International Journal of Medical Students

Cover, Credits, & Content

Executive Committee of IJMS — 2025-03-31

Hydatid Cyst Complicated by Dilated Bile Duct Treated with Endoscopic Retrograde Cholangiopancreatography (ERCP): A Case Report

Ahmad Hmaideh — 2025-03-31

Background: Echinococcosis, primarily caused by Echinococcus granulosus, frequently leads to the formation of hydatid cysts in various organs, particularly the liver and lungs. In rare instances, these cysts can rupture into the biliary tract, resulting in complications such as dilation of the Common Bile Duct (CBD) and obstructive jaundice. This study aims to document a rare case of CBD dilation due to the rupture of a hydatid cyst, highlighting the need for tailored diagnostic and therapeutic approaches for this unusual presentation.

The Case: A 37-year-old male patient presented with abdominal pain, anorexia, and jaundice. Abdominal ultrasonography and computed tomography (CT) scans identified multiple hydatid cysts in the liver, with one ruptured cyst extending into the CBD. An endoscopic retrograde cholangiopancreatography (ERCP) was performed to remove the hydatid cyst membranes, followed by the placement of a stent and irrigation of the biliary ducts. Surgical excision of remaining liver cysts was subsequently conducted. The use of ERCP allowed effective removal of cystic material from the biliary tract, reducing CBD obstruction and alleviating jaundice symptoms. Surgical intervention further ensured the complete removal of hydatid cysts.

Conclusion: This case highlights that Endoscopic Retrograde Cholangiopancreatography (ERCP) is an effective diagnostic and therapeutic tool for managing biliary complications associated with hydatid disease, particularly the dilation of the Common Bile Duct (CBD). The combination of ERCP with surgical intervention resulted in optimal outcomes for this patient, who presented an uncommon manifestation of echinococcosis.

Development and Evaluation of a Pilot Short-Term Mental Health Curriculum with Longitudinal Evaluation for Minority Youth

Robin Granberry — 2025-03-31

Background: Minority youth are susceptible to mental health issues in the United States. Early intervention with a mental health curriculum is valuable in building resilience and wellness. Our study’s purpose was to design, implement and evaluate a mental health curriculum (Mental Health Matters) for minority youth in a local community center.

Methods: We conducted a needs assessment of mental health topics important for minority youth. Pre-and post-lesson surveys were administered at each session to measure students’ knowledge and understanding of lesson objectives. We analyzed paired data using a Wilcoxon signed-rank test.

Results: The needs assessment identified a need for educating youth about emotional insight and regulation and interpersonal communication. From the needs assessment, we worked with a local community organization to design a short-term longitudinal mental health curriculum. With the same local community organization, we implemented the curriculum to an after-school program for minority youth. The pre- and post-survey showed the students gained a significant increase of perceived confidence: fundamentals of mental health (p=0.008); stress response, box breathing, and perceiving stress (p=0.046); coping skills (p=0.025); communication styles/conflict resolution strategies (p=0.031). Qualitative feedback from students and administrators indicated strengths of the curriculum included its adaptability and applicability to students’ lives.

Conclusion: Overall, we successfully developed a pilot mental health curriculum based on a community needs assessment for minority youth.

Am I A Fraud? Occurrence and Factors Associated with Impostor Phenomenon Among Medical Students of Khartoum University, 2022

Hiba K. A. Hamad — 2025-03-31

Background: The impostor phenomenon (IP) is the tendency to attribute success to external factors rather than to one’s abilities. It is frequent among students and has a negative impact on their wellbeing. This study aimed to assess the occurrence and mental health factors associated with IP in medical students.

Methods: Cross-sectional study of University of Khartoum Medical students (December 2021–January 2022), using convenience sampling. We collected the Clance Impostor Phenomenon Scale (CIPS), Patient Health Questionnaire-4 (PHQ-4: anxiety and depression), 2-item Maslach B burnout Inventory (MBI), and Single-Item Self-Esteem Scale (SISE). Data was analyzed using SPSS with correlation analyses, linear regression, and Chi-square tests.

