria (3%). 7

introduction: Oral health practitioners may be affected by occupational health-related conditions associated with their work environment. There is a lack of relevant data on the prevalence of these conditions among dentists, dental therapists and oral hygienists in KwaZulu-Natal. aim: To describe the burden of occupational health-related conditions among oral health practitioners in KwaZulu-Natal, South Africa. Methods: This cross sectional study evaluated data obtained through a self-administered questionnaire that sought information on demographics, occupational health, psychosocial risk factors, work tasks and planning. Data was exported from QuestionPro and analysed in SPSS version 24. Frequencies and means with standard deviations were calculated for categorical and continuous variables respectively. results: Oral hygienists most frequently reported symptoms of musculoskeletal disorders affecting the neck (70%) and the hand (56.5%). Dentists reported the highest prevalence of shoulder pain (55.8%) and of percutaneous injuries (42,3%). The dentists, dental therapists and oral hygienists also reported latex allergy (10.4%) and percutaneous injuries (32.6%). conclusion: The prevalence of occupational health-related conditions reported by the oral health care workers indicate the need to raise awareness about occupational health and warrants the inclusion of these issues on education programs and dental curricula to ensure a healthy work environment.

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