Background: Umeå University Faculty of Medicine (UUFM), Sweden, has a regionalized medical program in which students spend the final 2½ years of their undergraduate degree in district hospitals. In late 2018, UUFM started a “rural stream” pilot exposing students to smaller rural locations. Methods: The objectives are to deliver the benefits for medical education and rural workforce development that have been observed in longitudinal integrated clerkships (LICs) while maintaining consistency between learning experiences in the main campus, regional campuses, and rural locations. This article compares the UUFM rural stream with those typical of the LICs described in the medical education literature. Comparisons are made in terms of the four key criteria for LIC success, and additional characteristics including peer and interprofessional learning, “'continuity,” and curriculum development. Results: The rural stream has elements of length, immersion, position in the degree program, and community engagement that are both similar to, and different from, LICs. Key challenges are to ensure that participating students create close relationships with host medical facilities and communities. The rural stream also has some potential advantages, particularly in relation to team learning. Discussion: Alternatives to the LIC rural stream model as typically described in the literature may be required to allow for immersive medical education to occur in smaller rural communities and to be suitable for medical schools with more traditional approaches to education.

Background: Current research in medical education is increasingly exploring the relevance of emotional intelligence (EI) in the successful performance of health-care people. As assessments of core domains are markers of actual performance of the student when he or she is not observed, this systematic review was aimed to answer the question “what is the influence of EI on objective parameters of academic performance in undergraduate medical, dental, and nursing students aged 18–30 years?” Methods: Databases were systematically searched for empirical studies which measured EI of medical, nursing, or dental undergraduate students and compared it with academic performance during graduation years from January 1, 2000, to August 30, 2016. Quality appraisal and data abstraction was done by two independent authors. Results: Six hundred and twenty-three articles were retrieved from systematic search. Of these, 25 articles were selected. Quality appraisal further led to exclusion of two studies which did not meet ethical criterion. Medical undergraduates were included in 12, dental in 4, and nursing in 7 studies. Four studies examined the relationship of EI with clinical skills, 8 with communication skills, and 18 with overall academic performance. Discussion: The findings of review show that EI has a greater role in academic success of clinical year medical and dental students. Although the review has addressed different rungs of the health-care profession separately, it preludes that better EI skills of health-care team will have a holistic impact on health-care improvement.

Background: Canadian medical student and residents' severity ratings of professionalism vignettes were examined to identify the differences in ratings by the level of training and by sex. Methods: Eight hundred and thirty-five medical learners (400 medical students and 435 residents) were invited to participate in an online survey measuring medical professionalism. The survey was composed of questions about descriptive information and professionalism vignettes. The tool consists of 16 vignettes examining respondent's ability to recognize the professional and unprofessional behaviors. For each vignette, participants were asked to rate the severity of the infraction as “not a problem” to “severe.” Wilcoxon rank sum tests and Fischer's Chi-square tests were used to examine the differences in perceptions of professionalism by the level of training and sex, and logistic regression models were created with the level of training and sex to examine their association with binary vignette responses (not a severe infraction and severe infraction); controlling for the effect of the other variable. Results: Overall response rate for the completed survey was 30% (n = 253). Significant differences between males and females were found for lapse in excellence (P ≤ 0.039), inappropriate dress (P ≤ 0.003), lack of altruism (P ≤ 0.033), disrespect (P ≤ 0.013), shirking duty (P ≤ 0.028), and abuse of power (P ≤ 0.006). Females rated all six vignettes as more severe as compared to males. Shirking duty (P ≤ 0.002) was found to have the differences between learner responses. Regressions found sex to be associated with severity of professionalism infractions on seven vignettes. Discussion: Future work is needed in the area of professionalism and sex to understand why female and male learners may perceive professionalism differently.

Background: Like many Chinese universities, Ningbo University (NBU) has two undergraduate medical courses – one taught in Mandarin for domestic students, and one taught in English for international students. This study examines the experiences of medical students who recently completed the English language program that has a particular focus on clinical placements. Methods: In-depth, face-to-face, semi-structured interviews were conducted with 10 final year medical students at NBU in April 2019. Transcripts were analyzed using inductive thematic analysis. Results: All medical student participants were non native English speakers and had a limited grasp of Chinese. Their clinical teachers were all fluent in Chinese and had variable command of English. The large majority of patients in the teaching hospitals where placements took place spoke only in Chinese. Despite the obvious challenges arising from this, students still had predominantly positive experiences of clinical placements. Although students recognized that their clinical teachers' English proficiency was variable, they felt that other attributes, such as enthusiasm, interactivity, and a desire to teach were more important factors to their learning experiences. Discussion: Despite challenging linguistic circumstances, non native English-speaking students were able to navigate the challenges of studying clinical medicine from teachers with limited English language skills and with patients who spoke virtually no English. Further studies should explore the perceptions of teachers of the program, and graduate outcomes when these students enter the workplace. Educators involved in supporting international medical students should note that non technical curricular areas such as professionalism may require greater attention where language barriers exist.