Results: Among 409 medical students, the impostor phenomenon (IP) prevalence was 52.8% (216 students), with a mean CIPS score of 63.37 ± 17.02. IP was more common in females (71.8%) and students aged 19–21 years (40.7%). Anxiety (41.6%), depression (48.7%), and burnout (39.6% emotional exhaustion; 26.9% depersonalization) were prevalent, with higher rates in females. Regression analysis showed significant predictors of IP, including burnout (+1.32 points per unit, p < 0.001), perfectionism (+0.86 points per unit, p < 0.001), parental overprotection (+2.43 points per unit, p < 0.001), and depression (+2.90 points, p = 0.024), while self-esteem showed a negative association (−4.19 points per unit, p < 0.001). Gender differences were observed in three CIPS items, with stronger female endorsements.

Conclusions: IP is prevalent and linked to family dynamics, personality traits, and mental health issues. Efforts to increase awareness and facilitate IP management should be implemented.

Let’s Talk about Bias in Healthcare: Experiences from an Interactive Interprofessional Student Seminar

Mckenzie P. Rowe — 2025-03-31

Background: Education to increase awareness of the impact of bias in healthcare should be included in all health professions training programs. This report describes the implementation and outcomes of an interactive, interprofessional pilot seminar on racial bias in healthcare for health professions students.

Methods: Forty students across the University of Nebraska Medical Center’s six health profession colleges participated in a 3-part, 1-hour seminar, including a video vignette depicting examples of bias in the hospital, facilitated interprofessional small group discussions, and interaction with a health equity expert panel. We analyzed the results of participants’ Ethnic Perspective-Taking (EP) and Implicit Bias Knowledge scale (IBKS) scores before and after the seminar.

Results: There was a statistically significant increase (p<0.001) in the average post-seminar EP scores (30.6 post-seminar vs 27.8 pre-seminar). For the adapted IBKS, there were significant improvements in participant knowledge, skills to identify, and ability to explain the impact of implicit biases (p<0.05). Participants highlighted the importance of including education about bias in healthcare training, and some suggested mandatory education. All facilitators agreed that learners gained a deeper appreciation for the effect of bias and racism on health outcomes and participants understood how bias and racism affect patient care and clinician experience after the seminar.

Conclusion: Health professions training often lacks integrated interprofessional and health equity education. This seminar addresses both, engaging community voices without heavy resources. Despite low participation, results show the benefits of interactive sessions on health equity, helping students grasp their role in equitable care and influencing future practice.

Sport and Exercise Medicine: a misunderstood specialty among medical students and foundation doctors

Bonar McGuire — 2025-03-31

Objectives: To assess medical students’ and foundation doctors’ understanding of Sport and Exercise Medicine (SEM) and SEM careers; to gauge this cohort’s physical activity (PA) level and awareness of PA guidelines.

Design and Methods: An anonymised online survey was distributed to medical students and foundation trainees between 28^th October 2022 and 20^th January 2024.

Results: 144 respondents completed the survey. 72.2% were students. 87.5% were aware of SEM. While 98.6% knew that SEM doctors worked with sports teams, only 45.8% knew that they served the general population. Fewer than half of respondents (43.7%) knew that SEM specialty training existed. 22.2% were considering pursuing SEM careers, but only one respondent expressed an interest in exercise medicine. Only 29.2% knew that there were SEM posts in the NHS, and 11.1% believed that SEM was an entirely independent-sector specialty. Most respondents (62.5%) achieved the recommended minimum weekly aerobic PA target, with similar rates among students (62.7%) and foundation doctors (61.5%). 83.3% indicated that their PA level was limited by study or work commitments. Respondents performed no better than chance at identifying the minimum weekly aerobic exercise target recommended in the UK guidelines (26.4% vs 20%, p=0.055).

Conclusions: Although there is interest in SEM among medical students and foundation doctors, there is a lack of understanding of the role of SEM doctors and of the availability of SEM specialty training. This cohort was unfamiliar with PA guidelines and was slightly less physically active than the national average.

