Evaluation of the Reasons for the Choice of Their Learning Course by Resident Physicians of Anesthesia and Intensive Care Medicine (ICU) in Mali

Abstract

Anesthesia and intensive care is a medical specialty of the third cycle of medical studies characterized by a diversified practical training and an important theoretical training little approached during the second cycle of medical studies. In Mali, this young medical discipline is still looking for its bearings. we felt it was imperative to evaluate the motivations behind the choice of their apprenticeship program in order to understand the reasons behind the collapse of the numbers recruited and the dropouts during the program. Patients and Method: We conducted a prospective study using a self-administered questionnaire in the population of residents in Anesthesia and Intensive Care at the Faculty of Medicine of the Bamako University. Our study was conducted during the 2018-2019 academic year. An anonymous questionnaire was’ sent by email to all students of anesthesia-resuscitation of the specialized study diploma of Mali during the month of April 2019. Results: A total of 16/25 complete questionnaires were completed and returned that’s to say a response rate of 64%. Two-thirds (62%) of the residents had already attended the anesthesia-intensive care sector during the second cycle of medical studies before their admission to the specialty probationary period. Versatility, intellectual interest, emergency management, and technical aspect seemed to be the most attractive elements of the specialty. The points that might have made residents hesitate when choosing the specialist were the medico-legal risk, the important on-call activity, and the poor quality of life in the long term. Also, 12% (n = 2) were considering changing their specialized study diploma. Half of the residents were considering a professional practice in a public university hospital (50%), for 25% this choice was for the private sector and 12% in the humanitarian sector. On-call duty was perceived as formative for 75% of the anesthesia and intensive care students, while 18% of them considered it too numerous or even painful for 25%. 80% of the residents observed safety rest. During their internship in the different hospitals, the most appreciated points were, among others, their autonomy of decision, and the most negative were the fact of being too often alone. Residents in anesthesia-intensive care wished to have a depth training in locoregional anesthesia for 56% and pediatric anesthesia for 31%. Conclusion: Despite a relevant motivation for their choice, the difficult living and learning conditions were a source of demotivation for the anesthesia residents in Mali.