A Cross Sectional Study on Adherence to Medication among Patients with Hypertension and/or Diabetes Attending One of the Tertiary Care Institutes of Ahmedabad City, Gujarat, India

Janak Patel — 2025-03-31

Background: The lifelong management of chronic diseases such as Hypertension and Diabetes Mellitus necessitates a comprehensive approach, including lifestyle modifications and consistent adherence to medication. Present study aimed to evaluate treatment adherence among patients with diabetes and /or hypertension attending a tertiary care institute in Ahmedabad city, India.

Methods: A cross-sectional study was conducted among 200 patients aged over 18 years, diagnosed with diabetes and/or hypertension. The sample population was selected from a tertiary care institute at Ahmedabad city using a consecutive sampling method. Data collection utilized a pretested and predesigned proforma along with the Morisky Medication Adherence Scale (MMAS-8).

Results: Hypertension was present in 43.0% of the participants, while 20.0% reported diabetes mellitus. Additionally, 37.0% had both conditions. Out of total 200 patients 53.5% exhibited low adherence to treatment. Lower adherence to treatment was found to be more among Diabetics (67.5%) as compared to hypertensive patients (51.2%). Among participants having comorbidities 48.6% had low adherence to treatment. The association between disease type and adherence levels was not significant (p-value = 0.305). Not having any symptoms and forgetfulness were common reasons for low adherence among 41.1% and 24.2% of participants, respectively.

Conclusion: This study highlights the need for targeted interventions aimed at enhancing medication adherence among individuals managing with chronic illnesses like hypertension and diabetes. The findings provide valuable insights for healthcare professionals and policymakers to develop effective strategies for improving treatment adherence and subsequently mitigating the progression of these chronic conditions.

Psychiatric Outcomes in Patients with Trigeminal Neuralgia Treated with Anticonvulsants and Antidepressants: A Retrospective Cohort Study Using a National Database

Ashley Deng — 2025-03-31

Background: Trigeminal Neuralgia (TN) is a chronic craniofacial condition characterized by intense, sporadic shocks of pain through the trigeminal nerve. The unpredictable and severe nature of these episodes can be physically and mentally debilitating, significantly affecting the quality of life and often leading to anxiety, depression, and sleep disorders. This study investigated the psychiatric outcomes of anxiety, depression, and sleep disorders in TN patients who were treated with both anticonvulsants and antidepressants, compared to those who were treated only with anticonvulsants, to explore a multi-modal approach for addressing both pain and psychiatric symptoms.

Methods: A retrospective analysis of electronic health records was conducted using TriNetX, a collaborative health network encompassing over 250 million patient records worldwide. The analysis included 15,129 patient records, comparing two cohorts of TN patients.

Results: After adjusting for demographic factors, both cohorts were predominately female (73%), white (70%), and about 59 years of age. The results indicated that patients taking both anticonvulsants and antidepressants had higher risk, odds, and hazard ratios for developing depression (RR 10.448, OR 10.906, HR 10.763), anxiety (RR 2.680, OR 3.210, HR 3.013), and sleep disorders (RR 3.595, OR 3.696, HR 3.697) compared to those taking only anticonvulsants.

Conclusion: Despite limitations including inability to assess dosage and severity of pain, these findings suggest that concurrent use of anticonvulsants and antidepressants may exacerbate psychiatric symptoms in TN patients. However, these effects might improve with appropriate dosage adjustments, highlighting the need for including dosage adjustments and monitoring.

Pediatric Hepatoblastoma: A Single-Institution Case Series

Jessica Sawaya — 2025-03-31

Introduction: Hepatoblastomas comprise up to two-thirds of malignant liver masses in childhood and rank as the third most common malignant neoplasm in children under the age of three. Treatment and prognosis are highly dependent on tumor staging and characteristics. Our study’s aim is to analyze the clinical findings and outcomes of hepatoblastoma at our institution.

Methods: After Institutional Review Board (IRB) approval was granted from Loma Linda University #5240020, we conducted a retrospective review on all patients under the age of 18 with a diagnosis of hepatoblastoma between February 2000 to January 2022. Variables assessed included demographics, work up, surgical intervention, recurrence, and mortality.

Results: Fifteen patients were diagnosed with hepatoblastoma in that timeframe. Mean age was 18.7 months. Associated comorbidities included three patients with prematurity, one patient with Beckwith-Wiedemann Syndrome, and two unique presentations each of Prune Belly Syndrome and grade IV/V vesicoureteral reflux. There were four mortalities, two due to relapse in disease, one due to pulmonary and CNS metastasis at diagnosis, and another due to sepsis and multi-organ failure. Eleven patients continued monitoring without tumor recurrence. All patients were treated based on the Children’s Oncology Group (COG) guidelines.

Conclusion: Risk stratification is an important component of hepatoblastoma management. Our cohort demonstrated novel comorbidities of Prune Belly Syndrome and vesicoureteral reflux. Eleven patients received neoadjuvant chemotherapy that allowed for subsequent surgical resection. Our mortalities were associated with tumor metastasis and recurrence consistent with elevated alpha-fetoprotein (AFP) values. Future research should involve multi-institutional studies focusing on comorbidities and genetic analysis.

Academic Burnout in Mexican Medical Students: A Critical Review of Prevalence, Risk Factors, and Gaps in Intervention

Angel Alberto Puig-Lagunes — 2025-03-31

Academic Burnout Syndrome (ABS) is defined as a state of exhaustion and disengagement related to the educational environment that affects university students in diverse disciplines. The combination of an intense academic load, high expectations, competitiveness among students, and other factors during their education has the potential to affect negatively, among other things, academic performance, decision-making ability, physical and mental well-being, self-esteem, and overall quality of life. This review aims to delineate the most prominent findings and advancements on ABS in medical students in Mexico while identifying areas that require further attention and developing research proposals to enhance the comprehension and treatment of this problem. A critical narrative analysis was conducted following an exhaustive bibliographic search for articles in both English and Spanish across a range of databases, including PubMed, Google Scholar, Redalyc, SciELO, and DOAJ. The search took place in the period from January to July 2023. Randomized trial articles and original research were included in the analysis. Meta-analyses and incomplete studies were excluded while the articles were reviewed, resulting in a final selection of 22 relevant articles. Despite the vast number of studies conducted on ABS in medical students in Mexico, a significant part focuses on descriptive characteristics. At the same time, other aspects, such as prevention, treatment, and awareness of this problem, are often overlooked. To effectively address ABS, academic communities must implement comprehensive preventive and curricular measures that prioritize the well-being of students, fostering a healthy and supportive learning environment.

Artificial Intelligence in Healthcare: Medical Students' Perspectives on Balancing Innovation, Ethics, and Patient-Centered Care

Eleanor Roy — 2025-03-31

Artificial intelligence (AI) is transforming healthcare delivery, offering unprecedented opportunities for enhanced diagnostics, efficiency, and patient care. However, this transformation also introduces pressing ethical challenges, particularly concerning autonomy, algorithmic bias, and data privacy. In this editorial, we explore these issues through the lens of medical students and future physicians, emphasizing the need for ethical vigilance and proactive governance in the deployment of AI technologies in clinical settings.

We argue that while AI can support autonomy by providing personalized insights, opaque “black box” models and lack of informed consent can undermine shared decision-making and trust. Algorithmic bias further threatens equity in care, as many AI systems are trained on unrepresentative datasets, leading to disparities in diagnosis and treatment. Additionally, concerns about data ownership, consent, and commercial use of patient information demand renewed attention to privacy and transparency.

Medical education must evolve to prepare future clinicians to engage with AI critically and ethically. This includes training in bias recognition, responsible use, patient-centered communication, and contextual awareness. The integration of AI into curricula should go beyond technical literacy, fostering a deep understanding of its limitations and social implications.

Finally, robust governance and regulatory oversight are essential. Institutions, policymakers, and international organizations must ensure that AI systems in healthcare align with principles of justice, beneficence, and respect for persons. AI must enhance, not replace, human judgment, and its adoption must be guided by continuous ethical reflection and patient-centered values.

By embracing transparency, equity, and collaboration, AI can be a powerful tool that strengthens the foundations of ethical medical practice.

Public Health Longitudinal Integrated Foundation Training (LIFT) Program: A Junior Doctor’s Experience

Dawn Celine Siaw Chern Poh — 2025-03-31

This paper presents reflections on a one-year public health (PH) Longitudinal Integrated Foundation Training (LIFT) program at Betsi Cadwaladr University Health Board (BCUHB). The program, introduced by Health Education and Improvement Wales (HEIW), aims to expose junior doctors to preventative medicine and population health approaches. Key experiences included contributing to a preconception care draft strategy, participating in a nuclear power plant decommissioning consultation, attending a Cryptosporidium outbreak meeting, and witnessing the implementation of Wales' 20mph speed limit law. These experiences provided insights into the multifaceted nature of PH work, including health improvement, health protection, and healthcare PH. The placement highlighted the importance of interdisciplinary collaboration, evidence-based policymaking, and effective communication in addressing complex health issues. Challenges included balancing clinical responsibilities with PH learning opportunities and adapting to the broader scope of PH work. In conclusion, integrating PH training into medical education is crucial for addressing rising chronic diseases and encourages junior doctors to embrace such opportunities for professional growth and developing new perspectives on population health.

Collaborative Institutional Training Initiative (CITI): Student Experience

Lillian F. Nguyen — 2025-03-31

CITI Training (Collaborative Institutional Training Initiative) provides bioethical research training for investigators around the globe. We report a pilot case study on the user experience (thoughts, feelings) of completing mandatory CITI Training from the perspective of a rising high-school sophomore and a medical student with limited research knowledge. These experiences were compared via reflections after completing both CITI Trainings. The study results highlighted the obstacles experienced by a naïve researcher while completing CITI Training. We argue that CITI Training ought to make accommodations to ensure content is understandable to highschool and medical students with limited research knowledge.

Combating Rheumatic Heart Disease in Pakistan: An Experience of Training, Screening and Community Outreach

Amna Zaheer — 2025-03-31

This experience outlines a training session conducted by Darul Qalb, a U.S.-based organization dedicated to eradicating Rheumatic Heart Disease (RHD) in low-income countries, in collaboration with HOPES, a student-run welfare organization at Karachi Medical and Dental College. The session aimed to equip medical students with essential skills to detect subclinical RHD using advanced portable ultrasound devices. Led by Dr. Ahmad Akhtar, the session introduced the Point-of-Care Ultrasound (POCUS) technique, a critical tool for assessing heart valve changes indicative of RHD. Through hands-on practice, participants, including myself, learned to effectively use ultrasound technology, which was later applied in a community outreach initiative where we screened children for RHD. Guided by experienced mentors, I identified cases of subclinical RHD, highlighting the importance of early detection in improving health outcomes. This experience demonstrated the powerful synergy of medical education, technology, and community outreach in combating RHD in resource-limited settings like Pakistan.

The Measure of Success – A Day in the Life of a Pediatric Surgeon

Shalini G. Hegde — 2025-03-31

This article reflects what defines a successful surgeon through the eyes of a resident in paediatrics surgery. It is set against the clinical backdrop of an adolescent boy with intra-bronchial cancer and explores what surgical interventions can help him. The narrative delves into themes of teaching, learning, patient care and pivotal moments that define a career in medicine/surgery.

The Pupil’s P’s: An Alliterative Tool and Practical Framework for Managing Older Patients

Milton Louca — 2025-03-31

Geriatrics encompasses all specialties of medicine. Therefore, medical students must be aware of many factors during their geriatrics rotation. Herein, we distil our reflections from medical school into employment to create a practical framework using an novel alliteration in: The Pupil’s P’s. We acknowledge and complement existing mnemonics devices, which are largely based on diagnosis, to introduce medical students to major geriatric topics to assist management whilst they round on their patients – Peculiar Presentations, Psychological Pertubations, Peristaltic Products, Profound Pain, Polypharmacy, Pressure Sores, Physiological De-conditioning, Poor Perception, Partner Practitioners, Post-Hospital Plan, Palliative Care, and Parsimony. For students of geriatric medicine, The Pupil’s P’s literary device creates a succinct, educative tool with the added utility as a reference to generate the multi-factorial reasoning required to care for older patients. Ultimately, through our experience in aged care, we wish to convey the important lesson of holistic, patient-centered care to students . Accordingly, despite the numerous issues that may be encountered with older patients, we emphasize treating the patient holistically, and not the individual problems which may be discovered.